Elbow pain from lifting is a common symptom among individuals who lift weights, heavy objects, children, grocery bags, etc. Depending on the underlying cause, can conservative treatments relieve and heal elbow pain?

Elbow Pain Caused By Lifting

Elbow pain from lifting can result from weight training, repetitive daily tasks, or job duties like lifting small children or heavy objects. Pain can manifest at the sides or the front of the elbow. Most minor injury cases can be treated with ice, rest, and medications at home. However, pain after lifting can also be a sign of a serious injury, such as a tendon rupture/tear.

Minor Pain From Lifting

Lifting puts pressure on the tendons connecting the wrist and upper arm to the bones in the elbow joint. Minor elbow pain can occur from temporary inflammation in any of these structures after lifting an object. Tendonitis occurs when a tendon becomes inflamed, often from overuse or lifting something too heavy, and ranges from mild to severe. Mild tendonitis typically causes pain during the activity and improves with rest. (American Academy of Orthopaedic Surgeons, 2020) Common forms of tendonitis include:

• Tennis elbow - tendonitis on the outside of the elbow
• Golfer's elbow - tendonitis on the inside of the elbow.
• Biceps tendonitis - at the front of the elbow. (Kheiran A. Pandey, A. & Pandey R. 2021)

Self-Care

Self-care can help reduce elbow pain after lifting and include: (American Academy of Orthopaedic Surgeons, 2020)

Ice

• Add ice to the affected area for up to 20 minutes daily to decrease elbow pain.

Rest

• Avoid lifting heavy objects as much as possible when pain is present.

Wearing A Brace

• If the pain is at the tendons on the inside or outside of your elbow, try wearing a wrist brace to limit the use of your wrist muscles that connect to this area.

Stretching

Gently stretching the wrist flexors and extensors can help reduce elbow pain after lifting. Stretches can be performed several times daily, even after symptoms have resolved. (American Academy of Orthopaedic Surgeons, 2024)

• Hold the arm out in front with the palm down. Keep the elbow straight.
• Bend the wrist down so that the fingers are pointing toward the ground.
• With the other hand, gently pull the wrist further down until a stretch is felt along the back of the forearm.
• Hold this position for 15 seconds.
• Repeat five times.
• Next, bend the wrist upward so the fingers point toward the ceiling.
• Using the other hand, gently pull the hand backward until the stretch is felt along the front of the forearm.
• Hold for 15 seconds.
• Repeat five times.

Medication

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage elbow pain caused from lifting and include: (American Academy of Orthopaedic Surgeons, 2023)

• Advil/Motrin - ibuprofen
• Aleve - naproxen
• Bayer - aspirin
• Tylenol - acetaminophen

Healing

Mild cases can improve after a few days of self-care, whereas more pronounced elbow symptoms can take several weeks, months, or even a year. (Kheiran A. Pandey, A. & Pandey R. 2021) If self-care doesn't work, physical therapy may be recommended. A physical therapy team can use various modalities and treatments to help reduce pain and inflammation from elbow injuries. The therapy can include targeted exercises to strengthen weak muscles and stretch tight muscles that might contribute to the condition. In addition, the therapy team will help individuals modify their lifting technique to help prevent further injury.

Moderate to Severe Elbow Pain

In addition to sharp, severe pain, serious elbow pain caused from lifting have distinct symptoms, including: (American Academy of Orthopaedic Surgeons, 2022)

• Bruising
• Swelling
• Elbow weakness that suddenly happens. 

A biceps tendon rupture is a rare but serious injury usually caused from lifting. In addition to other visible signs of the injury, there will be a bulge at the top of the upper arm because the muscle bunches up as it is no longer attached to the elbow. (American Academy of Orthopaedic Surgeons, 2022) Individuals may hear an audible popping sound if an elbow ligament or tendon gets torn while lifting. (Johns Hopkins Medicine, 2024)

Treatment

Treatment depends on the severity of the injury, but most cases resolve on their own with rest and, if necessary, physical therapy. Conditions that cause severe pain require orthopedic surgeon expertise. These physicians specialize in treating musculoskeletal system injuries. Imaging such as X-rays, MRIs, or CT scans are often used to determine the extent of damage. Individuals with tendon or ligament tears in the elbow may need surgery to regain full range of motion and strength in their arm. After surgery, physical therapy will help restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Shoulder Pain Chiropractic Treatment

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Academy of Orthopaedic Surgeons. (2020). Sprains, strains, and other soft-tissue injuries. https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/

Kheiran, A., Pandey, A., & Pandey, R. (2021). Common tendinopathies around the elbow; what does current evidence say?. Journal of clinical orthopaedics and trauma, 19, 216–223. https://doi.org/10.1016/j.jcot.2021.05.021

American Academy of Orthopaedic Surgeons. (2024). Therapeutic exercise program for epicondylitis (tennis elbow/golfer's elbow). https://orthoinfo.aaos.org/globalassets/pdfs/2024-therapeutic-exercise-program-for-lateral-and-medial-epicondylitis.pdf

American Academy of Orthopaedic Surgeons. (2023). What are NSAIDs? https://orthoinfo.aaos.org/en/treatment/what-are-nsaids/

American Academy of Orthopaedic Surgeons. (2022). Biceps tendon tear at the elbow. https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendon-tear-at-the-elbow

Johns Hopkins Medicine. (2024). Ulnar collateral ligament. https://www.hopkinsmedicine.org/health/conditions-and-diseases/ulnar-collateral-ligament-ucl-injuries-of-the-elbow

Therapeutic massage guns are great for athletes and fitness enthusiasts. Can daily massage gun use be incorporated into a daily routine?

Daily Massage Gun Use

Athletes or individuals participating in recreational sports and exercise may consider adding a massage gun to their daily routine. Massage guns create short, repeated bursts of pressure on certain areas of the body. Most massage guns have multiple settings to allow for different preferences and levels of intensity. They can help by warming up the muscles and during recovery. While the benefits are still being researched, daily massage gun therapy can improve the quality of physical activity, exercise, and life.

Benefits

Because massage guns work by softly and repeatedly stimulating or massaging the muscles, they are gentle enough to use daily as long as they are used correctly. They offer several benefits, including increasing physical ability and reducing recovery time. One study found that consistently using a massage gun increased the quality of life in fibromyalgia patients, indicating potential beyond exercise and sports. (Kraft, K., Kanter, S., and Janik, H. 2013) Some of the benefits include:

Decrease Muscle Soreness

Delayed-onset muscle Soreness/DOMS is a feeling of soreness experienced after a workout or intense manual labor. An example is waking up and feeling sore from work or exercising the previous day (National Academy of Sports Medicine, 2024). A study compared the effectiveness of vibration and massage therapy on DOMS. Both were found to be equally effective in preventing delayed onset muscle soreness. (Imtiyaz, S., Veqar, Z., and Shareef, M. Y. 2014)

Help Prevent Muscle Fatigue

Muscle fatigue occurs when the muscles are overworked and cannot function. Reduced muscle performance can lead to shorter workouts and injuries. A study on non-athletic males found that massage therapy helped prevent or reduce muscle fatigue. Researchers also found that different massage gun settings prevented or prolonged the onset of muscle fatigue. (Otadi, K. et al., 2019)

Increase Range of Motion

Range of motion/ROM describes the flexibility of a muscle or joint in the body. When engaging in physical activity or exercise, it is vital to know and consider the range of motion of the joints to ensure proper form and decrease the risk of injury. One study found that massage therapy can improve joint performance by increasing an individual's range of motion. (Lyu, B. J. et al., 2020) The performance of the joints depends in part on the muscles that expand and contract to move it. Another research study found that a five-minute massage on certain muscle groups improved muscle performance and range of motion. (Konrad, A. et al., 2020)

Increase Muscle Strength and Endurance

Muscle strength and endurance are key components of a healthy musculoskeletal system and are essential to avoid straining or overworking muscles. Muscle strength describes the immediate performance of a muscle or muscle group, and muscle endurance describes how long performance can be sustained. (Lyu, B. J. et al., 2020) Massage therapy has been shown to improve muscle strength and endurance by helping increase immediate performance and the number of repetitions an individual can endure. (García-Sillero, M. et al., 2021)

Improve Agility

Agility is the ability to accelerate, decelerate, stabilize, and quickly change directions while maintaining proper posture. (National Academy of Sports Medicine, 2024) It is a skill that needs to be developed. One study found that engaging in massage therapy before a workout could improve agility. (Lyu, B. J. et al., 2020)

Daily Use

A massage gun is safe to use daily as long as it is used properly. Using a massage device correctly will improve effectiveness and prevent discomfort or injury. Recommended daily usage of a massage gun includes:

• Set the massage gun to the lowest setting.
• Use a light touch.
• Adjust the speed to comfort level, ensuring there is no pain.
• Focus the massage gun on an area for 10 to 30 seconds.
• Hover it across the muscle or tendon to allow the vibrations to do their job.
• Do this over the desired areas as part of a warm-up and cool-down.

Safety

While massage guns are useful for warmups and workout recovery, they should be used cautiously. Individuals should use massage guns over muscles and not on bony or sensitive areas. Individuals should avoid massaging around vital organs and/or inflamed body areas as these areas could cause a jarring or uncomfortable sensation and lead to injury. If the massage gun is causing bruising, sensitivity, or discomfort, stop using it and allow the body to recover before trying again. If pain persists, talk to a healthcare provider or a physical therapist. They can determine what is causing issues, whether a massage gun is being used correctly, and whether it is an appropriate self-care treatment for the individual. There are situations where using a massage gun is not advised. Individuals should talk to a healthcare provider before using the device if they have any of the following:

• Have a musculoskeletal condition like osteoporosis or arthritis.
• Take blood thinners.
• Have anemia.
• Have other blood-related conditions.
• Are older than 65.
• Take several medications.
• Have a broken bone or a fracture.
• Have varicose veins or a history of deep vein thrombosis.

Using a massage gun can help improve performance and reduce recovery time and can be incorporated into a daily routine.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic treats patients’ injuries and chronic pain syndromes. We focus on improving ability through flexibility, mobility, and agility programs tailored to the individual. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s care and wellness outcomes. Our providers use an integrated approach to create customized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. Patients who need other treatment will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide our community with the best clinical treatments.

Enhance Your Lifestyle With Chiropractic!

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

Kraft, K., Kanter, S., & Janik, H. (2013). Safety and effectiveness of vibration massage by deep oscillations: a prospective observational study. Evidence-based complementary and alternative medicine : eCAM, 2013, 679248. https://doi.org/10.1155/2013/679248

National Academy of Sports Medicine. Kaminski, J. (2024). Muscle soreness & DOMS. NASM. https://blog.nasm.org/doms-muscle-sorenes

Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS). Journal of clinical and diagnostic research : JCDR, 8(1), 133–136. https://doi.org/10.7860/JCDR/2014/7294.3971

Otadi, K., Ghasemi, M., Jalaie, S., Bagheri, H., Azizian, M., Emamdoost, S., Sarafraz, H., & Sepahvand, M. (2019). A prophylactic effect of local vibration on quadriceps muscle fatigue in non-athletic males: a randomized controlled trial study. Journal of physical therapy science, 31(3), 223–226. https://doi.org/10.1589/jpts.31.223

Lyu, B. J., Lee, C. L., Chang, W. D., & Chang, N. J. (2020). Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study. International journal of environmental research and public health, 17(1), 354. https://doi.org/10.3390/ijerph17010354

Konrad, A., Glashüttner, C., Reiner, M. M., Bernsteiner, D., & Tilp, M. (2020). The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles' Range of Motion and Performance. Journal of sports science & medicine, 19(4), 690–694.

García-Sillero, M., Jurado-Castro, J. M., Benítez-Porres, J., & Vargas-Molina, S. (2021). Acute Effects of a Percussive Massage Treatment on Movement Velocity during Resistance Training. International journal of environmental research and public health, 18(15), 7726. https://doi.org/10.3390/ijerph18157726

National Academy of Sports Medicine. Miller, K. (2024). Speed, agility, and quickess: SAQ. NASM. https://blog.nasm.org/sports-performance/speed-agility-quickness-saq

Skeletal muscles attached to the arms, legs, neck, back, and trunk bones are voluntary and consciously controlled. Weakness or inability to control these muscles can signal a health issue like a neuromuscular disorder or electrolyte imbalance. Can recognizing the symptoms can help healthcare providers develop effective treatment programs?

Voluntary Muscles

Voluntary muscles are the skeletal muscles that attach to bones and control movement of the limbs, head, neck, and body under an individual's conscious control. Skeletal muscles are controlled by neuromuscular signals from the brain that communicate with individual muscle fibers and cause them to contract.

Difference

• Voluntary muscles are skeletal muscles that contract and relax under conscious control.
• These muscles attach to bones and regulate movement of the body.
• Involuntary muscles are not under conscious control.
• Involuntary muscles involve automatic internal processes needed for survival, like controlling blood vessels and organs like the heart, lungs, and digestive system.
• They contract and relax automatically and receive signals from the autonomic nervous system, which regulates internal bodily functions.

Voluntary

Voluntary muscles are skeletal muscles that comprise 40% of the body's weight and 50% to 75% of the body’s proteins. These muscles can convert chemical and mechanical energy to cause voluntary muscle contraction and movement. (Trovato F.M. et al., 2016) Skeletal muscle comprises fascicles or bundled units of multiple muscle fibers or muscle cells. Each muscle fiber consists of a cross-banded structure further divided into myofibrils containing thick myosin and thin actin myofilaments, which give the muscle its stripe appearance, and the structure provides the characteristic striated structure. (Trovato F.M. et al., 2016) Muscle contraction occurs when these myofilaments move closer together, stimulated by the release of the neurotransmitter acetylcholine from nerve cells that communicate with the muscle fiber.

Involuntary

The autonomic nervous system controls involuntary muscles, regulating their contraction and relaxation. This system also controls the activity of organs and blood vessels for essential daily functions, including breathing, circulation, digestion, heartbeat regulation, and urination. Most involuntary muscles are composed of smooth muscles. Smooth muscles do not have the striated structure of skeletal muscles and consist of sheets or layers of smooth muscle cells. When the autonomic nervous system stimulates these muscle cells to contract by releasing hormones or other chemical signals, smooth muscle cells shorten through the movement of actin and myosin myofilaments. Involuntary smooth muscles include the blood vessel walls, diaphragm, intestines, and bladder. (Webb R. C. 2003) One exception of an involuntary muscle is the myocardium, or heart muscle. The myocardium comprises a specialized cardiac muscle cell found only in the heart. Cardiac muscle is striated like skeletal muscle but is controlled by the autonomic nervous system and pacemaker cells, causing it to contract automatically and rhythmically.

Weakened Voluntary Muscles

Skeletal muscle diseases, neuromuscular disorders, and other causes can weaken muscles. Neuromuscular or skeletal muscle disorders affect the nerves that send electrical signals to voluntary skeletal muscles to control movement. When the nerves are damaged, communication between the nerves and muscles becomes disrupted. This can result in significant muscle weakness, atrophy, and loss of function. Most neuromuscular disorders are genetic or caused by issues with the immune system. Nerves communicate with muscles through the release of neurotransmitters at the neuromuscular junction, which is the space between a nerve cell and muscle fiber. Neuromuscular disorders can damage the nerve or the neuromuscular junction. Neuromuscular disorder symptoms can include: (Cleveland Clinic, 2023)

• Numbness and tingling
• Muscle weakness
• Muscle twitches, cramps, or spasms
• Muscle pain
• Muscle atrophy
• Decreased coordination
• Balance problems
• Drooping eyelids and double vision from eye muscle weakness.
• Difficulty swallowing due to weakness of the pharynx.
• Difficulty breathing due to weakness of the diaphragm.

Common Neuromuscular Disorders

Amyotrophic Lateral Sclerosis - ALS

• More commonly known as Lou Gehrig’s disease, it is a genetic disorder that results from hardening of the spinal cord.
• It causes damage to the nerves that control muscles and voluntary movement.

Charcot-Marie-Tooth Disease

• This is a class of peripheral nerve disorders that cause muscle weakness, atrophy, and loss of sensation, most commonly in the legs and feet.
• It is a genetic disorder caused by a gene mutation that damages myelin, or the insulating sheath that surrounds all nerves and supports the conduction of electrical signals.

Multiple Sclerosis - MS

• MS causes degeneration of the myelin sheath surrounding nerves, decreasing the impulses along the nerves to muscles.
• It can result in muscle weakness, which is often more severe on the dominant side of the body.
• There are different forms of MS, but the condition is often progressive and gets worse over time if left untreated.

Muscular Dystrophies

• These are genetic diseases characterized by gradual loss of motor function, muscle weakness and atrophy, walking gait problems, progressive respiratory failure, and cardiomyopathy.
• There are nine types of muscular dystrophy, all caused by genetic mutations.

Myasthenia Gravis

• This is an autoimmune disease that causes inflammation throughout the body.
• An autoimmune disease occurs when the immune system attacks healthy cells by mistake.
• With myasthenia gravis, the body produces antibodies that attack the receptors for acetylcholine, reducing the body’s ability to contract muscles.
• This leads to muscle weakness, atrophy, and fatigue.

Myopathies

• These are diseases of muscles that cause muscle weakness and atrophy.
• Depending on the type, they may progress and get worse over time.

Electrolyte Imbalances

• Muscle weakness can result from altered sodium, potassium, calcium, or magnesium levels.

Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Working with a chiropractic team can help expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Chiropractic Massage Therapy

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Trovato FM, I. M., Conway N, Castrogiovanni P. (2016). Morphological and functional aspects of human skeletal muscle. J Funct Morphol Kinesiol., 1(3), 289-302. https://doi.org/https://doi.org/10.3390/jfmk1030289

Webb R. C. (2003). Smooth muscle contraction and relaxation. Advances in physiology education, 27(1-4), 201–206. https://doi.org/10.1152/advan.00025.2003

Cleveland Clinic. (2023). Mitochondrial diseases. https://my.clevelandclinic.org/health/diseases/15612-mitochondrial-diseases

Can individuals with rheumatoid arthritis incorporate various exercises to reduce joint pain and inflammation in their hands and feet?

Introduction

The joints in the human help provide function, mobility, and flexibility to the upper and lower extremities. The joints are part of the musculoskeletal system and have an outstanding relationship with the muscles, ligaments, and soft tissues that give the body structure and support that lets the individual move around and protects the important organs to function normally. However, when a person is dealing with injuries or illnesses that affect the body’s musculoskeletal function, it can cause pain to the individual. One of the symptoms that often correlate in the joints is chronic inflammation, leading to the development of an autoimmune disease known as rheumatoid arthritis. Today’s article looks at how rheumatoid arthritis affects the joints in the musculoskeletal system and how various exercises can help manage and reduce the symptoms associated with rheumatoid arthritis. We discuss with certified associated medical providers who consolidate our patients’ information to assess rheumatoid arthritis and its associated pain symptoms affecting the joints. We also inform and guide patients while asking their associated medical provider intricate questions to integrate various exercises into their personalized treatment plan to manage the pain correlated with rheumatoid arthritis. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

How RA Affects The Joints

Do you feel pain and tenderness in your joints affecting your daily routine? Do you experience stiffness first thing in the morning, and it goes away throughout the day? Or do you feel fatigued throughout the day, even after a good night’s sleep? Many individuals with these symptoms could be dealing with early development of rheumatoid arthritis in their joints. Now, rheumatoid arthritis is a chronic inflammatory autoimmune disorder that affects the body’s joints but is more prominent on the hands, wrists, and feet. The symptoms of rheumatoid arthritis can develop early or slowly depending on the environmental factors contributing to the development. Since rheumatoid arthritis is categorized as a systemic autoimmune disease, genetic and environmental risk factors that can contribute to rheumatoid arthritis development can trigger overlapping risk profiles on the joints. (Jang et al., 2022) When a person is dealing with the symptoms of rheumatoid arthritis, one of the key pain symptoms that can affect the joints drastically is inflammation. Inflammation is associated with rheumatoid arthritis; it is reflected by joint pain, leading to swelling and subsequent destruction of the cartilage and bone. (Scherer et al., 2020) This causes many individuals to be in constant pain and prevents them from doing any activities.

Additionally, when a few joints are being affected by rheumatoid arthritis in the early stages, some of the symptoms include:

• Fatigue
• Flu-like symptoms
• Swollen & tender joints
• Stiffness

However, when rheumatoid arthritis reaches the later stages in the joints, the autoantigens that are specific to rheumatoid arthritis can lead to a self-perpetuating chronic inflammatory state on the joints, thus causing an expansion on the periarticular bone at the cartilage-bone junction, leading to bone erosion and cartilage degradation. (Lin et al., 2020) Luckily, there are therapeutic options to reduce the pain and inflammatory effects of rheumatoid arthritis and help manage the symptoms that are affecting the joints.

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 Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?

Introduction

The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

What Is Ehlers-Danlos Syndrome?

Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)

The Symptoms

When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.

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 shoulder and upper back pain, could periscapular bursitis be a possible cause?

Periscapular Bursitis

The scapula/shoulder blade is a bone that shifts position with upper body and shoulder movement. The scapula motion is critical to the normal function of the shoulder and the spine. When abnormal or sudden shoulder movements occur, inflammation and pain symptoms can develop. (Augustine H. Conduah et al., 2010)

Normal Scapula Function

The scapula is a triangular bone on the upper back outside the rib cage. Its outer or lateral side contains the shoulder joint socket /glenoid, while the rest of the bone serves as attachment points for the different shoulder and back muscles. The scapula shifts on the rib cage when moving the arm forward and back. This movement is called scapulothoracic motion and is critical to the normal function of the upper extremity and the shoulder joint. When the scapula does not glide in a coordinated motion, the function of the torso and shoulder joints can become stiff and painful. (J. E. Kuhn et al., 1998)

Scapular Bursa

A bursa is a fluid-filled sac that allows smooth, gliding motion between structures, body tissues, bones, and tendons. Bursae are found throughout the body, including those in front of the kneecap, outside the hip, and at the shoulder joint. When a bursa becomes inflamed and irritated, normal movements can become painful. There are bursae around the scapula in the upper back. Two of these bursa sacs are between the bones and the serratus anterior muscle that controls scapular movement on the chest wall. One bursa sac is located on the upper corner of the scapula, close to the spine at the base of the neck, and the other is at the bottom corner of the scapula, close to the mid-back. Either or both bursa sacs can be affected by periscapular bursitis. There are other bursae around the scapula and the surrounding tendons, but the two corner sacs tend to be the primary bursae that develop periscapular bursitis.

Inflammation

When these bursae become inflamed and irritated, swollen, and thickened, the condition known as bursitis results. When bursitis occurs near the scapula, muscle, and shoulder blade movements can lead to discomfort and pain. The most common symptoms of periscapular bursitis include:

• Snapping with movement
• Grinding sensations or crepitus
• Pain
• Tenderness directly over the bursa (Augustine H. Conduah et al., 2010)
• Abnormal scapular sensations and movements

An examination of the scapula may display abnormal movements of the shoulder blade. This can lead to winging, where the shoulder blade is not held correctly to the rib cage and protrudes abnormally. Individuals with winging of the scapula typically have abnormal shoulder joint mechanics because the shoulder's positioning is altered.

Causes

The causes of periscapular bursitis can be varied. The most common is overuse syndrome, where a specific activity is causing irritation to the bursa. These can include:

• Sports-related activities that result from repetitive use.
• Work-related activities that result from repetitive use.
• Traumatic injuries that cause inflammation or irritation to the bursa.

Some conditions can cause abnormal anatomy or bone protuberances, irritating the bursa. One condition is a benign bone growth known as an osteochondroma. (Antônio Marcelo Gonçalves de Souza and Rosalvo Zósimo Bispo Júnior 2014) These growths can project off the scapula, leading to irritation and inflammation.

Treatment

Treatment of periscapular bursitis begins with conservative therapies. Invasive treatments are rarely needed to correct the problem. Treatment can include:

Rest

• The first step is to rest the irritated bursa and settle the inflammation.
• This can take a few weeks and can be accomplished by modifying physical, sports, or work-related activities.

Ice

• Ice is useful for reducing inflammation and controlling pain.
• Knowing how to ice an injury properly can help manage the pain and swelling.

Physical Therapy

• Physical therapy can alleviate the symptoms of inflammation through various exercises and stretches.
• The therapy can improve scapular mechanics so the injury does not become ongoing and recurrent.
• Abnormal movement of the scapula on the rib cage can not only lead to the development of bursitis, but if these abnormal mechanics are not addressed, the problem may recur.

Anti-Inflammatory Medications

• Non-steroidal anti-inflammatory medications are used to control the inflammation in the short term. (Augustine H. Conduah et al., 2010)
• The medications can help block the inflammatory response.
• Before taking any medication, individuals should confirm with their healthcare provider that it is safe.

Cortisone Injections

Successful treatment with a cortisone shot is a sign that surgery will be more effective for individuals who may need surgery.

Cortisone injections can be very helpful in delivering a powerful anti-inflammatory dose directly to the site of inflammation. (Augustine H. Conduah et al., 2010) Cortisone injections should be limited in terms of how many injections are offered to an individual, but in limited doses can be very helpful.

However, cortisone shots should only be performed once the diagnosis is confirmed.

Surgery

• Surgery is seldom necessary but can be effective in individuals who are unable to find relief with conservative treatments.
• Surgery is often used for individuals with abnormal scapular anatomy, like bone growths or tumors.

At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual's ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractor care plans and clinical services are specialized and focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Scapular Winging in Depth

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

Conduah, A. H., Baker, C. L., 3rd, & Baker, C. L., Jr (2010). Clinical management of scapulothoracic bursitis and the snapping scapula. Sports Health, 2(2), 147–155. https://doi.org/10.1177/1941738109338359

Kuhn, J. E., Plancher, K. D., & Hawkins, R. J. (1998). Symptomatic scapulothoracic crepitus and bursitis. The Journal of the American Academy of Orthopaedic Surgeons, 6(5), 267–273. https://doi.org/10.5435/00124635-199809000-00001

de Souza, A. M., & Bispo Júnior, R. Z. (2014). Osteochondroma: ignore or investigate?. Revista brasileira de ortopedia, 49(6), 555–564. https://doi.org/10.1016/j.rboe.2013.10.002

Can individuals with herniated discs find the relief they are looking for from traction therapy or decompression to provide pain relief?

Introduction

The spine allows the individual to be mobile and flexible without feeling pain and discomfort when a person is on the move. This is because the spine is part of the musculoskeletal system that consists of muscles, tendons, ligaments, the spinal cord, and spinal discs. These components surround the spine and have three regions to allow the upper and lower extremities to do their jobs. However, the spine also ages when the body starts to age naturally. Many movements or routine actions can cause the body to be stiff and, over time, can cause the spinal disc to herniate. When this happens, a herniated disc can lead to pain and discomfort in the extremities, thus making individuals deal with a reduced quality of life and pain in three spinal regions. Luckily, there are numerous treatments, like traction therapy and decompression, to alleviate the pain and discomfort associated with herniated discs. Today’s article looks at why herniated discs cause issues in the spine and the effects of how these two treatments can help reduce herniated discs. We talk with certified medical providers who consolidate our patients’ information to assess how a herniated disc in the spine may be the issue causing musculoskeletal pain. We also inform and guide patients on how integrating spinal decompression and traction therapy can help realign the spine and reduce disc herniation that is causing spinal issues. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments as part of their routine to reduce pain and discomfort in their bodies. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Why Herniated Discs Causes Issues In The Spine?

Have you been experiencing constant discomfort in your neck or back that doesn’t allow you to relax? Do you feel tingling sensations in your upper and lower extremities, making grasping objects or walking difficult? Or have you noticed that you are hunching over from your desk or standing and that stretching causes pain? As the spine keeps the body upright, its main components include the moveable vertebrae, the nerve root fibers, and spinal discs to help send neuron signals to the brain to allow movement, cushion the shocked forces on the spine, and be flexible. The spine allows the individual to perform various tasks without pain and discomfort through repetitive movements. However, when the body ages, it can lead to degenerative changes in the spine, causing the spinal disc to herniate over time. A herniated disc is a common degenerative musculoskeletal condition that causes the nucleus pulposus to break through any weak region of the annulus fibrosus and compress the surrounding nerve roots. (Ge et al., 2019) Other times, when repetitive motions start to cause a developing herniated disc, the inner portion of the disc can become desiccated and brittle. In contrast, the outer portion becomes more fibrotic and less elastic, causing the disc to shrink and be narrow. A herniated disc can affect young and old populations as they can have a multifactorial contribution that causes proinflammatory changes to the body. (Wu et al., 2020) 

When many people are dealing with pain associated with a herniated disc, the disc itself goes through morphological change through the characterization of the disc being partial damage, which is then followed by the displacement and herniation of the inner disc portion in the vertebral canal to compress the spinal nerve roots. (Diaconu et al., 2021) This causes symptoms of pain, numbness, and weakness in the upper and lower body portions through nerve impingement. Hence why, many individuals are dealing with referred pain symptoms from their arms and legs that are radiating pain. When nerve compression associated with herniated discs starts to cause pain and discomfort, many individuals begin to seek out treatment to reduce the pain that the herniated disc is causing to provide relief for their bodies.

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 joint pain incorporate acupuncture therapy to manage lupus symptoms and restore body mobility?

Introduction

The immune system is highly important to the body as its main job is to protect vital structures from foreign invaders that can cause pain-like issues and discomfort. The immune system has a healthy relationship with the different body systems, including the musculoskeletal system, as the inflammatory cytokines help heal muscle and tissue damage when the body is injured. Over time, however, when normal environmental and genetic factors start to develop in the body, the immune system will begin to send out these cytokines to healthy, normal cells. To that point, the body starts at risk of developing autoimmune diseases. Now, autoimmune diseases in the body can cause havoc over time when they are not managed, leading to chronic disorders that can cause overlapping symptoms in the musculoskeletal system. One of the most common autoimmune diseases is systemic lupus erythematosus or lupus, and it can cause a person to be in consistent pain and discomfort while correlating with muscle and joint pain. Today’s article looks at the factors and effects of lupus, the burden of joint pain in lupus, and how holistic approaches like acupuncture can help manage lupus while restoring body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how to minimize the pain effects caused by lupus on the joints. We also inform and guide patients on how acupuncture can help manage lupus and combine other therapies to reduce its pain-like symptoms affecting the musculoskeletal system. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating acupuncture therapy to relieve the inflammatory effects of lupus while finding natural ways to restore mobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

The Factors & Effects Of Lupus

Have you been experiencing joint pain in your upper or lower extremities, making it difficult to function throughout the day? Have you been feeling the constant effects of fatigue? Many individuals experiencing these pain-like issues could risk developing systemic lupus erythematosus. In this autoimmune disease, the body’s own immune system mistakenly starts to attack its tissues, thus leading to inflammation and a range of pain-like symptoms. Lupis is tricky to diagnose because of its complex immune dysregulation that can lead to an overproduction of cytokines that can affect the body. (Lazar & Kahlenberg, 2023) At the same time, lupus can affect a diverse population, with symptoms and severity varying depending on how mild or severe the factors affect the body. Lupus can impact various body parts, including the joints, skin, kidneys, blood cells, and other vital body parts and organs, as environmental and hormonal factors can influence its development. (Tsang & Bultink, 2021) Additionally, lupus can be closely associated with other comorbidities that are causing overlapping risk profiles with inflammation that can affect the joints in the musculoskeletal system.

The Burden of Joint Pain In Lupus

Lupus is tricky to diagnose since it often mimics other ailments; the most common pain symptom that lupus affects is the joints. Individuals with lupus experience joint pain, which can cause inflammatory effects and structural damage to the joints, tendons, muscles, and bones, causing pathological abnormalities. (Di Matteo et al., 2021) Since lupus causes inflammatory effects in the joints, many individuals will think that they are experiencing inflammatory arthritis, and it can cause overlapping risk profiles as it is accompanied by lupus, thus causing localized pain in the joints regardless of its origin. (Senthelal et al., 2024) Joint pain in lupus individuals can significantly hinder daily activities, reducing mobility and overall quality of life as they are trying to find relief. 

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 osteoarthritis find the relief they deserve through electroacupuncture to restore knee and hip mobility?

Introduction

The lower extremities provide movement and stability to the body, allowing people to be in motion. The hips, lower back, knees, and feet each have a function to do, and when traumatic issues start to affect the spinal structures, it can cause numerous symptoms to pop up and cause pain-like symptoms. Additionally, degenerative factors are natural to the joints of the lower extremities as many people make repetitive motions to their bodies that lead to the degenerative process. One of the most common degenerative issues that affect the lower extremities is osteoarthritis, which can make many people feel miserable. Today’s article looks at how osteoarthritis affects the lower extremities and how treatments like electroacupuncture reduce inflammation associated with osteoarthritis and restore knee and hip mobility. We talk with certified medical providers who consolidate our patients’ information to understand better how osteoarthritis affects their lower extremities. We also inform and guide patients on how electroacupuncture therapy can help reduce the inflammatory effects of osteoarthritis affecting the hips and knees. We encourage our patients to ask their associated medical providers intricate and important questions about reducing the progression of osteoarthritis through non-surgical treatments. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Osteoarthritis Affecting The Lower Extremities

Have you been dealing with stiffness in your knees, hips, and lower back in the mornings? Do you feel like you are wobbling a bit too much when walking? Or do you think radiating heat and swelling in your knees? When people experience these inflammatory pain issues in their joints, it is due to osteoarthritis, a degenerative joint disorder affecting the cartilage between the bones and the tissue components surrounding the joint. Osteoarthritis is multifactorial, meaning it can be idiopathic or secondary while influenced by heredity factors. (Bliddal, 2020) The most common places where people experience osteoarthritis are the lower back, hand, hips, and, most commonly, the knees. Some of the major environmental factors that contribute to the development of osteoarthritis include:

• Obesity
• Age
• Repetitive motions
• Family history
• Injuries

When people are dealing with osteoarthritis, environmental factors can lead to weight overloading on the joints, which results in compression and inflammation. (Nedunchezhiyan et al., 2022) 

When inflammation is associated with osteoarthritis, it can cause the joints and surrounding muscle tissues to swell and feel hot to the touch. At the same time, osteoarthritis is one of the leading causes of disability that can become a socio-economic issue for many people. (Yao et al., 2023) This is because many individuals with osteoarthritis have comorbidities that are associated with the effects of inflammatory cytokines, which can cause them to be physically inactive and miserable. (Katz et al., 2021) However, there are various ways to reduce the progression of osteoarthritis and reduce the inflammatory effects on the joints. 

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 dealing with plantar fasciitis, every step can be painful. Can taking an integrative approach and utilizing acupuncture help treat this condition and accelerate symptom relief?

Acupuncture Plantar Fasciitis

Plantar fasciitis is when the supportive tissue running under the foot, from the heel to the base of the toes, becomes irritated and painful. The disorder can be difficult to manage, but there are alternative treatment options. Acupuncture plantar fasciitis therapy is one potential method of relief, alleviating pain, and returning the individual to regular activities. Acupuncture involves inserting extremely thin needles into points in the body to restore and balance the normal flow of energy and improve overall health. (Johns Hopkins University. 2024) In traditional Chinese medicine or TCM, the body comprises a series of meridians/channels that supply energy flow or qi/chi.

Facts

Plantar fasciitis is a common disorder affecting the foot. The condition occurs when the plantar fascia, designed to absorb the forces that travel through the arch of the foot, becomes overloaded. When the bottom of the foot is constantly subjected to high amounts of strain, it leads to ligament degeneration, pain, and inflammation. The most common symptom is heel pain, the first thing an individual experiences in the morning or after a long day of work and activities. Anyone can get plantar fasciitis, but those who are more prone to the condition include individuals with:

• Tight calf muscles
• High arches
• Obesity issues
• Who participate in repetitive activities. (American Academy of Orthopaedic Surgeons. 2022)

1. The disorder is first treated conservatively with physical therapy focusing on relieving the pain symptoms and restoring foot and ankle flexibility.
2. Orthotics or custom-fabricated shoe inserts can help protect the foot and correct foot positioning,
3. Night splints help hold the foot in a flexed position at night.
4. Anti-inflammatory medications may also be used. (American Academy of Orthopaedic Surgeons. 2022)

Benefits of Acupuncture

Acupuncture and its effectiveness are still being studied, but there is evidence suggesting that it is beneficial in plantar fasciitis treatment.

• One review found significant pain improvements in individuals who had acupuncture for the condition compared to individuals who received standard treatments like stretching, orthotics, and strengthening. (Anandan Gerard Thiagarajah 2017) The same review also found benefits when comparing acupuncture to a placebo version of the treatment, further reinforcing the findings.
• Another medical review found that acupuncture helped alleviate heel pain and improve daily function when combined with nonsteroidal anti-inflammatory medications/NSAIDs such as ibuprofen or naproxen. (Richard James Clark, Maria Tighe 2012)

Side Effects

While acupuncture plantar fasciitis therapy is beneficial, it is important to remember there can be potential side effects that can include:

• Pain in the area where the needles were placed.
• Bleeding in the area where the needles were placed.
• Bruising or skin discoloration.
• Allergic reaction or contact dermatitis/itchy rash.
• Dizziness or light-headedness.
• Nausea or vomiting (Malcolm W C Chan et al., 2017)

The chances of a serious adverse side effect are relatively low when undergoing acupuncture on the foot.

Acupuncture Points and Sensations

The ways acupuncture works are not yet fully understood, but like other neuromusculoskeletal therapies, the process activates the body's healing properties.

• Inserting a needle into the body’s points stimulates the central nervous system.
• This leads to the release of chemicals in the brain, spinal cord, and muscles that promote healing.
• These same chemicals and reactions also reduce the body’s sensation of pain. (Teng Chen et al., 2020)

Number of Sessions

The amount of sessions that acupuncture takes to provide pain relief varies from person to person and case to case.

• One review found that treating plantar fasciitis weekly with acupuncture produced significant pain relief after four to eight weeks. (Anandan Gerard Thiagarajah 2017)
• This corresponds to another medical review that included a study showing significantly improved pain levels in individuals undergoing weekly acupuncture sessions for four weeks. (Richard James Clark, Maria Tighe 2012)

Individuals are recommended to consult a healthcare provider about personalized treatment plans and if they have a bleeding disorder, are on blood thinner medications, or are pregnant.

Understanding Plantar Fasciitis

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 discuss the subject matter above further, 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

Johns Hopkins University. (2024). Acupuncture (Health, Issue. https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

American Academy of Orthopaedic Surgeons. (2022). Plantar fasciitis and bone spurs. (Diseases and Conditions, Issue. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs

Thiagarajah A. G. (2017). How effective is acupuncture for reducing pain due to plantar fasciitis?. Singapore medical journal, 58(2), 92–97. https://doi.org/10.11622/smedj.2016143

Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 30(4), 298–306. https://doi.org/10.1136/acupmed-2012-010183

Chan, M. W. C., Wu, X. Y., Wu, J. C. Y., Wong, S. Y. S., & Chung, V. C. H. (2017). Safety of Acupuncture: Overview of Systematic Reviews. Scientific reports, 7(1), 3369. https://doi.org/10.1038/s41598-017-03272-0

Chen, T., Zhang, W. W., Chu, Y. X., & Wang, Y. Q. (2020). Acupuncture for Pain Management: Molecular Mechanisms of Action. The American journal of Chinese medicine, 48(4), 793–811. https://doi.org/10.1142/S0192415X20500408

Individuals in post-surgery recovery or dealing with illness or an injury can experience weakened muscles and endurance that can cause temporary loss of sleeping mobility and inability to move around normally because of weakness, decreased range of motion, or pain. Can they benefit from physical therapy to help get back to normal functional mobility?

Sleeping Mobility

For individuals who are hospitalized or homebound from injury, illness, or surgical recovery, a physical therapist will assess various areas of functional mobility. These include transfers - from sitting to standing positions, walking, and sleeping mobility. Sleeping mobility is the ability to perform specific motions while in bed. A therapist can assess sleeping or bed mobility and recommend strategies and exercises to improve movements. (O'Sullivan, S. B., Schmitz, T. J. 2016) A therapist may have the individual use specific devices, like an over-the-bed trapeze or a sliding board, to help move around.

Bed and Sleeping Mobility

When a physical therapist checks mobility, they will assess various motions that include: (O'Sullivan, S. B., Schmitz, T. J. 2016)

• Moving from sitting to lying down.
• Moving from lying down to sitting up.
• Rolling over.
• Scooting or sliding up or down.
• Scooting or sliding sideways.
• Twisting.
• Reaching.
• Raising the hips.

All of these movements require strength in different muscle groups. By checking out individual motions in sleeping mobility, a therapist can work out specific muscle groups that may be weak and require targeted exercises and stretches to restore mobility to normal. (O'Sullivan, S. B., Schmitz, T. J. 2016) Individuals visiting a therapist in an outpatient clinic or rehabilitation area may have the individual work on sleeping mobility on a treatment table. The same motions on the treatment table can be done in the bed.

Importance

The body is meant to move. For individuals who cannot move comfortably on their bed, the body may suffer disuse atrophy or the wasting away of muscular strength, which can lead to increased difficulties. Not being able to move can also lead to pressure ulcers, especially for individuals who are severely deconditioned and/or remain in one position for a long period. Skin health may start to break down, leading to painful wounds that require specialized care. Being able to move around in bed can help prevent pressure ulcers. (Surajit Bhattacharya, R. K. Mishra. 2015)

Improvement

A physical therapist can prescribe specific exercises to strengthen muscle groups and improve sleeping mobility.  The muscles include:

• Shoulder and rotator cuff muscles.
• Triceps and biceps in the arms.
• Gluteus muscles of the hips.
• Hamstrings
• Quadriceps
• Calf muscles

The shoulders, arms, hips, and legs work together when moving the body around the bed.

Various Exercises

To improve bed movement, physical therapy exercises can include:

• Upper extremity exercises
• Lower trunk rotation
• Glute exercises
• Bridges
• Leg raises
• Short arc quads
• Ankle pumps

Physical therapists are trained to assess these motions and functions and prescribe treatments to improve body movement. (O'Sullivan, S. B., Schmitz, T. J. 2016) Maintaining appropriate physical fitness can help the body stay active and mobile. Performing mobility exercises prescribed by a physical therapist can keep the right muscle groups working properly, and working with a physical therapist can ensure the exercises are correct for the condition and are performed properly.

Optimizing Your Wellness

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

O'Sullivan, S. B., Schmitz, T. J. (2016). Improving Functional Outcomes in Physical Rehabilitation. United States: F.A. Davis Company.

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 48(1), 4–16. https://doi.org/10.4103/0970-0358.155260

Individuals with plantar fasciitis may experience consistent flare-ups. Can knowing the causes help to find pain relief?

Plantar Fasciitis Flare-Up

Plantar fasciitis is a common cause of heel and foot pain. The plantar fascia is a band of tissue that runs along the bottom of the foot and becomes inflamed. Certain factors can cause plantar fasciitis flare-ups, including:

• Increased levels of physical activity. 
• Not stretching regularly.
• Wearing shoes without proper support.
• Weight gain.

Causes

A plantar fasciitis flare-up is often triggered by physical activity. (MedlinePlus. U.S. National Library of Medicine. 2022) It can also be brought on by underlying conditions, like increased body weight, arthritis, or the shape of the foot. (Johns Hopkins Medicine. 2023) Despite the root cause, there are activities and experiences that can contribute to and/or worsen the condition.

New Exercise Routine

• Being highly physically active can exacerbate plantar fasciitis symptoms.
• A plantar fasciitis flare-up can happen after a sudden increase in activity, like starting a new exercise program or adding new exercises to a routine. (MedlinePlus. U.S. National Library of Medicine. 2022)
• Walking or running on uneven surfaces or downhill can be a trigger. (Johns Hopkins Medicine. 2023)
• Minimizing physical activity and time standing can help.
• If this is not possible, wearing cushioned shoes with arch support can help minimize pain. (Johns Hopkins Medicine. 2023)

Weight Gain

• Individuals who have an increased or increasing body weight add more pressure to their feet, placing them at higher risk for plantar fasciitis. (MedlinePlus. U.S. National Library of Medicine. 2022)
• If experiencing consistent flare-ups, a healthcare provider may suggest an appropriate weight loss program combined with a treatment plan.

Pregnancy

• Rapid weight gain can cause a plantar fasciitis flare-up, including during pregnancy. (Boston Children's Hospital. 2023)

Shoes Without Support

• Wearing shoes without arch support can cause general foot pain and plantar flare-ups.
• Individuals should wear shoes with plenty of cushioning and arch support, like sneakers. (Ortho Info. Academy of Orthopaedic Surgeons. 2022)
• Shoes that are not recommended include:
• Flip-flops
• Shoes that are flat.
• High heels, boots, or shoes that raise the heel above the toes.
• Worn-out shoes like exercise workout shoes.

Not Stretching Properly or At All

• Tight calves can increase pressure on the plantar fascia.
• Stretching the calves, Achilles tendon/heel, and the bottom of the feet is highly recommended to help treat and prevent the condition. (Johns Hopkins Medicine. 2023)
• Not stretching thoroughly or skipping stretches can worsen symptoms.
• Individuals with plantar fasciitis are recommended to stretch before and after physical activities, exercise, before going to bed, and after waking up.

Working Through the Pain

• Individuals may try to continue physical activities during a flare-up.
• This is not recommended as doing so can cause more pain and worsen the condition.
• When pain presents, it’s recommended to:
• Stop all activities that strain the feet
• Stay off the feet for at least a week.

Tearing the Plantar Fascia

• The plantar fascia rarely tear completely from repeated stress known as a plantar fascia rupture.
• If this happens, sudden severe pain will present and individuals are advised to call their healthcare provider. (Stephanie C. Pascoe, Timothy J. Mazzola. 2016)
• However, individuals can recover relatively fast, and pain alleviates quickly.
• Individuals with tears will be recommended to wear a foot orthotic as the foot may have flattened more.

Risk Factors

Plantar fasciitis can happen to anyone, but individuals who have the following characteristics are at an increased risk: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

• A high-foot arch.
• Jobs or hobbies that place added strain on the feet.
• Tight calf muscles.
• A sudden increase in physical activity.
• A new exercise regimen.
• Increased body weight.
• Sudden weight gain like during pregnancy.

How Long Does a Flare Last?

• Plantar fasciitis can become chronic if untreated.
• With treatment, 90% of cases will improve within 10 months. (Ortho Info. Academy of Orthopaedic Surgeons. 2022)
• During a flare-up, stay off the feet as much as possible.

Treatment

 In addition to rest treatments for plantar fasciitis can include: (Ortho Info. Academy of Orthopaedic Surgeons. 2022)

Ice

• Icing the bottom of the foot for 15 minutes a few times a day decreases inflammation.

Nonsteroidal anti-inflammatory drugs - NSAIDs

• Over-the-counter NSAIDs like ibuprofen and naproxen, can reduce pain and inflammation.
• It is recommended to consult a healthcare provider for short-term use and dosage.

Proper Shoes

• Shoes with arch supports are highly recommended.
• A healthcare provider can order custom orthotics for more support.

Stretching

• Stretches are essential for treatment.
• Stretching the calf and bottom of the foot daily will keep the tissue relaxed.

Massages

• Massaging the area with a therapeutic massage ball soothes the tissues.
• Using a percussive massager can increase circulation.

What is Plantar Fasciitis?

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

MedlinePlus. National Library of Medicine.  (2022) U.S. Plantar fasciitis.

Johns Hopkins Medicine. (2023) Plantar fasciitis.

Boston Children's Hospital. (2023) Plantar fasciitis.

Ortho Info. Academy of Orthopaedic Surgeons. (2022) Plantar fasciitis and bone spurs.

Pascoe, S. C., & Mazzola, T. J. (2016). Acute Medial Plantar Fascia Tear. The Journal of orthopaedic and sports physical therapy, 46(6), 495. https://doi.org/10.2519/jospt.2016.0409

For individuals with a broken collarbone, can conservative treatment help in the rehabilitation process?

Broken Collarbone

Broken collarbones are very common orthopedic injuries that can occur in any age group. Also known as the clavicle, it is the bone over the top of the chest, between the breastbone/sternum and the shoulder blade/scapula. The clavicle can be easily seen because only skin covers a large part of the bone. Clavicle fractures are extremely common, and account for 2% - 5% of all fractures. (Radiopaedia. 2023) Broken collarbones occur in:

• Babies - usually during birth.
• Children and adolescents - because the clavicle does not fully develop until the late teens.
• Athletes - because of the risks of being hit or falling.
• Through various types of accidents and falls.
• The majority of broken collarbones can be treated with nonsurgical treatments, usually, with a sling to let the bone heal and physical therapy and rehabilitation.
• Sometimes, when clavicle fractures are significantly shifted out of alignment, surgical treatment may be recommended.
• There are treatment options that should be discussed with an orthopedic surgeon, physical therapist, and/or a chiropractor.
• A broken collarbone is not more serious than other broken bones.
• Once the broken bone heals, most individuals have a full range of motion and can return to the activities before the fracture. (Johns Hopkins Medicine. 2023)

Types

Broken clavicle injuries are separated into three types depending on the location of the fracture. (Radiopaedia. 2023)

Mid-Shaft Clavicle Fractures

• These occur in the central area which can be a simple crack, separation, and/or fractured into many pieces.
• Multiple breaks - segmental fractures.
• Significant displacement - separation.
• Shortened length of the bone.

Distal Clavicle Fractures

• These happen close to the end of the collarbone at the shoulder joint.
• This part of the shoulder is called the acromioclavicular/AC joint.
• Distal clavicle fractures can have similar treatment options as an AC joint injury.

Medial Clavicle Fractures

• These are less common and often related to injury to the sternoclavicular joint.
• The sternoclavicular joint supports the shoulder and is the only joint that connects the arm to the body.
• Growth plate fractures of the clavicle can be seen into the late teens and early 20s.

Symptoms

Common symptoms of a broken collarbone include: (National Library of Medicine: MedlinePlus. 2022)

• Pain over the collarbone.
• Shoulder pain.
• Difficulty moving the arm.
• Difficulty raising the arm from the side.
• Swelling and bruising around the shoulder.
• The bruising can extend down to the chest and armpit.
• Numbness and tingling down the arm.
• Deformity of the collarbone.

1. In addition to the swelling, some individuals may have a bump in the place where the fracture occurred.
2. It can take several months for this bump to fully heal, but this is normal.
3. If the bump appears inflamed or irritated, inform a healthcare provider.

Clavicular Swelling

• When the sternoclavicular joint swells up or gets bigger, it is referred to as clavicular swelling.
• It is commonly caused by trauma, disease, or an infection that affects the fluid found in the joints. (John Edwin, et al., 2018)

Diagnosis

• At the healthcare clinic or emergency room, an X-ray will be obtained to assess for the specific type of fracture.
• They will perform an examination to ensure the nerves and blood vessels surrounding the broken collarbone are unsevered.
• The nerves and vessels are rarely injured, but in severe cases, these injuries can occur.

Treatment

Treatment is accomplished either by allowing the bone to heal or by surgical procedures to restore the proper alignment. Some common treatments for broken bones are not used for clavicle fractures.

• For example, casting a broken collarbone is not done.
• In addition, resetting the bone or a closed reduction is not done because there is no way to hold the broken bone in proper alignment without surgery.

If surgery is an option the healthcare provider looks at the following factors: (UpToDate. 2023)

Location of Fracture and Degree of Displacement

• Nondisplaced or minimally displaced fractures are usually managed without surgery.

Age

• Younger individuals have an increased ability to recover from fractures without surgery.

Shortening of the Fracture Fragment

• Displaced fractures can heal, but when there is a pronounced shortening of the collarbone, surgery is probably necessary.

Other Injuries

• Individuals with head injuries or multiple fractures can be treated without surgery.

Patient Expectations

• When the injury involves an athlete, heavy job occupation, or the arm is the dominant extremity, there can be more reason for surgery.

Dominant Arm

• When fractures occur in the dominant arm, the effects are more likely to be noticeable.

The majority of these fractures can be managed without surgery, but there are situations where surgery can produce better results.

Supports for Non-surgical Treatment

• A sling or figure-8 clavicle brace.
• The figure-8 brace has not been shown to affect fracture alignment, and many individuals generally find a sling more comfortable. (UpToDate. 2023)

1. Broken collarbones should heal within 6–12 weeks in adults
2. 3–6 weeks in children
3. Younger patients are usually back to full activities before 12 weeks.
4. The pain usually subsides within a few weeks. (4
5. Immobilization is rarely needed beyond a few weeks, and with a doctor's clearance light activity and gentle motion rehabilitation usually begins.

Long-Lasting Injuries

General Disclaimer *

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

Radiopaedia. Clavicular fracture.

Johns Hopkins Medicine. Clavicle fractures.

National Library of Medicine: MedlinePlus. Broken collarbone - aftercare.

UpToDate. Clavicle fractures.

Edwin, J., Ahmed, S., Verma, S., Tytherleigh-Strong, G., Karuppaiah, K., & Sinha, J. (2018). Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT open reviews, 3(8), 471–484. https://doi.org/10.1302/2058-5241.3.170078

Individuals with hip bursitis often experience discomfort during physical activity, walking, and pain when lying on the affected side. What treatment options are available to control and manage the condition?

Hip Bursitis

Hip bursitis, also known as trochanteric bursitis, is a common condition that causes pain and discomfort in the hip and upper thigh along the outside of the hip joint. It occurs when one of the hip's bursae, or fluid-filled sacs cushion joints, becomes inflamed. Treatment for hip bursitis is to control the inflammation caused by this condition.

Causes

Hip bursitis can be caused by injury or overuse of the hip, such as repetitive activities, twisting, or rapid joint movement. It can also be caused by a direct blow or fall to the side of the hip.

Symptoms

• Pain from hip bursitis can be sharp at first and may feel dull and achy later.
• It may be worse when standing up after sitting, moving, or using the hip.
• Individuals may also notice pain when lying on the affected side or sitting for a long time.

Rest

This means a period of not participating in physical, exercise, and sports activities that aggravate symptoms. Any activity that causes hip pain should be avoided as this only contributes to inflammation of the bursa. (American Academy of Orthopaedic Surgeons, 2022) Modifying how particular activities are performed can help alleviate pressure on the inflamed bursa. Working with a physical therapist can also be recommended. They are experts in movement and alignment, and if certain muscles are overused compared to others, this can lead to unhealthy movement patterns, causing bursa irritation.

Anti-Inflammatory Medications

Nonsteroidal anti-inflammatory drugs, such as Motrin, Aleve, Naprosyn, etc., will help control inflammation (American Academy of Orthopaedic Surgeons, 2022). Anti-inflammatory medications can be extremely effective but should be taken cautiously. The instructions on the label need to be followed unless directed otherwise by a healthcare provider. Be aware of side effects and inform the healthcare provider if side effects present.

Cold Therapy

Applying ice to the hip area often helps alleviate the symptoms (National Library of Medicine, 2022). Ice can control inflammation by decreasing blood circulation to the area, especially after physical activity and exercise.

Aspiration

A needle is placed into the bursa to drain the fluid for those with a significant amount of fluid collected within the bursa. (National Library of Medicine, 2022) This is rarely needed in cases of hip bursitis, but when it is done, it can be combined with a cortisone injection.

Cortisone Injections

A cortisone injection may also be given into the bursa to alleviate pain. (American Academy of Orthopaedic Surgeons, 2022) The cortisone injection is helpful because it can be a diagnostic and therapeutic tool. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if it helps alleviate symptoms. Cortisone is a powerful anti-inflammatory medication that can be administered directly to the problem area. These injections are well-tolerated, but there can be possible side effects. Once the initial symptoms are under control, physical therapy strengthening and stretching exercises may be recommended.

Stretching

Most find relief by stretching the muscles and tendons over the outside of the hip, specifically the iliotibial band. The goal is for a better-conditioned muscle and tendon to glide more easily and not cause inflammation. Proper stretching techniques and posture are important in re-injury prevention.

Physical Therapy

Working with a physical therapist is an effective treatment adjunct for bursitis (American Academy of Orthopaedic Surgeons, 2022). Physical therapists correct muscle imbalances through stretching and exercise and improve alignment to prevent bursa irritation from reoccurring.

Surgery

Most patients get better with conservative treatment within about six weeks. Surgical treatment for hip bursitis is rarely needed (UCSF Health, 2024). Those who do not rest from their activities until the inflammation subsides often have a return of bursitis symptoms, and those who return too aggressively to activities and do not gradually build up also find that their symptoms return. In cases where surgery is needed, the healthcare provider may recommend an arthroscopic bursectomy. (American Academy of Orthopaedic Surgeons, 2022) The surgery is an outpatient minimally invasive procedure in which the bursa is removed through a small incision. After a short healing period, the individual can return to normal activity. Crutches may be used for a few days. Common complications are anesthetic-related complications and infection.

Injury Medical Chiropractic and Functional Medicine Clinic

As with any treatment program, always talk with your healthcare provider before initiating specific treatments. Fortunately, treatment of hip bursitis is generally accomplished with conservative therapies. Efforts to limit pressure directly on the bursa, alleviate inflammation, and restore normal movement to the hip joint will typically resolve symptoms. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate into a treatment plan to improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

The Chiropractic Approach for Pain Relief

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 Orthopaedic Surgeons. (2022). Hip bursitis. https://orthoinfo.aaos.org/en/diseases--conditions/hip-bursitis

National Library of Medicine. (2022). Bursitis: Learn More – How can bursitis be treated? InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK525763/

UCSF Health. (2024). Trochanteric bursitis treatments. https://www.ucsfhealth.org/conditions/trochanteric-bursitis

Individuals with inflammation, pain, and swelling on the tops of their feet or hands could be experiencing extensor tendonitis. What treatment options are available?

Extensor Tendonitis

These tendons attach to muscles that straighten the fingers and lift the toes and the top of the foot. Extensor tendonitis is characterized by inflammation of the tendons on the tops of the hands and feet. It often results from overuse of the muscles and from wearing tight shoes. Symptoms tend to worsen with activity and improve with rest. The condition does not usually require surgery; treatments include medications, home remedies/activity modification, and physical therapy.

Types

Tendonitis can develop in any tendon of the extensor muscles. These tendons are long, thin bands of tissue that can be felt on the tops of the hands and feet. The structures attach to muscles on one end and bones of the fingers and toes on the other. The extensor tendons in the hands include: (American Society for Surgery of the Hand, 2024)

• The extensor digitorum communis straightens the index, middle, ring, and small fingers.
• The extensor digiti minimi straightens the small finger.
• The extensor indicis proprius straightens the index finger.
• The extensor pollicis longus and extensor pollicis brevis muscles move the thumb into the thumb-up position.

Extensor tendons on the top of the foot attach to: (American Society for Surgery of the Hand, 2024)

• The extensor digitorum longus and extensor digitorum brevis muscles lift the second, third, fourth, and fifth toes.
• The extensor hallucis longus lifts the big toe.

Tendonitis vs Tendinopathy

• Chronic tendon pain can lead to a condition known as tendinopathy.
• Tendonitis results from inflammation.
• Tendinopathy is the degeneration/micro-tearing of a tendon that occurs with long-term overuse.
• Knowing which condition you are dealing with is important because it requires different treatments.

Symptoms

The primary symptom is pain in the affected tendon/s. Individuals may also experience swelling, and the skin can become red or warm to the touch. Extensor tendonitis can cause pain when using the affected muscles, moving the hand or foot in the opposite direction, and stretching the tendons. Usually, the pain worsens when using the affected muscles and improves with rest.

Causes

Extensor tendonitis in the hands usually results from overuse, which causes inflammation. However, it can also result from trauma, such as falling on the hand or an injury during physical or sports activities. Common activities include: (Hanson Z. C., and Lourie G. M. 2022)

• Manual labor work
• Typing
• Computer mouse use
• Weightlifting
• Gymnastics
• Playing a musical instrument

Extensor tendonitis in the foot can also result from overuse activities like running, especially uphill. However, it can also occur from wearing overly tight or tightly laced shoes for physical activities like running or dancing. Less common causes include: (Arthritis Foundation, N.D.)

• Medical conditions like diabetes or arthritis
• Medication side effects 
• Infection
• Joint deformities

Treatment

Extensor tendonitis usually improves with conservative treatment, which includes self-care, activity modification, physical therapy, and medication.

Medications

Individuals can treat inflammation with non-steroidal anti-inflammatory drugs NSAIDs like:

• Ibuprofen
• Naproxen
• Aspirin
• Acetaminophen can help reduce pain.
• In some cases, individuals may need prescription anti-inflammatory medications like corticosteroids or pain relievers for short-term use.

Self-Care and Activity Adjustments

Self-care includes:

• Rest and avoid any activities that increase pain symptoms. If you can't avoid them completely, take frequent breaks to allow the muscles to relax.
• Apply ice to the hand or foot several times daily for up to 20 minutes.
• Compression wraps should be applied on the foot or hand using an elastic bandage or soft splint to help support the injured tendons and reduce swelling.
• Elevate the hand or foot if swollen above the heart level when resting.

Activity Adjustments

• Modifying activities can help address the underlying cause/s.
• Hand extensor tendonitis can develop from poor positioning.
• Setting up an ergonomic workstation can help.
• Consult a coach or trainer if the tendonitis is related to sports or exercise.
• Individuals might need to adjust their technique or training schedule to decrease pressure on the tendons.

Physical Therapy

Physical therapy is an effective treatment. A therapy team can help determine the condition's underlying cause and provide a personalized treatment program. Interventions can include:

• Pain-reducing treatments like ultrasound, electrical stimulation, electroacupuncture, and laser therapy.
• Manual therapy
• Massage therapies
• Targeted exercise programs
• Prescription of orthotics like a hand splint or shoe inserts.

Surgery

Surgery is not necessary unless the tendon is torn. (Bronner S., Ojofeitimi S., and Rose D. 2008) (American Society for Surgery of the Hand, 2014) Recovery after surgical repair requires physical therapy treatment following specific protocols based on the patient's case.

Prognosis

Extensor tendonitis can take weeks or even months to fully heal. Early diagnosis and determining the condition's underlying cause rather than just treating symptoms are recommended for a faster and optimal recovery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers if other treatments are needed.

Move Better, Live Better, with Chiropractic

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 Society for Surgery of the Hand. (2024). Tendons. https://www.assh.org/handcare/safety/tendons#Finger%20Extensor

Hanson, Z. C., & Lourie, G. M. (2022). Middorsal Wrist Pain in the High-Level Athlete: Causes, Treatment, and Early Return to Play. Orthopaedic journal of sports medicine, 10(4), 23259671221088610. https://doi.org/10.1177/23259671221088610

Arthritis Foundation. Foundation, A. (N.D.). Tendinitis. https://www.arthritis.org/diseases/tendinitis

Bronner, S., Ojofeitimi, S., & Rose, D. (2008). Repair and rehabilitation of extensor hallucis longus and brevis tendon lacerations in a professional dancer. The Journal of orthopaedic and sports physical therapy, 38(6), 362–370. https://doi.org/10.2519/jospt.2008.2749

American Society for Surgery of the Hand. (2014). Extensor tendon injury. https://www.assh.org/handcare/condition/extensor-tendon-injury#:~:text=The%20tendon%20may%20take%20eight%20to%20twelve%20weeks,may%20include%20stitches%20%28for%20cuts%20in%20the%20tendon%29.

Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?

Introduction

The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Osteoarthritis Affecting Joint Mobility

Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.

Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.

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 provide beneficial results for individuals experiencing TMJ pain by providing relief to the jaw?

Introduction

Many individuals use their jaws to communicate with one another, eat delicious food, and express themselves. The jaw is part of the upper extremities as it has five muscles that allow it to function when the mouth is opening or closing, chewing, and moving from side to side. When common motor functions like yawning, chewing, or speaking produce loud pops or clicks, it can become very painful and more often lead to temporomandibular joint dysfunction or TMJ. TMJ is a joint disorder that can affect a person’s ability to use their jaws properly and can lead to visceral-somatic disorders that can affect the upper extremities, causing them to be miserable. Luckily, many individuals can incorporate various stretches to reduce the impact of TMJ and help relax the stiff muscles around the jaw. Today’s article looks at the effects of TMJ, how various stretches can effectively reduce TMJ, and how additional non-surgical treatments can relieve TMJ pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues associated with TMJ. We also inform and guide patients on various stretches for TMJ and ask their associated medical providers intricate questions to integrate a customized treatment plan to reduce the pain-like issues affecting their jaws. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

The Effects of TMJ

Do you feel stiffness in your jaw after clenching for an extended period? Do you hear excessive loud clicks when opening or closing your jaw? Or do you think your jaw is locking up constantly, making it difficult to open or close your mouth? When many individuals start to feel pain around their jaws excessively, many would often think that it could be tooth pain, but in actuality, it is the temporomandibular joint that is causing the issues. Temporomandibular joint disorder, or TMJ, can be developed through various causes that can impact a person’s jaw and can lead to pain and discomfort. Mechanical factors like jaw injuries, arthritis, teeth clenching, and grinding can cause excessive or unbalanced joint loading to the jaw, which can progress the development of TMJ. (Cardoneanu et al., 2022) When dealing with TMJ, pain can lead to symptoms of tenderness around the joint area of the jaw, difficulty chewing, ear pain, and stiffness.

At the same time, the effects of TMJ pain are often characterized by localized discomfort, as TMJ is a multifactorial musculoskeletal and neuromuscular disorder that can be difficult to diagnose. (Alolayan et al., 2022) This is because of how many individuals chew their foods on one side, which can lead to its development. When the masseter muscles of the jaw begin to overload on the TMJ, it can initiate remodeling on the non-working side of the jaw and cause the pain to flourish over time. (Santana-Mora et al., 2013) However, when dealing with TMJ pain, many individuals can seek out various treatment options that can reduce muscular impairment and disc displacement from the jaw and help improve the mandibular range of motion. (Brighenti et al., 2023) 

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 understanding the body's hinge joints and how they operate help with mobility and flexibility problems and manage conditions for individuals with difficulty fully bending or extending their fingers, toes, elbows, ankles, or knees?

Hinge Joints

A joint forms where one bone connects to another, allowing motion. Different types of joints differ in structure and movement depending on their location. These include hinge, ball and socket, planar, pivot, saddle, and ellipsoid joints. (Boundless. General Biology, N.D.) Hinge joints are synovial joints that move through one plane of motion: flexion and extension. Hinge joints are found in the fingers, elbows, knees, ankles, and toes and control movement for various functions. Injuries, osteoarthritis, and autoimmune conditions can affect hinge joints. Rest, medication, ice, and physical therapy can help alleviate pain, improve strength and range of motion, and help manage conditions.

Anatomy

A joint is formed by the joining of two or more bones. The human body has three main classifications of joints, categorized by the degree to which they can move. These include: (Boundless. General Biology, N.D.)

Synarthroses

• These are fixed, immovable joints.
• Formed by two or more bones.

Amphiarthroses

• Also known as cartilaginous joints.
• A fibrocartilage disc separates the bones that form the joints.
• These movable joints allow for a slight degree of movement.

Diarthroses

• Also known as synovial joints.
• These are the most common freely mobile joints that allow movement in multiple directions.
• The bones that form the joints are lined with articular cartilage and enclosed in a joint capsule filled with synovial fluid that allows for smooth motion.

Synovial joints are classified into different types depending on differences in structure and the number of motion planes they allow. A hinge joint is a synovial joint that allows movement in one plane of motion, similar to a door hinge that moves forward and backward. Within the joint, the end of one bone is typically convex/pointed outward, with the other concave/rounded inward to allow the ends to fit smoothly. Because hinge joints only move through one plane of movement, they tend to be more stable than other synovial joints. (Boundless. General Biology, N.D.) Hinge joints include:

• The finger and toe joints - allow the fingers and toes to bend and extend.
• The elbow joint - allows the elbow to bend and extend.
• The knee joint - allows the knee to bend and extend.
• The talocrural joint of the ankle - allows the ankle to move up/dorsiflexion and down/plantarflexion.

Hinge joints allow the limbs, fingers, and toes to extend away and bend toward the body. This movement is essential for activities of daily living, such as showering, getting dressed, eating, walking, standing up, and sitting down.

Conditions

Osteoarthritis and inflammatory forms of arthritis can affect any joint (Arthritis Foundation. N.D.) Autoimmune inflammatory forms of arthritis, including rheumatoid and psoriatic arthritis, can cause the body to attack its joints. These commonly affect the knees and fingers, resulting in swelling, stiffness, and pain. (Kamata, M., Tada, Y. 2020) Gout is an inflammatory form of arthritis that develops from elevated levels of uric acid in the blood and most commonly affects the hinge joint of the big toe. Other conditions that affect hinge joints include:

• Injuries to the cartilage within the joints or ligaments that stabilize the outside of the joints.
• Ligament sprains or tears can result from jammed fingers or toes, rolled ankles, twisting injuries, and direct impact on the knee.
• These injuries can also affect the meniscus, the tough cartilage within the knee joint that helps cushion and absorb shock.

Rehabilitation

Conditions that affect hinge joints often cause inflammation and swelling, resulting in pain and limited mobility. After an injury or during an inflammatory condition flare-up, limiting active movement and resting the affected joint can reduce increased stress and pain.

• Applying ice can decrease inflammation and swelling.
• Pain-relieving medications like NSAIDs can also help reduce pain. (Arthritis Foundation. N.D.)
• Once the pain and swelling start to subside, physical and/or occupational therapy can help rehabilitate the affected areas.
• A therapist will provide stretches and exercises to help improve the joint range of motion and strengthen the supporting muscles.
• For individuals experiencing hinge joint pain from an autoimmune condition, biologic medications to decrease the body’s autoimmune activity are administered through infusions delivered every several weeks or months. (Kamata, M., Tada, Y. 2020)
• Cortisone injections may also be used to decrease inflammation.

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

Chiropractic Solutions

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Boundless. General Biology. (N.D.). 38.12: Joints and Skeletal Movement - Types of Synovial Joints. In. LibreTexts Biology. https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Book%3A_General_Biology_%28Boundless%29/38%3A_The_Musculoskeletal_System/38.12%3A_Joints_and_Skeletal_Movement_-_Types_of_Synovial_Joints

Arthritis Foundation. (N.D.). Osteoarthritis. Arthritis Foundation. https://www.arthritis.org/diseases/osteoarthritis

Kamata, M., & Tada, Y. (2020). Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review. International journal of molecular sciences, 21(5), 1690. https://doi.org/10.3390/ijms21051690

Can individuals with joint hypermobility find relief through nonsurgical treatments in reducing pain and restoring body mobility?

Introduction

When a person moves their body, the surrounding muscles, joints, and ligaments are incorporated into various tasks that allow them to stretch and be flexible without pain or discomfort. Many repetitive motions enable the individual to continue their routine. However, when the joints, muscles, and ligaments are stretched farther than normal in the upper and lower extremities without pain, it is known as joint hypermobility. This connective tissue disorder can correlate with other symptoms that affect the body and cause many people to seek treatment to manage joint hypermobility symptoms. In today’s article, we will look at joint hypermobility and how various non-surgical treatments can help reduce pain caused by joint hypermobility and restore body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how their pain may be associated with joint hypermobility. We also inform and guide patients on how integrating various non-surgical treatments can help improve joint function while managing the associated symptoms. We encourage our patients to ask their associated medical providers intricate and insightful questions about incorporating non-surgical therapies as part of their routine to reduce pain and discomfort from joint hypermobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

What Is Joint Hypermobility?

Do you often feel your joints locked up in your hands, wrists, knees, and elbows? Do you experience pain and fatigue in your joints when your body feels constantly tired? Or when you stretch your extremities, do they extend farther than usual to feel the relief? Many of these various scenarios are often correlated with individuals experiencing joint hypermobility. Joint hypermobility is an inherited disorder with autosomal dominant patterns that characterize joint hyperlaxity and musculoskeletal pain within the body extremities. (Carbonell-Bobadilla et al., 2020) This connective tissue condition is often related to the flexibility of the connected tissues like ligaments and tendons in the body. An example would be if a person’s thumb is touching their inner forearm without feeling pain or discomfort, they have joint hypermobility. Additionally, many individuals dealing with joint hypermobility will often have a difficult diagnosis as they will develop skin and tissue fragility over time, causing musculoskeletal complications. (Tofts et al., 2023)

When individuals deal with joint hypermobility over time, many often have symptomatic joint hypermobility. They will present with musculoskeletal and systemic symptoms that lead to displaying skeletal deformities, tissue and skin fragility, and structural differences in the body’s system. (Nicholson et al., 2022) Some of the symptoms that joint hypermobility are shown in a diagnosis include:

• Muscle pain and joint stiffness
• Clicking joints
• Fatigue
• Digestive issues
• Balance issues

Luckily, there are various treatments that many people can use to help restrengthen the surrounding muscles around the joints and reduce the correlating symptoms caused by joint hypermobility. 

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 sacroiliac joint/SIJ dysfunction and pain, could applying kinesiology tape help bring relief and manage symptoms?

Kinesiology Tape For Sacroiliac Joint Pain

A lower back ailment that is common during pregnancy. The pain is usually on one or both sides of the back, just above the buttocks, that comes and goes and can limit the ability to bend, sit, and perform various physical activities. (Moayad Al-Subahi et al., 2017) The therapeutic tape provides support while allowing for movement and may help treat and manage sacroiliac joint/SIJ pain by:

• Decreasing muscle spasms.
• Facilitating muscular function.
• Increasing blood circulation to and around the pain site.
• Decreasing muscle trigger points.

Mechanism

Some studies have found that taping the SI joint has benefits that include:

• Improved joint function
• Increased lumbar flexibility
• Reduced pain and disability. (Do-Yun Shin and Ju-Young Heo. 2017)

1. One theory is it helps lift and hold the overlying tissues off of the SI joint, which helps decrease the pressure around it.
2. Another theory is that lifting the tissues helps create a pressure differential under the tape, like non-surgical decompression, allowing increased circulation to the tissues surrounding the sacroiliac joint.
3. This floods the area with blood and nutrients, creating an optimal healing environment.

Application

A sacroiliac joint on the right and left sides connects the pelvis to the sacrum or the lowest part of the spine. To apply the kinesiology tape correctly, locate the lowest part of the back within the pelvic area. (Francisco Selva et al., 2019) Ask a friend or family member for help if you can't reach the area.

Taping steps:

• Cut three strips of tape, each 4 to 6 inches long.
• Sit in a chair and bend the body slightly forward.
• If someone is helping, you can stand and slightly bend forward.
• Remove the lift-off strip in the middle and stretch the tape to expose several inches, leaving the ends covered.
• Apply the exposed tape at an angle over the SI joint, like making the first line of an X, just above the buttocks, with full stretch on the tape.
• Peel the lift-off strips from the ends and adhere them with no stretching.
• Repeat the application steps with a second strip, adhering at a 45-degree angle to the first strip, making the X over the sacroiliac joint.
• Repeat this with the final strip horizontally across the X made from the first two pieces.
• There should be a tape pattern of star shape over the sacroiliac joint.

1. Kinesiology tape can stay over the sacroiliac joint for three to five days.
2. Watch for signs of irritation around the tape.
3. Remove the tape if the skin becomes irritated, and consult your primary healthcare provider, physical therapist, or chiropractor for other treatment options.
4. Some individuals with specific conditions should avoid using the tape and get confirmation that it's safe.
5. Individuals with severe sacroiliac pain where self-management is not working should see a healthcare provider, physical therapist, and or chiropractor for an evaluation and to learn therapeutic exercises and treatments to help manage the condition.

Sciatica During Pregnancy

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

Al-Subahi, M., Alayat, M., Alshehri, M. A., Helal, O., Alhasan, H., Alalawi, A., Takrouni, A., & Alfaqeh, A. (2017). The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. Journal of physical therapy science, 29(9), 1689–1694. https://doi.org/10.1589/jpts.29.1689

Do-Yun Shin and Ju-Young Heo. (2017). The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility. The Journal of Korean Physical Therapy, 307-315. https://doi.org/https://doi.org/10.18857/jkpt.2017.29.6.307

Selva, F., Pardo, A., Aguado, X., Montava, I., Gil-Santos, L., & Barrios, C. (2019). A study of reproducibility of kinesiology tape applications: review, reliability and validity. BMC musculoskeletal disorders, 20(1), 153. https://doi.org/10.1186/s12891-019-2533-0

Can plantar fasciitis patients incorporate non-surgical treatments to reduce hip pain and restore mobility?

Introduction

Everyone is on their feet constantly as it helps people stay mobile and allows them to go from one location to another. Many people are constantly on their feet from childhood to adulthood. This is because the feet are part of the lower musculoskeletal extremities that stabilize the hips and allow sensory-motor function to the legs, thighs, and calves. The feet also have various muscles, tendons, and ligaments surrounding the skeletal structure to prevent pain and discomfort. However, when repetitive motions or injuries start to affect the feet, it can lead to plantar fasciitis and, over time, cause overlapping risk profiles that lead to hip pain. When people are experiencing these pain-like conditions, it can significantly affect their daily activities and overall quality of life. When this happens, many people seek various treatments to reduce the pain-like symptoms caused by plantar fasciitis and restore hip mobility. Today’s article looks at how plantar fasciitis correlates with hip pain, the connection between the feet and the hips, and how there are non-surgical solutions to reduce plantar fasciitis. We talk with certified medical providers who consolidate our patients’ information to assess how to mitigate plantar fasciitis and restore hip mobility. We also inform and guide patients on how numerous non-surgical treatments can help strengthen weak muscles associated with plantar fasciitis and help with restoring stabilization from hip pain. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating small changes to reduce the pain-like effects caused by plantar fasciitis. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

How Plantar Fasciitis Correlates With Hip Pain

Do you experience pain in your heels constantly after a long walk? Do you feel stiffness in your hips when stretching? Or do you feel your shoes are causing tension and pain in your feet and calves? Often, many of these pain-like scenarios are due to people dealing with plantar fasciitis, characterized by heel pain due to inflammation or degenerative irritation of the plantar fascia, a band of thick tissues is running across the bottom of the foot and connecting to the heel bone to the toes in the lower extremities. This band of tissues plays an essential role in the body, providing normal biomechanics to the foot while supporting the arch and helping with shock absorption. (Buchanan et al., 2024) Plantar fasciitis can affect the stability of the lower extremities since the pain affects the feet and causes hip pain.

So, how would plantar fasciitis correlate with hip pain? With plantar fasciitis, many people are experiencing pain in their feet. It can lead to abnormal foot posture, lower extremity muscle weakness, and muscle stress that can reduce the stability of the legs and hip muscles. (Lee et al., 2022) With hip pain, many people can experience a gait dysfunction that causes muscle weakness in the lower extremities and causes the accessory muscles to perform the primary muscles’ jobs. To that point, this forces people to scrap the ground when walking. (Ahuja et al., 2020) This is because normal conditions like natural aging, muscle overuse, or trauma can cause pain-like symptoms to the hips, including discomfort on the thighs, groin, and buttock region, joint stiffness, and reduced range of motion. Hip pain can cause overlapping risk profiles that may include repetitive strain on the feet, thus leading to symptoms of sharp to dull aches on the heel.

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 with arthritis, can incorporating acupuncture with other therapies help manage pain and other symptoms?

Acupuncture For Arthritis

Acupuncture has been around for thousands of years and is a form of traditional Chinese medicine that utilizes needles inserted into various parts of the body to relieve pain and inflammation. The practice is based on the concept of life energy that flows throughout the body along pathways called meridians. When the energy flow becomes disrupted, blocked, or injured, pain or illness can present. (Arthritis Foundation. N.D.) Further research is needed to determine how the acupuncture therapeutic mechanisms work and the overall effectiveness. However, there is emerging evidence suggesting that acupuncture can provide symptom relief for individuals with joint pain, especially those with osteoarthritis and rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Benefits

The actual method that reduces the pain and inflammation is still unclear. Theories include that the needles suppress inflammatory responses, improve blood flow, and relax muscles. Although acupuncture cannot cure or reverse arthritis, it may be useful for managing pain and decreasing associated symptoms, especially in combination with other therapies. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Rheumatoid Arthritis

A systematic review of 43 studies, including humans and animals with rheumatoid arthritis, demonstrated varied results. Several studies showed improvement in symptoms and decreased biological markers of rheumatoid arthritis following one to three sessions of acupuncture for four weeks or more. (Sharon L. Kolasinski et al., 2020) Beneficial outcomes following acupuncture treatment for rheumatoid arthritis include:

• Reduced pain
• Reduced joint stiffness
• Improved physical function

The results of the human and animal studies suggested that acupuncture has the potential to down-regulate:

• Levels of interleukins
• Levels of tumor necrosis factor
• Specific cell signaling proteins/cytokines involved in the inflammatory response, which become elevated in autoimmune conditions like rheumatoid arthritis. (Pei-Chi Chou, Heng-Yi Chu. 2018)
• Most of the study subjects were also receiving other forms of treatment, especially medication. Therefore, it is difficult to conclude how beneficial acupuncture is alone or as a supplemental addition to other medical treatments. (Pei-Chi Chou, Heng-Yi Chu. 2018)

Osteoarthritis

Acupuncture for osteoarthritis of the hand, hip, and knee is recommended, according to the American College of Rheumatology and Arthritis Foundation, meaning that it may be worth trying, although more research is needed to confirm its effectiveness. However, since the risk is relatively minor, acupuncture is generally considered a safe alternative treatment option for managing the symptoms. (Sharon L. Kolasinski et al., 2020)

Chronic Pain

As clinical trials suggest that acupuncture may be effective in providing pain relief, it may be a recommended option for individuals suffering from chronic pain. A recent systematic review of 20,827 patients and 39 trials concluded that acupuncture is effective for the treatment of chronic musculoskeletal pain, headache, and osteoarthritis pain. (Andrew J. Vickers et al., 2018)

Other possible benefits include the antioxidative effects: (Pei-Chi Chou, Heng-Yi Chu. 2018)

• Alleviating oxidative stress and inflammation
• Improving energy metabolism
• Triggering the release of endorphins/hormones that help reduce pain.

Safety

• Acupuncture is considered a safe procedure by a licensed and certified professional.
• To practice acupuncture in the United States, an acupuncturist needs a minimum of a master’s degree from a program accredited by the American Academy of Acupuncture and Oriental Medicine and a license in the state where they received their acupuncture treatment.
• Doctors with an MD or DO degree licensed in the United States to practice medicine can also be licensed by the American Academy of Medical Acupuncture after additional training.

Risks

Risks associated with acupuncture are bleeding and bruising, especially for individuals who have a bleeding disorder like hemophilia or take a blood thinning medication. Individuals are recommended to talk to their healthcare provider to determine if acupuncture is a safe option.

Side Effects

Most individuals do not experience any side effects, although possible reactions can include: (Shifen Xu et al., 2013)

• Soreness
• Bruising
• Scarring
• Needle shock: a vasovagal response that presents as feeling faint, clammy hands, chills, and slight nausea.

Acupuncture Session

• During the initial treatment, individuals will discuss their medical history and what joints and areas of their bodies are presenting with symptoms.
• After a physical exam, the individual will lie on a treatment table.
• Individuals may be face up or down depending on what areas of the body the acupuncturist needs to access.
• It is recommended to wear loose clothing that can be rolled up or moved out of the way to access different areas easily.
• Depending on what areas need to be accessed, individuals may be asked to change into a medical gown.
• The acupuncturist will use alcohol swabs to disinfect the area before inserting the needles.
• The needles are made of stainless steel and are extremely thin.
• Individuals may feel a slight pinch in sensitive areas like the hands and feet, but needle insertion should be comfortable and well-tolerated without significant discomfort.
• For electroacupuncture, the acupuncturist will pass a mild electric current through the needles, typically 40 to 80 volts.
• The needles stay in place for 20 to 30 minutes.
• After the treatment is finished, the acupuncturist will remove the needles and dispose of them.

Frequency

• The frequency of acupuncture sessions will vary depending on the severity of the symptoms and whether the visits are approved and reimbursed by the health insurance company.

Cost and Insurance

• Costs for acupuncture can vary from $75 to $200 per session.
• The first session, which involves an initial assessment and evaluation, usually costs more than follow-up visits.
• Whether the health insurance will cover some or all of the costs of acupuncture sessions depends on the individual insurance company and the condition being treated.
• Medicare currently covers acupuncture services up to 12 visits within a 90-day period for chronic low back pain only.
• Medicare will not cover acupuncture for other conditions. (Medicare.gov. N.D.)

Acupuncture is not a cure for arthritis, but it may be a useful tool to help manage pain and other symptoms. Make sure to consult a healthcare provider if acupuncture is safe to try based on medical history.

Arthritis Explained

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 discuss the subject matter above further, 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

Arthritis Foundation. (N.D.). Acupuncture for arthritis (Health & Wellness, Issue. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis

Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. https://doi.org/10.1155/2018/8596918

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists' Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

Xu, S., Wang, L., Cooper, E., Zhang, M., Manheimer, E., Berman, B., Shen, X., & Lao, L. (2013). Adverse events of acupuncture: a systematic review of case reports. Evidence-based complementary and alternative medicine : eCAM, 2013, 581203. https://doi.org/10.1155/2013/581203

Medicare.gov. (N.D.). Acupuncture. Retrieved from https://www.medicare.gov/coverage/acupuncture

Progress can be challenging for individuals in post total ankle replacement surgery. How can physical therapy help in recovery and restoring leg function?

Total Ankle Replacement Post Surgery Physical Therapy

Total ankle replacement surgery is a major procedure that takes time to recover. A total ankle replacement surgery or arthroplasty can benefit individuals with chronic ankle pain or disability. This procedure can significantly improve an individual's overall pain and function with time. Physical therapy is essential to regaining movement in the ankle and restoring full mobility. A physical therapist will work with the individual to control pain and swelling, restore the ankle's range of motion, train on walking gait and balance, and rebuild strength in the leg. This will help maximize the chances of a successful outcome after surgery.

Total Ankle Replacement

The ankle joint is the section of the lower leg where the shinbone/tibia meets the talus bone on the top of the foot. What can happen is the slippery surface/articular cartilage that coats the ends of these bones begins to thin or deteriorate. As the deterioration progresses, it can lead to significant pain, disability, and difficulty walking. (Cleveland Clinic. 2021) This is where a specialist may recommend total ankle replacement for the best results. Various conditions can be helped by this procedure, including:

• Joint damage caused by gout
• Post-traumatic arthritis
• Rheumatoid arthritis
• Advanced osteoarthritis
• Osteonecrosis
• Septic arthritis (Cort D. Lawton et al., 2017)

During an ankle replacement procedure, an orthopedic surgeon removes the damaged ends of the tibia and talus bones and replaces them with an artificial covering. A polyethylene component is also secured between the two structures to support the smooth movement of the new joint endings. (Massachusetts General Hospital. N.D.) Following the procedure, individuals are typically placed in a protective boot or splint. The healthcare provider will recommend staying off the leg for 4 to 8 weeks to allow healing.

Physical Therapy

Outpatient physical therapy is usually initiated several weeks after the ankle operation. (UW Health Orthopedics and Rehabilitation. 2018) Physical therapy can last for five months or more, depending on the severity of the condition and injury. The physical therapist will focus on different areas to get the best results. (Cort D. Lawton et al., 2017)

Pain and Swelling Control

Post-operative pain and swelling are normal after a total ankle replacement. It is not unusual for an ankle to be swollen for even six to 12 months after the operation. (UW Health Orthopedics and Rehabilitation. 2018) The surgeon will normally prescribe medication to help manage discomfort early on, and physical therapy also plays an important role in addressing the symptoms. Treatments used can include:

• Electrical stimulation - mild electrical pulses applied to the muscles.
• Ice
• Vasopneumatic compression, where an inflatable sleeve is used to create pressure around the area, is commonly utilized at the beginning of physical therapy to reduce pain or swelling.
• Other modalities, such as stretching and targeted exercises, are combined with other treatments.

Range of Motion

• Early after the procedure, the ankle will be very stiff and tight. This is due to several factors, including the inflammation and swelling after surgery and the time spent immobilized in a boot.
• The physical therapist will employ various techniques to improve the ankle joint's range of motion to rotate and flex.
• The physical therapist may employ passive stretching induced by an outside force such as the therapist or a resistance band) to help improve mobility.
• Manual techniques like soft tissue massage and joint mobilizations are also utilized. (Massachusetts General Hospital. N.D.)
• The therapist will develop a home rehabilitation program comprising self-stretching techniques and gentle movements.

Gait and Balance Training 

• After weeks of staying off the affected ankle, the surgeon will clear the patient to begin walking training.
• The physical therapist will work to improve the overall gait pattern and reduce limping.
• They will also help transition from using crutches or a walker to walking independently. (UW Health Orthopedics and Rehabilitation. 2018)
• After multiple weeks of reduced movement and lack of bearing any weight on the ankle, the muscles that surround the ankle have often atrophied/weakened, which can impact balance.
• When the individual can begin placing weight on the leg, the therapist will apply proprioceptive/sense of body position training to improve overall stability. (UW Health Orthopedics and Rehabilitation. 2018)
• Balance exercises will be added to the home program and will progress from week to week.

Strength

The muscles in the leg, ankle, and foot become weak from the surgery and the time spent in a splint or boot. These structures have a significant role in balance, the ability to stand, walk, and go up or down the stairs.

• Regaining the strength and power of these muscles is a critical goal of rehabilitation.
• In the first weeks, the physical therapist will focus on gentle strengthening exercises.
• Isometrics lightly activate the muscles but avoid irritating the surgical site.
• As time passes and weight-bearing is allowed, these gentle moves are replaced with more challenging ones, like resistance bands and standing exercises, to accelerate strength gains.

Treating Ankle Sprains with Chiropractic Care

General Disclaimer *

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

Cleveland Clinic. (2021). Total ankle replacement.

Lawton, C. D., Butler, B. A., Dekker, R. G., 2nd, Prescott, A., & Kadakia, A. R. (2017). Total ankle arthroplasty versus ankle arthrodesis-a comparison of outcomes over the last decade. Journal of orthopaedic surgery and research, 12(1), 76. https://doi.org/10.1186/s13018-017-0576-1

Massachusetts General Hospital. (N.D.). Physical therapy guidelines for total ankle arthroplasty.

UW Health Orthopedics and Rehabilitation. (2018). Rehabilitation guidelines following total ankle arthroplasty.

For individuals experiencing pelvis pain symptoms and associated problems, can integrating pelvic floor physical therapy exercises help with treatment and prevention?

Pelvic Floor Physical Therapy

• The pelvic floor muscles are located at the base of the pelvis and protect the pelvic organs like the vagina, cervix, uterus, bladder, urethra, and rectum. (U.S. Food and Drug Administration. 2019)
• They provide posture support, aid in orgasm function, facilitate sphincter function, and help pump lymphatic blood. (Dulcegleika Vilas Boas Sartori, et al., 2021) (Varuna Raizada, Ravinder K. Mittal. 2008)

When the muscles fail to function correctly, individuals can experience symptoms like:

1. Painful intercourse
2. Prolapse - when an organ or tissue drops or shifts out of place.
3. Urinary incontinence
4. Constipation problems
5. These conditions are common in pregnant individuals or older women.

These symptoms can be treated with pelvic floor physical therapy to alleviate discomfort. Pelvic floor physical therapy can help women and individuals with vaginas:

• Alleviate issues like painful sex, urinary leakage, and prolapse.
• In physical therapy, individuals work on breathing, relaxation, and lengthening and strengthening techniques to train their muscles to function optimally.

Causes of Pelvic Floor Issues

Pelvic floor dysfunction tends to happen with age, during pregnancy, or in combination with events like the postpartum period and menopause, which can lower hormone levels.

• Individuals who are pregnant are especially prone to pelvic floor issues but might not know they have a problem.
• The pregnancy weight of a uterus can pressure and strain the muscles.
• Vaginal childbirth can also stretch or weaken the muscles. (Ilaria Soave, et al., 2019)

Symptoms

Symptoms can include: (Columbia Surgery. 2022)

• Pain in the pelvis region
• Back pain
• Painful urination
• Constipation
• Urinary leakage or incontinence
• Stool leakage or incontinence
• Painful intercourse
• If left untreated, these symptoms can worsen over time.

Pelvic Floor Physical Therapy

An individual will meet with a specialist to discuss symptoms and undergo a physical examination that includes:

1. Pelvic floor exam.
2. Evaluation of posture, mobility, and core strength.
3. Once the initial exams and evaluation are complete, the practitioner will go over pelvic floor exercises and provide a treatment plan.
4. Recommended exercises vary based on symptoms but focus on relaxing, stretching, and/or strengthening muscles.

Muscle Relaxation

• To relax the muscles, a therapist may recommend breathing exercises.
• For pregnant individuals, this means timing breaths with contractions.
• For individuals experiencing constipation, breathing exercises can help the body relax and reduce strain.

Stretching Muscles

• Stretching can help relieve muscle tightness and stiffness.
• A therapist may help stretch the pelvic floor through various therapy modalities.
• This type of physical therapy can help loosen tight muscles or help gently reset dislocated organs back into place.

Strengthening Muscles

• After the pelvic floor is loose and relaxed, the focus typically switches to strengthening the muscles.
• Strength work may target abdominal muscles or the pelvic floor muscles themselves.

With time, commitment, and targeted treatment, individuals can use pelvic floor physical therapy to loosen tissues, strengthen muscles, and restore function.

Spinal Decompression In Depth

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 get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

U.S. Food and Drug Administration. (2019). Pelvic organ prolapse (pop).

Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and clinical urology, 62(1), 79–84. https://doi.org/10.4111/icu.20190248

Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493–vii. https://doi.org/10.1016/j.gtc.2008.06.003

Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives of gynecology and obstetrics, 299(3), 609–623. https://doi.org/10.1007/s00404-018-5036-6

Columbia Surgery. (2022). Pelvic floor disorders: frequently asked questions.

Nowadays, individuals trying to avoid surgery have more therapy options. Can regenerative medicine help treat neuromusculoskeletal injuries?

Regenerative Medicine

Regenerative medicine utilizes the body's raw cells and is used in cancer treatment and to reduce the risk of infections. (American Cancer Society. 2020) Researchers are looking for other ways to use these cells in medical therapies.

What are These Cells

• Stem cells are unspecialized cells that can develop into any cell and in certain cases renew themselves an unlimited number of times. (National Institutes of Health. 2016)
• These cells are found in embryos and adult cells.
• There are two types of cells - pluripotent and somatic. (National Institutes of Health. 2016)
• These cells can transform and become any of the cells in the body.
• Somatic cells or adult stem cells can form tissue or an entire organ. (National Institutes of Health. 2016)

Therapy

Regenerative cell therapy uses these cells as a treatment for a disease or condition.

• Regenerative cells are given to individuals to replace cells that have been destroyed or have died.
• In the case of cancer, they may be used to help the body regain the ability to produce regenerative cells after treatment. (American Cancer Society. 2020)
• For individuals with multiple myeloma and certain types of leukemia, regenerative cell therapy is used to eliminate cancer cells.
• The therapy is called graft-versus-tumor effect/GvT, where a donor's white blood cells/WBCs are used to eliminate the cancerous tumor. (American Cancer Society. 2020)

What They Can Treat

This is a new treatment that is still going through research. The Food and Drug Administration has only approved it for certain cancers and conditions that affect the blood and immune system. (Centers for Disease Control and Prevention. 2019) Regenerative cell therapy is FDA-approved to treat: (National Cancer Institute. 2015)

• Leukemia
• Lymphoma
• Multiple myeloma
• Neuroblastoma
• It is also used to decrease the risk of infection after regenerative cell transplantation in individuals with blood cancers. (U.S. Food & Drug Administration. 2023)

Researchers are studying how these cells can treat other conditions. Clinical trials are analyzing how to use the therapy for neurodegenerative diseases like:

• Parkinson's
• Alzheimer's
• Multiple sclerosis - MS
• Amyotrophic lateral sclerosis - ALS. (Riham Mohamed Aly. 2020)

Cell Types

During regenerative cell therapy, the cells are given through an intravenous line. The three places where blood-forming cells can be obtained are bone marrow, the umbilical cord, and blood. Transplants can include: (American Cancer Society. 2020)

Autologous

• The cells are taken from the individual who will be receiving the therapy.

Allogeneic

• The cells are donated by another individual.

Syngeneic

• The cells come from an identical twin, if there is one.

Safety

The therapy has shown to provide benefits but there are risks.

• One risk is known as graft-versus-host disease - GVHD.
• It occurs in one-third to half of allogeneic recipients.
• This is where the body does not recognize the donor's white blood cells and attacks them causing problems and symptoms throughout the body.
• To treat GVHD medications are given to suppress the immune system to stop attacking the donor cells. (American Cancer Society. 2020)

Other potential risks can include: (American Cancer Society. 2020)

• Cancer relapse
• New cancer
• Hepatic veno-occlusive disease
• Post-transplant lymphoproliferative disorder - PTLD

Future Possibilities

The future of regenerative cell therapy is promising. Research is ongoing to find out how these cells can treat conditions and find new ways to treat and cure diseases.

Regenerative medicine has been researched for over twenty years for conditions like macular degeneration, glaucoma, stroke, and Alzheimer's disease. (National Institutes of Health. 2022) This therapy is a new medical treatment that could be used in future therapies as part of a multidisciplinary approach to neuromusculoskeletal injuries and conditions.

Quick Patient Initiation Process

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 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 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 Cancer Society. (2020). How stem cell and bone marrow transplants are used to treat cancer.

National Institutes of Health. (2016). Stem cell basics.

Centers for Disease Control and Prevention. (2019). Stem cell and exosome products.

National Cancer Institute. (2015). Stem cell transplants in cancer treatment.

U.S. Food & Drug Administration. (2023). FDA approves cell therapy for patients with blood cancers to reduce risk of infection following stem cell transplantation.

Aly R. M. (2020). Current state of stem cell-based therapies: an overview. Stem cell investigation, 7, 8. https://doi.org/10.21037/sci-2020-001

American Cancer Society. (2020). Stem cell or bone marrow transplant side effects.

National Institutes of Health. (2022). Putting stem cell-based therapies in context.