Chiropractic + Wellness

Individuals may discover a lump, bump, or nodule under the skin around their lower back, hips, and sacrum that can cause pain by compressing nerves and damaging the fascia. Can knowing the conditions linked to them and their symptoms help healthcare providers determine a correct diagnosis and develop an effective treatment plan for them?

Painful Bumps, Nodules Around Low Back, Hips, and Sacrum

Painful masses in and around the hips, the sacrum, and the lower back are lumps of fat or lipomas, fibrous tissue, or other types of nodules that move when pressed on. Some healthcare providers and chiropractors, in particular, use the non-medical term back mice (In 1937, the term was used to describe lumps associated with episacroiliac lipoma) to describe the bumps. Some healthcare professionals argue against calling the masses mice because it is not specific and could lead to misdiagnoses or incorrect treatment.

• Most show up in the lower back and hip area.
• In some cases, they protrude or herniate through the lumbodorsal fascia or the network of connective tissue that covers the deep muscles of the lower and middle back.
• Other lumps can develop in the tissue under the skin.

Today, many conditions are associated with back mice lumps, including:

• Iliac crest pain syndrome
• Multifidus triangle syndrome
• Lumbar fascial fat herniation
• Lumbosacral (sacrum) fat herniation
• Episacral lipoma

Related Conditions

Iliac Crest Pain Syndrome

• Also known as iliolumbar syndrome, iliac crest pain syndrome develops when a tear in the ligament occurs.
• The ligament band connects the fourth and fifth lumbar vertebrae with the ilium on the same side. (Dąbrowski, K. Ciszek, B. 2023)
• Causes include:
• Tearing the ligament from repeated bending and twisting.
• Trauma or fracture of the ilium bone caused by a fall or vehicle collision accident.

Multifidus Triangle Syndrome

• Multifidus triangle syndrome develops when the multifidus muscles along the spine weaken and diminish function or ability.
• These muscles can atrophy, and intramuscular fatty tissue can replace the muscle.
• Atrophied muscles decrease the spine's stability and can cause lower back pain. (Seyedhoseinpoor, T. et al., 2022)

Lumbar Facial Fat Herniation

• The lumbodorsal fascia is a thin fibrous membrane covering the back's deep muscles.
• Lumbar fascial fat herniation is a painful mass of fat that protrudes or herniates through the membrane, gets trapped and inflamed, and causes pain.
• The causes of this type of herniation are currently unknown.

Lumbosacral (Sacrum) Fat Herniation

• Lumbosacral describes where the lumbar spine meets the sacrum.
• Lumbosacral fat herniation is a painful mass like lumbar facial herniation in a different location around the sacrum.
• The causes of this type of herniation are currently unknown.

Episacral Lipoma

Episacral lipoma is a small painful nodule under the skin that primarily develops over the top outer edges of the pelvic bone. These lumps occur when a portion of the dorsal fat pad protrudes through a tear in the thoracodorsal fascia, the connective tissue that helps hold the back muscles in place. (Erdem, H. R. et al., 2013) A healthcare provider may refer an individual to an orthopedist or orthopedic surgeon for this lipoma. An individual may also find pain relief from a massage therapist familiar with the condition. (Erdem, H. R. et al., 2013)

Symptoms

Back lumps can often be seen under the skin. They are typically tender to the touch and can make sitting in a chair or lying on the back difficult, as they often appear on the hip bones and sacroiliac region. (Bicket, M. C. et al., 2016) The nodules may:

• Be firm or tight.
• Have an elastic feel.
• Move under the skin when pressed.
• Cause intense, severe pain.
• The pain results from pressure on the lump, which compresses the nerves.
• Damage to the underlying fascia can also cause pain symptoms.

Diagnosis

Some individuals do not realize they have nodules or lumps until pressure is applied. Chiropractors and massage therapists often find them during treatments but do not diagnose the abnormal fatty growth. The chiropractor or massage therapist will refer the patient to a qualified dermatologist or medical professional who can perform imaging studies and a biopsy. Determining what the lumps are can be challenging because they are non-specific. Healthcare providers sometimes diagnose the nodules by injecting them with a local anesthetic. (Bicket, M. C. et al., 2016)

Differential Diagnosis

The fatty deposits can be any number of things, and the same applies to the sources of nerve pain. A healthcare provider may further diagnose by ruling out other causes, which can include:

Sebaceous Cysts

• A benign, fluid-filled capsule between the layers of skin.

Subcutaneous Abscess

• A collection of pus beneath the skin.
• Usually painful.
• It can become inflamed.

Sciatica

• Radiating nerve pain down one or both legs that is caused by a herniated disc, bone spur, or spasming muscles in the lower back.

Liposarcoma

• Malignant tumors can sometimes appear as fatty growths in the muscles.
• Liposarcoma is typically diagnosed by biopsy, where some tissue is removed from the nodule and examined for cancer cells. (Johns Hopkins Medicine. 2024)
• An MRI or CT scan may also be performed to determine the exact location of the nodule.
• Painful lipomas are also associated with fibromyalgia.

Treatment

Back nodules are usually benign, so there's no reason to remove them unless they're causing pain or mobility problems (American Academy of Orthopedic Surgeons: OrthoInfo. 2023). However, they should be examined to make sure they are not cancerous. Treatment usually involves injected anesthetics, such as lidocaine or corticosteroids, as well as over-the-counter pain relievers like NSAIDs.

Surgery

If pain is severe, surgical removal may be recommended. This involves cutting out the mass and repairing the fascia for lasting relief. However, removal may not be recommended if there are many nodules, as some individuals can have hundreds. Liposuction may be effective if the lumps are smaller, more extensive, and comprise more fluid. (American Family Physician. 2002) Complications of surgical removal can include:

• Scarring
• Bruising
• Uneven skin texture
• Infection

Complementary and Alternative Treatment

Complimentary and Alternative Medicine treatments like acupuncture, dry needling, and spinal manipulation can help. Many chiropractors believe back nodules can be successfully treated with complementary and alternative therapies. A common approach uses acupuncture and spinal manipulation in combination. A case study reported that anesthetic injections followed by dry needling, like acupuncture, improved pain relief. (Bicket, M. C. et al., 2016)

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive therapies and functional rehabilitation procedures focused on restoring normal body functions after trauma and soft tissue injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, 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, Functional Medicine Treatments, and in-scope care protocols. If the individual requires other treatment, they will be referred to a clinic or physician best suited for their condition, as Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers.

Beyond the Surface

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 call us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Dąbrowski, K., & Ciszek, B. (2023). Anatomy and morphology of iliolumbar ligament. Surgical and radiologic anatomy: SRA, 45(2), 169–173. https://doi.org/10.1007/s00276-022-03070-y

Seyedhoseinpoor, T., Taghipour, M., Dadgoo, M., Sanjari, M. A., Takamjani, I. E., Kazemnejad, A., Khoshamooz, Y., & Hides, J. (2022). Alteration of lumbar muscle morphology and composition in relation to low back pain: a systematic review and meta-analysis. The spine journal: official journal of the North American Spine Society, 22(4), 660–676. https://doi.org/10.1016/j.spinee.2021.10.018

Erdem, H. R., Nacır, B., Özeri, Z., & Karagöz, A. (2013). Episakral lipoma: Bel ağrısının tedavi edilebilir bir nedeni [Episacral lipoma: a treatable cause of low back pain]. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 25(2), 83–86. https://doi.org/10.5505/agri.2013.63626

Bicket, M. C., Simmons, C., & Zheng, Y. (2016). The Best-Laid Plans of "Back Mice" and Men: A Case Report and Literature Review of Episacroiliac Lipoma. Pain physician, 19(3), 181–188.

Johns Hopkins Medicine. (2024). Liposarcoma. https://www.hopkinsmedicine.org/health/conditions-and-diseases/sarcoma/liposarcoma

American Academy of Orthopedic Surgeons: OrthoInfo. (2023). Lipoma. https://orthoinfo.aaos.org/en/diseases--conditions/lipoma

American Family Physician. (2002). Lipoma excision. American Family Physician, 65(5), 901-905. https://www.aafp.org/pubs/afp/issues/2002/0301/p901.html

Many complex spinal surgeries take place in a hospital environment. The individual spends a night or two in the hospital, so medical staff can monitor them if any complications arise. However, outpatient surgeries have increased with new developments in minimally invasive procedures, pain management, and home rehabilitation. The improvements compared to traditional spinal surgical procedures are significant. These advancements have made it possible to perform more complex surgeries outside of a hospital. Outpatient surgeries have:

• Accelerated recovery times
• Decreased complications
• Decreased infections
• Healthier overall outcomes

Outpatient Surgery Candidates

Determining if outpatient surgery can be performed effectively depends on the injury/s and/or conditions that the individual is going through. An individual who is debilitated or has underlying medical conditions that increase their risk for complications or do not have support at home to assist with recovery and rehabilitation is recommended to have the surgery done in a hospital. To be considered for outpatient spine surgery, a surgeon looks at:

• Age
• Disease/s
• Condition/s
• Overall health
• Weight
• Body type

Individuals must also be a non-smoker or have quit before surgery, as smoking:

• Interferes with proper healing
• Can accelerate disc degeneration
• Can cause ill effects on the spine and other areas of the body

Recovery times vary on a case-to-case basis and procedure type. Most procedures' recovery time is between three weeks and three months.

Ambulatory Surgery Centers

An ambulatory surgery center or ASC is an outpatient clinic that offers surgical procedures. Standard outpatient procedures include:

• Abdominal hernia repairs
• Cataract surgeries
• Skin therapies

Standalone ambulatory surgery centers offer same-day surgical procedures for individuals that meet specific criteria. Medical staff assess the patient’s condition and determine recovery at home. If issues arise, the individual can be transferred to a hospital. Some facilities are single-specialty facilities, focusing on one medical specialty, and others are multi-specialty, meaning they offer a range of medical services from:

• Orthopedic
• Podiatry
• Pain management services

Procedures

Anterior Cervical Discectomy and Fusion - ACDF

ACDF is a two-part surgery. First, the surgeon removes part of an intervertebral disc with bulged and compressed nerves from the spinal cord.  Because there is less cushion, the vertebrae above and below are fused to prevent and eliminate painful movement. The discectomy:

• Provides more accessible access to the vertebrae
• Reduces healing time
• Causes less pain 

ACDF outpatient procedure treats several neck conditions that include:

• Cervical spinal stenosis
• Cervical radiculopathy
• Neck-related degenerative disc disease
• Herniated disc
• Cervical spinal fracture

Individuals recover in the surgical center for one to several hours following the surgery before returning home. Traditional ACDF procedure takes three weeks to three months to recover.

Lumbar Discectomy

A lumbar discectomy is a minimally invasive procedure that repairs a lower back herniated disc compressing the surrounding nerves. This procedure provides compression relief and allows the nerve to heal. A traditional lumbar discectomy takes four to six weeks to recover.

Lumbar Laminectomy

This minimally invasive procedure removes thickened ligaments and lamina from the lower back. This opens the spinal canal space, relieving pressure and bringing pain relief. The surgery commonly treats lower-back spinal stenosis. A traditional laminectomy takes four to six weeks to recover.

Lumbar Spinal Fusion

Outpatient lumbar spinal fusion permanently connects two or more vertebrae in the lower back. The surgery helps stabilize the spine from severe arthritis or herniated disc removal. Spinal fusion has been found to be effective for correcting certain spinal deformities. The surgery involves a short recovery time at the outpatient center, after which the individual can return home the same day. A traditional or open spinal fusion requires a two-to-three-day hospital stay. After four to six weeks and with a doctor's clearance, individuals can return to light activities, with full recovery requiring six months.

Chiropractic Spinal Decompression

References

International Journal of Spine Surgery. (April 16, 2021) “The expanding frontier of outpatient spine surgery.” https://pubmed.ncbi.nlm.nih.gov/33900984/

Mayo Clinic. (n.d.) “Spinal fusion.” https://www.mayoclinic.org/tests-procedures/spinal-fusion/about/pac-20384523

Neurosurgeons of New Jersey. (July 21, 2019) “Lumbar discectomy recovery timeline: Your guide to recovery.” https://www.neurosurgeonsofnewjersey.com/blog/lumbar-discectomy-recovery-time/#:~:text=The%20overall%20lumbar%20discectomy%20recovery,discectomy%20recovery%20time%20should%20progress

Rothman Orthopaedics. (March 2, 2017) “Outpatient spine surgery: A new way to look at surgery.” https://rothmanortho.com/stories/blog/outpatient-spine-surgery

Several conditions and factors can cause chronic pain. Usually, these are conditions that accompany normal aging, which affect bones and joints. The top three are osteoarthritis, rheumatoid arthritis, and fibromyalgia. Other common causes are nerve damage and injuries that fail to heal properly.

Spinal Cord and the Nerves of the Corresponding Organs

Individuals with fibromyalgia experience unexplained pain in almost every part of their bodies. Doctors and scientists are still trying to figure out what causes fibromyalgia. Currently, scientists think a part of the condition comes from an imbalance of certain chemicals in the brain. They believe the imbalances play a critical role. Fibromyalgia can create:

• Tender areas
• Muscle pain
• Headaches
• Long-term back pain
• Long-term neck pain

Osteoarthritis

Osteoarthritis causes severe sporadic or non-stop aches and pain in the knees, hips, spine, and feet. Associated symptoms include joint stiffness, swelling, and limited joint mobility. Individuals with osteoarthritis could have some pain throughout their lives. According to the CDC, around fifteen million adults with arthritis have severe pain in their joints.

Rheumatoid Arthritis

Rheumatoid arthritis causes continual aching that affects multiple joints. The hands, wrists, and knees are the most affected joints. Individuals with rheumatoid arthritis can present alternate symptoms, like joint stiffness, swelling, and fever.

Multiple Sclerosis

Multiple sclerosis is a disease of the brain and the spinal cord. What happens is the immune system targets and damages the protective covering of the nerves themselves. The brain can't properly and effectively communicate with the body. Multiple sclerosis causes pain in the legs, feet, arms, and hands. Associated symptoms include burning, prickling, or stabbing pain just about every day.

Sciatica

Sciatica can cause mild to sharp, electrical burning pain that travels from the lower back through the buttocks to the back of the leg and even into the foot. Chronic sciatica lasts for three months or more. The condition is more common in adults age 40 and older.

Carpal Tunnel Syndrome

Carpal tunnel syndrome causes pain and numbness in the:

• Hand
• Wrist
• Forearm
• Thumb
• Index finger
• Middle finger
• Ring finger

Common causes include:

• Repetitive hand movements
• Rheumatoid arthritis
• Diabetes
• Underactive thyroid gland
• Some women experience carpal tunnel during pregnancy

Injury Trauma

Around half of the cases involving chronic pain are linked to physical trauma and injury. Individuals hospitalized after a serious injury often report chronic pain symptoms within the first year. Scientists are still unsure of how injuries lead to chronic pain. They believe several factors increase the risk. These include:

• Pre-injury depression
• Anxiety
• Alcohol use
• Family history of chronic pain

Individuals that have sustained multiple injuries are at higher risk for chronic pain.

Spinal Injuries

One of the most common causes of chronic back pain. The lower back is the area likely to be affected. Certain types of chronic pain can have more than one cause. For example, general back pain could be caused by a single factor or a combination of factors like:

• Poor posture
• Improper lifting of heavy objects
• Improper carrying of heavy objects
• Being overweight places added strain on the back and knees
• Abnormal curvature of the spine
• Wearing high heels too often
• Sleeping on a worn-out mattress
• Degenerative disc changes

Combat Injuries

More than half of combat-related injuries are the result of explosions, from landmines, and shrapnel. Nearly all injured soldiers have to deal with some type of pain and many have a traumatic brain injury. A traumatic brain injury can cause chronic headaches. Delayed treatment and repeated injuries in injured soldiers make up for most chronic pain cases.

Sports Injuries

Sports injuries and chronic pain is nothing new. Studies found that 1 in 2 football players deal with chronic pain in their retirement. This along with sleep problems and mild-severe depression. Both can contribute to chronic pain. Athletes are continuously exposed to high-risk injury situations. Having the pressure of performing optimally and winning can take a toll on an athlete's health.

Weight

Obesity does not directly cause chronic pain, but it does raise the risk. Around 40% of individuals that are obese also experience mild to severe chronic pain. Plus, individuals that are severely overweight are more likely to develop a condition that can cause chronic pain like diabetes, arthritis, and fibromyalgia.

The source of chronic pain can be very complex. It can start with an injury or illness and develop slowly without the individual realizing it until it has become a full-blown chronic condition. This fact alone makes recommending a single course of treatment risky and is why health care providers recommend a number of different types of treatment options.

Auto Accident Injury 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*

Q: I'm experiencing back pain more so now. My question is, is this back pain from my baby is it normal or is it something else? I'm a 30-year-old woman in the second trimester with our first child. I would have back pain before I was pregnant but nothing serious, just normal work and a little soreness at the end of the day. There was never back soreness or pain that I thought warranted a visit to the doctor. My doctor says that it is normal from the weight of the baby and there is nothing amiss, but to discuss this with a chiropractor, as there could be some treatment/therapies/exercises to help.

El Paso, TX.

A: Having low back pain before you were pregnant concerns me, as what you are saying sounds like a possible herniated disc bulging or slipped disc. However, I cannot give you an official diagnosis unless I see you as a patient and can't say if it is something else.

But low back pain can be caused by a combination of things. This includes your pregnancy along with:

• Herniated disc
• Disc degeneration
• Age
• Muscle spasm/s
• Daily wear and tear
• Injuries
• Unknown injuries
• Added Weight

These are just a few of the things that could be causing your low back pain. Add pregnancy to this list and low back pain can become unbearable. Your pain can be made worse by a variety of factors.

For example, let's say you were lifting a few pieces of light furniture before you became pregnant, and that slight soreness you felt and thought was nothing could actually be a strain, muscle spasm, or over-stretch that did not cause an injury but is the beginning of an injury waiting to happen.

During pregnancy, a growing belly can put place more pressure on the:

• Intervertebral discs
• Joints
• Muscles
• Ligaments

Hormones that are released during pregnancy can also exacerbate your back pain. The hormone relaxin causes the pelvis and the ligaments of the lower back to gain flexibility. This is in preparation for the delivery and can cause low back pain because of the added flexibility you are more prone to injury, which is why doctors say to take it easy. It could all be a combination of these factors but I would have to examine you, go over your medical history to get a proper diagnosis to create a personalized treatment plan during pregnancy and after if the need is there.

Treatment During Pregnancy

There are several treatment options for back pain. During pregnancy is not the time to experiment with medications or back pain treatments that could cause a negative response or something else to your health. The goal during pregnancy is safety.

Here are four safe therapies for managing back pain while pregnant:

1. Gentle exercise/s like walking and yoga helps alleviate back pain and can also generate an overall feeling of wellness.
2. Physical therapy can decrease your back pain by strengthening the muscles. A physical therapist that has experience working with pregnant women is the best option.
3. Prenatal massage relaxes tense back muscles and reduces stress. Look for a massage therapist that specializes in prenatal massage.
4. Prenatal yoga classes are great for decompressing/destressing during pregnancy.

Discuss all of this with your doctor and all treatment options. It's not a good idea to start a new exercise program when you're pregnant. If there was a regular exercise routine before you were pregnant, you can continue, but you may have to make some adjustments as your body prepares for the delivery. Once the baby is born, you and your doctor can re-evaluate your treatment plan. But regardless of your treatment plan, you should still continue to maintain a proper healthy weight by eating right and exercising regularly to prevent back pain from worsening.

Treatment for Low Back Pain During Pregnancy

Chiropractic is a treatment method that has moved from more of an alternative treatment to widespread mainstream acceptance over the past few decades. There will always be pockets of naysayers that question its validity, but the millions of satisfied patients around the world speak volumes about the effectiveness of chiropractic treatment on the human body. There are literally dozens of health issues that benefit from chiropractic adjustments, but here are 3 common conditions that El Paso chiropractors help:

1) Headaches
 
We all get headaches from time to time. Some are mild, some are more severe, but all of them have the potential to disrupt your day. Whether it is a tension headache caused by hours of sitting at a desk or a migraine brought on by a specific health condition, when the pain starts it is difficult to focus on anything else.

El Paso chiropractors help relieve headache pain on a regular basis. A lot of the time the pain you feel in your head is actually being caused by misalignment of the vertebrae in your spine. After a gentle adjustment and proper maintenance, many patients report no more pain and no more need for pain medication.

2) Shoulder Pain
  
Shoulder pain is a problem that far too many people deal with.  Pain in the shoulder can be referred pain from the spinal misalignments, or it can be caused by a misalignment in the shoulder.

No matter what specific type of shoulder pain you have, El Paso chiropractors help relieve both the pain and any range of motion issues that are present. Our team will help to access your condition and give you the best advice we can on what you can do to remedy the situation.

3) Lower Back Pain

If headaches and shoulder pain are among the most common conditions for the general public then lower back pain is probably at the head of the pack. One of the most common reasons for lumbar pain is from misaligned spinal segments.

Chiropractors can help the pain and reduced mobility associated with lumbar strains and sprains and help patients get back to their normal routines. Even if you’ve had lower back pain for years and have been told there is nothing that will help, it’s always worth the time explore your possibilities.

Please don’t hesitate to call our team with any questions you might have.  Today is a great day to get started on a new path to health.

Chiropractic care focuses on re-establishing the natural healing of the body through manual adjustments and manipulation of the spine. A chiropractor diagnoses and treats neuromuscular disorders by restoring a healthy functionality between the spine and the nervous system, together with educating on the proper stretches, exercises, and a balanced nutrition to promote further healing. Chiropractic treatment restores normal spinal mobility which in turn alleviates the irritation of the spinal nerve that causes pain and affects the function of the other systems in the body. A chiropractor will offer relief to many conditions and disorders.  

A viscerosomatic response or VSR is when the internal organs are going through some distress, illness, or injury, causing pain symptoms. An example is the right shoulder presenting with pain when the gall bladder is inflamed. The pain signals are transmitted through the spinal cord, and the muscles in the area could spasm, creating sensitivity or pain when touched. However, viscerosomatic pain is often not worsened or changed by bending, reaching, or twisting in different directions causing musculoskeletal/MSK pain. Without a thorough exam, it's easy to confuse a VSR with an MSK or basic back ache. Individuals may sometimes feel visceral pain more through emotional symptoms like anger, anguish, or sadness than physical discomfort. Causation varies for everybody and can overlap with underlying conditions.

Causation

The visceral organs' pain receptors are not as tightly packed or evenly spread out, which makes finding the pain's source challenging to pinpoint.‌ The most common causes include:

Inflammation

A process of the body's white blood cells protecting the body from infections, bacteria, and viruses. In autoimmune diseases, the immune system reacts as if normal tissues are infected or have changed and attacks them causing damage. But in some conditions, like arthritis, the body's immune system triggers inflammation despite no infections, bacteria, or viruses. When inflammation activates, chemicals from the body's white blood cells enter the blood or tissues to protect the body raising the blood flow to the injured or infected area. Symptoms include:

• Redness
• Heat
• Irritation
• Chemicals can cause fluid to leak into the tissues.
• Swelling
• Pain

The symptoms depend on which organs are affected. Examples include:

• Inflammation of the heart/myocarditis can cause shortness of breath and/or fluid buildup.
• Inflammation of the tiny tubes in the respiratory system can cause shortness of breath.
• Inflammation of the kidneys/nephritis can cause high blood pressure and/or kidney failure.

Circulatory Issues

Decreased blood circulation can strain areas of the body. The body pulls oxygen into the lungs that enter the blood. It travels throughout the body through blood vessels, veins, and arteries. If circulation becomes obstructed or gets stopped, a severe problem called ischemia can develop. This means areas of the body are not getting enough blood and enough oxygen. Ischemia usually originates from a buildup, blockage in the arteries, or a blood clot. Atherosclerosis is plaque, a hard, sticky substance made mostly of fat that collects in the arteries. It builds up slowly over time and can harden and narrow the arteries slowing down blood flow because the blood has less space to circulate.

Swelling/Stretching Organs

Swelling occurs when excess fluids are trapped in the body's tissues, which can cause the affected organs to enlarge and stretch. Swelling can be internal or external. Internal swelling is usually caused by:

• Fluid retention
• Blockage of the bowels or urethra
• Organ inflammation
• Flatulence

Menstrual Cramps

Menstrual cramps are throbbing, aching cramps experienced in the lower stomach just before and during a woman's monthly period. They can range from mild to severe but are common and can strike right before and/or during the menstrual cycle. Some women can experience dysmenorrhea. Symptoms include:

• Aching in the stomach
• Pressure in the stomach
• Constipation
• Pain in the hips, low back, and inner thighs.

Severe cramp symptoms can include:

• Upset stomach
• Loose stools
• Vomiting

Cysts and Tumors

• Cysts and/or tumors in the pelvic or abdomen region can cause distress, irritation, inflammation, swelling, and pain viscerosomatic and musculoskeletal.

Chiropractic Causation Diagnosis 

There is a connection between the spinal nerves and internal organ function. Internal organs connect to the brain through the spinal cord and nerve ganglia plexuses. The organs cannot function properly if the transmitted signals are interrupted or blocked. A chiropractor uses manual and mechanized manipulation to realign the spine. Chiropractic treatment diagnoses causation, restores joint function, eliminates pain, and prevents further injury, preventing degeneration and slowing disease processes in bone, muscle, and organs.

Spinal Decompression

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bath M, Owens J. Physiology, Viscerosomatic Reflexes. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559218/

Berrueta, Lisbeth, et al. "Stretching Impacts Inflammation Resolution in Connective Tissue." Journal of cellular physiology vol. 231,7 (2016): 1621-7. doi:10.1002/jcp.25263

Carver AC, Foley KM. Types of Pain. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK12991/

Sikandar, Shafaq, and Anthony H Dickenson. "Visceral pain: the ins and outs, the ups and downs." Current opinion in supportive and palliative care vol. 6,1 (2012): 17-26. doi:10.1097/SPC.0b013e32834f6ec9

Back pain usually comes from lifting an object the wrong way or awkwardly moving the body, injuring the spinal structures or muscles. However, sometimes it could be signs/symptoms of a more serious medical condition. The back pain could be caused by:

• Kidney stones or infection
• Urinary tract infection - UTI
• Pancreatitis

How to know when the root cause of back pain is from something else in the body? There are two types of pain that pain specialists look at. These are visceral pain and somatic pain. Visceral pain comes from damage or injury to the organs or organ tissues. This internal pain can radiate to the spine from conditions like:

• Pancreatitis
• Ulcerative colitis
• Crohn's disease
• Gall stones
• Cancers
• Kidney pain
• Urinary tract infections

Somatic pain is injury or damage to the muscles, skin, and soft tissues. It can be caused by:

• Regular wear and tear
• Aging
• Injury
• Sedentary lifestyle

However, visceral pain can cause somatic/bodily pain to flare up. The stress the body is going through because of the medical condition can cause inflammation.

Kidney Infections and Stones

The kidneys are located in the rear of the body toward the middle of the back. The kidneys:

• Filter waste products from the body
• Regulate bodily fluids
• Perform other vital functions.

Kidney infections and kidney stones can easily mimic a sprain or strain in the back. Infections or stones can also present with other symptoms like:

• Fever
• Nausea
• Malaise
• Burning sensation when urinating.
• The pain feels like it's higher and deeper in the back compared to musculoskeletal low back pain.
• Side and groin pain could accompany the back pain.
• The pain does not go away after shifting positions or lying down.

Urinary Tract Infection UTI

Upper urinary tract infections in the kidneys or ureters can cause back pain. Upper UTIs happen when a lower UTI in the bladder or urethra goes unnoticed or does not respond to antibiotic treatment. Infections can occur at any age, with women and older men being more susceptible. The pain usually presents in the lower back and groin area. Other possible symptoms include:

• Pain in the back, sides of the lower abdomen between the lower ribs and hips.
• Fever
• Vomiting
• Frequent urination in small amounts
• Burning during urination
• Strong urge to urinate
• Foul-smelling urine
• Cloudy urine
• Fatigue.

The pain can feel like:

• Cramping pain
• Pressure
• Soreness

Pancreatitis

Pancreatitis is inflammation of the pancreas, the long flat organ located in the upper abdomen behind the stomach. It assists digestion and sugar management. The American Pancreatic Association reports acute pancreatitis can make individuals feel sick with moderate to severe abdominal pain that can radiate to the back and often worsens after eating. The pain is felt in the upper to middle back. Other possible symptoms include:

• Abdominal pain that radiates to the back
• Abdominal pain after eating
• Fever
• Nausea
• Vomiting
• Tenderness in the abdomen

The pain can feel like ​a pulled muscle or joint pain that increases and decreases at first and then strengthens after eating or lying down.

Inflammatory Bowel Diseases IBD

Ulcerative colitis and Crohn's disease are inflammatory bowel diseases not to be confused with irritable bowel syndrome.

• Ulcerative colitis affects the colon.
• Inflamed intestinal areas characterize Crohn's disease.
• Both can cause spreading back pain.

A study found 25% of individuals with IBD have chronic back pain. Other possible symptoms include:

• Abdominal pain and cramps
• Urgent need for bowel movements
• Diarrhea
• Constipation
• Rectal bleeding
• Fatigue
• Loss of appetite
• Weight loss

The pain can feel mild or severe, like a cramp in the lower abdomen around the low back. It can present in cycles as a flare-up, then goes away. It's essential to read the body's warning signs and not push through the pain or ignore it. If any back pain goes on for more than a week, consult a doctor or chiropractor for a thorough examination. A pain specialist could be recommended if there is chronic back pain from a severe medical condition. A primary doctor or specialist helps keep the medical condition in check, while a pain specialist and/or chiropractor can alleviate chronic musculoskeletal pain from inflammation, irritation, and overstimulated nerves.

Body Composition

Personalized Lifestyle Medicine

Personalized lifestyle medicine develops customized treatment/health plans to fit the individual. It includes:

• Research on how the body works as an integrated system.
• Combines new technology approaches in medicine.
• The relationship between nutrients and gene expression.
• Life and behavioral sciences.

Nutrigenomics testing helps individuals understand the influence of dietary components on their genes, which can help prevent the development of certain chronic diseases.

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Pancreatic Association (Pancreapedia). (2015). Pathogenesis and Treatment of Pain in Chronic Pancreatitis. https://pancreapedia.org/reviews/pathogenesis-and-treatment-of-pain-in-chronic-pancreatitis

American College of Rheumatology. (2019). The U.S. Prevalence of Inflammatory Bowel Disease and Associated Axial Pain: Data from the National Health & Nutrition Examination Survey (NHANES). https://acrabstracts.org/abstract/the-us-prevalence-of-inflammatory-bowel-disease-and-associated-axial-pain-data-from-the-national-health-nutrition-examination-survey-nhanes/

Chiropractic is more than spinal manipulation. More people are choosing chiropractic for their pain symptoms, conditions, and injuries. Many are exchanging pills and surgery for all-natural non-invasive medicine known as chiropractic. Chiropractors do not prescribe medications and do not perform surgery. But they are trained to recognize when an injury is outside the scope of their practice and will refer an individual to the appropriate medical specialist.

Here are a few reasons why individuals are trying out chiropractic:

Doctors recommend chiropractic

The American College of Physicians recommends chiropractic and other non-drug treatments, as a first-line treatment for chronic and acute low back pain. Spinal manipulation is strongly recommended as a natural remedy. It is highly effective when combined with gentle exercises like Pilates, yoga, and tai chi.

Studies show spinal manipulation highly effective

The Journal of the American Medical Association cited spinal manipulation to be highly beneficial in treating lower back pain. Results are consistently showing that chiropractic treatment, specifically spinal manipulation, is effective in helping low back pain and improving function while minimizing pain.

95% Return for treatment

In the 2016 Gallup-Palmer College of Chiropractic Annual Report, 95% of people who used chiropractic say that it is an effective treatment. 97% said that if back or neck pain returned they would seek chiropractic treatment again. More than half of adults that have never seen a chiropractor said they would seek chiropractic treatment if they developed neck or back pain.

Chiropractic rated higher than All other treatments for back pain

A Consumer Reports survey ranked chiropractic as a top treatment compared to medications for back pain, osteoarthritis, and neck pain relief.

Individuals prefer a whole-body approach that includes:

• Lifestyle recommendations
• Dietary advice
• Supplements for pain, immobility, and range of motion problems.

Many said they opted for natural treatments like chiropractic to avoid harmful and undesirable side effects of prescription medication.

Opioids

With the Centers for Disease Control declaring prescription abuse an epidemic, individuals are searching for safer options. Natural treatments are becoming more popular to avoid the potential for addiction. And not just addiction but the often side effects that come with prescription meds, like constipation, brain fog, nausea, dry mouth, etc.

Spine surgery rising Individuals seeking the less invasive option

Spinal fusion surgery has been on a steep rise, increasing by about 500%. Therefore many are going for natural treatment like chiropractic to avoid surgery. Chiropractic looks at the whole person along with advice on lifestyle habits, dietary adjustments, and exercise programs. The bottom line is it works. It is less invasive, and yes, it is drug-free, but most of all, it is effective.

How adjustments work

When the vertebrae become misaligned, they place pressure on the nerves and cause pain, swelling, awkward movement/s, etc. This is called a subluxation. Chiropractors use their repertoire of techniques that equal a form of spinal adjustment to treat the subluxations. An adjustment means that the vertebra is returned to the proper position in the spine. When the vertebrae are adjusted, tiny pockets of gas are released from the joints, sometimes make a popping/releasing noise. It is the same sound when cracking knuckles. 

The benefits

Individuals with the following conditions have found chiropractic to be helpful:

• Arthritis
• Bursitis and
• Fibromyalgia
• Headaches
• Leg pain
• Pain or stiffness in the neck, shoulders, back, arms, hands, chest, abdomen, hips, legs, feet.
• Sciatica
• Scoliosis
• Sports injuries
• Tendonitis
• Trauma injuries like auto accidents

Other Services

The main method of treatment is spinal adjustment, many chiropractors use a variety of therapies to treat patients, including:

• Health Coaching
• Exercise
• Diet
• Massage
• Weight loss
• Stress management

Chiropractic medicine is more than just spinal manipulation. Chiropractors use a variety of treatments to help the body heal itself and return individuals to a pain-free and healthy life.

Doctor Of Chiropractic Near Me

Subluxation describes what happens when the spinal joints get shifted out of alignment. This can be caused by:

• Stress
• Trauma
• Chemical imbalance

The nervous system, which consists of the (spine/nerves/brain) is the central headquarters of the body. Subluxation removal helps the body function at its optimum level.  

Chiropractic adjustments reduce pressure on the nerves and ease the flow of communication and signals going back and forth.

These adjustments trigger the release of endorphins, which cause instant pain relief.

Our hips are made durable, but with age and normal wear and tear, this cartilage wears down, which can lead to injury.

This also includes the:

• Muscles
• Tendons
• Bones in and around the hip

And can be caused by a number of conditions, including:

• Arthritis
• Avascular necrosis (osteonecrosis)
• Cancers
• Bursitis
• Hip fractures
• Hip labral tear
• Muscle/tendon strain
• Tendinitis

If adjustments seem to be only temporary, this could be an indicator of problems beyond the spine.

Pain or other symptoms in the body start with the body’s foundation: the feet.

When we walk there are incremental-segmental movements of the spine that are small motions but are very important in proper function.

If there are foot problems:

• Spinal subluxations
• Pain
• Degeneration throughout the body can happen.

Research has found that poor foot mechanics can create severe problems that affect the normal functions of the:

• Ankle
• Knee
• Hip
• Back

Symptoms of Vertebral Subluxation

• Neck and back pain
• Headaches
• Dizziness
• Balance issues
• Spine muscle spasms
• Tightness
• Weakness
• Spinal mobility
• Pain
• Numbness
• Tingling
• Joint pain
• Tenderness
• Stiffness

Treatment

If you are experiencing any of these symptoms, subluxation could be the cause.

Chiropractic treatment and custom orthotics are the best way to correct the subluxation.

Chiropractors are experienced in finding and correcting these problems. And the custom orthotics can help keep you and your spine in perfect alignment.

Reduce Low Back Pain with *FUNCTIONAL FOOT ORTHOTICS* | El Paso, TX (2019)

Approximately 80 percent of the population will experience some type of back pain sometime throughout their lifetime. Low back pain and sciatica are several of the most common complaints frequently reported in a doctor office setting. But, did you know that low back pain and sciatica can be caused due to foot problems? Custom-made functional foot orthotics can help support and promote the natural alignment of the spine.

Poor posture associated with foot problems and other health issues can be corrected through the utilization of custom-made functional foot orthotics. Because every individual has unique foot anatomy, custom-made foot orthotics can be beneficial for a variety of people with foot problems and other health issues. Dr. Alex Jimenez is the non-surgical choice for foot problems.

An assortment of diverse and difficult health conditions can be helped by a chiropractors in El Paso. Patients usually only associate chiropractic care with back problems, but in reality chiropractic can be helpful for the entire nervous system and musculoskeletal system.

Treating mild to severe headaches is probably not a thing most people think chiropractors can help, however, that and many other conditions are pretty common to see in our office. Naturally the sources of headaches can vary and many things could be the trigger or cause. It’s important to remember that any kind of pain which causes us to alter our natural posture or the way we walk requires professional care or treatment.

Therapeutic stretches and exercises can be given by a chiropractor which will help you avoid the same issues later on. Many chiropractors also offer lifestyle recommendations and nutrition that you can utilize to help improve your condition.

No matter what affliction or health problem you’re dealing with you want to have the best treatment solution. Having a precise diagnosis is the first step. Giving our doctor as much information as possible is critical. Providing us with a complete health history is an important first step.

If we cannot take care of your problem or help with the pain you are going through, we will take steps to point you to another healthcare provider. Our treatment methods can certainly be carried out in conjunction with various other medical treatments, thus giving a more holistic approach to musculoskeletal problems.

Selecting the right chiropractor can seem difficult, but it needn’t be when you stick to a couple of easy guidelines. If possible a referral from a good friend or co-worker can be a very smart way to find a good connection. Find a doctor that you can communicate well with and you’re well on your way.