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Risk Issues Associated With Coronary Heart Disease

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

The heart is a fantastic muscle in the body that allows hormones, oxygenated blood, and nutrients to travel and transport to all the muscles, tissues, and organs, providing functionality to the body. As one of the main components of the cardiovascular system, the heart works together with the lungs to help carry the deoxygenated blood to the pulmonary system to dispose of waste from the body. The human body needs the heart to stay healthy; however, factors like stress, obesity, autoimmune diseases, and unhealthy habits can affect the heart, causing cardiac issues associated with various body problems. Today’s article focuses on coronary heart disease, what are the risks associated with coronary heart disease, and ways to prevent coronary heart disease from progressively getting worse. We refer patients to certified providers specializing in cardiology treatments that help those with issues of coronary heart disease. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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What Is Coronary Heart Disease?

 

Have you been experiencing hypertension in your body or near your heart? How about unexplained chest pains that randomly showed up? Have you experienced pain running down your shoulders and arms? Many of these are signs that you could be experiencing coronary heart disease. Research studies have defined coronary heart disease as a common heart condition with plaque formation in the heart vessels that cuts off the supply of oxygenated blood to the heart and the rest of the body. As part of cardiovascular diseases, coronary heart disease can cause overlapping profile issues over time if it is not treated right away. Many disruptive factors can affect the heart muscle like:

  • Age and gender
  • Oxidative stress
  • Inflammation
  • Vascular immune dysfunction
  • Lack of physical activities 

These disruptive factors can increase cardiovascular disease mortality that can affect the heart and be co-morbidities associated with different issues affecting the body. Studies reveal that the mechanisms of cardiac pain are associated with the chest and upper left arm pain. This is defined as referred pain where the sensory input from visceral organs mimics cardiac distress, and the corresponding muscles are affected. But how does this correlate to the heart muscle, and why does the chest experience pain? Visceral pain is a bit trickier to diagnose when cardiovascular disorders overlap the risk profiles associated with other issues affecting the body. For example, you could be experiencing pain in your chest and upper back, but your brain is telling you something is affecting your heart.

An Overview Of CAD-Video

Mayo Clinic Explains Coronary Artery Disease

Have you experienced shortness of breath? How about pain located in your chest or radiating from your shoulders and arms? Have you noticed inflammation occurring in your body? Many of these are signs and symptoms of you experiencing coronary artery disease in your body. The video above explains what coronary artery disease is and the risk factors associated with the progression of this common heart disease. Studies reveal that the risk factors can overlap in profiles that contribute to the development of coronary heart disease:

  • Environmental factors
  • Lifestyle habits
  • Diabetes mellitus
  • Obesity
  • Symptomatic angina
  • Smoking

When a person has these risk profiles overlapping different associated issues, their body becomes dysfunctional. Sometimes the symptoms affect other areas of the body, while the brain might be signaled that something is wrong with the heart. Since coronary artery disease progresses slowly over time, many individuals don’t experience the symptoms affecting their heart muscles.

Risk Issues Associated With CHD

Some of these symptoms that overlap in risk profiles may seem like heart issues but may refer to different problems affecting the body. This is defined as viscero-somatic pain, where the pain in the internal organs is associated with the corresponding muscles that share the same nerve. Chest pain associated with heart issues is a perfect example. Studies reveal that chest pains can become indistinguishable from angina, which may result from abnormalities in the thoracic viscera that overlap in profiles with heart issues. So what does it mean? It implies that sensory neurons from different visceral organs might mimic cardiac pain-causing risk-associated problems that affect the thoracic region of the spine triggering neck and upper back issues. Everything is connected as chest pains, dyspnea, and dyspepsia are intertwined with the thoracic anteriority becoming a mediator for cardiovascular diseases.

 

Ways To Prevent CHD

So let’s visualize a person going to their primary physician due to them experiencing heart issues associated with chest pains after the doctor goes through a manual examination on checking the individual’s heart and chest to see what problems are affecting the body. What does this implicates, and how do chest and back pains correlate with each other if there are heart issues? Studies reveal that the peripheral tissues in the body might be damaged from traumatic events that cause an inflammatory swelling in the cervical and thoracic region of the spine, causing muscle stiffness. Chiropractic care might be the answer to relieving pain and swelling triggering cervical and thoracic pain. Chiropractors use chiropractic adjustments to deliver a non-invasive, gentle treatment that reduces spinal misalignments to enhance the functionality of the musculoskeletal system. This will improve spinal health in the cervical and thoracic regions of the body by decreasing inflammatory swelling associated with heart issues. Chiropractic care, a healthy diet, and exercise also work hand in hand by positively impacting co-morbidities of coronary heart disease and other body problems like obesity to reduce cholesterol, help strengthen the weak muscles along the neck and upper back, and promote blood flow to the heart.

 

Conclusion

As part of the cardiovascular system, the heart supplies hormones, oxygenated blood, and nutrients throughout the entire body by ensuring that the muscles, tissues, and organs are functioning. When factors like stress, obesity, and unhealthy habits begin to affect the heart, it can develop cardiac issues like coronary heart disease associated with various body problems. Chest pains associated with heart issues that trigger neck and back pain in the body are known as viscero-somatic pain. Available treatments like chiropractic care and changing unhealthy habits work hand in hand to positively impact co-morbidities of coronary heart disease and reduce muscle stiffness along the neck and back muscles of the cervical and thoracic spine.

 

References

Börjesson, M. “Visceral Chest Pain in Unstable Angina Pectoris and Effects of Transcutaneous Electrical Nerve Stimulation. (TENS). A Review.” Herz, U.S. National Library of Medicine, Apr. 1999, https://pubmed.ncbi.nlm.nih.gov/10372297/.

Foreman, Robert D, et al. “Mechanisms of Cardiac Pain.” Comprehensive Physiology, U.S. National Library of Medicine, Apr. 2015, https://pubmed.ncbi.nlm.nih.gov/25880519/.

Malakar, Arup Kr, et al. “A Review on Coronary Artery Disease, Its Risk Factors, and Therapeutics.” Journal of Cellular Physiology, U.S. National Library of Medicine, Aug. 2019, https://pubmed.ncbi.nlm.nih.gov/30790284/.

Shahjehan, Rai Dilawar, and Beenish S Bhutta. “Coronary Artery Disease – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 9 Feb. 2022, https://www.ncbi.nlm.nih.gov/books/NBK564304/.

Disclaimer

Chiropractor Recommendations Neck Problems and Cervical Stenosis

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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handsome sportsman having pain in neck and talking with friends in gym

Cervical spinal stenosis is a condition that causes narrowing of the neck region of the spine. This narrowing can compress the nerves causing pain and discomfort. The symptoms are caused by the misalignment/subluxation of the neck, which is usually the c1 and c2 vertebrae. Misalignments can be caused by daily wear and tear; injuries and tumors can cause or worsen the condition. Cervical spinal stenosis is a severe condition that worsens as time progresses and can cause permanent damage and paralysis. Chiropractor recommendations and non-invasive techniques can alleviate the symptoms, along with therapeutic stretches and exercises, and diet is all part of a personalized treatment plan.

Chiropractor Recommendations: Cervical Spinal Stenosis

Stenosis Symptoms

The most common symptom is neck pain. Doctors recommend avoiding all activities that worsen the pain; however, chiropractors suggest remaining as active as possible to keep the muscles strong. This is because inactivity over time can lead to muscular deterioration around the neck. Other symptoms besides neck pain include:

  • Neck discomfort and pain
  • Headaches
  • Numbness, tingling in the shoulder, arm, hand
  • Difficulty maintaining balance
  • Walking problems

Chiropractor Recommendations

Pain Or Stiffness In The Neck Should Not Be Ignored

  • Pain or stiffness in the neck that worsens rapidly or does not ease up or go away after two weeks requires medical attention.
  • Ignoring or dismissing the pain or stiffness can worsen the condition.

Looking Down At A Phone Too Long

  • Looking down too long increases the strain on the neck.
  • Keeping the head forward for extended periods increases the chances of pinching/compressing nerves and causing radiculopathy.

Exercises That Roll The Neck Around

  • Exercises that roll or pull the neck are not advised as they can exacerbate the condition.
  • A chiropractor will recommend specific neck stretches and exercises on a case-by-case basis.

Heavy Bag, Purse, BackPack On One Shoulder

  • It is recommended to carry a backpack with both shoulders to distribute the weight evenly.
  • Over time, a backpack, bag, or purse on the same shoulder will disrupt the walk cycle and pull down on one side of the neck, exacerbating cervical spinal stenosis.
  • For bags and purses with one strap, it is recommended to alternate shoulders or use a crossbody strap.

Sleeping On The Stomach

  • Sleeping on the stomach means having to turn the neck to one side.
  • This stresses and aggravates cervical stenosis.
  • It is recommended to sleep on the side or back.

Treatment, Therapy, and Rehabilitation

  • Chiropractic is recommended for spinal stenosis because it corrects and re-aligns dislocated and herniated discs and decompresses the spine.
  • Treatment reduces pressure on the spinal cord and its joints and nerve networks.
  • Various techniques include physiotherapeutic massage, spinal adjustments, cervical traction, spinal decompression, and flexion-distraction, which will address stenosis symptoms, treat pain, reduce inflammation, numbness, and restore muscle function.

Non-Surgical Cervical Decompression

References

Clark, Aaron J et al. “Cervical spinal stenosis and sports-related cervical cord neurapraxia.” Neurosurgical focus vol. 31,5 (2011): E7. doi:10.3171/2011.7.FOCUS11173

Kukurin, George W. “The amelioration of symptoms in cervical spinal stenosis with spinal cord deformation through specific chiropractic manipulation: a case report with long-term follow-up.” Journal of manipulative and physiological therapeutics vol. 27,5 (2004): e7. doi:10.1016/j.jmpt.2004.04.009

Isaac Z. Evaluation of the patient with neck pain and cervical spine disorders. UpToDate. https://www.uptodate.com/contents/evaluation-of-the-patient-with-neck-pain-and-cervical-spine-disorders. Last updated May 2, 2016. Accessed February 25, 2018.

The Gut-Brain Axis Affected By Somatovisceral Pain

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

The gut-brain axis is fundamental to the body as it communicates bi-directional with the brain and the gut. Separately they provide different functions that are required of the body. The brain, part of the central nervous system, allows the neurons to travel to each overlapping nerve root while having a causal relationship with different muscles and organs connected to the spinal cord. While the gut, which is part of the gastrointestinal and digestive system, helps modulate the body’s homeostasis and regulates the immune system. The nerves, muscles, and organs correspond as the nerve pathways interconnect to the spinal cord. When injuries or traumatic events affect the body, it can lead the individual to suffer from pain affecting their body while increasing the risk associated within different locations. For example, chronic stress causing gut inflammation is associated with headaches or neck and back pain. Today’s article focuses on the gut-brain axis, what happens when chronic issues affect the gut-brain axis, and how somatovisceral pain affects the gut-brain axis. We refer patients to certified providers specializing in gastroenterology treatments that help those with issues that affect the gut-brain axis and overlapping problems impacting the body. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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How Does The Gut & Brain Work Together?

The way the gut and brain correlate together is quite remarkable. The gut allows food to be digested in the stomach to be bio-transformed into nutrients the body needs to function. While the brain sends neuron signals through the spinal cord, those signals help provide the sensory-motor functions to make the body move. Now, how do the brain and gut work together in the body? Well, studies reveal that the gut-brain axis correlates to the various systems like the autonomic nervous system, the HPA axis, and the nerves surrounding the gastrointestinal tract help the brain influence intestinal activity and regulate cognitive function. Each of these vital organs has a causal relationship where they:

  • Help with sleep regulation
  • Improve memory functionality
  • Helps coordinate physical and emotional well-being
  • Regulating inflammatory responses

When chronic issues affect the gut-brain axis, it can cause an overlap in risk profiles that rise in the body and not just in the brain or the gut. Studies reveal that issues that begin to affect the gut-brain axis can cause alteration within the bi-directional pathway and trigger other problems that correlate to the body.

 

Chronic Issues Affecting The Gut-Brain Axis

Have you been suffering from fatigue? How about reoccurring headaches that never seem to go away? Do digestive complaints like IBS, GERD, or gut inflammation affect more than your gut? These chronic issues can be various factors that impact the bi-directional connection of the gut-brain axis. Stress, gut inflammation, traumatic events, food allergens, autoimmunity, and metainflammation are some overlapping risk profiles associated with neck and back pain. Studies reveal that chronic stress in the brain can affect the gut’s composition and functionality by alternating intestinal permeability. When the gut microbiome is being affected, the harmful bacteria begin to overproduce and trigger the sympathetic branch of the nervous system to cause an imbalance of hormones to be released and be associated with stress-related muscle dysfunction in the body. So what does this implicates to the body? Let’s say, for example, that you have been experiencing pain in the cervical region of the spine, but your brain is telling the body that it is a headache. This is known as somato-visceral pain. 

 

An Overview Of Somatosensory Tract-Video

Somatosensory tracts | Organ Systems | MCAT | Khan Academy

Have you been suffering from cognitive and memory dysfunction? How about experiencing gastrointestinal issues that are affecting your gut? Or have you experienced any cramping, gnawing, or sharp pain that seems to be triggered by movement and appears in one area of the body? This is known as somato-visceral pain and is defined as soft tissues and muscles experiencing pain that can affect the internal organs. Somato-visceral pain is much easier to identify than viscero-somatic pain because visceral pain is caused by damaged internal organs associated with distress in different body locations. At the same time, somato-visceral pain is often associated with musculoskeletal pain. The video above explains the somatosensory tract that is in the body and how the body responds to the somatosensory system. The somatosensory system is located within the peripheral and central nervous systems. It is responsible for modulating the body’s sense of touch, vibration, temperature, and pain receptors that are located in the body. When traumatic events affect the somatic nerves, they can trigger changes in the gut-brain axis and cause alterations to the affected organs.

Somatovisceral Pain Affecting The Gut-Brain Axis

When dealing with chronic stress, the effects cause a dysfunctional gut-brain axis and cause issues affecting the two organs. Studies reveal that when chronic stress becomes an associated mediator for gut disturbances and dysregulation of the gut-brain axis, it can cause an overlap in risk profiles in the body. So what does this mean, and how is the body affected by somato-visceral pain? First, let’s look at what happens when the body is affected by chronic stress. When stress affects the gut and the brain, it can cause issues like IBS (irritable bowel syndrome) or headaches. Studies reveal that IBS is one of the most common gastrointestinal disorders that trigger visceral and somatic hypersensitivity on the sensory nerves. So the body experiencing sharp pain in the back or neck may be associated with IBS.

Now looking at headaches and their causes on the body, it is one example of somato-visceral pain. When a person is dealing with neck trauma due to an auto accident that causes whiplash can trigger cervicogenic headache. How do the two correlate with somato-visceral pain? Well, somato-visceral pain is when soft muscles and tissues are affected and can cause an impact on the internal organs. For cervicogenic headaches may trigger mechanical pain along the cervical spine to be aggravated by movement and be associated with musculoskeletal issues like rheumatoid arthritis, ankylosing spondylitis, or muscle strain on the upper cervical spine. Many individuals go to available treatments that can help them better understand the issue that is causing them to be in pain and how to alleviate them.

Conclusion

The gut-brain axis is fundamental in the body as it communicates bi-directional with the brain and the gut. These two organs help keep the body functioning as the brain provides neuron signals while the gut regulates homeostasis. The gut-brain axis helps the body by correlating with the various systems that help influence intestinal activity and control cognitive function. When traumatic factors affect the body’s soft tissues and muscles and trigger organ issues, this is known as somato-visceral pain. Somato-visceral pain is when the muscles are affecting the organs, and an example is cervical muscle strain associated with headaches. Providing much-needed information on available treatments can help many individuals when being examined by their physicians.

 

References

Appleton, Jeremy. “The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health.” Integrative Medicine (Encinitas, Calif.), InnoVision Health Media Inc., Aug. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/.

Carabotti, Marilia, et al. “The Gut-Brain Axis: Interactions between Enteric Microbiota, Central and Enteric Nervous Systems.” Annals of Gastroenterology, Hellenic Society of Gastroenterology, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/.

Martin, Clair R, et al. “The Brain-Gut-Microbiome Axis.” Cellular and Molecular Gastroenterology and Hepatology, Elsevier, 12 Apr. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047317/.

Suslov, Andrey V, et al. “The Neuroimmune Role of Intestinal Microbiota in the Pathogenesis of Cardiovascular Disease.” Journal of Clinical Medicine, MDPI, 6 May 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124579/.

Yuan, Yao-Zong, et al. “Functional Brain Imaging in Irritable Bowel Syndrome with Rectal Balloon-Distention by Using Fmri.” World Journal of Gastroenterology, Baishideng Publishing Group Inc, June 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4611816/.

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Sports Performance Competitive Anxiety: Tension Release Chiropractor

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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The sportsman performing difficult exercise, sports gymnastics indoor. The exercise, gymnast, sportsman, health, gymnastics, training, athlete concept Caucasian fit model

Athletes train and practice constantly to prepare their mind and bodies for the big games, matches, etc. When the game is on, it is normal/natural to feel anxious and nervous, especially at the beginning, but then the athlete settles in and relaxes, letting their training take over. However, for some athletes, the anxiousness and nervousness don’t go away but intensify, the heart starts racing, and the individual can’t stop thinking about choking, failing, and losing. This is known as sports performance anxiety, or competitive anxiety, and is common.

Sports Performance Competitive Anxiety: Chiropractic Tension Release

Competitive Anxiety

Research shows that 30 to 60 percent of athletes experience the disorder. Doctors divide the signs and symptoms into mental and physical categories.

Physical Symptoms

Rapid Heartbeat

  • The stress can cause overproduction of adrenaline and cortisol, making the heart beat rapidly.

Muscle Tension

  • The muscles can tighten up, become painful, and cause tension and pain in the head.

Trembling

  • The hands could shake while holding the ball, bat, racket, or foot twitching could present.

Hyperventilation

  • Individuals report a sensation of choking or being unable to catch their breath.

Digestion Issues

  • The stress can cause foods to be quickly digested, causing cramping and/or the sudden urge to use the bathroom.

Mental Symptoms

Fear of Failing

  • The athlete imagines themselves losing all the time.
  • Worrying about letting the coach and team down or the audience or other athletes criticizing and laughing at your performance.

Unable to Focus

  • The athlete may have concentration issues and become absorbed in how others react to their performance.

Overthinking

  • The athlete can temporarily forget how to perform specific actions that are typically automatic.

Self-confidence issues

  • The athlete can start doubting their abilities.

Stress and Anxiety

The Yerkes-Dodson law explains how stress, anxiety, and arousal levels affect performance and how stress levels must be maintained within a range to perform well.

Low Arousal

  • It could be the athlete is not as into the sport as when they began, so they do not put forth the total effort.

High Arousal

  • This means the sport could be causing so much stress that the athlete panics or freezes up.
  • Competitive anxiety sets in.

Optimal Arousal

  • This means the athlete is fully engaged in pushing themselves to the fullest.
  • This can be applied to any performing task like play rehearsals to a tennis match.
  • Individuals have different optimal levels of stress.

Recommended Steps

Some recommended steps can be taken to handle and prevent sports competitive anxiety when trying to overcome those overwhelming feelings of nervousness and tension.

Positive self-talk

  • Self-talk is having a positive conversation with yourself.

Athletes who practiced positive self-talk reported:

  • Improved self-confidence
  • Reduced physical anxiety symptoms
  • Improved sports performance

Listen to Music

  • When anxious before a meet, game, match, etc., consider listening to some favorite or relaxing music.

Meditation

  • Meditation has been found to reduce all types of anxiety, including sports.

Chiropractic

Chiropractic treatment specializes in the musculoskeletal system and can realign the body and release any muscle tension and restriction through hands-on manipulation techniques and mechanical decompression. Treatment involves manipulating the muscles, ligaments, tendons, fascia, and soft tissues to relieve pain through therapeutic muscle therapies that include:

  • Massage
  • Myofascial release
  • Trigger point therapy
  • Chiropractic adjustments
  • Spinal decompression

One or a combination of therapies can alleviate symptoms related to muscle spasms, delayed onset muscle soreness, fascia restrictions, soft tissue injuries, and pain and dysfunction throughout the body, restoring function, movement, and strength.

Using The DRX9000 For Spinal Decompression

References

Elliott, Dave, et al. “The effects of relaxing music for anxiety control on competitive sport anxiety.” European journal of sports science vol. 14 Suppl 1 (2014): S296-301. doi:10.1080/17461391.2012.693952

Ford, Jessica L et al. “Sport-related anxiety: current insights.” Open access journal of sports medicine vol. 8 205-212. 27 Oct. 2017, doi:10.2147/OAJSM.S125845

Rice, Simon M et al. “Determinants of anxiety in elite athletes: a systematic review and meta-analysis.” British journal of sports medicine vol. 53,11 (2019): 722-730. doi:10.1136/bjsports-2019-100620

Rowland, David L, and Jacques J D M van Lankveld. “Anxiety and Performance in Sex, Sport, and Stage: Identifying Common Ground.” Frontiers in psychology vol. 10 1615. 16 Jul. 2019, doi:10.3389/fpsyg.2019.01615

Walter N, et al. (2019). Effects of self-talk training on competitive anxiety, self-efficacy, volitional skills, and performance: An intervention study with junior sub-elite athletes. mdpi.com/2075-4663/7/6/148

PTSD Physical Pain Symptoms Post Car Accident

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Stressed woman driver sitting on street side shocked after car accident. Road safety and insurance concept.

Motor vehicle crashes and accidents cause significant trauma in a few seconds changing an individual’s life completely. Severe injuries include traumatic brain injury, spinal cord damage, fractures, and amputations. Many individuals experience post-traumatic stress disorder – PTSD after a vehicle collision; even a minor accident can cause emotional trauma symptoms. PTSD commonly presents with other symptoms that range from depression to heart disease, and the most frequent symptom is physical pain. Chiropractic decompression, physical therapy, and therapeutic massage can help alleviate physical pain.

PTSD Physical Pain Symptoms

PTSD Physical Pain

Physical trauma can cause immediate physical effects and injury, as well as physical symptoms that present later on.

Symptoms

  • Flashbacks or reliving the collision incident.
  • Sleep disturbances.
  • Nightmares about the wreck.
  • Fatigue.
  • Memory and concentration problems.
  • Hyperarousal.
  • Fear.
  • Anxiety.
  • Irritability or anger.
  • Avoiding driving or riding in a vehicle.
  • Trying not to talk or think about the crash or accident with friends, family, places, or anything associated with the trauma.
  • Avoiding activities.
  • Emotional numbness.
  • Detachment.

All can generate physical muscle tension and chronic stress, leading to headaches, migraines, back pain, stomach pain, and body aches. Long-term physical pain symptoms can turn chronic pain and medication dependency into a vicious cycle.

Chiropractic Therapy

Chiropractic care diagnoses and treats disorders of the musculoskeletal system. Chiropractic treatment is recommended to help alleviate the physical symptoms of PTSD. Trauma causes individuals to store intense emotions in their bodies. Chiropractic manipulation and decompression release the tension in the muscles caused by the trauma and the emotional stress. Adjustments restore the body’s alignment and open the nervous system circulation, allowing signals to flow freely, leading to a healthier mind-body connection.

Non-Surgical Spinal Decompression Therapy

References

Beck, J Gayle, and Scott F Coffey. “Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations.” Professional psychology, research, and practice vol. 38,6 (2007): 629-639. doi:10.1037/0735-7028.38.6.629

Elder, Charles et al. “Comparative Effectiveness of Usual Care With or Without Chiropractic Care in Patients with Recurrent Musculoskeletal Back and Neck Pain.” Journal of general internal medicine vol. 33,9 (2018): 1469-1477. doi:10.1007/s11606-018-4539-y

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd

Hu, JunMei, et al. “Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study.” Pain vol. 157,2 (2016): 438-444. doi:10.1097/j.pain.0000000000000388

Muscle Memory – Low Back Pain and Sciatica

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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girl with pain in back after moving heavy boxes

The lower back core muscles initiate and control movement and posture. Total body movements start at the pelvis and are carried out by the low back and abdominal muscles. These core muscles provide control and stability when moving. When the body is not moving, standing and sitting posture habits (healthy and unhealthy) develop based on how an individual controls/holds their pelvis posture. The lower back muscles are in constant demand for performing repetitive motions or forceful actions. The muscles become chronically tight and sore,  joints and nerves get compressed, and bones and connective tissue stay in a stressed state, causing intense pain and damage to the body’s structure. These problems can result from muscle memory, the nervous system’s operating procedure to make movements automatic.

Muscle Memory, Back Pain and Sciatica

Muscle Memory

The nervous system controls the movement and contraction in the muscles and constantly reinforces and learns new movement patterns to become more efficient through muscle memory. However, this learning process allows for the development of healthy muscle habits and unhealthy muscular habits. An example is sitting using a slouching posture. The nervous system will store that posture data and subconsciously contract the abdominal and pectoral muscles, so the slouched posture takes over. Because of the continual usage and compromised postures, various muscles start to tighten up. Individuals are typically not aware of the gradual tightening until stiffness, soreness, and pain sets in. Tight muscles pull the skeleton in awkward ways that cause body misalignments, causing:

Individuals develop unique muscle patterns and tension levels throughout the body due to repetitive daily activities, stress responses, injuries sustained, and physical activities. Muscle memory issues can contribute to chronic back pain and sciatica. Unhealthy muscle memory causes the muscles not to return to their natural state but to the awkward position and makes that the natural state. Healthy muscle memory leads to instant reflexes that make movements smooth and effortless.

Chiropractic will relieve back and sciatica pain by inducing deep muscle relaxation that releases endorphins. The soreness and tension will be massaged, and mechanical decompression if necessary. Massage and stretching will help retrain muscle and movement memory, along with exercises to reinforce the retraining.

Spinal Decompression Therapy

References

Campbell, James N, and Richard A Meyer. “Mechanisms of neuropathic pain.” Neuron vol. 52,1 (2006): 77-92. doi:10.1016/j.neuron.2006.09.021

Wilder, David G et al. “Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomized controlled trial.” Trials vol. 12 161. 28 Jun. 2011, doi:10.1186/1745-6215-12-161

After Traveling Relieve Musculoskeletal Stress With Chiropractic Therapy

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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After traveling, body/musculoskeletal aches and pains can present from continual standing in line, sitting, staying in the same position, carrying a heavy bag or pulling a suitcase, and sleeping in an unfamiliar bed with different pillows, on a plane or car can cause body imbalances, jerking the spine out of alignment, straining the neck, shoulders, and back causing headaches, soreness, stiffness, back pain, and compression. Chiropractic massage and decompression will relieve travel pains, loosen stiff and sore joints, soothe aching muscles, realign the spine, and restore body health and comfort.

After Traveling Relieve Musculoskeletal Stress With Chiropractic Massage

Musculoskeletal Health

The musculoskeletal system is comprised of:

  • Muscles
  • Tendons
  • Ligaments
  • Bones
  • Joints
  • Tissues that move the body and help maintain structure and form.

The health of the musculoskeletal system is defined as the absence of injury, disease, or illness within the system. Keeping this system healthy is crucial for the health of the other body systems.

Common Muskuloskeletal Conditions

  • Musculoskeletal injuries – work-related, personal, automobile, sports, or physical activity
  • Neck pain
  • Back pain
  • Hip pain
  • Osteoarthritis
  • Crystal arthritis
  • Inflammatory arthritis
  • Osteoporosis
  • Fractures

Chiropractic Massage Therapy After Traveling

Musculoskeletal health is enhanced by increased circulation that increases oxygen flow that relaxes the mind and body. Overworked sore, tired muscles after traveling can keep the body tense which could lead to chronic stress symptoms. Chiropractic massage therapy effectively reduces stress and anxiety by manipulating the body tissues like the muscles, tendons, connective tissues, and ligaments, increasing blood circulation and improving flexibility.

Jet-Lag

  • The body is weak after traveling into different time zones, which can cause jet lag, stress, and relaxation problems.
  • Jet lag can cause sleep problems, leading to extreme fatigue, headaches, and nausea.
  • Chiropractic can alleviate jet lag effects quickly by working/massaging/stretching out the muscles, increasing blood flow, flushing out toxins, and calming the body.

Travel Stress

  • The stress starts right before the trip when preparing, packing, and setting up the house while away.
  • The body tenses up when traveling to maintain focus, stay alert, and be ready for surprises.
  • When on vacation, having fun and doing all kinds of activities can make individuals forget to relax.
  • Waking up early and going to bed late can contribute to travel stress.
  • Chiropractic therapy will relieve all the strain and return the body to a relaxed state.

Relieve Back Pressure

  • Sitting for hours can increase pressure on the spine.
  • The muscles become stiff from the immobility accumulating pressure on the body and the mind, increasing the risk for other pains.
  • Chiropractic therapy will help lower heart rate and blood pressure relieving discomfort and stiffness.

Relax and Sleep

  • The internal body clock can get thrown off when traveling, resulting in little to no sleep and irritability.
  • Driving or flying will drain the body and mind, which can cause fatigue and anxiety.
  • Chiropractic will restore body and mind functions resulting in sleep and relaxation.

Spinal Decompression Texas

References

Crofford, Leslie J. “Chronic Pain: Where the Body Meets the Brain.” Transactions of the American Clinical and Climatological Association vol. 126 (2015): 167-83.

Nichols B, Nova P, Jacobs, K. Ergonomic Strategies for Using a Suitcase. The American Occupational Therapy Association. https://www.aota.org/About-Occupational-Therapy/Patients-Clients/Adults/Ergonomic-Strategies-Suitcase.aspx. August 2018. Accessed May 2019.

Sadler, Sean G et al. “Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies.” BMC musculoskeletal disorders vol. 18,1 179. 5 May. 2017, doi:10.1186/s12891-017-1534-0

Waterhouse, J et al. “The stress of travel.” Journal of sports sciences vol. 22,10 (2004): 946-65; discussion 965-6. doi:10.1080/02640410400000264

Diet and Nutritional Supplements Impact On Chronic Pain

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
A family standing at a barbecue cooking food.

Nutrition is how the body utilizes consumed food. Nutrition plays a role in chronic pain; lifestyle behaviors can influence how food contributes to illness/diseases. A common cause of chronic pain is chronic systemic inflammation. Inflammation plays a role in many chronic disease conditions, including diabetes, heart disease, and cancer. Reducing inflammation can be achieved by adjusting diet to get individuals back to feeling better quickly and to aid them in maintaining and improving their overall health. Injury Medical Chiropractic and Functional Medicine Clinic offer diet and nutritional supplements guidance as part of a personalized treatment plan.

How Diet and Nutritional Supplements Effect Chronic Pain

Inflammation

The purpose of the inflammatory response includes:

  • Isolate the dangerous bacteria, viruses, or damaged cells.
  • Flush out the dead cells and other damaging substances.
  • Initiate the repair/healing process.

Types of inflammation

  • Localized inflammation occurs at the site of an injury or infection.
  • A sprained ankle that becomes swollen and painful or a cut that gets infected and becomes red and swollen are examples of localized inflammation.
  • Systemic inflammation occurs throughout the body. External factors can trigger this type of inflammation.
  • Viral and Bacterial infections.
  • Allergens or toxins in food and the environment.
  • Smoking
  • Alcohol consumption
  • It can also be triggered by internal factors, including:
  • Stress
  • Obesity
  • Autoimmune conditions
  • Genetic variations

Optimizing Diet and Nutritional Supplements Effect on Chronic Pain

The body needs protein, carbohydrates, fat, fiber, vitamins, and minerals for the health and the prevention of chronic disease.

  • Dietary intake can enhance the function of the nervous system, immune system, and endocrine system that directly affects pain symptoms and episodes.
  • Losing weight decreases the added pressure on joints and reduces inflammation.
  • Dietary intake and weight status impact the risk and/or severity of other chronic diseases that include:
  • Cardiovascular disease
  • Diabetes
  • Anxiety
  • Depression
  • Often occur simultaneously with chronic pain.

Prescribed diet modification, also known as diet therapy includes:

  • Modifying the entire diet.
  • Supplementing the diet with specific nutrients.
  • Changing dietary patterns to induce a fasting state.

Benefits include:

  • Calorie reduction
  • Increased antioxidants
  • Prebiotic supplementation for gastrointestinal health.

These approaches positively impact comorbidities of chronic pain and promote secondary gains, including:

  • Pain alleviation and management.
  • A positive promotion of health and well-being.
  • Reductions of comorbidities like obesity and cardiovascular disease.
  • Reducing healthcare costs.

Vitamin and Mineral Supplements

Diet and nutritional supplements provide added essential nutrients to a damaged, inflamed, or injured body. Dietary supplements improve overall health and wellness.

  • Vitamin D and calcium tablets help maintain optimal bone health, as low vitamin D levels can lead to back pain.
  • Omega-3 fatty acids help reduce inflammation.
  • Vitamins E and C, combined with copper, help with blood production, tissue repair, and brain and skin health.
  • Folic acid can help with joint pain and myofascial pain.
  • B Vitamins can help with pain and prevent liver dysfunction.

Nutritional supplements support the body until the body and/or organs have correctly healed. Recovery from an injury could cause body stress that can interfere with the healing process. Diet and nutritional supplements expedite the healing and recovery process by:

  • Helping overcome dietary deficiencies.
  • Improving immune system function.
  • Detoxifying toxins.
  • Contain antioxidants that help the body stay toxin-free.

Chiropractic restores and realigns the body by incorporating supplements to nourish the body tissues and recover optimally from injury.

InBody Nutrition

InBody in Nutrition
References

Dragan, Simona, et al. “Dietary Patterns and Interventions to Alleviate Chronic Pain.” Nutrients vol. 12,9 2510. 19 Aug. 2020, doi:10.3390/nu12092510

Lee, Mi Kyung, et al. “The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.” Chiropractic & manual therapies vol. 26 7. 20 Feb. 2018, doi:10.1186/s12998-018-0175-1

Li, Chuan, et al. “Macrophage polarization and meta-inflammation.” Translational research: the journal of laboratory and clinical medicine vol. 191 (2018): 29-44. doi:10.1016/j.trsl.2017.10.004

Nutrition and Chronic Pain https://www.iasp-pain.org/resources/fact-sheets/nutrition-and-chronic-pain/

Pahwa R, Goyal A, Jialal I. Chronic Inflammation. [Updated 2021 Sep 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/

The Gallbladder & The Parasympathetic Nervous System Function

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

Introduction

The digestive system in the body helps with the process of digesting food that the host consumes. The food being digested goes through a bio-transformation where it turns into nutrients and is stored in the intestines, liver, and gallbladder, where it turns into bile to be excreted out of the system to ensure a healthy functional gut system and body. But when disruptive factors like poor eating habits or gut issues start to affect the body and gallbladder, this causes many problems that can make an individual miserable. This affects their quality of life since they are dealing with painful issues in their bodies that overlap the primary source risk profiles. Today’s article looks at the gallbladder, how it functions with the body and parasympathetic nervous system, and how referred shoulder pain and gallbladder dysfunction are connected. We refer patients to certified providers specializing in gastroenterology and chiropractic treatments that help those with issues that affect their shoulders and gallbladder. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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What Is The Gallbladder?

The digestive system comprises the mouth, the internal organs from the GI tract, the liver, the gallbladder, and the anus, where food is consumed, digested, and excreted out of the body to keep it healthy. The gallbladder is a small organ that store and releases bile at the appropriate time into the intestines to be mixed with the digested foods to be excreted out of the body. This pear-shaped organ inflates and deflates like a balloon when it stores and releases bile while having a casual relationship with the nerves and hormones that help regulate the gallbladder functioning properly. Studies reveal that the ganglia become the target of causing the hormone cholecystokinin and the parasympathetic nerve to up or downregulate the neurotransmission to the gallbladder. This causes the gallbladder to be functional in the body.

 

What Are Its Functions In The Parasympathetic Nervous System?

So what are the functions that the gallbladder provides to the body? For starters, the parasympathetic nervous system allows the body to rest and digest the consumed food to be turned into nutrients. The parasympathetic nervous system also provides gallbladder stimulation as studies reveal that the gallbladder receives innervation from the parasympathetic nervous system connected to the vagus nerve that transmits information to the spine and the brain. Keeping and releasing bile from this pear-shaped organ helps regulate the gastrointestinal tract. This causal relationship between the gallbladder and the parasympathetic nerve is essential because the body needs to know when to store and release bile from the gallbladder, or it might trigger some issues that can do more harm to the body and even affect the gallbladder itself.

Do You Have Shoulder Pain?- Video

Do you have SHOULDER PAIN? Then check the Gall Bladder, Liver, Spleen, Lung and Cervical!

Have you been experiencing gut issues causing a sharp or dull ache in your back or sides? How about questionable shoulder pain that seems to come out of nowhere? Or are your experiencing inflammation in your digestive system? Many of these symptoms are signs of visceral-somatic pain affecting the gallbladder. Visceral-somatic pain is defined when there is damage to the organ, and it starts to affect the muscles in a different location in the body. The video above gives an excellent example of visceral-somatic pain in the gallbladder and the shoulder. Now many people wonder how shoulder pain is the mediator of the gallbladder? Well, inflammation in the liver and gallbladder causes the nerve roots to be hypersensitive and compressed. This leads to overlapping profiles, triggering pain in the shoulder muscles and associated with upper mid-back pain.

Referred Shoulder Pain & Gallbladder Dysfunction

 

Now say the individual is experiencing shoulder pain; however, when they rotate their shoulder, there is no pain? Where is the source of shoulder pain localized, and what is causing the issue? And why is it correlating to the gallbladder? This is known as referred pain, where the source of pain is poorly localized when it is located elsewhere. Studies reveal that gallbladder dysfunctions like cholecystitis might be associated with acute thoracolumbar shoulder pain. So what does this mean? It means that any referred pain that is the causation of shoulder pain gives the impression that something is wrong with the gallbladder. This would provide much-needed information when individuals are being examined by their physicians.

 

Conclusion

The body needs the digestive system to help process food the host consumes and excretes for a healthy functioning system. The gallbladder stores and releases bile to the digested food. This ensures that the nutrients and bile are transported and passed out of the body. When disruptive factors cause gut issues and affect the gallbladder, it can correlate to different problems impacting the body. An example would be gallbladder issues associated with shoulder pain. This is referred to as pain, which is from an affected organ and associated with the muscle in a different location. This can make the individual feel miserable and wonder what is going on with their shoulders when it might be something associated with their gallbladder. Available treatments can provide better knowledge to determine the problem and how to alleviate the issues.

 

References

Carter, Chris T. “Acute Thoracolumbar Pain Due to Cholecystitis: A Case Study.” Chiropractic & Manual Therapies, BioMed Central, 18 Dec. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683782/.

Jones, Mark W, et al. “Anatomy, Abdomen and Pelvis, Gallbladder.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Nov. 2021, https://www.ncbi.nlm.nih.gov/books/NBK459288/.

Mawe, Gary M., et al. “Nerves and Hormones Interact to Control Gallbladder Function.” Physiology, 1 Apr. 1998, https://journals.physiology.org/doi/full/10.1152/physiologyonline.1998.13.2.84.

Medical Professional, Cleveland Clinic. “Gallbladder: What Is It, Function, Location & Anatomy.” Cleveland Clinic, 28 July 2021, https://my.clevelandclinic.org/health/body/21690-gallbladder.

Disclaimer

Ear Problems: Chiropractic Spine Connection

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Young woman with ear pain

Ear problems like blockages or congestion can cause irritation and pain, as well as symptoms such as dizziness, ear discomfort, headaches, and sinus pain that can lead to infection. This condition can happen to anyone but is prevalent in children, individuals that live in high altitudes, and individuals who suffer from allergies. Spinal misalignments can cause interference to the nervous system that can create problems elsewhere in the body, like the ears.

Ear Problems: Spine Connection Chiropractor

If there is neck misalignment along with pinched, tangled nerve/s signal transmissions can misfire or cut off messages disrupting the process of draining the Eustachian tube. This creates a buildup of bacteria and fluid, which can cause pain and pressure. Chiropractic decompression treatment uses gentle manipulation of the cervical spine to release the pressure affecting the ear.

Ear Problems

Bacteria or viruses cause ear infections in the middle ear. Infection often results from another illness like cold, sore throat, flu, respiratory disease, or allergies that causes congestion and swelling of the nasal passages, throat, and eustachian tubes.

Eustachian Tubes

The tubes functions include:

  • Regulating air pressure in the middle ear
  • Resupply fresh air in the ear
  • Drain the middle ear

The eustachian tubes are two canals that connect the middle ear to the throat and nasal cavity, known as the nasopharynx. (The eustachian tubes are more narrow in children, which makes them difficult to drain and more likely to get clogged.)When the lining of these canals comes under stress, they can become inflamed/swollen, blocking or filling with fluid causing excessive pressure and pain. This fluid can become infected and cause ear infection symptoms.

If the ear problem is connected to a misalignment of the cervical spine, the following symptoms may be experienced:

  • Loss of hearing
  • Tinnitus
  • Vertigo
  • Aural fullness is the feeling of a plugged or full ear
  • Balance issues
  • Coordination issues
  • Frequent headaches
  • Nausea
  • Vomiting
  • Frequent episodes that result in vertigo and ringing in the ears could indicate Meniere’s disease, which affects balance and inner ear function.

Middle Ear Infections

Middle ear infection types include:

Acute otitis media

  • This type of infection happens suddenly.
  • It causes swelling and redness.
  • Fluid and pus become trapped under the eardrum/tympanic membrane.
  • Fever and ear pain can manifest.

Chronic otitis media

  • This type happens frequently or does not go away and can take months to years.
  • This type is usually not painful.
  • The ear canal may have liquid coming out.
  • It can be accompanied by a hole that forms in the eardrum and hearing loss.

Otitis media with effusion

  • Also called serous otitis media.
  • Fluid or effusion and mucus build up in the middle ear after an infection passes.
  • It can feel like the ear is full.
  • This can go on for months.
  • It can affect hearing.

Chronic otitis media with effusion

  • Fluid/effusion stays in the middle ear for an extended time.
  • It can build up over and over, despite no infection.
  • It can also affect hearing.

Misalignment in the upper cervical spine can cause muscles to flex awkwardly/irregularly, disrupting the opening and closing of the eustachian tubes and their positioning. This often causes inflammation along the eustachian canal, upper throat, and nasal cavity. If left untreated, the inflammation can develop into an infection, causing swelling and/or fluid buildup in the inner and middle ear. Common symptoms of middle ear infections in adults include:

  • Pain in one or both ears
  • Hearing is muffled
  • Sore throat
  • Fluid drainage from the ear

Chiropractic Realignment

Treatments are helpful for individuals who want to reduce taking antibiotics, which can minimize immunity by destroying the healthy bacteria in the gut. Chiropractic is a simple and effective way to treat ear problems. Realigning the vertebrae relieves tissue inflammation/swelling around the Eustachian tube to allow drainage, relieve pressure, and restore health.

Spinal Decompression Chiropractor

References

Collins, Rachael, et al. “Paralysis from an ear infection: a severe case of otitis externa leading to acute complete cervical cord syndrome.” BMJ case reports vol. 14,12 e245594. 1 Dec. 2021, doi:10.1136/bcr-2021-245594

Harmes, Kathryn M et al. “Otitis media: diagnosis and treatment.” American family physician vol. 88,7 (2013): 435-40.

Laulajainen Hongisto, Anu et al. “Severe Acute Otitis Media and Acute Mastoiditis in Adults.” The journal of international advanced otology vol. 12,3 (2016): 224-230. doi:10.5152/iao.2016.2620

Murphy, D R. “Chiropractic rehabilitation of the cervical spine.” Journal of manipulative and physiological therapeutics vol. 23,6 (2000): 404-8. doi:10.1067/mmt.2000.108143

Polkinghorn, B S. “Treatment of cervical disc protrusions via instrumental chiropractic adjustment.” Journal of manipulative and physiological therapeutics vol. 21,2 (1998): 114-21.

Low Back Pain Issues Masking Different Issues In The Body

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

Everyone around the world has dealt with pain that makes them feel uncomfortable and has them place their hands on the location where the pain is originating in their bodies. Many factors can become issues in the body, like a poor, unhealthy lifestyle that causes problems in the gut system and develop painful symptoms that affect the intestines. Stressful events that cause headaches that affect the neck and upper back muscles or gut issues that cause discomfort in the abdominal and back region. All these issues are known as referred pain, where a person feels pain in one part of their body, but it is caused by a different source of pain in a different location. An example would be an individual with back pain, but the pain is originating in their abdominal organs. Today’s article looks at various issues that mask low back pain in the body, how organ issues mimic low back pain, and how to alleviate these issues affecting the body. We refer patients to certified providers specializing in gastroenterology and chiropractic treatments that help those with issues that affect their back and gut system. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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Different Issues Masking Low Back Pain

Have you experienced discomfort in your abdominal region causing pain in your lower back? How about pelvic issues that are causing bowel discomfort? Or constipation issues that are compressing the nerves in your lower back? These signs and symptoms correlate to visceral-somatic pain, defined as poorly localized pain characterized by irritated internal organs that cause muscle hypersensitivity from the same nerve. So what does this mean for a person experiencing back issues affecting their quality of life? Well, this might be an indication of the individual that might be suffering from gastrointestinal problems that are correlating to low back pain. Studies reveal any disturbances causing musculoskeletal or gastrointestinal complaints that could induce referred pain through the sympathetic nervous system. An example will be if the body suffers from infections from the kidneys that are associated with low back pain.

So how would the kidneys be associated with low back pain? What is the correlation? For example, a person is constantly eating foods with either a high salt content or a high protein in their system. These high food contents begin to form kidney stones in one or both organs, thus causing a sharp pain that triggers low back pain. As the kidney stones pass through the urinary tract, it administrates radiating pain to the body’s lower abdominal and pelvic region. Another example of issues that can mask low back is constipation in the abdominal area associated with pelvic dysfunction. How does this correlate to the lower back? Think of your abdominal organs overlapped by risk profiles associated with gut disorders. Signs like hypothyroidism, SIBO, celiac disease, or IBS can increase the risk associated with pelvic floor dysfunction, which causes bloating and constipation to the abdominal organs. These issues are co-morbidities to IBS as studies reveal that the pelvic floor and abdominal muscles are co-activated to increase spine stability and intra-abdominal pressure. Now it may seem not a bad thing to the body unless the individual is constantly standing for an extended period or is obese, thus becoming a mediator for the host to suffer from low back pain while being associated with pelvic dysfunction.

Organ Issues Mimicking Low Back Pain- Video

Organ problems (visceral pain) can mimic or cause back pain (somatic pain)

Have you been feeling muscle tenderness in the lower extremities of your body? How about gut issues that are associated with low back pain? Or are you feeling bowel dysfunction in your pelvic region? All these issues correlate to viscerosomatic pain, where the infected organ is causing issues to the muscle in a different location. The video above explains how various organ issues can mimic spinal and back pain in the body. One of the examples that the video explains is how kidney infections are associated with back pain. Studies reveal that visceral pain originating from the upper urinary tract coincidently correlates with the characteristics of referred pain and changes in the somatic tissues of the body.

Alleviating Issues Affecting The Body

Say an individual is suffering from low back pain issues; as they get their mandatory examination, they explain to their physician about their low back pain and what is happening. Once the suffering individual is situated, the physician begins to look over the body where the pain is located, either by physical examination or through the intake form they are looking over. So what does this implicates in the body? Well, studies have revealed that systemic pathologies of the visceral organs can mimic or mask musculoskeletal pain. An example would be someone who is experiencing gastrointestinal issues in their gut, and it’s triggering muscle spasms in the back. This causes the nerve roots to be hypersensitive to the visceral organs and increases the risk associated with low back pain.

 

Conclusion

Dealing with pain is no joke, primarily when the pain is located in a different body region. Sometimes the pain can be an organ issue that mimics muscle pain in the back. This is known as viscero-somatic pain, defined where infected organs are either mimicking or triggering muscle issues in different body locations. This causation is usually due to various factors like unhealthy lifestyle habits affecting the visceral organs and affecting the muscles that correspond to the organs, like IBS issues affecting the lower back. Available treatments are there to figure out what problems affect the body and provide a better understanding to alleviate them.

 

References

Basso, Francesca Lo, et al. “Manual Treatment for Kidney Mobility and Symptoms in Women with Nonspecific Low Back Pain and Urinary Infections.” De Gruyter, De Gruyter, 1 May 2021, https://www.degruyter.com/document/doi/10.1515/jom-2020-0288/html.

Bussey, Melanie Dawn, et al. “Is Pelvic Floor Dysfunction Associated with Development of Transient Low Back Pain during Prolonged Standing? A Protocol.” Clinical Medicine Insights. Women’s Health, SAGE Publications, 27 May 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537301/.

J;, Stowell T;Cioffredi W;Greiner A;Cleland. “Abdominal Differential Diagnosis in a Patient Referred to a Physical Therapy Clinic for Low Back Pain.” The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, Nov. 2005, https://pubmed.ncbi.nlm.nih.gov/16355918/.

Lacy, Brian E, et al. “Management of Chronic Abdominal Distension and Bloating.” Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 1 Apr. 2020, https://www.cghjournal.org/article/S1542-3565(20)30433-X/fulltext.

PJ;, Pedersen KV;Drewes AM;Frimodt-Møller PC;Osther. “Visceral Pain Originating from the Upper Urinary Tract.” Urological Research, U.S. National Library of Medicine, 16 May 2010, https://pubmed.ncbi.nlm.nih.gov/20473661/.

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Reflex Pain Chiropractic Care

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Rehabilitation specialist helps a guy to do exercises for recovery from injury, who is sitting in a wheelchair with a corset around his neck. Concept of physical therapy for people with disabilities

Reflex pain is a complex condition that involves the body’s pain withdrawal reflex failing to turn off after the event that triggered the pain, so the pain sensations continue. This is a neurological condition known as the withdrawal reflex. It occurs when the body and brain undergo a chain of reactions to remove an affected body part from dangerous situations/stimuli. A typical example is a vehicle crash or accident. During the process, the body’s reflex muscle\s in the injured area tighten to protect the specific body part/s from further damage.

Reflex Pain Chiropractor

The reflex can feel like a muscle spasm that goes away over time. However, in the case of reflex pain, the signals keep firing. Reflex pain can occur all over the body as the muscles overcompensate to handle the prolonged pain; secondary injuries often develop. An example could be reflex pain in the ankle caused by injury or problems in the hips and back, where the individual tries to avoid moving the ankle in a specific way to prevent and avoid the pain symptoms. Individuals with reflex pain also experience headaches and referred spine and extremity pain. Reflex pain can become a cycle of symptoms that include:

  • Unusual tightness
  • Stiffness
  • Pain
  • Contracture – hardening or shortening of the affected muscles, tendons, or other tissues.
  • Decreased functional abilities.

Somatic Pain

Somatic pain causes receptors in tissues including the skin, muscles, connective tissues, joints, and skeleton to be activated. Stimuli like force trauma, vibration, extreme temperature, or inflammation/swelling activate these receptors. The pain is often described as:

  • Aching
  • Gnawing
  • Cramping
  • Sharp

Somatic pain is often localized to a particular area that is constant and stimulated by movement. There are two types.

  • Superficial pain occurs when everyday injuries activate pain receptors in the skin and mucous membranes.
  • Deep somatic pain occurs when stimuli activate pain receptors deeper in the body, including the tendons, joints, bones, and muscles. Deep body pain usually feels more like aching.
  • Pain can be confined to a local area or radiate to other areas of the body, depending on the extent of the injury.

Somatic pain can come from a variety of different potential causes that include:

  • Injury to joints or bones.
  • Trauma.
  • Fall or collision that damages connective tissues.
  • Strained muscles from overuse.
  • Bone fracture.
  • Arthritis that causes swelling in the joints.
  • Diseases that affect connective tissues.
  • Bone or skin cancers.

Sometimes these reflexes can stay in the on position and keep the body from achieving full relaxation.

In the nervous system, a body part is stimulated, and the message travels through the spinal cord and into the brain. The information is processed, then sent back through the spinal cord to the level that activates the specific body part. The reflexes transmit faster staying at the same spinal level without having to travel to the brain and back again.

During reflex pain, the body’s muscles are unable to relax, which is necessary for motion/movement. This prolonged contraction generates added pain and causes imbalances that can decrease excitability in the muscles. This can increase the activation of brain receptors that receive pain signals to respond by telling them to shorten and contract.

Therapy

Body misalignment can cause muscles to spasm, causing the nerves to stretch in an awkward way, compress, and get twisted and tangled around other nerves or other tissues. This disrupts communication resulting in pain, illness, and ailments that can lead to other health problems. Chiropractic care can address reflex pain by realigning the spine and improving joint motion and nerve conduction.

Chiropractic restores the body to its full and proper function by activating the natural healing abilities. Manual and mechanical spinal decompression realigns the vertebrae, reducing swelling, blockages, and nerve stress. A comprehensive examination will identify potential dysfunctional areas of the body using palpitations to identify which muscles are involved. Once identified, chiropractic, massage, and physical therapy options can be prescribed to rebalance the body’s muscles, and restore their ability to contract and relax normally.

  • Patient education will be provided concerning self-assessment techniques, instruction on how to treat pain, and an anti-inflammatory diet.
  • An exercise and stretching program will help maintain the adjustments, keep the body flexible, and strengthen the body.
  • Patients are helped to understand how to take control of their pain.

Spinal Decompression Testimonials

References

Biurrun-Manresa J, Neziry A, Curatolo M, Arendt-Nielson L, Anderson O. Test-retest reliability of the nociceptive withdrawal reflex and electrical pain thresholds after single and repeated stimulation in patients with chronic low back pain. Eur J Appl Physiol. 2011;111:83-92

Derderian C, Tadi P. Physiology, Withdrawal Response. [Updated 2021 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544292/

Muir, J M, and H Vernon. “Complex regional pain syndrome and chiropractic.” Journal of manipulative and physiological therapeutics vol. 23,7 (2000): 490-7. doi:10.1067/mmt.2000.108816

Neziri A, Haesler S, Steen P, et al. Generalized expansion of nociceptive reflex receptive fields in chronic pain patients. Pain. 2010;151(3):798-805

Szynkowicz, Peter, and Anthony Petrucci 4th. “Chiropractic Care of a Patient With Complex Regional Pain Syndrome Type 1 (CRPS-1): A Case Report.” Journal of chiropractic medicine vol. 19,2 (2020): 145-151. doi:10.1016/j.jcm.2020.05.001

Yezierski R, Vierck C. Reflex and pain behaviors are not equivalent: Lessons from spinal cord injury. Pain. 2010;151(3):569-577

Issues That Affect More Than The Heart

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

Introduction

In the body, the heart is a vital organ that pumps blood to all the muscles, organs, tissues, and ligaments that require the body to function and move. As part of the cardiovascular system, the heart keeps the body alive by supplying nutrients and disposing of waste and carbon dioxide away from the body. Various factors can affect the body and the heart as well stressful events, unhealthy eating habits, limited physical activities, or autoimmune conditions can cause strain on the heart. Still, they can correlate to different symptoms in the body. This causes an overlap of risk profiles that may feel something is wrong with the heart but might affect another body part. Today’s article focuses on viscero-somatic pain affecting more than the heart muscle, how referred pain is defined, and various ways for treating viscero-somatic pain in the body. We refer patients to certified providers specializing in cardiovascular and chiropractic treatments that help those with issues that affect their hearts. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

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Visceral-Somatic Pain Affecting More Than The Heart

Are you experiencing radiating pain affecting your neck, arms, or back? How about feeling discomfort in your chest? Do gut issues seem to cause a burning sensation affecting your chest? Many of these symptoms overlap in risk profiles that seem like issues in the heart but can refer to something else affecting the body. This is known as viscero-somatic pain, usually defined as pain coming from the internal organs affecting the muscles that share the same nerve. Studies revealed that the autonomic nervous system mediates visceral-somatic pain. For the heart, the parasympathetic innervation comes from the cardiac branches of the vagus nerves connected to the spine and the brain. Since there is extensive autonomic innervation of the heart, the vagus nerve has a minor role in afferent pain transmission signaling.

 

 

An example would be having esophageal issues that are causing chest pains in your chest. So how would that correlate to the heart? Think of it as a person experiencing chest pains and whose brain is being signaled that something is wrong with their heart. Then, when they get treated, their results show that it was esophageal issues. Studies have revealed that spinal neurons receive input from a distal esophagus and receive the same information from the heart through viscero-somatic and viscero-visceral convergence. So what does this mean? This means that the sympathetic innervation of the heart is in a casual relationship to the first five thoracic spinal nerves. This indicates that some pain fibers affecting the heart are directly from the upper thoracic spine. Additional studies have mentioned that the vagus nerve connected to the upper thoracic spine can influence harmful afferent signals of the visceral organs to involve pain and joint stiffness in multiple organs and body structures.

Visceral Pain Explained- Video

12.8 Visceral Pain

Do you feel pain occurring on your shoulders or neck? How about severe pressure on your chest that might be something else? Or have you noticed issues that are affecting your heart are affecting your chest? Many of these are signs of visceral pain, where the pain of the damaged organ affects the muscle in a different body location. The video above explains visceral pain and uses an example of the cardiac muscle being affected by visceral pain. Studies reveal that the sensory input from different visceral organs can mimic cardiac pain due to viscero-somatic convergence of the cardiac input affecting the spinothalamic tract neurons in the spine to cause back issues in the thoracic region. So what does this implicates to the body? Well, say a person is experiencing chest and shoulder pains in their body; however, they’re experiencing heart problems that also affect them.

Treating Visceral-Somatic Pain In The Body

 

So, a person starts experiencing chest pain radiating from heart issues and goes to the doctor to see what is wrong with them. The physicians will begin to check on their hearts to see if anything is wrong or will be looking at their spine and chest through manual examination to see what is the issue that is affecting their bodies. So what does this mean to the body? Well, it could indicate that joint and muscle dysfunction in the neck and thorax is causing non-cardiac issues in the body. The influence of the spinal nerves on the cardiovascular function of the heart, since the afferent and parasympathetic efferents innervation of the heart, could disturb the upper cervical subluxation as the vagus nerve is being compressed. This correlates to other visceral organs mimicking cardiac pain and being the cause of musculoskeletal issues in the back.

 

Conclusion

In conclusion, the heart is a vital organ in the body that pumps blood to all the muscles, organs, tissues, and ligaments for functionality and nutrients distribution. The heart also share nerves in the parasympathetic innervation that connects to the vagus nerves which connects to the spine and brain to send information. However, various factors like lifestyle habits can affect the heart muscle and cause the individual chest pains that the brain is getting the signals that something is wrong with the heart. This is known a viscero-somatic pain where affected organs can cause muscle issues in the body in a different location. Treatments are available to figure out what the problem is going on with the body to understand better how to alleviate these viscero-somatic issues.

 

References

Foreman, Robert D, et al. “Mechanisms of Cardiac Pain.” Comprehensive Physiology, U.S. National Library of Medicine, Apr. 2015, https://pubmed.ncbi.nlm.nih.gov/25880519/.

Garrison, David W, et al. “Viscerosomatic Convergence onto Feline Spinal Neurons from Esophagus, Heart and Somatic Fields: Effects of Inflammation.” Pain, U.S. National Library of Medicine, June 1992, https://pubmed.ncbi.nlm.nih.gov/1408304/.

Leach, Austin, and Mike Fisher. “Myocardial Ischaemia and Cardiac Pain – a Mysterious Relationship.” British Journal of Pain, SAGE Publications, Feb. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590151/.

Soares, Bruno, et al. “Accuracy of Physical Assessment in Nursing for Cervical Spine Joint Pain and Stiffness: Pilot Study Protocol.” JMIR Research Protocols, JMIR Publications, 17 Dec. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726037/.

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Gardening Tips and Stretches: Low Back Pain Prevention

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Gardening is healthy for the body and does count as exercise, which works the major muscle groups that include the neck, shoulders, arms, abdomen, back, glutes, and legs. However, gardening can cause stress to the body with unhealthy posture/positioning, not using proper lifting techniques, using the wrong tools, and not taking breaks to stretch out the body, move around, and rehydrate. This can lead to body soreness, pain, and injuries. Here are some recommended gardening tips and stretches for pain prevention.

Gardening Tips and Stretches For Pain Prevention

Gardening Tips and Stretches

A sore back and body can stem from staying in a single posture for too long and repetitive motions/movements. Here are a few tips to help maintain musculoskeletal health while gardening:

Tools

  • Choosing the right garden tools can spare a lot of pain and money.
  • Focus on the fundamental tools and purchase the best quality tools that the budget will allow.
  • Size weight, task level, material, grips, handle length, and attachments are things to consider
  • Maintaining quality tools will go a long way.

Digging

  • Digging requires the right tools to get the job done safely and efficiently.
  • Make sure the shovel is sharp enough to reduce using extra force to break up the dirt.
  • The shovel handle should be long enough to avoid excessive bending.
  • Utilize proper digging posture while using a shovel.
  • If using too much pressure, soak the soil to loosen it up.
  • Try not to twist when shoveling the dirt/soil; instead, move the whole body to where the dirt needs to be.

Lifting

  • Prolonged lifting of bags, plants, pots, and equipment can take a toll on the spine and spinal muscles.
  • Bend the knees and use the hips to lift, as the hip muscles are stronger than the low back muscles.
  • Do not bend the waist to come back; use the hips.
  • Investing in an elevated garden or gardening seat/stool is recommended to avoid bending.

Weeding

  • Weeding can require prolonged sitting or bending, depending on the number of weeds.
  • To avoid excessive sitting and bending, a gardening seat/stool can help, as well as a standing weeding tool will reduce the pressure on the back.
  • This is also helpful for knee and/or hip pain.

Mowing

Take Breaks

  • Do not push through; take a break even if the body feels great.
  • Every half hour, the body needs to rest.
  • Try to work in 30-minute increments then break to move around, stretch, relax, and rehydrate.
  • Squatting, bending, digging, lifting bags, and pushing wheelbarrows is a form of strength training that helps achieve stronger muscles, healthier bones, and joints.
  • But if there are no breaks, the chances for pain and injuries increase.

Stretches

Simple stretches can reduce the strain and pain of gardening. Stretching before, during, and after the gardening session is recommended.

Cat Stretch

  • This is a simple yoga pose that helps with back soreness.
  • On your hands and knees, keep the hands at shoulder distance and the knees at hip distance.
  • Pull the navel up to the spine and arch/round the back.
  • Slowly straighten the back.

Cow Stretch

  • The cow stretch is the opposite of the cat pose.
  • Start in the same position.
  • Drop the stomach to the floor and lift the head up and back.
  • The spine will arch and gently stretch the back.

Head Rolls

  • Head rolls will help with shoulder and neck pain.
  • Drop the chin down toward the chest.
  • Gently roll the head to one side going around back to the center.
  • Repeat in the opposite direction.

Supine Twists

  • Supine twists can help the lower back.
  • Lay down with the legs at a 45-degree angle and the arms out to the sides.
  • Twist the legs to one side and look in the opposite direction.
  • Hold the pose until the stretch is felt, and then move back to the starting point.
  • Repeat on the opposite side.

Chiropractic

Chiropractic medicine can help alleviate aches and pains and rehabilitate, realign, and strengthen the body to optimal health. Individuals are educated on the musculoskeletal system, injury prevention, nutrition, and exercise to maintain wellness and a pain-free lifestyle.

Pain-Free Gardening Tips and Stretches

References

Howarth, Michelle et al. “What is the evidence for the impact of gardens and gardening on health and well-being: a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription.” BMJ open vol. 10,7 e036923. 19 Jul. 2020, doi:10.1136/bmjopen-2020-036923

Masashi Soga A et al. “Gardening is beneficial for health: A meta-analysis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153451/pdf/main.pdf.

Scott, Theresa L et al.”Positive aging benefits of home and community gardening activities: Older adults report enhanced self-esteem, productive endeavors, social engagement, and exercise” SAGE open medicine vol. 8 2050312120901732. 22 Jan. 2020, doi:10.1177/2050312120901732

The Somatovisceral Interface With Pelvic Pain

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

Introduction

Pain in different body areas can excruciate the host as it can affect other regions. In the body, pain can affect the muscles, tissues, organs, and skeletal joints through environmental factors that affect the body’s systems. For example, the gut system provides the body with overall health and wellness by regulating homeostasis and metabolism, which can be affected by common factors like stress or unhealthy eating habits that can cause joint inflammation due to overproducing harmful gut bacteria. Or how about poor posture affecting the organs in the pelvic region and causing the lower back and neck muscles to have a dull ache in the body. Today’s article looks at how pelvic pain affects the somato-visceral reflexes in the body and how there are treatments for relieving pelvic pain. We refer patients to certified providers specializing in chiropractic treatments that help those with pelvic pain. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

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Somatovisceral Reflexes & Pelvic Pain

Have you experienced pain in your lower back or pelvic regions from sitting too long? Have you experienced bladder dysfunction that is causing you to urinate frequently? Or are you suffering from muscle cramps in the pelvic area? Studies have revealed that pelvic pain can be a chronic, persistent pain associated with co-morbidities like IBS (irritable bowel syndrome), neurological disorders, or low back pain. Pelvic pain is challenging to diagnose since it is multifactorial and shares various nerve roots that send signals to the brain. For example, individuals that suffer from pelvic pain will complain about the somatovisceral convergence affecting their reproductive organs and connective tissues. Other issues like prolonged sitting and poor posture can also affect the lumbosacral nerve root as it is being compressed, causing low back pain and pelvic organ dysfunction.

 

 

The somato-visceral reflexes of the pelvic muscles can become overstretched and compress the surrounding nerve roots like the sciatic nerve and the lumbosacral nerve, causing issues of sciatica or lower back pain. Studies have also revealed that individuals who suffer from spinal cord injuries can disrupt the somatic lumbosacral nerve pathway that is responsible for coordinating bladder function to the pelvic region. These pathways can also produce different autonomic reflex responses to the various organs and somatic afferents. For example, if a female is experiencing pain in her hips or thighs from hyper-sensitive nerve roots, the brain will register that as pain in her reproductive system. Or, if the pelvic muscles are hypersensitive to the touch, something might be affecting the genital regions.

An Overview Of Pelvic Pain- Video

Pelvic Pain - Mayo Clinic

Have you experienced muscle tenderness located in the pelvic region? Have stressful events caused changes in the reproductive system? Have you experienced pelvic pain that is associated with low back pain? You might be experiencing these systems due to pelvic pain and associated co-morbidities. The video above gives an overview of pelvic pain and how it affects the body. Research studies have revealed that the characteristic of mechanically induced pelvic pain and organic dysfunction that correlates to lower sacral nerve root compression results from low back disorders. The environmental factors that can cause low back conditions include:

  • Obesity
  • Heavy lifting
  • Muscle strain
  • Poor posture
  • Herniated disc

Treatments For Pelvic Pain

 

Various treatments can help relieve these overlapping risk profiles associated with pelvic pain and low back pain that are causing the issue and strengthen the weak muscle affected. Exercising can help support the hip and thigh muscles to prevent muscle strain on the low back and pelvic muscles with the combination of chiropractic therapy to provide beneficial pain relief. Chiropractic therapy on the lumbar spine can help alleviate pelvic pain and lumbosacral nerve root irritation affecting the pelvic region. The effects of chiropractic therapy help sustain the caudal flexion of the lumbar spine and release the muscle that aggravates the lumbosacral nerve root that is running along the pelvic region. 

 

Conclusion

Pain affecting the pelvic region can be due to co-morbidities affecting different areas in the body. With pelvic pain being multifactoral, it can be a challenge to diagnose since it shares various nerve roots signaling to the brain. This causes many individuals to complain about somatovisceral convergence that can affect their reproductive organs and connective tissues in the pelvic region. Other issues like low back pain associated with prolonged sitting and poor posture can cause pelvic pain too. Treatments like chiropractic therapy and exercising can help strengthen the low back and pelvic muscles to alleviate painful symptoms that are causing underlying issues and discomfort in the body.

 

References

Browning, J E. “Mechanically Induced Pelvic Pain and Organic Dysfunction in a Patient without Low Back Pain.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Sept. 1990, https://pubmed.ncbi.nlm.nih.gov/2212886/.

Browning, J E. “Chiropractic distractive decompression in treating pelvic pain and multiple system pelvic organic dysfunction.” Journal of manipulative and physiological therapeutics vol. 12,4 (1989): 265-74. https://pubmed.ncbi.nlm.nih.gov/2527938/

CM;, Spitznagle TM;Robinson. “Myofascial Pelvic Pain.” Obstetrics and Gynecology Clinics of North America, U.S. National Library of Medicine, 9 June 2014, https://pubmed.ncbi.nlm.nih.gov/25155122/.

Craggs, Michael D. “Pelvic Somato-Visceral Reflexes after Spinal Cord Injury: Measures of Functional Loss and Partial Preservation.” Progress in Brain Research, U.S. National Library of Medicine, 2006, https://pubmed.ncbi.nlm.nih.gov/16198702/.

Dydyk, Alexander M, and Nishant Gupta. “Chronic Pelvic Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Nov. 2021, https://www.ncbi.nlm.nih.gov/books/NBK554585/.

Disclaimer

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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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