Accidents and Injuries

With intense automobile, work, and sporting/fitness accidents, and natural disasters, individuals can experience multiple traumas also known as polytrauma. Recovery and rehabilitation can be a difficult and challenging journey. Multiple traumas are serious medical emergencies only given to individuals going through a severe situation. Polytrauma references multiple severe traumas that occurred at the same time. An individual can experience a:

• Broken hip/s
• Skull fracture
• Broken arm/s, leg/s
• Nerve damage
• Concussion
• Variety of superficial wounds

Physical therapy and chiropractic rehabilitation could be part of a treatment program. This is to restore the body's mobility, function, and promote the body's natural healing abilities. The importance of creating the proper rehabilitation program can make all the difference and restoring the integrity of the spine is critical.

Spinal Stabilization

Any type of trauma despite its severity can have the potential to interfere/disrupt spinal functions.

• Suffering a concussive hit to the head could cause damage to the cervical spine.
• Falling off a ladder could shift the vertebral discs.
• Hitting the knee on an object can cause a spinal misalignment from shifting the weight to the other leg for a day or two.

Spinal misalignments and/or dysfunction are common in multiple trauma cases. Dealing with broken bones and substantial wounds often means the spine could need to be realigned. Even if there are no localized injuries to the back or neck. Spinal misalignment, translation/rotation, herniated discs, or other conditions can hinder the overall recovery process and present new health issues.

Nerve Damage

Often, a lasting issue from multiple traumas is nerve damage. The severity can completely destroy nerve endings making it impossible to regain feeling or movement in certain areas of the body. The nerve damage can be regenerated if the impediment is rooted in the spine and is addressed in time.

Correcting spinal discs that have shifted along with subluxations that can compress the nerves and interfere with signal communication can help restore the areas directly affected. Example: Broken arms or legs can lose sensations that can be regained by spinal realignment. There are arteries that follow the spinal pathway. When the spinal integrity is restored proper circulation/blood flow is achieved, which is essential in natural recovery.

Trauma Beyond the Injury

Developing the correct rehabilitation treatment plan could mean the difference in a speedy and healthy recovery. Chiropractic can be an integral part of the recovery process, especially for a body that has sustained severe musculoskeletal injuries. The spine is an extension of the central nervous system. This means that bringing relief to the spine can affect positive healing in the injured areas. The critical role of the spine in an individual's rehabilitation and whole well-being is why no matter the extent of the trauma, we deliver relief.

Car Accident Injury Chiropractor

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Kroupa, J. “K definici polytraumatu a polytraumatismu” [Definition of "polytrauma" and "polytraumatism"]. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca vol. 57,4 (1990): 347-60.

Axial neck pain is also known as uncomplicated neck pain, whiplash, and cervical/neck strain. They refer to pain and discomfort running along the back or posterior of the neck. Axial is defined as forming or around an axis. This type of pain stays around the neck and immediate surrounding structures. It does not spread/radiate out to the arms, hands, fingers, and other areas of the body. Axial neck pain differs from two other neck conditions. They are:

• Cervical radiculopathy
• Myelopathy

Cervical radiculopathy describes irritation or compression/pinching of the nerve as it exits the spinal cord. The nerves of the cervical spine are known as the peripheral nerves. They are responsible for relaying signals to and from the brain to specific areas of the arms and hands. The signals that are sent from the brain are for muscle movement, while signals going to the brain are for sensation.

When one of these nerve/s gets irritated, inflamed, or injured it can result in:

• Muscle pain
• Weakness
• Numbness
• Tingling sensation
• Burning pain
• Other types of abnormal sensations in the arms, hands, or fingers.

Cervical myelopathy describes compression of the spinal cord itself. The spinal cord is the information highway/pipeline to all parts of the body. There is a range of symptoms that can include:

• Same symptoms as cervical radiculopathy
• Balance problems
• Coordination problems
• Loss of fine motor skills
• Bowel and bladder incontinence

Axial neck pain

Axial neck pain is a quite common type of neck pain. It affects around 10% of the population. However, the majority of these cases do not involve severe symptoms that limit daily activity.

Symptoms

Pain in the back of the neck is the primary and most common symptom. Sometimes the pain travels to the base of the skull, shoulder, or shoulder blade. Other symptoms include:

• Neck stiffness
• Headaches
• Localized muscle pain
• Warmth
• Tingling

Developmental Risk factors

Poor posture, lack of ergonomics, and muscle weakness increase the chances of developing axial neck pain. Risk factors for development include:

• Age
• Trauma - Auto accident, sports, personal, work injury
• Headaches
• Depression
• Chronic neck pain
• Sleep problems

Diagnosis

Based on symptoms and physical exam findings are how a diagnosis is usually achieved. A doctor will typically order an x-ray, CT, or MRI of the cervical spine. There could be severe symptoms that could indicate something more dangerous causing pain like infection, cancer, or fracture. This calls for an immediate visit to a hospital/clinic for evaluation. These symptoms include:

• Prior trauma/injury from a fall, automobile accident, sports, work injury
• Fever
• Weight loss
• Night sweats
• Constant night pain

Rheumatic conditions/diseases that cause neck pain can include morning stiffness and immobility that gets better as the day progresses. If symptoms continue for more than 6 weeks, imaging of the spine could be recommended. Especially, for individuals that have had previous neck or spine surgery or if it could be cervical radiculopathy or myelopathy.

Treatment

There is a wide range of treatment options. Surgery is rarely required except for severe cases. Returning to normal activities almost right away is one of the most important things to do to prevent the pain from becoming chronic. First-line treatments typically begin with:

• Physical therapy
• Chiropractic
• Stretching routine
• Strengthening exercises
• Acetaminophen
• Anti-inflammatory medication/s
• Muscle relaxants are sometimes prescribed

If a cervical spine fracture has been diagnosed, a neck brace could be recommended for short term use. A soft collar could be utilized if the pain is severe but a doctor will usually discontinue use after 3 days. Other non-invasive treatment options include:

• TENS - transcutaneous electrical nerve stimulation
• Electromagnetic therapy
• Qigong
• Acupuncture
• Low-level laser therapy
• Cognitive-behavioral therapy

Invasive treatments like injections, nerve ablation, and surgery are rarely required. But if necessary it can be beneficial for those cases.

Causes

A variety of the neck's anatomical structures can contribute to the pain. Common causes include:

• Poor posture
• Age
• Degeneration
• Ergonomics
• Injury to muscles or ligaments
• Arthritis

All of these can affect vertebral bodies, discs, and facet joints. Shoulder arthritis or a rotator cuff tear can imitate axial neck pain. Dysfunction of the temporomandibular jaw joint or the blood vessels of the neck can cause axial pain but it is rare.

Prognosis

Symptoms are usually alleviated within 4-6 weeks from when the pain started. Pain that continues beyond this should encourage a visit to a chiropractic physician.

Prevention

• Keep neck muscles strong with exercise.
• Stretch the neck regularly.
• A healthy diet specifically for bone support.
• Proper sleep posture for example sleeping on the back or side with a pillow that supports the natural curve of the neck.
• If on a computer for work or a long period align the eyes with the top third of the screen.
• Avoid looking down when on the phone, reading, etc for a long time by keeping the arms supported on an armrest.
• Glasses should be pushed up on the bridge of the nose, if they slide down there is a tendency for the head to follow.
• Don't forget to look up frequently.

Optimizing posture, ergonomics, and muscle strengthening can help in the prevention of the onset of pain and help alleviate the symptoms.

Whiplash Injury Chiropractic Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Finding the right surgeon specializing in an individual's specific spinal conditions and physical health means doing some research. There are several types of procedures for spinal problems. The type of surgery depends on the condition and an individual's medical history. If surgery is recommended for a lumbar herniated disc or LHD combined with sciatica here are a few things to think about.

Researching a spine surgeon

First and foremost look for surgeons with:

• Medical credentials like are they board-certified or board-eligible
• Completed a fellowship in spine surgery
• Devotes at least 50% of their practice to spinal conditions
• Specializes in treating herniated disc/s and sciatica. This means they will have added/specialized knowledge and expertise.

It is extremely important that an individual feels comfortable and feels they are able to communicate freely with the surgeon. A professionally qualified surgeon should:

• Spend adequate time with the individual
• Answer all questions
• Provide all information needed about the condition and treatment
• Listen to what the individual has to say
• Is open-minded
• Is not hard to get in contact with
• Has experience in the latest methods and techniques

What to look at and think about

Individuals can feel uncomfortable asking questions, but thorough communication is key. Remember, it is your body, and it is your right to know the details of the spinal disorder, along with non-surgical and surgical approaches to treatment that are available. There is time to consider the options and make an informed decision about the treatment plan as most spinal procedures are elective. Ask the surgeon all the questions you have to help decide wisely and with confidence. Make sure they address all concerns, and any others not listed.

The surgeon's specialization/focus

Orthopedic surgeons and neurosurgeons perform spinal procedures. Each will have a specific interest and expertise in certain spinal condition/s. For example, some surgeons may specialize in treating adult or pediatric patients, and some may only treat either lumbar/low back or cervical/neck conditions. Within those groups, some focus on:

• Spinal deformities
• Tumors
• Myelopathy a spinal cord disease
• Specific spinal cord diseases

Minimal invasive surgery option

Minimally invasive spine involves tiny incisions, that reduces the recovery time needed to heal. With this type, individuals can be up and walking within hours after surgery. Unfortunately, not all conditions can take this approach.

Is the surgery absolutely necessary, or can it be treated non-surgically?

Sciatica and herniated discs can be quite painful and cause disability. Never rush into surgery just to relieve symptoms. As surgery can cause other types of pain symptoms and issues. Herniation and sciatica can be resolved with:

• Chiropractic
• Physical therapy
• Medications
• Injections
• Lifestyle changes
• Diet adjustments
• Regular exercise
• Weight loss

However, if there are neurologic symptoms, like weakness in the leg, foot, numbness, or loss of bladder or bowel control - this is considered a medical emergency - then surgery is absolutely needed.

The number of similar procedures performed

The surgeon’s experience is very important. The more experienced, the better. Ask if they can refer to other patients who have had similar procedures.

Recovery time

Every patient is unique, as is the type of surgery, and recovery times. They all vary accordingly. General health, physical condition, and the severity of the disorder play a role in how long and how involved recovery time will be. Experienced surgeons can provide more specific answers concerning recovery/healing time.

Complication rate

All surgeries carry some risk of complication. Complication rates that are more than 10% is a red flag. Possible post-surgery complications.

Infection rate

Surgeons should have an infection rate lower than 10%. However higher rates do not always mean that surgeon is at fault as higher rates can come from performing highly complex procedures. Another reason for high infection rates could be the patients themselves like smokers or individuals with diabetes have increased risks for infection. However, do not feel uncomfortable asking the surgeon to explain a high infection rate. 

Decide to not opt for spine surgery

As a surgeon produces a diagnosis, they should present a recommended treatment plan, including alternative treatments/therapies. Ask for another explanation of any part of the evaluation, diagnosis, or available treatment options.

Get a second opinion

A second opinion should be encouraged. A second opinion can reinforce the surgeon’s recommendations and offers a new perspective. The surgeon should be comfortable with a second opinion. This does not mean that the individual does not trust the surgeon. It does mean that there is considerable interest in achieving optimal health and making sure that surgery is the absolute right thing to do. Pass on surgeons that discourage or disapprove of second opinions and continue looking.

Whiplash Chiropractic Massage Therapy

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Whiplash injuries very rarely call for surgery. But with those rare occurrences, that are severe cases, surgery is considered appropriate when neck or shoulder pain worsens. Doctors recommend patients go through 4 to 6 weeks of non-surgical treatment. If there is no improvement or the condition is worsening then a doctor could recommend whiplash surgery as the best option.

A spine surgeon will recommend the best procedure for the specific injury. Ask all the questions you have to fully understand the exact process, the outcome, and the recovery time. Surgery is an individual's decision. The surgeon can recommend it, but the patient has the final say. The procedure depends on what area/s the cervical spine is injured/damaged.

Disc Herniation

Depending on the type of trauma individuals can rupture or herniate the intervertebral disc/s, located between the vertebrae. This can generate constant pain, numbness, and weakness. With cases like this sometimes removal of the disc is necessary.

A surgeon will remove all or portion of the damaged disc through a process called a discectomy. After the discectomy, a doctor may have to permanently stabilize the area. This is because the spine becomes unstable and can move in abnormal ways. This increases the risk of a serious neurological injury. Therefore a discectomy is usually followed with a re-stabilization of the spine. Spinal stabilization techniques used:

Artificial Disc Replacement

Cervical artificial disc replacement also known as ADR could be performed instead of standard discectomy combined with spinal fusion. An artificial disc is implanted into the empty space following the procedure. Artificial disc replacement preserves or restores movement of the neck.

Fusion and Spinal Instrumentation

This form of spine stabilization can be done on its own or in combination with decompression surgery. The bones in the spine fuse together over time usually several months or longer depending on how the surgeon set up the fusion process. The surgeon will use a bone graft or a biological chemical that stimulates bone growth. A surgeon could use spinal instrumentation. These are:

• Interbody device/s
• Screws
• Rods
• Plates

These all are used to increase stability and help fuse the bones properly. The fusion prohibits movement between the vertebrae for long-term stability.

Stenosis

Whiplash surgery could also be necessary if the injury caused the spinal canal in the neck to narrow. Here a cervical corpectomy could be performed to remove part of the vertebra and intervertebral disc/s. This reduces the added pressure on the spinal cord and nerves.

A surgeon could also do a laminectomy or a laminoplasty. Both focus on the lamina, which is the bony plate at the back of each vertebra. The lamina protects the spinal cord and canal. The lamina could also present added pressure on the spinal cord. This is where the surgeon will create extra space for the cord by removing all or part of the lamina. This is a laminectomy.

A laminoplasty re-shapes the lamina to create more room for the spinal cord. If there is a narrowing of the space where the nerve exits the canal, a cervical foraminotomy could be utilized. The foramen is the area where the nerve roots exit the spinal canal. This is removed to allow for more space for the nerves to move through. A larger pathway is less likely to pinch/compress the nerve.

Complications

A doctor will discuss all the potential risks before being asked to sign a surgical consent form. Complications can include:

• Injury to the spinal cord, nerves, esophagus, carotid artery, vocal cords
• The bone fusion does not heal known as pseudoarthrosis
• Improvement does not occur
• Instrumentation breaks or gets damaged
• Infection
• Bone graft site pain
• Pain and swelling in the leg veins known as phlebitis
• Blood clots in the lung
• Urination problems

Complications could lead to more surgery, so make sure there is a complete understanding of the surgery and the risks before proceeding. The final decision is up to the individual.

Whiplash Surgery Recovery

After surgery, things might not be great right away. More than likely individuals are out of bed within 24 hours, and on pain meds for 2 to 4 weeks. Individuals will receive instructions on how to sitting down, and standing up. The body needs time to heal, so the doctor will recommend restricting certain activities that involve moving the neck too much. Avoid sports, twisting, or heavy lifting during recovery. And report any problems like fever increased pain, or infection right away.

Whiplash Chiropractic Massage Therapy

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Minimally invasive surgical procedures can be used to treat spinal compression fractures. These procedures are utilized to reduce severe pain, stabilize the fracture itself, and restore lost height or shape of the broken vertebral body. These procedures are known as:

• Balloon kyphoplasty
• Vertebroplasty
• Vertebral body augmentation

A vertebral compression fracture is a type of spinal fracture that can be caused by osteoporosis. This is a metabolic disease that weakens bone density and increases the risk of fracture/s in the spine, wrist, and hip. Osteopenia and osteoporosis affect millions, according to the National Osteoporosis Foundation. If left untreated, it can progress without an individual knowing and painlessly until the bone/s fracture. A vertebral compression fracture is more frequent than hip fractures and can lead to extended disability.

Vertebroplasty

Vertebroplasty is a minimally invasive treatment done through the skin for painful vertebral compression fractures. It also helps with strengthening the surrounding vertebral bodies also at risk of fracturing. Orthopedic bone cement is injected into the fractured vertebral body.

How is it performed?

Under general anesthesia, a specialized needle for bone is slowly inserted through the soft tissues of the back towards the vertebral compression fracture. The surgeon sees the position of the needle at all times through a real-time x-ray. Once reached a small amount of orthopedic bone cement, called polymethylmethacrylate, is injected into the vertebral body. Polymethylmethacrylate is a medical-grade bone cement that'ss been used for years for various orthopedic procedures.

The cement can sometimes be combined with an antibiotic to reduce the risk of infection along with a powder that has barium or tantalum. This allows it to be seen on the x-ray. The cement is a thick paste that hardens quickly. The fractured body is injected on the right and left sides, the midline of the back. After a few hours, the patient is up and moving. Most go home on the same day.

Balloon kyphoplasty

Balloon Kyphoplasty is another newer minimally invasive surgery for vertebral compression fractures that can be associated with osteoporosis. Kyphoplasty utilizes a balloon that expands the compressed bone to help restore lost vertebral height while creating a space where bone cement is injected. Kyphoplasty stabilizes fractures, restores lost vertebral height, and reduces deformities.

How it is performed?

Balloon kyphoplasty is performed under local or general anesthesia. Using real-time x-ray two small incisions are made, and a probe is inserted into the vertebral body space. The bone is drilled and balloon/s, called a bone tamp is a pump that is inserted on each side.

These balloons are inflated with contrast medium so the surgeon can see on the real-time x-ray until each balloon expands to the correct height, and then are taken out. The balloon is used to create a space for the bone cement and helps expand the compressed vertebral body bone. The cement binds and stabilizes the fracture. The cement provides:

• Strength
• Stability
• Hardens rapidly
• Restores height
• Relieves pain

Vertebral augmentation implant

A vertebral augmentation implant is different from vertebroplasty and kyphoplasty. This minimally invasive procedure for middle and lower back spinal compression fractures utilizes a flexible loop spring style spinal implant. It is performed under local or general anesthesia. A real-time x-ray is used to visualize the spinal anatomy and guide the placement of the device. The implant is delivered through a small incision. Once the implant is in place, the bone cement is injected, and the implant is removed.

Potential benefits include:

• Reduction of new fractures above or below the existing fracture
• Improves the spine's angle
• Reduced spinal deformity
• Reduces bone cement leakage
• Reduces the amount of bone cement

Benefits of all

Vertebral compression fractures and the limited abilities of traditional surgical options led to the refinement of these surgical systems. Each procedure provides options, as to how the treatment helps relieve pain, reduce and stabilize fractures, reduce spinal deformity, and stop the progressive worsening of untreated osteoporosis.

Added benefits:

• Surgical time is minimal
• Local or general anesthesia is all that is needed
• Hospital stay is a day or only a few hours
• Patients can quickly return to normal activities
• No bracing required

A spine surgeon will explain the purpose and aims of the recommended procedure, including the benefits and risks to help make an informed decision.

The Difference Using Custom Foot Orthotics 

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

An individual may need to wear a neck brace or cervical collar after cervical spine surgery, or after experiencing a traumatic injury to the neck, from an automobile accident, sports, work, or personal injury. Neck braces are some of the most common spinal braces. A doctor might call these orthoses or orthotics. There are different types of neck braces also called cervical collars, and function for different purposes.

• They can be utilized in stabilizing the neck after cervical/neck surgery.
• They can provide non-surgical relief after experiencing trauma or injury to the neck

Neck braces or collars are used to limit movement, support the head, and take the load off the neck. This gives the muscles time to rest, recover, and heal properly and thoroughly.

• Soft and Hard Collars
• Philadelphia Collar
• Sterno-occipital-mandibular Immobilization Device
• Halo brace 

Soft and Hard Neck Braces

Soft braces are made to be flexible and are made of a polyurethane foam rubber. They easily wrap around the neck and are secured with Velcro.

Soft collars are usually worn for a minor injury that just needs to be worn for a short time or to transition from wearing a hard brace from a more serious injury or surgery. Soft braces are worn typically at the end or completion of the healing process. The main purpose is to help with the gradual transition to remove the brace.

Hard neck braces look sort of like soft braces. The difference is that they are made of hard polyethylene and are rigid/stiff to really keep the neck from moving. These braces provide support and pain relief for spinal conditions like cervical spondylosis and acute neck pain.

Philadelphia

A Philadelphia brace is made of stiff foam and is made in two pieces that attach with Velcro. The upper portion supports the lower jaw with the lower brace extending down to cover the upper back.

This brace is made to protect more of the neck area than a soft or hard brace. However, it does place a higher restriction on the neck and body's range of motion. Because of its effectiveness for limiting movement, it is usually prescribed after cervical surgery for a healthy recovery. The Philadelphia neck brace is also used for stabilization of minor cervical fractures and to reduce pain brought on from neck muscle strain.

Sterno-Occipital-Mandibular Immobilization

The Sternooccipital mandibular immobilization brace is a highly rigid brace used to position the neck in straight alignment with the spine. This brace immobilizes the neck completely by preventing the head and neck from moving at all. This allows the injured/damaged structures to heal correctly and quickly. Sterno comes from the sternum. The brace has a front chest plate, and bars that go over the shoulder.

It is secured with straps that attach to the front chest plate. It also has a removable chin piece where the mandibular comes from, which is the lower jawbone. And there is an optional headpiece for added protection and support. Occipital is referring to the occipital bone at the back of the head. This type of brace is used for the treatment of severe neck injury/s or cervical pain caused by a chronic condition, like arthritis. It can also aid in recovery after cervical spine surgery.

Halo

The halo brace is the most rigid of the neck braces. It completely immobilizes the head and neck from moving. Sometimes it is necessary to immobilize the spine after a major neck procedure or for stabilizing fractures in the neck or middle back area. Halo bracing is considered a form of spinal traction. Traction pulls the spine in 2 different directions.

The tension reduces the abnormal curvature associated with spinal conditions, like scoliosis. A halo brace has a metal ring secured to the head using pins. The ring is connected to bars that are attached to a properly weighted vest. The weight of a halo brace is different depending on the individual wearing it. A halo brace is worn at all times until completely healed and recovered.

Effectiveness

Neck braces are the most effective when they are used as directed by a doctor, chiropractor, or spine specialist. Working with an orthotist, or a specialist that designs and custom fits spinal braces can be extremely beneficial. Any questions about how to wear and care for a spinal brace should be brought up with a doctor or orthotist. They will help ensure a full understanding of how to get the most benefit from the treatment.

Chiropractic Neck Pain Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Chiropractic works great for neck and back problems, but it is highly effective for the entire body. Carpal tunnel syndrome or CTS is becoming a widespread health issue with so many working on computers, devices, phones, etc. Chiropractic is perfect for treating CTS. It relieves pain, loosens/stretches the ligaments, and promotes healing without meds.

Carpal Tunnel

Carpal tunnel is diagnosed as a repetitive stress injury. This is a condition that affects the hands and wrists. The most common symptoms include:

• Tingling
• Numbness
• Weakness in the middle, index, and thumb
• Pain in the wrist/hand
• Gets worse at night

It is found in:

• Hairdressers
• Office workers - typing, writing, filing, etc.
• Mechanics
• Cashiers
• Those who perform repetitive hand motions throughout the day

It is estimated that around 3% of adults will deal with CTS at some time in their lives. Around 50 percent of workplace injuries are attributed to CTS. Research has shown that job occupation plays a large role in how it develops.

The carpal tunnel lies on the front side of the wrist. Here is where the blood vessels, nerves, and tendons necessary for the hand to move and work reside. The carpal tunnel can become inflamed, damaged, or strained with added pressure on the area compressing the arteries and nerves. This is when CTS develops. It starts slowly with symptoms gradually worsening as the condition progresses.

How chiropractic helps

There are 3 primary ways that chiropractors treat carpal tunnel syndrome. Manual Adjustment of the:

• Upper spine
• Arm
• Wrist

If the spine is out of alignment it could contribute and exacerbate the carpal tunnel. Chiropractic utilizes spinal manipulation to realign the spine to its correct position. These adjustments are performed by hand, but special devices, instruments, tools, rollers, etc, could be used during the treatments. A chiropractor will make adjustments to the arm and wrist, as well.

Ultrasound

Ultrasound uses low energy sound or high energy sound. The sound waves are highly focused and penetrate the body’s tissue at a very deep level. These waves are quite effective in reducing inflammation, alleviating pain, and relaxing the muscles. It could be used as a stand-alone treatment or along with chiropractic treatment.

Wrist Supports

Wrist supports are used to keep the wrist properly aligned with the rest of the arm to reduce pressure and compression. It can be used as a preventative measure against carpal tunnel. A chiropractor could go with this option if the individual does repetitive work that could contribute to the condition.

This is usually done in conjunction with regular chiropractic care. When treating carpal tunnel, a chiropractor could suggest certain therapeutic exercises and a dietary change to help promote optimal wellness. This is to help the individual get the most benefits from the treatment and to help prevent the condition from worsening, as well as, other conditions.

Posture

Proper posture is essential for optimal health, well being, can help avoid age-related conditions and allows the organs room to operate properly and efficiently. Posture can be affected in different ways. Sustaining an injury is one in which the body compensates by listing to one side or hunching over to relieve the pain.

Another reason is slouching. Those of us that just don’t stand and sit up straight through bad habits, lack of exercise, improper diet, medication, and the list goes on and on. Whatever the reason, poor posture will gradually lead to:

• Back pain
• Headaches
• Increased risk of injury
• Decreased flexibility
• Decreased mobility

It can cause the body to age quicker. However, in most cases, even those with extremely poor posture can find help and return to a high quality of life. Chiropractic has shown to help many regain a straight, healthy posture.

Postural Conditions

There are postural conditions that chiropractic is very helpful in alleviating, include:

• Pelvic unleveling
• Damage to the low back, mid-back, and neck
• Forward head posture - usually associated with mobile devices
• Kyphosis
• Scoliosis

Treatment

A chiropractor will:

• Discuss the problem/s you are experiencing
• Listen to the complaints
• Find out when the problem started
• Go through events or work that could have contributed to the problem
• Thoroughly evaluate the medical history
• Observe the way you sit, walk, bend, and move around

A chiropractor will request x-rays and assess the alignment of the spine. If necessary a neurological or orthopedic test could be done to ensure that there is no underlying condition or injury that is causing the problem.

They will ask you to stand straight and possibly take measurements to determine if there is any visible deviation from the optimum posture. They will then ask you to move and bend while they test the range of motion, mobility, flexibility along with muscle strength and length.

Posture Plan

Once the assessments are complete the chiropractor will discuss the best treatment option available. They will walk you through the adjustments that will be performed along with other therapies they might recommend. The best course of action to relieve any pain will be discussed, as well as get your spine into proper alignment improving posture. They will also talk to you about stretching exercises and things to do at home. They could also discuss:

• Sleep positions
• Diet
• Work area adjustments
• Exercise
• Weight loss

Chiropractic focuses on whole-body treatment. This means addressing lifestyle changes and getting the individual into optimal shape. Basic chiropractic adjustments can help improve posture within a few sessions.

After the body is in alignment you will feel more energetic, healthier, and happier. The body is an intricate machine and when one part is out of order it begins to affect all the other parts. Chiropractic can improve overall health and wellness. We want to get your body functioning more effectively and efficiently and feeling better.

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Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Spinal stimulation is a treatment option that could help bring relief from pain and improve the quality of life for individuals dealing with chronic pain, like low back, and leg pain. Spinal stimulation can help reduce and manage chronic pain that does not alleviate or reduce with physical therapy, pain medications, injections, and other non-surgical treatments/therapies.

It is a form of neuromodulation that works by blocking pain signals that the nerves send out from reaching the brain. A spinal stimulator is a tiny device that is implanted underneath the skin. The device delivers a very low electrical impulse that masks/changes pain signals before they reach the brain.

A Spinal Stimulation System

Neurostimulator:

This is the entire device that is implanted and sends out electrical impulses through a lead wire to the nerves in the spine.

Lead:

The thin wire that delivers the electrical impulses from the neurostimulator.

Remote control:

This turns on/off the stimulator and increases or decreases the amount of stimulation.

Charger:

Stimulators are rechargeable and normally require recharging about one hour every two weeks.

Spinal Stimulator Types:

Traditional stimulators

These produce a gentle ringing/tingling sensation that masks the pain.

Burst stimulators

These send out random interval bursts of electrical impulses designed to copy the way the body sends out nerve impulses.

High-frequency stimulators

These reduce pain without generating tingling sensations.

Types of Pain Spinal Stimulation Treats

Spinal stimulation is approved by the U.S. FDA to treat chronic back and leg pain, including pain that doesn't go away after back surgery known as failed back surgery syndrome. Chronic neuropathic back and leg pain are the most common types that stimulation treats. This means back or leg pain caused by nerve damage from:

• Auto accident
• Injury - personal, sports, work
• Disease

Acute pain is like stepping on a sharp piece of glass, where the pain serves as protection letting you know something is wrong and not to continue. Whereas chronic neuropathic pain lasts for 3 months or more and does not help protect the body.

Spinal stimulation is also used to treat complex regional pain syndrome or CRPS. This is a rare condition that affects the arms/hands or legs/feet and is believed to be caused by damage or malfunction of the nervous system. It is also used in treating peripheral neuropathic pain. This is damage to the nerves outside of the spinal cord often in the hands/feet that is caused by an:

• Infection
• Trauma
• Surgery
• Diabetes
• Other unknown causes

Appropriate Treatment

Spinal cord stimulation should not be used in patients that are pregnant, unable to operate the stimulation system, went through a failed trial of spinal stimulation, and are at risk for surgical complications. The decision to use spinal stimulation is based on an individual's needs and risks. Talk to a doctor, spine specialist, chiropractor to see if spinal stimulation could be an option.

Benefits and Risks

The effects of stimulation are different for everyone. Therefore, it is important to understand that spinal stimulation can help reduce pain, but not completely eliminate it.

The Benefits of Spinal Cord Stimulation

In addition to reducing pain, other benefits of spinal stimulation include:

• Better sleep
• Improved body function
• Increased activity
• Improved mobility
• Reduced opioid medication/s use
• Less need for other types of pain meds
• Reduced dependence on braces/bracing

Risks

During the implantation, there is a risk for:

• Bleeding
• Infection
• Pain at the site of incision
• Nerve damage
• Rarely paralysis

For some individuals, scar tissue can build up over the electrode, which can block the stimulator's electrical impulse. The lead wire could move or shift out of position. This could lead to impulses being sent to the wrong location. The device itself could shift under the skin causing pain, making it hard to re-charge or communicate with the remote.

There is a risk that the lead wire could detach or break off causing a malfunction and require a replacement. Also, individuals could respond well to the stimulation at first, but later on, they develop a tolerance, and so the therapy no longer has the same impact and the pain could get worse because the nerves stop responding.

Take Precautions

Discuss with a doctor, spine specialist, or chiropractor what you can and can't do after the stimulator is implanted and activated. Here are a few precautions:

• Do not drive or operate heavy equipment when the stimulator is active.
• Stimulation systems could set off metal detectors, which could require manual screening.

MRIs, electrocautery, diathermy, defibrillators, and cardiac pacemakers could have a negative interaction with certain types of stimulators. This could result in injury or damage to the spinal stimulator. Talk to your doctor to determine if a spinal stimulator is a treatment option that will work for you.

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Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico

Steroid injections into the cervical spine can help with radiating neck pain. Neck pain affects people all over the world. Although it is not as common as back pain, neck pain can really take a toll on a person’s quality of life and ability to work.  This comes in the form of:

• Sleep problems
• Radiating/Spreading pain
• Mental health issues and more

Much like back pain neck pain can be hard to treat effectively without identifying the root cause known as the pain generator. If natural treatments like chiropractic aren't working then injections could be the next phase.

Injections can help with:

• Identifying the source/root cause of the pain as a diagnostic
• Treats the pain as a therapeutic

The most commonly used are cervical epidural steroid injections, medial branch blocks (MBBs), and facet joint injections. Learn about what they are, what they treat, and the scientific research behind their risks and benefits.

Cervical Epidural Steroid

The phrase cervical epidural steroid injection:

• Injection means that medicine is delivered through a needle.
• Cervical means the cervical spine, which is the neck.
• Epidural means the dura or outer layer of the soft tissue that encases the spinal cord, nerve roots, and cerebrospinal fluid. Epidural means the medicine goes into the space around the dura.

Spine specialists use image guidance with a contrast dye called fluoroscopy ensuring the medicine gets delivered to the proper area.

2 Types

The needle enters the space through a transforaminal approach or interlaminar approach. Words like epidural just refer to where the needle goes. These injections also called nerve root blocks, are performed by entering the epidural space through the opening where the nerve roots branch out. This space is known as the intervertebral foramen.

When it is called a selective nerve root block, this is for cases where multiple nerve roots are being compressed and the injection is being used in a diagnostic purpose to identify which nerve is the pain generator. The needle in an interlaminar epidural injection goes through the opening that exists between two adjacent vertebrae.

Candidates

Cervical epidural steroid injections may be appropriate for someone who has severe neck pain with:

• Numbness
• Weakness
• Altered sensation in the arm, shoulder, or between the shoulder blades

Cervical epidural steroid injections are reserved as a second-line treatment for individuals that have neck pain that does not stop for more than 4 weeks despite conservative treatment like physical therapy, chiropractic, or medical pain management using NSAIDs or acetaminophen. The source of the pain is usually what determines if injections are appropriate.

With a patient’s:

• Past medical and surgical history
• Pain history
• Physical exam findings
• Imaging Results like CT computed tomography scan, MRI magnetic resonance imaging or a nerve test like an EMG electromyography test all can help in finding the source of the pain.

If a spine specialist thinks the nerve compression was brought on by a disc herniation, spondylolisthesis or the shifting of vertebral levels, scarring, or arthritic conditions is causing the pain, then an injection may be appropriate. If the pain comes from an infection or cancer, then this treatment is unlikely to be recommended.

Potential Benefits

The effects of injections are different for everyone, because of the variables:

• The Duration of symptoms
• The Cause of symptoms
• Any Additional treatment

More than 50% will have at least 50% improvement in their pain for around 4 weeks. Then there are individuals that experience relief, up to 6 months. There are no significant differences in outcomes between the transforaminal and interlaminar approaches.

Overall alleviation from the pain is enhanced/improved when the injections are combined with a full-on treatment plan that includes physical therapy/chiropractic and pain medications.

Possible Risks

Common complications associated with injections are usually minor and temporary. These are:

• Headache/s
• Facial flushes
• Light Headedness
• Rash
• Pain increase
• Extended Numbness

Major complications are rare, but they can happen. These include infection, paralysis, stroke, and death. However, this happens in less than 1% of individuals undergoing this treatment. These complications are thought to happen from direct spinal cord penetration of the needle, bleeding into the spinal canal, or the medicine inadvertently getting injected into the blood vessels. Surgical groups and facilities have strict guidelines to limit these complications.

This treatment is commonly used, and when done correctly can be a powerful tool in the treatment of persistent, severe neck pain. Everyone is different so if you are considering a cervical epidural spinal injection find a qualified spine specialist or consult with a chiropractor to find out if injections are necessary.

Neck Pain Treatment

Living in the desert means we don't have to deal with digging/shoveling through snow and ice, but there are still proper techniques, tools, body mechanics, posture, and core strength that we should pay attention to and apply to guard our spines and general health. It is no surprise that when shoveling many individuals experience muscle fatigue, low back strain, vertebral disc damage (herniated disc), and even spinal fractures.

A great deal of these injuries come from excessive stress to spinal structures by slip and fall accidents. Shoveling is a frequent cause of back pain and injuries. Injuries are not only limited to the musculoskeletal system but excessive shoveling can also place added stress on the cardiovascular system.  Any hint of shortness of breath or chest pain, stop shoveling immediately but if symptoms continue, seek medical attention.

A study published indicated when handling heavy material with a shovel, the L5-S1 disc has been identified as the weakest link in the body. The most severe injuries along with pain are likely to occur in the back. Here are some tips to prevent injury.

Shoveling Basics

Shoveling can be compared to weight lifting and intense aerobic exercise. To help your body function correctly consider the following tips:

• Eat long before shoveling so you have fuel but don't cramp up.
• Avoid caffeinated drinks/beverages. Stimulants can increase heart rate and cause blood vessels to constrict.
• If you experience pain, stop immediately and get assistance.
• Pace yourself when shoveling.
• Take plenty of breaks.
• Drink plenty of water to rehydrate your body.
• For snow, if the ground is icy or slick, throw sand or salt to help create traction. But still be aware that some areas can still be uneven and cause you to slip, trip, or fall.