Accidents and Injuries

Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?

Bone Growth Stimulator

Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.

How They Work

Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn't heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)

• They come in various shapes, sizes, and technologies depending on the location of the fracture.
• The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
• The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
• Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.

Electrical Stimulation

• Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.

Ultrasound Stimulation

• They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.

Implantable vs. External

• Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.

The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.

Effectiveness

Studies of bone stimulator effectiveness suggest two benefits:

1. Less pain is associated with the bone healing process.
2. Faster fracture healing.

However, these studies haven't shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)

• While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
• Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
• It's important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it's the right treatment option.

When Stimulation is Necessary

Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)

Nonunion Fractures

• When a fracture doesn't heal within the expected timeframe.
• Open fractures
• Stress fractures
• Scaphoid bone fractures
• Talus fractures

Failed Fusions

• When a spinal fusion hasn't been successful.

High-Risk Patients

• For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications

Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

From Injury to Recovery with Chiropractic Care

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

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

Email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

U.S. Food & Drug Administration. (2022). AccelStim Bone Growth Stimulator – P210035. Retrieved from https://www.fda.gov/medical-devices/recently-approved-devices/accelstim-bone-growth-stimulator-p210035#:~:text=What%20is%20it?,the%20transducer%20to%20the%20fracture

Childs, S. G. (2003). Stimulators of bone healing. Biologic and biomechanical. Orthopedic nursing, 22(6), 421–428. https://doi.org/10.1097/00006416-200311000-00010

Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. https://doi.org/10.1038/srep31724

Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What's all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. https://doi.org/10.4103/0019-5413.50844

What are the recommendations for a pulled muscle injury to fully recover?

Pulled Muscle Recovery Time

A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015)  Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.

Timeline

The timeline for recovering from a pulled muscle depends on the injury's severity. Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)

Grade 1 (mild)

• Heals in a few days.
• A microscopic tear or stretch in the muscle fiber.
• It might feel sore, but you can still use the muscle.

Grade 2 (moderate)

• Heals in four to six weeks.
• A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.

Grade 3 (severe)

• Heals in several months
• This type of muscle strain causes a complete tear, also known as a rupture.
• It results in intense pain, significant swelling, and inability to use the muscle.
• Surgery may be required in some cases.
• Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.

Body Parts More Susceptible To Injury

The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)

• Neck - levator scapulae and trapezius
• Shoulders - rotator cuff muscles
• Lower back - erector spinae
• Groin - adductors
• Front of the thigh - quadriceps
• Behind the thigh - hamstrings
• Calves - gastrocnemius and soleus

Healing Stages and Factors

Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).

Inflammatory Stage (zero to three days)

• When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
• Rest is important during this stage to prevent the injury from getting worse.

Repair Stage (three to 21 days)

• Damaged muscle fibers are repaired and regrow during this stage.
• Collagen fills in any tears to rebuild damaged muscle tissue.
• Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
• Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.

Remodeling Stage (three weeks to one year)

• Repaired tissue gets stronger and adapts to regular movement.
• Scar tissue may form.
• Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

• Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
• Prolonged rest can slow healing, so maintain a balance between rest and exercise.

Ice

• Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
• Ice helps control inflammation by limiting blood flow to the injured area.

Compression

• Use compression stockings or wrap the injured part in bandages to help reduce swelling.
• Ensure the binding is not too tight so circulation is not cut off.

Elevation

• Raise the injured area above heart level throughout the day.
• This helps reduce swelling by allowing fluids to drain away from the injury site.

Heat

• After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.

Eat Healthy

• Get enough protein for muscle repair.

Maintain Hydration

• Drink plenty of water to help with circulation and muscle lubrication.

Massage and Physical Therapy

• These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.

Over-the-counter Medications

• If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
• Only use as directed.

These steps can help promote faster healing and expedite returning to normal daily activities.

When to Resume Normal Activity

Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It's essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)

• Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
• Slowly resume normal activities, avoiding overexerting the injured area.
• Gradually increase activity levels and stop if there is any pain.
• Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.

Contact a Healthcare Provider

While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)

• Pain persists or worsens after seven to 10 days.
• This can indicate a more serious injury, such as a severe torn muscle.
• Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
• It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
• There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
• There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.

A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Say Goodbye to Pain with Chiropractic Care

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY - PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains

Individuals who have fractured their scaphoid bone may experience pain and swelling in the wrist just below the thumb. Can immobilization with a cast and physical therapy help?

Scaphoid Fracture

A scaphoid fracture is a break in one of the wrist's small or carpal bones. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include swelling and pain in the wrist just below the base of the thumb. These fractures can be difficult to diagnose since they don't always appear on an X-ray. If the X-ray is negative and the healthcare provider suspects a scaphoid fracture, an MRI may be necessary. Surgery may be required in more severe cases or when the injury is not healing correctly. (American Academy of Orthopaedic Surgeons, 2023)

A Break In The - Navicular Bone

The scaphoid is one of eight carpal bones in the wrist. It is located just below the thumb's base and is shaped like a kidney bean. This bone can be identified by holding a thumbs-up position and feeling for the hollow between the two tendons below your thumb. The scaphoid is located at the base of the hollow. A break in the scaphoid bone most commonly occurs in the middle of the bone but can also happen at either end. A scaphoid fracture can be displaced or non-displaced (American Academy of Orthopaedic Surgeons, 2023)

Displaced Fracture

• It is when the bone fragments have moved out of alignment.

Non-displaced Fracture

• It is when the fragments are still in their normal location in the hand.

The scaphoid’s blood supply comes from a small vessel that enters the most distant part of the bone and flows back through the bone. Because of this one small blood supply, a fracture in the center can stop the circulation to the proximal portion of the bone. Because of this, scaphoid fractures need immediate diagnosis and treatment.

Symptoms

Pain or deep aching on the thumb-side of the wrist, typically after a fall on an outstretched arm, could be a scaphoid fracture. Other symptoms experienced include: (American Academy of Orthopaedic Surgeons, 2023)

• Tenderness at the base of the hollow area.
• Pain at the base of the hollow area.
• Swelling in the wrist
• Difficulty gripping objects

Pain can become worse from: (American Academy of Orthopaedic Surgeons, 2023)

• Grasping
• Pulling
• Pushing
• Pinching

Diagnosis

A healthcare provider will evaluate the hand for tenderness and pain in the hollow and/or the bone. If a break is suspected, they will order an X-ray. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) Many patients are diagnosed with a wrist sprain when they have a fracture. Diagnosis can be difficult because the fracture often doesn’t appear on X-rays until weeks after the healing process starts. Physicians commonly treat a wrist injury as a scaphoid fracture initially and then repeat X-rays within two weeks. (American Academy of Orthopaedic Surgeons, 2023) If the injury doesn't show on an X-ray, the provider may order an MRI, as these fractures can be easier to see on an MRI. An MRI can help ensure appropriate treatment immediately. (Wong S. B. S., & Peh W. C. G. 2019)

Treatment

If a wrist fracture is diagnosed, the wrist will be immobilized in a cast. However, a healthcare provider may also put the wrist in a cast if the X-ray is negative but they suspect a fracture. This will stabilize the injury until an MRI can be performed. With immobilization and follow-up treatment, scaphoid fractures often heal without surgery. Repeat X-rays are taken over several weeks or months so the provider can make sure the injury is healing correctly. If it is not healing correctly, surgery may be recommended. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) If the fracture is displaced, healing correctly may be a challenge. In this case, a physician may recommend initial surgery to reposition the bones. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) This type of surgery involves pinning the bone in place with screws.

Healing Time

• With treatment, non-displaced fractures can heal in 6 weeks, while most displaced fractures take 10 to 12 weeks. (Clementson M., Björkman A., & Thomsen N. O. B. 2020)
• Scaphoid fractures can take longer than this, and sometimes, they don't heal. (American Academy of Orthopaedic Surgeons, 2023)

Recovery

With the wrist in a cast, individuals will be instructed on activities to avoid placing even a small amount of strain (American Academy of Orthopaedic Surgeons, 2023)

• Lifting
• Pushing
• Pulling objects that weigh more than one pound.
• Sports activities
• Throwing
• Climbing
• Using tools or machinery that vibrate.

Rehabilitation is an important part of healing because immobilization takes a long time. Wrist range-of-motion exercises can be started, followed by strengthening exercises for the wrist flexors and extensors. Supination, pronation, and grip exercises are also part of physical therapy.

Complications

Scaphoid fractures can lead to serious complications, especially when not properly treated. These include: (American Academy of Orthopaedic Surgeons, 2023) (Almigdad A. et al., 2024)

Nonunion

• This describes a fracture that fails to heal.

Carpal Collapse

• This is a form of degenerative arthritis.

Osteoarthritis

• This condition causes degeneration of the cartilage in the joint.

Avascular Necrosis

• This is when the blood supply to the bone is reduced or cut off, causing the bone to die.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Skateboarding Injury Treatment

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Academy of Orthopaedic Surgeons. (2023). Scaphoid fracture of the wrist. https://orthoinfo.aaos.org/en/diseases--conditions/scaphoid-fracture-of-the-wrist

Clementson, M., Björkman, A., & Thomsen, N. O. B. (2020). Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT open reviews, 5(2), 96–103. https://doi.org/10.1302/2058-5241.5.190025

Wong, S. B. S., & Peh, W. C. G. (2019). The role of magnetic resonance imaging in the evaluation of scaphoid fractures. Journal of Medical Radiation Sciences, 66(1), 3–4. https://doi.org/10.1002/jmrs.316

Almigdad, A., Al-Zoubi, A., Mustafa, A., Al-Qasaimeh, M., Azzam, E., Mestarihi, S., Khair, Y., & Almanasier, G. (2024). A review of scaphoid fracture, treatment outcomes, and consequences. International orthopaedics, 48(2), 529–536. https://doi.org/10.1007/s00264-023-06014-2

Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program?

Wrist Sprain

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include:

• Pain
• Swelling
• Bruising
• Decreased range of motion
• Weakness
• Tingling

The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully.

Grades and Types

The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024)

Grade 1

• Ligaments are stretched; this is considered a mild sprain.
• The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)

Grade 2

• Ligaments are partially torn; this is considered a moderate sprain.
• It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)

Grade 3

• Ligaments are torn completely or have pulled away from the bone.
• Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
• This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)

The wrist is made up of three joints (American Society for Surgery of the Hand, 2017)

Distal radioulnar

• This joint is between the two forearm bones.
• The radius on the thumb side.
• The ulna on the pinky side.

Radiocarpal

• This joint is between the radius and three small bones in the base of the hand.
• The scaphoid
• The triquetrum
• The lunate

Ulnocarpal

• This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.

Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist.

Symptoms

The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024)

• Decreased range of motion
• Swelling
• Bruising
• Feeling instability in the wrist 
• Weakness
• Numbness/tingling
• Popping sensation
• Warm skin

Causes

The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include:

• Repetitive overuse work injuries.
• Housework and tasks.
• Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.

Diagnosis

A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include:

• Magnetic resonance imaging - MRI
• Computed tomography - CT scan
• Arthrogram -X-rays with contrast dye

Treatment

Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024)

Rest

• Minimize using the injured wrist for at least two days.
• Wear a splint for support.
• Avoid sudden movements.
• Avoid placing too much pressure on the wrist.

Ice

• Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.

Compression

• Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.

Elevation

• To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.

1. Grade 1 sprains usually heal with basic care within a week or two.
2. Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
3. The removable brace or splint should be worn when using the arm.
4. It can be taken off at rest at night and when bathing. (National Health Service, 2020)
5. Individuals may need the brace for a week or more.

A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength.

Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020)

Healing Time

Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Path to Healing Personal Injury

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf

American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases--conditions/wrist-sprains

Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain

American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints

National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html

American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist

Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050

American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament

Experiencing a whiplash injury can be disorienting and painful. Can recognizing the signs of more serious complications, seeking timely medical intervention, and following a structured whiplash rehabilitation plan help individuals find relief and restore function and quality of life?

Whiplash Rehabilitation

For individuals who have recently been in an automobile accident, once the initial neck pain and stiffness have passed, it's crucial to recognize potential delayed symptoms, such as nerve damage. While many recover quickly, some may experience prolonged symptoms requiring more aggressive treatment and management.

Neck Injury

Whiplash injuries result from sudden, forceful whipping back and forth of the head, commonly occurring in rear-end vehicle collisions, and are one of the most common neck injuries. Other potential causes include: (Johns Hopkins Medicine, 2024)

• Automobile Accidents (American Academy of Physical Medicine and Rehabilitation, 2024)
• Sports injuries 
• Falls (Rush University Medical Center, 2014)

Symptoms can include: (Johns Hopkins Medicine, 2024)

• Pain that radiates to the shoulders and/or upper back
• Neck stiffness
• Headaches

Mobility, Flexibility, and Sensations 

The symptoms of a neck injury can vary in severity but commonly include: (Johns Hopkins Medicine, 2024) (American Academy of Physical Medicine and Rehabilitation, 2024) (Medline Plus, 2024)

• Neck pain and stiffness are often the most noticeable symptoms and can take several hours to appear and worsen the following day.
• Decreased range of motion
• Difficulty turning or tilting the head
• Tenderness, pain, or stiffness in the shoulders, upper back, or arms - sometimes accompanied by numbness or tingling.
• Having no energy
• Fatigue 
• Headaches
• Tiredness and irritability
• Dizziness
• Blurred vision
• Unusual sensations around the face
• Difficulty concentrating or remembering things

Individuals may not feel any symptoms directly following an accident, as it can sometimes take several hours or weeks to develop. (Medline Plus, 2024)

Immediate Medical Attention

Seek immediate medical attention from a healthcare provider or the emergency clinic for any of the following symptoms (NHS, 2023)

• Injured neck and are experiencing severe pain that isn't relieved by over-the-counter medication.
• Feeling pins and needles or tingling in one or both sides of the body.
• Have difficulty walking or sitting upright.
• Experience a sudden shock sensation in the back or neck, extending into the arms and legs.
• Arms or legs feel weak, as these symptoms may indicate nerve damage in the neck or back.

Temporary Pain Relief

Temporary treatment often involves medications to reduce pain, inflammation, and muscle spasms and include. (University of Rochester Medical Center, 2024)

• Non-steroidal anti-inflammatory Drugs
• Muscle relaxants
• Topical gels
• Injections
• Anticonvulsants for individuals experiencing nerve-related pain or tingling sensations. (Medline Plus, 2020)

Other treatments may include: (University of Rochester Medical Center, 2024)

• Ice usually for the first 24 hours
• Neck brace
• Physical therapy
• Gentle neck exercises

Following a healthcare provider's recommendations regarding medication use, including dosage and duration, is critical to managing symptoms while effectively minimizing potential side effects.

Rehabilitation Steps

To determine the appropriate treatment whiplash rehabilitation plan, a healthcare provider will assess how much the pain affects daily life, including mental health and the ability to do regular activities (American Academy of Physical Medicine and Rehabilitation, 2024). X-rays or other imaging tests will be done to determine how serious the damage to the neck or spine is. Resting and icing the injured area are recommended to relieve inflammation. A provider may recommend slowly increasing neck movements several times daily and continuing with normal daily activities, as exercise will help maintain flexibility. Not moving the neck may prolong pain, stiffness, and healing. Physical therapy may be recommended if symptoms continue for over one or two weeks. (American Academy of Physical Medicine and Rehabilitation, 2024)

How Soon Until Pain and Symptoms Resolve

Whiplash rehabilitation healing and restoration of function depend on the severity of the injury. Many recover quickly; however, in extreme cases, pain and other symptoms can last 12 months or longer. (American Academy of Physical Medicine and Rehabilitation, 2024) It is recommended to see a provider if: (Johns Hopkins Medicine, 2024)

• Pain worsens
• Symptoms last longer than the healthcare provider estimated
• Other symptoms develop, like weakness, numbness, or a sensation of pins and needles.

Long-Term Injury Side Effects

 Individuals in whiplash rehabilitation usually recover in a few weeks to months, but some may have longer-lasting pain as the injury can cause nerve damage. (Fundaun J. et al., 2022) Discuss any new or worsening symptoms with a healthcare provider for guidance. (Johns Hopkins Medicine, 2024)

Chronic Neck and Back Pain Management

Treatments for chronic neck and back pain include: (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

• Physical therapy to help strengthen muscles.
• Acupuncture.
• Non-surgical decompression.
• Over-the-counter pain relievers, such as acetaminophen or NSAIDs.
• Muscle relaxants for tightness and tension.
• Prescription pain medications.

If pain becomes chronic, antidepressants such as serotonin and norepinephrine reuptake inhibitors may be prescribed. These medications can help manage pain and improve sleep quality. (Ferreira G. E. et al., 2023) For severe inflammation and pain, corticosteroid injections directly into the affected area can provide relief. Healthcare providers administer these injections, offering long-lasting effects. (Harvard Health Publishing, 2015)

Injury Medical Chiropractic and Functional Medicine Clinic

Navigating a whiplash injury can be challenging, but understanding the whiplash rehabilitation process can significantly aid in recovery. A healthcare provider can determine the most effective treatment strategies. It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Personal Injury Rehabilitation

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Johns Hopkins Medicine. (2024). Whiplash Injury. https://www.hopkinsmedicine.org/health/conditions-and-diseases/whiplash-injury

American Academy of Physical Medicine and Rehabilitation. (2024). Cervical whiplash. https://www.aapmr.org/about-physiatry/conditions-treatments/musculoskeletal-medicine/cervical-whiplash

Rush University Medical Center. (2014). 5 facts about whiplash. https://www.rush.edu/news/5-facts-about-whiplash

National Library of Medicine. MedlinePlus. (2024). Whiplash. Retrieved from https://medlineplus.gov/ency/imagepages/9853.htm

National Health Service NHS. (2023). Whiplash. https://www.nhs.uk/conditions/whiplash/

University of Rochester Medical Center. (2024). Whiplash injury. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=p01388

National Library of Medicine. MedlinePlus. (2020). Pregabalin. Retrieved from https://medlineplus.gov/druginfo/meds/a605045.html

Fundaun, J., Kolski, M., Baskozos, G., Dilley, A., Sterling, M., & Schmid, A. B. (2022). Nerve pathology and neuropathic pain after whiplash injury: a systematic review and meta-analysis. Pain, 163(7), e789–e811. https://doi.org/10.1097/j.pain.0000000000002509

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back pain: diagnosis, treatment, and steps to take. Retrieved from https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take

Ferreira, G. E., Abdel-Shaheed, C., Underwood, M., Finnerup, N. B., Day, R. O., McLachlan, A., Eldabe, S., Zadro, J. R., & Maher, C. G. (2023). Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ (Clinical research ed.), 380, e072415. https://doi.org/10.1136/bmj-2022-072415

Harvard Health Publishing. (2015). New recommendations aim to improve safety of pain-relieving spinal steroid injections. Harvard Health Publishing
Harvard Medical School. https://www.health.harvard.edu/blog/new-recommendations-aim-to-improve-safety-of-pain-relieving-spinal-steroid-injections-201505077991

Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?

Correct Manual Lifting Technique

Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)

Lifting Guide

Individuals can protect their backs and prevent injury by following simple steps when lifting objects.

Support Base

• Ensure there is a healthy support base from which to lift.
• Keep feet shoulder-width apart with one foot slightly in front of the other.

Ask For Help

• If coworkers or colleagues are available, ask for assistance.
• If the load is too heavy, ask for help lifting and moving the object/s.

Use Mechanical Assistant Devices

• Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.

Squat To Lift Object

• Bend at the hips and knees only, not the back.
• Put one knee on the ground to ensure stability before lifting.

Check Posture

• Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.

Lift Slowly

• Lift with the knees and hips only, gradually straightening the lower back.

Load Positioning

• Once upright, hold the load close to the body around the stomach.

Move and Maintain Alertness

• Always take small steps.
• Maintain alertness as to where you are going.
• Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.

Rest

• If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.

Squat To Set Object Down

• Squat with the knees and hips and set the load down slowly.
• Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset. 

Planning and Tips

Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:

Make a Plan Before Lifting

• Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
• Set and clear a path.
• If lifting something with another person, ensure both agree and understand the plan.

Lift Close to The Body

• Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
• Make sure there is a firm hold on the object.
• It is easier to maintain balance close to the body.

Maintain Feet Shoulder-Width Apart

• Keep the feet about shoulder-width apart.
• Having a solid base of support is important while lifting.
• Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
• Take short steps.

Visualize The Motions Involved and Practice The Motions Before Lifting

• Think about the motion before lifting.
• Practice the lifting motion before lifting the object.
• Focus on keeping the spine straight.
• Raise and lower to the ground by bending the knees.
• Avoid bending at the waist or hips.

Tighten the Stomach Muscles

• Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.

Lift With the Legs

• The legs are stronger than the back muscles, so let the leg strength do the work.
• Lower yourself to the ground by bending the knees, not the back.

Keep Eyes Up

• Looking slightly upwards will help maintain a better spine position and help keep the back straight.

Avoid Twisting or Bending

• Face in the direction you are walking.
• Stop, take small steps, and continue walking if turning is required.

Back Belts

It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.

Injury Medical Chiropractic and Functional Medicine Clinic

Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Chiropractic Care For Injury Recovery

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from https://www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf

CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts - Do They Prevent Injury? (No. 94-127). Retrieved from https://www.cdc.gov/niosh/docs/94-127/

Are there blood tests for individuals with chronic and severe back pain symptoms that can help healthcare providers diagnose?

Blood Tests To Help Diagnose Back Pain

If a healthcare provider suspects an infection or inflammatory arthritis is the cause of back pain, blood tests may be used to diagnose. When trying to find the cause of back pain, a healthcare provider will examine the patient's medical history, perform a physical examination, and, if necessary, order diagnostic tests. (Dansie E. J. and Turk D. C. 2013) For example, the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that MRIs can reveal abnormalities in the spine. Still, a person may not feel pain or experience any other symptoms.  The NIAMS also says healthy, pain-free individuals can have elevated SED levels. A high sedimentation rate or sed rate, also known as an erythrocyte sedimentation rate (ESR) test, can indicate inflammation in the body. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

Commonly Used Tests

Blood tests that can help diagnose back pain include:

Complete Blood Count - CBC

• This test can indicate inflammation or infections. 

Sed Rate or Erythrocyte Sedimentation Rate

• This test measures inflammation by analyzing how red blood cells settle through plasma.
• Inflammation could point to an infection. (Harrison M. 2015)
• If the SED rate indicates that inflammation is present, the possibility of an underlying cause may be some form of arthritis or a tumor, which is rare.

CRP or C-reactive Protein

• Another test that measures inflammation that could indicate an infection or some form of arthritis. (Sproston N. R. and Ashworth J. J. 2018)

HLA-B27

• A genetic marker in the blood that is more common in individuals with ankylosing spondylitis and reactive arthritis. (McMichael A. and Bowness P. 2002)
• This marker may be tested if the healthcare provider suspects either disease.
• Ankylosing spondylitis is an inflammatory arthritis affecting the sacroiliac joints, hips, and spine. (Sieper J. et al., 2002)
• Reactive arthritis is a type that occurs after an infection in a different body system or area. (Hamdulay S. S., Glynne S. J., and Keat A. 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. Our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness and nutrition, Functional Medicine Treatments, and in-scope care protocols. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Integrative Medicine Approach

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. https://doi.org/10.1093/bja/aet124

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back Pain. Retrieved from https://www.niams.nih.gov/health-topics/back-pain

Harrison M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Australian prescriber, 38(3), 93–94. https://doi.org/10.18773/austprescr.2015.034

Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in immunology, 9, 754. https://doi.org/10.3389/fimmu.2018.00754

McMichael, A., & Bowness, P. (2002). HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis research, 4 Suppl 3(Suppl 3), S153–S158. https://doi.org/10.1186/ar571

Sieper, J., Braun, J., Rudwaleit, M., Boonen, A., & Zink, A. (2002). Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61 Suppl 3(Suppl 3), iii8–iii18. https://doi.org/10.1136/ard.61.suppl_3.iii8

Hamdulay, S. S., Glynne, S. J., & Keat, A. (2006). When is arthritis reactive?. Postgraduate medical journal, 82(969), 446–453. https://doi.org/10.1136/pgmj.2005.044057

Individuals who have sustained trauma to the knee area from work, physical activity, or a motor vehicle collision can experience significant pain and mobility impairment. Can physical therapy help heal and strengthen the PLC?

Posterolateral Corner Knee Injury

The posterolateral corner, or PLC, comprises muscles, tendons, and ligaments in the back of the knee that help support and stabilize the outside region. The primary role of the PLC is to prevent the knee from excessive amounts of rotation or bowing/turning outward. (Chahla J. et al., 2016) Posterolateral corner injuries can cause significant pain and can dramatically impact an individual's ability to walk, work, or maintain independence. Treatment options will depend on the severity of the injury.

The Posterolateral Corner

The posterolateral corner comprises multiple structures that support and stabilize the outside of the knee. The structures are subdivided into primary and secondary stabilizers. The primary group includes:

• Lateral collateral ligament- LCL
• Popliteofibular ligament - PFL
• Popliteus tendon

The secondary stabilizers include:

• The lateral capsule of the knee.
• Coronary ligament.
• Fabellofibular ligament.
• Lateral gastrocneumius tendon.
• The long head of the biceps femoris.
• Iliotibial/IT band (Chahla J. et al., 2016)

The primary role is to prevent the knee from excessively turning outward, so the grouping provides secondary assistance in preventing the lower leg bone/tibia from shifting forward or backward on the thighbone/femur. Occasionally, one or several posterolateral corner structures can be sprained, strained, or torn.

How Injury Occurs

An injury occurs when a direct blow to the inner portion of the front of the knee causes the leg to bow outward. A posterolateral corner injury may also be sustained without contact, for example, if the knee hyperextends or buckles away from the other leg into a varus/bow leg position. Because the knee usually moves during a PLC, concurrent sprains or tears to the anterior cruciate ligament/ACL or posterior cruciate ligament/PCL are also common. (Chahla J. et al., 2016) Other situations that can also cause PLC injuries include automobile crashes and falls from elevated surfaces. (Shon O. J. et al., 2017) When this type of trauma causes a posterolateral corner injury, bone fractures are also common.

Symptoms

Depending on the severity of the injury, multiple symptoms may be present, including:

• Difficulty walking or climbing stairs due to instability. (Shon O. J. et al., 2017)
• Numbness or tingling in the lower leg.
• Pain, swelling, bruising, and hardening in the knee and surrounding area.
• Outward bowing position of the affected knee when standing.
• Foot drop presents on the injured side. (Chahla J. et al., 2016)

For individuals who suspect that they have sustained a PLC injury or have any of the symptoms listed, it is critical to be seen by an orthopedic specialist or emergency room physician. A healthcare provider will properly evaluate the leg and develop the appropriate treatment.

Diagnosis

Diagnosis begins with a comprehensive examination. In addition to looking for the symptoms noted, a healthcare provider will move the legs in different directions to assess for any instability. The dial test may be performed, which involves having the patient lie on their stomach while the healthcare professional assesses the side-to-side rotation in the leg to check for excessive motion. (Shon O. J. et al., 2017) Imaging is frequently ordered to determine which anatomical structures are affected more accurately. X-rays can help rule out concurrent fractures and check for excessive laxity in the knee area. MRIs are also useful for visualizing the various tendons and ligaments, helping the healthcare provider look closely at any sprains or tears that may have occurred. However, MRIs may be less accurate in diagnosing PLC injuries after 12 weeks, so they should be obtained as soon as possible. Based on this evaluation, the injury may be classified using the following system (Shon O. J. et al., 2017)

Grade 1

• 0 to 5 degrees of rotational or varus/bowing instability.
• Incompletely torn posterolateral corner.

Grade 2

• 6 to 10 degrees of rotational or varus/bowing instability.
• Incompletely torn posterolateral corner.

Grade 3

• Eleven or more degrees of rotational or varus/bowing instability.
• Completely torn posterolateral corner.

Treatment

The care received after a posterolateral corner injury can vary depending on the structures involved and the overall severity.

Nonsurgical

Nonsurgical treatment is typically reserved for isolated grade 1 or 2 PLC injuries. (Shon O. J. et al., 2017) Depending on which structures are affected, a stabilizing brace may be worn, and crutches are often needed to decrease the strain on the knee. Physical therapy is also commonly prescribed and focuses on the following goals:

• Gradually reducing crutch use.
• Improving balance and stability.
• Improving walking patterns.
• Regaining the range of motion in the knee.
• Strengthening the leg muscles.
• Gradually reintroducing specific movements like running and jumping.

Surgery

Non-surgical treatment tends not to work with grade 3 injuries. If surgery is not performed, individuals may also suffer from chronic knee instability or develop long-term osteoarthritis. (Chahla J. et al., 2019) Surgical treatment is often recommended for grade 3 injuries. The damaged primary stabilizers are surgically reconstructed using a graft from another body region. Surgical repairs may also be performed on any secondary stabilizers to improve stability. (Chahla J. et al., 2019) Any other ligament injuries, such as ACL, PCL, or concurrent fractures, will also be addressed. Following the procedure, individuals immobilize their knee with a brace and do not place weight on the affected leg to protect the surgical area. Depending on the surgeon's recommendations, this can last six weeks or more. Physical therapy is also initiated after a surgical procedure. Though rehabilitation progresses slowly, the goals are often the same as when treating milder PLC injuries. Returning to work, sports, and/or physical activity after surgery may take six months of therapy or more. (Shon O. J. et al., 2017)

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improve flexibility, mobility, and agility, relieve pain, and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Knee Injury Rehabilitation

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Chahla, J., Moatshe, G., Dean, C. S., & LaPrade, R. F. (2016). Posterolateral Corner of the Knee: Current Concepts. The archives of bone and joint surgery, 4(2), 97–103.

Shon, O. J., Park, J. W., & Kim, B. J. (2017). Current Concepts of Posterolateral Corner Injuries of the Knee. Knee surgery & related research, 29(4), 256–268. https://doi.org/10.5792/ksrr.16.029

Chahla, J., Murray, I. R., Robinson, J., Lagae, K., Margheritini, F., Fritsch, B., Leyes, M., Barenius, B., Pujol, N., Engebretsen, L., Lind, M., Cohen, M., Maestu, R., Getgood, A., Ferrer, G., Villascusa, S., Uchida, S., Levy, B. A., Von Bormann, R., Brown, C., … Gelber, P. E. (2019). Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 27(8), 2520–2529. https://doi.org/10.1007/s00167-018-5260-4

Can learning about comminuted fracture symptoms and repair help individuals and healthcare providers develop effective treatment and rehabilitation programs?

Comminuted Fractures

A comminuted fracture is a severe break in which the bone splits into at least three pieces. Comminuted fractures typically happen in the long bones like those in the arms and legs. But they can also happen in other places, including the ribs. (Corinne Tarantino, 2022) They are usually caused by intense impact, like an automobile collision/accident or a severe fall. Depending on the location of the fracture, recovery from a comminuted fracture can take months and often involves:

• Surgery - A surgeon will place screws and rods to hold the pieces of the bone in position. Sometimes, the hardware is left in permanently. (American Academy of Orthopaedic Surgeons, 2021)
• Wearing a cast for several months.
• Physical therapy.

Types

In these types of fractures, the bone is completely broken, not just cracked. The break is a highly comminuted fracture if the bone is broken into four or more pieces. (Corinne Tarantino, 2022)

Symptoms

The symptoms are the same as those of other broken bones, but they can be more intense because the bone is broken in multiple areas, which means there may also be more soft tissue injuries than with a simple fracture. Broken bone symptoms include: (MedlinePlus, 2024)

• Persistent pain
• Swelling
• Bruising
• Deformity - the bone looks out of place or is at an odd angle.
• Tingling
• Numbness
• Difficulty moving the limb.

Causes

An intense force causes a comminuted fracture, often a car accident or a hard fall, but it can also result from sports injuries. (Corinne Tarantino, 2022)

Diagnosis

A comminuted fracture is diagnosed by X-ray, which shows where the bone has broken and how many pieces it has split into (MedlinePlus, 2024). Healthcare providers will diagnose any broken bones but also look for other injuries.

Treatment

Typically, broken bones can be treated with casts, braces, or a boot to keep them immobilized. (MedlinePlus, 2024) Because comminuted fractures are more severe, they often need other treatments, including surgery. Sometimes, the bone can be reset instead of surgery using a closed reduction technique, where the healthcare provider resets the bone manually. Surgery may be recommended if that’s not possible or doesn't work.

Types of Surgery

Surgery allows the healthcare provider to correctly position all the pieces of the bone to heal in a strong, stable formation. The two types commonly used to treat comminuted fractures are: (American Academy of Orthopaedic Surgeons, 2021)

External Fixation

• This surgery uses rods and screws outside the body to stabilize the bone.
• This external frame is placed during surgery and later removed.

Open Reduction Internal Fixation - ORIF

• During this surgery, the bone is stabilized with metal plates, screws, rods, and/or wires placed inside your body.
• Sometimes, these are permanent, but in other cases, they are removed later.
• An orthopedic surgeon performs these surgeries.

Casting

After surgery, a cast is usually needed to prevent the bone from moving and allow healing. Typically, the cast is worn for six to eight weeks, but it may need to be worn longer with comminuted fractures. Some need a cast for several months (American Academy of Orthopaedic Surgeons, 2021). Sometimes, those with an external fixation must continue wearing a cast after removing the pins and rods, giving the bone more time to stabilize. The healthcare provider will inform the patient how long the cast will need to be worn and which sports activities should be avoided even after the cast comes off.

Physical Therapy

The healthcare provider may recommend physical therapy to help treat the fracture. Usually, when the cast is removed, physical therapy is activated to help rebuild strength and range of motion. (Corinne Tarantino, 2022)

Prognosis

Although these fractures are severe, they are treatable. The prognosis is good for individuals who follow their healthcare provider’s treatment plan. Most don’t have lingering pain after the initial injury and can eventually return to regular activities. (American Academy of Orthopaedic Surgeons, 2021)

Recovery

Healing a comminuted fracture can take months. During that time, it's helpful to focus on tasks that can be accomplished, like new hobbies that don’t involve physical injury. Talk to the healthcare provider about any problems with the cast or ongoing pain and what to expect during recovery.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

The Path to Healing Personal Injury

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Corinne Tarantino, MPH. Osmosis. (2022). Comminuted Fracture: What is it, Examples and More. https://www.osmosis.org/answers/comminuted-fracture

Throckmorton T.W. American Academy of Orthopaedic Surgeons. (2021). Fractures (broken bones). https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/

MedlinePlus. National Library of Medicine. (2024). Fractures Also called: Broken bone. Retrieved from https://medlineplus.gov/fractures.html

Individuals suffering from a jammed finger: Can knowing the signs and symptoms of a finger that is not broken or dislocated allow for at-home treatment and when to see a healthcare provider?

Jammed Finger Injury

A jammed finger, also known as a sprained finger, is a common injury when the tip of a finger is forcefully pushed toward the hand, causing the joint to become compressed. This can cause pain and swelling in one or more fingers or finger joints and cause ligaments to stretch, sprain, or tear. (American Society for Surgery of the Hand. 2015) A jammed finger can often heal with icing, resting, and taping. This is often enough to allow it to heal in a week or two if no fractures or dislocations are present. (Carruthers, K. H. et al., 2016) While painful, it should be able to move. However, if the finger cannot wiggle, it may be broken or dislocated and require X-rays, as a broken finger or joint dislocation can take months to heal.

Treatment

Treatment consists of icing, testing, taping, resting, seeing a chiropractor or osteopath, and progressive regular use to regain strength and ability. 

Ice

• The first step is icing the injury and keeping it elevated.
• Use an ice pack or a bag of frozen vegetables wrapped in a towel.
• Ice the finger in 15-minute intervals.
• Take the ice off and wait until the finger returns to its normal temperature before re-icing.
• Do not ice a jammed finger for over three 15-minute intervals in one hour.

Try To Move The Affected Finger

• If the jammed finger does not move easily or the pain gets worse when trying to move it, you need to see a healthcare provider and have an X-ray to check for a ​bone fracture or dislocation. (American Society for Surgery of the Hand. 2015)
• Try to move the finger slightly after swelling, and the pain subsides.
• If the injury is mild, the finger should move with little discomfort for a short time.

Tape and Rest

• If the jammed finger is not broken or dislocated, it can be taped to the finger next to it to keep it from moving, known as buddy taping. (Won S. H. et al., 2014)
• Medical-grade tape and gauze between the fingers should be used to prevent blisters and moisture while healing.
• A healthcare provider may suggest a finger splint to keep the jammed finger lined up with the other fingers.
• A splint can also help prevent a jammed finger from re-injury.

Resting and Healing

• A jammed finger must be kept still to heal at first, but eventually, it needs to move and flex to build strength and flexibility.
• Targeted physical therapy exercises can be helpful for recovery.
• A primary care provider might be able to refer a physical therapist to ensure the finger has a healthy range of motion and circulation as it heals.
• A chiropractor or osteopath can also provide recommendations for helping rehabilitate the finger, hand, and arm to normal function.

Easing The Finger Back to Normal

• Depending on the extent of the injury, the finger and hand can be sore and swollen for a few days or weeks.
• It can take some time to start feeling normal.
• Once the healing process begins, individuals will want to return to using it normally.
• Avoiding using a jammed finger will cause it to lose strength, which can, over time, further weaken it and increase the risk of re-injury.

If the pain and swelling persist, see a healthcare provider to get it checked for a possible fracture, dislocation, or other complication as soon as possible, as these injuries are harder to treat if the individual waits too long. (University of Utah Health, 2021)

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes and improving ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. Our goal is to relieve pain naturally by restoring health and function to the body. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments.

Treatment for Carpal Tunnel Syndrome

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Society for Surgery of the Hand. (2015). Jammed finger. https://www.assh.org/handcare/condition/jammed-finger

Carruthers, K. H., Skie, M., & Jain, M. (2016). Jam Injuries of the Finger: Diagnosis and Management of Injuries to the Interphalangeal Joints Across Multiple Sports and Levels of Experience. Sports Health, 8(5), 469–478. https://doi.org/10.1177/1941738116658643

Won, S. H., Lee, S., Chung, C. Y., Lee, K. M., Sung, K. H., Kim, T. G., Choi, Y., Lee, S. H., Kwon, D. G., Ha, J. H., Lee, S. Y., & Park, M. S. (2014). Buddy taping: is it a safe method for treatment of finger and toe injuries?. Clinics in orthopedic surgery, 6(1), 26–31. https://doi.org/10.4055/cios.2014.6.1.26

University of Utah Health. (2021). University of Utah Health. Should I worry about a jammed finger? University of Utah Health. https://healthcare.utah.edu/the-scope/all/2021/03/should-i-worry-about-jammed-finger

Those experiencing neck pain, stiffness, headache, shoulder and back pain may suffer from a whiplash injury. Can knowing whiplash signs and symptoms help individuals recognize the injury and help healthcare providers develop an effective treatment plan?

Whiplash Signs and Symptoms

Whiplash is a neck injury that typically occurs after a motor vehicle collision or accident but can happen with any injury that rapidly whips the neck forward and backward. It is a mild to moderate injury of the neck muscles. Common whiplash signs and symptoms include:

• Neck pain
• Neck stiffness
• Headache
• Dizziness
• Shoulder pain
• Back pain
• Tingling sensations in the neck or down the arms. (Johns Hopkins Medicine. 2024)
• Some individuals can develop chronic pain and headaches.

The symptoms and treatment depend on the severity of the injury. Treatment can include over-the-counter pain medicines, ice and heat therapy, chiropractic, physical therapy, and stretching exercises.

Frequent Signs and Symptoms

The sudden whipping movement of the head can affect several structures within the neck. These structures include:

• Muscles
• Bones
• Joints
• Tendons
• Ligaments
• Intervertebral discs
• Blood vessels
• Nerves. 
• Any or all of these can be affected by a whiplash injury. (MedlinePlus, 2017)

Statistics

Whiplash is a neck sprain that occurs from a fast neck-jerking motion. Whiplash injuries account for more than half of vehicle traffic collision injuries. (Michele Sterling, 2014) Even with a minor injury, the most frequent symptoms include: (Nobuhiro Tanaka et al., 2018)

• Neck pain
• Next stiffness
• Neck tenderness
• Limited range of motion of the neck

Individuals can develop neck discomfort and pain shortly after an injury; however, the more intense pain and stiffness typically do not occur right after the injury. Symptoms tend to worsen the next day or 24 hours later. (Nobuhiro Tanaka et al., 2018)

Beginning Symptoms

Researchers have found that approximately more than half of individuals with whiplash develop symptoms within six hours of the injury. Around 90% develop symptoms within 24 hours, and 100% develop symptoms within 72 hours. (Nobuhiro Tanaka et al., 2018)

Whiplash vs. Traumatic Cervical Spine Injury

Whiplash describes a mild to moderate neck injury without significant skeletal or neurological symptoms. Significant neck injuries can lead to fractures and dislocations of the spine that can affect the nerves and spinal cord. Once an individual develops neurological problems associated with a neck injury, the diagnosis changes from whiplash to traumatic cervical spine injury. These differences can be confusing as they are on the same spectrum. To better understand the severity of a neck sprain, the Quebec classification system divides neck injury into the following grades (Nobuhiro Tanaka et al., 2018)

Grade 0

• This means there are no neck symptoms or physical examination signs.

Grade 1

• There is neck pain and stiffness.
• Very few findings from the physical examination.

Grade 2

• Indicates neck pain and stiffness
• Neck tenderness
• Decreased mobility or neck range of motion on physical examination.

Grade 3

• Involves muscle pain and stiffness.
• Neurologic symptoms include:
• Numbness
• Tingling
• Weakness in the arms
• Decreased reflexes

Grade 4

• Involves a fracture or dislocation of the bones of the spinal column.

Other Symptoms

Other whiplash signs and symptoms that can be associated with the injury but are less common or only occur with a severe injury include (Nobuhiro Tanaka et al., 2018)

• Tension headache
• Jaw pain
• Sleep problems
• Migraine headache
• Difficulty concentrating
• Reading difficulties
• Blurred vision
• Dizziness
• Driving difficulties

Rare Symptoms

Individuals with severe injuries can develop rare symptoms that often indicate traumatic cervical spine injury and include: (Nobuhiro Tanaka et al., 2018)

• Amnesia
• Tremor
• Voice changes
• Torticollis - painful muscle spasms that keep the head turned to one side.
• Bleeding in the brain

Complications

Most individual generally recover from their symptoms within a few weeks to a few months. (Michele Sterling, 2014) However, whiplash complications can occur, especially with severe grade 3 or grade 4 injuries. The most common complications of a whiplash injury include chronic/long-term pain and headaches. (Michele Sterling, 2014) Traumatic cervical spine injury can affect the spinal cord and be associated with chronic neurological problems, including numbness, weakness, and difficulty walking. (Luc van Den Hauwe et al., 2020) 

Treatment

The pain is typically more severe the next day than after the injury. Whiplash musculoskeletal injury treatment depends on whether it is an acute injury or the individual has developed chronic neck pain and stiffness.

• Acute pain can be treated with over-the-counter medicines like Tylenol and Advil, which effectively treat the pain.
• Advil is a nonsteroidal anti-inflammatory that can be taken with the pain reliever Tylenol, which works in different ways.
• The mainstay of treatment is encouraging regular activity with stretching and exercise. (Michele Sterling, 2014)
• Physical therapy uses various range of motion exercises to strengthen the neck muscles and relieve the pain.
• Chiropractic adjustments and non-surgical decompression can help realign and nourish the spine.
• Acupuncture can cause the body to release natural hormones that provide pain relief, help relax the soft tissues, increase circulation, and reduce inflammation. The cervical spine can return to alignment when the soft tissues are no longer inflamed and spasming. (Tae-Woong Moon et al., 2014)

Neck Injuries

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Medicine, J. H. (2024). Whiplash Injury. https://www.hopkinsmedicine.org/health/conditions-and-diseases/whiplash-injury

MedlinePlus. (2017). Neck Injuries and Disorders. Retrieved from https://medlineplus.gov/neckinjuriesanddisorders.html#cat_95

Sterling M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of physiotherapy, 60(1), 5–12. https://doi.org/10.1016/j.jphys.2013.12.004

Tanaka, N., Atesok, K., Nakanishi, K., Kamei, N., Nakamae, T., Kotaka, S., & Adachi, N. (2018). Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury. Advances in orthopedics, 2018, 4765050. https://doi.org/10.1155/2018/4765050

van Den Hauwe L, Sundgren PC, Flanders AE. (2020). Spinal Trauma and Spinal Cord Injury (SCI). In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554330/ doi: 10.1007/978-3-030-38490-6_19

Moon, T. W., Posadzki, P., Choi, T. Y., Park, T. Y., Kim, H. J., Lee, M. S., & Ernst, E. (2014). Acupuncture for treating whiplash associated disorder: a systematic review of randomised clinical trials. Evidence-based complementary and alternative medicine : eCAM, 2014, 870271. https://doi.org/10.1155/2014/870271

For individuals dealing with knee pain symptoms from injury and/or arthritis, can incorporating an acupuncture and/or electroacupuncture treatment plan help in pain relief and management?

Acupuncture For Knee Pain

Acupuncture involves inserting very thin needles into the skin at specific acupoints on the body. It is based on the premise that the needles restore the flow of the body’s energy to activate and promote healing, relieve pain, and help the body relax.

• Acupuncture can help address various health conditions, including knee pain caused by arthritis or injury.
• Depending on the type and severity of pain, treatments can help reduce the pain for days or weeks.
• Acupuncture is often used as a complementary therapy - treatment in addition to other treatment or therapy strategies like massage and chiropractic.

Acupuncture Benefits

Knee pain caused by osteoarthritis or injury can reduce flexibility, mobility, and quality of life. Acupuncture can help provide relief.

When the acupuncture needles are placed on the body, a signal is sent along the spinal cord to the brain, which triggers a release of endorphins/pain hormones. Medical researchers believe this helps reduce pain. (Qian-Qian Li et al., 2013) Acupuncture also helps decrease the production of cortisol, a hormone that helps control inflammation. (Qian-Qian Li et al., 2013) With reduced pain sensations and less inflammation after acupuncture treatments, knee function and mobility can be improved.

• Various factors play a role in the pain relief experienced from acupuncture. Some evidence suggests that an individual's expectations may impact the results of acupuncture treatment. (Stephanie L. Prady et al., 2015)
• Researchers are currently assessing whether the expectation that acupuncture is beneficial contributes to a better outcome after treatment. (Zuoqin Yang et al., 2021)
• In 2019, acupuncture was recommended in treating knee osteoarthritis in the American College of Rheumatology/Arthritis Foundation guidelines for hand, hip, and knee osteoarthritis pain management. (Sharon L. Kolasinski et al., 2020)

Research

• Different clinical studies support acupuncture’s ability to help in knee pain relief and management.
• One study found that acupuncture helps manage various conditions that cause chronic pain. (Andrew J. Vickers et al., 2012)
• A scientific review analyzed previous studies on pain management interventions after knee surgery and found supporting evidence that the treatments delayed and reduced the use of medications for pain relief post-surgery. (Dario Tedesco et al., 2017)

Osteoarthritis

• A systematic review analyzed randomized control studies to determine whether or not acupuncture reduced pain and improved joint function in individuals with chronic osteoarthritis knee pain. (Xianfeng Lin et al., 2016)
• Individuals received six to twenty-three weekly acupuncture sessions for three to 36 weeks.
• The analysis determined that acupuncture can improve short and long-term physical function and mobility and provide up to 13 weeks of pain relief in individuals with chronic knee pain caused by osteoarthritis.

Rheumatoid Arthritis

• Rheumatoid arthritis is a chronic disease that affects joints, including the knee joint, causing pain and stiffness.
• Acupuncture is beneficial in treating rheumatoid arthritis/RA.
• A review found that acupuncture alone and in combination with other treatment modalities benefits individuals with RA. (Pei-Chi, Chou Heng-Yi Chu 2018)
• Acupuncture is believed to have anti-inflammatory and antioxidant effects to help regulate immune system function.

Chronic Knee Pain

• Various conditions and injuries can cause chronic knee pain, making mobility difficult.
• Individuals with joint pain often turn to complementary therapies for pain relief management, with acupuncture being one of the popular modalities. (Michael Frass et al., 2012)
• A study showed modest improvements in pain relief at 12 weeks. (Rana S. Hinman et al., 2014)
• Acupuncture resulted in modest improvements in mobility and function at 12 weeks.

Safety

• Acupuncture is considered safe when administered by a trained, licensed professional.
• Few complications have been reported from the use of acupuncture. (National Center for Complementary and Integrative Health. 2022)

Side Effects

• Side effects can include soreness, bruising, or bleeding at the site of needle insertion and dizziness.
• Less common side effects include fainting, increased pain, and nausea. (Harvard Medical School. 2023)
• Working with a licensed, professional acupuncture practitioner can reduce the risk of unwanted side effects and complications.

Types

Other acupuncture options that may be offered include:

Electroacupuncture

• A modified form of acupuncture where a mild electrical current passes through the needles, providing additional stimulation to the acupoints.
• In one research study, individuals with knee osteoarthritis reported significant improvements in their pain, stiffness, and physical function after electroacupuncture treatment. (Ziyong Ju et al., 2015)

Auricular

• Auricular or ear acupuncture works on acupoints in the ear corresponding to the body's different parts.
• A research review analyzed several studies on auricular acupuncture for pain relief and found that it can provide relief within 48 hours of pain onset. (M. Murakami et al., 2017)

Battlefield Acupuncture

• The military and veteran healthcare facilities use a unique form of auricular acupuncture for pain management.
• Studies show that it is effective at providing immediate pain relief, but more research is necessary to determine long-term pain relief effectiveness. (Anna Denee Montgomery, Ronovan Ottenbacher 2020)

Before trying acupuncture, consult a healthcare professional for guidance, as it may be integrated with other therapies and lifestyle adjustments.

Overcoming an ACL Injury

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and central autonomic regulation. Evidence-based complementary and alternative medicine : eCAM, 2013, 267959. https://doi.org/10.1155/2013/267959

Prady, S. L., Burch, J., Vanderbloemen, L., Crouch, S., & MacPherson, H. (2015). Measuring expectations of benefit from treatment in acupuncture trials: a systematic review. Complementary therapies in medicine, 23(2), 185–199. https://doi.org/10.1016/j.ctim.2015.01.007

Yang, Z., Li, Y., Zou, Z., Zhao, Y., Zhang, W., Jiang, H., Hou, Y., Li, Y., & Zheng, Q. (2021). Does patient's expectation benefit acupuncture treatment?: A protocol for systematic review and meta-analysis. Medicine, 100(1), e24178. https://doi.org/10.1097/MD.0000000000024178

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During a fall individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one's hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

• Follow the R.I.C.E. protocol for acute injuries
• Visit a healthcare provider or local emergency clinic
• Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles' fracture

• A wrist fracture where the end of the arm bone is displaced backward.

Smith's fracture

• A wrist fracture, similar to a Colles' fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer's fracture

• A fracture of the small bones in the hand.
• Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture