Acute, Chronic, Alternating, and Bilateral Sciatica Clinic

A female physiotherapist giving diathermy treatment on the patient's back.

Sciatica is common and affects up to 40% of the general population. Different types include acute, chronic, alternating, and bilateral sciatica. The sciatic nerve comprises three specific nerve roots in the lower back. The three nerves originate in the L4 and L5 vertebrae and the sacrum, just below the vertebrae. The nerve then branches off and runs through the back of each thigh. Injury, compression, or irritation of these nerves can cause various symptoms, including numbness, tingling, electrical shooting pain, and muscle spasms in the low back, the leg, and the foot. Chiropractic care can realign the spine, relax the muscles, release compression and relieve sciatica.

Table of Contents

Acute, Chronic, Alternating, and Bilateral Sciatica

Acute

Acute pain can be brought on by sudden irritation to the nerves that have become pinched, compressed, or a combination.
Causes a constant burning or shooting sensation through the low back, buttocks, down the leg, and possible hip discomfort.
It becomes worse when sitting.
It can cause immediate and short-term pain lasting for 1-2 weeks.

Chronic

Chronic sciatica can last for months or years on and off or continuously.
It can be caused or worsened by inflammatory conditions like rheumatoid arthritis, injuries, infections, and spinal misalignment issues.
It can resolve but will come back without treatment or lifestyle and activity adjustments.

Bilateral

Sciatica typically takes place in one leg; it has been known to be bilateral and experienced in both legs.
This type of sciatica is rare but can occur from degenerative changes in the vertebrae and/or the discs at several spinal levels.
If there is pain in both legs, it is likely not a herniation but degenerative changes like spinal stenosis.
The symptoms can range from infrequent to irritating to severe and debilitating.
It could be a red flag symptom of cauda equina syndrome.
Weakness may be felt in the leg and foot, or a feeling of heaviness, making it difficult to lift the foot off the floor.

Alternating

Alternating sciatica affects both legs alternately. It is usually connected to bilateral sciatica that switches sides.
This type is rare and can result from degenerative problems in the sacroiliac joint, the joint connecting the spine to the hips, or sacroiliac arthritis.

Spinal Sources

Sciatica occurs when L4, L5, and/or S1 nerve roots are affected.

L4 Nerve Root

Pain in the hip, thigh, inner medial areas or the knee, and the calf.
Weakness in the thigh and hip muscles.
Reduced knee-jerk reflex.
Loss of sensation around the calf.

L5 Nerve Root

Pain in the buttock and the outer area of the thigh.
Weakness in the buttock and leg muscles.
Difficulty moving the ankle and lifting the big toe upward.
Loss of sensation between the big toe and the second toe.

S1 Nerve Root

Known as classic sciatica.
Pain in the buttock, back of the calf, and side of the foot.
Fatigue in the buttock and foot muscles.
Difficulty and discomfort raising the heel off the ground or walking on tiptoes.
Loss of sensation in the foot’s outer side, including the third, fourth, and fifth toes.
Reduced ankle-jerk reflex.

Chiropractic Care

Chiropractic care can directly address the root cause of the problem, treat the cause, and alleviate the symptoms. Chiropractic manipulation is recommended by the American College of Physicians as a first line of treatment for back pain before medication, muscle relaxants, injections, and surgery. Treatments to address sciatic nerve impingement:

Ice/Cold Therapy

Reduces inflammation and swelling.
Prepares the patient for massage and adjustments.

Therapeutic Tissue Massage

This therapy promotes muscle relaxation and lessens the muscle spasm/recoil response.

Ultrasound

Soothing heat created by sound waves penetrates the muscles, increases circulation, and relaxes the muscles to alleviate spasms, stiffness, and pain.

Transcutaneous Electrical Nerve Stimulation/Tens Unit

A muscle stimulation machine applies electrical impulses to relax the muscles and untangle muscle knots.

Spinal Manipulation

This process realigns the spine to move properly and restores vertebral health.

Stretches and Exercises

This ensures treatment will last once treatment has or is coming to an end.

Spinal Decompression

Pulls and stretches the body to release any compression on the nerve roots and infuse circulation back into the discs.

The pressure is taken off the sciatic nerve, and routine adjustments will retrain the muscles to maintain their re-alignment. The duration of treatment will vary based on the root cause of sciatica. Each treatment plan is tailored to the individual patient’s situation.

Severe and Complex Sciatica Syndromes

References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/

Hernández C.P., Sanchez N., Navarro-Siguero A., Saldaña M.T. (2013) What is Sciatica and Radicular Pain?. In: Laroche F., Perrot S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. doi.org/10.1007/978-1-907673-56-6_1

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Ngnitewe Massa R, Mesfin FB. Herniation, Disc. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441822/

Ombregt L. The dural concept. In: A System of Orthopaedic Medicine. Elsevier; 2013:447-472.e4. doi:10.1016/b978-0-7020-3145-8.00033-8

Witenko, Corey, et al. “Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low-back pain.” P & T : a peer-reviewed journal for formulary management vol. 39,6 (2014): 427-35.

Wright R, Inbody SB. Radiculopathy and Degenerative Spine Disease. In: Neurology Secrets. Elsevier; 2010:121-130. doi:10.1016/b978-0-323-05712-7.00007-6

Trigger Points Associated With Levator Scapulae

Dr. Alex Jimenez

Table of Contents

Introduction

The muscles in the body help provide motion and protect the skeletal joints from harm. Each muscle group has ligaments, tissues, and muscle fibers that retract, stretch, and contract the body while helping the host to do everyday movements, breath, digest food, stabilize, and even rest. When a person is dealing with pain from a traumatic event or making repetitive motions, it can affect the muscles over time. Factors like not drinking enough water, constantly looking down on the phones, and being hunched over can cause strain on the muscles, causing overlapping pain on top of other chronic issues that may develop. When the muscles begin to cause pain along the shoulders and neck, it can become a risk of developing trigger points in the levator scapulae muscles. Today’s article examines the levator scapulae muscles, how trigger points affect these muscles, and how treatments can help manage the trigger points on the levator scapulae muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points associated with the neck and shoulders affecting the levator scapulae muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Levator Scapulae?

Have you been dealing with pain along the neck or shoulders? Do you feel stiffness when turning your head from side to side? Or do you feel tenderness in the base of your neck and shoulders? Many individuals with shoulder and neck pain risk developing trigger points along the levator scapulae. The levator scapulae muscles originate from the posterior tubercles of the C1 through C4 vertebrae in the neck that is between the superior angle and the root of the scapulae spine. This superficial muscle’s primary function is to elevate the scapulae or the shoulder blades while working together with the trapezius and rhomboid muscles to assist the movement. The levator scapulae muscles also assist in providing neck extension, ipsilateral rotation, and lateral flexion. When pathologies like fibromyalgia, levator scapulae syndrome, or cervical myofascial pain begin to affect the levator scapulae muscles, the symptoms can potentially involve the shoulders and neck to cause referred pain to the upper extremities.

How Trigger Points Affect The Levator Scapulae?

Many individuals with shoulder and neck pain have described radiating pain from their neck to their shoulders. Known as referred pain, the pain is located in one area of the body but in a different location. Studies reveal that when pain radiates from the neck and shoulders, any movements that are overstretching the levator scapulae can aggravate overlapping symptoms on the affected side. This allows small nodules to form along the levator scapulae muscle fibers, causing trigger points to affect the shoulder and neck muscles.

Trigger point associated with the levator scapulae muscles causes the individual to have pain-like symptoms in the neck that causes muscle stiffness. This causes an emphasis on referred pain symptoms from the levator scapulae, like neck tension and restriction of range of motion on the neck. Studies reveal that pain over the superior angle of the levator scapulae is a common musculoskeletal disorder that is often accompanied by radiating pain on the neck, head, and shoulders. Some of the ways that trigger points form along the levator scapulae muscle can be due to ordinary factors like:

Stress
Posture
Over-exercising
Upper respiratory infections

Some of these factors above can shorten the levator scapulae muscle and restrict muscle movement to provide a full range of motion for the head and neck to turn. To that point, treatments are available to help loosen up and stretch the levator scapulae muscles to allow rotation and flexion on the neck and shoulders.

Trigger Points Anatomy On The Levator Scapulae- Video

Levator Scapulae - Trigger Point Anatomy

Have you been dealing with stress that is affecting your neck and shoulders? Have you been dealing with neck stiffness when turning your head? Or have you been feeling muscle tenderness between the neck and shoulders? Some of these symptoms are associated with trigger points affecting the levator scapulae muscles between the neck and shoulder. The video above overviews common trigger points and how they affect the levator scapulae, causing shoulder and neck pain. Since the levator scapulae muscles lay behind the trapezius muscle, studies reveal that trigger points or myofascial pain syndrome can cause hyperirritability in the muscle tissues and affect mobility functions in the nerve ends. Even though referred pain affects the neck and shoulder of the body, treatments are available to manage trigger points on the levator scapulae and relieve neck and shoulder pain.

Treatments To Manage Trigger Points On The Levator Scapulae

When there is trigger point pain affecting the levator scapulae, some common complaints that many individuals often complain about are neck and shoulder pain. However, various ways can alleviate the pain symptoms from the neck and shoulders while managing trigger points associated with the levator scapulae. Studies reveal that stretching the levator scapulae muscle in a seated position can improve muscle length along the levator scapulae and the cervical range of motion. Stretching the levator scapulae muscle can help reduce the pain along the levator muscle. To that point, it even helps reduce muscle imbalances and movement dysfunction along the cervical joints. Many individuals are referred to pain specialists like chiropractors by their doctors to reduce pain and functionality disability in the neck and realign the spine to loosen up the stiff muscles caused by subluxation. Realigning the cervical spine and stretching can reduce future trigger points and reduce pain symptoms from affecting the muscle.

Conclusion

The levator scapulae muscles in the body provide movement functionality to the neck and shoulders. The levator scapulae work together with the trapezius and rhomboid muscles to elevate the shoulder blades and assist with neck extension, ipsilateral rotation, and lateral flexion. When pathologies affect the levator scapulae muscles, they can develop trigger point pain along the muscle and cause neck and shoulder pain. The factors that cause trigger point pain can either be ordinary or traumatic and cause referred pain to the neck and shoulders. Fortunately, treatments like stretching and adjustments can help reduce the pain and loosen up stiff muscles along the levator scapulae. This will allow a cervical range of motion back to the neck and shoulder and elongate the levator scapulae.

References

Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.

Henry, James P, and Sunil Munakomi. “Anatomy, Head and Neck, Levator Scapulae Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK553120/.

Jeong , Hyo-Jung, et al. “Stretching Position Can Affect Levator Scapular Muscle Activity, Length, and Cervical Range of Motion in People with a Shortened Levator Scapulae.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, 4 Apr. 2017, pubmed.ncbi.nlm.nih.gov/28578252/.

Kulow, Charlotte, et al. “Levator Scapulae and Rhomboid Minor Are United.” Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft, U.S. National Library of Medicine, Aug. 2022, pubmed.ncbi.nlm.nih.gov/35367623/.

Menachen, A, et al. “Levator Scapulae Syndrome: An Anatomic-Clinical Study.” Bulletin (Hospital for Joint Diseases (New York, N.Y.)), U.S. National Library of Medicine, 1993, pubmed.ncbi.nlm.nih.gov/8374486/.

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Yogurt and Gut Health: Functional Sciatica Clinic

Dr. Alex Jimenez

Happy healthy young woman enjoying yogurt — Happy healthy young woman enjoying a tub of fresh yogurt in the kitchen smiling as she looks aside in a low angle view

Yogurt is a dairy product made by the bacterial fermentation of milk. The bacteria used are called yogurt cultures, which ferment lactose, which is the natural sugar found in milk. This process produces lactic acid that causes milk proteins to curdle, giving yogurt its flavor and texture. It can be made from all types of milk. Although research is ongoing, the benefits of adding yogurt to one’s nutrition plan can improve overall health, including improved bone health, circulation, immune system function, and probiotics/healthy bacteria that improve digestion and gut health.

Table of Contents

Health Benefits

Yogurt comes from milk that varies; some are made from skim and fat-free, whereas whole milk is full-fat. Other nutrients include calcium, vitamin B-2, vitamin B-12, potassium, and magnesium. More research is needed, but there is some evidence that active cultures can help certain gastrointestinal conditions, including:

Constipation
Diarrhea
Inflammatory bowel disease
Lactose intolerance
H. pylori infection
Colon cancer

The benefits are thought to be due to the:

Changes in the microbiota of the gut.
The faster time food takes to circulate through the bowels.
Immune system improvement.

Feel Fuller

Yogurt is rich in protein and healthy fats, which makes it very filling. Both of these nutrients are key to feeling full for longer. A study found consuming high-protein Greek yogurt in the afternoon resulted in less hunger, increased fullness and delayed the need to eat before dinner.

Probiotics

Look for brands that say living cultures or contain active cultures.
Probiotics help regulate bowel movements, combat infections, and restore balance to the digestive system.
Different cultures are thought to have various benefits.

Choosing Options

Look for yogurts that are unflavored and low or no sugar.
Yogurt naturally contains about six to eight grams of sugar
Add toppings and fruit for flavor and sweetness.

Use in Recipes

Yogurt can be used as a substitute ingredient in a variety of recipes.
Plain yogurt can substitute for sour cream.
It can replace the fat, oil, and/or butter in muffin, brownie, or cake recipes.

Speak with a nutritionist and health coach to find out if yogurt would be beneficial. Nutritionists work with individuals to find the best foods for their body type, age, and health condition, explain how different foods impact the body, and what foods to avoid.

Functional Nutrition

References

Andoh, Akira. “Physiological Role of Gut Microbiota for Maintaining Human Health.” Digestion vol. 93,3 (2016): 176-81. doi:10.1159/000444066

Bull, Matthew J, and Nigel T Plummer. “Part 1: The Human Gut Microbiome in Health and Disease.” Integrative medicine (Encinitas, Calif.) vol. 13,6 (2014): 17-22.

Cleveland Clinic: “Which Yogurt is Right For You?” “Why — and When — You Should Include Probiotics in Your Diet.”

Jandhyala, Sai Manasa, et al. “Role of the normal gut microbiota.” World journal of gastroenterology vol. 21,29 (2015): 8787-803. doi:10.3748/wjg.v21.i29.8787

Le Roy, C.I., Kurilshikov, A., Leeming, E.R. et al. Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome. BMC Microbiol 22, 39 (2022). doi.org/10.1186/s12866-021-02364-2

Wu, Hsin-Jung, and Eric Wu. “The role of gut microbiota in immune homeostasis and autoimmunity.” Gut microbes vol. 3,1 (2012): 4-14. doi:10.4161/gmic.19320

Trigger Points Affect Posterior Cervical Muscles

Dr. Alex Jimenez

Table of Contents

Introduction

The cervical spine has a casual relationship with the central nervous system as the brain and spinal cord works together to send neuron signals through the nerve pathways spread throughout the entire body. The cervical spine is part of the neck, where ligaments and muscles encompass the cervical joints to stabilize the head, neck, and shoulders. The neck has various muscles that support the head and can succumb to various injuries that can cause muscle strain and other associated symptoms that can affect the upper extremities of the body. Today’s article looks at the posterior cervical muscles, how trigger points affect the posterior cervical muscles, and how non-invasive treatments can help manage myofascial cervical pain. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with the neck affecting the posterior cervical muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Are The Posterior Cervical Muscles?

Have you been experiencing random headaches that affect your day? Do you feel any tension in your neck? Or do you experience stiffness and limited mobility when turning your neck? Most of these symptoms are associated with trigger pain affecting the posterior cervical muscle on the neck. The posterior cervical muscles function in the neck’s anatomic region while protecting the cervical spine. The muscles in the cervical spine form a triangle on the neck while providing functionality and movement to the neck, the head, shoulder, and upper back. Some of the muscles that work together with the cervical spine include:

Levator scapulae
SCM (Sternocleidomastiod)
Trapezius
Erector spinae
Deep cervical flexors
Suboccipitals
Semispinalis
Splenius

These muscles and soft tissues provide stability to the neck and work together with the tendons and ligaments to rotate, extend, and retract the head, neck, shoulders, and upper back. To that point, if the neck muscles become strained, it can lead to various issues that can cause pain to the neck and cervical spine.

How Trigger Points Affect The Posterior Cervical Muscles

Studies reveal that a musculoskeletal disorder known as cervical myofascial pain causes the surrounding muscles in the neck and shoulder regions to become tender to the touch and evoke pain in different areas of the body. When the posterior cervical muscle has become strained from various issues like poor posture, over-exercising, getting involved in an auto accident, or have suffered from a degenerative condition, it can cause the muscles to be overused, hypersensitive, and stiff while potentially being at risk of developing trigger points along the neck and shoulder muscles. Trigger points are a bit problematic as they are associated with referred pain and can be either latent or active as they create tiny nodules along the taut muscle fibers in the area. Research studies reveal that referred pain from cervical myofascial pain can be elicited by active trigger points on the affected muscle. To that point, the active trigger points can mimic other pain symptoms along the upper extremities, making diagnosing myofascial pain challenging. Thankfully there are ways to manage trigger point pain associated with the posterior cervical muscles along the neck and cervical spine.

Exercises For Neck & Shoulder Pain-Video

#012 Exercises for neck and shoulder pain caused by trigger points of myofascial pain syndrome

Have you been experiencing stiffness along the sides of your neck or on your shoulders? Do headaches make it impossible to get through an entire day? Or have you been feeling tightness along your jawline? Many people with neck pain and its associated symptoms could risk developing myofascial trigger pain along the posterior cervical muscles. Having myofascial trigger pain associated with the posterior cervical muscle and affecting the neck and upper extremities can cause many people to be miserable; however, there are many ways that people can utilize to relieve the pain along the posterior cervical muscles and manage myofascial cervical pain associated with the neck. The video above provides various neck and shoulder pain exercises correlating with myofascial trigger points. To that point, finding non-invasive available treatments to manage myofascial cervical pain can help reduce the effects of pain along the neck and posterior cervical muscles.

Non-Invasive Treatments To Manage Myofascial Cervical Pain

Many people suffer from neck pain associated with myofascial cervical pain; many factors can contribute to developing tiny nodules along the posterior muscles. Studies reveal that activities, whether work-related or for entertainment, can yield repetitive stress on the muscle groups that cause chronic tension in the muscle fibers to form trigger points. To that point, myofascial trigger pain causes the taut muscle bands to be hyper-sensitive and affect the muscle area. Many people suffering from myofascial trigger pain can utilize non-invasive treatments to manage myofascial pain associated with the posterior cervical muscle. Some of the treatments that help manage myofascial cervical pain include:

Acupuncture
Trigger point release therapy
Chiropractic care
Heat therapy
Exercise/stretching

Many of these treatments help release the trigger points from the affected muscles and help prevent them from re-occurring on the affected muscles along the upper extremities.

Conclusion

The neck has many muscles, ligaments, and tissues that help support the upper extremities of the body. When issues begin to affect the functionality of the neck muscles, it can lead to the development of myofascial trigger pain in the posterior cervical muscles along the neck to cause painful symptoms. This can lead to overlapping chronic issues like stiffness and tenderness in the upper extremities. Non-invasive treatments can help alleviate the pain and manage the symptoms caused by myofascial cervical pain in the upper extremities of the body. This allows the affected muscle to return to its functionality and prevents future issues from affecting the body.

References

Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.

Fernández-de-Las-Peñas, César, et al. “The Role of Myofascial Trigger Points in Musculoskeletal Pain Syndromes of the Head and Neck.” Current Pain and Headache Reports, U.S. National Library of Medicine, Oct. 2007, pubmed.ncbi.nlm.nih.gov/17894927/.

Stathakios, James, and Michael A Carron. “Anatomy, Head and Neck, Posterior Cervical Region.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 July 2021, www.ncbi.nlm.nih.gov/books/NBK551521/.

Touma, Jeffrey, et al. “Cervical Myofascial Pain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK507825/.

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Misaligned Uneven Shoulders Chiropractic Sciatica Clinic

Dr. Alex Jimenez

Pleasant physiotherapy procedure in a rehabilitation center — Pleasant physiotherapy procedure in a military rehabilitation center, a friendly doctor conducts session to a military patient with modern apparatus

When the body is correctly aligned, the shoulders are the same height, and face forward. Uneven shoulders are when one shoulder begins to raise higher than the other. It usually starts with a slight difference but can turn into a more severe imbalance causing discomfort, tightness, and pain in the neck, shoulders, hips, and back. Chiropractic treatment can bring the body back into balance and alignment through various techniques and therapy modalities.

Table of Contents

Misaligned Uneven Shoulders

Several factors can lead to uneven shoulders. Misalignments can be caused by:

Often the shoulder on the dominant side tends to be slightly lower.
Constantly using one hand or side for everything.
Carrying a heavy bag on the dominant shoulder.
Structural issues or muscular skeletal imbalances in other areas of the body.

For example, if the ankle or hip gets injured, it can cause an individual to bring their body out of alignment to adjust to how they position themselves and move. Other common causes include:

Overuse of the shoulders
Tight upper back muscles
Unhealthy posture
Uneven hips
Pinched nerve
Weak muscles
Flat feet
Sedentary lifestyle
Varying leg length
Osteoporosis
Scoliosis
Shoulder injuries
Incorrect sleeping position or sleeping on one side
Sports like tennis, golf, and baseball have an increased risk of causing misaligned, uneven shoulders and posture imbalances.

Symptoms

Uneven shoulders can result in discomfort, tightness, and stiffness in the neck, shoulders, and lower back.

Continued tightness and pulling in the higher shoulder.
Rounded shoulders
Headaches
Head misalignment
Hip misalignment
Shifting pelvis
Bursitis
Tendonitis

Chiropractor

A chiropractic massage and functional medicine team will bring the shoulders back into normal alignment.

Therapeutic myofascial release massage will release tension, relax the muscles, and increase flexibility.
Chiropractic adjustments
Spinal decompression therapy
Stretches and muscle-building exercises to balance the shoulders.
Lifestyle adjustment instructions for switching shoulders when carrying bags, using armrests, using the phone, using a mouse, and using ergonomic chairs.
Posture training includes learning to stay aware of one’s posture throughout the day when standing or sitting and completing regular activities.
Learning to use the non-dominant arm to balance the workload.
Incorporating relaxation, meditation, and breathing techniques to relieve stress, tension, and tightness.

Shoulder Pain Treatment

References

Burbank, Kelton M et al. “Chronic shoulder pain: part I. Evaluation and diagnosis.” American family physician vol. 77,4 (2008): 453-60.

Foroozan Mahmoodi et al. The effect of corrective exercises on the pain and degree of uneven shoulder deformity rsr.basu.ac.ir/article_625_en.html

Mayo Clinic Staff. (2017). Stress management. mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

Mitchell, Caroline, et al. “Shoulder pain: diagnosis and management in primary care.” BMJ (Clinical research ed.) vol. 331,7525 (2005): 1124-8. doi:10.1136/bmj.331.7525.1124

Pu Chu, Eric Chun, and Kevin Hsu Kai Huang. “Bridging the gap between observation and brace treatment for adolescent idiopathic scoliosis.” Journal of family medicine and primary care vol. 6,2 (2017): 447-449. doi:10.4103/jfmpc.jfmpc_52_17

Trigger Points Affecting The Neck & Splenius Muscles

Dr. Alex Jimenez

Table of Contents

Introduction

The neck is the connector to the head and shoulders, allowing mobility and functionality to stabilize the head from dropping down. The neck is also part of the cervical spine, where many neuron pathways, ligaments, and muscles work with the central nervous system to provide sensory-motor signals to the brain. The neck muscles also work together with the shoulder and upper back muscles to function for the upper extremities. These are known as the splenius muscles and help support the cervical spine. However, like all muscles in the body, the neck can succumb to traumatic injuries or common factors that can cause the neck muscles to be overused, injured, and strained to cause the nerves to send out disruptive signals to the brain and issues to develop. Today’s article looks at the splenius muscles on the neck, how trigger points affect the splenius muscles, and how to manage neck pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with neck pain affecting the splenius muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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The Splenius Muscles On The Neck

Have you been experiencing muscle pain in your neck? What about feeling tightness on the sides of your neck when you move your head from side to side? Or do random headaches seem to pop out of nowhere and affect your day? Most of these symptoms are associated with neck pain affecting the splenius muscles and can cause overlapping issues affecting the neck and the upper back. The splenius muscles are split into two muscle groups: the splenius capitis and the splenius cervicis. Both of the splenius muscles each have a job for neck functionality. The splenius capitis provides rotation and extension to the head, while the splenius cervicis provides rotation and extends to the cervical spine. The splenius capitis fibers are connected with the SCM (sternocleidomastoid) muscles that help move the head. The splenius cervicis encompasses the upper three cervical vertebrae and attach their muscle fibers to scapulae muscles. Even though these two muscles offer different functions, they could potentially be involved in injuries that can cause neck and upper back issues.

How Trigger Points Affect The Splenius Muscles

One of the most common complaints many people seem to be impacted is shoulder and neck pain. Various factors can cause an impact on the shoulders and neck due to overusing the splenius muscles connected to the neck and shoulders and developing trigger points associated with the splenius muscles. Studies reveal that trigger points or myofascial pain can make the splenius muscles hypersensitive and tender along the taut band of the splenius muscles. To that point, the splenius muscles become palpable and produce localized pain to other structures along the neck, shoulders, and head. Trigger points are a bit complex to diagnose because they mimic other chronic issues that affect the body and potentially involve many common symptoms that could happen daily. Studies reveal that common symptoms like headaches are associated with trigger points along the head, neck, and shoulder muscles. Since trigger points are challenging to diagnose, they can make the taut band of the musculoskeletal fibers and become either active or latent when pressure is on the affected area. To that point, causes tension occurs in the body’s head, neck, and shoulders. Fortunately, various ways to manage trigger point pain are associated with neck pain along the splenius muscles.

Trigger Points & Splenius Muscles- Video

Splenius Cervicis - Trigger Point of the Week

Have you been dealing with random headaches that randomly occur throughout the day? What about experiencing muscle stiffness and tenderness located on your neck and shoulders? Or have you been experiencing poor sleep throughout the night? Most of these symptoms are associated with trigger point pain associated with neck pain along the splenius muscles. The video above explains how trigger points affect the splenius muscles and some of the causes that lead to the development of trigger point pain along the splenius muscles. Many people dealing with trigger points associated with neck pain often explain to their doctors that they have been feeling muscle stiffness along their neck, causing limited mobility. Studies reveal that active myofascial trigger points along the neck and shoulder muscles elicited referred pain to contribute to symptoms of pain intensity, disability, and poor sleep quality to mechanical neck pain. To that point, many individuals try to incorporate various treatments to alleviate the symptoms and manage neck pain associated with trigger points.

Managing Neck Pain Associated With Trigger Points

Many people dealing with neck pain associated with trigger points along the splenius muscles often don’t realize that some causes affect how the muscles are used. Ordinary factors like poor posture, looking down at the phones, or leaning closer to any screens can cause strain on the splenius muscles. In contrast, traumatic factors like whiplash or auto accidents can inflict pain on the muscle fibers. Various ways to manage neck pain associated with trigger points are non-invasive unless the pain is severe. When a person goes to their primary doctor for a routine check-up, they describe the symptoms of pain affecting their bodies while the doctor examines them. Once the issue is diagnosed, many doctors will refer their patients to a pain specialist specializing in the matter. So say if a person is dealing with neck pain associated with trigger point pain along their splenius muscles that is causing them headaches, would be referred to a pain specialist like a chiropractor to relieve myofascial trigger pain along the splenius muscles that are suffering from spinal subluxation in the musculoskeletal system. Spinal adjustments allow the stiff muscles to become loose and even break up the adhesion of the trigger points on the muscle. Incorporating chiropractic care to treat neck pain associated with trigger points can bring back functionality to the body.

Conclusion

The neck allows the head to be mobile and help keeps it stable. As part of the cervical spine, the neck has many neuron pathways, ligaments, and muscles that work with the central nervous system to provide sensory-motor function. The muscles that provide functionality to the shoulders, neck, and upper back are called the splenius muscles. The splenius muscles consist of two groups: the capitis and cervicis, which have different jobs for neck functionality. However, like any muscle in the body may potentially be impacted by various issues that can cause neck and upper back issues. Common and traumatic issues can lead to the development of myofascial trigger pain along the neck muscles. To that point causes neck pain and disability to the neck. When this happens, various treatments are available to manage neck pain associated with myofascial pain and alleviate the symptoms, causing relief to the neck.

References

Chatchawan, Uraiwan, et al. “Characteristics and Distributions of Myofascial Trigger Points in Individuals with Chronic Tension-Type Headaches.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Apr. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6451952/.

Henson, Brandi, et al. “Anatomy, Back, Muscles – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537074/.

Muñoz-Muñoz , Sonsoles, et al. “Myofascial Trigger Points, Pain, Disability, and Sleep Quality in Individuals with Mechanical Neck Pain.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Oct. 2012, pubmed.ncbi.nlm.nih.gov/23158466/.

Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.

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Damaged, Injured Nerve Roots Sciatica Clinic

Dr. Alex Jimenez

Woman physiotherapist massaging male patient back in clinic — African American man lying on massage table and receiving therapeutic rehabilitation massage in physical therapy center

Spinal nerves send motor, sensory, and autonomic signals between the central nervous system and the body and are part of the peripheral nervous system. They are essential for carrying information that controls body movements and sensations to the brain. When a nerve gets injured, compressed, or damaged, it can cause discomfort, increased sensitivity, numbness, muscle weakness, and pain.

Table of Contents

Damaged Nerve Roots

Nerve root pain is often caused by other underlying conditions that have caused compression or damage to the nerve root. Causes of nerve root pain can include:

Herniated discs
Spinal injury
Spinal stenosis
Arthritis
Spondylosis
Spinal infection
Bone spurs
Inflammatory disease
Spinal tumors
Spinal cysts

Spinal nerves impacted by injuries or infection can lose their ability to control the body areas, lose their functional capacity, lose sensation, and die.

Spinal Imaging

Nerve damage can be diagnosed on a neurological exam and correlated with MRI and X-ray imaging. Conditions that MRI can identify include herniated discs, spinal cord compression or fracture, arthritic development, tumors, or cysts pressing on a nerve.

MRI images are obtained with a magnetic field and radio waves.
MRI shows spine images from the side/sagittal view and cross-sectional/axial views.
This allows the chiropractic doctor to see the vertebrae and discs and identify abnormalities.
The spinal cord is a gray area in the middle surrounded by the spinal fluid, which appears white.
Little white channels on either side of the spinal cord are where the nerve roots branch off.
X-rays can show the alignment of the bones along the spine and determine any narrowing or damage to the discs.

It is important to be evaluated and diagnosed for signs and symptoms of nerve injury as soon as possible, as nerve damage accelerates and worsens.

Function Restoration

Sometimes, the symptoms improve by themselves and do not require treatment. Nonetheless, physicians begin with conservative, non-surgical approaches to treat nerve root pain. Chiropractic and physical massage therapy involves specific movements, stretches, and exercises to keep the affected muscles and joints active, prevent stiffness and help restore function and feeling. Treatment can include:

Therapeutic massage
Manual adjustment/resistance treatment
Trigger point therapy
Instrument-assisted soft tissue therapy
Decompression
Traction
Joint stretching
Electrical stimulation
Ultrasound
Specialized exercise
Activity modification
Anti-inflammatory diet

Nerve Chiropractor

References

Liu, Yan, and Huan Wang. “Peripheral nerve injury-induced changes in the spinal cord and strategies to counteract/enhance the changes to promote nerve regeneration.” Neural regeneration research vol. 15,2 (2020): 189-198. doi:10.4103/1673-5374.265540

Menorca, Ron M G, et al. “Nerve physiology: mechanisms of injury and recovery.” Hand clinics vol. 29,3 (2013): 317-30. doi:10.1016/j.hcl.2013.04.002

Shehab, Safa Al-Deen Saudi. “Fifth lumbar spinal nerve injury causes neurochemical changes in corresponding and adjacent spinal segments: a possible mechanism underlying neuropathic pain.” Journal of chemical neuroanatomy vol. 55 (2014): 38-50. doi:10.1016/j.jchemneu.2013.12.002

Stoll, G, and H W Müller. “Nerve injury, axonal degeneration, and neural regeneration: basic insights.” Brain pathology (Zurich, Switzerland) vol. 9,2 (1999): 313-25. doi:10.1111/j.1750-3639.1999.tb00229.x

Ye, Xuan, et al. “Nerve fascicle transfer using a part of the C-7 nerve for spinal accessory nerve injury.” Journal of neurosurgery. Spine vol. 28,5 (2018): 555-561. doi:10.3171/2017.8.SPINE17582

Myofascial Trigger Pain On The Occipitofrontalis Muscle

Dr. Alex Jimenez

Table of Contents

Introduction

Having headaches can affect anyone at any time, and various issues (both underlying and non-underlying) can play a part in the development. Factors like stress, allergies, traumatic events, or anxiety can trigger the causes of headaches to develop and can affect a person’s day-to-day schedule. Headaches can come in various forms and be the cause or symptom of other conditions. Many complain about headaches affecting their forehead, where the occipitofrontalis muscle resides, and explain to their doctors about a dull ache affecting them. To that point, the cause of the headache could affect them differently. Today’s article examines the occipitofrontalis muscle, how myofascial trigger pain affects this muscle, and ways to manage myofascial trigger pain associated with headaches. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from myofascial trigger pain associated with headache symptoms affecting the occipitofrontalis muscle. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Occipitofrontalis Muscle?

Have you been experiencing unexplainable headaches that seem to affect your daily life? Do you feel muscle tension in your head or neck? Or do certain areas in your upper body seem tender to the touch? Many individuals suffer from headaches, and it could be due to myofascial trigger pain associated with the occipitofrontalis muscle. The occipitofrontalis muscle surprisingly plays an important part in the facial muscles. The occipitofrontalis muscle is the only muscle that can raise eyebrows, convey emotions, and provide non-verbal communication as part of its functionality to the head. The occipitofrontalis muscle has two different sections in the head that play different roles. Studies reveal that the occipital and frontal bellies have other actions but work together despite being connected to the galea aponeurotica. However, like all muscles in different body sections, various factors can affect the muscles to become tender and form multiple symptoms associated with pain.

How Does Myofascial Trigger Pain Affect The Occipitofrontalis?

When various factors begin to affect the occipitofrontalis muscle, it could potentially be at risk of developing myofascial trigger pain associated with headaches in the muscle. Studies reveal that myofascial trigger pain is a musculoskeletal disorder associated with muscle pain and tenderness that can be identified as latent or active. When the occipitofrontalis is affected by myofascial pain, it could potentially lead to tension-type headaches as a symptom. Studies reveal that headaches, especially tension headaches, are associated with trigger points in the head and neck muscles. Myofascial pain occurs when the muscles become overused and sensitive to the touch. The affected muscle then develops small nodules along the muscle fibers and can cause referred pain in a different body section. To that point, the affected muscle becomes hypersensitive due to an excess of nociceptive inputs from the peripheral nervous system, thus eliciting referred pain or muscle contraction. When this happens to the individual, they experience constant, throbbing pain in their forehead and try to find relief to diminish the pain.

Myofascial Exercises For Headaches-Video

Myofascial Exercises for Headaches & Migraines

Have you been feeling tension and pain in your neck or head? Do headaches seem to affect your daily activities? Does the slightest pressure seem to cause you pain in your muscles? Experiencing these symptoms may be a sign that you may have myofascial trigger pain associated with the head and neck that is causing headache-like pain along the occipitofrontalis muscle. The video above demonstrates various stretching exercises for headaches and migraines associated with myofascial trigger pain. Myofascial trigger pain associated with headaches can cause overlapping issues in the upper extremities of the body since myofascial trigger pain can mimic other conditions that affect the head and neck muscles. Known as referred pain, the underlying cause of pain affects a different body part than the actual location. Luckily, there are ways to manage myofascial trigger pain associated with headaches along the occipitofrontalis muscle.

How To Manage Myofascial Trigger Pain Associated With Headaches

There are many ways to manage headache symptoms associated with myofascial trigger pain along the occipitofrontalis muscle. Many people will take over-the-counter medicine to dull the pain, while others use a cold/hot pack to be placed on their forehead to relieve the tension caused by the headache. Those experiencing trigger point pain along the affected muscles that are not responding to the at-home treatments will go to a specialist that uses various techniques to manage myofascial trigger pain associated with headaches. Studies reveal that manual trigger point therapies for the head and neck may reduce the frequency, intensity, and duration of various headaches affecting the occipitofrontalis muscle. Other treatments that help manage myofascial pain associated with the occipitofrontal muscle include:

Chiropractic care: Spinal misalignment or spinal subluxation in the cervical spine can potentially lead to the development of myofascial trigger pain associated with muscle pain
Acupuncture: Dry needles are placed on the trigger points associated with the affected muscle to relieve pain
Hot/cold compress: Ice or heat packs are placed on the affected muscle to relieve tension.
Massage therapy: Deep tissue massage can relieve the inflamed area, reduce pain, and prevent trigger points from reemerging.

Utilizing these treatments can help prevent myofascial pain and manage headache symptoms associated with the muscle.

Conclusion

Headaches can affect anyone, and various issues can affect their development. Whether it is an underlying or non-underlying cause, multiple problems can trigger a headache to form and cause a dull ache in the affected muscle. One of the most common forms of headaches occurs in the occipitofrontalis muscle located in the forehead and near the base of the skull. The occipitofrontalis muscle is the only muscle that controls eyebrow movement, conveys emotions, and provides non-verbal communication as part of head functionality. However, like all muscles, the occipitofrontalis can become affected and potentially risk developing myofascial trigger pain. When this happens, the occipitofrontalis could develop tension-type headaches associated with myofascial trigger pain. Luckily available treatments are there to manage myofascial trigger pain associated with the occipitofrontalis muscle and alleviate headaches from the affected muscle.

References

Bérzin, F. “OCCIPITOFRONTALIS Muscle: Functional Analysis Revealed by Electromyography.” Electromyography and Clinical Neurophysiology, U.S. National Library of Medicine, 1989, pubmed.ncbi.nlm.nih.gov/2689156/.

Falsiroli Maistrello, Luca, et al. “Effectiveness of Trigger Point Manual Treatment on the Frequency, Intensity, and Duration of Attacks in Primary Headaches: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Frontiers in Neurology, Frontiers Media S.A., 24 Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5928320/.

Moraska, Albert F, et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.” American Journal of Physical Medicine & Rehabilitation, U.S. National Library of Medicine, Sept. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5561477/.

Pessino, Kenneth, et al. “Anatomy, Head and Neck, Frontalis Muscle – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 31 July 2021, www.ncbi.nlm.nih.gov/books/NBK557752/.

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Muscle Guarding After Strain or Injury Chiropractic Sciatica Clinic

Dr. Alex Jimenez

Woman doing exercises on simulator with rehabilitation specialist at the gym. Concept of physical therapy for strengthening and recovery. Idea of recovery after pregnancy

Individuals that have experienced a muscle strain, pull, spasm, etc., that has healed can begin to behave overly cautious, avoiding putting full weight on the area or using full motion out of fear of re-injuring it. This can and does strain other body areas because of the imbalance and awkward positioning. It also leads to anxiety, emotional distress, and decreased self-confidence in everyday movement. Adjustments, massage, and decompression therapy can maintain musculoskeletal health, and a chiropractor can help retrain individuals on healthy posture and confident movement.

Table of Contents

Muscle Guarding

Muscles can be held in a position of readiness to act, like the stress response of fight or flight. When this happens, the muscles are partially contracted in preparation for action and is a form of muscle-guarding. But once the fight or flight passes, the muscles relax into their normal position. With injury muscle guarding, the fears and stresses after recovering from an injury can cause the injured and non-injured muscles to stay in the guarded/semi-contracted position. The longer the muscle guarding continues, fatigue begins to set in, decreasing function, restricting mobility, and making the body more vulnerable to damage and injury.

The Brain

The discomfort, pain, or just the thought reinforces the need to guard the area. The brain will find a way to move without causing pain and create compensating but unhealthy movement patterns that strain the other areas of the body. The body adapts to not using the formerly injured muscles and now relies on the other muscles to perform the functions in a non-relaxed state that can become normal, causing stiffness, soreness, tenderness, tendon tension, and pain.

An example is a hip strain, pull or spasm that has been treated and has healed, but the individual is fearful of another injury or going through the painful experience again and begins walking by shifting all their weight to the other side and steps with a limp or some abnormal motion that strains and/or injures the rest of the body.

Chiropractic Treatment and Retraining

Individuals experiencing muscle guarding can find help through chiropractic to retrain their muscles to return to their normal position and regain confidence in their movements. The body will be rebalanced by releasing and relaxing the tight muscles. Then therapeutic repetitive movements, specialized exercises, stretches, and relaxation techniques will help the individual relearn to use the muscles without fear.

Protective Muscle Guarding

References

Hanlon, Shawn et al. “Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.” Journal of athletic training vol. 51,2 (2016): 111-7. doi:10.4085/1062-6050-51.3.06

Olugbade, Temitayo et al. “The relationship between guarding, pain, and emotion.” Pain reports vol. 4,4 e770. 22 Jul. 2019, doi:10.1097/PR9.0000000000000770

Prkachin, Kenneth M et al. “Pain behavior and the development of pain-related disability: the importance of guarding.” The Clinical journal of pain vol. 23,3 (2007): 270-7. doi:10.1097/AJP.0b013e3180308d28

Myofascial Trigger Pain On The Face

Dr. Alex Jimenez

Table of Contents

Introduction

Everyone in the world has various expressions that reflect how they are feeling. From being excited, worried, sad, angry, and disgusted, facial expressions defy people who they are, what they eat, and how they look. Each of the different muscles that make up the face has other jobs to work at the various locations of the upper extremities. The muscles on the forehead and near the eyes help people see while opening, closing, and raising their eyebrows. The muscles around the nose help take in air to breathe. The muscles located in the jaw help people chew food and speak. The neck muscles help support the head and provide mobility. All these muscles have specific jobs, and when issues affect the upper body extremities, they can potentially lead to different problems. When environmental factors like stress, anxiety, or depression begin to affect the body, it can also affect its facial features, causing unwanted symptoms to develop. Today’s article focuses on myofascial trigger pain on the face, the signs and symptoms associated with myofascial facial pain, and how to manage myofascial facial pain. We refer patients to certified providers who specialize in musculoskeletal and oral treatments to aid individuals suffering from myofascial trigger pain affecting their facial muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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How Does Myofascial Trigger Pain Affect The Face?

Have you been experiencing pain-like symptoms in your jaw? What about feeling constant pressure around your nose or cheeks? Do you feel tenderness in certain body areas around your face? Many of these symptoms you are experiencing could potentially involve myofascial trigger pain affecting the facial muscles. Having myofascial trigger pain in the upper extremities of the body can be challenging, as studies reveal that myofascial pain syndrome is a muscular pain disorder that is often misunderstood as it involves referred pain from small, tender trigger pain within the muscle fibers causing pain in different locations of the body than the actual source. Myofascial trigger pain often mimics other chronic conditions that cause doctors to be confused when patients mention that they have been experiencing symptoms and it’s affecting their daily lives. For myofascial trigger pain affecting the face, studies reveal that facial pain associated with myofascial trigger pain can be classified in various ways that affect the nasal, orbital, and oral cavities, the temporomandibular joint, and the sinuses from underlying pathologies. Myofascial pain correlating with the face can have many trigger points that can make a person feel miserable and affect their daily lives.

Signs & Symptoms Associated Myofascial Facial Pain

Like the rest of the body, the face has numerous nerves that branched out from the brain in the central nervous system, providing sensory-motor functions to the muscles. The trigeminal nerves help give movement to the face, and when myofascial pain affects the facial regions, studies reveal that the causes can include:

Idiopathic factors
Trigeminal neuralgia
Dental problems
TMJ disorders
Cranial abnormalities
Infection
Acute muscle injury
Stress and anxiety

These signs are associated with myofascial facial pain due to common overlapping symptoms affecting each muscle around the face. Some of the symptoms related to myofascial facial pain include:

Tingling sensations
Throbbing pain
Headaches
Toothaches
Neck pain
Shoulder pain
Feeling stuffed up
Muscle tenderness

Chronic Facial Pain-Video

Have you been experiencing muscle tenderness in certain parts of your face? What about feeling stuffed up around the areas of your cheeks and nose? Or have you been feeling stiffness and pain along your jaw, neck, or shoulders? If you have been experiencing these pain symptoms, it could be facial pain associated with myofascial trigger pain. The video above overviews chronic facial pain and how it affects the head and neck. Research studies reveal that pain affecting the body for more than six months is considered chronic. Just like any other chronic pain symptoms in the body, chronic facial pain causes a neuropathic response to the central nervous system, making an injury hypersensitive and potentially involving associated symptoms from other chronic disorders. Myofascial dysfunction related to facial pain may become severe to activate trigger points along the facial muscle fibers, causing prickling sensations in the face. Luckily, there are available treatments for managing myofascial facial pain.

Management Of Myofascial Facial Pain

When managing myofascial pain associated with the face, many patients will go to their primary doctor and explain that they are experiencing pain and other symptoms that make them miserable. Doctors then examine the patient to see what is ailing them through a physical examination. Some doctors often utilize manual manipulation and other tools to diagnose that myofascial pain might be the cause. As stated earlier, myofascial pain associated with the face can be a bit complex as it can mimic other chronic conditions. Once the doctor diagnoses myofascial pain related to the face, they can refer their patients to pain specialists like chiropractors, physical therapists, physiatrists, and massage therapists to alleviate myofascial pain related to the face by examining where the causes are coming from. Pain specialists incorporate various techniques to relieve myofascial pain associated with the face:

Stretch & spray (Stretching the muscle and spraying a coolant spray to loosen tight muscles along the neck)
Putting pressure on the trigger point (This helps smooth out the affected muscle and fascia)
Gentle stretching exercises (Help strengthen the affected muscles)
Hot or cold compress (Helps relax the muscles and break up the adhesion from scar tissue)

Incorporating these treatments can help manage the symptoms associated with myofascial pain and can help alleviate muscle pain, thus preventing further issues from developing over time.

Conclusion

The facial muscles have specific jobs with different functions that help the body function properly. These jobs help various sections of the face by expressing how we feel, what we eat and taste, breath, and other jobs that define people. When issues begin to affect the upper extremities of the body, they can cause lead to different problems that affect the facial features of the face and cause unwanted symptoms to develop. This is known as myofascial pain and is often misunderstood,s since it can mimic other chronic conditions that affect the body. Different factors and symptoms associated with myofascial pain can become difficult to diagnose. Still, various techniques can help manage the symptoms over time to prevent further injuries from occurring on the face and the body.

References

Fricton, J R, et al. “Myofascial Pain Syndrome of the Head and Neck: A Review of Clinical Characteristics of 164 Patients.” Oral Surgery, Oral Medicine, and Oral Pathology, U.S. National Library of Medicine, Dec. 1985, pubmed.ncbi.nlm.nih.gov/3865133/.

Williams, Christopher G, et al. “Management of Chronic Facial Pain.” Craniomaxillofacial Trauma & Reconstruction, Thieme Medical Publishers, May 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3052669/.

Yoon, Seung Zhoo, et al. “A Case of Facial Myofascial Pain Syndrome Presenting as Trigeminal Neuralgia.” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, U.S. National Library of Medicine, 25 Dec. 2008, pubmed.ncbi.nlm.nih.gov/19111486/.

Zakrzewska, J M. “Differential Diagnosis of Facial Pain and Guidelines for Management.” Define_me, July 2013, www.bjanaesthesia.org/article/S0007-0912(17)32972-0/fulltext.

Zakrzewska, Joanna M, and Troels S Jensen. “History of Facial Pain Diagnosis.” Cephalalgia : an International Journal of Headache, SAGE Publications, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5458869/.

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Sports Exercise Headaches Sciatica Clinic Chiropractor

Dr. Alex Jimenez

Neck exercises. Woman is in health center getting help by doctor.

Sports exercise headaches are exertion headaches that involve pain during or immediately after sports, exercise, or some physical activity. They come on quickly but can last a few minutes, hours, or days. Activities associated with exercise headaches include running, weightlifting, tennis, swimming, and rowing. Chiropractic, massage, decompression, and traction therapies can realign the body and relax the muscles allowing for optimal circulation and certain strategies to help prevent future episodes. Usually, there is no underlying disease or disorder, but it is recommended to talk to a healthcare provider to make sure.

Table of Contents

Sports Exercise Headaches

When individuals exert their bodies intensely, they need added blood and oxygen, particularly with activities that involve tightening/tensing the abdominal muscles or increasing chest pressure. Doctors and scientists believe an exertional headache occurs when intense physical activity causes the veins and arteries to expand to circulate more blood. The expansion and increased blood circulation generate pressure in the skull that can cause pain.

Alternate Triggers

Exercising is not the only cause; other physical activities that can trigger an exertion headache include:

Sneezing
Coughing
Straining to use the bathroom
Sexual intercourse
Lifting or moving a heavy object

Symptoms

Symptoms of a sports exercise headache include:

Neck stiffness or pain
Pain on one or both sides of the head
Pulsating pain discomfort
Throbbing pain discomfort
Shoulder tightness, discomfort, and/or pain

Sometimes individuals report the headache can feel like a migraine that could include:

Vision problems like blind spots
Nausea
Vomiting
Light sensitivity

Most exercise headaches last five to 48 hours and can continue for three to six months.

Diagnosis

An underlying disease or disorder does not cause most exertional headaches. However, individuals experiencing severe or frequent headaches should consult their doctor or a healthcare provider. Tests will be ordered to rule out possible causes that include:

MRI will take computer-generated images of the brain.
Angiography examines the blood vessels, usually through a CTA, computed tomography, or an MRA or magnetic resonance angiography.
A spinal tap/lumbar puncture takes a sample of fluid from the spine for testing.

If there is no underlying cause found, the medical provider can diagnose exertion headaches if there have been at least two headaches that:

Were caused by exercise or physical activity.
Started during or after the physical activity.
Lasted less than 48 hours.

Chiropractic Treatment

According to the American Chiropractic Association, spinal adjustments are an effective headache treatment option. This includes migraines, tension headaches, or sports exercise headaches. Using the targeted approaches, chiropractic restores the body’s natural alignment to improve function and alleviate stress on the nervous system. This allows the body to operate at optimal levels reducing muscle stress and muscle tension.

DOC Decompression Table

References

American Migraine Foundation. Secondary Headaches. (americanmigrainefoundation.org/resource-library/secondary-headaches/) Accessed 11/17/2021.

Evans, Randolph W. “Sports and Headaches.” Headache vol. 58,3 (2018): 426-437. doi:10.1111/head.13263

International Headache Society. HIS Classification ICHD-3. (ichd-3.org/other-primary-headache-disorders/4-2-primary-exercise-headache/) Accessed 11/17/2021.

McCrory, P. “Headaches and exercise.” Sports medicine (Auckland, N.Z.) vol. 30,3 (2000): 221-9. doi:10.2165/00007256-200030030-00006

National Headache Foundation. Exertional Headaches. (headaches.org/2007/10/25/exertional-headaches/) Accessed 11/17/2021.

Ramadan, Nabih M. “Sports-related headache.” Current pain and headache reports vol. 8,4 (2004): 301-5. doi:10.1007/s11916-004-0012-1

Trotta K, Hyde J. Exercise-induced headaches: prevention, management, and treatment. (www.uspharmacist.com/article/exerciseinduced-headaches-prevention-management-and-treatment) U.S. Pharm. 2017;42(1):33-36. Accessed 11/17/2021.

What Is TMJ Dysfunction?

Dr. Alex Jimenez

Table of Contents

Introduction

The lower jaw of the body has the mastication muscles surrounding the mandible and provides functionality to the jaw through chewing, moving the lower jaw up, down, left, and right, and speaking. The jaw also has joints known as the temporomandibular joints that slide back and forth to provide movement also. The jaw is also home to the teeth and tongue, which play a role in the mouth by consuming and grinding food into smaller bites to travel down to the gut system. Just like every joint and muscle in the body, common issues or injuries can affect the jaw and cause pain symptoms associated with the problem. Sometimes normal wear and tear can affect the joints in the jaw, or traumatic events can affect the surrounding muscles causing soreness in the jaw area. If the issue involving the jaw is not treated over time, it can lead to chronic disorders and overlap with other chronic disorders that can affect the whole body and the jaw. One of the jaw disorders is TMJ dysfunction, which can cause overlapping symptoms in the jaw and the body. Today’s article examines what TMJ dysfunction is, the signs and symptoms, and ways to manage TMJ dysfunction in the jaw. We refer patients to certified providers who specialize in musculoskeletal and oral treatments to aid individuals suffering from TMJ dysfunction affecting their jaws. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is TMJ Dysfunction?

Have you been experiencing muscle pain in your neck, shoulders, and jaw? What about tenderness in your cheek when you lightly touched it? Or do you have difficulty chewing or moving your jaw when speaking? Many of these symptoms are signs that you could be experiencing TMJ dysfunction in your jaw. TMJ dysfunction, or temporomandibular dysfunction, is part of a group of orofacial pain conditions that affects the jaw joint and muscle, thus causing overlapping issues in the lower jaw. TMJ dysfunction also affects the mastication muscles that help move the jaw by making the muscles hyperactive and causing referred pain to the rest of the body. Studies reveal that about 25% of the population does get affected by TMJ dysfunction since it is a degenerative musculoskeletal condition associated with morphological and functional jaw deformities.

The Signs & Symptoms Of TMJ Dysfunction On The Jaw

TMJ dysfunction may potentially not only cause jaw pain but can also affect the neck and shoulders connected to the cervical spine. Studies reveal that TMJ dysfunction is correlated with neck disability, jaw dysfunction, and muscle tenderness in many individuals that suffer pain with or without TMJ dysfunction. TMJ dysfunction is associated with these issues because the jaw structures are affected by trigger points along the neck and jaw. To that point, TMJ dysfunction is often accompanied by back, joint, and abdominal pain. But how would TMJ dysfunction correlate with these pain issues? Studies reveal that disturbances in the upper body extremities may cause an increase in muscle tension associated with the whole-body imbalance that is potentially causing TMJ dysfunction. Some of the related symptoms of TMJ dysfunction in the jaw include:

Pain in neck and shoulders
The jaw becomes “locked” in an open or closed position
Headaches
Earaches
Muscle tenderness in the jaw
Having difficulty chewing
Swelling on the side of the face
Body imbalance

Exercises For TMJ Dysfunction- Video

TOP 3 EXERCISES FOR TMJ- Temporomandibular Joint Pain/Disorder

Have you been experiencing muscle tenderness in your jaw? What about having some difficulty chewing or speaking? Do you hear popping sounds when your open or close your mouth? Some of these symptoms are associated with a musculoskeletal jaw disorder known as TMJ (temporomandibular joint) dysfunction. The video above shows the top 3 exercises for TMJ dysfunction that can help alleviate pain from the jaw, face, or ear. TMJ dysfunction is a musculoskeletal disorder that affects the mastication muscles and causes referred pain to the neck, head, and ear. TMJ dysfunction is tricky to diagnose since trigger points associated with TMJ may also affect the teeth, causing tooth pain in the oral-facial region. This is known as somato-visceral, where the affected muscle correlates with the corresponding organ. Thankfully, there are ways to manage TMJ dysfunction and its associated symptoms.

Ways To Manage TMJ Dysfunction In The Jaw

Many people can use various ways to manage TMJ dysfunction in the jaw to alleviate the pain. Some non-surgical treatments that individuals can incorporate include:

Heat or cold pack applied to the side of the face
Gentle stretching exercises for the jaw
Eating soft foods
Wearing a night guard while sleeping

If the pain from TMJ dysfunction still affects the individual, therapies like chiropractic care can help manage the symptoms. Chiropractic care can effectively treat TMJ dysfunction, especially spinal subluxation or misalignment in the cervical region. Chiropractors will fully evaluate the patient’s temporomandibular joint and surrounding muscles, joints, and ligaments to identify the TMJ problem and the underlying causes. To that point, a chiropractor may suggest a range of treatments, which includes stretches and exercises to not only alleviate pain and stiffness in the jaw point but also to bring back balance to the body. This allows minimal rubbing and friction in the jaw joint.

Conclusion

Overall, TMJ dysfunction is a musculoskeletal jaw disorder that affects the mastication muscles and causes referred pain to different areas in the upper extremities of the body. Some of the symptoms of TMJ dysfunction can make it difficult for the jaw to open or close, causing pain, headaches, and muscle tenderness in the neck and shoulders. To that point, individuals suffering from TMJ dysfunction may potentially deal with pain-related symptoms. Various non-surgical treatments are available to manage TMJ dysfunction and reduce associated pain symptoms affecting the jaw.

References

Kim, Doori, et al. “The Relationship between Spinal Pain and Temporomandibular Joint Disorders in Korea: A Nationwide Propensity Score-Matched Study – BMC Musculoskeletal Disorders.” BioMed Central, BioMed Central, 29 Dec. 2019, bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-3003-4.

Murphy, Meghan K, et al. “Temporomandibular Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies.” The International Journal of Oral & Maxillofacial Implants, U.S. National Library of Medicine, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4349514/.

Silveira, A, et al. “Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4391655/.

Walczyńska-Dragon, Karolina, et al. “Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?” BioMed Research International, Hindawi Publishing Corporation, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4090505/.

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Clean Eating: Functional Sciatica Clinic

Dr. Alex Jimenez

Side view of a multi-ethnic adult family serving food sitting at a table, talking and smiling during a meal together outside on a patio in the sun

Clean eating for beginners is a way to approach how you eat by removing unnecessary fats, sugars, and carbs, avoiding processed foods, and embracing vegetables, whole foods, unrefined grains, lean proteins, and healthy fats. The more you practice, the more the craving for salts and sweets decreases and no longer satisfies. The idea is to combine a clean eating lifestyle with an active life that turns into long-term healthy habits.

Table of Contents

Clean Eating

Junk food refers to processed/refined foods, artificial flavors, sugars, salts, high saturated fats, and other foods that don’t provide nutrition. Clean foods fill the body with an abundance of vitamins and minerals, high-quality protein, and healthy fats, which improve heart and brain health, assist with weight management, strengthen the immune system and increase energy levels. Clean eating guidelines include:

Preparing and Cooking Own Food

Preparing and cooking your food is an easy way to control what goes into your body.
You control the salt, sugar, flavors, and fats with the objective of keeping the levels as low as possible.
Restaurant and diner food tastes great, but it is usually because salt, sugar, and butter are added to everything.

Whole Foods

Whole foods have not been modified, processed or refined, or saturated with preservatives, added sugars, dyes, fats/hydrogenated fats, or salt to add extra flavor or to enhance shelf life.
They include fresh fruits and vegetables, lean proteins, unsalted nuts/seeds, whole grains, full-fat dairy products, and dried beans/legumes.
Unrefined foods contain more nutrients and fiber, essential for healthy body function.

Balanced Meals

Choose foods with a combination of protein, carbs, and fats.
For example – broccoli is a carbohydrate but provides a lot of fiber, antioxidants, and other nutrients, so it’s recommended when eating clean.
Fats should come from unsaturated fats as much as possible, avoiding saturated and trans fats when possible.
This should be practiced with every meal, whether a snack or dinner.

Limit Adding Salt, Sugar, and Fats

Avoid unnecessary additives, like fat, salt, and sugar, when choosing foods.
Clean eating detoxes the body, so pastries, hamburgers, fries, and fried foods begin to taste too sweet or salty because the body is no longer used to them.
The body and tastebuds become acclimated to whole foods with no longer a need for additives.

Five to Six Small Meals

Counting calories does not take into account the value of each calorie.
Making mindful decisions for all foods, like lean protein, complex carbohydrates, fats, fresh fruits, and vegetables, will make the calories count.
Eating five to six times a day in the right amounts with three small main meals and two to three healthy snacks prevents:
Over-eating
Skipping meals
Exhaustion or jitteriness from unstable blood sugar levels.
Helps to lose weight.

Nutrition Labels

Look for labels with few ingredients.
Avoid foods with labels that include words like modified, which indicates added processing, and words that end with the letters ose, which indicate added sugars/fructose.
Look for labels with whole grains and whole wheat.
High-calorie foods should have low saturated fat and sugar levels and calories that come from fiber and lean proteins.
Sodium levels should be as low as possible; the body only needs 250 mg daily.

Drink Plenty of Water

Water needs to be consumed throughout the day, every day.
Water will maintain body hydration and function and prevent hunger.
Sodas and other unhealthy drinks contain high fructose corn syrup and/or other refined sugars providing no health benefits.
Fruit juices contain more nutrients than soda but can be high in calories and sugar. Read the labels.

To start, take small steps so the body can gradually transition into healthy habits that will last long-term. This is a new lifestyle, not a trending fad. Individuals are recommended to ease into it, and then it will begin to feel normal. Injury Medical Chiropractic Clinic has a Functional Medicine team, including a certified nutritionist, to help individuals develop a nutrition plan specific to their needs.

For Beginners

References

Ambwani, Suman et al. “”It’s Healthy Because It’s Natural.” Perceptions of “Clean” Eating among U.S. Adolescents and Emerging Adults.” Nutrients vol. 12,6 1708. 7 Jun. 2020, doi:10.3390/nu12061708

Allen, Michelle, et al. “The Dirt on Clean Eating: A Cross-Sectional Analysis of Dietary Intake, Restrained Eating, and Opinions about Clean Eating among Women.” Nutrients vol. 10,9 1266. 8 Sep. 2018, doi:10.3390/nu10091266

Ghaderi, Ata. “A European perspective on “clean eating”: Commentary on Negowetti et al. (2021).” The International journal of eating disorders vol. 55,1 (2022): 49-51. doi:10.1002/eat.23615

www.nia.nih.gov/health/how-read-food-and-beverage-labels

TMJ Dysfunction On The Lateral Pterygoid Muscle

Dr. Alex Jimenez

Table of Contents

Introduction

The jaw allows the host to chew, speak, and move while being stabilized by the surrounding muscles that help the jaw structure. The other surrounding muscles that support the jaw are the neck muscles when food is consumed and swallowed. The lower jaw has joints on each side that connect to the upper part of the skull, while the surrounding muscles provide the motor function to the jaw. To that point, normal wear and tear or various factors can not only affect the joints and the surrounding muscles, but they can cause overlapping pain profiles to the tendons, organs, and jaw muscles that may potentially affect a person’s quality of life. Today’s article examines the lateral pterygoid muscle, how TMJ dysfunction and trigger points affect this muscle, and ways to manage TMJ dysfunction and trigger points in the jaw. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger point pain associated with TMJ dysfunction affecting the lateral pterygoid muscle. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Lateral Pterygoid Muscle

Have you heard popping sounds in your jaw when you open or close your mouth? Does your jaw feel stiff, and the pain travels down the neck? Does your jaw lock up, causing difficulty for you to open or close your mouth? Some of these symptom overlap with pain associated with the lateral pterygoid muscle. As part of the mastication muscles, the lateral pterygoid muscle is also a craniomandibular muscle that has a crucial role in the inferior temporal region. The lateral pterygoid muscle works together with the medial pterygoid muscle to provide functionality to the mandible or the lower jaw. The lateral pterygoid muscle also has nerves that branch off the trigeminal nerve and sends information to the brain. This information causes the muscles to move and function when food is consumed; however, when injuries or traumatic events affect the lateral pterygoid, it can disrupt the lower jaw structure and the surrounding muscles.

How TMJ Dysfunction & Trigger Points Affect The Lateral Pterygoid

When the lateral pterygoid is affected by TMJ (temporomandibular joint) dysfunction, studies reveal that many individuals often experience pain around the jaw causing limited jaw movement and pain in the lateral pterygoid muscles. When the lateral pterygoid muscles become overused due to excessive chewing or by traumatic forces that affect the jaw, it can cause the muscle fibers of the lateral pterygoid to develop tiny knots known as trigger points to affect the jawline. Trigger points cause pain symptoms associated with other chronic issues that cause jaw pain. When trigger points affect the lateral pterygoid, it can develop discomfort and pain in TMJ dysfunction.

According to Dr. Janet G. Travell, M.D., many people with severe pain in their jaws may have myofascial pain syndrome from musculoskeletal disorders caused by active trigger points in the lateral pterygoid muscle. Since the lateral pterygoid is potentially involved with trigger points associated with TMJ dysfunction, studies reveal that the lateral pterygoid muscle may suffer from muscle atrophy while correlating with disc displacement associated with TMJ dysfunction. TMJ dysfunction is when the surrounding muscles and ligaments around the lower jaw are irritated from active trigger points. When a person suffers from TMJ dysfunction, the pterygoid muscles become stiff and cause pain-related symptoms affecting the jaw and the surrounding oral-facial region.

Jaw Pain & TMJ Dysfunction-Video

Jaw Pain and TMJ Disorders: Mayo Clinic Radio

Have you been experiencing pain along your jawline? Do your jaw muscles feel stiff when your open or close your mouth? Have you heard popping sounds when you open your jaw, and it hurts? Many of these symptoms are associated with TMJ dysfunction affecting the lateral pterygoid muscle. The video above explains how TMJ disorder and jaw pain affect the body. Studies reveal that the activities of the lateral pterygoid muscle allow movement to the jaw for the host; however, when factors begin to affect the jaw and the lateral pterygoid muscle, it may lead to derangement and disc displacement in the TMJ. TMJ dysfunction associated with trigger points in the jaw may be combined with other factors that cause pain to the jaw and the rest of the body. This is known as somato-visceral pain, where the muscle affects the corresponding organ. TMJ dysfunction associated with trigger points is complex and challenging to diagnose since trigger points often mimic other chronic symptoms that may be potentially involved. Since the lateral pterygoid muscle has sensory-motor functions in the jaw, when the muscle becomes sensitive, those neuron signals become hypersensitive and cause disorganized muscular activation to the jaw; thus, determining factors in TMD (temporomandibular disorders) make an appearance. Luckily there are ways to manage TMJ dysfunction associated with trigger pain in the jaw from affecting anyone.

Managing TMJ Dysfunction & Trigger Pain In The Jaw

When a person is experiencing pain symptoms in the jaw from TMJ dysfunction associated with trigger point pain, many try to find various treatments to minimize the pain. Since trigger point pain in the jaw can cause referred pain associated with toothaches and tension-type headaches, the pain that a person is feeling can be confusing when there is no physical alteration. To that point, many people would take over-the-counter medicine to dull the pain. However, those who want to manage pain without medication can go to a musculoskeletal specialist that their primary doctor refers to, who can come up with a treatment plan catered to that person. Many musculoskeletal specialists, like chiropractors, can obtain the patient’s information on where they feel pain during the examination. Afterward, chiropractors can devise a solution through clinical thinking before applying the treatment to the patient’s pain. Some of the various techniques that a chiropractor utilizes for an individual dealing with jaw pain associated with trigger points include:

Stretch and spray: Where the lateral muscle is stretched and sprayed with a coolant to alleviate the trigger points.
Cervical spinal manipulation: Spinal adjustment to the cervical spine to loosen up stiff muscles surrounding the neck and lower jaw.
Heat compression: A hot pack is placed on the jaw to relax the muscles.

When chiropractors utilize these techniques on the trigger points affecting the lateral pterygoid, it may potentially alleviate TMJ dysfunction symptoms associated with trigger points.

Conclusion

The lateral pterygoid is part of the mastication muscles that work with the medial pterygoid muscle to stabilize the jaw and provide motor function when the host is chewing or speaking. When the lateral pterygoid muscle becomes overused through excessive chewing or being affected by traumatic factors can cause the development of pain symptoms associated with trigger points. Trigger points are tiny knots in the muscle that can cause referred pain to different locations in the body. When this happens, many individuals suffer from other chronic conditions associated with trigger points. One of them is TMJ dysfunction, where the surrounding muscles in the lower jaw become irritated and can make the jaw lock up. Fortunately, various treatments exist for many individuals to relieve trigger point pain associated with TMJ dysfunction affecting their jaws and help prevent the associated symptoms from progressing further.

References

Litko, Monika, et al. “Correlation between the Lateral Pterygoid Muscle Attachment Type and Temporomandibular Joint Disc Position in Magnetic Resonance Imaging.” Dento Maxillo Facial Radiology, The British Institute of Radiology., Oct. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5595028/.

Liu, Meng-Qi, et al. “Functional Changes of the Lateral Pterygoid Muscle in Patients with Temporomandibular Disorders: A Pilot Magnetic Resonance Images Texture Study.” Chinese Medical Journal, Wolters Kluwer Health, 5 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7065862/.

Lopes, Sérgio Lúcio Pereira de Castro, et al. “Lateral Pterygoid Muscle Volume and Migraine in Patients with Temporomandibular Disorders.” Imaging Science in Dentistry, Korean Academy of Oral and Maxillofacial Radiology, Mar. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4362986/.

Rathee, Manu, and Prachi Jain. “Anatomy, Head and Neck, Lateral Pterygoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Oct. 2021, www.ncbi.nlm.nih.gov/books/NBK549799/.

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Disc Protrusion Sciatica Clinic Chiropractor

Dr. Alex Jimenez

cropped view of chiropractor massaging back of man in hospital

Spinal disc deterioration from aging is normal, but health issues or injuries can advance the degenerative process. Disc protrusions are related to herniated discs but are the mildest form of the condition and are a common form of spinal disc deterioration that can cause neck and back issues. However, individuals may have a small protruding disc that can go undetected unless it irritates or compresses the surrounding nerves. Chiropractic care, decompression, and massage therapy can realign the disc back into position, relieving discomfort and pain.

Table of Contents

Disc Protrusion

A disc is like a sturdy, soft rubber shock absorber/cushion with added gel inside. The gel acts as a shock absorber. When the gel begins to protrude out slightly, this is a disc protrusion. Once a protruding disc develops, it usually remains in that position. The disc can sometimes reabsorb on its own and realign back into position, but there is no way of knowing that will happen or how long it will take. With age and/or injuries, the body’s parts change. The spine’s discs dehydrate and lose elasticity, weakening the discs and making them more vulnerable to herniation stages:

First Stage

Following natural weakening can be classified as a disc protrusion when the disc’s core begins pushing into the spinal column.
Disc protrusions can be tiny or push out an entire side of the disc.

Second Stage

Disc deterioration often involves a bulging disc when the core pushes out farther around the circumference beyond the disc’s outer layer, called the annulus fibrosus, creating the telltale bulge.
A bulging disc involves more than 180 degrees of the disc’s circumference.

Third Stage

The third stage is a herniated disc, meaning the disc’s outer wall has torn, allowing the inner gel to leak out, usually irritating the surrounding nerves.

Fourth Stage

The fourth stage is sequestration, a herniated disc in which a piece of the nucleus breaks free of the vertebral disc fragments and falls into the spinal canal.

Types

A disc protrusion is one type of disc herniation that pushes out but remains connected. Different types compress and irritate the discs differently and produce various symptoms, including:

Paracentral

This is the most common, where the disc protrusion jams the space between the central canal and the foramen.

Central

This is where the disc protrusion intrudes into the spinal canal, with or without spinal cord compression.

Foraminal

The disc intrudes into the foramen, the space through which nerve roots branch off the spinal cord and exit the vertebrae.

Symptoms, Diagnosis, and Chiropractic Care

Individuals with a disc protrusion can experience symptoms similar to sciatica, which includes discomfort in the back, buttock, and leg, numbness, and pain sensations.

Treatment for disc protrusion will be based on the individual’s symptoms.
A chiropractor will take a detailed medical history and perform a physical examination.
A spinal MRI test could be ordered depending on the injury or condition.
A customized treatment plan will be developed to fit the individual’s medical needs.

Most disc protrusions improve after a few weeks of rest, avoiding strenuous activities, activity modification, an anti-inflammatory diet, and gentle exercises that the chiropractic team will provide.

True Spinal Decompression

References

Fardon, David F et al. “Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology.” The spine journal: official journal of the North American Spine Society vol. 14,11 (2014): 2525-45. doi:10.1016/j.spinee.2014.04.022

Mysliwiec, Lawrence Walter, et al. “MSU classification for herniated lumbar discs on MRI: toward developing objective criteria for surgical selection.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 19,7 (2010): 1087-93. doi:10.1007/s00586-009-1274-4

www.ninds.nih.gov/low-back-pain-fact-sheet#3102_7

Urban, Jill P G, and Sally Roberts. “Degeneration of the intervertebral disc.” Arthritis research & therapy vol. 5,3 (2003): 120-30. doi:10.1186/ar629