Back Pain: Inflammatory or Mechanical and Chiropractic Care

attractive chiropractor touching hand of patient in grey t-shirt

It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.

Table of Contents

Inflammatory vs. Mechanical Pain

Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.

Inflammatory

Pain caused by inflammation can be described as:

Not having a known definite cause.
Characterized by stiffness, especially after waking up.
Pain reduces with movement, activity, stretching, exercise.
Is worst during the early hours of the morning.
Is often accompanied by pain in the buttocks/sciatica symptoms.

Mechanical

Mechanical pain can be described as:

Pain that becomes worse with activity, stretching, or exercise.
Pain reduces with rest.
There is no stiffness after sleeping.
This pain is not constant but can become intense/severe for short periods.
Pain in the buttocks/sciatica symptoms do not present.

Inflammatory and Non-Inflammatory

Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:

Chiropractic adjusting
Physical therapy
Spinal decompression

Contributing Autoimmune Diseases

When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:

Rheumatoid Arthritis

Arthritis causes the immune system to attack the joints throughout the body.

Ankylosing Spondylitis

This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.

Multiple Sclerosis

This is a disease where the immune system attacks nerve fibers and can lead to back pain.

Psoriatic Arthritis

This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.

Inflammatory Pain Treatment

Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.

Chiropractic and Physical Therapy

These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:

Chiropractic adjustments
Flexion-distraction
Posture correction
Personalized exercises

Inflammation Night Pain

Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.

Stretch Before Bed and When Waking

Performing stretches before going to bed and after waking up helps keep the body limber.

Inspect Pillows and Mattress

Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.

Exercises

Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.

Cardio

These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:

Swimming
Walking
Cycling

Strength-Building

Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:

Cat and cow
Upward and downward dog
Glute Press
Plank
Bridge
Superman

Body Composition

Mediterranean Lifestyle

Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:

Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
Go vegetarian for one day a week.
Cut out processed meats with high levels of preservatives.
Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
Add dairy like cheese and Greek or plain yogurt.
Increase physical activity into a routine.
Talk to friends and family.

References

Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002

Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2

Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5

Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001

Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745

Sciatic Nerve Pain In Rainy Conditions

Dr. Alex Jimenez

Unhappy man feeling pain in lower back outdoors — Middle-aged gentleman in elegant suit suffering from backache while walking on the street

Rain generally comes with a drop in barometric pressure. A low-pressure system you may have heard from the local weather forecast. Lower pressure outside can cause tissues inside the body to swell and irritate sensitive nerves. For those who have sciatic nerve pain, rainy, hot, humid weather can cause the nerve tissues to expand causing increased compression, inflammation, and pain.

Table of Contents

Rainy Weather

For anyone who is prone to inflammation, there are ways to cope with rainy weather-related symptoms, including:

Stay inside air-conditioned areas where the humidity level is lower.
Use a dehumidifier to keep the indoor air at 40-60% relative humidity for comfort.
Utilize vent fans in the kitchen and in laundry areas and after baths/showers in bathrooms.

Easy Physical Activity

Easing the pain can also be done through:

At work, school, home adjust the seat to work for you. Individuals with sciatic nerve pain already know how to make adjustments to chairs and other places for sitting.
If you’re heading out to a baseball or soccer game, you may want to use a comfortable sideline seat that provides cushion and support. If attending a pro game, check online or call to see if you can bring a therapeutic seat cushion.
Stretch throughout the day and evening
Try not a hunch over or crouch
Whether job occupation, house, or yard work use a stool or a pair of kneepads
Take a regular stand up, move around, and stretch breaks
Walking will keep the muscles, tendons, and nerves stretched and loose
Light exercise will help bring down swelling

Traveling

Going on a trip whether road or flight, seats might not be comfortable or supportive. Tips that can help maintain comfort to mitigate the pain, include:

Adjust the seat for proper posture to maintain spinal curvature
Use lumbar support
Maintaining a workout routine is key leading up to your trip. If the body is inactive for a period of time, the back muscles are more likely to spasm when having to sit in tight quarters.
Don’t overpack. Carrying around heavy luggage increases the risk of straining the muscles.
Pack pain medication or anti-inflammatories on hand in case of a flare-up.

Inflammation

Target inflammation with ice therapy
Using topical heat or a heating pad can get the blood circulation flowing through the area
Wear compression garments over the affected areas to bring down swelling and promote blood and nerve circulation.

Chiropractic Rainy Day Relief

Chiropractors know the whole musculoskeletal system. Chiropractic massage therapy induces deep muscles relaxation and the release of endorphins/natural painkillers. A regular spa massage can release sore muscles and tension, chiropractic massage focuses on soothing and healing sciatica. Adjustments or spinal manipulations allow the disc/s rest back into position and relieve the pressure on the sciatic nerve. This will lessen the pain and generate nerve signal flow and mobility.

Spinal decompression relieves the compression of the nerves that are causing sciatica pain. This includes techniques to lengthen the spine and enhance the space between the vertebrae.
A chiropractor will recommend exercises to prevent nerve aggravation and help release the pressure that comes from the inflamed and tight muscles.
Exercises include stretching programs that can be done at home to release pressure on the nerve and ease irritations.

Body Composition

About Fat

Fat, also known as adipose tissue, contributes to overall body weight. This is also the type that individuals want to get rid of when talking about weight loss. Two different kinds of fat:

Subcutaneous fat is the fat that is beneath the skin.
Visceral fat lies deep in the abdominal cavity and surrounds the organs.
Having a certain amount of fat tissue is necessary for a healthy body.
The body stores unused energy from food as fat. This is to provide a reliable source of fuel when the body needs it.
Fat tissue acts as insulation to keep the body warm and as a cushion to protect the vital organs.
Fat is an endocrine organ. This means that it releases hormones and regulates blood sugar.
The problem/issue is excess body fat. This is what leads to higher body weight and altered hormone release that can make the excess weight condition worse.

References

National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.

StatPearls [Internet]. (2020) “Anatomy, Sciatic Nerve.” www.ncbi.nlm.nih.gov/books/NBK482431/

Zwart, J A et al. “Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers.” Acta neurologica Scandinavica vol. 97,1 (1998): 41-5. doi:10.1111/j.1600-0404.1998.tb00607.x

Zwart, John-Anker, and Trond Sand. “Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica.” 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. 11,5 (2002): 441-6. doi:10.1007/s005860100333

Bowling Injuries: Chiropractic Care and Rehabilitation

Dr. Alex Jimenez

Beautiful woman bowling — Happy friends having fun and enjoying playing bowling together

Bowling is a fun physical activity that is enjoyable for all ages. Today, there are college bowlers, recreational bowlers, amateur, semiprofessional, professional leagues, and tournaments worldwide. Although it might not be the first sport that comes to mind when thinking of injuries and chronic pain conditions, it can place significant stress on the muscles and tendons of the upper and lower body. It is important to know and understand how to avoid injuries.

Table of Contents

How Bowling Injuries Happen

There are two main causes of injuries and chronic pain related to bowling. The first is poor mechanics, and the second is repetitive over-use. Both cause/develop painful symptoms that can turn into injuries that become chronic conditions. Many injuries are caused by:

Slip and fall accidents
Players dropping the ball on their feet
The majority of injuries come from overuse/repetition and improper body mechanics.
Overuse injuries result from repetitive and/or strenuous actions/movements that place profound stress on the body’s musculoskeletal system.

For example, a semi-pro and professional bowler will play fifty or more games a week. This means throwing a sixteen-pound ball for ten frames per game. When consistently repeated over and over, this can cause serious wear and tear to the body. With amateur and recreational bowlers, they don’t play as much, so they don’t experience overuse injury as much, but what they do experience is improper/poor form techniques that shift the body in non-ergonomic ways, wrong equipment like oversized/too-small shoes that can cause awkward postures and body motions, a ball that is too heavy causing an individual to overthrow and strain their arms, backs, hips, and legs. Or a ball with small finger holes that get stuck or too large, causing finger, hand, arm, shoulder pulls strains, and sprains.

Common Bowling Injuries

The most common injuries and conditions associated with bowling include:

Hand pain
Finger sprain
Trigger/bowling finger
Wrist Tendonitis
Carpal Tunnel Syndrome
Medial epicondylitis
Annular ligament sprain
Shoulder Tendonitis
Rotator Cuff Tear
Shoulder Instability
Low Back Pain
Hip Bursitis
Piriformis Syndrome
Sciatica
Herniated Disc
Low back strain and sprain
Spondylolysis
Knee ACL injury
Knee LCL injury
Knee MCL injury
Knee PCL injury
Knee Meniscus Tear
Patellofemoral Syndrome
Illiotibial Band Syndrome
Arthritis

Many of the injuries can lead to tendonitis or arthritis later in life.

Trigger/Bowler’s Finger

Symptoms include:

Hand pain after bowling, specifically in the fingers
A clicking or popping when moving the fingers
A finger gets locked in a bent position

Rest, and no bowling is recommended. How long a rest depends on how long the symptoms have been presenting. Physical therapy, along with chiropractic exercises, can help improve finger strength. Splinting the finger could be required to improve the condition. If all fails or does not generate adequate relief, hand surgery could be optioned with a trigger finger release. The surgery allows the finger to move more freely.

Bowler’s Thumb

This usually happens to bowlers that want to generate a lot of spin on the ball. If the thumb’s hole is too tight, it can pinch the ulnar nerve inside the thumb. If the thumb injury is not serious, rest and getting the correct ball size can correct the issue. This is where purchasing a personal bowling ball can help.

Finger Sprain

This is an injury to one or more of the ligaments in the fingers. It most often takes place in the collateral ligaments along the sides of the fingers inside the ball. The ligament/s gets stretched or torn when the finger is forced beyond its normal range of motion. Common symptoms of a finger sprain include swelling, tenderness, stiffness, and pain in the affected finger. This usually occurs from:

The weight of holding the ball with the fingers alone
A poor release
Using a ball that doesn’t properly fit the fingers
A finger sprain falls into grades on the severity of how much the ligament is stretched or torn:

Grade 1

Stretching or microscopic tearing.

Grade 2

Less than 90% of the ligament is torn.

Grade 3

More than 90% of the ligament is torn. Grade three sprains can be accompanied by joint instability and immobility.

Herniated Disc

A herniated disc is when the discs get injured/damaged from overuse, wear, and tear, or a traumatic injury to the spine. The disc can dry out, become less flexible, bulge out, or rupture. Bowlers are constantly:

Bending during the final approach and throw
Carrying a heavy ball
Shifting, twisting, and releasing, increasing the pressure within the discs

In bowling, the majority of herniated discs happen in the low back. The most common symptom is backaches and back pain. Lumbar herniated discs left untreated can cause sciatica.

Avoid and Prevent Injury

The best way to prevent injury is to stay aware of body position, mechanics, equipment, and what the body says.

Stretching

Stretching is one of the best things to avoid injury before practicing, competing, or just playing. Stretching will increase flexibility, especially in the wrist, hand, arm, and low back.

Improving technique

Continually using poor techniques over and over is a perfect set-up for injury. Working with a coach will ensure the proper form. This is important when it comes to generating spin on the ball, as well as, making sure the grip does not place too much strain on the hands.

Using the right ball

The ball being used might not be the right fit for your hand or strength. The holes could be too far apart, causing strain on the fingers. Get as much information as possible and try out different styles and weights to get a comfortable feel for the right ball.

Bowling less

Hard-core bowlers could be overdoing it. Cutting back, and creating a balance will allow the body to recover thoroughly and not cause flare-ups.

Getting in shape

Studies show that individuals who bowl and do not exercise significantly increase the risk of a back injury than those who exercise their back and core. Bowling is not as strenuous as other sports, but it still requires the body to be able to handle the stress.

Body Health

Test Body Composition

Testing body composition regularly is the best way to ensure the body stays healthy. Tracking body composition tracks Lean Mass and Fat Mass gain or loss. The information provided allows the individual to make the necessary changes to ensure they stay fit and healthy.

Diet adjustment

Diet needs to be adjusted to match the individual’s current activity level, or risk running a caloric surplus. A great way to optimize diet is to use Basal Metabolic Rate which will make sure the body is getting enough nutrients to fuel muscle growth, and lose belly fat.

Physical activity that fits the new lifestyle

Increase physical activity levels that work with current lifestyle. This does not mean performing at high levels every day. Be active on a schedule that works for you. Two days of strength training a week offer great physical and mental benefits. The key is to maintain the balance between food consumption and exercise/physical activity that fits your current lifestyle.

References

Almedghio, Sami M et al. “Wii knee revisited: meniscal injury from 10-pin bowling.” BMJ case reports vol. 2009 (2009): bcr11.2008.1189. doi:10.1136/bcr.11.2008.1189

Kerr, Zachary Y et al. “Epidemiology of bowling-related injuries presenting to US emergency departments, 1990-2008.” Clinical pediatrics vol. 50,8 (2011): 738-46. doi:10.1177/0009922811404697

Kisner, W H. “Thumb neuroma: a hazard of ten pin bowling.” British journal of plastic surgery vol. 29,3 (1976): 225-6. doi:10.1016/s0007-1226(76)90060-6

Miller, S, and G M Rayan. “Bowling related injuries of the hand and upper extremity; a review.” The Journal of the Oklahoma State Medical Association vol. 91,5 (1998): 289-91.

The Hands: Injuries, Symptoms, Causes, Medical Care

Dr. Alex Jimenez

Professional nurses and finger injuries patients First aid and injury bandage treatment Use of finger immobilizers in nursing rooms or emergency rooms.

The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.

Table of Contents

Anatomy

The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:

Nerves
Arteries
Veins
Muscles
Tendons
Ligaments
Joint cartilage
Fingernails
Get injured or damaged in some way; there is increased potential for various injuries.

Causes

The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:

Lacerations/cuts
High-pressure injection injuries – nail guns, staple guns
Fractures
Dislocations
Soft tissue injuries
Burns
Infections
Amputations

Other hand injuries include:

Finger injuries
Wrist injuries
Broken hand
Nail injuries
Finger infection

Symptoms

Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:

Lacerations

Tenderness
Pain
Bleeding
Numbness
Decreased range of motion
Difficulty moving
Weakness
Pale appearance

Fractures and Dislocations

Swelling
Discoloration
Tenderness
Deformity
Reduced range of motion
Numbness
Weakness
Bleeding

Soft Tissue Injuries and Amputations

Swelling
Discoloration
Tenderness
Deformity with or without tissue loss/bone loss
Bleeding
Weakness
Numbness

Infection

Tenderness
Swelling
Warmth/Heat around the area
Redness
Deformity
Reduced range of motion
Fever is rare in hand infections

Burns

Redness
Tenderness
Blistering
Complete numbness
Discoloration
Loss of tissue
The texture of the skin change
Areas of tissue blackened
Deformity

High-pressure Injection Injury

Pain
Swelling
Bleeding
Skin discoloration
Muscle, tendon, ligament tears
Cracked/Broken bones

Medical Care

Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.

Severe bleeding
Severe pain
Numbness
Loss of motion
Loss of strength
Deformity
Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
Exposure of structures – tendons, bones, joints, arteries, veins, or nerves

Diagnosis

A medical examination can include a medical history and physical examination.

Medical History

Past medical history
Does the patient have diabetes or arthritis?
Is the patient right or left-handed?
Occupation
Extracurricular activities and hobbies
How does the patient use their hands?
How did the injury occur, mechanism of injury?
Does the patient smoke?

Physical Exam

Visual inspection look at the injury
Sensory nerve exam feeling
Vascular exam circulation of blood supply
Muscular and tendon exam movement and strength
Bone exam broken bones or dislocated joints

Tests

A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly

Body Composition

Artificial Sweeteners And Muscle Gain

Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:

Greek yogurt
Fruit with nuts or nut butter
Hummus with whole-grain crackers
Tuna
Hard-boiled eggs

References

Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.

Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177

Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5

MedscapeReference.com. High-Pressure Hand Injury.

MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.

Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016

WebMD.com. Finger, Hand, and Wrist Injuries.

Infections of The Spine: Symptoms, Risks, Diagnosis

Dr. Alex Jimenez

Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:

In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining

These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.

Table of Contents

Spinal Infection Types

They are classified according to the type of tissue they infect. The most common include:

Vertebral Osteomyelitis

This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:

Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site

Treatment includes:

Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.

Discitis

This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.

The Staphylococcus aureus bacterium, known as staph, is the most common microbe that can cause discitis.
Other forms of staph that cause discitis include:
E. coli
Salmonella
Strep
Fungi
Autoimmune disorders

Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:

Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving

Treatment options include:

Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility

Epidural Abscess

This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:

Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems

Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.

Risk Factors

Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:

Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery

Risk factors include:

Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.

Surgical risk factors:

Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area

Diagnosis

Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:

Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI

Outcome

These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.

Body Composition

Practice Mindfulness

Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.

Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.

References

American Association of Neurological Surgeons. Spinal Infections. www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.

Stat Pearls. (2021). Diskitis. www.ncbi.nlm.nih.gov/books/NBK541047/

Stat Pearls. (2021). Spinal Epidural Abscess. www.ncbi.nlm.nih.gov/books/NBK441890/

Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. www.frontiersin.org/articles/10.3389/fmed.2014.00007/full

Microorganisms. (2020). Spinal Infections: An Update. www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/

The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext

Straining, Spasming, Injuring The Lat Muscles

Dr. Alex Jimenez

Couple Carrying Sofa Into New Home On Moving Day

The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:

Repetitive overuse in a job or doing a task/chore that requires constant
Bending
Pulling
Pushing
Reaching
Twisting
Kneeling
A result of poor technique in sports or similar physical activities.

Chiropractic treatment, along with exercises, can help prevent and relieve this pain.

Table of Contents

Symptoms of lat pain

The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:

Lower, middle, and upper back
Back of the shoulders
The base of the shoulder blade
Lower arms
Inside of the arms, extending down to the fingers

In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:

Extends their hands forward and out in front
Raises their hands above their head
Tosses or throws an object

Damage or injury to the latissimus dorsi

Tissue damage or injury can cause other symptoms to present. These include:

Tingling in the lower arms
Breathing causes aching and/or pain
Tendonitis in the middle and/or lower back

If the source of the back pain cannot be identified, or if it is accompanied by:

Fever
Breathing problems
Abdominal pain
Consult a doctor as these could be symptoms of a more serious condition.

Uses and Causes

The lat muscles are used in everyday activities. These include:

Picking up objects like grocery bags
Opening heavy doors
Chest expansion for breathing
Pushing against the armrests of a chair to stand up
Using handrails to climb stairs

For sports or working out, the lats are used in:

Weightlifting exercises using the upper body
Bench-presses
Rowing
Swimming
Throwing

Common causes of pain include:

Overusing the muscles
Using poor techniques
Exercising without warming up

Risk of injury

Individuals that are at risk of developing this injury include those that:

Are continually reaching overhead
Regularly chop wood
Perform regular shoveling
Move furniture or other heavy objects
Regularly practice poor posture

Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:

Golfers
Baseball pitchers
Gymnasts
Swimmers
Tennis players

Exercises that can help bring relief

Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.

Back bow

This pose is known as the superman pose. To perform:

Lay facedown on the floor
Extend the legs so they are straight
Stretch arms away from the body, so they are in front of the head
Use the back to raise the shoulders
Extend the arms and legs upward
Hold the position for 10 seconds

Pelvic raise/lift

To perform this exercise:

Lay flat on your back with the arms at the sides
Bend the knees like for a sit-up with the heels close to the buttocks
Keeping the hands and feet in place
Lift the pelvis upward
Slowly lower back to the floor

Prevention

Individuals can prevent lat pain with lifestyle adjustments. These include:

Using proper technique and posture during work, sports, and exercise
Staying aware to not overuse the muscles
Staying hydrated
Warming up and cooling down thoroughly before and after a workout, sports, physical activities
Regular stretching
Applying ice and heat before and after work, sports, and physical activities
Chiropractic care
Physical therapy massage

Body Composition

Nutrition and Recovery Advantage

Two important steps to achieve optimal health include:

Nutrition

Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesis after exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.

Recovery

For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.

References

Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
www.ajronline.org/doi/abs/10.2214/AJR.04.1247

Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb

Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20

George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581

Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4

What is Hypnosis? | El Paso, Tx (2021)

Dr. Alex Jimenez

In this Functional Medicine podcast Dr. Alex Jimenez invites Master Hypnotist Eric Richmond CRNA, BCH, CI, RM and Connie Pemberton – retired RN to talk to us and take us a little deeper into what Hypnosis is and the benefits it can bring into our lives. Enjoy our newest podcast and stay tuned for more content during the week.
Thanks for Watching!

If you have any questions you can call us at 915-850-0900
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If you have enjoyed this video and/or we have helped you in any way
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Thank You & God Bless.
Dr. Alex Jimenez DC, MSACP, ATN, IFMCP. CIFM, CCST

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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.

Muscle Cramp and Muscle Spasm: Bio-Chiropractic Insight

Dr. Alex Jimenez

Sportswoman being troubled by back muscle soreness — Cropped photo of a muscular woman wearing sport clothes holding on to her back at the gym

Muscle cramp and muscle spasm: Three types of muscles make up the body.

Cardiac muscle makes up the heart.
Smooth muscle cells line the blood vessels, gastrointestinal tract, and organs.
Skeletal muscles attach to the bones and are used for voluntary movements.

A muscle spasm happens when skeletal muscle contracts and does not go back to its relaxed state. Spasms are forceful and involuntary. A muscle spasm that sustains/continues is a muscle cramp. The leg muscles, especially the quadriceps/thigh, hamstrings/back of the thigh, and gastrocnemius/calves, are prone to cramping, but any skeletal muscle can cramp. Charley horse is another name for a muscle cramp.

Table of Contents

Causes

There can be a variety of causes for muscle cramps. This includes:

Physical exertion in hot weather
Overexertion
Dehydration
Electrolyte imbalance
Physical deconditioning
Certain medications and supplements could contribute to muscle cramping.

Muscle Symptoms and Anxiety

Generalized anxiety disorder or GAD can include symptoms like:

Muscle aches
Muscle tension
Muscle twitching
Symptoms that usually accompany anxiety:
Fatigue
Sweating
Nausea
Shortness of breath

Most times, muscle cramps are not a cause for alarm. However, there are times when cramps could be indicating a more serious health issue like:

Liver cirrhosis
Atherosclerosis
ALS
Thyroid disorders
Problems or issues with the spine or spinal nerves.

Signs and Symptoms

They can range from mild discomfort to incapacitating throbbing pain.
The muscle that is cramping could look distorted or look like a knot.
Muscle twitching could present.
The area of the cramp could be firm/sensitive to the touch.
Some last just a few seconds.
Others can last 15 minutes or more.

Medication Causation

Medications can cause cramps through differing mechanisms. These include:

High blood pressure medications
Insulin
Birth control pills
Cholesterol-lowering medications
Certain types of asthma medications – beta-agonists

They can interfere with electrolyte levels, contribute to the breakdown of muscle tissue, and/or interfere with blood circulation. Any medication-related muscle cramping should be reported to a doctor.

Night Cramping

Night cramping, especially in the calves, is common and affects up to 60% of adults. Women are more prone to night-leg cramps than men. They are also common with age and a common contributor to insomnia. Muscle fatigue and nerve dysfunction are believed to be a factor. Management remedies include:

Stretching
Self-Massage
Topical muscle pain ointments/creams
Ice therapy

Remedies and Treatment

The majority of cramps resolve on their own within a few minutes without treatment.

It is recommended that as soon as a cramp begins, stop the activity.
Stretch and massage the area,
Hydrate with water and, if necessary healthy sports drink to replenish sodium, vitamins, electrolytes, and more.
Apply heat to help relax the muscle.
Apply an ice pack.
Nonsteroidal anti-inflammatory medications (NSAIDs) can help if the pain is substantial.
Consult a doctor if cramps are severe or are recurring often.

Prevention

Strategies for reducing the risk include:

To vary exercise routines
Maintain proper hydration
Maintain proper levels of electrolytes. Sodium and potassium are lost during physical activity, especially in the heat and with consistent sweating.
Regular Stretching
Warm-up with a quick jog or quick walk before stretching the body.

Body Composition

Insulin and the body

Insulin assists the transport and storage of energy glucose to cells, tissues, and organs. These include the body’s glucose storage like the skeletal muscles and liver. Once the blood sugar returns to a base level as the glucose is absorbed, the pancreas begins producing glucagon instead of insulin. Glucagon tells the liver to release the stored sugar, which typically happens between meals. What happens to the body when eating too much sugar and carbohydrates than the glucose-storing organs can handle?

Individuals with Type 1 diabetes have a pancreas that does not produce insulin. Type 1 diabetics need to control their glucose levels with lifelong insulin therapy.

With Type 2 diabetes, the pancreas ends up producing insulin through frequent outbursts. When this starts to happen more than normal, the cells eventually lessen their insulin sensitivity. The body becomes numb to the signaling that there is excess blood sugar in the body. This is what happens in individuals with insulin resistance or Type 2 diabetes. This type of diabetes can be managed or prevented with diet adjustments.

References

AAOS: “Muscle Cramps.” Jun. 2017.

American Academy of Orthopedic Surgeons: “Muscle Cramp.”

American Academy Physician: “AAN Recommendations on Symptomatic Treatment for Muscle Cramps.”

American Family Physician: “Nocturnal Leg Cramps.”

American Osteopathic Association: “Muscle Cramp – A Common Pain.”

Journal of the American Academy of Orthopedic Surgeons: “The Athlete With Muscular Cramps: Clinical Approach.”

National Cancer Institute: “Muscle Types.”

National Institute of Mental Health: “What Is Generalized Anxiety Disorder?”

Chiropractic Adjustments For Vertigo Symptoms

Dr. Alex Jimenez

Physiotherapist doing manual treatment — Professional senior physiotherapist doing manual treatment to a young woman with spine problems in the cabinet of rehabilitation clinic

Getting dizzy can happen, usually after standing up too fast or staring at an optical illusion then looking away. The unsteadiness can be troubling but is minimal when compared to vertigo symptoms. Vertigo is a symptom rather than a condition that causes dizziness combined with a spinning sensation, even when an individual stands completely still. Vertigo can make everyday life a debilitating nightmare:

It causes individuals to feel nauseous.
It makes it difficult to walk.
It interrupts vision and hearing.

Vertigo symptoms usually begin with a communication issue with the inner ear and brain. This neurological connection involves the spinal cord, which chiropractic can treat and cure. A chiropractor will implement the necessary techniques to help alleviate vertigo symptoms.

Table of Contents

Causes

The most common signs and symptoms are dizziness accompanied by a spinning sensation. Vertigo symptoms can also include:

Balance issues
Body swaying
Headache/s
Tinnitus
Sweating
Nausea
Vomiting

Vertigo is a common symptom in individuals that have gone through trauma to the neck and/or head. A disturbance/interruption occurs in the nerve pathways in the spinal column. Disruption, injury, or damage to the vestibular system/inner ear also causes vertigo symptoms. Other causes include:

Ear infections
Pressure changes
Movement of particles within the inner ear

Chiropractic Treatment

Chiropractic treatment can cure vertigo symptoms through various exercises and spinal adjustments. When nerve signals don’t transmit correctly, it can cause a feeling of dizziness along with the other symptoms. Adjustments or manipulations help alleviate the symptoms by allowing nerve energy to circulate properly. Spinal adjustments realign the joints and vertebrae in the cervical spine. This opens the nerves pathways and allows for clear communication.

A common type of vertigo is known as benign paroxysmal positional vertigo or BPPV. This is the movement of particles around the inner ear. These particles come from otolith organs. The particles break loose and fall into other parts of the vestibular labyrinth. This alters the center of balance and can cause dizziness. A chiropractor may use the Epley maneuver, which maneuvers the head into different positions. A chiropractor will recommend specific exercises at home to benefit the vestibular system and its communication with the brain.

Body Composition

A Common Cold

The common cold, aka upper respiratory tract inflammation. It is the most common infectious respiratory disease. It is called this because of the effects on the nose and throat. According to the Center for Disease Control and Prevention, an adult will catch 2–3 colds a year. A cold-causing virus enters the respiratory tract directly when an individual inhales droplets or direct skin contact from an infected person. Cold symptoms include:

Runny nose
Stuffy nose
Sneezing
Coughing
Headaches
Body aches

The duration of a cold differs, but most individuals with a healthy immune system recover in 7–10 days. However, individuals with compromised immune systems, asthma, or COPD have an increased risk of developing serious illnesses like bronchitis or pneumonia. Quickly recovering from a cold requires boosting the immune system with proper rest, a nutritious diet, and drinking plenty of water.

References

Collins, Matthew E, and Tom M Misukanis. “Chiropractic management of a patient with post-traumatic vertigo of complex origin.” Journal of chiropractic medicine vol. 4,1 (2005): 32-8. doi:10.1016/S0899-3467(07)60110-4

Dalby, B J. “Chiropractic diagnosis and treatment of closed head trauma.” Journal of manipulative and physiological therapeutics vol. 16,6 (1993): 392-400.

Sajko, Sandy S et al. “Chiropractic management of benign paroxysmal positional vertigo using the Epley maneuver: a case series.” Journal of manipulative and physiological therapeutics vol. 36,2 (2013): 119-26. doi:10.1016/j.jmpt.2012.12.011

Spinal Imaging Back Pain Clinic Expectations

Dr. Alex Jimenez

selective focus of smiling radiologist writing on clipboard while assistant operating ct scanner

Chiropractors and spine specialists utilize spinal imaging through X-rays, MRIs, or CT scans to figure out what is causing back problems and pain. Imaging is common. Whether chiropractic or spinal surgery, they help immensely discover back issues and allow the individual to see what is happening. Types of cases include back pain that:

Comes from trauma
Has lingered for four to six weeks
It is accompanied by a history of:
Cancer
Fever
Night sweats

Doctors use these images when diagnosing a spinal condition. Here is some insight into spinal imaging.

Table of Contents

X-rays

X-rays for back pain can be quite helpful. An X-ray is radiation-based and is used to examine the conditions of the bone structures. X-rays are optimal for bone tissue or tissues that are ossified or calcified. They work the best with hard tissues, specifically bones. Soft tissues like muscles, ligaments, or intravertebral discs do not present as well.

Individuals undergoing a back X-ray will be scanned by a machine that generates a beam. A receiver picks registers the beam after it passes through the body and generates an image. It takes around five minutes to complete but could be longer depending on the doctor’s number of images. X-rays are helpful for insurance purposes and rule out bone conditions like compression fractures and/or bone spurs. X-rays are ordered for specific reasons and are often part of a whole-body diagnostic study. This includes MRI and/or CT scan.

CT Scan

CT stands for computed tomography. It is a series of X-rays that are digitized into images using a computer. The advantage of a CT scan to standard X-rays is that it offers different views/angles of the body and can be in 3D. CT scans are most often used in trauma cases or individuals who have had surgery. They take around five minutes. For X-rays, individuals stand up or lay under the X-ray machine as it scans the body. A CT scan has the individual lie down in a circular donut-looking machine that scans while rotating during the imaging. Individuals are recommended to wear casual loose, comfortable clothing. Sometimes a dye, or intravenous contrast, is used to get the vascular tissues to stand out, generating clearer images.

MRI

MRI is short for magnetic resonance imaging. MRIs use magnets to generate images. MRI imaging is often used in individuals that have undergone surgery. They take longer, usually around 30 to 45 minutes. No metallic objects are allowed in the MRI. Patients are asked to remove items like belts, jewelry, etc. Contrast dye can be a part of an MRI. The machine is like a tunnel. This can become challenging for individuals that have claustrophobia. Consult with a doctor and find out how to get comfortable during the process.

Other Forms of Spinal Imaging

Other forms of imaging include:

CT navigation

CT navigation shows real-time CT scans during the procedure.

Fluoroscopy

Fluoroscopy involves an X-ray beam that passes directly through the body that shows live, moving images.

Both of these types of spinal imaging are utilized during surgeries. For some cases, intraoperative imaging is used. This type of imaging uses high-tech robotics to help surgeons navigate through tight spaces during the procedure. This increases the surgeon’s accuracy and reduces the size of the incision.

Ultrasound

Ultrasound can be used for spinal conditions. This is an imaging test that uses sound waves to generate images. However, the imaging tests which are used in spinal imaging are primarily X-rays and MRIs.

Imaging Appointment

Talk with your doctor or chiropractor ahead of time to understand what to expect during the imaging process. They will let you know how to prepare and any special instructions before the appointment. Along with medical history and a physical examination, spinal imaging is an important part of the diagnostic process to find what is causing the pain and to develop the best treatment plan.

Body Composition

Short-term Effects of Coffee and Blood Pressure

The caffeine in coffee is a stimulant or substance that excites the body’s systems. When caffeine is ingested, individuals experience an increase in excitement, specifically in the cardiovascular system. This excitement causes the heart rate and blood pressure to rise and then lower back to a baseline level for healthy individuals. Coffee slightly increases short-term blood pressure. Moderate coffee consumption is safe for individuals that do not have pre-existing cardiovascular conditions.

References

United States Nuclear Regulatory Commission. (May 2021) “Doses in Our Daily Lives” www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

X-Ray for Back Pain: Current Reviews in Musculoskeletal Medicine. (April 2009) “What is the role of imaging in acute low back pain?” www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/

Weight Training To Strengthen The Back Muscles

Dr. Alex Jimenez

beautiful determined sportswoman in weight lifting gloves training with barbell at sports center

When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.

Table of Contents

Back muscles development

With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:

Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.

Guidelines while using weights

When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:

Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s

Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.

Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.

Smaller weights build strength progressively

Effective ways to strengthen the spine.

Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches

Exercise machines can be recommended instead of free weights.

Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.

It is recommended to combine regular walking activity with a weight training program.

Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.

Training program and benefits

Gaining the most benefits from strength training, tips to keep in mind:

Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.

Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.

Body Composition

Carbohydrates and Muscle Growth

Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.

Carbs prevent muscle weakness.

Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.

Carbs help muscles recover after exercise.

Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.

References

Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.

Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050

Testosterone deficiency in Men | EL PASO, TX (2021)

Dr. Alex Jimenez

Welcome to our newest functional Medicine presentation, in this episode we will talk Testosterone Deficiency in Men.
An expert will help us describe testosterone deficiency, its prevalence in the male population, and relationship to aging. He will also list etiologies of diminished testosterone levels, and physiological impact of low testosterone levels. We will Identify signs, symptoms, and conditions associated with low testosterone and choose the most useful laboratory tools to assess men with low testosterone. And finally we will be able to develop a plan for prescribing nutraceuticals, diet and lifestyle interventions to enhance production, transport, sensitivity and detoxification of testosterone. Stay tuned for the next part of this presentation brought to you by Dr. Alex Jimenez…
If you have any questions you can call us at 915-850-0900
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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!
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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.

The Importance Of Sleeping On The Right Pillow

Dr. Alex Jimenez

Happy young African American woman posing after wake up — Good Morning. Portrait of beautiful carefree well-slept black lady lying on the white bedsheets at home, looking aside at window, resting in bedroom, feeling good after waking up on weekend

Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.

Table of Contents

Importance of Pillows

Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.

Shape

The shape of the pillow has a definitive role in the cervical/neck’s curvature.

Posture

Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.

Sleep quality

Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.

Height

Cervical alignment can become significantly impacted by the shape and height of the pillow.

Pillow Comfort Importance

Trying to find the right pillow will require trial and error. The basics to consider include:

One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
A new pillow to consider are those that control temperature.
Cooling pillows are made to prevent heat retention. If a warm/hot pillow is keeping you up at night.

Temperature affects sleep quality.

Tossing and turning all night means loss of sleep.
The frustrating, angry, shifting movements can aggravate back and neck pain/issues.
Consider bed linens and pillowcases that cool the body.

Pillow Types

Today’s pillows are made from a variety of materials. Learning about the different kinds of materials can help make an educated choice.

Choose a retailer or brand that offers a guarantee or fair return/exchange program.
If the pillow isn’t right, you can return it and try another type.

Memory Foam

This material is polyurethane that has been combined with certain chemicals to make it viscoelastic.
These pillows return to their shape, can stretch and conform to the curves of the body.
Different kinds of memory foam include Open cell, Egg crate, and Gel.
They will mold to the contour of the spine, helping with misalignments.

Down Pillows and Down Alternative/polyfill

These pillows are generally softer.
They are made from actual down feathers or a non-allergic synthetic alternative that feels like real down.
There is not a great deal of firmness, but they are a good option because they are soft and workable.

Latex

These can be natural or synthetic latex, also known as rubber pillows.
They offer soft cushioning and proper support.
The latex is generally shredded, meaning it can be customized with more or less filling depending on the individual’s needs.

Combo style

There are combination pillows that could have a foam core with down around it for comfort and support.
Gel cores are common, specifically in cooling pillows.

How to Choose

Tips and things to keep in mind include:

Does it conform to the shape of your neck and spine?
How soft is it?
Is the pillow stiff?
Is it too high?

Remember the importance of sleeping positions. Back, side, or stomach. Pillows that match an individual’s sleeping position criteria:

Back sleepers are recommended to use a medium-thick pillow. This keeps the head, neck, and spine properly aligned.
Side sleepers are recommended to use a slightly thicker, firmer pillow for proper alignment.
Stomach sleepers are a challenge because of the strain placed on the pelvis and lower back. An almost flat pillow is recommended.

Shopping

If possible, try out the pillow before buying it.
Most stores will allow this, and some companies take it further.
For example, The Sleep Number company offers a service called PillowFit.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed, make it as comfortable as possible.

Body Health

Sleep Body Composition Importance

Not getting enough sleep makes it difficult to gain muscle.

Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.

Not getting enough sleep makes it difficult to lose fat.

Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
Tiredness reduces spontaneous movements.

References

“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017. pubmed.ncbi.nlm.nih.gov/28626314/

“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. pubmed.ncbi.nlm.nih.gov/27635354/

“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA. www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows

“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. pubmed.ncbi.nlm.nih.gov/25008402/

“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. pubmed.ncbi.nlm.nih.gov/33895703/

Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14

Chronic Pain and Nutritional Habits

Dr. Alex Jimenez

Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.

At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, a health coach, and a nutritionist to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.

Table of Contents

Salt, Sugar, and Fat Affects the Body

A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.

Changing unhealthy eating habits is up to the individual.

Individuals can be advised to cut back or cut out unhealthy diet choices; however, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.

Nutrition Discussion

Chronic pain associated with inflammation linked to a poor diet is the first step in the diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.

The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen in stages. An example could be:

Having one cheeseburger and not two.
Having a burger without cheese.
Eating a burger without the buns.
Switching to a plant-based burger.
There are many options to be explored to improve eating habits in small steps.

Willpower also has to be addressed in a controlled and supportive setting. This is where the whole team comes in. Many individuals’ eating habits are part of who they and adjusting them can be an uphill challenge. To educate on:

Methods of accountability
Keeping a journal
Having the family or friends eat healthy with them
These are techniques and methods to increase willpower to make healthy changes.

Body Composition

Foods Can Support Body Detoxing

The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:

Neutralize oxidative stress
Lower inflammation
Increase immunity
Strengthen the musculoskeletal system
Foods and nutrients that detoxify can be a part of a healthy lifestyle.

References

Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015

Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346

Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421

Stress Management and The Body’s Health

Dr. Alex Jimenez

Young male osteopath doing a craniosacral massage on a female patient gently massaging and palpating the cranium and spinal fluid with his hands

More individuals are reporting extreme levels of stress. Studies indicate that an increasing number of individuals are feeling worried, anxious, or depressed regularly from various stressors. Maintaining the body’s health includes:

Following a balanced diet
Getting enough exercise
Taking vitamins or supplements to ensure the body gets what it needs for optimal function.

However, research has found that a sudden increase in stress, specifically stress associated with anger, can trigger:

Arrhythmias
Heart attacks
Sudden death

This type of stress can affect individuals that did not know they had heart disease. Intense short-term stress can have dangerous effects on the body’s health, leading to chronic stress. Chronic stress continues at a low level for weeks, months, or years. It can significantly change the way the body functions. Stress management is very important for overall well-being. Learning how to handle stress properly is the goal.

Table of Contents

Poor Stress Management

When stress hits it triggers the brain to release various hormones. These hormones increase heart rate and raise blood pressure. This comes from evolution that helped early humans escape from predators and stay safe from different types of physical danger. This same stress reaction is what we go through, however, it is not to escape danger but to deal with work, family, school, commuting, and social issues, etc. And when the stress response happens on a regular basis it can have serious and long-term effects on the body’s ability to function properly. Stress includes mental, behavioral, and physical symptoms. The effects of stress that are most familiar are related to mood. Mood changes that can result from chronic low-level stress include:

Feelings overwhelmed
Increased anxiety
Generalized anxiety that is not connected with anything specific
Unmotivated or unfocused
Sadness
Depression
Irritability
Impatience
Unusually quick to anger
Restlessness

These mood changes can be tied to changes in behavior. The following behaviors are associated with increased stress levels:

Alcohol and/or drug abuse
Starting or increasing tobacco use
Eating changes – undereating or overeating
Withdrawing from friends and family
Avoiding social interaction
Little to no physical activity

Physical effects that are associated with long-term stress.

Chronic stress that lasts for a long period can affect the whole body. The immune system, digestive system, sleep cycles, etc. Physical symptoms include:

Tension in the neck and back
Persistent headaches
Stomach aches
Constant fatigue, even after waking up
Sleeping pattern changes
Insomnia
Muscle pain
Changes in libido
Being more prone to infections because of a weakened immune system
Chest pain

Learning Healthy Stress Management

Mental health is now an important part of living a healthy life. Stress comes from all kinds of different places. We can’t always change these moments, but we can change our reactions to reduce the negative effects and results. To manage stress, it is important to know what is causing it.

It could be an argument with a boss, co-worker, family member, or significant other.
Work deadlines
School grades, teachers, kids, etc
Bills
Repairs

Clearly identifying the main stressors will help individuals anticipate them and form a plan. There are different ways of dealing with it. The different strategies need to be researched and tried by individuals to see what works for them. Think about what helps the mind and body relax and unwind. A few recommended ways include:

Watching favorite shows or movies
Listening to music
Breathing techniques
Spend time with friends or family
Make time for yourself to do something you love – alone time
Unplug from devices like phones, tablets, or computer
Play a sport
Practice yoga
Physical activity
Take a nature hike
Write, paint, sculpt, knit, sew, crafts, make music, play instrument/s – real media or digital
Meditate and practice mindfulness techniques

These are strategies that can be incorporated into regular daily life. Be sure to set time aside to focus on mental wellbeing. Learn to recognize the signs when getting overwhelmed. Don’t hesitate to ask for help when needed. This can be a support system or mental health professional. This is to empower individuals to take better care of themselves in both body and mind.

Body Composition

Setting Attainable Goals

Individuals that have trouble achieving health goals might want to look at the goals themselves. Individuals typically have a general idea of their fitness journey. However, it is hard to reach those goals without a map. Losing weight or getting healthy is the goal but these goals are not measurable. This is too broad that can be different things to different people. Trying to accomplish a vague goal makes it hard to plan, making it happen, or seeing progress. A recommended strategy for goal setting is to use the SMART system. The acronym stands for:

Specific
Measurable
Attainable
Realistic
Timed

When goals fall into these parameters, it provides a clear picture of what is trying to get accomplished and the ability to plan accordingly. An example could be: An individual will work out at home or the gym for one hour, five days a week for one month. This is a specific and measurable goal when compared to I’m going to work out more. This provides clear guidelines of what needs to happen to achieve success.

References

Bailey, Ryan R. “Goal Setting and Action Planning for Health Behavior Change.” American journal of lifestyle medicine vol. 13,6 615-618. 13 Sep. 2017, doi:10.1177/1559827617729634

Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395

Jamison, J R. “Stress management: an exploratory study of chiropractic patients.” Journal of manipulative and physiological therapeutics vol. 23,1 (2000): 32-6. doi:10.1016/s0161-4754(00)90111-8

Jamison, J. “Stress: the chiropractic patients’ self-perceptions.” Journal of manipulative and physiological therapeutics vol. 22,6 (1999): 395-8. doi:10.1016/s0161-4754(99)70085-0

Inflammatory vs. Mechanical Pain

Inflammatory

Mechanical

Inflammatory and Non-Inflammatory

Contributing Autoimmune Diseases

Inflammatory Pain Treatment

Chiropractic and Physical Therapy

Inflammation Night Pain

Stretch Before Bed and When Waking

Inspect Pillows and Mattress

Exercises

Cardio

Strength-Building

Body Composition

Mediterranean Lifestyle

References

Rainy Weather

Easy Physical Activity

Traveling

Inflammation

Chiropractic Rainy Day Relief

Body Composition

About Fat

References

How Bowling Injuries Happen

Common Bowling Injuries

Trigger/Bowler’s Finger

Bowler’s Thumb

Finger Sprain

Herniated Disc

Avoid and Prevent Injury

Stretching

Improving technique

Using the right ball

Bowling less

Getting in shape

Body Health

Test Body Composition

Diet adjustment

Physical activity that fits the new lifestyle

References

Anatomy

Causes

Symptoms

Lacerations

Fractures and Dislocations

Soft Tissue Injuries and Amputations

Infection

Burns

High-pressure Injection Injury

Medical Care

Diagnosis

Medical History

Physical Exam

Tests

Body Composition

Artificial Sweeteners And Muscle Gain

References

Spinal Infection Types

Vertebral Osteomyelitis

Treatment includes:

Discitis

Epidural Abscess

Risk Factors

Diagnosis

Outcome

Body Composition

Practice Mindfulness

References

Symptoms of lat pain

Damage or injury to the latissimus dorsi

Uses and Causes

Common causes of pain include:

Risk of injury

Exercises that can help bring relief

Back bow

Pelvic raise/lift

Prevention

Body Composition

Nutrition and Recovery Advantage