Biologics For Ankylosing Spondylitis: Sciatica Clinic

Woman collecting blood samples for testing on different diseases, modern laboratory, copy space

Ankylosing spondylitis is an inflammatory condition that causes pain and stiffness in the spine’s joints. Over time, it can progress to fusing the bones of the spine/vertebrae, limiting the spine’s mobility and leading to discomfort symptoms. The condition is more common in men but also affects women. There is not a known, singular cause, but individuals with a particular gene, HLA-B27, have an increased risk of developing the condition. However, the gene itself does not mean an individual has ankylosing spondylitis; genetics and other outside and environmental factors also play a role. DMARDs, or Disease-Modifying Antirheumatic Drugs, suppress inflammation. An emerging DMARD treatment uses biologics that further target and suppresses specific inflammatory compounds.

Table of Contents

Biologics

Unlike regular medications, which are synthesized, biologics are made from and inside living sources.

They are grown in cultures or harvested from blood.
Biologics are complex and expensive.
Biologics provide some of the most powerful treatments for many conditions.
Two biologics commonly used to treat ankylosing spondylitis are:
TNF inhibitors.
IL-17 inhibitors.

TNF Inhibitors

TNF – tumor necrosis factor, TNF inhibitors are a biological medication that targets and suppresses TNF, which is involved in inflammatory processes throughout the body.
Blocking or suppressing TNF decreases inflammation and can delay the progression of ankylosing spondylitis.
It could be administered through an injection or infusion to provide the medication.

Side Effects

Side effects associated with this medication, along with other conditions, include:

Skin irritation – rashes or infections
Heart failure
Lupus
Lymphoma
Disorders that target the neurological system are known as demyelinating disorders. These can include conditions such as:
Multiple sclerosis
Guillain-Barré Syndrome

IL-17 Inhibitors

IL – interleukin – IL-17 is a protein involved in inflammatory processes and conditions.
IL-17 inhibitors suppress inflammation which are newer medications that have been shown to benefit those with ankylosing spondylitis.
Doctors often administer IL-17 inhibitors through an injection.

Side Effects

Minor side effects include:

Headaches
Runny nose
Irritation at the injection site.

More serious side effects include:

Certain cancers
Severe infections
High blood pressure

Other Treatments

Treatment goals for ankylosing spondylitis include:

Slowing the disorder’s progression.
Decreasing inflammation.
Reducing pain.
Improving or maintaining joint and spinal range of motion.

Biologics are not the first-line treatment for ankylosing spondylitis.

Providers usually first treat an initial diagnosis with anti-inflammatory medications, like NSAIDs, to decrease inflammation and slow the condition’s progression.
Chiropractic care and physical therapy are recommended to maintain and/or improve posture, muscle strength, and endurance.
Recommended lifestyle and nutritional modifications.
Posture training stretches and exercises.
Optimal movement strategies to safely and confidently complete everyday tasks.

Biologic Medications

Biologics for ankylosing spondylitis may or may not be suitable. These medications are meant to help relieve the inflammation associated with the condition and slow the disorder’s progression. Your healthcare team will work with you to determine the right treatment option/s and explain the benefits, risks, and types of treatment. They will monitor the condition, track progress, and adjust the plan accordingly.

Assessing Hormone Therapy

References

Ankylosing spondylitis. (n.d.) National Institute of Arthritis and Musculoskeletal and Skin Diseases. U.S. Department of Health and Human Services. Available at: www.niams.nih.gov/health-topics/ankylosing-spondylitis#:~:text=Ankylosing%20spondylitis%20is%20a%20type,the%20spine%20can%20cause%20stiffness (Accessed: October 12, 2022).

Chen C, Zhang X, Xiao L, Zhang X, Ma X. Comparative Effectiveness of Biologic Therapy Regimens for Ankylosing Spondylitis: A Systematic Review and a Network Meta-Analysis. Medicine (Baltimore). 2016 Mar;95(11):e3060. doi: 10.1097/MD.0000000000003060. PMID: 26986130; PMCID: PMC4839911.

Gerriets V, Goyal A, Khaddour K. Tumor Necrosis Factor Inhibitors. [Updated 2022 July 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482425/

Lindström, U., Olofsson, T., Wedrén, S. et al. Biological treatment of ankylosing spondylitis: a nationwide study of treatment trajectories on a patient level in clinical practice. Arthritis Res Ther 21, 128 (2019). doi.org/10.1186/s13075-019-1908-9

Yin, Y., Wang, M., Liu, M. et al. Efficacy and safety of IL-17 inhibitors for the treatment of ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Res Ther 22, 111 (2020). doi.org/10.1186/s13075-020-02208-w

Myofascial Trigger Pain Affecting The Sartorius Muscle

Dr. Alex Jimenez

Table of Contents

Introduction

The lower body extremities help provide stability to the various body parts, including the hips, thighs, pelvis, legs, knees, and feet. The hips and thighs comprise multiple muscles and nerves that provide mobility to the lower half and allow the host to move around in different locations. While the hip muscles act on the thigh muscles at the hip joint and stabilize the pelvis, the thigh muscles allow the lower body to bend, flex and rotate while bearing most of the upper body’s weight and keeping alignment with the hips and legs. One of the thigh muscles is the sartorius muscle, and if it becomes overused and injured can lead to complications in the form of myofascial pain syndrome. Today’s article post examines the sartorius muscle, how myofascial trigger pain is associated with the sartorius, and the effectiveness of myofascial pain treatment on the thighs. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh pain treatments correlating to myofascial pain syndrome, to aid individuals dealing with pain symptoms along the sartorius muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Sartorius Muscle?

Are you experiencing pain in the upper, mid, or lower parts of your thighs? Do you have difficulty walking for long periods? Or do your knees hurt more than usual? Most of these issues correlate with myofascial trigger pain associated with the sartorius muscle. As the longest muscle that spans from the hips to the knee joints, the sartorius muscle, or the “tailor muscle,” serves as both a hip and knee flexor while working with other muscles that allow hip mobility. The sartorius shares its origin location with the TFL (tensor fascia latae) muscle at the anterior superior iliac spine and is responsible for internal rotation at the hips. In the book, “Myofascial Pain and Dysfunction,” the author Dr. Janet G. Travell, M.D., mentioned that the sartorius muscle assists the iliacus and the TFL muscles in hip flexion while assisting the short head of the bicep femoris in the knees for knee flexion, allowing the individual to walk for long distances. Even though this long muscle assists in hip and knee flexion, it can succumb to injuries and create issues with the hips and knees in the lower body.

Myofascial Trigger Pain Associated With The Sartorius Muscle

When traumatic forces or normal factors begin to affect the sartorius muscle, the surrounding muscles on the thighs and hips are also affected. The sartorius muscle allows the individual to move around and allows flexion to the hips and knees when injuries or the muscle is being overused; it can cause pain-like symptoms that correlate with hip and knee issues associated with myofascial trigger pain. Myofascial trigger pain along the sartorius muscle doesn’t usually occur in the muscle but can occur in conjunction with trigger point involvement in the surrounding muscles. Studies reveal that myofascial trigger pain is found in the hip muscles and can cause issues in the lumbopelvic-hip muscles of the lower body. This causes referred pain on the sartorius to be more diffused and superficial to the knees. When myofascial trigger pain is associated with the sartorius, many individuals often mistake it for knee pain. To that point, myofascial trigger pain could affect how a person walks and bends at the knees.

Anatomy & Palpation Of The Sartorius Muscle- Video

Are you experiencing issues when you are walking? Do your knees hurt constantly? Or are you experiencing tenderness or pain in your thighs? Most of these issues correlate with myofascial trigger pain associated with the sartorius muscle. The sartorius is a long muscle that connects the hips and spans to the knee joints to provide hip and knee flexion. The sartorius muscle works with the other muscles in the thighs and hips, allowing hip mobility and motor function to the legs. When multiple issues affect the sartorius and the surrounding muscles, it can develop into myofascial trigger pain and cause overlapping risk profiles to the knees and hips. To that point, it causes referred pain issues in the hips and knees, making the individual have difficulty walking from place to place. However, there are available treatments to reduce the pain in the hips and knees and manage the myofascial trigger pain from affecting the sartorius muscle on the thighs. The video above explains the anatomy of the sartorius muscle location and how palpation is used to locate the muscle to see if it is tight or could be affected by trigger points along the muscle fibers. This is one of the techniques that is used when a person is dealing with myofascial trigger pain associated with the sartorius muscle.

The Effectiveness Of Myofascial Pain Treatment On The Thighs

When a person is dealing with myofascial trigger pain in their thighs, and it is affecting the sartorius, many will often try to find available treatments to alleviate the pain. Treatments like dry needling are one of the various myofascial pain treatments that can reduce pain and related disability on the thighs, hips, and knees. Studies reveal that dry needling treatments can help manage knee pain syndrome associated with trigger points on the thighs. However, treatment alone can not be the only solution to reduce myofascial trigger pain in the thighs. Various hip stretches can loosen up tight hip flexors and help elongate the sartorius muscles to break up the nodules and improve mobility function to the hips and knees. People can even utilize self-ischemic compression to allow a more effective stretch on the sartorius muscle.

Conclusion

As the longest muscle in the thighs, the sartorius helps provide a service to hip and knee flexion while working with various muscles to keep the legs moving. When the sartorius muscles become overused and start to cause referred pain to the hips and knees, it can develop into myofascial trigger pain along the sartorius muscle. This can make many individuals believe they are suffering from knee pain when it’s their thigh muscle. However, myofascial trigger pain is treatable through treatments and corrective actions that people can incorporate into their daily activities to prevent pain from escalating and manage trigger points along the sartorius muscle. This can allow people to get back their mobility in their legs.

References

Rahou-El-Bachiri, Youssef, et al. “Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis.” Journal of Clinical Medicine, MDPI, 29 June 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7409136/.

Samani, Mahbobeh, et al. “Prevalence and Sensitivity of Trigger Points in Lumbo-Pelvic-Hip Muscles in Patients with Patellofemoral Pain Syndrome.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 15 Oct. 2019, pubmed.ncbi.nlm.nih.gov/31987531/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Walters, Benjamin B, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Thigh Sartorius Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK532889/.

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Kidney Detox: Sciatica Clinic

Dr. Alex Jimenez

cropped view of doctor examining kidney of patient with ultrasound scan in clinic

Maintaining kidney health is important to the body’s overall health and well-being. The kidneys are fist-sized organs located beneath the rib cage on both sides of the spine. A kidney detox maintains health allowing the body to filter and expel waste properly and produce hormones to help the body function at its full potential.

Table of Contents

Kidney Health

The kidneys perform several functions that include:

Filters and cleanses out impurities from the blood.
Produces hormones that regulate blood pressure and control the production of red blood cells.
Filter’s waste products stored in the bladder and expelled through urine.
Filters toxins.
Expels excess water.
Regulates pH, salt, and potassium levels.
Balances electrolytes.
Activates vitamin D to support body absorption of calcium for bone repair and regulating muscle function.

Kidney Detox

A key measure of keeping the kidneys clean and healthy is to engage in a healthy nutrition plan. Doctors recommend implementing lifestyle changes to help the kidneys filter at full capacity. Certain foods can help detox the kidneys and promote their health.

Pumpkin seeds

Pumpkin seeds can help prevent the accumulation of uric acid, one of the compounds that cause kidney stones.

Grapes

These fruits contain a compound called resveratrol to reduce kidney inflammation.

Lemons

Lemons help with digestion.
They have vitamin C, which enhances the immune system and supports white blood cells to fight infections.
Citrate binds with calcium in the urine to stop the growth of calcium crystals, preventing kidney stones.

Carrots

Carrots have beta-carotene, alpha-carotene, and vitamin A.
Antioxidants for inflammation.

Ginger

Ginger can help in the dissolving process of kidney stones and prevents them from reforming.

Beets

Improves blood circulation to the kidneys.

Celery

Celery has alkaline and diuretic properties to help expel excess fluids.
It has coumarins which can help to increase vascular flow.
It is rich in vitamins D, C, and K.

Apples

Apples contain fiber to unclog the arteries, specifically the kidney arteries will improve filtration.

Maintain Hydration

The human body is almost 60 percent water, with every organ requiring water.

The kidneys (body filtration system) require water to secrete urine.
Urine is the primary waste product that allows the body to eliminate unwanted and unnecessary substances.
Low water intake means low urine volume.
Low urine output can lead to kidney dysfunction, like kidney stones.
Maintaining the body’s hydration is crucial so the kidneys can thoroughly flush out excess waste materials.
The recommended daily intake of fluids is around 3.7 liters a day for men and 2.7 liters a day for women.

Functional Medicine

This is an example of a two-day kidney cleanse to help strengthen the kidneys and detoxify the body.

Day 1

Breakfast

Smoothie made with:
8 ounces of fresh lemon, ginger, and beet juice
1/4 cup of sweetened dried cranberries

Lunch

Smoothie made with:
1 cup almond milk
1/2 cup tofu
1/2 cup spinach
1/4 cup berries
1/2 apple
Two tablespoons of pumpkin seeds

Dinner

Large mixed-greens salad
4 ounces of lean protein – chicken, fish, or tofu
Top with 1/2 cup of grapes
1/4 cup peanuts

Day 2

Breakfast

Smoothie made with:
1 cup soy milk
One frozen banana
1/2 cup spinach
1/2 cup blueberries
One teaspoon spirulina

Lunch

A bowl of:
1 cup orzo rice
1 cup fresh fruit
Two tablespoons of pumpkin seeds

Dinner

Large mixed-greens salad
4 ounces of lean protein – chicken, fish, or tofu
Top with 1/2 cup of cooked barley
Add fresh lemon juice
4 ounces each of unsweetened cherry juice and orange juice

Consult a healthcare provider, nutritionist, or dietitian to ensure it is safe.

Dietary Prescription

References

Chen, Teresa K et al. “Chronic Kidney Disease Diagnosis and Management: A Review.” JAMA vol. 322,13 (2019): 1294-1304. doi:10.1001/jama.2019.14745

Den Hartogh, Danja J, and Evangelia Tsiani. “Health Benefits of Resveratrol in Kidney Disease: Evidence from In Vitro and In Vivo Studies.” Nutrients vol. 11,7 1624. 17 Jul. 2019, doi:10.3390/nu11071624

nap.nationalacademies.org/read/10925/chapter/6

Pizzorno, Joseph. “The Kidney Dysfunction Epidemic, Part 1: Causes.” Integrative medicine (Encinitas, Calif.) vol. 14,6 (2015): 8-13.

Saldanha, Juliana F et al. “Resveratrol: why is it a promising therapy for chronic kidney disease patients?.” Oxidative medicine and cellular longevity vol. 2013 (2013): 963217. doi:10.1155/2013/963217

Tack, Ivan MD, Ph.D. Effects of Water Consumption on Kidney Function and Excretion. Nutrition Today: November 2010 – Volume 45 – Issue 6 – p S37-S40
doi: 10.1097/NT.0b013e3181fe4376

Myofascial Pain Syndrome On The Tensor Fasciae Latae

Dr. Alex Jimenez

Table of Contents

Introduction

The thighs in the lower half of the body work together with the hips to stabilize the legs when the body is in motion. The thighs and the hips also support the weight of the upper half of the body and are surrounded by muscles, ligaments, and nerve roots to supply blood and sensory-motor function to the legs. One of the thigh muscles that work with the hips is the tensor fasciae latae (TFL) muscle. When the thigh muscles are being overused or suffer from injuries, tiny nodules known as trigger points (myofascial pain syndrome) can affect a person’s ability to function worldwide. Today’s article examines what the tensor fasciae latae muscles do, how myofascial pain syndrome affects the thighs, and various stretches/techniques for the thighs. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh pain treatments correlating to trigger points, to aid individuals dealing with pain symptoms along the tensor fasciae latae muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Does The Tensor Fasciae Latae Muscle Do?

Do you have difficulty walking for a long period? So you feel that your hips feel unstable when you move? Or do you feel radiating pain down from your thighs to your knees? Thigh pain associated with these symptoms can affect a person’s ability to move around from one location to another due to trigger points affecting the tensor fasciae latae muscle. The tensor fasciae latae (TFL) muscles are located at the proximal anterolateral thigh and originate from the anterior superior iliac spine. The TFL muscle is between the superficial and deep muscle fibers of the iliotibial (IT) band, as its attachment assists with knee flexion and lateral rotation. The TFL muscles also work together with the gluteus muscles in various hip movements. Studies reveal that the primary function of the TFL muscles is providing balance to the body’s weight and the non-weight-bearing leg to walk. The TFL muscles allow the individual to walk, run, and assist with movement and stabilization to the hips and knees without pain inflicted on the joints and muscles.

Myofascial Pain Syndrome Affecting The Thighs

Since the TFL muscles allow the person to walk and run, this muscle can become overused and strained through repetitive motions causing many issues to the hips, knees, and thighs. When these issues affect the TFL muscles, they can develop nodules along the muscle fibers known as trigger points or myofascial pain syndrome. Myofascial pain syndrome is a musculoskeletal disorder that can invoke referred pain in one location of the body while affecting the surrounding muscles in a different body location. Myofascial pain syndrome associated with the TFL muscles can cause issues to the hips, thighs, and knees while affecting a person’s ability to walk. Studies reveal that the prevalence of myofascial pain syndrome on the TFL muscles correlates to pain and disability in the thighs. When myofascial pain syndrome affects the TFL muscles, it can mimic chronic knee osteoarthritis.

Even though myofascial pain syndrome is challenging to diagnose, it is treatable through various stretches and techniques. In Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction,” it mentioned that when patients have active trigger points in their TFL muscles, they become aware of the referred pain affecting their hip joints and are unable to lie comfortably on their sides due to the body-weight pressure pressing on the affected TFL muscle. The book also points out that when pain is referred to from trigger points associated with the TFL muscles, it can be mistaken for pain in the glutes.

Trigger Point Of The Week: Tensor Fasciae Latae- Video

Tensor Fascia Latae - Trigger Point of the Week

Have you been experiencing difficulty walking from one location to another? Do you feel pain in your thighs or knees? Or do you have a problem lying down on your side that is causing you pain? If you have been dealing with walking issues, it could be due to myofascial trigger pain in your tensor fasciae latae (TFL) muscles affecting your ability to walk. The TFL muscles help provide stability to the hips and thighs and assist with knee flexion and lateral rotation. This muscle also allows people to walk and run without any pain inflicted on the joints and muscles. When repetitive motions start to cause the TFL muscles to become overused and strained, it can lead to myofascial pain syndrome or trigger points developing, causing referred pain to the thighs. The video above explains where the TFL muscles are located and where the trigger points on the TFL muscles are causing pain to the thighs. Myofascial pain syndrome can mimic other chronic conditions like knee osteoarthritis, which causes pain and disability to the lower half of the body.

Various Stretches & Techniques For The Thighs

Now myofascial pain syndrome is challenging to diagnose in an examination due to the referred pain affecting one location of the body than the actual source of where the pain is coming. However, it is treatable through various techniques and stretches for the thighs to restore leg mobility. Studies reveal that direct stretching of the TFL (tensor fasciae latae) muscles can reduce long-term pain effects on the hips, thighs, and lower back and improve hip and thigh mobility. Various stretches like hip extensions and laterally rotating the hips can break the myofascial trigger points in the TFL muscle. Using a foam roller on the hips can gently stretch and loosen the muscle fibers on the TFL and help warm up the muscle before working out. Sitting down correctly in a chair can help the hips from causing more muscle strain to the thighs and prevent the TFL muscles from being shortened. Incorporating these stretches and techniques can improve hip and thigh mobility in the legs, allowing the individual to walk or run without pain.

Conclusion

The TFL (tensor fasciae latae) muscles are located on the proximal anterolateral thigh between the IT (iliotibial) band, which assists with knee flexion and lateral rotation. The TFL muscle also works with the gluteal muscles and allows the person to walk, run, and help with stability movement to the hips and knees with inflicted pain on the joints and surrounding muscles. When the TFL muscles become overused, they can develop myofascial trigger pain on the TFL, causing referred hip, knee, and thigh pain. This can cause the individual not to be able to walk for long periods and think they might have osteoarthritis in the knees. Fortunately, people can incorporate various stretches and techniques to reduce the pain in the thighs and hips while managing myofascial trigger pain along the TFL muscles. These various stretches and techniques allow mobility back to the hips and thighs so the individual can walk without pain.

References

Gottschalk, F, et al. “The Functional Anatomy of Tensor Fasciae Latae and Gluteus Medius and Minimus.” Journal of Anatomy, U.S. National Library of Medicine, Oct. 1989, www.ncbi.nlm.nih.gov/pmc/articles/PMC1256751/.

Ohtsuki, Keisuke. “A 3-Month Follow-up Study of the Long-Term Effects of Direct Stretching of the Tensor Fasciae Latae Muscle in Patients with Acute Lumbago Using a Single-Case Design.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, May 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4047246/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Sánchez Romero, Eleuterio A, et al. “Prevalence of Myofascial Trigger Points in Patients with Mild to Moderate Painful Knee Osteoarthritis: A Secondary Analysis.” Journal of Clinical Medicine, MDPI, 7 Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7464556/.

Trammell, Amy P, et al. “Anatomy, Bony Pelvis and Lower Limb, Tensor Fasciae Muscle – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK499870/.

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THYROID DYSFUNCTION MUST WATCH (Assessment and treatment) | El Paso, Tx (2022)

Dr. Alex Jimenez

In this episode an expert will discuss the assessment and treatment of Thyroid Dysfunction including analyzing underlying causes for the high incidence of hypothyroid dysfunction in the general population. We will discuss important signs, symptoms and conditions as well as the most powerful laboratory tools to accurately assess individuals with thyroid dysfunction. Also we will cover the development of plans for prescribing nutraceuticals, diet and lifestyle interventions to modulate and balance overall production, transport, sensitivity and detoxification of thyroid hormones and more. Stay tuned for more episodes of this educational presentations brought to you by Dr. Alex Jimenez 2X.

Thanks for Watching!

Our care plans are base on Functional Medicine as a systems approach based on biology that focuses on identifying and addressing the root cause of disease. We focus on the paradigm that symptom or differential diagnosis may be one of many contributing factors to an individual’s illness.

This approach shifts from the traditional disease-centered focus of most medical practices to a more holistic person-centered approach.

Our discussions team includes Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, and Exercise Performance Specialists.
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We present, bridge, and connect these various health programs, functional medicine protocols, fitness methods, injury recovery programs, and offer complete wellness packages.

To that end, we shed light and offer treatment options and bring a deep understanding of the real underlying causes of those suffering from acute and interconnected chronic degenerative disorders.

Ultimately, we empower you to achieve and maintain your personalized, healthy way of living by understanding the root causes of disorders.

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LIVING, LOVING & MATTERING

Join us in improving your health.

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Subluxation Chiropractor: Sciatica Clinic

Dr. Alex Jimenez

physiotherapist treating the patient's shoulder

Subluxation is when a joint shifts out of alignment, which can happen to any joint in the body. Spinal subluxation indicates a misalignment of one or more portions of the spinal vertebrae. It is common in the spine from all the reaching, bending, twisting, and flexing the body goes through. Spinal subluxations, if left untreated, can cause disc degeneration, permanent nerve damage, neurological conditions, and chronic pain symptoms. A subluxation chiropractor will realign and decompress the spine combined with massage therapy to relax the muscles and restore mobility and function.

Table of Contents

Subluxation Chiropractor

Some subluxations don’t cause any problems or pain, but that doesn’t mean they aren’t affecting the back and body. A spinal subluxation can cause long-term problems by:

Advancing the disc degeneration process.
Gradually pushing, pulling, and/or compressing nerves.
Causing the body to compensate through unhealthy postures.
Delaying nervous system responses and signal transmissions.

Symptoms

While some spinal subluxations may not be symptomatic, the majority of them are and include:

Muscle tightness, weakness, or spasms around the back.
Back aching and pain.
Neck aching and discomfort.
Headaches.
Limited mobility.
Digestive issues.
Tingling or pain in the arms or legs.

Causes

Common causes include:

Unhealthy postures.
Sleeping in awkward positions.
Sitting or standing for long periods.
Lifting objects improperly.
Wearing a heavy bag on one shoulder for an extended
Heightened stress levels can cause the back muscles to tighten, which can cause subluxations.
Automobile accidents, falls, or other traumas.
Playing contact sports.
Edema
Hyperemia – lack of blood circulation.
Atrophy
Fibrosis

Effects

Research shows that spinal subluxations can affect many facets of the body. Long-term effects may include:

Sleep problems
Low energy
Brain fog
Mood swings
Anxiety and depression
Digestive issues
Respiratory problems
Bone spurs
Spinal arthritis

Chiropractic Care

When the spine is out of alignment, it can cause issues throughout the body. Changes in one area affect the rest of the body. A subluxation chiropractor looks at the spine’s neurological and mechanical components and aims to reset everything back into its proper position. Similar to the way a massage helps the mind and body relax and de-stress, a spinal adjustment helps by:

Increasing circulation
Relieving discomfort and pain
Releasing tension
Improving mood
Reducing stress levels
Improving sleep function
Increasing energy levels

When the spine is properly aligned, the body can operate at its full potential.

Adrenal Dysfunction

References

Brian S. Budgell, Reflex effects of subluxation: the autonomic nervous system, Journal of Manipulative and Physiological Therapeutics, Volume 23, Issue 2,
2000, Pages 104-106, ISSN 0161-4754, doi.org/10.1016/S0161-4754(00)90076-9. (www.sciencedirect.com/science/article/pii/S0161475400900769)

Green, J D et al. “Anterior subluxation of the cervical spine: hyperflexion sprain.” AJNR. American journal of neuroradiology vol. 2,3 (1981): 243-50.

Meyer, S. “Thoracic spine trauma.” Seminars in roentgenology vol. 27,4 (1992): 254-61. doi:10.1016/0037-198x(92)90004-l

Neva MH, Häkkinen A, Mäkinen H, et al. High prevalence of asymptomatic cervical spine subluxation in patients with rheumatoid arthritis waiting for orthopedic surgeryAnnals of the Rheumatic Diseases 2006;65:884-888.

Nourollahi, Maryam, et al. “Awkward trunk postures and their relationship with low back pain in hospital nurses.” Work (Reading, Mass.) vol. 59,3 (2018): 317-323. doi:10.3233/WOR-182683

Vernon, Howard. “Historical overview and update on subluxation theories().” Journal of chiropractic humanities vol. 17,1 (2010): 22-32. doi:10.1016/j.echu.2010.07.001

Piriformis Syndrome & Myofascial Pain Syndrome

Dr. Alex Jimenez

Table of Contents

Introduction

The lumbar region of the spine has various muscles and nerve roots that work together with the lower body extremities, like the hips, buttocks, legs, knees, and feet, for mobility and walking function. The various muscles in the buttock region include the gluteal muscles. They have a casual relationship with the hip muscles as they work together for hip mobility and erect good posture in the body. These various muscles and nerves also supply sensory-motor function for the legs to be mobile and provide hip mobility. The piriformis is one of the muscles assisting in the hips and buttock region. When this muscle becomes overused, it can cause mobility issues in the legs and affect a person’s ability to walk. Today’s article looks at the piriformis muscle, how trigger points are associated with piriformis syndrome, and how to manage piriformis syndrome associated with trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain and piriformis syndrome treatments related to trigger points, to aid individuals dealing with pain symptoms along the piriformis muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Piriformis Muscle?

Have you been having issues walking from one place to another? Do you feel muscle tightness in your hips or buttock region? Or are you experiencing radiating pain traveling to your knees and feet? These pain symptoms are correlated with trigger points affecting the piriformis muscle. The piriformis is a flat, pear-shaped muscle, one of the six short rotator muscle groups in the gluteal region of the hips and thighs. The rotator muscle groups consist of the following:

Gemelli
Quadratus Femoris
Obturator Internus
Obturator Externus

This muscle is parallel to the posterior margins of the gluteus medius and deep into the gluteus maximus. This muscle is very important to the body as it provides lower-body movement by stabilizing the hip joint and can lift and rotate the thighs away from the body. The piriformis muscle also surrounds the sciatic nerve, as this long nerve runs deep beneath the piriformis and enters the gluteal region of the rear. When the piriformis muscle becomes overused or suffers from associated traumatic factors, it can aggravate the sciatic nerve and even develop tiny nodules known as trigger points, causing mobility issues.

Trigger Points Associated With Piriformis Syndrome

When abnormal factors affect the piriformis muscles, they can develop into trigger points associated with piriformis syndrome and cause issues in the pelvic and hip regions of the body. According to Dr. Janet G. Travell, M.D., “Myofascial Pain and Dysfunction,” trigger points can be activated when repetitive strain affects the piriformis muscle and causes symptoms of muscle weakness and pain in the hips. This causes overlapping issues in the surrounding muscles and the sciatic nerve, making diagnosing tricky for trigger points. Studies reveal that trigger points associated with piriformis syndrome may potentially cause muscle spasms or an inflammatory process to irritate the sciatic nerve that may be presented as identical to lumbar disk syndrome without neurological findings. Trigger points associated with piriformis syndrome may mimic chronic issues like fibromyalgia. Even though trigger points are tricky to pinpoint in a thorough examination, there are various ways to reduce the pain and prevent trigger points from affecting the piriformis muscle causing sciatic nerve pain.

Trigger Point Of The Week: Piriformis Muscle- Video

Have you been dealing with sciatic nerve pain? Have you found it difficult to walk for a short period? Or are you dealing with muscle tenderness or soreness in your buttock or hips? People experiencing these symptoms could be dealing with piriformis syndrome associated with trigger points. The piriformis is a small, fan-shaped muscle, one of the six short rotator muscle groups that help with hip and thigh mobility through stabilization. The piriformis muscles also surround the sciatic nerve and can succumb to injuries. When traumatic forces affect the hips and thighs, the piriformis muscle develops nodules known as trigger points, causing the muscle to irritate the sciatic nerve and cause pain in the legs. The video above shows where the piriformis muscle is located and how trigger points can mimic sciatic nerve pain in the leg without neurological findings. Studies reveal that trigger points could be a rare anatomical variation that can correlate with piriformis syndrome associated with sciatica. However, there is some good news, as there are ways to manage piriformis syndrome associated with trigger points.

Managing Piriformis Syndrome Associated With Trigger Points

Various techniques can help manage piriformis syndrome associated with trigger points to relieve the piriformis muscle. Studies reveal that Kinesio tape on the piriformis muscle can help reduce pain and improve many individuals’ hip joint range of motion. Other techniques like stretching or deep tissue massage can help loosen up the stiff muscles and relieve trigger points from forming on the piriformis. For sciatica pain associated with trigger points along the piriformis muscle, decompression therapy can help the piriformis muscle lay off pressure on the sciatic nerve and reduce aggravated pain. These techniques can help improve hip joint mobility and increase the range of motion to the hips and lower extremities.

Conclusion

The piriformis is a small muscle that provides hip and thigh mobility. This small muscle surrounds the sciatic nerve, which helps give motor function to the legs. When traumatic factors affect the piriformis muscle, it can develop trigger points and cause sciatic pain in the hips. This causes mobility issues and pain around the hips. Various treatments are provided to help reduce the trigger points along the piriformis muscle and reduce sciatic nerve pain from causing more problems to the hips and legs mobility.

References

Chang, Carol, et al. “Anatomy, Bony Pelvis and Lower Limb, Piriformis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 3 Oct. 2022, www.ncbi.nlm.nih.gov/books/NBK519497/.

Pfeifer, T, and W F Fitz. “[The Piriformis Syndrome].” Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete, U.S. National Library of Medicine, 1989, pubmed.ncbi.nlm.nih.gov/2618150/.

R;, Hashemirad F;Karimi N;Keshavarz. “The Effect of Kinesio Taping Technique on Trigger Points of the Piriformis Muscle.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 8 Feb. 2016, pubmed.ncbi.nlm.nih.gov/27814861/.

Ro, Tae Hoon, and Lance Edmonds. “Diagnosis and Management of Piriformis Syndrome: A Rare Anatomic Variant Analyzed by Magnetic Resonance Imaging.” Journal of Clinical Imaging Science, Medknow Publications & Media Pvt Ltd, 21 Feb. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5843966/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Aging Arthritis: Sciatica Clinic

Dr. Alex Jimenez

Smiling Attractive Multi-ethnic Young Female Doctor or Nurse Wearing Scrubs and Stethoscope Talking with Patient.

Aging Arthritis: How the body changes as the years go by is determined by an individual’s diet, physical activity/exercise, genetics, stress levels, sleep patterns, and self-care. As the body ages, natural degeneration from everyday wear and tear will present. The focus is on understanding how age-related degeneration can affect the body and what to do to prevent and treat it.

Table of Contents

Aging Arthritis

Arthritis refers to joint inflammation and is the fundamental cause of various disorders that include:

Osteoarthritis
Fibromyalgia
Infectious arthritis
Gout – metabolic arthritis
Rheumatoid arthritis
Lupus
Childhood arthritis

Inflammation is just one symptom usually accompanied by swelling, pain, stiffness, immobility, and loss of function.

Osteoarthritis

The most common type of arthritis is osteoarthritis, where the cartilage within joints begins to break down, and the bones begin to reshape.
It’s known as degenerative joint disease/wear and tear arthritis.
The hands, hips, and knees are the most commonly affected joints.
These changes often develop slowly but worsen if not treated.
Symptoms include intense pain, stiffness, and swelling.

Fibromyalgia

Fibromyalgia is a condition that causes pain in various areas of the body, sleep problems, and fatigue.
Individuals with fibromyalgia can be more sensitive to pain sensations.
Treatments and management plans are available to help ease symptoms and restor function.

Infectious Arthritis

Infectious arthritis or septic arthritis is caused by an infection in the joints.
Bacteria from another area of the body can invade a joint or the fluid surrounding it.
Bacteria can enter the body from open wounds, injections, or surgery.
Infectious arthritis is usually only present in one joint.
Staphylococcus aureus is a bacteria that lives on healthy skin and is the cause of most infectious arthritis cases.
A virus or fungus can also generate arthritic inflammatory symptoms.

Gout

Gout is a common type of arthritis that causes inflammation and pain.
It usually only affects one joint, most commonly the big toe joint.
Symptoms can intensify, known as flares, and other periods with no symptoms, known as remission.
Recurrent gout episodes can degenerate into gouty arthritis, a more serious form of arthritis.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune and inflammatory disease in which the immune system attacks healthy cells, causing inflammation.
Rheumatoid arthritis attacks numerous joints simultaneously, specifically in the hands, wrists, and knees.
Rheumatoid arthritis causes the joint lining to become inflamed and starts to damage nearby tissues.
Tissue damage that is severe or chronic enough can cause pain, balance problems, and visible deformities.
Rheumatoid arthritis can also affect organs, like the lungs, heart, and eyes, by causing inflammation.

Lupus

Lupus is an autoimmune disease that affects various body systems.
An autoimmune disease is when the immune system mistakes its tissues for bacterial, viral, or fungal intruders and attacks them.
Lupus symptoms can be vague, making the disease hard to diagnose.
The disease is known as the great imitator because symptoms can mimic other diseases.
Symptoms range from mild to life-threatening.
Seeing a rheumatologist is recommended, as they are specialists that can diagnose and treat arthritis, lupus, and other joint-related diseases.

Childhood Arthritis

Arthritis in children is known as juvenile or childhood arthritis.
Juvenile idiopathic arthritis/juvenile rheumatoid arthritis is the most frequent form.
The condition can cause long-term joint damage that can lead to disability.

Aging Arthritis and Chiropractic Care

Chiropractic care is recommended for the treatment of any form of arthritis. Chiropractic care can work with other therapies to reduce swelling and inflammation, alleviate pain, and improve mobility and flexibility.

A chiropractor will utilize body imagery before beginning treatment.
Imaging gives insight into the condition of the joints, and the visual, combined with a self-report from the individual, allows the chiropractor to create a personalized treatment plan.
Once a chiropractor has identified which techniques the body can handle, treatment will commence that can include:
Therapeutic massage
Percussive massage
Ultrasound
Electrotherapy
Low-level cold laser therapy
Infrared heat

A chiropractor’s objective is to rebalance, realign and strengthen the body, relieve pressure or stress at the junction of the joints, and expedite healing and rehabilitation.

LLT Laser Therapy

References

Abyad, A, and J T Boyer. “Arthritis and aging.” Current opinion in rheumatology vol. 4,2 (1992): 153-9. doi:10.1097/00002281-199204000-00004

Chalan, Paulina, et al. “Rheumatoid Arthritis, Immunosenescence and the Hallmarks of Aging.” Current aging science vol. 8,2 (2015): 131-46. doi:10.2174/1874609808666150727110744

Goronzy, Jorg J et al. “Immune aging, and rheumatoid arthritis.” Rheumatic diseases clinics of North America vol. 36,2 (2010): 297-310. doi:10.1016/j.rdc.2010.03.001

Greene, M A, and R F Loeser. “Aging-related inflammation in osteoarthritis.” Osteoarthritis and cartilage vol. 23,11 (2015): 1966-71. doi:10.1016/j.joca.2015.01.008

Sacitharan, Pradeep Kumar. “Ageing and Osteoarthritis.” Sub-cellular biochemistry vol. 91 (2019): 123-159. doi:10.1007/978-981-13-3681-2_6

Sciatica Pain & The Gluteus Minimus Muscles

Dr. Alex Jimenez

Table of Contents

Introduction

The buttock and the lower back have a casual relationship to the body, as the lower back has various muscles and nerves surrounding the spinal column. In contrast, the buttock region has multiple muscles and the sciatic nerve to keep the body upright. The sciatic nerve travels from the lumbar region of the spine across the gluteus muscles and down to the legs. The gluteus muscles include the Maximus, medius, and minimus, and they work with the sciatic nerve regarding good posture. When normal or traumatic factors begin to affect the body, like sciatica or poor posture, it can lead to developing trigger points associated with the gluteus minimus affecting the sciatic nerve. Today’s article examines the gluteus minimus, how trigger points mimic sciatic pain on the gluteus minimus, and various treatments to relieve sciatic nerve pain. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles associated with sciatica. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Gluteus Minimus?

Have you been experiencing radiating pain traveling down to your leg? Do you have difficulty walking or sitting down? Do you feel tenderness or referred pain near your buttock region? Some of the issues correlate with trigger points affecting the gluteus minimus, causing pain in the sciatic nerve. As the smallest muscle in the gluteal region of the buttock, the gluteus minimus shares similar characteristics to the gluteus medius while being located beneath the medius muscle. One of the primary functions of the gluteus minimus is that it predominantly acts as a hip stabilizer and abductor. The nerves from the gluteal muscles include the sciatic nerve, which is on top of the gluteus muscles and the other nerves help supply the muscles to function in the posterior region of the body. Studies reveal that the structural integrity of the gluteus minimus muscles is the key to the lateral hip muscle, which contributes to pelvic stability and lower extremity function. However, when issues affect the gluteal muscles’ posterior region could trigger point pain mimicking sciatica.

How Trigger Points Mimic Sciatic Pain On The Gluteus Minimus?

When the lower body extremities begin to suffer from multiple issues that cause the individual to have mobility dysfunction, various factors could correlate to the dysfunction. When the gluteus minimus muscles have been overused or been through a traumatic experience, they can develop trigger points along the muscle fibers and even cause nerve entrapment along the sciatic nerve. Trigger points along the gluteus minimus can mimic sciatic nerve pain down to the back or even the side of the legs that causes excruciating and deep pain in the posterior region. Studies reveal that pain in the buttock region is a deep gluteal syndrome caused by non-discogenic pain that causes sciatic nerve entrapment.

The book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., states that many patients with active trigger points located in their gluteus minimus would complain about hip pain that could cause them to limp-walk when they are going to places. The pain caused by the active trigger points can make it difficult to stand up from a seated position due to the painful movements. The associated pain that the trigger points are causing to the gluteus minimus can be constant and excruciating; even small stretches can not alleviate the pain. The book also mentioned that trigger points could cause referred pain to the gluteus minimus that can cause various somato-visceral issues to the hips, legs, and knees if the pain worsens.

Sciatic Type Pain: Gluteus Minimus Trigger Points- Video

Are you dealing with pain in your hips, low back, and legs? Do you find it difficult to walk or stand up constantly? Or are you experiencing sciatic nerve pain that is radiating down your leg? All these pain-like symptoms are associated with trigger points along the gluteus minimus affecting the sciatic nerve. The gluteus minimus is the smallest of the gluteal muscles with the same function as the gluteus medius and predominately acts as the hip’s stabilizer and abductor. When the gluteus minimus muscles have been overused from traumatic events or normal factors, they can develop trigger points in the muscle fibers, entrap the sciatic nerve and irritate the nerve causing sciatica. The video above explain where the gluteus minimus is located and pinpoints where the trigger points are in the muscle fibers. Trigger points along the gluteus minimus can mimic sciatica by causing referred pain to travel down the leg. This can cause the individual to be unable to walk or even stand up due to the excruciating pain that they are in. Luckily, trigger points are treatable even though they are tricky to diagnose.

Various Treatments To Release Sciatic Nerve Pain

Even though trigger points along the gluteus minimus are tricky to diagnose, they are treatable through various treatments to alleviate the pain that the person is experiencing and can reduce sciatic nerve pain from causing more issues in the legs. Studies reveal that the effectiveness of active soft tissue release and trigger point block treatments combined can release entrapped nerves from the gluteus minimus and reduce low back and sciatic pain from the lower extremities. Now the treatments alone can only do so much to the individual, as many doctors tell their patients to take corrective actions or techniques to reduce the chances of trigger points from forming again on the gluteus minimus. Techniques like glute stretches, ischemic compressions, or using a foam roller can break the myofascial triggers from the gluteus minimus muscles and reduce the pain in the glutes and legs. This will help bring mobility back to the lower extremities.

Conclusion

As the smallest muscle in the body’s gluteal region, the gluteus minimus is the lower body’s predominant hip stabilizer and abductor. The gluteus minimus contributes to pelvic stability and lower extremity functionality that can be overused and can develop trigger points associated with sciatica. Trigger points along the gluteus minimus can cause referred pain to the legs and lower back while mimicking sciatic nerve pain. Thankfully various treatments and techniques can help reduce the chances of trigger points forming along the gluteus minimus and release nerve entrapment from the aggravated muscles pressing on the sciatic nerve, bringing back lower extremity mobility to the body.

References

Greco, Anthony J, and Renato C Vilella. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Minimus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 May 2022, www.ncbi.nlm.nih.gov/books/NBK556144/.

Kameda, Masahiro, and Hideyuki Tanimae. “Effectiveness of Active Soft Tissue Release and Trigger Point Block for the Diagnosis and Treatment of Low Back and Leg Pain of Predominantly Gluteus Medius Origin: A Report of 115 Cases.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6382483/.

Martin, Hal David, et al. “Deep Gluteal Syndrome.” Journal of Hip Preservation Surgery, Oxford University Press, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4718497/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Whiler, Lisa, et al. “Gluteus Medius and Minimus Muscle Structure, Strength, and Function in Healthy Adults: Brief Report.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/.

Disclaimer

Breathing Back Discomfort Causes: Sciatica Clinic

Dr. Alex Jimenez

Female physiotherapist examining female patient injured back in modern clinic.

Back discomfort symptoms include stiffness, spasms, tenderness, and headaches often caused by unhealthy posture and overuse muscle strain. Breathing back discomfort can be caused by injuries to the spinal musculoskeletal system, conditions and/or disease in the back, lungs, or heart, and other conditions unrelated to the back. When taking a breath, the intercostal muscles surrounding the rib cage contract, expanding the chest and allowing the lungs to fill with air. These muscles directly affect the spine, which is why back issues can present when breathing. Chiropractic care, decompression, and massage therapy, combined with a functional medicine approach, can realign the spine, release tight muscles, and restore function.

Table of Contents

Breathing Back Discomfort

A problem in the back could be a root cause for discomfort and back problems while breathing.

Spinal Conditions

Scoliosis

Scoliosis causes the spine to curve sideways, either in one direction, creating a C shape, or generating an S shape in two directions.
The curvature can be so minimal that it cannot be seen or so severe that it can be life-threatening. Most scoliosis cases fall in between.
Taking deep breaths can cause discomfort and pain because the spine curvature puts extra strain on certain muscles meant to support the body’s weight in tandem with other muscles that have limited function or are no longer functioning.
The condition normally begins in adolescence but can start later in life.

Scoliosis treatment varies depending on the severity.

Monitor

A spinal physician will monitor the individual for mild curvature, as sometimes the process stops before it becomes serious. This is known as the wait-and-see, what-happens approach.

Activity, Chiropractic, and Physical Therapy

Yoga can stop and even reverse the progression.
Chiropractic care and physical therapy can help alleviate symptoms.

Bracing

Bracing can be effective at stopping the progression.

Surgery

For severe cases, surgery may be necessary.
In this case, spinal fusion is the most common surgical procedure for this condition.
Newer procedures like vertebral body tethering and ApiFix have been approved and could be an option.

Kyphosis

Kyphosis is another curve in the back that is supposed to be there.

Instead of curving like scoliosis, kyphosis causes a curve forward in the thoracic spine/upper back.
Problems arise when the curve is too pronounced.
This curve can come from unhealthy posture, Scheuermann’s disease, or being born with it.
Kyphosis causes breathing back discomfort by straining the muscles in the upper back, which are used for each breath.
Treatment often involves chiropractic and/or physical therapy to restore proper curvature and reduce inflammation.
A back brace could be prescribed if discomfort and pain continue.
Spinal fusion could be recommended for severe cases.

Lungs

The lungs and the spine are close to each other, which is why back discomfort and problems with breathing are connected.

Pneumonia

Pneumonia is an infection in the lungs that causes the tiny sacks known as alveoli to fill with fluid.
This is where the body takes oxygen from the inhaled air to the bloodstream.
The infection causes inflammation and discomfort symptoms in and around the chest and back while taking deep breaths.

Lung Cancer

Lung cancer can cause back issues and pain.
Frequently coughing causes the muscles around the ribs and back to become overused and strained from the jerking and heaving.
The strained muscles cause discomfort and pain when taking a breath.
Tumors can push on sensitive nerves in the back, causing inflammation and pain.

Pleurisy

There is a thin layer of protective tissue surrounding the lungs called pleura.
Pleurisy describes the layer becoming infected and/or inflamed, which causes discomfort symptoms in the back when breathing.
Pleurisy can be caused by injury, infection, or cancer.
Individuals with autoimmune disorders are more at risk of developing the condition.

Pneumothorax

Pneumothorax describes a full or partial lung collapse, usually on one side.
The lung can collapse as a result of severe illness or injury.
The lung collapses because air gets between the pleura and the lung and not allowing the lung to expand.
Pain with breathing is a common indicator of pneumothorax.
Individuals with this condition also experience severe shortness of breath and chest pain on one side.

Pulmonary Embolism

A pulmonary embolism occurs when a blood clot gets stuck in an artery, blocking blood flow to part of the lung.
The lungs will display signs of distress through back pain when trying to take a deep breath.
This is a life-threatening condition that causes chest pain, coughing up blood, a heart rate over 100 beats per minute, dizziness or leg swelling, and painful breathing; get to an emergency room immediately.

Heart

Heart Attack

The nerves associated with pain in the muscles and bones differ from those surrounding the organs, including the heart.
However, a heart attack can cause back pain as the nerves of the heart travel along the same path as spinal nerves, specifically in the upper back.
The brain can misinterpret pain signals from the same roots that supply peripheral nerves in the chest, arm, jaw, and back.
Because they share nerve pathways, the upper back can present with pain during a heart attack.

Aortic Dissection

The largest artery in the body is called the aorta.
It comes off the top of the heart and then drops to supply blood to the rest of the body.
Sometimes, the vessel can get a small tear in the chest area, which grows from the blood circulation pressure.
Aortic dissection can cause intense back pain while breathing.

Chiropractic care, decompression, and massage therapy combined with functional medicine can help realign the spine, stretch and loosen the overused and strained muscles, and provide postural training and nutritional planning to help alleviate symptoms and restore function.

Deep Breathing Back Pain

References

Costumbrado J, Ghassemzadeh S. Spontaneous Pneumothorax. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459302/

Floman, Y., Burnei, G., Gavriliu, S. et al. Surgical management of moderate adolescent idiopathic scoliosis with ApiFix®: a short peri- apical fixation followed by post-operative curve reduction with exercises. Scoliosis 10, 4 (2015). doi.org/10.1186/s13013-015-0028-9

Hunter MP, Regunath H. Pleurisy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK558958/

www.lung.org/lung-health-diseases/lung-disease-lookup/pneumothorax/symptoms-diagnosis-treatment

www.lung.org/lung-health-diseases/lung-disease-lookup/pulmonary-embolism/treating-and-managing

Mansfield JT, Bennett M. Scheuermann Disease. [Updated 2022 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK499966/

Raitio A, Syvänen J, Helenius I. Vertebral Body Tethering: Indications, Surgical Technique, and a Systematic Review of Published Results. Journal of Clinical Medicine. 2022; 11(9):2576. doi.org/10.3390/jcm11092576

Lumbago Pain & Gluteus Medius Trigger Pain

Dr. Alex Jimenez

Table of Contents

Introduction

Many individuals utilize the lower half of their bodies to go to different places and use the various surrounding muscles that provide stability on the hips and low back while supporting the upper body’s weight. Along the lower back is the buttock region, where the gluteal muscles help stabilize the pelvis, extend the hips, and rotate the thighs. The gluteal muscles also help shape and support the spine and have an erect posture in the body. One of the gluteal muscles that support the lower body is the gluteus medius, which can succumb to injuries and strain when overused or strained. This leads to developing trigger points that can cause various issues in the lower extremities and lead to corresponding chronic conditions. Today’s article focuses on the gluteus medius muscles, how the lumbago is associated with gluteus medius trigger pain, and various techniques to manage trigger points along the gluteus medius muscle. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like butt and low back pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles near and surrounding the body’s lower extremities. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Is The Gluteus Medius?

Have you been experiencing pain near your buttock and lower back? Have you been feeling unstable when you are walking? What about feeling pain in your tailbone that makes it unbearable to sit down? Many of these issues are associated with referred pain caused by trigger points affecting the gluteus medius. As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus is a flat, triangular muscle and is the primary hip abductor. The gluteus medius and minimus work together for internal rotation for the thighs and lateral rotation for the knees when they are extended. The gluteus medius muscles also help stabilize the pelvis, while the trunk maintains an upright position when the legs are in motion. Studies reveal that the gluteus medius is a key lateral hip muscle that correlates with muscle function with other muscle groups like the quadriceps and abdominal muscles. When injuries or not activating the gluteal muscles often, various muscle issues can cause problems to the gluteus medius muscles.

Lumbago Associated With Gluteus Medius Trigger Pain

Dysfunction in the hips can lead to various issues that can either be acute or chronic, depending on how severely the muscles have been overused or injured. Studies reveal that low back pain has been identified as the leading contributor to disability and when there is dysfunction in the lumbopelvic-hip complex, causing a reduction in gluteus medius strength. When the gluteus medius muscles have become overused or injured through trauma, it can develop trigger points on the muscle causing low back pain issues. When trigger points affect the gluteus medius, additional studies reveal that latent trigger points along the gluteus medius muscles may cause joint movement limitation while causing overload by affecting muscle activation from the hips.

According to Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” patients with active trigger points along their gluteus medius complain of pain when they are doing normal actions like walking or sitting. The pressure from the trigger points along the gluteus medius causes the individual to be in a slumped position, causing them to be uncomfortable. This causes instability in the hips and lower body extremities, making many people miserable. The book also explains that the referred pain patterns caused by gluteus medius trigger points can overlap other chronic conditions like sacroiliac joint dysfunction, low back pain, and inflammation of the subgluteus medius bursa.

Trigger Point Of The Week: Gluteus Medius- Video

Have you been dealing with hip pain? Do you feel uncomfortable pain when walking or sitting down? Or Do you feel muscle stiffness or tenderness near your tailbone constantly? If you have been experiencing these painful symptoms constantly in your lower back or your hips, it could be due to your gluteus medius muscles being affected by trigger points. The video above overviews the gluteus medius location and how trigger points or myofascial pain syndrome causes referred pain to the lower back and hips. When trigger points affect the gluteus medius, the referred pain can overlap and correlate to low back and hip pain, thus causing various issues to the muscles surrounding the low back and buttock region. Regarding trigger points affecting the gluteus medius, they can be treatable through multiple techniques specific to the low back, buttocks, and hips.

Various Techniques For Managing Trigger Pain Along The Gluteus Medius

When issues of low back or hip pain begin to cause a problem in the lower extremities, the gluteus muscles can invoke pain-like symptoms in the affected muscle regions, thus developing trigger points. Even though trigger points are tricky to diagnose, they can be treated with various techniques that many people can incorporate into their daily lives. Exercises like resistance training on the gluteus medius can help improve hip abductor functionality and increase the strength of the gluteus medius. To manage trigger points along the gluteus medius, many people must do these corrective actions to reduce the pain that they may be causing to their glutes. When people are putting on pants, it is best to sit down and then put on their pants to prevent muscle strain on their hips and gluteus medius. Another corrective action is to move around after sitting down for a prolonged period to avoid trigger pain from developing. These corrective actions and techniques can help strengthen the lower body extremities and improve hip mobility.

Conclusion

As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus by being a primary hip abductor. The gluteus medius helps with pelvic stabilization and helps the trunk maintain an upright position when the legs are in motion. When normal or traumatic factors affect the gluteus medius, it can develop trigger points on the muscle fibers, causing referred pain to the hips and lower back. Trigger points along the gluteus medius are manageable through various techniques that people can use to prevent hip and low back issues. These techniques can minimize the trigger points and strengthen the gluteus medius muscles in the glutes.

References

Bagcier, Fatih, et al. “The Relationship between Gluteus Medius Latent Trigger Point and Muscle Strength in Healthy Subjects.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, Jan. 2022, pubmed.ncbi.nlm.nih.gov/35248262/.

Sadler, Sean, et al. “Gluteus Medius Muscle Function in People with and without Low Back Pain: A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 22 Oct. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6805550/.

Shah, Aashin, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Medius Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK557509/.

Stastny, Petr, et al. “Strengthening the Gluteus Medius Using Various Bodyweight and Resistance Exercises.” Strength and Conditioning Journal, Strength and Conditioning Journal, June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4890828/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Training Oneself To Enjoy Vegetables: Sciatica Clinic

Dr. Alex Jimenez

adult man slicing vegetables for salad at kitchen

First, know that it is not crazy, and you’re not alone. It is difficult for individuals to achieve health and fitness goals when they don’t like to eat vegetables. Intermittent fasting, Paleo, vegan, Mediterranean, or New Nordic, almost all healthy nutrition plans require vegetable consumption to achieve optimal health. However, it is never too late to learn to enjoy vegetables. Injury Medical Chiropractic and Functional Medicine Clinic can recommend ways not just to eat vegetables because they are healthy but to truly enjoy them.

Table of Contents

Training Oneself To Enjoy Vegetables

Everyone’s taste preferences are different.

Many individuals grew up in homes where vegetables were prepared in unappetizing ways.
Over boiling and steaming are common preparation methods that many had experience with, including broccoli, cauliflower, asparagus, and Brussels sprouts, which made them flavorless, mushy and is where many decided they were not going to eat these foods.
Many don’t like vegetables because many have chemical compounds that make them taste bitter.
If food intake is more packaged and less fresh, an individual’s palate will be more conditioned to seek out processed food’s fatty, sweet flavors.
Some individuals may be genetically inclined to dislike vegetables.

Vegetable Purpose

Vegetables are full of nutrients that are very beneficial to the body.

Vegetables contain antioxidants, vitamins, minerals, fiber, and phytonutrients.
These nutrients help keep the mind and body healthy and avoid deficiencies.
Vegetables add fiber that provides a feeling of fullness by giving volume to fill the stomach without added calories.
This controls energy balance/calories in vs. calories out, which helps shed body fat without feeling hungry and maintain body weight.
Vegetables feed the intestinal bacteria that help the digestive tract.
Vegetables provide hydration that helps the fiber eliminate waste products.
Vegetables add variety to help maintain healthy nutrition.

Branching Out

The key is to branch out incrementally. Most individuals will have a vegetable or two that they can tolerate. This could be a starting point by expanding on new variations on those tolerable vegetables that will lead to broadened taste preferences. This can be done through different cooking methods that include:

Roasting
Baking
Sautéing
Grilling

Regardless of where you’re starting, there are simple ways to make the vegetable bitterness less intense, more palatable, and more enjoyable that consists of:

Vegetable Challenge
Vegetable Complement
Vegetable Cushion

Vegetable Challenge

Pick a vegetable that you would not normally eat that requires effort to try.
Motivate yourself to try it – health reasons, children, family, friends, etc.
Take a small bite; you may hate it, like it, or it has no effect.
You at least tried it.
Research suggests that individuals may need to try new foods many times (prepared differently) before tolerating or liking them.

Vegetable Complement

Build on flavor perception
Well-developed recipes have flavor harmony.
It means pairing food with a vegetable to activate various tastes and flavors pleasing to the palate simultaneously.

Vegetable Cushion

On the tongue are a variety of receptors that bind to the chemicals in food.
When these receptors are activated, they send a chemical signal to the brain about the taste.
Variations in the number and type of receptors help develop flavor preferences.
Basic tastes – sweet, sour, spicy, salty, bitter, and umami.
Pairing bitterness with other distinct flavors, like sweet and spicy, can develop and change the brain’s perception of bland or bitter vegetables to tasty and delicious.
Cushions for bitterness include honey, real maple syrup, sour cream, Mexican crema, hot sauce, oils, almonds, and butter used in balance to enhance and bring out flavors.

The objective is to start small and work your way to becoming more comfortable with experimenting and combining more flavors. Consultation with a professional nutritionist can help individuals get on a healthy nutrition plan that they can enjoy.

Tip From A Dietitian

References

Christoph, Mary J et al. “Intuitive Eating is Associated With Higher Fruit and Vegetable Intake Among Adults.” Journal of nutrition education and behavior vol. 53,3 (2021): 240-245. doi:10.1016/j.jneb.2020.11.015

Melis M, Yousaf NY, Mattes MZ, Cabras T, Messana I, Crnjar R, Tomassini Barbarossa I, Tepper BJ. Sensory perception of salivary protein response to astringency as a function of the 6-n-propylthioural (PROP) bitter-taste phenotype. Physiol Behav. 2017 Jan 24;173:163-173.

Mennella JA. Development of food preferences: Lessons learned from longitudinal and experimental studies. Food Qual Prefer. 2006 Oct;17(7-8):635-637.

Tordoff, Michael G, and Mari A Sandell. “Vegetable bitterness is related to calcium content.” Appetite vol. 52,2 (2009): 498-504. doi:10.1016/j.appet.2009.01.002

Wallace, Taylor C et al. “Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake.” Critical reviews in food science and nutrition vol. 60,13 (2020): 2174-2211. doi:10.1080/10408398.2019.1632258

Wieczorek, Martyna N et al. “Bitter taste of Brassica vegetables: The role of genetic factors, receptors, isothiocyanates, glucosinolates, and flavor context.” Critical reviews in food science and nutrition vol. 58,18 (2018): 3130-3140. doi:10.1080/10408398.2017.1353478

Experiencing Pain In Your Gluteus Max? Could Be Trigger Points

Dr. Alex Jimenez

Table of Contents

Introduction

The body’s lower extremities have various muscles that allow the legs and feet to move around from one location to another. The different muscles that make up the lower extremities of the body help stabilize the hips and allow mobility to the legs. The legs and hip muscles have a mutual relationship with one body muscle that helps the lower body, and it’s the glutes, specifically the gluteus maximus. Many individuals must realize that the glutes must be activated when working out. When the glutes are not activated, it can lead to the rest of the lower extremities, like the lower back, hips, and knees, taking most of the loaded weight on the body. This leads to the development of trigger points associated with butt pain along the gluteus maximus, causing referred pain down the legs. Today’s article looks at the gluteus maximus muscles, how trigger points are associated with butt pain, and relieving pain is associated with trigger points along the gluteus maximus. We refer patients to certified providers who incorporate multiple techniques in the lower body extremities, like butt pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus maximus muscles near and surrounding the body’s lower extremities. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Gluteus Maximus?

Have you been experiencing pain in your hips, low back, and knees? Are you uncomfortable when you are trying to sit down? Or are you experiencing sciatic pain-like symptoms running from your buttock to your leg? These issues affecting the body’s lower extremities may correlate with trigger points along the gluteus maximus in the buttock. The gluteus maximus is the largest gluteus muscle that makes up the shape and form of the buttock and hip areas of the body. The gluteus maximus can come in different sizes depending on the individual’s body type. This large muscle plays a prominent role in the body as it helps maintain an erect posture for the upper body. Studies reveal that the gluteus maximus is one of the primary hip extensors, and some of its functions include extending and externally rotating the thighs. The gluteus maximus, when trained properly through exercise, can increase in size and strength while supporting the upper body. However, only a few people realize that when their gluteus maximus muscles are not properly trained, it can lead to various issues that can cause trigger points to form along the gluteus maximus.

Trigger Points Associated With Butt Pain

As mentioned earlier, when individuals don’t properly strengthen their gluteus maximus through exercises, it can lead to unwanted pain symptoms affecting the lower back, hips, and knees in the lower body. When the gluteus maximus muscles are not fully activated to their full potential, they can develop into trigger points associated with butt pain. Studies reveal that trigger points or myofascial pain syndrome associated with the gluteus maximus can affect the entry point of the inferior gluteal nerve, causing pain and a limited range of motion to the joints. Dr. Janet G. Travell, M.D., who wrote “Myofascial Pain and Dysfunction,” mentioned that the symptoms caused by active trigger points could make the individual uncomfortable and cause a cramping sensation to the gluteus maximus. At the same time, trigger points along the gluteus maximus can correlate with referred pain that can entrap the sciatic nerve causing sciatica to affect the legs. When this happens, many other issues can pop up and affect the lower extremities, mimicking low back pain.

How To Release Trigger Points On The Gluteus Maximus-Video

Treating Trigger Points - How to Release Triggers in Gluteus Maximus

Are you experiencing a cramping sensation in your buttock? What about feeling an electric sense running down your leg? Or are you dealing with low back pain? Many of these issues are associated with trigger points affecting the gluteus maximus, causing butt pain. The gluteus maximus is a large, superficial muscle that helps support the hips and ensures that the upper body has an erect posture. When issues affect the gluteus maximus, it can lead to unwanted pain in the lower back, hips, and knees, causing the individual to be in constant pain. This leads to the development of trigger points along the gluteus maximus, thus mimicking sciatica. The video above demonstrates where the trigger points are located in the gluteus maximus and how they can potentially overlap to cause sciatica nerve pain. The video also shows how to use various techniques to relieve the pain from the trigger points and help release the trapped muscle from causing additional pain in the lower body.

Relieving Pain Associated With Trigger Points Along The Gluteus Maximus

Since the gluteus maximus is a large important muscle, it is important to strengthen the glutes to prevent low back pain. When it comes to relieving pain associated with trigger points along the gluteus maximus, there are various techniques that many people can utilize to release the tension from the gluteus maximus and the rest of the lower body. Various glute stretches can help elongate the gluteus maximus muscle after a workout and reduce the chances of triggering points and referred pain re-occurring. Another technique that many people should do is to bend at the knees when lifting heavy objects to reduce overload on the lower back and cause more issues on the gluteus maximus.

Conclusion

The gluteus maximus is a large superficial muscle with a very important function in the body. This muscle helps with extending and externally rotating the thighs and helps keep the posture erect for the upper back. However, the gluteus maximus muscles are not properly trained and can lead to unwanted issues that cause referred pain to the hips, low back, and knees that correlate with triggering points. Luckily though, through proper training and stretching, the lower body can prevent the gluteus maximus from developing trigger points and help improve a person’s posture.

References

Akamatsu, Flavia Emi, et al. “Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle.” BioMed Research International, Hindawi, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5733974/.

Elzanie, Adel, and Judith Borger. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Maximus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Mar. 2022, www.ncbi.nlm.nih.gov/books/NBK538193/.

Neto, Walter Krause, et al. “Gluteus Maximus Activation during Common Strength and Hypertrophy Exercises: A Systematic Review.” Journal of Sports Science & Medicine, Uludag University, 24 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7039033/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

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Stomach Back Pain Causes: Sciatica Clinic

Dr. Alex Jimenez

Female doctor examining male patient in physical therapy clinic — Woman healthcare medical worker keeping hands near male back while performing manual examination in wellness center

Back pain is one of the most common reasons individuals go to a doctor, massage therapist, physiotherapist, osteopath, and chiropractor. Various health conditions, some spine-related, others not, list back pain as a symptom. Many of these conditions begin in the stomach or abdominal cavity, which leads to stomach and back pain. Stomach and back pain happening simultaneously, independently, or in combination could be caused by gut problems, back issues, or something completely different. Understanding what causes these two types of pain simultaneously can help figure out a treatment plan.

Table of Contents

Stomach Back Pain Causes

Problems in the abdominal cavity and stomach issues can cause back pain and vice versa. Symptoms can also include referred pain when the pain is felt in one part of the body but is caused by pain or injury in another area. Stomach back pain causes depend on the type of condition/s that can include:

Appendicitis

Inflammation in the appendix can cause sudden sharp pain in the abdomen.
It presents mostly in the lower right area of the abdomen but can appear in or spread to other sites, especially the back.

Dysmenorrhea

The medical term for painful menstrual periods.
Dysmenorrhea can cause pain in the abdomen and back at the same time.
This type of pain can be:
Primary – A condition experienced throughout life.
Secondary – Starts later in life due to another condition.

Endometriosis

Endometriosis causes tissue to grow outside of the uterus.
Similar to dysmenorrhea, symptoms include:
Abdominal pain
Referred low back pain

Fibromyalgia

This condition generates pain across the muscles and joints of the body.
It shows up with irritable bowel syndrome -IBS.
Fibromyalgia can simultaneously present a wide range of stomach problems and back pain.

Gallstones

Gallbladder stones or gallstones can cause blockages, inflammation, and painful swelling.
A major symptom of gallstones is pain in the upper right of the abdomen, which can spread to the back.

Kidney Dysfunction

Kidney stones, infections, and chronic kidney disease can cause pain that’s felt in the abdomen/flank and the mid and/or upper back.

Irritable bowel syndrome – IBS

Bloated and distended muscles are common symptoms that can cause back pain.

Inflammatory Bowel Disease – IBD

Inflammatory Bowel Disease is a family of immune-mediated, similar to autoimmune conditions with back pain as a symptom that includes:
Crohn’s disease
Ulcerative colitis

Pancreatitis

An inflamed pancreas can cause symptoms like:
Stomach issues.
Pain across the abdomen and back.

Pancreatic Cancer

A common symptom of pancreatic cancer is a dull pain in the upper abdomen/belly and/or middle and/or upper back that is on and off.
This can be because of a tumor that has formed on the tail of the pancreas or an area where it presses on the spine.

Stomach Bloating and Low Back Pain

Bloating is caused by pressure in the abdomen increasing to the point that it causes discomfort and pain.
It can cause simultaneous stomach and back pain as the bloating adds pressure on the muscles, organs, and spine.
One of the most common causes of bloating is trapped gas in the GI tract.
This happens when the body cannot properly move the gas through the system.
Bloating can also be caused by extra sensitivity to regular pressure increases.
In these cases, the amount and movement of gas in the system are normal, but the body reacts as though something is wrong.
Several GI tract disorders can cause similar bloating issues that include:
Dyspepsia
Gastritis
Celiac disease Diverticular disease
Food allergies

A chiropractic functional medicine team can work with an individual’s primary physician or specialist to develop a personalized treatment plan to alleviate back pain symptoms, re-balance the body, strengthen the musculoskeletal system and restore function.

Back and Stomach

References

Clauw DJ. Chapter 258, Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain. Goldman-Cecil Medicine. Goldman L (ed.). 26th ed. Elsevier; 2020. 1774-1778. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323532662002587

Ford AC, Talley NJ. Chapter 122, Irritable Bowel Syndrome. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier: 2021. 2008-2020. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623001223?scrollTo=%23hl0001104

Inadomi JM, Bhattacharya R, Hwang JH, Ko C. Chapter 7, The Patient with Gas and Bloating. Yamada’s Handbook of Gastroenterology. 4th ed. John Wiley & Sons; 2019. doi.org/10.1002/9781119515777.ch7

Kliegman RM, St Geme JW, Blum NJ, et al. Chapter 378, Pancreatitis. Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. 2074-2080. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323529501003783

Krames E, Mousad DG. Spinal Cord Stimulation Reverses Pain and Diarrheal Episodes of Irritable Bowel Syndrome: A Case Report. Neuromodulation. 2004 Mar 22;7(2):82-88. doi.org/10.1111/j.1094-7159.2004.04011.x

Sifri CD, Madoff LC. Chapter 78, Appendicitis. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Bennett JA (ed.). Elsevier; 2020. 1059-1063. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323482554000783

Stephen Norman Sullivan, “Functional Abdominal Bloating with Distention,” International Scholarly Research Notices, vol. 2012, Article ID 721820, 5 pages, 2012. doi.org/10.5402/2012/721820

Wang DQH, Afdhal NH. Chapter 65, Gallstone Disease. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier: 2021. 1016-1046. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623000655?scrollTo=%23hl0001772

Weisman, Michael H et al. “Axial Pain and Arthritis in Diagnosed Inflammatory Bowel Disease: US National Health and Nutrition Examination Survey Data.” Mayo Clinic proceedings. Innovations, quality & outcomes vol. 6,5 443-449. 16 Sep. 2022, doi:10.1016/j.mayocpiqo.2022.04.007

Whorwell PJ. Chapter 13, Abdominal Bloating. Irritable Bowel Syndrome: Diagnosis and Clinical Management. Emmanuel A, Quigley EMM (eds.). John Wiley & Sons; 2013. doi.org/10.1002/9781118444689.ch13

Yarze JC, Friedman LS. Chapter 12, Chronic Abdominal Pain. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier; 2021. 158-167. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623000126?scrollTo=%23hl0000408

Pelvic Floor Muscles & Trigger Points

Dr. Alex Jimenez

Table of Contents

Introduction

The body’s pelvic region has many functions crucial for functionality with the host. The various muscles surrounding the pelvis help provide stability to the body’s core, allow circulation to the heart in the cardiovascular system, support the reproductive and abdominal organs, and much more the body requires. The pelvic joints’ various muscles also allow hip mobility and function for the lower body extremities. When traumatic injuries or abnormal activities start to affect the pelvic floor muscles, the various issues can affect the functionality of the pelvic region and cause problems in bladder control for both the male and female bodies. Many of these issues correlate with trigger points surrounding or on the pelvic floor muscles that can affect how the vital organs operate in the body. Today’s article examines the pelvic floor muscles, how trigger points correlate with pelvic pain, and managing pelvic pain is associated with trigger points. We refer patients to certified providers who incorporate multiple techniques in the lower body extremities, like pelvic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the pelvic floor muscles near and surrounding the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Are The Pelvic Floor Muscles?

Have you been experiencing bladder issues that constantly make you go to the bathroom? Have you been dealing with severe cramps that mimic sciatica pain? Or does it hurt when you are sitting down? Many of these issues correlate with muscle pain associated with trigger point pain along the pelvic floor muscles. The pelvic floor muscles are a unique anatomical body location with a balance of different pressures (visceral, muscular, or liquid) that play a fundamental role in the body’s lower extremities. The pelvic floor muscles have four divided compartments but have different parts and functions to allow optimal bodily function. The four pelvic floor compartments include:

Anterior or urinary (bladder)
Medium or genital (uterus in women, prostate in men)
Posterior or anterior (anus, anal cavity, and rectum)
Peritoneal (endopelvic fascia and perineal membrane)

Some of the functions that the pelvic floor muscles allow the body to perform properly include proper contraction for sexual function, allowing respiration in the abdominal organs, maintaining bodily fluid actions like going to the restroom, and maintaining good posture by working together with the thoracolumbar and lumbosacral columns of the spine. Studies reveal that the spine’s autonomic nerves, which include the sympathetic and parasympathetic, help supply the posterior and anterior compartments in the pelvic floor. When traumatic factors affect the pelvic floor muscles, it can lead to correlating issues regarding trigger points in the pelvic muscles.

How Do Trigger Points Correlate With Pelvic Pain?

The pelvic floor has four different components to allow the muscles to function properly when traumatic factors start to invoke pain-like symptoms that can affect pelvic functionality in both the male and female body, thus developing trigger point pain associated with pelvic pain. For the female body, trigger points along the bulbospongiosus muscle (part of the pelvic floor muscles) may cause aching pain in the perineal region. In contrast, in the male body, trigger points along the retroscrotal area may cause discomfort while sitting erect. According to the book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that many individuals that are dealing with trigger point pain along their pelvic floor muscles would often complain about feeling localized aching pain in their anal region and may experience painful bowel movements when going to the bathroom.

Studies reveal that myofascial trigger points develop “muscle contraction knots” of the pelvic floor muscles, may be identified in many patients suffering from pelvic pain syndrome (urological, colorectal, and gynecological), and are associated with trigger points. Trigger points are tricky when diagnosing where the pain is located since myofascial pain syndrome mimics other chronic conditions of the surrounding muscles, causing referred pain. Additional studies reveal that the location and severity of pelvic floor myofascial pain was significantly correlated with various pelvic pain symptoms that can affect both males and females with different conditions. When doctors recognize that their patients are dealing with trigger points associated with pelvic pain after an examination, they devise a treatment plan and work with other specialists to manage trigger points and reduce pain in the pelvic region.

Managing Pelvic Pain Associated With Trigger Points

Various treatments can manage pain associated with trigger points through multiple therapies that can reduce pain-like symptoms along the pelvic floor muscles. Many therapies, like trigger point therapy and muscle training, can help reduce the pain along the pelvic floor muscles and bring back bowel function to the pelvic region. Studies reveal that doctors provide a range of protocols designed to strengthen the pelvic floor muscles and the different muscle groups around the pelvic area while improving function. However, treatment alone can only go so far, as people must take corrective actions to ensure that the trigger points do not return in the future. Movements like corrective posture exercises focusing on the lower back, hips, and pelvis and eating a fiber-rich diet can reduce pelvic pain. This allows the individual to get their lower half mobility back.

Conclusion

The pelvic floor muscle has four divided components that will enable optimal bodily function that has different jobs in the male and female bodies. The pelvic floor muscles have many crucial functions that provide the host stability in the body’s core, allow circulation to the cardiovascular system, and, most importantly, support the reproductive and abdominal organs. When issues affect the pelvic floor muscles, it can lead to pelvic pain associated with trigger points that can disrupt many from going to the bathroom or disrupting sexual functionality. All is not lost, as various therapies can reduce the pain and strengthen the pelvic muscles in the lower body. This allows lower body mobility back to the host and prevents unnecessary issues from reoccurring.

References

Bordoni, Bruno, et al. “Anatomy, Abdomen and Pelvis, Pelvic Floor.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK482200/.

Marques, Andrea, et al. “The Status of Pelvic Floor Muscle Training for Women.” Canadian Urological Association Journal = Journal De L’Association Des Urologues Du Canada, Canadian Medical Association, Dec. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/.

Meister, Melanie R, et al. “Pelvic Floor Myofascial Pain Severity and Pelvic Floor Disorder Symptom Bother: Is There a Correlation?” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6732028/.

Moldwin, Robert M, and Jennifer Yonaitis Fariello. “Myofascial Trigger Points of the Pelvic Floor: Associations with Urological Pain Syndromes and Treatment Strategies Including Injection Therapy.” Current Urology Reports, U.S. National Library of Medicine, Oct. 2013, pubmed.ncbi.nlm.nih.gov/23943509/.

Raizada, Varuna, and Ravinder K Mittal. “Pelvic Floor Anatomy and Applied Physiology.” Gastroenterology Clinics of North America, U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2617789/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.