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For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles? Myofascial Pain Syndrome Spasm Cycles Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa. Spasm Pain Cycle Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021) Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014) Trigger Points - Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.
Muscle Tension - A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.
Pain-Spasm-Pain Cycle - The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.
How Spasms and Pain Present Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and the top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014) Causes Repetitive Motions - Repeating the same movement, like typing on a computer, can trigger muscle tension and points.
Poor Posture - Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.
Muscle Injury - Past injuries can leave muscles susceptible to developing trigger points and pain cycles.
Stress - Psychological stress can lead to muscle tension and exacerbate existing trigger points.
Break the Cycle Physical Therapy - A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.
Exercise - Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.
Heat Therapy - Applying heat to affected areas can help relax muscles and alleviate pain.
Ergonomics - Modifying work habits and posture to reduce strain on muscles.
Stress Management - Techniques like deep breathing and meditation can help reduce stress-related muscle tension.
Injury Medical Chiropractic and Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. https://doi.org/10.1155/2014/523924 Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. https://doi.org/10.1016/j.jcm.2016.08.010 Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. https://doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5 THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. https://www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024 Cleveland Clinic. (2023). Chronic myofascial pain (CMP). https://my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. https://doi.org/10.1589/jpts.27.3283 Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. https://doi.org/10.1007/s11916-012-0289-4
Can non-surgical treatments help individuals with piriformis syndrome reduce referred sciatica pain and help restore hip mobility? Piriformis Muscle & Piriformis Syndrome Within the lower extremities, various muscles, ligaments, tendons, and nerve roots allow the legs, hips, and thighs, enabling individuals to be mobile and help with good posture. One of the muscles, known as the piriformis muscle, is located in the gluteal region of the lower body, which helps the major muscles with every movement and allows the individual to walk, run, and rotate at the hips. (Chang et al., 2024) At the same time, the piriformis muscle is over the sciatic nerve, the longest and largest nerve that travels through the lower limbs down to the heel and provides motor-sensory function to the lower limbs. (Giuffre et al., 2024) Environmental factors like physical inactivity, excessive sitting or standing, lifting heavy objects, or improper posture can affect the piriformis muscle and develop musculoskeletal issues in the lower extremities. We associate with certified medical providers who inform our patients of the effects of piriformis syndrome, which affects their lower body extremities and causes pain and discomfort. While asking important questions to our associated medical providers, we advise patients to incorporate various non-surgical therapies to reduce the pain-like symptoms associated with piriformis syndrome. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Have you experienced a pins and needles sensation in your hips and thighs that make it unbearable to walk? Do you feel radiating pain that travels down to your feet? Or have you noticed tightness in your hips and glutes region when stretching? When environmental factors impact the body, especially in the upper and lower extremities, they can cause overlapping risk profiles that can develop into chronic conditions. So, environmental factors affecting the piriformis muscle can lead to a musculoskeletal condition called piriformis syndrome. Piriformis syndrome is a somatic and neuropathic musculoskeletal condition caused by excessive or prolonged contraction of the piriformis muscle. (Jankovic et al., 2013) Many individuals who have dealt with piriformis syndrome will begin to report pain in the gluteal region that is causing sensations down the leg that can compress the sciatic nerve. (Hicks et al., 2024) 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*
Can individuals dealing with narcolepsy find ways to reduce its effects on the musculoskeletal system and improve sleep? What Is Narcolepsy? Around the world, many individuals have gotten 8 hours of sleep by doing errands to function throughout the day. Sometimes, it is important to take naps between certain hours of the day to give the body a chance to rest and continue for the rest of the day before going to bed. However, more individuals have experienced sleep disturbances like scrolling through their phones, dealing with chronic conditions like migraines or insomnia, or not having a proper sleep schedule that can negatively impact their sleep. One of the sleep disturbances is narcolepsy, which can cause individuals to have sleep issues throughout the day and even affect their musculoskeletal system. In today’s article, we will be looking at what narcolepsy is, its symptoms, how it affects the muscles, and what treatments can reduce narcolepsy and improve sleep. We associate with certified medical providers who inform our patients of the effects narcolepsy causes on a person and their bodies. While asking important questions to our associated medical providers, we advise patients to include various techniques to reduce the overlapping risk profiles related to narcolepsy and help improve their sleep quality. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Do you often feel extremely tired throughout the day, and is it causing you to take a nap in weird places? Do your arms and legs feel weak from carrying various objects? Or do you feel general aches or pains in your neck, shoulders, and back? Many of these scenarios are associated with sleep disturbances that can affect the musculoskeletal system. One of the sleep disturbances is narcolepsy, characterized by the onset of rapid eye movement (REM) sleep that can correlate with the lack of orexin neurons from the central nervous system, thus causing daytime sleepiness. (Slowik et al., 2024) Narcolepsy has two forms depending on the severity of the condition: type 1 (narcolepsy with cataplexy) and type 2 (narcolepsy without cataplexy). Depending on the severity of narcolepsy, it can disrupt the brain from generating and regulating REM sleep and cause issues for the body when it is awake during the day. (Thorpy et al., 2024) This chronic sleep disorder can disrupt a person’s quality of life and affect their socio-economic lifestyle. 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*
Is applying ice the best option for individuals who experience an acute back strain injury? Temperature Treatment Ice temperature treatment, also known as cryotherapy or cold therapy, is a treatment that uses freezing temperatures to reduce pain and swelling. It can be applied in a variety of ways, including: - Ice packs:
- Ice massage
- Coolant sprays
- Whirlpools
- Ice baths
Ice is usually recommended for acute injuries and is a common and simple way to treat pain and swelling. Individuals can buy freezable gel packs or make their own with ice cubes in a plastic bag or towel. Heat therapy tends to be used more with chronic issues involving muscle spasms to increase blood circulation. How Ice Relieves Pain and Reduces Inflammation Ice temperature treatment works by: - Narrowing blood vessels slows blood circulation to the injured area and soft tissues and reduces swelling.
- Reduced blood flow also helps control excessive swelling.
- Ice has a short-term analgesic-numbing effect. The coldness numbs nerve endings, relieving pain symptoms.
- Relieving the pain allows the muscles to relax.
Controlling blood circulation helps control pain by reducing the flow of irritating chemicals that can inundate the injury site. These chemicals are a natural and the correct response to inflammation, but the ice keeps them in check to help control pain. After a Back Injury For a back strain injury, ice and anti-inflammatory medication like NSAIDs are the first line of treatment during the inflammatory phase, which usually lasts 24 to 72 hours. Because heat can increase inflammation by increasing blood circulation, it is not recommended as an initial treatment. After the first few days, most doctors and pain specialists recommend using ice or heat, depending on the individual's preference. While researchers continue to investigate the best ways to treat acute injuries, most doctors still recommend ice as the first line of defense for back injuries. A review of studies evaluated 20 different treatment categories to learn about their safety and effectiveness. (McIntosh G. & Hall H. 2011) Treatments included over-the-counter pain medications, acupuncture, McKenzie exercises, other back exercises, and temperature treatments. Regarding temperature treatment, the review found moderate evidence that using a heat wrap 5 days after the injury could help relieve pain. However, there was not enough evidence to support the effectiveness of any of the temperature treatments, necessitating more research. (McIntosh G. & Hall H. 2011) Physical Therapy and Activity The review found that prolonged rest should be avoided, and gentle exercise and a progressive return to physical activity should be encouraged to achieve the best outcomes for pain relief and restoring function. Staying active significantly reduces time off from work and chronic disability for up to 1 year compared to traditional medical treatment. (McIntosh G. & Hall H. 2011) Research also found that introducing physical therapy early on could expedite recovery. Mobility work, targeted exercises, and strengthening exercises have been shown to relieve pain, reduce injury recurrence, and improve overall function. More research supports physical activity and exercise as effective treatment options for acute lower back strains. However, further research regarding temperature treatments is required. (French S. D. et al., 2006) (See Q. Y. et al., 2021) Injury Medical Chiropractic and Functional Medicine Clinic It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References McIntosh, G., & Hall, H. (2011). Low back pain (acute). BMJ clinical evidence, 2011, 1102. French, S. D., Cameron, M., Walker, B. F., Reggars, J. W., & Esterman, A. J. (2006). A Cochrane review of superficial heat or cold for low back pain. Spine, 31(9), 998–1006. https://doi.org/10.1097/01.brs.0000214881.10814.64 See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. https://doi.org/10.11622/smedj.2021086
Can bioidentical hormone replacement therapy can help many individuals dealing with pain and fatigue while regulating hormone function? Introduction Many individuals have dealt with pain and discomfort in their bodies due to environmental factors that can impact the various muscles, tissues, organs, and bones. However, environmental factors can also affect the body’s hormones. They can cause overlapping risk profiles that can cause disastrous issues like pain, fatigue, unexplained weight changes, and even visceral-somatic issues. However, many individuals can seek various treatments to replenish their hormones and start getting back to their normal selves. In this 2-part article series, we will look at what hormones are exactly, what hormone replacement therapy is, and what types of hormones are in our bodies. In part 2, we will go in-depth with hormone therapy and its beneficial properties. We talk with certified associated medical providers who inform our patients about hormone therapy and how it can help provide helpful results to reduce pain in the body. While asking their associated medical provider intricate questions, we advise patients to incorporate non-surgical treatments combined with hormone therapy to reduce pain and discomfort from returning to the body. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer. What Are Hormones? Do you experience an elevated blood sugar level more than usual? Do you experience changes in your heartbeat even though you are walking at a normal pace? Or have you noticed that you are more thirstier than usual? Many people who are experiencing these issues could be dealing with a hormone imbalance. Hormones are chemicals produced and released by specialized cells, many of which are found in endocrine glands. They are released into the bloodstream and affect the target cells’ biochemistry. The presence of hormone receptors, intracellularly in the target cells or on the cell surface, controls hormone activity. Hormones activating the cellular machinery result in higher metabolism, protein synthesis, improved cellular repair, and increased cell formation. Hormones affect every facet of aging and often decrease with age, resulting in many individuals having a higher hormone dosage to induce a change in cell function. For this very reason, people require ideal hormone levels. Additionally, even if their levels are normal, their bodies still require more hormones to function and feel better. These hormonal shifts impede tissue healing and repair of the body. Hormone shortages and endocrine dysfunction have been linked to the signs and symptoms of aging, as research has now demonstrated that hormone therapy is an effective way to enhance and extend quality of life. Since aging cannot be stopped, hormones can halt the progression and support by keeping our health in check. Many individuals are trying to find the genetic location that can help regulate aging, and using genetic engineering to modify these genes is necessary for effective age reversal. Regretfully, no technology is currently available to reverse this age through genetic engineering. We must make the most of these changes by incorporating small changes like non-surgical treatments, avoiding risk factors for disease, eating a healthy diet, getting enough exercise, limiting our calorie intake, using antioxidant treatment, and replacing hormones at ideal levels. Slowing the aging process to have less disease and less degradation can provide a higher quality of life while improving feelings and functioning. 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*
Can healthcare professionals implement H.E.A.R.T. protocols for trafficked individuals while providing a safe space? Introduction Across the world, many local media and organizations are paying close attention to a phenomenon that many people should be aware of. This phenomenon is known as trafficking, and it can be associated with numerous activities, from forced labor to sex labor, and can affect a person’s sense of self-worth. While many people will correlate that trafficking affects many women and children, it can affect many individuals regardless of age, gender, and background. While many survivors of trafficking are dealing with the psychological and physical injuries that they obtain from their traffickers, many medical professionals can implement protocols and roles through the implementation of H.E.A.R.T. to provide a safe space for individuals suffering from trafficking. Today’s article focuses on the definition of trafficking, what H.E.A.R.T. is, and how it is used in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in a clinical approach while providing a safe space. We also inform and guide patients while asking their associated medical provider intricate questions to formulate customized treatment plans for their pain and provide them with a safe space and positive experience. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. The Definition Of Trafficking
When it comes to defining trafficking, it can be challenging as it is frequently associated with other issues. However, the main definition for trafficking is “recruiting, transporting, transferring, or harboring many individuals or a person that are threatened or forced to achieve the consent of a person having control of the individuals for exploitation.” With human trafficking being a pressing public concern that affects all races, social classes, demographics, and genders, it can impact society and the individual who is being trafficked. (Toney-Butler et al., 2024) Additionally, many people often mistake trafficking and smuggling as they are completely different. Smuggling requires a person to be transported into a nation through voluntary illicit means. While trafficking can come in two forms, which are labor and commercial sex, it can happen within the person’s own home. (Rambhatla et al., 2021) This is because many survivors who are going to get healthcare services will feel various emotions of fear or shame that can prevent them from asking for help due to what they have been through with their trafficker. However, when many individuals who are trafficking survivors are suffering from significant physical, mental, and social health problems and are seeking healthcare services, many healthcare professionals play an important role by creating a safe and responsive space for them. (The Lancet Regional Health-Western, 2022) 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*
The levator scapulae muscles could be overstretched for individuals experiencing upper back, shoulder, and neck pain. Can physical therapies help relieve pain and retrain the muscles to function properly? Levator Scapulae Muscles The levator scapulae muscles stretch along the spine across the upper back and neck. They originate from the cervical vertebrae C1 to C4 and attach to the inside top edge of the scapula. (Chotai P. N. et al., 2015) They elevate the shoulder blades, tilt the head, and work with other muscles to stabilize the spine and influence neck motion and upper back posture. The shoulder blade/scapula is the flat, triangular-shaped bone that sits on top of the upper part of the rib cage. Where the levator scapulae attaches, the muscles raise the shoulder blade, a movement called elevation, and indirectly rotates the scapula's bottom tip downward towards the spine. These shoulder blade movements are part of the shoulder joint's larger flexion and abduction movements. - Flexion occurs when moving the arm forward and up, and abduction occurs when moving the arm out to the side.
- The levator scapulae muscles contract during flexion and/or abduction,
- The muscles also contract when moving the neck in side bending, lateral flexion, rotation, or twisting.
Symptoms Neck and shoulder pain are common problems for office workers, truck drivers, and others who sit most of the day for their jobs. It can worsen when there is no spinal support for maintaining correct alignment. Poorly designed work chairs may contribute to chronic muscle tension and spasms, plus they may contribute to muscle weakness. One of the primary functions of the levator scapulae muscles is to keep the shoulder blade in a position that supports a vertical alignment of the head and to prevent forward head posture. (Yoo W. G. 2018) However, the shoulder blade is an extremely movable bone. Maintaining stability and correct neck posture takes work. The levator scapulae muscles may not be strong enough to keep the shoulder blade where it's supposed to be for healthy posture, and instead, they become overstretched. When muscles are overstretched, they often become taut to try to maintain some form of stability. It can feel like muscle tension because the muscles shorten, but there is a difference. The situation can worsen if one slouches, has no lumbar support, and/or the desk or steering wheel is too high or too low, which may force the shoulder blade upward or downward. Pain Relief The levator scapulae muscles are two of several shoulder muscles that may contribute when neck pain presents. This is why a qualified, licensed health professional should diagnose any pain or dysfunction in the area. Physical therapy can help get the body back on track. (Yoo W. G. 2018) Treatment may consist of restoring muscle strength and flexibility in the shoulder, neck, and upper back muscles and developing better posture habits. Physical therapy exercises, particularly those that address upper back posture, can help reduce the stress placed on the levator scapulae muscles and can help decrease kyphosis, often a precursor to forward head posture. Stretching, strengthening, and posture lessons will help relieve pain and increase the physical functioning of the upper body. Other tips for avoiding and relieving muscle pain include: - Stretching regularly by gently rotating the neck and shoulders.
- Applying heat to promote relaxation.
- Regular massage therapy.
- Adjusting chairs and/or monitor height to align with a straight line of sight.
- Not carrying heavy bags, especially on one shoulder.
- Avoiding side sleeping without proper head support.
Injury Medical Chiropractic Clinic Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Chotai, P. N., Loukas, M., & Tubbs, R. S. (2015). Unusual origin of the levator scapulae muscle from mastoid process. Surgical and radiologic anatomy: SRA, 37(10), 1277–1281. https://doi.org/10.1007/s00276-015-1508-6 Yoo W. G. (2018). Effects of thoracic posture correction exercises on scapular position. Journal of physical therapy science, 30(3), 411–412. https://doi.org/10.1589/jpts.30.411
How do healthcare professionals provide a clinical approach in the role of nursing to reducing pain in individuals? Introduction The practice of Registered Nurses (RN), Advanced Practice Registered Nurses (APRN), and Licensed Practical Nurses (L.P.N.) is governed by the Nurse Practice Act. Nurses working in the specializations above must keep up their practice skills and knowledge, which includes familiarity with the rules and regulations that pertain to their profession. Practicing practical nursing is authorized for Licensed Practical Nurses (L.P.N.s). Today’s article looks at the role of nursing. We discuss with certified associated medical providers who consolidate our patients’ information to assess any pain or discomfort they are experiencing. We also inform and guide patients while asking their associated medical provider intricate questions to integrate into their personalized treatment plan to manage the pain. Dr. Jimenez, DC, includes this information as an academic service. Disclaimer. The Roles In Nursing The Nurse Practice Act describes practical nursing as “the performance of selected various actions, including the administration of numerous treatments and medications, in the care of the ill, injured, and providing the promotion of wellness, health maintenance and prevention of illnesses while following under the direction of a registered nurse, a licensed physician, osteopathic physician, podiatric physician, or a licensed dentist.” It was revised in 2014 and now teaches broad health and wellness concepts to non-nursing students and the public. The main goal for an RN is to complement the access to health care for individuals in pain or who are dealing with chronic issues. (Cassiani & Silva, 2019) Many individuals are under the supervision of a registered nurse, doctor, or dentist, individuals who have completed a prelicensure practical nursing education program approved by the Board, a professional nursing education program, and graduate practical nursing students qualifying as professional nursing students; however, licensed practical nurses who have not completed the specified course under Rule 64 B9-12.005, FAC, may perform a limited scope of intravenous therapy. This range consists of: Intravenous Therapy Within the Scope of the Practical Nurse: - Calculate and adjust the flow rate of IV therapy.
- Observe and report both subjective and objective signs of various reactions to IV administration to the patient.
- Must inspect the insertion site, change the dressing, and remove the intravenous needle or catheter from the peripheral veins
- Hanging bags or bottles of hydrating fluid.
Intravenous Therapy Outside the Scope of the Practical Nurse: - Initiation of blood and blood products
- Initiation or administration of cancer chemotherapy
- Initiation of plasma expanders
- Initiation of administration of investigational drugs
- Making IV solution
- IV pushes, except for heparin flushes and saline flushes
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*
How do healthcare professionals provide a clinical approach to recognizing trafficking to individuals seeking a safe environment? Introduction Around the world, there is a phenomenon that local media and organizations are paying more attention to and that many people should be aware of. This is known as trafficking, and it can encompass a wide range of activities, from forced labor in various industries to sex work. While most individuals of trafficking are usually young women or children, it can affect many individuals of all ages and backgrounds. Many survivors of trafficking are compelled to live with the psychological and physical injuries they sustained from the mistreatment they endured at the hands of their traffickers. This course aims to give medical professionals and others in allied fields an understanding of the realities of human trafficking, as well as the kinds of resources and interventions that can be used to help many individuals trafficking in this two-part series. Today’s article overviews trafficking and how it can impact the individual. In part two, we will discuss the roles and protocols of how healthcare professionals can identify trafficking while providing a safe and positive space for the individual. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic. We also inform and guide patients while asking their associated medical provider intricate questions to integrate a customized treatment plan for their pain and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. The Definition of Trafficking It can be challenging to define trafficking since it frequently coexists with other problems like forced marriage, sexual assault, domestic abuse, and forced labor. (Hume & Sidun, 2017) As the United Nations stated, trafficking encompasses the following activities: “as recruitment, transportation, transfer, harboring, or receipt of many individuals using the threat or use of force to achieve the consent of a person having control over another person, for exploitation.” (United Nations Human Rights Office of the High Commissioner, n.d.) The following components of this definition include: Additionally, the definition of trafficking also has the following divisions that are also feasible (United Nations Office on Drugs and Crime, n.d.): - Act: This is a reference to the different forms of human trafficking, including the hiring, transferring, receiving, and harboring of individuals.
- Means: Coercion, force, fraud, kidnapping, deception, abuse of power or weakness, or providing cash or other rewards to someone in a position of authority over the victim are typically used to carry out trafficking.
- Purpose: Traffickers engage in forced labor, prostitution, sexual exploitation, forced servitude, slavery, and even organ harvesting to further their financial interests.
While the terms are occasionally used synonymously, human trafficking and people smuggling are not the same. Human smuggling is the transportation of a person into the nation by illicit means; it is voluntary, as the person smuggled usually offers compensation to another individual or party to achieve this purpose (Lusk & Lucas, 2009). 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*
Can various stretches can help relieve individuals with plantar fasciitis to reduce foot pain and restore gait function? Introduction As human beings, we are constantly on the move, and our feet are the ones that take a toll after a long day. The feet have various muscles, ligaments, tendons, and soft tissues that help protect the joints and provide stability. The feet are part of the lower body extremities that aid in mobility and strength of the upper body. When many individuals are constantly on their feet, the muscles and ligaments become overworked and can develop into pain-like issues. Most of the time, it is just muscle aches and pain; however, when repetitive motions start to cause more problems on the feet, it can lead to micro tears in the foot’s fascia. This, in turn, can lead to the development of plantar fasciitis, affecting a person’s gait ability. Today’s article looks at how plantar fasciitis affects gait function and how various stretches can help alleviate plantar fasciitis. We discuss with certified associated medical providers who consolidate our patients’ information to assess plantar fasciitis and its associated comorbidities. We also inform and guide patients on various stretches for plantar fasciitis and ask their associated medical providers intricate questions to integrate a customized treatment plan to incorporate multiple stretches to reduce the pain-like symptoms correlated with it. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. How Plantar Fasciitis Affects Gait Function Do you feel like you are walking crooked from one location to another? Do you feel a stabbing pain when you take your first steps? Or do you feel constant pain in your feet while you are resting? As stated earlier, many individuals are constantly on their feet and have dealt with some pain that can affect their quality of life. Since the feet are part of the lower body extremities, a person experiencing a lot of pain in their heels can lead to a chronic musculoskeletal condition known as plantar fasciitis. The plantar fascia plays a huge part in the human body as it helps with the normal biomechanics of the foot, supports the arch, and provides shock absorption when a person is stepping. (Buchanan et al., 2024) When a person has been doing repetitive motions on their feet, it can lead to the development of plantar fasciitis. Plantar fasciitis is a common musculoskeletal disease that causes chronic degenerative changes in the plantar fascia. This musculoskeletal disease is also associated with mechanical factors such as repetitive stress and weight bearing that can lead to microtears in the muscle fibers. (Tseng et al., 2023) That point causes many individuals to have gait issues and other comorbidities. Some risk factors correlated with plantar fasciitis are decreased ROM in plantarflexion and increased tensile load, which can cause many individuals to have gait issues while walking. (Hamstra-Wright et al., 2021) Since many individuals rely on walking and are experiencing pain from plantar fasciitis, not only their gait function is being affected, but the surrounding muscles in the legs are also affected. Pain symptoms like intrinsic muscle weakness, reduced muscle strength on the legs and dorsiflexion, leg length discrepancy, and arch deformity can increase the chances of plantar fasciitis developing. (Khammas et al., 2023) This can cause many individuals to have gait dysfunction since the pain can be unbearable. Additionally, when people deal with plantar fasciitis, they shift their weight to one side of their bodies to reduce the pain and allow their secondary muscles to take on the unnecessary weight load. Luckily, there are ways to minimize the pain-like effects of plantar fasciitis and help restore a person’s gait function. 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*
How do healthcare professionals in a chiropractic clinic provide a clinical approach to recognizing impairment for individuals in pain? Introduction Any article you read about substance abuse among nurses will almost certainly repeat the claims made by the American Nurses Association, which states that, in line with the general public, 10% of nurses, or one in ten or about 300,000 Registered Nurses in the United States, are dependent on drugs of some kind. Impairment of any kind at work, particularly if it stems from substance misuse or usage, can have serious repercussions for the nurse and the nursing profession for several reasons. Preciseness, correctness, the capacity for critical thought, and observation are essential in the nursing profession. Because errors or accidents may occur, any inability to deliver these abilities puts patients, coworkers, and the nurse at risk. Additionally, people view nurses as trustworthy, dependable, and honest. Impairment can damage that perception, particularly if it is brought on by alcohol or drugs. In the following sections, we’ll examine impairment, its reasons, and your ethical and legal obligations if you believe a coworker is impaired. Today’s article focuses on the clinical approach to recognizing impairment in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues they are experiencing. We also inform and guide patients on various treatments and ask intricate questions to their associated medical providers to integrate a customized treatment plan. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. A Definition of Impairment The fundamental definition of impairment is “The state of being decreased, weakened or harmed, especially mentally or physically” (“Impairment,” n.d.”) You’ll see that this is merely a description of a state of being and that no reason is given. This is a result of the abundance of possible reasons. While some causes might be simple to prove, others might not. Consequently, it is important to identify and consider the context and cause, if known, while talking about impairment. The impaired populace that surrounds us as nurses is: They are patients of ours. They are in a reduced, weakened, or damaged state, albeit they may be compromised by disease or injury. Similarly, you are compromised by illness if you have worked a shift with a bad cold. Symptoms of feeling slower, impaired thinking, and reviewing your work more frequently are examples of impairment in a clinical setting. A disease or injury may have different consequences and affect how well you execute your job to varied degrees, but as the degree of impairment increases, so does the chance that you will make a mistake. The safety of both you and those around you, including your patients and coworkers, is inversely correlated with your degree of impairment. You, your patients, and your coworkers are less safe the more your performance is negatively impacted. Even though nurses know that the patients are vulnerable because they are compromised in some way. We also know that impairments can make it more likely for you to make mistakes. You are a responsible person and would never work if your impairment was severe enough to put your patients in danger. However, what if a coworker has a disability? Even worse, what if you think it was somehow self-inflicted? How do you proceed? Do you talk to them? Do you inform someone else about it? Do you hope nothing bad happens and ignore it? 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*
How do healthcare professionals in a chiropractic clinic provide a clinical approach to preventing medical errors for individuals in pain? Introduction Medical errors resulted in 44,000–98,000 hospitalized American deaths annually, and many more caused catastrophic injuries. (Kohn et al., 2000) This was more than the number of people who died annually from AIDS, breast cancer, and auto accidents at the time. According to later research, the actual number of deaths may be closer to 400,000, placing medical errors as the third most common cause of death in the US. Frequently, these mistakes are not the product of medical professionals who are inherently bad; rather, they are the outcome of systemic issues with the health care system, such as inconsistent provider practice patterns, disjointed insurance networks, underutilization or absence of safety protocols, and uncoordinated care. Today’s article looks at the clinical approach to preventing a medical error in a clinical setting. We discuss associated medical providers specializing in various pretreatments to aid individuals suffering from chronic issues. We also guide our patients by allowing them to ask their associated medical providers very important and intricate questions. Dr. Alex Jimenez, DC, only utilizes this information as an educational service. Disclaimer Defining Medical Errors Determining what medical error is the most crucial step in any conversation about preventing medical errors. You might assume this is a very easy chore, but that is only until you delve into the vast array of terminology utilized. Many terms are used synonymously (sometimes mistakenly) since some terminology is interchangeable, and occasionally, the meaning of a term depends on the specialty being discussed. Even though the healthcare sector stated that patient safety and eliminating or reducing medical errors were priorities, Grober and Bohnen noted as recently as 2005 that they had fallen short in one crucial area: determining the definition of “perhaps the most fundamental question… What is a medical error? A medical error is a failure to complete a planned action in a medical setting. (Grober & Bohnen, 2005) However, none of the terms that one would often identify expressly with a medical error—patients, healthcare, or any other element—are mentioned in this description. Despite this, the definition offers a solid framework for further development. As you can see, that specific definition consists of two parts: - An execution error: A failure to complete a planned action as intended.
- A planning error: is a technique that, even with perfect execution, does not produce the desired results.
The concepts of faults of execution and planning errors are insufficient if we are to define a medical error adequately. These may occur anywhere, not only at a medical establishment. The component of medical management must be added. This brings up the idea of unfavorable occurrences, known as adverse events. The most common definition of an adverse event is unintentional harm to patients brought about by medical therapy rather than their underlying disease. This definition has gained international acceptance in one way or another. For example, in Australia, the term incidents are defined as in which harm resulted in a person receiving health care. These consist of infections, injury-causing falls, and issues with prescription drugs and medical equipment. Certain unfavorable occurrences might be avoidable. 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*
For individuals experiencing back pain from a herniated disc, can understanding the difference between surgery and chiropractic help individuals find the right treatment plan? Surgery or Chiropractic Living with back pain can be a nightmare, and yet many struggle without seeking care. Today, there are a vast number of surgeries and noninvasive techniques that are better at treating spine and back problems and managing symptoms. For individuals who may have a herniated disc or are curious about ways to relieve their back pain, a health care provider, physical therapist, spine specialist, and chiropractor can inform them of treatment options. Surgery and chiropractic therapy are popular treatments for a herniated, bulging, or slipped disc. - A herniated disc is when the cartilage discs that cushion the vertebrae shift out of position and leak out.
- Surgery for a herniated disc involves removing or repairing the disc.
- Chiropractic nonsurgically repositions the disc and realigns the spine.
- Both treatments have the same goals with key differences.
Chiropractic Care Chiropractic is a system of therapy that focuses on adjusting and maintaining spinal alignment to help with back and posture problems. Chiropractors are trained and licensed medical professionals who take a nonsurgical approach, a proven therapy for chronic pain, flexibility, and mobility issues. The Way It Works Chiropractic treatment encourages and supports the body’s natural healing processes. It is considered for joint pain in the back, neck, legs, arms, feet, and hands. It typically involves sessions in which the chiropractor physically and carefully adjusts the vertebrae by hand, also known as spinal manipulation or chiropractic adjustments. (MedlinePlus. 2023). A chiropractor performs a thorough medical evaluation and runs tests to establish a diagnosis. A chiropractor will develop a treatment plan that may involve a team of massage and physical therapists, acupuncturists, health coaches, and nutritionists to treat affected areas with various techniques, recommend targeted exercises, adjust lifestyle and nutrition to support the treatment, and monitor progress. Combined with stretching and sustained pressure, the multiple methods can increase joint mobility and relieve pain symptoms. (National Center for Complimentary and Integrative Health. 2019) Added protocols to support or enhance chiropractic therapy include: - Heating and ice therapies to reduce inflammation and increase blood circulation.
- Using devices to stimulate muscles and nerves electrically.
- Developing relaxation and deep breathing techniques.
- Incorporating exercises to promote rehabilitation.
- Establishing a regular fitness routine.
- Making adjustments to diet and lifestyle.
- Taking certain dietary supplements.
Spinal manipulation and chiropractic adjustments have been shown to improve symptoms and restore mobility in cases of chronic back pain. One review found that individuals with chronic lumbar/low back pain reported significant improvement after six weeks of chiropractic treatment. (Ian D. Coulter et al., 2018) Prices The out-of-pocket expenses of chiropractic treatment depend on various factors. Insurance may or may not cover the treatment, and the amount an individual has to pay can vary based on the severity of their case, what their plan covers, and where they live. One review found the cost can range between $264 and $6,171. (Simon Dagenais et al., 2015) Surgery There is a range of minimally invasive surgical procedures to treat herniated discs. These work to ease nerve compression by removing or replacing damaged discs or stabilizing the vertebrae, relieving pain and inflammation. The Way It Works A herniated disc can happen in any part of the spine but is more common in the lower back/lumbar spine and in the neck/cervical spine. Surgery is recommended when: (American Academy of Orthopaedic Surgeons. 2022) - More conservative treatments, like medications and physical therapy, are unable to manage symptoms.
- The pain and symptoms impact daily life and functioning.
- Standing or walking becomes difficult or impossible.
- The herniated disc causes difficulty walking, muscle weakness, and bladder or bowel control loss.
- The individual is reasonably healthy, without infection, osteoporosis, or arthritis.
Specific surgical procedures used include: Fusion Surgery - Spinal fusion is the most common procedure for a lower back herniated disc.
- It involves using artificial bone material to fuse vertebrae to increase stability and release and prevent nerve irritation and compression. (American Academy of Neurological Surgeons. 2024)
Laminotomy and Laminectomy - Herniated disc symptoms appear from compression placed on the nerves.
- Laminotomy involves making a small cut in the lamina, or the arch of the spinal vertebrae, to release the pressure.
- Sometimes, the entire lamina is removed, known as a laminectomy. (American Academy of Neurological Surgeons. 2024)
Discectomy Artificial Disc Surgery - Another approach involves implanting an artificial disc.
- This is most often used for hernia in the lower spine; the worn or damaged disc is removed, and a specialized prosthetic replaces the removed disc. (American Academy of Orthopaedic Surgeons. 2022)
- This allows for more mobility.
The success of herniated disc surgery depends on different factors. Advances in minimally invasive techniques have significantly improved long-term outcomes, with one review finding that around 80% reported good—excellent results at a six-year follow-up. (George J. Dohrmann, Nassir Mansour 2015) However, there is the possibility of recurrence. About 20% to 25% of individuals with herniated lumbar discs experience re-herniation at some point. (American Academy of Neurological Surgeons. 2024) Prices - Surgery for a herniated disc is specialized, and the costs depend on the scope and scale of the treatment.
- The individual's specific insurance plan also determines the expenses.
- The typical costs of surgery range between $14,000 and $30,000. (Anna N A Tosteson et al., 2008)
Choosing Treatment When choosing between chiropractic and surgery for a herniated disc, a number of factors can determine the decision, including: - Chiropractic is the less invasive nonsurgical option.
- Chiropractic adjustments cannot help certain severe cases of herniated discs.
- Chiropractic adjustments prevent the herniated disc from getting worse and ease symptoms.
- Surgery provides pain and symptom relief faster than chiropractic or conservative treatment but requires significant recovery time and is expensive. (Anna N A Tosteson et al., 2008)
- Surgery may not be appropriate for individuals with osteoarthritis or osteoporosis.
Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with surgery. Generally, surgery is only recommended when noninvasive methods haven’t been able to stop or manage the pain and symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References MedlinePlus.MedlinePlus. (2023). Chiropractic. Retrieved from https://medlineplus.gov/chiropractic.html National Center for Complimentary and Integrative Health. (2019). Chiropractic: in-depth. Retrieved from https://www.nccih.nih.gov/health/chiropractic-in-depth Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The Spine Journal: official North American Spine Society journal, 18(5), 866–879. https://doi.org/10.1016/j.spinee.2018.01.013 Dagenais, S., Brady, O., Haldeman, S., & Manga, P. (2015). A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC health services research, 15, 474. https://doi.org/10.1186/s12913-015-1140-5 American Academy of Orthopaedic Surgeons. (2022). Herniated disk in the lower back. https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/ American Academy of Neurological Surgeons. Surgeons, A. A. o. N. (2024). Herniated disc. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc Dohrmann, G. J., & Mansour, N. (2015). Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical principles and practice: international journal of the Kuwait University, Health Science Centre, 24(3), 285–290. https://doi.org/10.1159/000375499 Tosteson, A. N., Skinner, J. S., Tosteson, T. D., Lurie, J. D., Andersson, G. B., Berven, S., Grove, M. R., Hanscom, B., Blood, E. A., & Weinstein, J. N. (2008). The cost-effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 33(19), 2108–2115. https://doi.org/10.1097/brs.0b013e318182e390
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Can individuals find therapeutic ways to reduce restless leg syndrome and improve their sleep quality in their beds? What Is Restless Leg Syndrome? Do you feel general aches or leg pain, causing you to feel restless? Do you experience fatigue throughout the day, making it difficult to fall asleep? Or do you feel uncomfortable sensations in your legs, making falling and staying asleep difficult? Many people worldwide have experienced these issues known as restless leg syndrome. Also known as Willis-Ekbom disease, restless leg syndrome is often characterized by an uncomfortable urge to move legs when a person rests for the night and can be accompanied by unpleasant sensations that cause irresistible restlessness. (Gossard et al., 2021) Restless leg syndrome (RLS) can also be primary or secondary depending on the severity of the issue affecting the individual’s legs. Since the legs allow the individual to be mobile through walking, running, and jumping, the various muscles and tendons that make up the legs can succumb to RLS. As it is a chronic movement disorder, it is common to many individuals. It is associated with abnormal, non-painful sensations that are active when a person rests and relieved when they are in motion. (Mansur et al., 2025) We associate with certified medical providers who inform our patients of how restless leg syndrome affects their legs. While asking important questions to our associated medical providers, we advise patients to incorporate ways to reduce restless leg syndrome and restore their sleep quality. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer. Causes What causes individuals to develop RLS can often be correlated with environmental factors. Additionally, since RLS can be primary or secondary, the overlapping risk profiles also play a factor. Environmental factors like stress and anxiety can cause the central nervous system to go haywire, causing the sensations to set off and become worse. When RLS is primary, the central nervous system can cause the legs to develop RLS by not getting enough dopamine, which is a neurotransmitter that regulates body movement. The RLS symptoms can worsen when there isn’t enough dopamine in the body. When RLS is secondary, it could be due to iron deficiency that the brain areas have low levels of iron being transported to the blood-brain barrier and not being imported to the neuronal cells. (Vlasie et al., 2022) This can cause numerous symptoms and affect the legs when a person is trying to get a good night’s rest. 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*
Can individuals with insomnia find various ways to reduce its effects, such as a full night’s rest and promoting healthy sleep habits? Insomnia Many people have often struggled to get a full night’s sleep occasionally, as environmental factors can keep them from falling asleep, making them tired throughout the day. In most cases, many individuals sometimes suffer from a chronic condition known as insomnia. Insomnia is a common sleep disorder, whether short-term or chronic, and it can negatively impact a person’s ability to sleep and stay asleep. (Dopheide, 2020) Insomnia can be in two forms: primary and secondary. Primary insomnia is a fairly common condition that can be resolved without treatment, while secondary insomnia is due to medication side effects or neurological issues that are causing sleep issues. Additionally, insomnia can be developed through various environmental factors like genetic variants, early life stress, major life events, and brain functions and structures that can cause individuals to be vulnerable and have insomnia. (Van Someren, 2021) We associate with certified medical providers who inform our patients of the effects of insomnia that can affect the body when they are not getting enough sleep. While asking important questions to our associated medical providers, we advise patients to incorporate healthy sleeping habits into their treatment plan to reduce insomnia and get proper sleep. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer. How It Affects The Body
So, how does insomnia affect the body and a person’s daily routine? Well, when environmental factors start to impact a person, it can cause overlapping risk profiles in the body that can develop into mental disorders like depression. There is a bi-directional relationship between insomnia and depression, as it can cause sleep alterations that can affect the nervous system and develop into chronic conditions. (Riemann et al., 2020) Some of the symptoms that insomnia can affect the body include: (Naha et al., 2024) - Fatigue
- Memory impairment
- Cardiovascular disorders
- Gastrointestinal disorders
- PTSD
- Daytime napping
However, there are ways to manage insomnia and reduce the co-morbidities. 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*
Can individuals receive a full night’s rest by recognizing sleep disturbances to only get proper muscle function and improve their health? What Causes Sleep Disturbances? As many people are in a constant state of motion and trying to complete their tasks, they will feel extremely exhausted and tempted to take a quick nap on their bed. However, a short nap can sometimes turn longer and thus affect a person’s sleep schedule. At the same time, when the body is ready to go to sleep, sometimes the mind is wide awake, causing people to become more tired throughout the day. These types of sleep disturbances can not only affect the person but also affect the body as well. In today’s article, we will be looking at what causes sleep disturbances, how improper sleep affects the muscles in the body, and how to incorporate various ways to reduce sleep disturbances. We discuss with certified medical providers who inform our patients how various sleep disturbances can affect the individual and the body. While asking informed questions to our associated medical providers, we advise patients to include various techniques to reduce sleep disturbances that can impact the musculoskeletal system. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer. How often do you feel general aches and pains in your upper and lower extremities that make you sluggish? Do you experience constant headaches that make it difficult to get out of bed? Or do you feel stiffness in your neck, shoulder, and back in the morning that goes away throughout the day? When it comes to the correlation between what causes sleep disturbance to the body, it can vary from person to person, depending on the situation. Let’s say a person is dealing with a stressful situation that causes them to be unable to get a good night’s rest; that would be known as a sleep disturbance. Sleep disturbances, by definition, are causes that can impact a person’s fundamental aspects of their sleep hygiene. (Cormier, 1990) Understandably, everyone is trying to practice good sleep hygiene; however, when environmental factors cause overlapping risk profiles to develop into sleep disturbances, they can affect the body. These can range from cognitive disorders to musculoskeletal conditions and chronic conditions. How Does Improper Sleep Affect The Muscles & Body? When classifying sleep disorders that can cause improper sleep in the body, four major categories can be the issue. They are: - Disorders that initiate and maintain sleep
- Excessive somnolence disorders
- Sleep-wake schedule disorders
- Various dysfunctions are associated with sleep (Weitzman, 1981)
These four categories can cause many people to develop improper sleeping habits that can affect their bodies and muscles. Symptoms like fatigue correlate with poor sleep quality and can increase muscle pain intensity. At the same time, many individuals dealing with fatigue can experience muscle pain intensity associated with comorbidities that can make a person feel miserable. (Boggero et al., 2022) Environmental factors affecting the musculoskeletal system can correlate with metabolic disorders and thus affect sleep. Additionally, improper sleep and disturbances have been interplayed with metabolic disorders that can increase the risk of obesity, hypertension, insulin resistance and cause many people to have improper sleeping habits and, which, in turn, affects their musculoskeletal system. (Wei et al., 2022) Some of the effects of improper sleep that can affect muscle include: - Muscle weakness
- Instability
- Muscle pain
- Discomfort
However, when people start to decide to try to improve their sleep schedule and reduce sleep disturbances, many people start to look for ways to get a full night’s rest. 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*
Can hormone replacement therapy provide relief by replenishing lost hormones in menopausal women and in men to restore their body function? Introduction Hormones help regulate the body and ensure that it functions properly in all body systems. When a person is doing a normal routine, from eating food, being physically active, or reducing stress, hormones can help regulate body temperature and make sure that the various organs are properly working and the body is functioning. When environmental factors start to impact the body, it can make the individual deal with overlapping risk profiles and, over time, develop into chronic conditions, hence why many individuals seek out hormone therapy to replenish the lost hormones. In this 2-part series, we will get an in-depth look at hormone therapy and how it can help menopausal women. Part 1 explains what hormones are and how hormone therapy helps the body. We talk with certified associated medical providers who inform our patients about how hormone therapy can help reduce the pain-like effects of the body. While asking their associated medical provider intricate questions, we advise patients to incorporate non-surgical therapies combined with hormone therapy to reduce pain and discomfort from affecting the body. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer. To Bleed or Not to Bleed Celebrity books and talk shows have made bioidentical hormones a popular topic. Because of the media’s emphasis on the term, both men and women, particularly aging ones, are now familiar with it. The term “natural” can now be defined as “bioidentical,” which offers everyone a fresh perspective on hormone replacement. New “experts” with “expert” opinions on how to take hormones have surfaced from this media frenzy. Unfortunately, a lot of women are nervous about one of these “expert” methods of hormone replacement. Some people are so unhappy that they completely avoid taking hormones. According to some experts, it is natural and advised to cycle or create a monthly period. It is implied that women have menstruation while they are “young” and in good health. Therefore, all menopausal women should continue to menstruate to maintain that same level of health. This “cycling” is accomplished by establishing a menstrual cycle by halting progesterone for one week per month. This advice is deemed inadequate by the majority of women as they decide to go with hormone replacement therapy if they think that taking hormones necessitates getting their period.
What is menstrual cycling? It is the decline of women’s hormones that causes menstruation. Consequently, a woman will cycle and bleed if she stops taking progesterone for a few days each month. This can happen even if a woman hasn’t had a period for years—unless they’ve had a hysterectomy, of course. Menopausal women do not necessarily need or benefit from it just because it is “natural” for younger women. Menopause is when a woman is dealing with hormonal changes that cause an irregular menstrual cycle and a major physiological change to the body. (Ko & Kim, 2020) 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*
For individuals who may need to take pain medications to manage an injury or condition, can knowing the potential side effects help in treatment? Medications For Pain Side Effects Over-the-counter and prescription pain medications can help relieve physical discomfort and distress but can also cause side effects. Patients may not manifest side effects when using certain meds or experience mild, limited, severe, or intolerable effects. Pain medication side effects can include: - Allergic reactions
- Upset stomach
- Bruising
- Dizziness
However, medication side effects don't affect everyone in the same way. Pain Relief The patient and their healthcare provider can decide whether they risk developing side effects and which effects they are more predisposed to. Individuals may be susceptible to side effects from certain medications but are likely to tolerate others. For example, individuals with a history of ulcers may be recommended to avoid anti-inflammatories. For those who have trouble sleeping, it is recommended to avoid pain meds that are known to interfere with sleep. Reading Labels and Asking Questions When taking over-the-counter medications, read the label for side effects, then weigh the possible risks against the medicine's benefits for pain relief. Ask a pharmacist or healthcare provider about anything that is not understood. Some side effects are medical emergencies, such as allergic reactions. Recognizing the signs of an allergic reaction and being prepared to call for emergency help if symptoms present. (American Academy of Allergy, Asthma & Immunology, 2024) These can include: - Itching
- Hives
- Rash
- Mouth or facial swelling
- Shortness of breath
If a healthcare provider prescribes medication, discuss the anticipated risks and benefits. The prescription will come with a label that lists the side effects associated with the drug. Opioid Risks Opioids are powerful prescription meds, usually used for severe, short-term use, like post-surgery pain or after a severe traumatic injury. Some effects of opioids include: (Plein L. M. and Rittner H. L. 2018) Common side effects include sedation, constipation, and nausea. Chronic use can lead to depression and/or sexual dysfunction. With narcotics, there is the risk of addiction that can change an individual's life, as addiction can be difficult to overcome. One of the reasons the CDC published a guideline on opioid prescriptions was because of the number of overdoses and deaths. - The CDC recommends that practitioners not prescribe opioids as a first-line treatment for chronic back pain.
- The CDC recommends that healthcare providers initially treat patients with chronic back or neck pain using non-pharmacological therapies or medications other than opioids.
- Opioids should only be used if the expected benefits for pain and function are anticipated to outweigh the risks to the patient.
With more than half of regular opioid users experiencing back pain, they aren't proven to help return individuals to work or normal life faster, nor did they improve functioning when used for the treatment of an acute episode. (Deyo R. A. Von Korff M. and Duhrkoop D. 2015) The effectiveness of opioids is about 30% for short-term relief and did not improve physical functioning. Examples and Comparisons Examples of common medications used to treat back pain. Advil - Active Ingredient - Ibuprofen
- Drug Class - NSAID
- Over-the-counter or Prescribed - Available over-the-counter
- Side Effects - GI-related symptoms and Reye's Syndrome in children
Aleve and Other Generic Brands - Active Ingredient - Naproxen
- Drug Class - NSAID
- Over-the-counter or Prescribed - Available as both depending on strength.
- Side Effects - GI-related symptoms, headaches
Tylenol and Other Generic Brands - Active Ingredient - Acetaminophen
- Drug Class Analgesic - pain reliever
- Over-the-counter or Prescribed - Available as both and can be prescribed with codeine.
- Side Effects - Potential liver damage
Lyrica - Active Ingredient - Pregabalin
- Drug Class - Anticonvulsant
- Over-the-counter or Prescribed - Prescribed FDA-approved for shingles pain and neuropathy in diabetes. Other uses off-label.
- Side Effects - Dizziness, drowsiness, swelling, weight gain.
Neurontin - Active Ingredient - Gabapentin
- Drug Class - Anticonvulsant
- Over-the-counter or Prescribed - Prescribed FDA-approved for shingles pain
- Side Effects - Dizziness, drowsiness, allergic reaction, withdrawal, and seizures.
Injury Medical Chiropractic and Functional Medicine Clinic Chiropractic therapy is among the more conservative treatment options and may be tried first. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References American Academy of Allergy, Asthma & Immunology. (2024). Anaphylaxis Symptoms & Diagnosis. https://www.aaaai.org/conditions-treatments/allergies/anaphylaxis Plein, L. M., & Rittner, H. L. (2018). Opioids and the immune system - friend or foe. British journal of pharmacology, 175(14), 2717–2725. https://doi.org/10.1111/bph.13750 Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. BMJ (Clinical research ed.), 350, g6380. https://doi.org/10.1136/bmj.g6380
Back pain is one of the most common reasons for seeking health care. Individuals dealing with back pain but don't know the cause may have some inflammatory joint disease or autoimmune condition. Can seeing a rheumatologist help? Rheumatologist Depending on what's causing the back pain, individuals may need to see their primary doctor for a referral. Individuals are recommended to see a rheumatologist if they have back pain that doesn't come from an injury that doesn't go away after a few weeks, pain that comes back after treatment, or symptoms that suggest a rheumatic condition. Rheumatologists treat severe or persistent back pain and are experts in autoimmune diseases, including lupus, Sjogren's syndrome, rheumatoid arthritis, ankylosing spondylitis, axial spondylitis, Psoriatic arthritis, and other forms of inflammatory or autoimmune arthritis. What Do They Do? A rheumatologist is an internist or pediatrician who has completed special training in treating conditions that are: - Inflammatory
- Autoimmune
- Related to painful joint disease
The doctors diagnose, treat, and manage these conditions long-term. Depending on diagnosis and care needs, they may also lead or be part of a team that includes other healthcare providers. Symptoms When muscles ache, pain presents, or joints hurt, and especially if there are signs of inflammation that don't go away, seeing a healthcare provider is recommended. Symptoms of inflammation include: - Redness
- Swelling
- Pain
- Stiffness
- Loss of joint function
Usually, to see a rheumatologist, individuals need a referral from their primary care provider and may be referred when: - There is no evidence of a back injury.
- At-home therapies like heat application, prescription medications, or physical therapy are unsuccessful.
- There is uncertainty about what's causing the back pain, but I suspect it's rheumatological.
- Blood tests for inflammatory markers or certain antibodies yield abnormal results.
- There is a diagnosis of a rheumatic condition and recommend a specialist to manage it.
- There is a family history of a rheumatic or autoimmune condition that may cause back pain.
- There is a chronic pain condition that later develops back pain (Hospital for Special Surgery, 2023)
Individuals may also be referred to a rheumatologist if their back pain is accompanied by: Some types of arthritis can cause permanent, progressive joint damage. Conditions Conditions that can affect the spine and cause back pain and are treated by a rheumatologist include: (Johns Hopkins Medicine, 2024) Rheumatoid arthritis (RA) - This often starts in smaller joints of the hands and feet and later moves to the neck and/or back.
- It can also affect different body organs and have systemic symptoms.
Ankylosing Spondylitis (AS) - Primarily a disease of the spine, it may also impact the shoulders, hips, knees, and ankles.
- Systemic symptoms, including fever and fatigue, can manifest.
Axial Spondylitis - This primarily affects the spine, chest, and pelvis.
- It may also cause problems with the connective tissue, eyes, bowel, and skin.
Psoriatic Arthritis (PsA) - Pain in the lower back is common, especially in severe cases.
- It can affect other joints and cause psoriasis.
Reactive Arthritis - This is a reaction to infection.
- It is more common in the limbs, hands, and feet joints but can involve the spine.
Enteropathic Arthritis - This mainly affects the spine but can include other joints.
- It is associated with inflammatory bowel disease.
Autoimmune diseases that don't specifically target the spine but can also cause back pain include: - Lupus
- Sjögren's syndrome
- Hashimoto's thyroiditis
Finding a Doctor Individuals may be fine with their primary healthcare provider's choice regarding which rheumatologist to see. However, they may want to research other options to ensure the right rheumatologist is chosen. Things to look at include: - Search online medical directories.
- Visit the websites of the doctors being considered to learn more about their training, approach, and specialties.
- Check online reviews.
- Check on health insurance coverage.
- Ask members of the healthcare team, friends, and family for recommendations.
- Contact rheumatologists' offices to see if they are accepting new patients.
- Once decided, pass along the information to the primary care doctor so they can make the referral.
Preparing For The Initial Visit Before seeing a new rheumatologist, take a few minutes to prepare so you can make the most of the appointment. Individuals will want to have: - A list of back-related symptoms, including frequency and severity.
- A list of what makes symptoms better or worse.
- A copy of recent test results and records from other doctors.
- Individuals can ask their provider/s to send their medical information to the rheumatologist's office in advance.
- A list of treatments that have been tried and how well they worked.
- A list of all medications, over-the-counter and prescription, supplements, and herbal products taken.
- A list of medication allergies.
- Complete medical history and family history of potentially related diseases.
- A list of any questions regarding conditions, treatment, etc.
- If possible, fill out any paperwork for the new office beforehand to save time on the appointment day.
Injury Medical Chiropractic and Functional Medicine Clinic Talking with a healthcare provider is important. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. Using an integrated approach to treating injuries and chronic pain syndromes to improve flexibility, mobility, and agility and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Hospital for Special Surgery. (2023). What Is a Rheumatologist, and What Conditions Do They Treat? https://www.hss.edu/conditions_what-is-a-rheumatologist.asp#when Yale University School of Medicine. Dee, J. E. (2021). 5 reasons why a patient should see a rheumatologist. https://medicine.yale.edu/news-article/5-reasons-to-see-a-rheumatologist/ National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Autoimmune diseases. Retrieved from https://www.niams.nih.gov/health-topics/autoimmune-diseases Johns Hopkins Medicine. (2024). Spinal arthritis (arthritis in the back or neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
Can individuals with stiff person syndrome incorporate non-surgical treatments to reduce muscle stiffness and restore muscle mobility? Introduction The musculoskeletal system allows the body’s extremities to be mobile, provides stability to the host, and has an outstanding relationship with the other body systems. The musculoskeletal system’s muscles, tissues, and ligaments help protect the body’s vital organs from environmental factors. However, many individuals often deal with repetitive motions in the upper and lower body extremities that can cause pain and discomfort. Additionally, environmental factors, illnesses, and injuries can affect the musculoskeletal system and play a part in co-morbidities in overlapping risk profiles. These issues can cause the musculoskeletal system to develop a condition known as stiff person syndrome. Today’s articles focus on what stiff person syndrome is, the symptoms it is associated with, and how non-surgical treatments can help alleviate the symptoms of stiff person syndrome. We discuss with certified associated medical providers who consolidate our patients’ information to assess stiff person syndrome and its associated symptoms affecting the musculoskeletal system. We also inform and guide patients while asking their associated medical provider intricate questions to integrate non-surgical treatments to reduce the overlapping symptoms correlating with stiff person syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. What Is Stiff Person Syndrome Have you been dealing with muscle stiffness in your lower extremities affecting your mobility? Have you noticed that your posture is rigid due to ongoing muscle spasms in your lower back? Or have you felt tightness in your back muscles? Many pain-like symptoms are associated with back pain, a common musculoskeletal condition; however, they can also correlate with a rare condition known as stiff person syndrome. Stiff person syndrome is a rare autoimmune disorder that is progressive and is characterized by rigidity and stimulus-triggered painful muscle spasms that affect the lower body and extremities. (Muranova & Shanina, 2024) There are three classifications that a person is experiencing with stiff person syndrome, and they are: - Classic Stiff Person Syndrome
- Partial Stiff Person Syndrome
- Stiff Person Syndrome Plus
Since stiff person syndrome is a rare condition, many individuals may not exhibit any objective findings early on, which then causes a delayed diagnosis that can impact a person’s quality of life (Newsome & Johnson, 2022). At the same time, since stiff person syndrome is a rare autoimmune disease, it can affect the musculoskeletal system with associated pain-like symptoms. 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*
How can healthcare professionals recognize and establish protocols for individuals who are being trafficked and provide a safe place? Introduction Today, we will look at part two of this series, which is about recognizing trafficking in a clinical setting. Today’s article in this two-part series of recognizing trafficking helps inform many healthcare professionals to understand the roles and protocols for identifying trafficking that is affecting their patients and help provide a safe, positive space for them. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic while taking the proper protocols to ensure patient safety. We also inform and guide patients while asking their associated medical provider intricate questions to integrate and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. Health Care Professional’s Role in Identifying Trafficking Even though they may come across victims of human trafficking and have the chance to step in, many healthcare professionals believe they lack the knowledge and self-assurance needed to recognize these victims and offer them the kind of aid they need. As an illustration: - Just 37% of social workers and medical professionals surveyed again had any training in recognizing and supporting victims of human trafficking (Beck et al., 2015).
- It is extremely hard for processors to identify and aid victims because traffickers move their victims around a lot and employ various strategies to evade discovery. Frequently, it could be your final interaction with the victim (Macy & Graham, 2012).
- There can be a companion who comes across as very domineering, who won’t let the patient spend time alone with you, or who insists on filling out paperwork or talking on the patient’s behalf.
- It’s possible that neither the victim nor their friend will have identification or insurance paperwork and will just pay in cash.
- The victim or their companion may refuse to answer questions.
- The victim may decline additional testing and follow-up care.
- The victim may have physical injuries, sexually transmitted diseases, and signs of psychosocial stress.
- The victim may not know the city and state that they are in.
- The victim may appear fearful when asked questions or in the presence of their companion.
- The victim may exhibit feelings of shame, guilt, helplessness, or humiliation.
- You may notice inconsistencies in basic information, such as age, name, address, work history, or information regarding living status and daily activities.
- If the patient does not speak English, where are they from, and how did they arrive?
- If the patient is a minor, who and where is the guardian?
- The victim may have unusual tattoos to indicate that they are the “property” of their trafficker.
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*
How do healthcare professionals provide a clinical approach to recognizing HIV for individuals in pain and providing relief? Introduction The human body has dealt with various environmental factors, injuries, and pathogens that can cause issues to the body system. As many individuals are always on the go from one location to another, being healthy is extremely important. Making time to make an appointment for a person’s health and well-being is extremely important, as many people have experienced comorbidities and overlapping risk profiles that are causing them pain. When individuals experience onset issues of fatigue, muscle and joint pain, or immune disorders, many healthcare professionals must assess the situation and ask the individuals when they experienced these overlapping risk profiles and how they affect their daily activities. One of the overlapping risk profiles that seems to affect the body is a viral infection known as Human Immunodeficiency Virus or HIV. This can get many healthcare professionals to come up with a personalized treatment plan to reduce these overlapping risk profiles and educate the individual on what to do to manage HIV symptoms. Today’s article looks at how HIV can impact a person, their symptoms, and non-surgical treatments to manage HIV. We discuss with certified associated medical providers who consolidate our patients’ information to assess the effects of HIV and its associated symptoms. We also inform and guide patients on how to be aware of the impact of HIV and ask their associated medical providers intricate questions to integrate a customized treatment plan to incorporate multiple non-surgical therapies to manage the symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. What Is HIV? Do you constantly feel tired even after taking a good night’s rest? Do you feel your throat being sore without the flu symptoms? Or are you experiencing muscle and joint pain in different locations of your body? Worldwide, many individuals have often experienced these symptoms from a viral infection known as Human Immunodeficiency Virus or HIV. HIV belongs to the retroviridae family, which targets the body’s immune system, especially the CD4+ T cells. The CD4+T cells play an important role in the body’s immune response, but when HIV starts to deplete the receptors and terminate the host cells. (Masenga et al., 2023) This causes individuals to have acute stages of HIV and, if not treated immediately, can lead to the progression of severe stages. However, how do individuals contract HIV? Well, the most common mode is through unprotected sexual intercourse, sharing needles, or through maternal-infant exposure, which diminishes the T-helper cell population and, over time, can increasingly weaken the immune system. (van Heuvel et al., 2022) This causes many individuals to develop various symptoms from HIV that can vary, depending on the severity and the progression stages of the virus. The Symptoms Now, for the progression of HIV to infect the body’s immune system and cause various symptoms to affect the individual, many healthcare professionals have to look at the process of the host’s exosomes and their correlation role with HIV. The generational process of exosomes causes overlapping risk profiles with the viral assembly of HIV as exosomes can transport the virus from the infected cells to the uninfected cells of the body by helping it regulate the host’s immune response to the virus infection. (Chen et al., 2021) To that point, it can lead to the progression of several stages of HIV and its associated symptoms. When a person is dealing with an HIV infection in its acute stages, the symptoms can be mild and easily mistaken for a common viral infection. Some of the symptoms can include: - Muscle aches
- Joint pain
- Difficulty falling asleep
- Fatigue
- Neuropathy
- Shortness of breath
- Swollen glands
This is because the inflammatory cytokines from the immune system are heightened and influenced by HIV. When inflammatory cytokines become associated with HIV, symptoms have a huge impact on an individual’s life, causing them to be miserable. (Schnall et al., 2020) Additionally, when HIV is in a clinical latency stage, the virus is less active but can still replicate without exhibiting any symptoms in the body. However, when HIV progresses to its severe stage, it can lead to the development of AIDS. Luckily, treatment advancements to treat HIV from its acute stages can help manage the associated symptoms. 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*
Can individuals dealing with musculoskeletal trigger points seek non-surgical treatments to reduce pain in their extremities? Introduction The musculoskeletal system has various muscles, tendons, ligaments, and soft tissues that allow the lower and upper extremities to function in multiple tasks that the person is doing. From physical activities to relaxing or just doing errands, the musculoskeletal system has a wonderful relationship with all the various body systems. It helps protect the vital organs from environmental factors and injuries. However, when environmental factors or injuries affect the body, many overlapping risk profiles affect the upper and lower quadrants, thus affecting the muscles and the soft tissues. When the musculoskeletal system starts to feel symptoms of pain and discomfort, it can cause visceral-somatic referred pain in different body locations and cause the development of trigger points in the muscle tissues. This causes the individual to be in excruciating pain and discomfort and is seeking treatment to reduce the pain-like symptoms. Today’s article gives us an understanding of musculoskeletal trigger points and how various non-surgical treatments can alleviate musculoskeletal trigger points in the body. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues affecting their musculoskeletal system that are correlating to trigger point pain. We also inform and guide patients on various non-surgical treatments and ask their associated medical providers intricate questions to integrate a customized treatment plan to reduce musculoskeletal trigger point pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. Understanding Musculoskeletal Trigger Points Do you often experience pain in your legs, arms, hands, and feet throughout the day? How often do you experience symptoms of stiffness and discomfort in your neck, shoulder, or back? Or do you feel tingling and numbing sensations in your hands and feet? More often than not, many people who are experiencing these overlapping pain issues in their musculoskeletal system might have trigger points in their muscle fibers. Trigger points are part of a painful musculoskeletal condition known as myofascial pain syndrome. This painful musculoskeletal condition constitutes a hyperirritable spot within the taut band of the musculoskeletal system, causing pain when being compressed. (Lavelle et al., 2007) When a person is dealing with musculoskeletal trigger points, they will often experience referred pain and discomfort, motor dysfunction, and autonomic issues. This is because when many individuals experience pain in the upper or lower muscle quadrants, they deal with referred pain from the affected muscles. When the affected muscles have abnormal tender muscle regions, it can lead to impaired movements associated with the affected muscles in any joint area. (Macdonald, 1980) Additionally, musculoskeletal trigger points can be identified as latent or active based on the development of where the pain originates from within the musculoskeletal system. To that point, when environmental factors or injuries develop trigger points, pain-like symptoms like muscle stiffness, dysfunction, and restricted range of motion show up when a pain specialist is assessing a person. (Shah et al., 2015) Fortunately, musculoskeletal trigger points are not difficult to treat once the pain source is located in the musculoskeletal system. This is because non-surgical treatments help manage the pain-like symptoms by inactivating the trigger points and restoring the affected resistant muscles to their full range of motion. (Rubin, 1981) 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*
Can athletic individuals incorporate MET (muscle energy techniques) therapy to reduce the pain-like effects of adductor strain? Introduction The body’s lower extremities have an important role as they provide stability and mobility to the individual. Many athletes utilize their lower extremities by adding much power to exert the energy to win matches or competitions. The various muscles, soft tissues, ligaments, and joints help support the body’s skeletal structure and can succumb to injuries from repetitive motions or environmental factors. One of the muscles that can be affected by constant repetitive motions and environmental factors is the adductor muscles, which can cause many athletes to be in continuous pain and affect their performance during competitions. Luckily, there is a technique that many treatments offer to reduce muscle strain in the adductors and provide relief to the lower extremities. Today’s article looks at how adductor strain can affect many individuals, how MET therapy can help with an adductor strain, and its positive effect on athletic individuals. We discuss with certified medical providers who consolidate our patients’ information to assess the pain-like effects of an adductor strain in the lower extremities. We also inform and guide patients on how MET therapy can help stretch and strengthen tight adductor muscles to reduce strain and provide relief. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating MET and other non-surgical therapies into their personalized treatment plan for a healthier lifestyle. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer. How Does Adductor Strain Affect Individuals? Do you feel tightness along your thighs and legs after a long day at work? Do you experience instability when walking from one location to another? Or do you feel pain when stretching your thighs that causes temporary relief? Many individuals experiencing pain in their lower extremities will often think it is hip pain, but their adductor muscles are in pain. The adductor muscles consist of three muscles that provide torque to the lower extremities by allowing them to move inward when a person is walking and help keep the trunk muscles steady. So, when many athletes begin to make constant repetitive motions while performing, it can cause issues for the adductors. As a common injury to many athletes, adductor strain can put exaggerated stress on the actual tendon, leading to biomechanical abnormalities affecting the musculoskeletal system. (Kiel & Kaiser, 2024a) Also, when athletes start to use constant repetitive motions during an increased volume or intensity of the training workload, it can cause stress factors in the lower extremities. (Kiel & Kaiser, 2024b) This, in turn, can have many individuals feel like they are experiencing hip and groin pain when it is, in fact, stress fractures in the adductor muscles causing myofascial pain. So, for athletic individuals dealing with adductor strain, primary doctors need to differentiate between adductor strain and regular muscle strain in the lower extremities, as the pain symptoms sometimes have overlapping risk profiles with acute onset pain symptoms associated with distinct injury mechanisms. (McHugh et al., 2023) This is because when athletes overuse their adductor muscles, it causes pain, as many injuries within the adductors are associated with the hips and groin region. (Koscso et al., 2022) However, there are ways for athletes to find the relief they seek to reduce adductor strain and return to their routine. 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*
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. 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
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Discover the vicious cycle of myofascial pain syndrome spasm cycles and how it perpetuates muscle tightness and pain. For answers to any questions you may have, call Dr. Jimenez at 915-850-0900 or 915-412-6677