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Headache Trigger Points and Bio-Chiropractic Treatment

By
Dr. Alex Jimenez
-
Overworked Arab Businessman Suffering From Migraine At Work, Having Strong Headache. Stressed Millennial Eastern Man Feeling Unwell While Sitting At Workplace In Modern Office, Copy Space

Individuals that experience frequent headaches can have sensitive headache trigger points. Every case is different and requires a thorough examination before a proper and personalized chiropractic treatment plan can begin. Headaches can be brought on from a variety of causes. This could be:

  • Drug reactions
  • Temporomandibular joint dysfunction (TMJ)
  • Tightness in the neck muscles
  • Low blood sugar
  • High blood pressure
  • Stress
  • Fatigue

The majority of recurrent headaches fall into three types:

  • Tension headaches, also known as cervicogenic headaches
  • Migraine headaches
  • Cluster headaches, which are related to migraines.

Headache Trigger Points and Bio-Chiropractic Treatment

Tension

Tension headaches are the most common and affect around 77% of individuals experiencing chronic headaches. Most individuals describe a tension headache as a consistent dull ache on one side of the head and sometimes both sides. They are often described as having a tight band/belt around the head or behind the eyes. These headaches usually start slowly, gradually and can last for a few minutes or days. They tend to start in the middle of the day or before the end of the day.

These headaches can be the result of stress and/or poor posture. The most common cause is subluxations in the upper back and neck, usually combined with active headache trigger points. This stresses the spinal muscles in the upper back and neck. A tension headache or stress headache can last 30 minutes to a few days. Chronic tension headaches can last for months. The pain can be severe; however, these headaches are typically not associated with symptoms like throbbing, nausea, or vomiting.

If the top cervical vertebrae shift out of their position and lose their normal motion, a small muscle called the rectus capitis posterior minor/RCPM begins to spasm. This small muscle has a tendon that slips between the upper neck and the base of the skull. It attaches to a thin, sensitive tissue called the dura mater that covers the brain. The dura mater is very pain-sensitive. When the RCPM muscle goes into spasm, the tendon pulls the dura mater causing a headache. Individuals that work at a desk station for long hours tend to experience headaches from this cause. Another cause comes from referred pain caused by headache trigger points in the Sternocleidomastoid/SCM or levator muscle on the side of the neck. This cause tends to happen more to individuals that have suffered a whiplash injury with muscle damage in the neck region.

Migraine Headaches

Migraines are intense and throbbing headaches that are associated with nausea and sensitivity to light or noise. They can last for a few hours to a few days. Many experience visual symptoms known as an aura just before they come on. This is described as seeing flashing lights or when things take on a dream-like appearance. However, even in individuals that don’t experience the aura, most can tell that a migraine is getting ready to present. Individuals usually have their first attack before age 30. They tend to run in families supporting a genetic component. Some have attacks several times a month, while others can have less than one a year. Most individuals find that migraines happen less and become less severe as they get older.

These headaches are caused by the constriction of blood vessels in the brain. During the constriction period, there is a decrease in blood circulation. This is followed by dilation/enlargening of the blood vessels. This is what leads to the visual symptoms. Then the blood vessels dilate, generating a rapid increase in blood pressure inside the head. This increased pressure is what leads to a pounding headache. Every time the heart beats, it sends another shock wave through the carotid arteries in the neck into the brain. There are different theories as to why the blood vessels constrict, but they are still unknown. What is known is that several factors can trigger a migraine. This includes:

  • Lack of sleep
  • Stress
  • Flickering lights
  • Strong smells
  • Changing weather
  • Foods that are high in an amino acid known as tyramine

Cluster

Cluster headaches are very short excruciating headaches. They are usually felt on one side of the head behind the eyes. These headaches affect about 1 million individuals and are more common in men. This type of headache tends to happen at night. They are called cluster headaches because they tend to happen one to four times a day over several days. After one cluster is over, it could be months or even years before they present again. Like migraines, cluster headaches cause the dilation of the blood vessels in the brain, increasing the pressure.

Trigger Points

Headache trigger point therapy involves four muscles. These are the:

The Splenius muscles involve two individual muscles, the Splenius Capitis and the Splenius Cervicis. These muscles run along the upper back to the skull base or the upper cervical/neck vertebrae. Trigger points in the Splenius muscles are a common contributor to pain that travels through the head to the back of the eye and top of the head.

The Suboccipitals are a group of four small muscles that maintain proper movement and positioning between the first cervical vertebra and the skull base. Trigger points in these muscles can cause pain that feels like it’s happening inside the head, from the back to the eye and forehead. Individuals report that the whole side of the head hurts. This is a pain pattern similar to a migraine.

The Sternocleidomastoid muscle runs along the base of the skull, behind the ear, down the side of the neck. It attaches to the top of the sternum/breastbone. Although most are not aware of this muscle’s trigger points, the effects are evident. This includes:

  • Referred pain
  • Balance issues
  • Visual symptoms

Referred pain tends to be eye pain, headaches over the eye, and can even cause earaches. An unusual characteristic of SCM headache trigger points is that they can cause dizziness, nausea, and balance problems.

The trapezius muscle is the large, flat muscle in the upper and middle back. Pain can be felt in the temple and back of the head. A common trigger point is located at the top of the muscle. This particular point can activate secondary trigger points in the temple or jaw muscles, leading to jaw or tooth pain.

Headache Triggers

  • Stress can be a trigger.
  • Depression, anxiety, frustration, and even pleasant excitement can be associated with headache development.
  • A headache diary can help determine whether factors like food, weather, and/or mood correlate with headache patterns.
  • Repeated exposure to nitrite compounds can result in a dull headache accompanied by a flushed face. Nitrite dilates blood vessels and is found in products like heart medications, and is also used as a chemical to preserve meat. Processed meats containing sodium nitrite can contribute to headaches.
  • Foods prepared with monosodium glutamate or MSG can result in headaches. Soy sauce, meat tenderizers, and various packaged foods contain this chemical as a flavor enhancer.
  • Exposure to poisons, even household varieties like insecticides, carbon tetrachloride, and lead, can contribute.
  • Contact with lead batteries or lead-glazed pottery.
  • Foods that are high in the amino acid tyramine should be avoided. This could be ripened cheeses like cheddar, brie, chocolate, and pickled or fermented food.

Bio-Chiropractic

Chiropractic adjustments are highly effective for treating tension headaches, especially those that originate in the neck. Research has found that spinal manipulation resulted in almost immediate improvement and had fewer side effects and longer-lasting relief than taking common medications. There is a significant improvement by manipulating the upper two cervical vertebrae, combined with adjustments to the area between the cervical and thoracic spine.

Body Composition Testing

Vibration Exercise

Vibration exercise is believed to stimulate the muscle fibers without going to a gym or stressing the bones. One study broke up postmenopausal women into three groups: resistance training, vibration training combined with resistance training, or no exercise/training. Their body composition was measured before starting the study. After the study was completed, the findings included:

  • Both the resistance group and the resistance group with vibration training increased lean tissue mass.
  • The control group did not show an increase in lean tissue and, in fact, gained body fat.
  • The combination group, using vibration training with resistance training, showed a drop in body fat.

Another study placed male athletes in a training program that included vibration training. The first group had lower-limb strength training combined with vibration training, and the other had lower-limb strength training without vibration training. The researchers found that the athletes in the vibration training group improved leg extension strength by five percent. In addition, the vibration training groups balancing ability and vertical lift/jumping test improved as well.

References

Bryans, Roland et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008

Chaibi, Aleksander et al. “Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial.” BMC research notes vol. 10,1 310. 24 Jul. 2017, doi:10.1186/s13104-017-2651-4

Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63.

Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89.

The Sciatic Nerve

By
Dr. Alex Jimenez
-
Physiotherapist looking on the woman's back during the medical examination at the rehabilitation office with suspension medical equipment

The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve’s path. This could be the:

  • Low back
  • Buttocks
  • Thighs
  • Calves
  • Feet
  • Or it could be a combination of all the areas

 

The Sciatic Nerve

Neurological Symptoms

When the nerve is compressed,  neurological symptoms can accompany the pain. These include:

Thigh muscle weakness

If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.

Leg and foot muscle weakness

Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.

Numbness

Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:

  • Side of the calf
  • Side of the heel
  • Bottom of the foot
  • Top of the foot

Paresthesia

This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:

  • Tingling
  • Tightness
  • Pins-and-needles
  • Crawling feeling along the back of the thigh and/or leg

The Sciatic Nerve Gets Affected

The sciatic nerve can become:

  • Irritated
  • Compressed
  • Inflamed
  • This lumbar/low back radiculopathy means that the pain originates in and around the lumbar and/or sacral/sacrum nerve roots.

Compression

Physical forces could affect the nerve following common conditions:

Disc Herniation

A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.

Stenosis

Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.

Instability

Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.

Inflammatory Response

The body’s own chemicals can irritate the nerve causing inflammation. These chemical irritants include:

  • Hyaluronic acid
  • Fibronectin protein fragments leak out of degenerated or herniated discs onto and around the sciatic nerve roots.
  • There are times when degenerated discs can cause nerve tissues to grow into a disc. The tissue penetrates the outer and inner layers of the disc, causing inflammation and pain.
  • Some studies have shown how an immune system response can contribute to sciatic pain when there is exposure to the disc material from herniated disc/s.

Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.

Body Composition

The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:

  • Overweight individuals
  • Obese individuals
  • Older individuals
  • Tall individuals

Work Injuries

Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:

  • Semi-Truck operators
  • Machine operators
  • Construction workers
  • Hairstylists
  • Office workers
  • Athletes that lift weights

This comes from:

  • Sitting for long amounts of time
  • Poor posture
  • Constant bending forward or sideways
  • Regularly lifting the arms above shoulder level
  • All are risk factors.

Vitamin B12 deficiency

Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.

Body Analysis

Alleviating Nerve Pain Through Clinical Nutrition

Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:

  • Sometimes, sciatica can be triggered by constipation from an unhealthy diet
  • Incorporate fiber-rich foods
  • Fruits and vegetables will prevent constipation
  • Oily fish like salmon and halibut are rich in omega 3 fatty acids
  • Fresh pineapples and berries are anti-inflammatories that support healing and boost the immune system
  • 2-3 cups of green tea
  • Add turmeric, ginger, and garlic to meals
  • B-Vitamins are important to take in when going through sciatica and are found in green peas, spinach, navy beans, nuts, bananas
  • Foods that are rich in A-Vitamins like dairy products, dark leafy vegetables, orange-colored fruits, eggs, and oily fish
  • Foods rich in C-Vitamins, like citrus and tomatoes
  • K-Vitamins like  broccoli and spinach
  • Drink plenty of water, between 6 to 8 glasses a day

Foods to Avoid

  • Nutritionists recommend cutting out meat products except for oily fish for the first two weeks.
  • Foods that contain sunflower oil, corn oil, sesame oil, margarine, and partially hydrogenated oil.
  • Stressor foods like caffeine, processed food, soda, refined sugars, and chocolate.
  • Alcohol
References

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482431/.

Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-Trøndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.

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

Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.

Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.

Summer Activities For Back Pain That Are Easy On The Spine

By
Dr. Alex Jimenez
-
Happy family together in outdoor leisure funny activity on alternative healthy vehicle bike - people moving on the road - cheerful tourists take selfie picture driving four wheels bike

It is time for outdoor summer activities. Summer is iconic in its association with a wide range of outdoor activities. However, many can be physically strenuous and require a great deal of body movement. Summer gets individuals thinking of:

  • Hiking
  • Bicycling
  • Swimming
  • Water sports
  • Tennis
  • Golf
  • Gardening

This is when individuals have to figure out which activities will be easy on their backs. For those dealing with regular and/or chronic back or neck pain, athletic/movement-based activities can be done with:

  • Proper planning
  • Strain prevention/reduction
  • Activity modification/s
  • Most activities can be manageable.
  • Preventing/avoiding worsening the pain is the most recommended solution.

Individuals can still enjoy favorite outdoor activities for those who do have back pain, whether from an injury, herniated disc, muscle strain, arthritis, osteoporosis, or another cause.

Summer Activities For Back Pain That Are Easy On The Spine

Safe Summer Activities Safe For The Spine

Swimming

The best summer activity for the spine/back is swimming or any movement in the water. It is recommended and utilized in physical therapy for those with injuries and pain conditions and is shown to prove that it brings relief and exercise. Hot weather makes it easy to get in the water, whether a pool, river, or lake. Doing basic water stretches, exercises, or walking movements can bring significant pain relief. This is because the body’s weight is lessened, which lessens the spine’s pressure.

Walking

Getting outside every day and running can cause a great deal of strain. However, walking is extremely safe and effective, especially on the spine. The key is to take it slow and build up the ability to walk longer and further. However, those with spinal stenosis, which is the narrowing of the spinal canal, might find that walking increases pain. It is recommended to start with light walking sessions and modify them as much as needed. An example could be walking half a block; if pain presents, perform some other movement/s that does not cause pain, and then walk another half block. Taking it slow.

Hiking

It is not out of the question for individuals who like to hike, but caution should be taken. This is because hiking adds factors that can increase the risk for injuries or conditions if the activity is not modified. Most hikes involve hills, elevation changes, climbing, and uneven surfaces. This requires planning and preparation. It is recommended to choose hiking paths that will not exhaust an individual, and that can be easily backtracked if pain or issues arise. This is especially important for those that are flexion-intolerant.  This is when individuals feel pain when bending or leaning forward over the hips. This could be hiking up and down hills that are likely to cause flare-ups.

Fishing

Fishing is a favorite summer activity and is recommended because of the relaxed atmosphere and ability to be modified easily. Individuals can sit in a supportive chair and fish, or they can stand and fish. There is not a lot of quick bending or rotating and totally open to modifications.

Activity Moderation and/or Modification

Figuring out movement modifications or mix up the time. Activities can be enjoyed; it just requires making the right adjustment/s that will make the activity manageable. For those with back pain usually know what movements will cause pain. This can help make it easier to modify specific movements/motions. Activities that more than likely will cause inflammation flare-ups are about finding a way to do it so that the result is not as extreme.

  • One way to modify summer activities is by altering/changing the amount of time engaged. For example, instead of spending 4-6 hours fixing up the yard/gardening, break it up by doing the activity for an hour, stop, stretch, relax, rehydrate, and then continue, respectively.
  • Modification can also be done by changing the functional components of the activity/s. Rather than bending and picking up tools, pulling weeds, etc., get a work stool/bench and perform the activity sitting. This goes for any activity.

Body Composition Health

Can more fat be burned by exercising in the heat?

Individuals wonder if exercising when it’s hot out causes the body to burn more fat. After all, the body is hotter and sweating much more. However, it’s more complicated. Studies show that when exercise is done in high temperatures, the heat can affect the body’s hormonal and metabolic response. The same studies show a consistent shift from breaking down fat cells for energy and breaking down carbohydrates for energy. When exercising in extreme heat, the energy demand becomes too high to break down more fat.  Instead, it uses carbohydrates. So the extra sweat is just water, salt, and not fat. But heat can still play a positive role in improving body composition. Two ways include:

  • Heat shock proteins – HSP – Without exercise, exposure to heat can cause heat shock proteins to activate. Heat shock proteins live inside cells and aid in muscle protein synthesis and repair. When exposed to temperature/thermal stress, they increase to meet the demand.
  •  Human Growth Hormone – HGH – Synthetic Human Growth Hormone increases lean mass, reduces body fat, and improves performance. However, it is naturally produced by the body and can be enhanced through exercise.
References

American Journal of Physical Medicine & Rehabilitation. (February 2018) “Aquatic Exercises in the Treatment of Low Back Pain: A Systematic Review of the Literature and Meta-Analysis of Eight Studies”

Gobbo, Stefano et al. “Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace.” Journal of Functional morphology and kinesiology vol. 4,3 43. 5 Jul. 2019, doi:10.3390/jfmk4030043

Grabovac, Igor, and Thomas Ernst Dorner. “Association between low back pain and various everyday performances: Activities of daily living, ability to work and sexual function.” Wiener klinische Wochenschrift vol. 131,21-22 (2019): 541-549. doi:10.1007/s00508-019-01542-7

Preventive Medicine Reports. (2017.)“Gardening is beneficial for health: A meta-analysis.” ncbi.nlm.nih.gov/pmc/articles/PMC5153451/pdf/main.pdf

Selby, Sasha et al. “Facilitators and barriers to green exercise in chronic pain.” Irish Journal of medical science vol. 188,3 (2019): 973-978. doi:10.1007/s11845-018-1923-x

Keeping The Neck In One Position For Too Long

By
Dr. Alex Jimenez
-

Many individuals will be looking up at the fireworks this 4th of July weekend. A word of caution when keeping the neck in one position for too long can cause neck discomfort and/or pain. Neck discomfort and pain can cause significant disruption with everyday activities. The neck is an area that is constantly in motion. Keeping it in one position for an extended period can cause damage/injury and spinal misalignment. Although neck pain often resolves on its own in a few days. However, it can lead to headaches or an inability to concentrate, affecting an individual’s quality of life. Here are some potential causes and remedies for decreasing neck discomfort and pain.

Keeping The Neck In One Position For Too Long

Keeping The Neck In One Position For Too Long Can Cause

  • Mechanical issues and imbalances in the upper spine, known as the cervical spine
  • Muscle tension
  • Muscle strain
  • Spinal misalignment
  • Poor posture
  • Sleeping problems
  • Injury or trauma to the neck from the force and weight
  • Chronic neck misalignment

If symptoms come on suddenly, are severe, or result in neurological issues like severe shooting pain, tingling, numbness, or sudden loss of arm strength, seek medical attention immediately.

Treatment

When the neck is strained or out of alignment, it disrupts nerve circulation integrity. Spinal misalignment is subtle in nature and can be difficult to detect without a professional examination. A chiropractor is trained to recognize any underlying issues to reset/realign the entire spine to optimal form. They will assess, guide, and treat the issue/s specific to the individual’s needs. Once the nerves are working uninhibited, a chiropractor can recommend neck exercises, stretches, and more to strengthen and prevent neck problems. When spinal alignment is restored, the body will begin to operate at full potential.

Healthy Body Composition

Meal Prep to Success

For individuals that want to eat less and change eating habits, change up the approach.

Meal prepping is a healthy habit that many have had success with because it helps achieve sustainable outcomes in weight loss. Every meal plan will vary for everyone.

  1. First, individuals have different health goals.
  2. Second, everyone has a different approach to their diet choices. For example, an individual might want to go low-carb and goes with the ketogenic diet. In comparison, some individuals are comfortable planning a week in advance and freezing labeled plastic containers.

Regardless of goals, dietary, or fitness preferences, a workable meal plan is recommended. The ultimate goal is to prevent feeling overwhelmed about planning the next healthy meal and resort to a junk food meal. To steer clear of unhealthy food choices and achieve a healthy body composition, here is a real-world tip to create and stick to a healthy meal plan.

Have a well-stocked fridge and pantry

Keeping to a meal plan is easier with a well-stocked fridge and pantry. Ensure to keep a list of essential groceries whenever going to the store to ensure plenty. This list of staples includes:

  • Eggs
  • A favorite protein
  • Whole grains
  • Yogurt
  • Healthy oils
  • Herbs and spices
  • Butter
  • Leafy greens
  • Beans

Having these ingredients ready to go means a healthy meal can be quickly put together when short on time.

Be realistic and make room for crazy days

You don’t have to come up with a seven-day weekly meal plan. It is important to change up the routine, so boredom doesn’t set in. Before planning and prepping several meals, double-check the calendar. Allow yourself some slack. This could be one or two lunches or dinners in a week just in case something comes up. If batch cooking, even schedule days for leftovers for that extra flexibility.

References

BMJ. 2017 Advances in the diagnosis and management of neck pain. Available at: pubmed.ncbi.nlm.nih.gov/28807894/

Mayo Clin Proc. 2015. Epidemiology, diagnosis, and treatment of neck pain. Available at: pubmed.ncbi.nlm.nih.gov/25659245/

Open Orthop J. 2016. A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification. Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC5301418/

Phys Ther. 2018. A Mechanism-Based Approach to Physical Therapist Management of Pain. Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC6256939/

***Mitochondrial Assessment**** and Therapeutics (3/3) | El Paso, Tx (2021)

By
Dr. Alex Jimenez
-
***Mitochondrial Assessment**** and Therapeutics (3/3) | El Paso, Tx (2021)
Welcome to part 3 of our Functional Medicine podcasts brought to you by Dr. Alex Jimenez. In this episode an expert will be discussing with us the mitochondrial structure, function and metabolism. He will help us identify the mechanisms of how dietary factors and toxins can contribute to mitochondrial dysfunction. We will also talk about recognizing how Reactive Oxygen Species (ROS) can affect mitochondrial function and how antioxidants can mitigate these effects. We will connect certain signs, symptoms and disease presentations with mitochondrial dysfunction.

If you have any questions you can call us at 915-850-0900
–
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share with us.

Thank You & God Bless.
Dr. Alex Jimenez DC, MSACP, ATN, IFMCP. CIFM, CCST

Join our webinars!
el-paso-tx-functional-medicine.eventbritestudio.com

Additional Online Links & Resources (Available 24/7)

Online Functional Medicine Assessment: bit.ly/functionmed

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Online Physical Injury / Accident Intake Form: bit.ly/Fill-Out-Your-Online-History

If you are someone who truly cares about their health we recommend you look at the care plans we offer on our site:

www.functionalmedicine.expert/

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Disclaimer:
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our presentations share knowledge and information from research, experience, and the collaborative functional medicine community. The information and scope are limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. Our discussions include Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, Exercise Performance Specialists, Physicians, and others. Each specialist practices within their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care plans for the musculoskeletal system’s injuries or disorders. Our discussions, videos, posts, topics, subjects, and insights cover clinical matters and issues that relate to and support, directly or indirectly, our collaborative clinical scope of practice. We make a reasonable attempt to provide supportive citations and identify the relevant research studies supporting our presentations. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover issues that may require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subjects matters presented, please feel free to contact Dr. Alex Jimenez.

Mitochondrial Assessment and Therapeutics | El Paso, Tx (2021)

By
Dr. Alex Jimenez
-
Mitochondrial Assessment and Therapeutics | El Paso, Tx (2021)
Welcome to the newest edition of our Functional Medicine podcasts brought to you by Dr. Alex Jimenez. In this episode an expert will be discussing with us the mitochondrial structure, function and metabolism. He will help us identify the mechanisms of how dietary factors and toxins can contribute to mitochondrial dysfunction. We will also talk about recognizing how Reactive Oxygen Species (ROS) can affect mitochondrial function and how antioxidants can mitigate these effects. We will connect certain signs, symptoms and disease presentations with mitochondrial dysfunction.

If you have any questions you can call us at 915-850-0900
–
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share with us.

Thank You & God Bless.
Dr. Alex Jimenez DC, MSACP, ATN, IFMCP. CIFM, CCST

Join our webinars!
el-paso-tx-functional-medicine.eventbritestudio.com

Additional Online Links & Resources (Available 24/7)

Online Functional Medicine Assessment: bit.ly/functionmed

Online Appointments or Consultations: bit.ly/Book-Online-Appointment

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Disclaimer:
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our presentations share knowledge and information from research, experience, and the collaborative functional medicine community. The information and scope are limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. Our discussions include Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, Exercise Performance Specialists, Physicians, and others. Each specialist practices within their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care plans for the musculoskeletal system’s injuries or disorders. Our discussions, videos, posts, topics, subjects, and insights cover clinical matters and issues that relate to and support, directly or indirectly, our collaborative clinical scope of practice. We make a reasonable attempt to provide supportive citations and identify the relevant research studies supporting our presentations. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover issues that may require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subjects matters presented, please feel free to contact Dr. Alex Jimenez.

Human Musculoskeletal System

By
Dr. Alex Jimenez
-
Male osteopath performing trigger point treatment on a young woman applying pressure with his fingers to release tension and relieve pain

Maintaining the body’s musculoskeletal system and keeping it strong can be done through chiropractic and by managing general overall health. This system includes the:

  • Bones
  • Muscles
  • Tendons
  • Ligaments
  • Soft tissues

These all work together to support the body’s weight and allow for movement. Injuries, disease, and aging can cause stiffness, pain, and other issues with mobility, function that can lead to various conditions and/or disease.

Human Musculoskeletal System

The musculoskeletal system

The skeleton provides the framework for the muscles and other soft tissues. Working together, they support the body’s weight, help to maintain proper posture and the ability for movement. Various disorders and conditions can lead to problems with the musculoskeletal system. This includes:

  • Aging
  • Injuries
  • Congenital anomalies (congenital disabilities)
  • Disease
  • All can cause pain and limit movement.

Focusing on overall health and maintaining it will keep the system in top form. This is done by:

  • Eating a healthy balanced diet
  • Maintaining a healthy weight
  • Regular physical activity/exercise
  • Chiropractic support will take the body to optimal health levels.

How does the system work?

The nervous system is the body’s central command center. It controls voluntary muscle movements. Voluntary muscles are controlled intentionally. Large muscle groups are utilized to do activities like lifting a large object. Smaller groups are used for movements, like pressing a button. Movement/motion occurs when:

  • The nervous system which includes the brain and nerves, transmits a signal to activate the skeletal/voluntary muscles.
  • The muscle fibers contract/tense in response to the signal.
  • When the muscle activates, it pulls on the tendon.
  • Tendons attach muscles to bones.
  • The tendon pulls the bone, generating movement.
  • For the muscle to relax, the nervous system sends another signal.
  • This signal triggers the muscle/s to relax/deactivate.
  • The relaxed muscle releases tension
  • The bone is moved to a resting position.

System Parts

The musculoskeletal system functions to help stand, sit, walk, run and move in general. The adult body has 206 bones and more than 600 muscles. These are connected by ligaments, tendons, and soft tissues. The parts of the system are:

Bones

Bones support the body, protect organs and tissues, store calcium, fat and produce blood cells.

  • A bone’s outside shell encapsulates a spongy center.
  • Bones provide structure and form to the body.
  • They work with the muscles, tendons, ligaments, and other connective tissues to help with movement.

Cartilage

This is a type of connective tissue.

  • Cartilage provides cushion to the bones inside the joints, along the spine, and ribcage.
  • It is firm and rubbery.
  • It protects bones from rubbing against each other.
  • It is also found in the nose, ears, pelvis, and lungs.

Joints

Bones come together and form joints.

  • Some have a large range of motion, for example, the ball-and-socket shoulder joint.
  • Others, like the knee, allow bones to move back and forth but do not rotate.

Muscles

Every muscle is made of thousands of fibers.

  • The muscles allow the body to move, sit upright, and remain still.
  • Some muscles help with running, dancing, and lifting.
  • Others are for writing, fastening something, talking, and swallowing.

Ligaments

  • Ligaments are made of tough collagen fibers
  • They connect the bones and provide stability to the joints.

Tendons

  • Tendons connect the muscles to the bones.
  • They are made of fibrous tissue and collagen
  • They are tough but not as stretchable.

Conditions and disorders

Various conditions can cause problems with the musculoskeletal system. They can affect the way an individual moves. The most common causes of inflammation, pain, and mobility issues are:

Aging

  • With the natural aging process, bones lose density.
  • Less-dense bones can lead to osteoporosis and bone fractures/broken bones.
  • As the body ages, muscles lose their mass, and cartilage starts to wear down.
  • This can lead to pain, stiffness, and decreased range of motion.
  • After an injury, an individual might not heal as quickly.

Arthritis

Pain, inflammation, and joint stiffness are the result of arthritis.

  • Older individuals are more likely to develop osteoarthritis. This is from the cartilage inside the joints breaking down. However, the condition can affect individuals of all ages.
  • Other types of arthritis also cause pain and inflammation. This includes:
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Gout

Back problems

  • Back pain and muscle spasms can result from muscle strains or injuries, for example, a herniated disc.
  • Some conditions like spinal stenosis and scoliosis can cause structural problems in the back.
  • This can lead to pain and limited mobility.

Cancer

Congenital abnormalities

Congenital abnormalities can affect the body’s structure, function, and appearance. For example, clubfoot is a common musculoskeletal condition that babies can be born with. It causes stiffness and reduces the range of motion.

Disease

A wide range of diseases can affect bones, muscles, and connective tissues functionality.

  • For example, osteonecrosis causes the bones to deteriorate and the cells to die.
  • Other disorders, like fibrous dysplasia and brittle bone disease, cause the bones to fracture/break easily.
  • Conditions that affect the skeletal muscles are known as myopathies include types of muscular dystrophy.

Injuries

  • All types of injuries can affect bones, muscles, cartilage, and connective tissues.
  • Injuries can occur from repetitive overuse. Examples include:
  • Carpal tunnel syndrome, Bursitis, and Tendinitis
  • Sprains
  • Muscle tears
  • Broken bones
  • Injuries to the tendons, ligaments and other soft tissues can lead to chronic conditions.

Maintaining musculoskeletal health

  • Recommended ways of maintaining a healthy musculoskeletal system are to keep the bones and muscles healthy by getting:

Regular physical activity and exercise

  • This includes weight-bearing exercises combined with cardiovascular activities. Strengthening the muscles will support the joints and protect/prevent damage.

Proper sleep

  • This is so the bones and muscles can recover and rebuild.

Maintain a healthy weight

  • Added weight places pressure on the bones and joints.
  • This causes various health problems.
  • If there is added weight, it is recommended to consult a health coach and nutritionist about a personalized weight-loss plan.
  • They can help make healthy food choices that will make for strong bones and include anti-inflammation foods.

Quit tobacco use

  • Smoking decreases blood flow in the body.
  • The bones, muscles, and soft tissues need proper blood circulation to maintain health.

Regular chiropractic adjustments

  • Adjustments will help maintain the body’s balance and alignment.
  • This, along with recommended stretches and exercises, will take the body to optimal health.

Healthy Body Composition

Bodyweight Squat

This is one of the best strength exercises for building general functional low body strength. The muscle groups that get worked include the:

  • Quadriceps
  • Hamstrings
  • Glutes
  • Deep abdominals
  • Hip abductors
  • Hip rotators

Squats work almost every muscle in the legs. This also builds core strength to help with everyday movements like pushing, pulling, and lifting. There is no need to load added weight on the back to benefit from this exercise. Using the body’s weight is a perfect workout. This can be done with several variations once strength is built up. The objective is to focus on strict form for maximum effectiveness.

  • The feet should be shoulder-width apart.
  • Bend at the hips
  • Don’t let the knees go past the toes.
  • Lower the body until the thighs are parallel to the floor
References

American Chiropractic Association. Back Pain Facts and Statistics. Accessed 1/5/2021.

Centers for Disease Control and Prevention. Arthritis. Accessed 1/5/2021.

Centers for Disease Control and Prevention. Arthritis-Related Statistics. Accessed 1/5/2021.

Centers for Disease Control and Prevention. Work-Related Musculoskeletal Disorders & Ergonomics. Accessed 1/5/2021.

Merck Manuals. Effects of Aging on the Musculoskeletal System. Accessed 1/5/2021.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Healthy Muscles Matter. Accessed 1/5/2021.

Auto Accident Hidden Injuries and Bio-Chiropractic Care/Rehabilitation

By
Dr. Alex Jimenez
-
Female Paramedic Helping Female Driver With Whiplash Neck Injury Involved In Road Traffic Accident

After an auto accident that might not have caused serious damage, individuals often believe that they’re fine only to find out later that there is a serious injury. How do these hidden injuries happen?  It is because of the body’s fight or flight response that it activates into high gear. It does whatever is necessary to get out of harm’s way. The result is that individuals might not realize/discover that they have been injured until after the dangerous circumstances have passed. Auto accident doctors and chiropractors are very familiar with these types of hidden injuries.

The injuries sustained from non-damage-causing auto accidents are often not visible. This can be internal injuries and joint and muscle misalignments that can often only be seen through extensive x-rays, MRIs, or detailed physical examination. However, a professional chiropractor can determine the root causes of an injury from a single consultation.

Auto Accident Hidden Injuries and Bio-Chiropractic Care/Rehabilitation

Hidden Injuries

Whiplash

Some injuries, like delayed whiplash, do not present immediately because it can take days for symptoms to develop. This is the most common injury caused by an auto accident. This is when the head snaps back and then forward rapidly/violently during a collision. The jolting back-and-forth motion causes muscle strain, sprain, which can stretch and/or tear the tendons and muscles in the neck. The injury can be worsened as the individual does not realize that they have this injury, and they turn, rotate, and crane their necks like normal. Symptoms include:

  • A stiff/tight neck
  • Dull neck pain
  • Upper back pain
  • Shoulder stiffness, aches, and pain

It is recommended to see a doctor or chiropractor as soon as possible for diagnosis and treatment.

Muscle, Tendon, and Ligament Injuries

Muscle, tendon, and/or ligament injuries can happen due to whiplash, but they can also happen in other parts of the body like the hands, elbows, knees, and ankles.

Contact Injuries Bruises and Swelling

Drivers and passengers can bruise and swell from contact with hard surfaces like the steering wheel, dashboard, and doors. Seat belts can also cause injury from quick/rapid braking or a crash.

Concussion

This is when the brain forcefully makes contact with the skull resulting in bruising/injury to the brain. It is recommended to see a doctor immediately if any of the following  are experienced after an auto accident:

  • Dizziness
  • Loss of balance/equilibrium when standing and walking
  • Difficulty concentrating
  • Difficulty remembering things

Spinal Trauma

The spine can sustain separate injury/s or trauma as a result of an auto accident. This includes:

  • Dislocation/s
  • Fractures
  • Compressed vertebrae
  • Crushed vertebrae
  • More symptoms can present after the shock wears off.
  • This often reveals severe, debilitating injury/s that affect the nerves and muscle control of different organs and body parts.

Bio-Chiropractic Treatment and Rehabilitation

One of the most effective and recommended ways to relieve pain and properly heal hidden injuries is chiropractic treatment and rehabilitation. A professional chiropractor can prevent further injuries from developing while easing and alleviating current pain.

No Medication Necessary

More people are becoming addicted to prescription medications following accidents and other trauma. Chiropractic care treats the cause of pain without medications. This allows the body to heal naturally and for movement to come back naturally.

Reduces Long Term Pain

Many continue to deal with back, neck, and other chronic pain conditions after an accident. Chiropractic gets to the root of the problem. The therapy sessions manipulate the body and help naturally restore the body’s total range of movement. A chiropractor will recommend exercises and stretches to keep the body strong and flexible to help prevent pain.

Reduces Scar Tissue

After the body goes through a trauma like an auto accident, muscles and ligaments can be stretched and torn. This can cause areas of internal scar tissue can develop. This can limit movement. Chiropractic helps reduce scar tissue by keeping the tissues loose and relaxed. This allows a normal range of movement.

Inflammation Alleviation

Auto injury/s can lead to long-term inflammation that can make life miserable. Chiropractors are trained to spot hidden micro-tears that x-rays are not able to scan. However, it is microscopic tears inside the muscles that are often the leading cause of inflammation. With physical manipulation, the body will be able to rerelease IL-6 substances naturally. This is a vital anti-inflammatory.

Healthy Body Composition

Personalized Functional Medicine

Personalized functional medicine is a new model of medicine that considers an individualized approach when making health recommendations. The body works as an integrated system, not as individual parts. This form of medicine combines new technology approaches, including recent gene expression and life and behavioral sciences discoveries. Personalized functional medicine looks at the subject of nutrigenomics. Nutrigenomics is defined as the relationship between nutrients and gene expression. Like identifying individual body composition, nutrigenomics testing can help individuals understand how dietary components influence their genes. This can help prevent the development of chronic diseases.

References

Calil, Ana Maria et al. “Mapping injuries in traffic accident victims: a literature review.” Revista latino-americana de enfermagem vol. 17,1 (2009): 120-5. doi:10.1590/s0104-11692009000100019

Dindi, Kuru et al. “Road traffic injuries: Epidemiology, challenges, and initiatives in India.” The National medical journal of India vol. 32,2 (2019): 113-117. doi:10.4103/0970-258X.275355

Minich, Deanna M, and Jeffrey S Bland. “Personalized lifestyle medicine: relevance for nutrition and lifestyle recommendations.” TheScientificWorldJournal vol. 2013 129841. 26 Jun. 2013, doi:10.1155/2013/129841

Palmnäs, Marie et al. “Perspective: Metabotyping-A Potential Personalized Nutrition Strategy for Precision Prevention of Cardiometabolic Diseases.” Advances in nutrition (Bethesda, Md.) vol. 11,3 (2020): 524-532. doi:10.1093/advances/nmz121

Sims, J K et al. “Automobile accident occupant injuries.” JACEP vol. 5,10 (1976): 796-808. doi:10.1016/s0361-1124(76)80313-9

Acute and Cumulative Soccer Injuries

By
Dr. Alex Jimenez
-
athletic soccer player kicking ball on soccer pitch

Although many soccer injuries involve the legs and lower extremities, other body areas are susceptible to injury/s as well. Acute or cumulative is how soccer injuries are generally described. Acute injuries are traumatic. They are usually caused by a slip, trip, and fall, getting hit, and crashing into other players. Cumulative injuries involve repetitive stress on a muscle, joint, or connective tissue. This triggers progressive aches, pain, and physical impairment that gets worse with time. Understanding how and why they happen is the first step in injury prevention. The more common injuries experienced among soccer athletes include.

Acute and Cumulative Soccer Injuries

Concussion

This is a form of mild traumatic brain injury mTBI caused by a sudden hit/impact to the head. Players are trained to head the ball; however, concussions can happen if not ready for impact or heading at an awkward position.

Ankle Sprains

Ankle sprains are when there is stretching and tearing of ligament/s that surround the ankle joint.

  • Lateral ankle sprains or outside of the ankle can happen when a player kicks the ball with the top of the foot.
  • A medial ankle sprain or inside of the ankle can happen when the toes are turned out when the foot is flexed up.

Achilles Tendonitis

This is a chronic injury that occurs from overuse with pain in the back of the ankle. Players are constantly performing repetitive and sudden movements that, over time, can cause this type of injury.

Achilles Tendon Rupture

A rupture involves a partial or complete tear of the Achilles tendon. Often players say with a popping sound. This happens when players perform fast, explosive movements. Rapid stopping, starting, shifting, jumping can all contribute.

Groin Pull/Strain

This is a type of strain that happens when the inner thigh muscles are stretched beyond their limit. As a result, a player can pull the groin when kicking and/or resistance from an opponent trying to take the ball or kick in the opposite direction.

Hamstring Injury

These injuries involve the three back muscles of the thigh and can vary from minor strains to complete ruptures/tears. This comes from running, sprinting, jumping, and stopping, leading to these types of injuries.

Iliotibial Band Syndrome

This is an overuse/repetitive injury that involves a tendon known as the IT band. This is the connective tissue that runs along the outside of the thigh. Constant running can create friction as the band gets pulled along the outside of the knee, which can cause tendonitis.

Plantar Fasciitis

This causes foot pain caused by inflammation of the tissue bands that run from the heel to the toes. Several factors can cause the condition. This could be players using inappropriate or not correctly fitting shoes, shoes that do not provide proper arch support or playing on a hard surface.

Calf Muscle Pull

This is when one of the muscles of the lower leg gets pulled from the Achilles tendon. Again, quick and spontaneous sprinting, running, or jumping is usually the cause.

Knee Injuries

The most common soccer injuries are those that involve the knee. This is because of the stopping and shifting directions quickly and suddenly. The explosive, spontaneous movements place extreme stress on the knees and the supporting ligaments. When the stress goes beyond the ligament’s limits, it can cause a sprain or tear in the joint. When there is an injury to the knee/s, it is diagnosed using a grading scale.

  • Grade 1 Mild sprain
  • Grade 2 Partial tear
  • Grade 3 Complete tear

Runner’s Knee

Patellofemoral pain syndrome, also known as runner’s knee, is a condition where the cartilage under the kneecap gets damaged from an injury or overuse. This happens when there is a misalignment in the knee and/or strained tendons.

ACL Injury

The anterior cruciate ligament or ACL is at the front of the knee. These are the most common knee injuries. This is because the ligaments are less retractable than muscles or tendons. And those in the knees are highly vulnerable to damage.

Cruciate Ligament Injury

This type of injury does not always cause pain but often causes a popping sound when it happens. Pain and swelling develop within 24 hours. This is followed by the loss of range of motion and tenderness around and along the joint.

Meniscus Injury

The Meniscus involves a C-shaped piece of cartilage that cushions the space between the femur and the shin bone. These tears are painful and are often the result of twisting, pivoting, decelerating, or quick/rapid impact.

Shin Splints

The term describes a variety of painful symptoms that develop in the front of the lower leg. This often happens from over/intense training, or the training gets changed. Players can also develop shin splints from training while not using appropriate shoes.

Stress Fractures

These types of fractures are usually the result of overuse or repeated impact on a bone. The result is severe bruising or a slight crack in the bone.

Tendonitis

When tendons get inflamed, it is referred to as tendonitis. This comes with repetitive overuse but can also develop from a traumatic injury that causes micro-tears in the muscle fibers.

Soccer Injuries Prevention

Many of these injuries result from overuse, overtraining, improper conditioning, and/or not warming up properly. Here are few tips to help reduce the risk.

Warm-up for at least 30 minutes before playing

Pay special attention to stretching the:

  • Groin
  • Hips
  • Hamstrings
  • Achilles’ tendons
  • Quadriceps

Wear protective gear

This includes:

  • Mouthguards
  • Shin guards
  • Kinesio tape
  • Ankle supports
  • Eye protection
  • Ensure they are correctly sized and maintained.

Check the field

Check for anything that could cause injury/s. This includes:

  • Holes
  • Puddles
  • Broken glass
  • Stones
  • Debris

Avoid playing in bad weather

Or immediately after heavy rain when the field is especially slick and muddy.

Allow enough time to heal after an injury.

This also goes for minor soccer injuries. Trying too fast to get back increases the risk of worsening the injury, re-injury, and/or creating new injuries.

Body Composition

Athletes and Carb Loading

Carb loading is a strategy that athletes use.

Endurance athletes

Utilize carb-loading to help them increase energy storage for long runs, bike rides, swims, etc. When timed effectively, carb-loading has been shown to increase muscle glycogen, leading to improved performance.

Bodybuilders and fitness athletes

Use carbo-loading to build size and mass before competitions. The timing and efficacy of carb-loading vary from person to person. Make sure to experiment before the next big competition.

References

Fairchild, Timothy J et al. “Rapid carbohydrate loading after a short bout of near maximal-intensity exercise.” Medicine and science in sports and exercise vol. 34,6 (2002): 980-6. doi:10.1097/00005768-200206000-00012

Kilic O, Kemler E, Gouttebarge V. The “sequence of prevention” for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature. Phys Ther Sport. 2018;32:308-322. doi:10.1016/j.ptsp.2018.01.007

Lingsma H, Maas A. Heading in soccer: More than a subconcussive event?. Neurology. 2017;88(9):822-823. doi:10.1212/WNL.0000000000003679

Pfirrmann D, Herbst M, Ingelfinger P, Simon P, Tug S. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review. J Athl Train. 2016;51(5):410–424. doi:10.4085/1062-6050-51.6.03

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

By
Dr. Alex Jimenez
-
Fit girl doing stretching exercies for legs

APT is short for anterior pelvic tilt.  APT is when the pelvis tilts more down than forward, which can cause strain on the surrounding muscles and the spine to hold the torso up. The body’s own anatomical structure causing the condition and/or part of a bad habit that an individual has grown accustomed to. This can be from injury/s, back, and/or hip pain causing an individual to take on awkward postures to compensate for the discomfort and try and avoid it. However, these unhealthy postures cause their own set of musculoskeletal problems. Addressing this form of poor posture can help reduce and alleviate low back and hip pain and prevent further injuries.  Chiropractic can pinpoint an anterior pelvic tilt and fix it.

Anterior Pelvic Tilt

What happens is the pelvis becomes tilted or rotated forward. Place the hands, specifically the fingertips, on the hips. There are bone ridges. These are the iliac crests. If they’re facing more toward the ground than directly forward, this could be an anterior pelvic tilt. It usually happens when the hip flexors become tight and pull the pelvis down. Another contributor is the glute and hamstring muscles have weakened and are not strong enough to counteract the forward pulling. This can be caused by sitting for long periods, poor posture, and for women who wear high heels regularly. These contribute to tightening the hip flexors and the glutes, hamstrings, and core muscles.

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

 

An anterior pelvic tilt causes an increase in the curve of the lower back. It can feel like the hip flexors are tightening up. It typically affects the lower back at the lowest two levels, which are L4-5 and L5-S1. There can be long-term issues if an anterior pelvic tilt is left untreated. The spine becomes more vulnerable to disc issues that can include:

  • Compressed degenerative disc
  • Disc tears, aka annular tears
  • Disc bulges
  • Herniation

Exercises

An anterior pelvic tilt is a repairable condition. Several exercises can help loosen/relax the hip flexors and strengthen the core and posterior muscle chain. This in addition to walking and reducing wearing high heels regularly. A few exercises for anterior pelvic tilt.

The Tail Tuck

This is literally trying to tilt the tailbone forward, like tucking in an imaginary tail. This can be done for 10-12 reps and up to 3 times.

Plank

Core-strengthening exercises can help with all types of back and hip problems. If possible, do the exercises in front of a mirror to ensure no arching of the back or the butt sticking out. If it is too difficult on the hands, go to the elbows. If there are wrist or shoulder issues, planks can be done on a raised surface, like a table or couch. Hold as long as possible, maintaining proper form. Start with 10-30 seconds and build up to minutes.

Strengthening the Glutes

It is recommended to strengthen the glute muscles. This can be done with exercises like clams or side-stepping with resistance bands. For clams, lie on the side and raise each leg up and down 10-12 times, up to 3 sets. For side-stepping, place resistance bands around the ankle/shin area and step to the side for 8-10 steps. Then go the other direction for the same number of steps. Repeat up to 3 sets.

Hip Flexor Stretch

Lunge forward while standing or lunge and kneel with the other leg on the ground. Then move the torso back a little and engage the core to stretch the hip flexors in the front of the thigh/pelvis area. Hold for 30 seconds, then release. Repeat 3-5 times per leg.

Lifestyle

These exercises can help, but if there is no progress around a month, contact a qualified chiropractor or physical therapist for further instruction and supervision. Also, if any neurological symptoms present like:

  • Sciatica
  • Shooting pain
  • Numbness
  • Tingling
  • Weakness
  • See a doctor as soon as possible.

Fixing posture-related problems require individuals to learn to be posture aware along with making some lifestyle adjustments. One way to do these exercises is to tack them onto a workout. Also, set reminders on a calendar to get up, stretch, and move around if sitting most of the day.

Body Composition Health

Difference between Processed sugar and Natural sugar

There are different types of sugar. There are natural sugars that are found in:

  • Fruits
  • Vegetables
  • Nuts
  • Whole grains
  • Beans

All sugar is broken down into glucose. However, foods that contain natural sugar are also rich in nutrients, including:

  • Vitamins
  • Minerals
  • Fiber
  • Protein
  • All which the body requires for optimal health.

Natural sugar does not lead to excess sugar intake; it happens with processed sugar. Processed sugar is extracted from sugarcane or sugar beet and is normally found as sucrose. This is present in cakes, cookies, cereal, and beverages. Processed sugar is also hidden in foods that are not sweet, like:

  • Microwave meals
  • Spaghetti sauce
  • Low-fat yogurt
  • Ketchup
  • Sports drinks

Foods that contain processed sugar are an energy source, but they contain little or no nutrients and can cause blood sugar levels to spike. In addition, consuming too much sugar is linked to an increased risk of:

  • Diabetes
  • Accelerated aging
  • Weight gain

Research has found that added sugar contributes to around 17% of the total calorie intake for adults. The recommended daily amount of calories from added sugar is 10%.

References

Azaïs-Braesco, Véronique et al. “A review of total & added sugar intakes and dietary sources in Europe.” Nutrition journal vol. 16,1 6. 21 Jan. 2017, doi:10.1186/s12937-016-0225-2

Centers for Disease Control and Prevention (CDC). (May 2020) “Acute Low Back Pain” www.cdc.gov/acute-pain/low-back-pain/index.html

National Institute of Neurological Disorders and Stroke. (March 2020) “Low Back Pain Fact Sheet” www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Orlando Health. (2019) “Bad Posture Often to Blame for Chronic Pain and Health Issues, But Survey Finds Too Few Americans Are Concerned” www.orlandohealth.com/content-hub/bad-posture-often-to-blame-for-chronic-pain-and-health-issues

Re-Energize From Lack of Energy and Fatigue With Bio-Chiropractic

By
Dr. Alex Jimenez
-
chiropractor massaging neck of man lying on towel in hospital

Re-energize from a lack of energy and fatigue with Bio-chiropractic. Millions of individuals struggle to get through the day or night depending on work/school schedules because of deficient energy levels that result in fatigue. Unfortunately, many begin taking over the counter or prescription medication, drinking coffee or highly caffeinated/energy beverages, or taking days off to catch up on rest. There is a wide range of high-sugar and caffeine energy products to help with fatigue. But, research has shown how overconsumption of these products can contribute and/or cause:

  • High blood pressure
  • Cardiovascular disease
  • Diabetes
  • When a tired body takes in caffeinated energy, it is only for a temporary energy boost.
  • Energy products can mask the fatigue causation. This could be a disease, a type of condition, or an overlapping of causes.

 

Re-Energize From Lack of Energy and Fatigue With Bio-Chiropractic

Nervous System

The nervous system is the body’s life energy source. It is responsible for facilitating millions of functions that occur throughout the body every day. These include:

What often happens is that:

  • Poor posture
  • Accidents
  • Injuries
  • Birth trauma
  • Shifts the spine out of alignment, placing added pressure on the delicate nerves in the neck and back. 

The compression causes nerve interference that disrupts optimal nerve energy flow from reaching the organs. This leads to:

  • Fatigue
  • Pain
  • Organ dysfunction
  • Eventually disease

Bio-Chiropractic

Bio-Chiropractic is a scientific and researched based form of musculoskeletal corrective care. It aims to unblock nerve interference through the proper realignment of the spine, returning it to its proper curvature. As a result, many individuals under chiropractic care report immediate relief from neck or back pain, along with a vibrant, energized feeling, and with time their overall health improves.

Body Composition Feedback

Malnutrition

Malnutrition can be defined as a deficiency, excess, or imbalance in an individual’s intake of energy and nutrients. Protein-energy deficiency is a common form of malnutrition. It is a health condition that can have immediate/negative effects on body composition. This deficiency causes damage to skeletal muscle mass as the body progresses into starvation mode, breaking down its own protein stored in the muscles for fuel.

Micronutrient deficiency is a lack of nutrients like minerals and vitamins. These support important functions like cell regeneration, the immune system, and eyesight. Common examples are iron and/or calcium deficiencies. Micronutrient deficiency has the greatest impact on the body’s physiological functions/processes. They can occur at the same time that protein-energy deficiency is happening overlapping each other. Nutritional deficiencies can impact processes like:

References

Berkson, D L. “Osteoarthritis, chiropractic, and nutrition: osteoarthritis considered as a natural part of a three-stage subluxation complex: its reversibility: its relevance and treatability by chiropractic and nutritional correlates.” Medical hypotheses vol. 36,4 (1991): 356-67. doi:10.1016/0306-9877(91)90010-v

Jensen, Gordon L et al. “Recognizing malnutrition in adults: definitions and characteristics, screening, assessment, and team approach.” JPEN. Journal of parenteral and enteral nutrition vol. 37,6 (2013): 802-7. doi:10.1177/0148607113492338

Oakley, Paul A et al. “Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics® (CBP®) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders.” Journal of physical therapy science vol. 32,9 (2020): 601-610. doi:10.1589/jpts.32.601

I Threw Out My Back, What That Means

By
Dr. Alex Jimenez
-
Man Carrying Boxes In Warehouse

I threw my back out. Most of us have heard and possibly experienced throwing our backs out. But, what does throwing out your back really mean? Find out from our experts. When talking about throwing one’s back out, it’s usually a result of twisting, turning, coughing, sneezing, or lifting incorrectly. The medical equivalent to this injury is an ankle sprain. It can be excruciating, individuals might not see or feel a tear, but the ligaments have been injured, causing inflammation and pain. The same thing can happen to the spine.

I Threw Out My Back, What That Means

What it means when you throw out your back.

Most experience acute pain in the lower region of their backs. Individuals can throw out their back at any age doing all kinds of activities. These can range from:

  • Changing a tire
  • Moving lifting boxes, going upstairs, etc
  • House chores/tasks
  • Gardening
  • Sports
  • Working out
  • Bending over to pick up an object

It is more common as individuals age. This is when individuals notice how they could take a serious injury and walk away when they were young. However, with age, something like a cough or sneeze could cause the back to become sprained. When the ankle is sprained, it is immobilized to allow it to rest and heal.

However, it is not as easy to immobilize the spine as large muscles in the back around the spine. Any time tissue is injured, the muscles automatically spasm to act as a splint. These spasms usually tend to be the worst part when back pain presents. This is because the back muscles are large; they cause intense inflammation and pain when they spasm. Combined with this, the back can feel like it is stuck, significantly decreasing the range of motion. This type of injury can take a couple of days to reduce and up to two to six weeks to return to normal function.

This is what is really happening

The majority of the time, what has happened is there is a small ligament strain or an annular tear, which is a tear in the ligament that connects the vertebra to the disc. When standing upright and lifting properly, the disc/s work like hydraulics.

When individuals bend over not using their legs, the back part of the spine widens/opens up, and instead of a hydraulic effect, it becomes a cantilever structure. Bending and twisting compound the pressure across the disc. Prevention is key and by using the legs and keeping the back straight, let the hydraulic system do its natural job.

Misconceptions

Chiropractors specialize in difficult to treat musculoskeletal pain conditions. The term threw out one’s back is similar to the knee, arm, shoulder being blown out. The terminology can create fear associated with the idea of throwing something out of place, especially when it comes to the spine. When individuals come in with back pain, they can become fearful of what will be found. These include:

  • What has happened to my spine?
  • Is it going to get better?
  • Is this going to be a life-long injury?
  • Will I be able to walk normally?

Through research, doctors now know that fear is an inflammatory response. Therefore, when individuals become fearful, their immune system kicks in, causing the pain to worsen.

Treatment

A few things have been proven to work well, along with seeing a doctor, spine specialist, or chiropractor.

Ice and heat

It depends on individual preference. Ice reduces inflammation and pain, and the heat helps to get the blood flowing in and around the area to help heal the injury.

Abdominal support

An abdominal corset is a stretchy band that is worn around the lower mid-section. The abdominal muscles supply support for the lower body. The corset can help take some of the weight off of the spine to help ease discomfort and pain.

Anti-inflammatories

Advil or a prescription Ibuprophen from a physician is better than narcotics. However, if narcotic medications are necessary, they should be short-term, a few days to a week. In addition, individuals need to show caution as they can cause constipation, making back pain even worse.

Chiropractic and Physical Therapy

Seeing a chiropractor and physical therapist can help heal the injury faster. They will strengthen the spinal muscles and educate the individual on stretches, exercise, posture, anti-inflammatory diet for optimal spinal health. Individuals usually take two to six weeks to heal completely. However, individuals should still be able to do most physical activities once the spine injury heals. Maintaining the back muscles can be achieved with regular exercise, lifting correctly with the legs, and not over-twisting and over-reaching are important elements to prevent back injuries.

Body Composition Analysis

Summer Heat and The Body

How the body reacts to extreme heat. It is a process known as thermoregulation, where the body strives to maintain a temperature between 97.7 to 99.5 degrees Fahrenheit. The hypothalamus, a gland in the brain, is in charge of managing the core temperature. If outside weather is extreme, causing a change in the body’s core temperature, the hypothalamus triggers a specific process to heat or cool the body back to the normal range. When the hypothalamus registers that the body’s core temperature is rising because it’s sweltering outside, it kicks in.

To remove the extra heat, the hypothalamus increases circulation, moving the blood toward the surface, dilating blood vessels so that the heat can dissipate through the skin. When this happens, the veins can protrude, and the skin flushes. Along with increased circulation, the hypothalamus also activates the sweat glands. The evaporation of the water released onto the skin cools the body down, reducing temperature. Finally, the thyroid is activated to lower heat created through the metabolic processes.

References

Disc tears: Stat Pearls. (11/17/2020).” Annular Disc Tear.” ”https://www.statpearls.com/ArticleLibrary/viewarticle/17615

Fear and Pain: Journal of Pain Research. (2018). “Assessments of Pain-Related Fear in Individual with Chronic Pain Conditions.” www.ncbi.nlm.nih.gov/pmc/articles/PMC6280906/

Mittinty, Manasi M et al. “Assessment of pain-related fear in individuals with chronic painful conditions.” Journal of pain research vol. 11 3071-3077. 30 Nov. 2018, doi:10.2147/JPR.S163751

Different Individuals Different Sciatica Treatment Approaches

By
Dr. Alex Jimenez
-
Millennial African American guy suffering from back pain, leaning on sofa, cannot walk at home. Young black man having injury or trauma, needing rehabilitation. Healthcare concept

Living with sciatica can be debilitating and exhausting. Find out how different individuals reduced their pain from this condition. Sciatica has different treatment options. It is often a matter of trial and error to find a treatment/therapy that works for the individual. These include:

  • Physical therapy
  • Medication
  • Chiropractic
  • Injections
  • Acupuncture
  • Surgery

Different Individuals Different Sciatica Treatment Approaches

Different individuals with sciatica share what works for them. Here are their stories.

Rudy Found Relief With Self Care

A bad fall left Rudy, a graphic designer, with a broken pelvis and broken foot. I was in the hospital for a few days, and when I came home, I noticed I was hobbling. I had developed sciatica. I was in a lot of pain but decided to try the treatment that had helped me manage chronic migraines. This was yoga. Specifically, it was hot yoga sessions that, despite the pain, worked. However, for others, he recommends not staying still. The body can’t stay stagnant with no movement.

Rudy follows a plant-based diet. Eating right has helped significantly. He starts the day with a green smoothie and sips one throughout the day. This reduces inflammation and pain. His stress would also contribute to the pain. Anything felt from a pain perspective becomes amplified when in a sad, frustrated, confused mood. Rudy’s advice is to get the body moving. And follow a plant-based anti-inflammation diet.

Medication and a Topical Pain Balm Work For Jose

Jose, 66, figured how his sciatica developed was when he decided to insulate the garage. I was bending, twisting, turning, and contouring my body every which way. A week after the job, I developed excruciating pain that got worse over the following weeks. I would jolt out of bed at 2-3 in the morning with severe pain. My doctor gave me steroids that didn’t do anything. I could barely sit down and had to go through a careful method of getting into a chair. I was prescribed Vicodin – hydrocodone/acetaminophen. I took them for a week and a half.

The pain went away, but it came right back as soon as I stopped taking the meds. The meds were only masking the pain. I decided only to use it when the pain was excruciating. This was because I was worried about addiction. I tried chiropractic, massage, acupuncture, cupping, and physical therapy. Unfortunately, I was not feeling any real relief. Then I went to a pain management doctor, who ordered an X-ray and an MRI.

The doctor informed me that my spine was in great shape. The pain management doctor gave me a piriformis injection and, later, an epidural steroid injection. There were still no positive results. My primary care doctor prescribed gabapentin. This is an anti-epilepsy medication that has been shown to help some cases of back pain. Most of the major pain is gone, and I’m pretty sure it’s from the gabapentin along with weekly deep massage sessions. I also use CBD cream with arnica. Movement is important; during the day, I make sure to stand up and walk around.

 

Epidural Injections Work For Isabel

Isabel has chronic pain. This comes from arthritis, migraines, and fibromyalgia. Sciatica developed as a result of these conditions. Soon she couldn’t get into the car or even empty the dishwasher without going through excruciating pain. Nerve ablation or physical therapy was ineffective at relieving the pain. Then my doctor suggested getting an epidural injection. This is not the same type of injection as when having a baby. It is not the same at all. The injection includes a steroid medication called a corticosteroid that is an anti-inflammatory, along with an anesthetic. I tried it and got some relief, but the pain came back. However, after a month and a half, I began to feel more relief. The pain is not completely gone. I do feel better, but there is still some pain. My doctor told me that patients are all different and require different amounts of medication and time to work.

Surgery Gave Pablo His Life Back

Pablo, 50, is no stranger to back pain or back surgery. After living with chronic back pain from a roll-over auto accident, Pablo underwent a laminectomy. A doctor removed a portion of the vertebra in 1998 and spinal fusion in 2004 that fused the discs from L5 to S1. Life was going well until I was laid off from my desk job. I started working at a warehouse doing light work, but I would still help lift moderate/heavy bags, boxes, etc. I just pushed through the pain, thinking it was a strain that would go away.

However, during the last six months, the pain was so bad I had to stop working. I needed a cane to get out of a chair. Friends and family told me I was walking like a 90-year-old. I also lost feeling in a couple of my toes. In 2021 I had another fusion and had a broken screw from my earlier fusion repaired. The surgery went well, and they said as long as I don’t do any heavy lifting, I should be alright. Although there is still pain, it is much less than it was before the surgery. My doctor recommended a new desk job and a physical therapy rehabilitation, stretching, and strengthening program.

Body Composition

Calories burned from 10,000 steps

Estimations of how many calories are burned from exercises like walking or running depends on how heavy an individual is. Heavier people use more energy to move than lighter people. Estimates revolve around 100 calories burned per mile for a 180-pound person. 10,000 steps comes to around roughly 5 miles. Assuming an individual weighs 180 pounds means 100 calories x 5 miles equals 500 calories. Over a week, it becomes 3,500 calories. However, lighter or heavier individuals will burn less or more calories while walking the same number of steps or distance.

Chiropractic Care For Individuals Post Back Surgery or Spinal Fusion

By
Dr. Alex Jimenez
-
Professional senior physiotherapist doing manual treatment to a men's thoracic spine in the cabinet of rehabilitation clinic

Individuals that go through severe low back pain caused by degeneration, herniated discs, vehicle, personal, work, and sports injuries, surgery, or spinal fusion is usually a last resort if non-invasive treatments fail to provide relief or not enough relief. Patients try to avoid spinal fusion because it can be an intense experience and requires a year-long recovery period. Unfortunately, individuals still experience discomfort and pain after surgery. Do individuals want to know what other treatment options are available, including chiropractic care?

Chiropractic Care For Individuals Post Back Surgery or Spinal Fusion

Doctors will inform post-op patients of the risks involved with chiropractic therapy. However, chiropractic medicine can bring natural pain relief after surgery. Chiropractic treatment requires that an individual be adequately or fully healed before beginning a personalized treatment plan. At Injury Medical Chiropractic and Functional Medicine Clinic, we consult patients post-surgery about the effectiveness of rehabilitation spinal adjustments and physical therapy massage.

Wait Time After Surgery

Spinal fusion surgery involves removing the discs between two or more vertebrae and fusing the bones with metal screws and plates. The objective is to correct conditions like herniated discs and degenerative diseases by immobilizing the spine in that area. It can take at least three months for the vertebrae to fuse for a fully immobilized graft. Once the graft is complete, a few months of physical therapy are recommended to loosen/stretch and strengthen the muscles around the graft. Initial recovery combined with physical therapy typically takes a full year for a complete recovery.

It is during recovery where it can be difficult and for discomfort and pain to present. The reason is patients are recommended to avoid any twisting, bending, over-reaching motions, or the graft could break. This can make an individual take on awkward poses/postures, flexing and contracting muscles incorrectly, causing strain. The result is added discomfort and/or pain.

How Chiropractic Helps

Spinal fusion is not guaranteed to alleviate an individual’s back pain completely. But many do experience discomfort or pain post-surgery. This could be for a little while or longer, depending on their condition or injuries. Fortunately, chiropractic treatment can help bring pain relief through mobilization, manipulation, and massage techniques. Manipulations’ objective is to adjust and/or realign the bones of the spine and other areas of the body. Because of the intricacy of spinal manipulations, many who have undergone back or spinal fusion surgery are hesitant to seek chiropractic treatment. Discuss possible chiropractic care with your physician to determine if the surgical graft is strong enough to withstand spinal manipulations. If the graft is adequately/fully healed and your physician believes it can endure mild adjustments, reach out to a chiropractor to discuss a customized treatment plan.

Body Composition Testing

Poor Leg Skeletal Muscle Mass

The gluteal muscles or buttock muscles are the largest muscle group in the body. Individuals can start losing bone density by their 30s. This increases the risk of injury and further bone density loss. Bone density loss is a natural process, but the process can be accelerated for individuals with under-developed skeletal muscle mass. The health of muscles and bones are closely linked. Researchers found that individuals with less muscle mass than average for their height tended to have narrower and thinner bones. This resulted in limited lower bending strength.

Decreased muscle mass was shown to be linked to balance problems and increased risk of falls. There is a higher prevalence of sarcopenia or muscle wasting for patients with hip fractures and a reduction of leg muscle mass. The combination of:

  • Low muscle mass
  • Low bone density
  • Hip fractures
  • It can have lifelong consequences
References

Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” 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. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y

Keller, Glenda. “The effects of massage therapy after decompression and fusion surgery of the lumbar spine: a case study.” International journal of therapeutic massage & bodywork vol. 5,4 (2012): 3-8. doi:10.3822/ijtmb.v5i4.189

O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7

Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post-spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0

Szulc, Pawel et al. “Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study.” Journal of bone and mineral research: The American Society for Bone and Mineral Research vol. 20,5 (2005): 721-9. doi:10.1359/JBMR.041230

Lower/Lumbar Back Total Disc Replacement or Fusion Options

By
Dr. Alex Jimenez
-
Young radiologist showing x-ray image to her aged patient and giving recommendations about treatment

Many doctors/surgeons rely on the widely adopted lumbar spinal fusion. However, experts have asserted that lumbar total disc replacement or TDR should be made available and increased for treating degenerative disc disease and other spinal conditions. Individuals interested in total disc replacement, the ability to have it done, and if insurance will pay? What to know about TDR and fusion before deciding and moving forward.

Lower/Lumbar Back Total Disc Replacement or Fusion Options

Total Disc Replacement

Spinal fusion has been the traditional approach for relieving lower back pain. In this procedure, a bone graft is inserted between two or more vertebrae. This eliminates movement that causes pain or could be dangerous to the individual. Total disc replacement demands more on a technical level than spinal fusion. However, the worn-out, injured, or damaged disc is fully replaced, even a completely degenerated disc, with a metal and/or plastic one. Benefits from lumbar TDR surgery include:

  • Shown to be a safe procedure with minimal complications
  • Significant improvement in health and quality of life
  • High rates of successful outcomes
  • Mobility is preserved

Who Needs Disc Replacement?

Low back problems affect more than a third of the population. This can come from:

  • Personal
  • Work
  • Sports
  • Automobile injuries
  • Aging
  • All are risk factors

Fusion or Total disc replacement

Fusion reduces and eliminates motion around the affected area which also changes with the spine’s mechanics. It can also place increased stress on the surrounding segments. However, the lack of motion is to eliminate the pain. Total disc replacement does increase mobility, but it can’t fully relieve the pain.  It can relieve pain generated from the disc but not from other causes. TDR has been shown to:

  • Provides motion preservation
  • Reduces staying at the hospital
  • Provides long-term durability
  • Lower reoperation rates compared to fusion

Total disc replacement issues:

  • The procedure is more time-consuming
  • A lot of time making decisions
  • A lot of time preparing

An example could be the patient has a narrow disc space. Looking at the X-rays of the discs above and below, the surgeon has to make sure they choose the right size. Next, the narrow space needs to be mobilized back to a normal height that cannot be too high or too short. Finally, the surgeon has to make sure that the disc is anchored and fits properly.

Why Surgeons Still Choose Fusion?

Despite the benefits, there are reasons why surgeons still choose fusion.

  • There are strict rules as to when TDR can be used. This means insurers are prone only to approve fusion procedures.
  • The surgical technique is challenging. TDR surgery is a highly demanding procedure. As a result, many doctors specializing in fusion for 20 years or more can be reluctant to perform the procedure.
  • Complications and revision surgeries. Reoperations are sometimes necessary, but this happens in both fusion and TDR.

Individual Needs

Fortunately, most individuals with lower back problems never need total disc replacement. And those that do have severe pain/conditions are recommended to try non-invasive/surgical treatment. This ranges from:

  • Chiropractic
  • Physical therapy
  • Massage

Imaging and lab tests will be required.

However, if an operation is necessary, ask questions about both procedures. For example, if a surgeon insists that fusion is the only option, ask why total disc replacement is not an option?

Body Composition Testing

Protein and Weight Loss

Protein is one of three basic macronutrients found in food. Proteins are made up of smaller units called amino acids. There are 22 amino acids, with 9 of these being essential. This means the body needs them, as the body cannot produce them. These essential amino acids can be obtained by eating protein-rich foods like:

  • Eggs
  • Meat
  • Fish
  • Vegetarian/vegan options include:
  • Nuts
  • Seeds
  • Beans
  • Tofu

Generally, all the essential amino acids cannot be obtained from just one food. Therefore it is recommended to eat a variety of animal and plant-based proteins. Protein is in almost every structure and function of the body.

Antibodies

These proteins fight off any infections, bacteria, etc.

Repair, maintenance, and structural

Proteins are the building blocks of the body’s muscles, bones, skin, and hair.

Hormones

Chemical messenger proteins are how cells and organs communicate. For example, Growth Hormone affects muscle gain and fat loss.

Enzymes

Not all proteins are enzymes; however, all enzymes are proteins. These proteins are catalysts or starters for chemical reactions in the body.

Transportation and storage

Some proteins carry molecules where they are needed. For example, hemoglobin or the red blood cells carry oxygen to cells, then transport carbon dioxide away.

Not getting enough protein in one’s diet can have serious consequences on the body’s health. Without enough protein, the muscles can begin to atrophy or waste away, taking Lean Body Mass, strength, and energy away as well.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

phone: 915-850-0900

Licensed in: Texas & New Mexico*

References

Salzmann, Stephan N et al. “Lumbar disc replacement surgery-successes and obstacles to widespread adoption.” Current reviews in musculoskeletal medicine vol. 10,2 (2017): 153-159. doi:10.1007/s12178-017-9397-4

Hopkins overview of Lumbar TDR (for consumers) www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

“Comparison of Lumbar Total Disc Replacement With Surgical Spinal Fusion for the Treatment of Single-Level Degenerative Disc Disease: A Meta-Analysis of 5-Year Outcomes From Randomized Controlled Trials”, Zigler J, et al., Global Spine Journal, June 2018, PMC602295 www.ncbi.nlm.nih.gov/pmc/articles/PMC6022955/

“Overview of Lumbar TDR” (for consumers); Johns Hopkins Medical Center www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

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Sciatica Specialist
STOP SUFFERING! We specialize in advanced non-surgical approaches in treating sciatica. Our focus is to stop the pain, remove the cause and prevent chronic recurrence of complex sciatica pain syndromes. We treat with advanced protocols and supportive care plans. Blessings - Dr. Alex Jimenez DC, MSACP, IFMCP, CIFM, ATN
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