Neuropathy "The Painful Enigma"

Individuals experiencing pain symptoms like shooting, stabbing, or electrical sensations to the latissimus dorsi of the upper back could be caused by a nerve injury to the thoracodorsal nerve. Can knowing the anatomy and symptoms help healthcare providers develop an effective treatment plan?

Thoracodorsal Nerve

Also known as the middle subscapular nerve or the long subscapular nerve, it branches out from a part of the brachial plexus and provides motor innervation/function to the latissimus dorsi muscle.

Anatomy

The brachial plexus is a network of nerves that stem from the spinal cord in the neck. The nerves supply most of the sensation and movement of the arms and hands, with one on each side. Its five roots come from the spaces between the fifth through eighth cervical vertebrae and the first thoracic vertebra. From there, they form a larger structure, then divide, re-combine, and divide again to form smaller nerves and nerve structures as they travel down the armpit. Through the neck and chest, the nerves eventually join and form three cords that include:

• Lateral cord
• Medial cord
• Posterior cord

The posterior cord produces major and minor branches that include:

• Axillary nerve
• Radial nerve

The minor branches include:

• Superior subscapular nerve
• Inferior subscapular nerve
• Thoracodorsal nerve

Structure and Position

• The thoracodorsal nerve branches off the posterior cord in the armpit and travels down, following the subscapular artery, to the latissimus dorsi muscle.
• It connects to the upper arm, stretches across the back of the armpit, forming the axillary arch, and then expands into a large triangle that wraps around the ribs and the back.
• The thoracodorsal nerve lies deep in the latissimus dorsi, and the lower edge typically reaches close to the waist.

Variations

• There is a standard location and course of the thoracodorsal nerve, but individual nerves are not the same in everyone.
• The nerve typically branches off the posterior cord of the brachial plexus from three different points.
•  However, different subtypes have been identified.
• The thoracodorsal nerve supplies the teres major muscle in about 13% of individuals. (Brianna Chu, Bruno Bordoni. 2023)
• The lats can have a rare anatomical variation known as a Langer’s arch, which is an extra part that connects to muscles or connective tissue of the upper arm beneath the common connecting point.
• In individuals with this abnormality, the thoracodorsal nerve supplies function/innervation) to the arch. (Ahmed M. Al Maksoud et al., 2015)

Function

The latissimus dorsi muscle cannot function without the thoracodorsal nerve. The muscle and nerve help:

• Stabilize the back.
• Pull the body weight up when climbing, swimming, or doing pull-ups.
• Assist with breathing by expanding the rib cage during inhalation and contracting when exhaling. (Encyclopaedia Britannica. 2023)
• Rotate the arm inward.
• Pull the arm toward the center of the body.
• Extend the shoulders by working with the teres major, teres minor, and posterior deltoid muscles.
• Bring down the shoulder girdle by arching the spine.
• To bend to the side by arching the spine.
• Tilt the pelvis forward.

Conditions

The thoracodorsal nerve can be injured anywhere along its path by trauma or disease. Symptoms of nerve damage can include: (U.S. National Library of Medicine: MedlinePlus. 2022)

• Pain that can be shooting, stabbing, or electrical sensations.
• Numbness, tingling.
• Weakness and loss of function in the associated muscles and body parts, including wrist and finger drop.
• Because of the nerve's path through the armpit, doctors have to be cautious of the anatomical variants so they don’t inadvertently damage a nerve during breast cancer procedures, including axillary dissection.
• The procedure is performed to examine or remove lymph nodes and is used in staging breast cancer and in treatment.
• According to a study, 11% of individuals with axillary lymph node dissection suffered damage to the nerve. (Roser Belmonte et al., 2015)

Breast Reconstruction

• In breast reconstruction surgery, the lats can be used as a flap over the implant.
• Depending on the circumstances, the thoracodorsal nerve can be left intact or severed.
• The medical community has not agreed on which method has the best outcomes. (Sung-Tack Kwon et al., 2011)
• There is some evidence that leaving the nerve intact can cause the muscle to contract and dislocate the implant.
• An intact thoracodorsal nerve may also cause atrophy of the muscle, which can lead to shoulder and arm weakness.

Graft Uses

A portion of the thoracodorsal nerve is commonly used in nerve graft reconstruction to restore function after injury, which includes the following:

• Musculocutaneous nerve
• Accessory nerve
• Axillary nerve
• The nerve can also be used to restore nerve function to the triceps muscle in the arm.

Rehabilitation

If the thoracodorsal nerve is injured or damaged, treatments can include:

• Braces or splints.
• Physical therapy to improve range of motion, flexibility, and muscle strength.
• If there is compression, surgery may be required to alleviate the pressure.

Exploring Integrative Medicine

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

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer's arch: a rare anomaly affects axillary lymphadenectomy. Journal of surgical case reports, 2015(12), rjv159. https://doi.org/10.1093/jscr/rjv159

Britannica, The Editors of Encyclopaedia. "latissimus dorsi". Encyclopedia Britannica, 30 Nov. 2023, https://www.britannica.com/science/latissimus-dorsi. Accessed 2 January 2024.

U.S. National Library of Medicine: MedlinePlus. Peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(1), 169–175. https://doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Anatomic basis of interfascicular nerve splitting of innervated partial latissimus dorsi muscle flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. https://doi.org/10.1016/j.bjps.2010.12.008

For individuals dealing with chronic pain conditions can having a better understanding of pain management specialists help in developing effective multidisciplinary treatment plans?

Pain Management Specialists

Pain management is a growing medical specialty that takes a multi-disciplinary approach to treating all types of pain. It is a branch of medicine that applies scientifically proven techniques and methods to relieve, reduce, and manage pain symptoms and sensations. Pain management specialists evaluate, rehabilitate, and treat a spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, chronic pain conditions, and more. Many primary healthcare providers refer their patients to pain management specialists if pain symptoms are ongoing or significant in their manifestation.

Specialists

Healthcare providers specializing in pain management recognize the complex nature of pain and approach the problem from all directions. Treatment at a pain clinic is patient-centric but depends on the clinic's available resources. Currently, there are no set standards for the types of disciplines needed, another reason treatment options vary from clinic to clinic. Experts say that a facility should offer patients:

• A coordinating practitioner specializing in pain management and consulting specialists on the patient's behalf.
• A physical rehabilitation specialist.
• A psychiatrist to help the individual deal with any accompanying depression or anxiety, especially when dealing with chronic pain. (American Society of Regional Anesthesia and Pain Medicine. 2023)

Other Medical Specialties

Other specialties represented in pain management are anesthesiology, neurosurgery, and internal medicine. A coordinating healthcare provider may refer an individual for services from:

• Occupational medicine specialists
• Social workers
• Alternative medicine practitioners
• Complementary medicine practitioners (American Academy of Pain Medicine. 2023)

A healthcare provider should have completed additional training and credentialing in pain medicine and be an MD with board certification in at least one of the following (American Board of Medical Specialties. 2023)

• Anesthesiology
• Physical rehabilitation
• Psychiatry
• Neurology

A pain management physician should also have their practice limited to the specialty they hold the certification.

Management Goals

The field of pain management treats all types of pain as a disease. Chronic, such as headaches; acute, from surgery, and more. This allows for applying science and the latest medical advances to pain relief. There are now many modalities, including:

• Medication
• Interventional pain management techniques - nerve blocks, spinal cord stimulators, and similar treatments.
• Physical therapy
• Alternative medicine

1. The objective is to minimize and make symptoms manageable.
2. Improve function.
3. Increase the quality of life. (Srinivas Nalamachu. 2013)

A pain management clinic will go through the following:

• Evaluation.
• Diagnostic tests, if necessary.
• Physical therapy - increases the range of motion, strengthens the body, and prepares individuals to return to work and daily activities.
• Interventional treatment - injections or spinal cord stimulation.
• Referral to a surgeon if indicated by the tests and evaluation.
• Psychiatry to deal with depression, anxiety, and/or other issues that accompany chronic pain symptoms.
• Alternative medicine to support and enhance the other treatments.

Individuals who do well with a pain management program

Individuals who have:

• Back pain
• Neck pain
• Had multiple back surgeries
• Failed surgeries
• Neuropathy
• Individuals determined that surgery does not benefit their condition.

A better understanding of pain syndromes by communities and insurance companies and increased pain studies will help increase insurance coverage for treatments and technology to improve interventional outcomes.

Chiropractic Care for Leg Instability

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

American Society of Regional Anesthesia and Pain Medicine. (2023). The specialty of chronic pain management.

American Academy of Pain Medicine (2023). About the American Academy of Pain Medicine.

American Board of Medical Specialties. (2023). The Most Trusted Medical Specialty Certification Organization.

Nalamachu S. (2013). An overview of pain management: the clinical efficacy and value of treatment. The American journal of managed care, 19(14 Suppl), s261–s266.

American Society of Interventional Pain Physicians. (2023). Pain Physician.

Individuals diagnosed with peripheral neuropathy, or with small fiber neuropathy, can understanding symptoms and causes help with potential treatments?

Small Fiber Neuropathy

Small fiber neuropathy is a specific classification of neuropathy, as there are different types, which are nerve injury, damage, disease, and/or dysfunction. Symptoms can result in pain, loss of sensation, and digestive and urinary symptoms. Most cases of neuropathy like peripheral neuropathy involve small and large fibers. Common causes include long-term diabetes, nutritional deficiencies, alcohol consumption, and chemotherapy.

• Small fiber neuropathy is diagnosed after diagnostic testing showing it is clear that the small nerve fibers are involved.
• The small nerve fibers detect sensation, temperature, and pain and help regulate involuntary functions.
• Isolated small-fiber neuropathy is rare, but research is ongoing on the type of nerve damage and potential treatments. (Stephen A. Johnson, et al., 2021)
• Small fiber neuropathy is not specifically dangerous but is a sign/symptom of an underlying cause/condition that is damaging the body’s nerves.

Symptoms

Symptoms include: (Heidrun H. Krämer, et al., 2023)

• Pain - symptoms can range from mild or moderate discomfort to severe distress and can happen at any time.
• Loss of sensation.
• Because the small nerve fibers help with digestion, blood pressure, and bladder control - symptoms of autonomic dysfunction can vary and can include:
• Constipation, diarrhea, incontinence, urinary retention - the inability to completely drain the bladder.
• If there is progressing nerve damage, the intensity of the pain can decrease, but the loss of normal sensation and autonomic symptoms can worsen. (Josef Finsterer, Fulvio A. Scorza. 2022)
• Hypersensitivity to touch and pain sensations can cause pain without a trigger.
• The loss of sensation can make individuals unable to accurately detect sensations of touch, temperature, and pain in affected areas, which can lead to various types of injuries.
• Although more research is needed, certain disorders that were not considered neuropathies may have small fiber neuropathy components involved.
• A study suggested that neurogenic rosacea, a skin condition, could have some elements of small fiber neuropathy. (Min Li, et al., 2023)

Small Nerve Fibers

• There are several types of small nerve fibers; two in small fiber neuropathy include A-delta and C. (Josef Finsterer, Fulvio A. Scorza. 2022)
• These small nerve fibers are distributed throughout the body including the tops of the fingers and toes, trunk, and internal organs.
• These fibers are usually located in the superficial areas of the body, such as close to the skin’s surface. (Mohammad A. Khoshnoodi, et al., 2016)
• The small nerve fibers that get damaged are involved in transmitting pain and temperature sensations.
• Most nerves have a special type of insulation called myelin that protects them and increases the speed of nerve impulses.
• Small nerve fibers may have a thin sheath, making them more susceptible to injury and damage at earlier stages of conditions and diseases. (Heidrun H. Krämer, et al., 2023)

Individuals At Risk

Most types of peripheral neuropathy cause damage to the small and large peripheral nerve fibers. Because of this, most neuropathies are a mix of small-fiber and large-fiber neuropathy. Common risk factors for mixed fiber neuropathy include: (Stephen A. Johnson, et al., 2021)

• Diabetes
• Nutritional deficiencies
• Overconsumption of alcohol 
• Autoimmune disorders
• Medication toxicity

Isolated small-fiber neuropathy is rare, but there are conditions that are known to contribute to the cause and include: (Stephen A. Johnson, et al., 2021)

Sjogren Syndrome

• This autoimmune disorder causes dry eyes and mouth, dental problems, and joint pain.
• It can also cause nerve damage throughout the body.

Fabry Disease

• This condition causes a buildup of certain fats/lipids in the body that can lead to neurological effects.

Amyloidosis

• This is a rare disorder that causes a buildup of proteins in the body.
• The proteins can damage tissues like the heart or nerves.

Lewy Body Disease

• This is a neurological disorder that causes dementia and impaired movement and can lead to nerve damage.

Lupus

• This is an autoimmune disease that affects joints, skin, and sometimes nerve tissue.

Viral Infection

• These infections typically cause a cold or gastrointestinal/GI upsetness.
• Less often they can cause other effects like small fiber neuropathy.

These conditions have been seen to cause isolated small-fiber neuropathy or begin as small-fiber neuropathy before progressing to the large nerve fibers. They can also begin as a mixed neuropathy, with small and large fibers.

Progression

Often the damage progresses at a relatively moderate rate, leading to added symptoms within months or years. The fiber nerves that are affected by the underlying condition usually progressively deteriorate, regardless of where they are located. (Mohammad A. Khoshnoodi, et al., 2016) Medications can help alleviate damage to the peripheral nerves. For individuals that are diagnosed in the early stage, it is possible to stop the progression, and potentially prevent involvement of the large fibers.

Treatments

Treatment toward preventing the progression requires controlling the underlying medical condition with treatment options depending on the cause. Treatments that can help prevent the progression include:

• Blood sugar control for individuals with diabetes.
• Nutritional supplementation for the treatment of vitamin deficiencies.
• Quitting alcohol consumption.
• Immune suppression for control of autoimmune diseases.
• Plasmapheresis - blood is taken and the plasma is treated and returned or exchanged for the treatment of autoimmune diseases.

Symptom Treatment

Individuals can get treatment for the symptoms that will not reverse or cure the condition but can help with temporary relief. Symptomatic treatment can include: (Josef Finsterer, Fulvio A. Scorza. 2022)

• Pain management can include medications and/or topical analgesics.
• Physical therapy - stretching, massage, decompression, and adjustments to keep the body relaxed and flexible.
• Rehabilitation to help improve coordination, which can be impaired by loss of sensation.
• Medications to relieve GI symptoms.
• Wearing specialized clothes such as neuropathy socks to help with foot pain symptoms.

Treatment and medical management of neuropathies usually involve a neurologist. A neurologist may prescribe medication to help alleviate pain symptoms and provide medical interventions like immunotherapy if there is concern that an autoimmune process could be the cause. Additionally, treatment could include the care of a physical medicine and rehabilitation physician or a physical therapy team to provide stretches and exercises to help strengthen the body and maintain mobility and flexibility.

Peripheral Neuropathy Myths & Facts

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

Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. https://doi.org/10.1212/WNL.0000000000012894

Finsterer, J., & Scorza, F. A. (2022). Small fiber neuropathy. Acta neurologica Scandinavica, 145(5), 493–503. https://doi.org/10.1111/ane.13591

Krämer, H. H., Bücker, P., Jeibmann, A., Richter, H., Rosenbohm, A., Jeske, J., Baka, P., Geber, C., Wassenberg, M., Fangerau, T., Karst, U., Schänzer, A., & van Thriel, C. (2023). Gadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers. Journal of neurology, 270(8), 3981–3991. https://doi.org/10.1007/s00415-023-11740-z

Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., & Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Frontiers in pain research (Lausanne, Switzerland), 4, 1122134. https://doi.org/10.3389/fpain.2023.1122134

Khoshnoodi, M. A., Truelove, S., Burakgazi, A., Hoke, A., Mammen, A. L., & Polydefkis, M. (2016). Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA neurology, 73(6), 684–690. https://doi.org/10.1001/jamaneurol.2016.0057

Cisgender has nothing to do with an individual's sexual orientation. Therefore how do sex and gender differ and where does cisgender fall within the spectrum of gender identities?

Cisgender

Cisgender is a segment of the larger spectrum of gender identities. Also referred to as "cis," it describes an individual whose gender identity corresponds to the sex they were assigned at birth. Therefore if an individual assigned sex at birth is female and identifies as a girl or a woman they are a cisgender woman.

• The term describes how a person sees themselves and helps others communicate more accurately and respectfully.
• Although many individuals may identify as cisgender, a cisgender person is not typical nor has qualities or characteristics that inherently differentiate them from a person of other gender identities.
• Cisgender women commonly use the pronouns she and her.
• A common mistake is using the term cis-gendered.
• The proper usage of the term is cisgender.

Sex and Gender Differences 

• The terms sex and gender are often used interchangeably, however, they are not the same.
• Sex is a biological and physiological designation based on an individual's sex chromosomes and sexual organs.
• It refers to an individual's sex chromosomes and the characteristics assigned by those chromosomes. (Janine Austin Clayton, Cara Tannenbaum. 2016)
• This includes an individual's genitals and sex organs.
• It also encompasses secondary characteristics - like body size, bone structure, breast size, and facial hair - that are regarded as female or male.

Differences

Gender is a social construct that refers to roles and behaviors that society assigns as being masculine or feminine. The construct infers behaviors that are accepted or appropriate based on how an individual behaves, speaks, dresses, sits, etc.

• Gender titles include sir, ma'am, mister, or miss.
• Pronouns include him, she, he, and her.
• Roles include actress, actor, prince, and princess.
• Many of these suggest a power hierarchy of who has it and who does not.
• Cisgender women often fall victim to these dynamics.

Sex

• Refers to an individual's chromosomes and the way that their genes are expressed.
• Typically described in terms of male and female characteristics or the sex assigned at birth.

Gender

• A social construct.
• Refers to the social roles, behaviors, and expectations considered and/or deemed appropriate for men and women.
• Historically defined as masculine and feminine, however, definitions can change as society changes.

Gender Identities Glossary

Today, gender is viewed as a spectrum where an individual might identify as one gender, more than one gender, or no gender. The definitions are often subtle and can often overlap, co-exist, and/or change. Gender identities include:

Cisgender

• An individual whose gender identity matches their assigned sex at birth.

Transgender

• An individual whose gender identity does not align with their assigned sex at birth.

Non-binary

• An individual who feels their gender identity cannot be defined.

Demigender

• An individual who experiences a partial, but not full/complete connection to a particular gender.

Agender

• An individual who feels neither male nor female.

Genderqueer

• Similar to non-binary but infers refusal of societal expectations.

Gender-neutral

• Non-binary similarities but focuses on abandoning gender labels.

Gender fluid

• An individual who experiences multiple genders or shifts between genders.

Polygender

• An individual who experiences or expresses more than one gender.

Pangender

• An individual who identifies with all genders.

Third gender

• Third gender is a concept in which individuals are categorized, either by themselves or by society, as neither male nor female, not transitioning.
• They are a different gender altogether.

Twin gender

• A Native American term describing someone who is male and female or of two spirits simultaneously.

Cis Woman Identity

The terms cis woman or cis female are used to describe individuals who were assigned female at birth and identify as a woman or female. For cisgender woman, this means their gender identity aligns with their primary sex organs and secondary sex traits that include:

• Higher pitch voice.
• Wider pelvis.
• Broadening of hips.
• Breast development 

It can also involve cisnormativity - a concept that everyone identifies as the gender they were assigned at birth. This could inform how a cis woman is expected to dress and act. An even more extreme concept is gender essentialism - this is the belief that gender differences are rooted purely in biology and cannot be changed. However, even cisnormativity beauty standards can influence the perceptions of transgender women that end up reinforcing gender stereotypes. (Monteiro D, Poulakis M. 2019)

Cisgender Privilege

Cisgender privilege is the concept that individuals who are cisgender receive added benefits compared to individuals who don't conform to the gender binary norm. This includes cisgender women and men. Privilege happens when a cisgender individual assumes they are the norm and consciously or unconsciously takes action against those who are outside the definition of masculine and feminine. Examples of cisgender privilege include:

• Not being denied work and social opportunities because of not fitting into the boy's or girl's club.
• Not having to have sexual orientation questioned.
• Not being denied healthcare due to provider discomfort.
• Not fearing that civil rights or legal protections will be taken.
• Not worrying about being bullied.
• Not having to worry about attracting questioning looks in public.
• Not being challenged or questioned about the clothes being worn.
• Not being demeaned or mocked because of pronoun use.

Gender Identity and Sexual Orientation

• Gender identity and sexual orientation are not the same. (Carla Moleiro, Nuno Pinto. 2015)
• Gender identity and sexual orientation are not the same.
• A cisgender individual can be heterosexual, homosexual, bisexual, or asexual and so can a transgender individual.
• Being cisgender has no correlation to an individual's sexual orientation.

Chiropractic Care After Accidents and 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

Clayton, J. A., & Tannenbaum, C. (2016). Reporting Sex, Gender, or Both in Clinical Research? JAMA, 316(18), 1863–1864. https://doi.org/10.1001/jama.2016.16405

Monteiro, Delmira and Poulakis, Mixalis (2019) "Effects of Cisnormative Beauty Standards on Transgender Women’s Perceptions and Expressions of Beauty," Midwest Social Sciences Journal: Vol. 22: Iss. 1, Article 10. DOI: https://doi.org/10.22543/2766-0796.1009 Available at: https://scholar.valpo.edu/mssj/vol22/iss1/10

Moleiro, C., & Pinto, N. (2015). Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems. Frontiers in Psychology, 6, 1511. https://doi.org/10.3389/fpsyg.2015.01511

The brachial plexus is a network of nerves that begin in the cervical/neck spinal cord and travel down the cervicoaxillary canal into the armpit. Forming in the area of the shoulder joint at the branch junction of the brachial plexus, the radial nerve extends down the arm, through the elbow joint, into the forearm, across the wrist, and tips of the fingers. The nerves are susceptible to injury that can cause abnormal function leading to unusual sensations and impaired muscle function.

Radial Nerve

One of the major nerves of the upper extremity.

• There is one brachial plexus on each side of the body that carries the nerves to each arm.
• The radial nerve has two major functions.
• One is to provide sensations in the hands, forearms, arms, and fingers.
• The other is to deliver messages to muscles about when to contract.

Motor Function

• The radial nerve transmits signals to the muscles of the back of the arm and forearm on when to contract.
• Individuals who have abnormal radial nerve function can experience weakness of the muscles and symptoms like wrist drop.
• A wrist drop occurs when the back forearm muscles cannot support the wrist, causing the individual to hold the wrist in a flexed posture.
• Abnormal radial nerve function can cause symptoms of numbness or tingling in the back of the hand.

Conditions

Associated conditions to the radial nerve include lacerations, contusions, fractures, and palsies.

Nerve Contusion

• A contusion typically occurs through blunt force trauma that can crush and smash the nerve area.
• This causes abnormal or no function.
• A nerve contusion can occur from a personal, work, or sports injury or other conditions that generate intense pressure on the nerve/s.

Nerve Lacerations

• A laceration occurs when there is a penetrating injury that cuts and/or severs the nerve.
• This injury can occur from stab wounds or sliced by broken glass, metal, etc.

Fractures

• Broken bones of the upper extremity can lead to extended damage to the nerves near the damaged bone.
• The most common type of fracture associated with radial nerve malfunction is fractures to the humerus bone.
• The nerve wraps tightly around the humerus and can be injured with a fracture.
• Most fracture-related radial nerve injuries heal on their own and do not require surgery.
• However, the way the injury heals can be the difference between normal function and chronic pain.

Crutch Palsy

• Crutch palsy is pressure on the radial nerve in the armpit resulting from using crutches incorrectly.
• To use crutches properly, the individual needs to support their body weight through the hands.
• However, many tend to place pressure around the armpit at the top of the crutch, causing irritation to the nerve in that area.
• Padding the top of crutches and using the proper form can prevent the condition.

Saturday Night Palsy

• Saturday night palsy is the abnormal function of the radial nerve after sleeping in a position that causes direct pressure against the nerve.
• This often occurs when an individual falls asleep with their arm draped over an armrest on a chair.
• The name comes from when individuals are intoxicated and fall asleep in a location other than the bed and in awkward positions.

Treatment

Nerve injuries often cause symptoms at different locations other than where the nerve damage is, complicating diagnosis. Determining the specific location of nerve damage is the first step in developing an appropriate treatment plan. Once the location has been identified, steps can be taken to prevent worsening damage to the nerve.

• The objective is to relieve the pressure from the irritation or compression.
• Chiropractic treatment can relieve symptoms and restore function through:
• Massage to relax the area and increase blood circulation.
• Decompression to physically restore alignment.
• Adjustments to restore body balance.
• Exercises and stretches to maintain treatment, strengthen the muscles, and prevent injuries.
• In cases where there is structural damage, surgery may be necessary to remove pressure or repair damage.

Avoid Surgery

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

Ansari FH, Juergens AL. Saturday Night Palsy. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557520/

Barton, N J. “Radial nerve lesions.” The Hand vol. 5,3 (1973): 200-8. doi:10.1016/0072-968x(73)90029-6

Daly, Michael, and Chris Langhammer. “Radial Nerve Injury in Humeral Shaft Fracture.” The Orthopedic Clinics of North America vol. 53,2 (2022): 145-154. doi:10.1016/j.ocl.2022.01.001

DeCastro A, Keefe P. Wrist Drop. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532993/

Eaton, C J, and G D Lister. “Radial nerve compression.” Hand Clinics vol. 8,2 (1992): 345-57.

Glover NM, Murphy PB. Anatomy, Shoulder and Upper Limb, Radial Nerve. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534840/

Ljungquist, Karin L et al. “Radial nerve injuries.” The Journal of hand surgery vol. 40,1 (2015): 166-72. doi:10.1016/j.jhsa.2014.05.010

Węgiel, Andrzej, et al. “Radial nerve compression: anatomical perspective and clinical consequences.” Neurosurgical review vol. 46,1 53. 13 Feb. 2023, doi:10.1007/s10143-023-01944-2

When temperatures are elevated in summer, heat-induced and severe headaches like migraines are common during the hot months. However, a migraine caused by heat is not the same as a headache caused by heat, as the two have different symptoms. What they have in common is that they’re both triggered by the way hot weather affects the body. Understanding the causes and the warning signs of a heat headache can help prevent and treat potentially dangerous heat-related conditions. Injury Medical Chiropractic and Functional Medicine Clinic use various techniques and therapies customized to the individual to relieve pain and improve function.

Heat-Induced Headaches

Headaches and migraines are common, affecting 20 percent of women and nearly 10 percent of men. An increase in frequency can be caused by

• Dehydration.
• Environmental factors.
• Heat exhaustion.
• Heat stroke.

A heat-induced headache can feel like a dull pulsing ache around the temples or in the back of the head. Depending on the cause, a heat-induced headache may escalate to a more intensely felt internal pain.

Causes

A heat-induced headache may not be caused by the hot weather but by how the body responds to heat. Weather-related triggers of headaches and migraine include:

• Sun glare
• Bright light
• High humidity
• Sudden drops in barometric pressure
• Weather conditions can also cause changes in serotonin levels.
• Hormonal fluctuations are common migraine triggers that can also cause headaches.
• Dehydration - can trigger both headaches and migraine.

When exposed to higher temperatures, the body needs more water to compensate for the lost water as it uses and sweats it out. Prolonged exposure to high temperatures puts the body at risk for heat exhaustion, one of the stages of heat stroke, with headaches as a symptom of heat exhaustion. Any time the body is exposed to high temperatures or spends a long time outside in the hot sun, and a headache occurs afterward, a heat stroke is possible.

Heat Headache Symptoms

Symptoms of a heat-induced headache can vary according to the situation. If the headache is triggered by heat exhaustion, the body will have heat exhaustion symptoms and head pain. Heat exhaustion symptoms include:

• Dizziness.
• Muscle cramps or tightness.
• Nausea.
• Fainting.
• An extreme thirst that does not go away.

If the headache or migraine is related to heat exposure but not connected to heat exhaustion, the symptoms may include the following:

• A throbbing, dull sensation in the head.
• Dehydration.
• Fatigue.
• Sensitivity to light.

Relief

Individuals can be proactive about prevention.

• If possible, limit time outside, protect the eyes with sunglasses, and wear a hat with a brim when staying outdoors.
• Exercise indoors in an air-conditioned environment if able.
• Increase water consumption as temperatures rise, and utilize healthy sports drinks to replenish electrolytes.

Home remedies can include:

• Lavender or peppermint essential oils.
• Cold packs.
• Iced herbal teas.
• Over-the-counter acetaminophen and ibuprofen.

Chiropractic Care

Chiropractic treatment can include:

• Craniocervical mobilization involves gentle chiropractic pressure on the neck to adjust the joints.
• Spinal manipulation involves applying more force and pressure at certain points along the spine.
• Neuromuscular massage includes kneading joints and muscles and relieves pain by releasing pressure from compressed nerves.
• Myofascial release massage is aimed at the tissues that connect and support muscles and focuses on trigger points in the back and neck or head to relax muscles and improve blood circulation.
• Trigger point therapies target tense areas to help relax muscles while improving blood flow and relieving stress.
• Traction therapy.
• Decompression therapy.
• Exercises designed specifically to reduce pain.

From Inflammation to Healing

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, 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

Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of Manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008

Demont, Anthony, et al. “Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta-analyses.” PM & R: the journal of Injury, Function, and Rehabilitation vol. 15,5 (2023): 613-628. doi:10.1002/pmrj.12856

Di Lorenzo, C et al. “Heat stress disorders and headache: a case of new daily persistent headache secondary to heat stroke.” BMJ case reports vol. 2009 (2009): bcr08.2008.0700. doi:10.1136/bcr.08.2008.0700

Fernández-de-Las-Peñas, César, and María L Cuadrado. “Physical therapy for headaches.” Cephalalgia: an international journal of Headache vol. 36,12 (2016): 1134-1142. doi:10.1177/0333102415596445

Swanson JW. (2018). Migraines: Are they triggered by weather changes? mayoclinic.org/diseases-conditions/migraine-headache/expert-answers/migraine-headache/faq-20058505

Victoria Espí-López, Gemma, et al. “Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review.” Journal of the Japanese Physical Therapy Association = Rigaku ryoho vol. 17,1 (2014): 31-38. doi:10.1298/jjpta.Vol17_005

Whalen, John, et al. “A Short Review of the Treatment of Headaches Using Osteopathic Manipulative Treatment.” Current pain and headache reports vol. 22,12 82. 5 Oct. 2018, doi:10.1007/s11916-018-0736-y

A pinched, compressed, overly stretched, twisted, and entangled nerve can happen throughout the body. The most common locations are the neck, shoulder, upper back, upper chest, arm, elbow, hand, wrist, low back, legs, and feet. This disrupts the nerve's ability to function properly. Each nerve stimulates muscles and detects sensations in specific areas of the skin or internal organs so they work properly. Common symptoms are tingling, numbness, pain, weakness, and musculoskeletal problems. The average pinched nerve duration can last a few days to as long as 4 to 6 weeks or, in some cases, longer, in which case individuals should see a doctor or neurologist. Injury Medical Chiropractic and Functional Medicine Clinic can relieve, release, and restore nerve health.

Pinched Nerve

A pinched nerve is caused by pressure from surrounding tissues that place added stress on it. Muscles, bones, cartilage, and tendons can all press, pull, or entangle a nerve. This can result in a loss of function, which can then lead to symptoms including:

• Tingling
• Numbness
• Muscle weakness
• Various types of pain - sharp, electrical, throbbing, aching, and radiating/spreading out to other areas.
• Burning sensation
• A pinched nerve can become serious, cause chronic pain conditions and lead to permanent nerve damage.
• More severe cases may require surgery.

Pinched Nerve Duration

Pinched nerve duration depends on the injury, which can happen suddenly or gradually. A temporary case with an acute cause, such as injury or poor posture, can last several days. Cases related to chronic conditions, like arthritis, may last longer. Treatment, as well as recovery, also vary based on the location of the injury and what’s causing the pressure.

Body Locations

Neck

A pinched nerve in the neck can cause tingling sensations and pain, which can travel to the shoulders and arms. This type can be caused by:

• Sleeping position
• Repetitive movements
• Injuries
• The pain will usually ease within several days unless a chronic health condition is the cause of the pinching.

Lower back

A pinched nerve in the lower back is often brought on by herniated discs that compress nerve roots.

• It may also be caused by arthritis or injuries.
• Individuals may feel a sharp pain in the lower back, as well as in the buttocks and back of the leg.
• Sciatica may be a symptom.
• Lower back pain may be acute, lasting only a few days.
• If the injury doesn’t resolve, it may cause chronic back pain that can last 12 weeks or more.

Leg

• The legs can develop pinched nerves from herniated discs or injuries.
• If left untreated can lead to peripheral neuropathy.
• This can develop over several weeks or years.

Hip

A pinched nerve in the hip can last a few days if related to an injury. If the pain lasts longer than a few days, consult a doctor. Possible causes of chronic hip pain may include:

• Obesity
• Bone spurs
• Arthritis

Shoulder

Shoulder pain brought on by a pinched nerve usually starts in the upper spine and is caused by:

• Injury
• Tendinitis
• Arthritis
• To tell if the pain symptoms are from a pinched nerve and not a muscle strain, the pain tends to occur in one shoulder, and there is a sharpness to the aches.
• Left untreated, arthritis or tendinitis can lead to chronic pain that can come and go for several weeks, months, or years.

Wrist

Repetitive overuse is commonly linked to pinched nerves in the wrist.

• Pinched nerves can lead to carpal tunnel syndrome - pain and numbness extending through the arm, hand, and fingers.
• Pain lasting over two months could indicate other underlying conditions, like arthritis.

Chiropractic Relief

Chiropractic adjustments identify the impacted nerve/s and use various therapies to remove the compression, relieving symptoms and the injury or issue. A personalized treatment plan can include the following:

• Different types of massage.
• Multiple adjustments.
• Non-surgical decompression therapy.
• Muscle Energy Technique - MET
• Targeted stretches and exercises.
• Posture training.
• Anti-inflammatory nutritional recommendations.

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 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, 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

Cornwall, R, and T E Radomisli. “Nerve injury in traumatic dislocation of the hip.” Clinical orthopedics and related research, 377 (2000): 84-91. doi:10.1097/00003086-200008000-00012

Dmytriv, Mariya, et al. “PT or cervical collar for cervical radiculopathy?.” The Journal of family practice vol. 59,5 (2010): 269-72.

Hochman, Mary G, and Jeffrey L Zilberfarb. “Nerves in a pinch: imaging of nerve compression syndromes.” Radiologic clinics of North America vol. 42,1 (2004): 221-45. doi:10.1016/S0033-8389(03)00162-3

Lopez-Ben, Robert. “Imaging of nerve entrapment in the foot and ankle.” Foot and ankle clinics vol. 16,2 (2011): 213-24. doi:10.1016/j.fcl.2011.04.001

Needham, C W. “Pinched nerves and signature signs.” Connecticut Medicine vol. 57,1 (1993): 3-7.

Siccoli, Alessandro, et al. “Tandem Disc Herniation of the Lumbar and Cervical Spine: Case Series and Review of the Epidemiological, Pathophysiological and Genetic Literature.” Cureus vol. 11,2 e4081. 16 Feb. 2019, doi:10.7759/cureus.4081

As humans, there are a variety of stressors experienced daily. Stress collects in various body areas, most commonly the upper back, jaw, and neck muscles. Stress leads to tension in the muscles. The built-up tension can cause the spinal bones to shift out of alignment, irritating the nerves between the spinal bones. A cycle begins as increased nerve tension causes the muscles to continue to contract/tighten. The extra muscle tension continues to pull the spinal bones out of alignment, making the spine stiff and less flexible affecting posture, balance, coordination, and mobility, causing the spine to become further unstable. Chiropractic treatment at regular intervals is recommended to help realign and maintain proper position.

Why The Spine Goes Out of Alignment

The nerves in the body are intricately linked to the spinal cord, and small distortions in the alignment can cause nerves to misfire and malfunction. When the spine goes out of alignment, the nervous system/brain and nerves get stuck in a stressed or tense state. Even a minor misalignment can cause a series of discomfort symptoms to travel throughout the body.

Causes

Causes of misalignment that creates tension in the nerves and muscles include:

• Previous injuries.
• Unhealthy sleep.
• Stress - mental and physical.
• Physically demanding jobs.
• Overtraining.
• Sedentary habits.
• Foot conditions and problems.
• Unhealthy eating habits.
• Being overweight.
• Chronic inflammation.
• Arthritis.

Chiropractic Treatment

Chiropractic examination procedures:

Palpation

• A chiropractor will feel/palpate the spine to see if the bones are in alignment, move well, or are out of alignment and not moving correctly or moving at all.

Posture Exam

• If the head, shoulders, and hips are uneven or the shoulders and head are pulling forward, the spinal bones are out of alignment/subluxations.

Balance and Coordination

• Unhealthy balance and coordination can indicate the brain, nerves, and muscles are malfunctioning by spinal misalignment.

Range of Motion

• A loss of spinal movement flexibility can show tension in the nerves, muscles, and misalignments.

Muscle Test

• Loss of strength in a muscle can indicate the nerve signals are weak.

Orthopedic Tests

• Tests that put the body in stressful positions focus on what tissue/s may be injured and the causes.

X-rays

• X-rays look for abnormalities, dislocations, bone density, fractures, hidden/invisible injuries, and infections.

Injury Medical Chiropractic and Functional Medicine Clinic provide personalized treatment plans. These specific therapies are made to generate long-term spine benefits. Spinal manipulation, deep tissue massage, MET, and other manual therapy techniques, combined with exercise, help get the bones moving properly, the muscles functioning correctly, and the spine back into proper form. Treatment relieves muscle spasms, tension, and joint dysfunction, increases circulation, and retrains the muscles to remain relaxed.

The Natural Way to Heal

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, 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

Ando, Kei et al. “Poor spinal alignment in females with obesity: The Yakumo study.” Journal of Orthopaedics vol. 21 512-516. 16 Sep. 2020, doi:10.1016/j.jor.2020.09.006

Le Huec, J C et al. “Sagittal balance of the spine.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 28,9 (2019): 1889-1905. doi:10.1007/s00586-019-06083-1

Meeker, William C, and Scott Haldeman. “Chiropractic: a profession at the crossroads of mainstream and alternative medicine.” Annals of internal medicine vol. 136,3 (2002): 216-27. doi:10.7326/0003-4819-136-3-200202050-00010

Oakley, Paul A et al. “X-Ray Imaging is Essential for Contemporary Chiropractic and Manual Therapy Spinal Rehabilitation: Radiography Increases Benefits and Reduces Risks.” Dose-response: a publication of International Hormesis Society vol. 16,2 1559325818781437. 19 Jun. 2018, doi:10.1177/1559325818781437

Shah, Anoli A, et al. “Spinal Balance/Alignment - Clinical Relevance and Biomechanics.” Journal of biomechanical engineering, 10.1115/1.4043650. 2 May. 2019, doi:10.1115/1.4043650

The lumbar/low back muscles support the upper body's weight and are involved in moving, twisting, bending, pushing, pulling, and reaching. These repetitive actions can result in a lumbar strain, which is muscle damage or injury to the tendons or muscles of the lower back, causing spasms, soreness, and pain. A lumbar strain can be the source of severe pain symptoms; it can be debilitating and, if left untreated, can lead to chronic conditions. Injury Medical Chiropractic and Functional Medicine Clinic can relieve symptoms, realign the body, relax, rehabilitate, strengthen muscles, and restore function.

Lumbar Strain

The lumbar vertebra makes up the region of the spine in the lower back. Sudden injuries or overuse injuries can damage the tendons and muscles. Lumbar muscle strain is caused when the muscle fibers are abnormally stretched or torn. Lumbar strain can be acute/sudden or chronic/lingering. A strain that has been present for days or weeks is referred to as acute. It is considered chronic if it has persisted for over three months. It can occur at any age but is most common in individuals in their forties. Increased risk factors can include:

• Weakened back or abdominal muscles can cause
• Tight hamstrings can pull the low back muscles down.
• Excessive lower back curvature.
• Forward-tilted pelvis.

Symptoms

Lumbar strain can have varied signs and symptoms depending on the location, damage, and cause of injury. The damage can range from simple overstretching injuries to partial or complete tears of varying degrees. The tears cause inflammation in the surrounding area, resulting in back spasms and difficulty moving. A muscle spasm is a cramp caused by a sudden and involuntary contraction or twitch and can be one of the symptoms of a lumbar strain. Other symptoms can include:

• Muscle spasms either with activity or when resting.
• Stiffness in the low back.
• Difficulty standing or walking, with slight relief when resting.
• Trouble doing simple tasks like bending or climbing stairs.
• Low back pain can radiate into the buttocks without affecting the legs.
• The lower back may be tender and sore to the touch.
• Decreased muscle strength.
• Restricted or limited range of motion.
• Inability to maintain healthy posture because of stiffness and/or pain.
• Discomfort symptoms that persist.
• Discomfort ranges from mild aches to sharp, debilitating pain.
• Intermittent flare-ups.

Causes

There are often multiple underlying risk factors contributing to the injury or damage. A few of the most common causes:

• Aging
• Unhealthy posture
• Repetitive motions
• Overusing the muscles
• Improper body mechanics
• Trauma caused by injuries
• Muscle atrophy
• Genetics

Chiropractic

Depending on the severity, a doctor or health care provider could recommend chiropractic treatment and physical therapy. The chiropractor will perform an evaluation, combined with the doctor's diagnosis, to develop a customized/personalized treatment plan. Treatment may include:

• Ice and heat therapy
• Massage to stimulate blood circulation
• Percussive muscle stimulation
• Pelvic traction
• Ultrasound
• Stretching exercises
• Exercises to do at home for long-term relief.

It is a safe option to loosen tight back muscles, relieve pain, and promote lower back healing.

Spine Injuries In Sports

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

Ball, Jacob R et al. "Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations." Sports medicine - open vol. 5,1 26. 24 Jun. 2019, doi:10.1186/s40798-019-0199-7

Domljan, Z et al. "Lumbalni strain-sindromi" [Lumbar strain syndromes]. Reumatizam vol. 38,5-6 (1991): 33-4.

Li, H et al. "Rehabilitation effect of exercise with soft tissue manipulation in patients with a lumbar muscle strain." Nigerian journal of clinical practice vol. 20,5 (2017): 629-633. doi:10.4103/njcp.njcp_126_16

Williams, Whitney, and Noelle M Selkow. "Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance." Journal of sport rehabilitation vol. 29,4 400-404. 18 Oct. 2019, doi:10.1123/jsr.2018-0306

Nerve irritation occurs when the nerves exiting the spine become irritated and sensitized. Also known as nerve gliding restriction, it is a condition whereby a nerve becomes irritated by inflamed swelling of structures close to the nerve, such as joints, ligaments, muscles, or discs, that have sustained an accumulative strain which results in swelling and inflammation. A thorough chiropractic assessment and examination can diagnose the extent of the irritation and develop a personalized treatment plan.

Nerve Irritation

When swelling and inflammation interfere with the nerve root, the nerve transmits signals to the brain to let it know there is a threat. The brain interprets these signals and creates a protective response to avoid worsening the damage to the nerve. The protective reactions vary from person to person but can include the following:

• Muscle tightness and guarding
• Aching sensation
• Cramping
• Radiating discomfort or pain
• Pins and needles
• Tingling
• Numbness
• Nerve root irritation also inhibits the body from recovering as fast as it should.

Nerve irritation is not to be confused with nerve root compression or radiculopathy. This is when the nerve becomes compressed/pinched, resulting in the loss of its functions like muscle strength and sensation. Sometimes individuals with nerve irritation can also experience increased neural tension. The nerves adapt to the mechanical loads placed on them through regular movements. Restrictions to neural mobility can cause symptoms to worsen along the pathway and distribution of the nerve.

• The nervous system consists of the brain, spine, and nerve branches.
• The branches, similar to electrical cables, cannot stretch.
• Tension is generated when straightening out body areas, creating a pull and gliding of the nerve to the spinal cord.
• When nerve irritation occurs, signals are sent to protect the body, brain, spine, and branches.

Causes

Most commonly, nerve irritation occurs when a structure adjacent to the nerve; this could be a joint, ligament, and/or muscle that accumulates strain and becomes dysfunctional, swollen, inflamed, and/or spasms resulting from protective guarding.

• Mild nerve irritation can include accumulated strain from postural overload and swelling from a minor tear in an adjacent ligament.
• Often nothing shows as a problem on an MRI scan.
• Severe nerve irritation can include disc herniation and shows up on an MRI scan; surgery could be required in some cases.

Symptoms

• Stiffness
• Tightness
• Aches
• Pains
• Persist even after days of rest, stretching, targeted exercises, avoiding movements, etc.
• Stretching feels good at first, but the pain returns or worsens a few hours later or the next day.
• The irritation blocks the effective recovery of muscle, joint, tendon, and ligament discomfort symptoms.

Chiropractic Care

Treatment involves various therapies and strengthening the supporting structures while relaxing and releasing tight structures to avoid recurring injuries. Chiropractic care realigns the spine, corrects joints that have shifted out of place, helps to regulate the nervous system's function, and relieves irritation and inflammation. Whether in the form of an adjustment, traction, or guided exercise, all systems in the body are moved closer to a balanced state. This includes the:

• Nervous system
• Immune system
• Respiratory system
• Circulatory system
• Endocrine system
• Skeletal system
• All help support the body's self-healing process and increase the nervous system's function.

The chiropractic team will guide the patient through the rehabilitation process to get back to full strength.

Peroneal Nerve Irritation

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 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 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, 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

Ellis, Richard F, and Wayne A Hing. "Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy." The Journal of manual & manipulative therapy vol. 16,1 (2008): 8-22. doi:10.1179/106698108790818594

Gibson, William, et al. "Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults." The Cochrane database of systematic reviews vol. 9,9 CD011976. 14 Sep. 2017, doi:10.1002/14651858.CD011976.pub2

O'Shea, Simone D et al. "Peripheral muscle strength training in COPD: a systematic review." Chest vol. 126,3 (2004): 903-14. doi:10.1378/chest.126.3.903

Rozmaryn, L M et al. "Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome." Journal of hand therapy: official Journal of the American Society of Hand Therapists vol. 11,3 (1998): 171-9. doi:10.1016/s0894-1130(98)80035-5

Sipko, Tomasz, et al. "Mobility of cervical spine and postural equilibrium in patients with spinal overload syndrome." Ortopedia, traumatologia, rehabilitacja vol. 9,2 (2007): 141-8.

Neck injuries and whiplash symptoms can be minor and go away within a few days. However, whiplash symptoms can manifest days later and become varied and chronic, ranging from severe pain to cognitive problems. These are collectively called whiplash-associated disorders because of the varied complexity of the symptoms. A common condition is a whiplash nerve injury. These injuries can be severe and require chiropractic treatment.

Whiplash Nerve Injury

Surrounding muscles, tissues, bones, or tendons can cause a whiplash nerve injury. The neck's spinal nerve roots become compressed or inflamed, leading to cervical radiculopathy symptoms of tingling, weakness, and numbness that can radiate down the shoulder, arm, hand, and fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.

Neurological Cervical Radiculopathy

• Neurological problems can become severe and can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed.

Cervical radiculopathy involves one or more of the following neurological deficiencies.

• Sensory - Feelings of numbness or reduced sensation. There can also be tingling and electrical sensations.
• Motor - Weakness or reduced coordination in one or more muscles.
• Reflex - Changes in the body's automatic reflex responses. An example is a diminished ability or reduced hammer reflex exam.

Symptoms

Because every case is different, symptoms vary depending on the location and severity. Symptoms can flare up with certain activities, like looking down at a phone. The symptoms then go away when the neck is upright. For others, symptoms can become chronic and do not resolve when the neck is resting and supported. Common symptoms include:

Fatigue

• Decreased energy levels could be related to sleep problems, depression, stress, pain, concussion, or nerve damage.

Memory and/or concentration problems

• Cognitive symptoms could involve difficulty with memory or thinking.
• Symptoms can start shortly after the injury or not appear until hours or days later.
• Cognitive problems could be from a brain injury or related to various types of stress.

Headaches

• This could be neck muscles tightening or a nerve or joint becoming compressed or irritated.

Dizziness

• Dizziness could be from neck instability, a concussion/mild traumatic brain injury, and nerve damage.

Vision problems

• Blurry vision or other visual deficits could result from any number of causes, including concussion or nerve damage.
• Vision problems could also contribute to dizziness.

Ringing in the ears

• Also called tinnitus, this can be ringing or buzzing in one or both ears and can range from intermittent and minor to constant and severe.
• Whiplash complications such as injury to the brain region that controls hearing, nerve or vascular damage, jaw injury, or stress can lead to tinnitus.

Chiropractic Care

The appropriate chiropractic treatment is unique to each whiplash nerve injury and is directed at the primary dysfunctions detected during the initial examination. A personalized treatment plan addresses factors in an individual's work, home, and recreational activities. Treatment includes:

• Massage manual and percussive for nerve and muscle relaxation
• Decompression therapy
• Nerve release techniques
• Targeted stretches and exercises
• Ergonomics
• Health and nutritional recommendations

El Paso's Chiropractic Team

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 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 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, 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

Goldsmith R, Wright C, Bell S, Rushton A. Cold hyperalgesia as a prognostic factor in whiplash-associated disorders: A systematic review. Man Ther. 2012; 17: 402-10.

McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard "Netter diagram" distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.

Murphy DR. History and physical examination. In: Murphy DR, ed. Conservative Management of Cervical Spine Syndromes. New York: McGraw-Hill, 2000:387-419.

Shaw, Lynn, et al. “A systematic review of chiropractic management of adults with Whiplash-Associated Disorders: recommendations for advancing evidence-based practice and research.” Work (Reading, Mass.) vol. 35,3 (2010): 369-94. doi:10.3233/WOR-2010-0996

Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1, 2nd ed. Baltimore, MD: Williams and Wilkens, 1999.

Noninvasive treatments like chiropractic care, non-surgical decompression, massage therapy, non-steroidal anti-inflammatory drugs/NSAIDs, targeted/specific exercises, and ice/heat therapy successfully treat most cases of sciatica. However, more aggressive treatment could be necessary for severe cases, and this is where sciatica nerve block injections come in. The Injury Medical Chiropractic team can help you understand the diagnosis and explain the benefits.

Sciatica Nerve Block

Sciatic nerve block treatments can provide profound relief for intense, non-stop symptoms. The procedure can also provide important diagnostic information to help the spine specialist locate the exact nerve fibers contributing to the symptoms.

• The nerve block stops sciatic pain signals from transmitting.
• The procedure involves injecting an anesthetic and a steroid into the nerve roots.
• The steroid reduces inflammation.
• The anesthetic prevents nerve impulses from reaching the central nervous system - CNS.
• If the procedure is successful, surgery could be avoided altogether.

What to Expect

Individuals undergoing a sciatic nerve block will be awake during the procedure. Individuals that rather be sedated are recommended to speak with their healthcare provider during the planning phase.

• When the procedure begins, a nurse sterilizes the area around the injection site and applies a local anesthetic.
• The nurse will check the injection area for numbness.
• Then the spine physician inserts a needle using direct visualization from an ultrasound, fluoroscope, or CT scan and then injects the medications.
• After the procedure, the individual is moved to a recovery area and monitored.
• Most individuals can walk almost immediately after the injection, and vigorous exercise can be resumed a few days following the procedure, depending on the injury and what the spine specialist recommends.

Possible Complications

The procedure is done under direct visualization to minimize the risk of complications. However, possible complications could present and are usually linked to the needle insertion into the spinal column. These include:

• Bleeding
• Nerve Injury
• Infection

Complications are rare, but side effects like soreness around the injection site, nausea, and a headache are common and only last a little while.

Candidates

Individuals with underlying conditions and that are taking various medications may not qualify for a sciatic nerve block or have to consult their doctor for reasons that include the following:

Long-Term Anticoagulant Use

• Individuals taking blood thinners like daily aspirin, Plavix, or coumadin, will need to stop taking these medications before the procedure.

Allergy to Contrast Dye

• Sciatic nerve blocks are done using contrast dye or ultrasound.
• Individuals with an allergy to contrast dye will need to verify with their doctor or surgeon the feasibility of only using ultrasound guidance.

Abnormal Spinal Anatomy

• Individuals with abnormal spine anatomy have an increased risk for complications and are recommended not to have the procedure.

Morbid Obesity

• Morbid obesity is a significant risk factor for developing sciatica.
• The pain and symptoms often improve with weight loss.

Infection

• Inserting a needle with an injury, wound, or active infection near or around the injection site could cause spreading.

Treatment Duration

There is a wide range of responses to sciatic nerve blocks.

• Most individuals experience pain and symptom relief between two weeks and two to four months.
• Some individuals have a long-term resolution of their symptoms.
• However, it is also possible for the nerve block to be unsuccessful.

Unsuccessful Outcomes

The sciatic nerve is the longest in the body, and there are multiple potential sites for an anesthetic blockade.

• If a sciatic nerve block does not work, the spine specialist will reanalyze the diagnosis and see if the injection site was correct.
• Identifying the exact section of the nerve to anesthetize can be difficult and may require multiple nerve block attempts.

Individuals who continue to experience debilitating sciatica symptoms after a sciatic nerve block could be recommended to undergo surgical procedures.

• Sciatic nerve ablation is a procedure that destroys nerve pathways identified to cause pain and can provide long-term relief.
• If sciatica is caused by misalignment of the vertebrae or intense external pressure on the sciatic nerve, surgery to correct the underlying cause could offer a permanent solution.

Sciatica Syndrome

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from 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 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 feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

5 Questions to Answer Before Considering Sciatica Surgery, Johns Hopkins Medicine, accessed September 28, 2022, https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/5-questions-to-answer-before-considering-sciatica-surgery.

Jönsson, B et al. “Diagnostic lumbar nerve root block.” Journal of spinal disorders vol. 1,3 (1988): 232-5.

Kanaan, Tareq, et al. “The Efficacy of Therapeutic Selective Nerve Block in Treating Lumbar Radiculopathy and Avoiding Surgery.” Journal of pain research vol. 13 2971-2978. 18 Nov. 2020, doi:10.2147/JPR.S276331

Rodziewicz TL, Stevens JB, Ajib FA, et al. Sciatic Nerve Block. [Updated 2022 June 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470391/

Sciatica: Harvard Health Publishing, (2016, February 19), accessed September 28, 2022, of all the nerve https://www.health.harvard.edu/pain/sciatica-of-all-the-nerve.

Senthelal S, Dydyk AM, Mesfin FB. Ablative Nerve Block. [Updated 2022 April 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499975/

Aging Arthritis: How the body changes as the years go by is determined by an individual's diet, physical activity/exercise, genetics, stress levels, sleep patterns, and self-care. As the body ages, natural degeneration from everyday wear and tear will present. The focus is on understanding how age-related degeneration can affect the body and what to do to prevent and treat it.

Aging Arthritis

Arthritis refers to joint inflammation and is the fundamental cause of various disorders that include:

• Osteoarthritis
• Fibromyalgia
• Infectious arthritis
• Gout - metabolic arthritis
• Rheumatoid arthritis
• Lupus
• Childhood arthritis

Inflammation is just one symptom usually accompanied by swelling, pain, stiffness, immobility, and loss of function.

Osteoarthritis

• The most common type of arthritis is osteoarthritis, where the cartilage within joints begins to break down, and the bones begin to reshape.
• It's known as degenerative joint disease/wear and tear arthritis.
• The hands, hips, and knees are the most commonly affected joints.
• These changes often develop slowly but worsen if not treated.
• Symptoms include intense pain, stiffness, and swelling.

Fibromyalgia

• Fibromyalgia is a condition that causes pain in various areas of the body, sleep problems, and fatigue.
• Individuals with fibromyalgia can be more sensitive to pain sensations.
• Treatments and management plans are available to help ease symptoms and restor function.

Infectious Arthritis

• Infectious arthritis or septic arthritis is caused by an infection in the joints.
• Bacteria from another area of the body can invade a joint or the fluid surrounding it.
• Bacteria can enter the body from open wounds, injections, or surgery.
• Infectious arthritis is usually only present in one joint.
• Staphylococcus aureus is a bacteria that lives on healthy skin and is the cause of most infectious arthritis cases.
• A virus or fungus can also generate arthritic inflammatory symptoms.

Gout

• Gout is a common type of arthritis that causes inflammation and pain.
• It usually only affects one joint, most commonly the big toe joint.
• Symptoms can intensify, known as flares, and other periods with no symptoms, known as remission.
• Recurrent gout episodes can degenerate into gouty arthritis, a more serious form of arthritis.

Rheumatoid Arthritis

• Rheumatoid arthritis is an autoimmune and inflammatory disease in which the immune system attacks healthy cells, causing inflammation.
• Rheumatoid arthritis attacks numerous joints simultaneously, specifically in the hands, wrists, and knees.
• Rheumatoid arthritis causes the joint lining to become inflamed and starts to damage nearby tissues.
• Tissue damage that is severe or chronic enough can cause pain, balance problems, and visible deformities.
• Rheumatoid arthritis can also affect organs, like the lungs, heart, and eyes, by causing inflammation.

Lupus

• Lupus is an autoimmune disease that affects various body systems.
• An autoimmune disease is when the immune system mistakes its tissues for bacterial, viral, or fungal intruders and attacks them.
• Lupus symptoms can be vague, making the disease hard to diagnose.
• The disease is known as the great imitator because symptoms can mimic other diseases.
• Symptoms range from mild to life-threatening.
• Seeing a rheumatologist is recommended, as they are specialists that can diagnose and treat arthritis, lupus, and other joint-related diseases.

Childhood Arthritis

• Arthritis in children is known as juvenile or childhood arthritis.
• Juvenile idiopathic arthritis/juvenile rheumatoid arthritis is the most frequent form.
• The condition can cause long-term joint damage that can lead to disability.

Aging Arthritis and Chiropractic Care

Chiropractic care is recommended for the treatment of any form of arthritis. Chiropractic care can work with other therapies to reduce swelling and inflammation, alleviate pain, and improve mobility and flexibility.

• A chiropractor will utilize body imagery before beginning treatment.
• Imaging gives insight into the condition of the joints, and the visual, combined with a self-report from the individual, allows the chiropractor to create a personalized treatment plan.
• Once a chiropractor has identified which techniques the body can handle, treatment will commence that can include:
• Therapeutic massage
• Percussive massage
• Ultrasound
• Electrotherapy
• Low-level cold laser therapy
• Infrared heat

A chiropractor's objective is to rebalance, realign and strengthen the body, relieve pressure or stress at the junction of the joints, and expedite healing and rehabilitation.

LLT Laser 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 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 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 feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Abyad, A, and J T Boyer. "Arthritis and aging." Current opinion in rheumatology vol. 4,2 (1992): 153-9. doi:10.1097/00002281-199204000-00004

Chalan, Paulina, et al. "Rheumatoid Arthritis, Immunosenescence and the Hallmarks of Aging." Current aging science vol. 8,2 (2015): 131-46. doi:10.2174/1874609808666150727110744

Goronzy, Jorg J et al. "Immune aging, and rheumatoid arthritis." Rheumatic diseases clinics of North America vol. 36,2 (2010): 297-310. doi:10.1016/j.rdc.2010.03.001

Greene, M A, and R F Loeser. "Aging-related inflammation in osteoarthritis." Osteoarthritis and cartilage vol. 23,11 (2015): 1966-71. doi:10.1016/j.joca.2015.01.008

Sacitharan, Pradeep Kumar. "Ageing and Osteoarthritis." Sub-cellular biochemistry vol. 91 (2019): 123-159. doi:10.1007/978-981-13-3681-2_6

Can individuals with sensory nerve dysfunction incorporate nonsurgical decompression to restore sensory-mobility function to their bodies?

Introduction

The spinal column in the musculoskeletal system comprises bones, joints, and nerves that work together with various muscles and tissues to ensure that the spinal cord is protected. The spinal cord is part of the central nervous system where the nerve roots are spread out to the upper and lower body parts that supply sensory-motor functions. This allows the body to move and function without pain or discomfort. However, when the body and spine ages or when a person is dealing with injuries, the nerve roots can become irritated and cause weird sensations like numbness or tingling, often correlating with body pain. This can cause a socio-economic burden on many individuals and, if not treated right away, can lead to chronic pain. To that point, it can lead to many individuals dealing with body extremity pain associated with sensory nerve dysfunction. This causes many individuals dealing with musculoskeletal disorders to start looking for treatment. Today’s article examines how nerve dysfunction affects the extremities and how nonsurgical decompression can help reduce nerve dysfunction to allow mobility back to the upper and lower limbs. We speak with certified medical providers who incorporate our patients’ information to provide nonsurgical solutions like decompression to help individuals with nerve dysfunction. We also inform patients how nonsurgical decompression can restore mobility-sensory to the upper and lower extremities. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the sensory nerve dysfunction. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

How Nerve Dysfunction Affects The Extremities

Do you experience tingling or numb sensations in your hands or feet that don’t want to go away? Do you feel pain in different back portions that can only be relieved through stretching or resting? Or does it hurt to walk for long distances that you feel like you need to rest constantly? Many pain-like scenarios are associated with sensory nerve dysfunction that can affect the upper and lower extremities. When many individuals experience sensory nerve dysfunction and deal with weird sensations in their extremities, many think it is due to musculoskeletal pain in their neck, shoulders, or back. This is only part of the issue, as many environmental factors can be associated with sensory nerve pain, as the nerve roots are being compressed and agitated, causing sensory nerve dysfunction in the extremities. Since the nerve roots are spread out from the spinal cord, the brain sends the neuron information to the nerve roots to allow sensory-mobility function in the upper and lower extremities. This allows the body to be mobile without discomfort or pain and functional through daily activities. However, when many individuals start to do repetitive motions that cause the spinal disc to be compressed constantly, it can lead to potential disc herniation and musculoskeletal disorders. Since numerous nerve roots are spread to the different extremities, when the main nerve roots are aggravated, it can send pain signals to each extremity. Hence, many people are dealing with nerve entrapment that leads to lower back, buttock, and leg pain that can affect their daily routine. (Karl et al., 2022) At the same time, many people with sciatica are dealing with sensory nerve dysfunction that affects their walking ability. With sciatica, it can be associated with spinal disc pathology and causes many individuals to seek treatment. (Bush et al., 1992)

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Individuals experiencing headaches on top of the head could be caused by different factors. Can recognizing the what triggers pain or pressure help prevent this type of headache, and healthcare providers develop effective treatment plans?

Headache On Top of The Head

Various factors could cause a headache on top of the head; common causes include:

• Stress
• Sleep problems
• Eye strain
• Caffeine withdrawal
• Dental problems
• Hormonal changes
• Alcohol consumption

Causes

Many causes have to do with underlying issues happening in other parts of the body.

Stress

• Stress is a common cause of headaches, including one on top of the head.
• Researchers don't know exactly how stress causes headaches, but they think it causes tightening of the muscles in the back of the head or neck, which
• pulls the tissues down, resulting in pain or pressure in the scalp and/or forehead area.
• These are also called tension headaches.
• Headaches caused by stress generally feel like dull pressure rather than throbbing pain.

Sleep Problems

• Not getting enough sleep can induce a headache on top of the head.
• When the mind and body do not get proper sleep, it can interfere with body functions like temperature, hunger, and sleep-wake cycles, which can lead to headaches.
• It is common to feel more stressed when sleep-deprived, which can cause or compound a headache and other symptoms.

Eye Strain

• You may develop a headache on the top of your head after you've been reading, watching, or otherwise focusing on something for a while.
• Over time, your eye muscles tire and have to work harder, causing them to contract.
• These spasms can lead to headaches. Squinting can make the muscle contractions even worse.

Caffeine Withdrawl

• Individuals may feel pain on the top of their heads if they skip their regular coffee.
• Regular caffeine consumption can lead to dependency and withdrawal symptoms, which include headaches when intake is reduced or stopped.
• This type of headache can be moderate to severe and can feel worse with activity.
• Most individuals start to feel better from caffeine withdrawal after a week. (World Health Organization. 2016)

Dental Problems

• Teeth issues like cracks, cavities, or impaction can irritate the trigeminal nerve, setting off head pain.
• Teeth grinding can also lead to headaches.

Hormonal Changes

• Individuals who have a low level of thyroid hormone may experience headaches.
• This could be from having too little thyroid or a symptom of the condition.
• Like stress-induced headaches, this type is generally dull and not throbbing.
• Some women may feel pain on the top of their heads before menstruation triggered by estrogen levels dropping.

Alcohol

• Some individuals develop a headache on the top of their head or elsewhere within a few hours after drinking alcohol.
• This is known as a cocktail headache.
• Alcohol-induced headaches usually resolve within 72 hours.
• The mechanism behind this headache is not fully researched, but it's been thought that the widening of blood vessels in the brain/vasodilation when consuming alcohol may trigger head pain.
• This type of headache is different than a hangover headache that comes from overconsumption and is based on dehydration and the toxic effects of alcohol. (J G Wiese, M. G. Shlipak, W. S. Browner. 2000)

Rare Causes

Top-of-the-head pain can also result from more serious and rare causes:

Brain Tumor

• Headaches are one of the most common symptoms of brain tumors.
• A headache on the top of the head depends on the location and size of the tumor. (MedlinePlus. 2021)

Brain Aneurysm

• This is a weak or thin area in a brain artery that bulges and fills with blood, which can cause a life-threatening rupture.
• Headaches are the most common symptom. (Brigham and Women's Hospital. 2023)

Brain Bleed

• Also known as a brain hemorrhage, this condition can cause intensely painful and quick headaches.
• Brain bleeds can be caused by head trauma, high blood pressure, an aneurysm, a bleeding disorder, or liver disease. (New York-Presbyterian. 2023)

Treatment

Treatment for reducing a headache on top of the head includes:

• Putting an ice bag over the area to reduce inflammation.
• Getting an eye examination.
• Making healthy lifestyle adjustments like drinking more water throughout the day.
• Less caffeine intake.
• Changing sleep patterns for a healthier, rested mind and body. 
• Taking a therapeutic bath to relax the body.
• Gentle exercises like walking, pilates, or yoga.
• Practicing deep breathing.
• Mindfulness exercises like meditation.
• Taking non-steroidal anti-inflammatory medication or NSAIDs like aspirin, Advil/ibuprofen), or Aleve/naproxen.

Depending on the cause and symptoms, a doctor may suggest specialist treatment options like:

• Physical therapy
• Cognitive behavioral therapy
• Chiropractic therapy
• Acupuncture
• Prescription medication

A medical professional will be able to help identify the type of headache being experienced, offer treatment options, and advise on how to manage triggers.

Neck Injuries, El Paso, Texas

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

World Health Organization. (2016) Headache disorders.

Wiese, J. G., Shlipak, M. G., & Browner, W. S. (2000). The alcohol hangover. Annals of internal medicine, 132(11), 897–902. https://doi.org/10.7326/0003-4819-132-11-200006060-00008

MedlinePlus. (2021) Brain tumor.

Brigham and Women's Hospital. (2023) Brain aneurysm.

New York-Presbyterian. (2023) Brain hemorrhage.

For individuals about to engage in physical activity or exercise, how does warming up the body help prepare for the work ahead?

Central Nervous System Activation

A proper warm-up before physical activity or working out prepares the mind and body to reduce risks of injury, mentally and physically transition to physical activity work, and enhance performance. A well-designed warm-up also primes the central nervous system/CNS for activity. The central nervous system transmits messages to the muscles to prepare them for action. Central nervous system activation increases motor neuron recruitment and engages the sympathetic nervous system so the body can better handle the physical stressors. The process may seem complex, but priming the nervous system is as simple as warming up with light aerobic activity before getting into more explosive movements.

CNS

The CNS consists of the brain and spinal cord. This central communication system uses another part of the nervous system known as the peripheral nervous system or PNS to transmit and receive messages throughout the body. The PNS is connected to the entire body and the brain and spinal cord (CNS).

• Nerves run throughout the body, receiving signals from the CNS to the muscles, fibers, and organs, transmitting various information back to the brain. (Berkeley University. N.D.)
• There are two types of systems within the peripheral nervous system - somatic and autonomic.

1. Somatic nervous system actions are those controlled by the person through voluntary actions like choosing to pick something up.
2. The autonomic system is involuntary and generates actions like breathing or heartbeat. (Cleveland Clinic. 2020)

Properly preparing the body for an intense strength training session or other physical activity needs the correct messages to be sent through the autonomic nervous system.

Parasympathetic and Sympathetic States

The autonomic nervous system consists of two subcategories, which are parasympathetic and sympathetic.

• The sympathetic nervous system helps the body get ready to face stress which includes physical stress. (R. Bankenahally, H. Krovvidi. 2016)
• The fight, flight, or freeze response describes the sympathetic nervous system's aspect.
• The parasympathetic nervous system is responsible for relaxation and de-stressing.

Individuals are recommended to perform a few calming movements and actions after a workout to return the body to a parasympathetic state. This can be:

• Stretching
• Lying with the legs elevated
• Relaxing yoga poses
• Box breathing
• Taking a warm shower or bath
• Foam rolling
• Massage

Returning the mind and body to a calm state helps with recovery and reduces stress hormone production. (National Academy of Sports Medicine. 2022)

Why Activate the CNS

Activating the CNS can increase performance and prevent injuries. The process wakes up and alerts the body for the activity. Individuals are recommended before beginning a training session, to communicate to the body about the physical stress it is about to endure and to prepare for the work ahead. This is a concept known as post-activation potentiation/PAP. (Anthony J Blazevich, Nicolas Babault. 2019) PAP helps increase force and power production, which enhances physical performance.

• Whenever an individual trains, the brain adapts and learns what the body is doing and the purpose of the training.
• Muscle memory describes this interaction.
• Individuals who have started up a new strength training routine or after an extended break report feeling awkward for the first few sessions, or even weeks, depending on their experience. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)
• However, after a few sessions, the body is more adept at performing the movements and ready to increase resistance, repetitions, or both.
• This has to do with the neural drive and muscle memory than it has to do with true potential physical abilities. (Simon Walker. 2021)
• Training the CNS to be alert and pay attention can increase the development of a healthy mind-muscle connection combined with muscle memory. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)

General Warm-Up

The first step is a general warm-up that should use large muscle groups and be of low intensity so as not to exhaust the body before beginning the actual training. General warm-up benefits central nervous system activation and the entire body include: (Pedro P. Neves, et al., 2021) (D C. Andrade, et al., 2015)

• Increases blood circulation.
• Assists the release of oxygen from hemoglobin and myoglobin.
• Warms the muscles, so they contract more effectively.
• Increases nerve impulse speed.
• Increases nutrient delivery.
• Lowers joints' resistance through increased synovial fluid/joint lubrication.
• Increases joint range of motion.
• Improves joint resiliency.
• Removes metabolic waste quicker.
• Reduces risk of injury.

A general warm-up can be simple as any aerobic activity will work. This can include:

• Performing bodyweight movements - light jumping jacks or jogging in place.
• Treadmill
• Rowing machine
• Stair climber
• Elliptical trainer

It is recommended to use the rating perceived exertion scale/RPE to determine the general warm-up effort. An exertion rating of between 5 to 6 is equivalent to moderate walking or a slow jog. Individuals should be able to speak clearly without taking a pause.

Try this strategy before the next workout to see increased performance and reduced injury risks.

Ankle Sprains Recovery

General Disclaimer *

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

The nervous system. Berkeley University.

Cleveland Clinic. Nervous system: What it is, types, symptoms.

Bankenahally R, Krovvidi H. (2016) Autonomic nervous system: anatomy, physiology, and relevance in anesthesia and critical care medicine. BJA Education. 16(11):381-387. doi:10.1093/bjaed/mkw011

National Academy of Sports Medicine. Sympathetic vs. parasympathetic overtraining.

Blazevich, A. J., & Babault, N. (2019). Post-activation Potentiation Versus Post-activation Performance Enhancement in Humans: Historical Perspective, Underlying Mechanisms, and Current Issues. Frontiers in physiology, 10, 1359. https://doi.org/10.3389/fphys.2019.01359

Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor perspectives in medicine, 8(6), a029769. https://doi.org/10.1101/cshperspect.a029769

Walker S. (2021). Evidence of resistance training-induced neural adaptation in older adults. Experimental gerontology, 151, 111408. https://doi.org/10.1016/j.exger.2021.111408

P. Neves, P., R. Alves, A., A. Marinho, D., & P. Neiva, H. (2021). Warming-Up for Resistance Training and Muscular Performance: A Narrative Review. IntechOpen. doi: 10.5772/intechopen.96075

Andrade, D. C., Henriquez-Olguín, C., Beltrán, A. R., Ramírez, M. A., Labarca, C., Cornejo, M., Álvarez, C., & Ramírez-Campillo, R. (2015). Effects of general, specific, and combined warm-up on explosive muscular performance. Biology of sport, 32(2), 123–128. https://doi.org/10.5604/20831862.1140426

How does spinal decompression help reduce somatosensory pain associated with individuals dealing with back and leg pain?

Introduction

As we all know, the human body is a complex system that works together to perform various actions without feeling pain or discomfort. With muscles, organs, tissues, ligaments, bones, and nerve roots, each component has its job and interacts with other body parts. For instance, the spine collaborates with the central nervous system to instruct the muscles and organs to function correctly. Meanwhile, the nerve roots and muscles work together to provide mobility, stability, and flexibility to the upper and lower body extremities. However, as time passes, the body ages naturally, and this can lead to unwanted issues. Normal and traumatic factors can interfere with the neuron signals from the brain and cause somatosensory pain in the upper and lower extremities. This pain-like sensation can affect each body section, making the individual miserable. Luckily, there are ways to reduce somatosensory pain and provide relief to the body. Today’s article explores how somatosensory pain can impact the lower extremities, particularly the legs and back, and how non-surgical treatments like spinal decompression can alleviate somatosensory pain in the lower extremities. At the same time, we work hand-in-hand with certified medical providers who use our patient’s information to treat and mitigate somatosensory pain affecting the legs and back. We also inform them that non-surgical treatments like spinal decompression can help alleviate residual pain-like symptoms from the lower extremities. We encourage our patients to ask essential and important questions while seeking education from our associated medical providers about their pain. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer

How Does Somatosensory Pain Affect The Legs & Back?

Are you experiencing numbness or tingling in your legs or back that disappears after a few minutes? Do you feel questionable pain in your lumbar spine after work? Or do you feel a warm sensation in the back of your legs that turns into sharp shooting pain? These issues may be related to the somatosensory system within the central nervous system, which provides voluntary reflexes to muscle groups. When normal movements or traumatic forces cause problems to the somatosensory system over time, it can lead to pain that affects the body’s extremities. (Finnerup, Kuner, & Jensen, 2021) This pain may be accompanied by burning, pricking, or squeezing sensations that affect the lumbar region. Many factors can be associated with somatosensory pain, which is part of the central nervous system and works with the spinal cord. When the spinal cord becomes compressed or aggravated due to injury or normal factors, it can lead to low back and leg pain. For example, a herniated disc in the lumbosacral area can cause nerve roots to send pain signals to the brain and cause abnormalities in the back and legs. (Aminoff & Goodin, 1988)

When people are dealing with back and leg pain from somatosensory pain, it can cause them to be miserable by reducing their quality of life and leading to a life of disability. (Rosenberger et al., 2020) At the same time, individuals dealing with somatosensory pain will also begin to feel inflammatory effects from the affected muscle area in the legs and back. Since inflammation is a body’s natural response when dealing with pain, the inflammatory cytokines can cause a cascading effect from the brain through the spinal cord, causing leg and back pain. (Matsuda, Huh, & Ji, 2019) To that point, somatosensory pain is associated with inflammation caused by normal or traumatic factors that can cause overlapping risk factors contributing to leg and back pain. Luckily, numerous treatments can reduce these overlapping risk factors caused by somatosensory pain and help restore the lower body extremities’ function.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

A nerve becomes pinched/compressed when added pressure is placed on it by surrounding structures that can include muscles, bones, ligaments, tendons, or a combination. This injures and damages the nerve causing function problems and symptoms and sensations in that area or other parts of the body that are supplied by that nerve. Medical practitioners refer to this as nerve compression or entrapment. Although compressed nerves are more commonly associated with the neck, arms, hands, elbows, and lower back, any nerve in the body can experience irritation, spasms, inflammation, and compression. The causes and treatment of a compressed nerve in the knee.

Compressed Nerve In The Knee

There’s only one nerve that goes through the knee that has an increased risk of getting compressed. It’s a branch of the sciatic nerve called the peroneal nerve. The nerve goes around the outside of the knee before traveling down the outside of the lower leg. At the bottom of the knee, it lies between the bone and skin, making it vulnerable to irritation or compression by anything that can put pressure on the outside of the knee.

Causes

Traumatic injuries over time can lead to pressure on the nerve from inside the knee. Common causes of a compressed nerve in the knee include:

Frequently Crossing Legs

• Compression by the opposite knee, while the legs are crossed is the most common cause.

Knee Brace

• A too-tight or strong brace can compress the leg and nerve.

Thigh-High Compression Stockings

• Designed to maintain pressure on the legs, if too tight these stockings can compress the nerve.

Squatting Posture For Long Periods

• This position places pressure on the side of the knee.

Fractures

• A fracture of the large lower leg bone/tibia or sometimes the small bone/fibula near the knee can entrap the nerve.

Lower Leg Cast

• The portion of the cast around the knee can be tight and compress the nerve.
• Tell the doctor if a cast or brace feels tight or is causing numbness or pain in the leg.

Knee-High Boots

• The top of a boot can land right below the knee and be too tight pinching the nerve.

Knee Ligament Injury

• The nerve can become compressed due to bleeding or inflammation from an injured ligament.

Knee Surgery Complications

• This is rare, but the nerve can inadvertently get pinched during knee replacement surgery or an arthroscopic procedure.

Prolonged Bed Rest

• When lying down the legs tend to rotate outward and the knees flex.
• In this position, the mattress can place pressure on the nerve.

Tumors or Cysts

• Tumors or cysts can develop right on top or next to a nerve irritating and compressing the area.

Abdominal or Gynecologic Surgery

• The equipment used to keep the legs rotated outward and the knees flexed for gynecologic and abdominal surgeries can compress the nerve.

Symptoms

The peroneal nerve supplies sensation and movement to the outside of the lower leg and the top of the foot. When compressed, it becomes inflamed, which causes the symptoms of a compressed nerve. Usually, only the lining/myelin sheath around the nerve is what gets injured. However, when the nerve gets damaged, the symptoms are similar but more severe. Common symptoms include:

• Weakness that limits the ability to lift the foot toward the leg aka dorsiflexion.
• This causes dragging the foot when walking.
• The ability to turn the foot outward and extend the big toe is also affected.
• Symptoms can be felt on the outside of the lower leg and on the top of the foot and include:
• Tingling or pins and needles sensations.
• Numbness.
• Loss of sensation.
• Pain.
• Burning.
• For individuals that have had a pinched nerve for two or more weeks, the muscles supplied by the nerve can begin to waste away or atrophy.
• Symptoms can be intermittent or continuous depending on the cause.
• The other common cause is a pinched nerve in the lumbar/lower spine.
• When this is the cause, sensations, and pain will present in the lower back or the back and outside of the thigh.

Diagnosis

A doctor will look at medical history and perform an examination to make a diagnosis, determine the cause, and lay out a personalized treatment plan. The nerve in the knee can be felt as it travels around the top of the tibia, so a doctor may tap on it. If there is shooting pain down the leg, a pinched nerve may be present. Tests a doctor may order can include:

Knee X-ray

• Shows any bone fractures or abnormal masses.

Knee MRI

• Can confirm the diagnosis
• Shows masses within the nerve.
• Shows details of fractures or other problems in the bones.

Electromyogram - EMG

• Tests electrical activity in the muscles.

Nerve Conduction Test

• Tests the signal speed of the nerve.

Treatment

Treatment is aimed at reducing pain and improving mobility.

Over-the-Counter Pain Medication

• OTC medication can reduce inflammation and improve symptoms short term.

Ice and Heat

• Applying either heat or ice for 15 to 20 minutes at a time can provide relief from the symptoms.
• An ice pack can make symptoms worse if it adds more pressure on the nerve.

Chiropractic and Physical Therapy

• Chiropractic and physical therapy can release the compressed nerve, realign the structures, strengthen the muscles, and provide gait training.

Orthotic Boot

• If walking gait is affected because the foot cannot bend, an orthotic boot can help.
• This is a support that maintains the foot in a neutral position to walk normally.

Corticosteroid Injection

• A corticosteroid injection can reduce inflammation and relieve pressure on the nerve.

Surgery

• The nerve can suffer permanent damage if it has been pinched for a long time.
• If that happens, surgery cannot repair the damage.
• A doctor can perform surgery to correct a fracture, tumor, or other invasive problem causing a compressed nerve.
• If conservative treatment doesn’t work, a peroneal nerve decompression procedure can be done to remove the pressure.
• If surgery is needed, symptoms can disappear immediately, but it takes around four months to recover and rehabilitate.

Injury Rehabilitation

General Disclaimer *

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

Krych, Aaron J et al. “Is peroneal nerve injury associated with worse function after knee dislocation?.” Clinical orthopedics and related research vol. 472,9 (2014): 2630-6. doi:10.1007/s11999-014-3542-9

Lezak B, Massel DH, Varacallo M. Peroneal Nerve Injury. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549859/

Soltani Mohammadi, Sussan, et al. “Comparing the squatting position and traditional sitting position for ease of spinal needle placement: a randomized clinical trial.” Anesthesiology and pain medicine vol. 4,2 e13969. 5 Apr. 2014, doi:10.5812/aapm.13969

Stanitski, C L. “Rehabilitation following knee injury.” Clinics in sports medicine vol. 4,3 (1985): 495-511.

Xu, Lin, et al. Zhongguo gu Shang = China Journal of Orthopedics and Traumatology vol. 33,11 (2020): 1071-5. doi:10.12200/j.issn.1003-0034.2020.11.017

Yacub, Jennifer N et al. “Nerve injury in patients after hip and knee arthroplasties and knee arthroscopy.” American Journal of physical medicine & Rehabilitation vol. 88,8 (2009): 635-41; quiz 642-4, 691. doi:10.1097/PHM.0b013e3181ae0c9d

Introduction

The central nervous system is responsible for sending neuron signals to all the organs and muscles in the body, allowing for mobility and proper functioning. These signals are constantly exchanged between the organs, muscles, and brain, informing of their activities. However, environmental factors and traumatic injuries can impact the nerve roots, disrupting the flow of signals and leading to musculoskeletal disorders. This can result in misalignments in the body and chronic pain if left untreated. Today’s article will inform us about peripheral neuropathy, a nerve injury correlated with back pain, and how spinal decompression can relieve this condition. We work with certified medical providers who use our patients’ valuable information to provide non-surgical treatments, including spinal decompression, to relieve pain-like symptoms associated with peripheral neuropathy. We encourage patients to ask essential questions and seek education about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

What Is Peripheral Neuropathy?

Peripheral neuropathy refers to a range of conditions that affect the nerve roots and can cause chronic symptoms throughout the body, as research studies revealed. The nerve cells in our body transmit messages between the brain and other body parts. When these cells are damaged, it can disrupt communication between the central nervous system, leading to muscle and organ problems. Studies have linked peripheral neuropathy to pain and other symptoms, which can have a negative impact on daily activities, quality of life, and mental and physical well-being. Additionally, peripheral neuropathy may increase the risk of falls.

How Peripheral Neuropathy Correlates With Back Pain

Have you recently felt a tingling or sharp sensation when you stepped or experienced constant lower back pain? These symptoms could be related to peripheral neuropathy, which can cause back pain. “The Ultimate Spinal Decompression,” a book by Dr. Perry Bard, D.C. and Dr. Eric Kaplan, D.C., FIAMA, explains that peripheral neuropathy is nerve damage that affects the legs, causing numbness, pain, tingling, and oversensitivity to touch in the toes and feet. This can cause the muscles in the lower back to shift weight away from the painful areas, leading to low back pain. Research studies have revealed that chronic low back pain can involve both nociceptive and neuropathic pain mechanisms. Nociceptive pain is a response to tissue injury that activates the muscles. In contrast, neuropathic pain affects nerve roots branching from the spine and lower limbs, often resulting from damaged spinal discs. Fortunately, there are ways to manage peripheral neuropathy and its associated back pain.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

The nervous system communicates with the entire body and reacts to internal and external changes using electrical and chemical impulses to send and receive messages. Messages travel/synapse from one neuron to another using specialized chemicals known as neurotransmitters.

Paresthesia refers to sensations of numbness, tingling, prickling, skin crawling, itching, or burning, usually in the arms, hands, legs, and/or feet, but can affect other areas of the body. 

Chiropractic care, massage therapy, decompression therapy, and functional medicine can relieve tissue and nerve compression, improve flexibility, range of motion, and mobility, and strengthen the muscles surrounding the affected nerve to maintain optimal health and prevent worsening or further injury.

Paresthesia

The sensation comes on without warning and is usually painless and described as tingling or numbness. There are different causes of paresthesia, including:

• Compressed or pinched nerve.
• Nerve injury.
• Nerve damage from diabetes.
• High levels of vitamin D or other vitamins.
• High blood pressure.
• Infection.
• Fibromyalgia.
• Multiple sclerosis.
• Stroke.
• Tumor in the spinal cord or brain.

Some individuals have chronic or long-term paresthesia, which can be a sign of a more serious nerve injury or condition. Added physical stress can cause surrounding tissues to irritate or entangle the nerve leading to building pressure. This pressure causes paresthesia in the area interrupting circulation and function. A pinched nerve can happen anywhere in the body, like the neck, shoulder, wrist, back, and face.

• A herniated disc in the lower spine can cause back pain and paresthesia in the leg or foot on the affected side.
• Carpal tunnel syndrome is a pinched nerve in the wrist that causes numbness and tingling in the hand and fingers.
• Pinched nerve symptoms can be intermittent or constant.
• Usually, a temporary sensation is caused when pressure is placed on the affected nerve.
• Once that pressure is relieved, the discomfort goes away.

Individuals with an Increased Risk

Overuse Injury

• Individuals with jobs or hobbies requiring repetitive motions are at a higher risk for nerve compression, paresthesia, or injury.
• Anyone can get a pinched nerve, and most individuals will experience paresthesia at some point.

Prolonged Lying Down

• Lying down for extended periods can cause nerve compression.

Obesity

• Extra weight places added pressure on nerves.

Diabetes

• Diabetes can cause nerve and tissue damage.

Pregnancy

• Weight and water gain can cause swelling and increase pressure on nerves.

Thyroid Disease

• This puts individuals at risk for carpal tunnel syndrome.

Rheumatoid arthritis

• This causes inflammation, which can also compress nerves in the joints.

Diagnosis

To diagnose paresthesis, a doctor will look at the individual's medical history and ask questions about the symptoms. They will perform a physical examination and, depending on the findings, may recommend tests that can include:

Nerve Conduction Study

• This measures how fast nerve impulses travel in the muscles.

Electromyography - EMG

• To look at the electrical activity of how nerves and muscles interact.

Magnetic Resonance Imaging - MRI

• This looks at the different areas of the body in high definition.

Ultrasound

• Used to produce images, this can be applied to the smaller areas to look for nerve compression or damage.

Chiropractic

Treatment options depend on the cause of the paresthesia. Body misalignments can cause nerve interference that can lead to health problems such as migraines, or can disrupt nerve communication and block proper circulation. Chiropractic care focuses on treating the nervous system and is a safe and effective method for treating nerve problems that cause discomfort and sensations. After a thorough examination of problem areas, massage, decompression, and chiropractic adjustments will:

• Realign and restore proper nerve function.
• Restore proper blood circulation.
• Increase the function of the body's systems.
• Promote optimal levels of health and wellness.

The Science of Motion

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, 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

Bova, Joseph, and Adam Sergent. “Chiropractic management of a 24-year-old woman with idiopathic, intermittent right-sided hemiparesthesia.” Journal of chiropractic medicine vol. 13,4 (2014): 282-6. doi:10.1016/j.jcm.2014.08.002

Christensen, Kim D, and Kirsten Buswell. “Chiropractic outcomes for managing radiculopathy in a hospital setting: a retrospective review of 162 patients.” Journal of chiropractic medicine vol. 7,3 (2008): 115-25. doi:10.1016/j.jcm.2008.05.001

Freihofer, H P Jr. “Parästhesien” [Paresthesia]. Schweizerische Monatsschrift fur Zahnheilkunde = Revue mensuelle suisse d'odonto-stomatologie vol. 89,2 (1979): 124-5.

Karne, Sampada Swapneel, and Nilima Sudhakar Bhalerao. “Carpal Tunnel Syndrome in Hypothyroidism.” Journal of Clinical and diagnostic research: JCDR vol. 10,2 (2016): OC36-8. doi:10.7860/JCDR/2016/16464.7316

An acute injury or changes to the upper body over time can cause a compressed/pinched nerve in the shoulder. A pinched nerve in the shoulder happens when a muscle, ligament, tendon, or bone irritates or presses on a nerve exiting the neck. Shoulder nerve pain can develop from various sources, such as overuse work injuries, sports injuries, household chores, tendinitis, arthritis, torn cartilage, and other medical conditions, and injuries can contribute to symptoms. Chiropractors are highly qualified to treat pinched nerves. They are trained in whole-body realignment and rehabilitation techniques that find the root source and relieve pressure on compressed nerves.

Shoulder Nerve Pain

The shoulder joint is one of the most complex joints because of its wide range of motion. It is used so frequently that repetitive motion strain is common, often leading to injury. It is usually because of the continued use combined with an unhealed strain/injury that leads to shoulder nerve injury or when surrounding tissues like cartilage or tendons irritate or compress the nerves.

• Pinched nerves also occur when a nerve root in the neck is damaged through wear and tear or an acute injury.
• Individuals 50 years and older are likely to experience pinched nerves because of degeneration in the cervical spine and/or arthritis.
• A nerve can become pinched when bone spurs form around the spinal discs.
• Bone spurs are formations of bone that grow when discs weaken with age.
• Bone spurs grow around the discs putting pressure on the nerve root.

Symptoms

Compressed Pinched Nerve/Cervical Radiculopathy

• Pain sensations in the shoulder.
• Tingling and/or pins and needles in fingers or hand.
• Weakness in shoulder and arm muscles.

Symptoms have been known to overlap with shoulder arthritis, frozen shoulder, swimmer's shoulder, or rotator cuff tears, so it's always best to consult a chiropractor to understand possible causes. Other conditions with symptoms to compare:

Shoulder Arthritis

• Stiffness in the joint.
• Aching inside the shoulder.
• Grinding when moving the joint.

Frozen Shoulder/Adhesive Capsulitis

• Stiffness in the joint.
• Pain in one shoulder.
• Decreased range of motion and movement.

Swimmer's Shoulder/Impingement

• Pain and discomfort in the shoulder.
• Weakness in the surrounding area.
• Stiffness or tightness in the joint.
• Impeded range of motion.

Rotator Cuff Tears

• Pain and discomfort symptoms when moving the shoulder.
• Weakness in the arm.
• Deep aching sensations along the top and side of the joint.

Chiropractic Treatment

Chiropractors are experts on the neuromusculoskeletal system. First, a thorough medical examination will be conducted, including health history and regular activities, to understand the nature of the symptoms. Depending on the type of injury, tests and exams may be needed to help diagnose and pinpoint the cause. Then the chiropractor will develop a personalized treatment plan. The objective is to relieve pressure and tension on the nerves and relax the muscles. In addition to adjusting the joint or other impacted areas, the therapy team will provide at-home exercises and stretches to maintain the adjustments and expedite healing.

Chiropractic Rehab

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, 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

Kokkalis, Zinon T et al. “Nerve Injuries around the Shoulder.” Journal of long-term effects of medical implants vol. 27,1 (2017): 13-20. doi:10.1615/JLongTermEffMedImplants.2017019545

Leider, Joseph D et al. "Treatment of suprascapular nerve entrapment syndrome." Orthopedic reviews vol. 13,2 25554. 11 Jul. 2021, doi:10.52965/001c.25554

Matzkin, Elizabeth, et al. "Swimmer's Shoulder: Painful Shoulder in the Competitive Swimmer." The Journal of the American Academy of Orthopaedic Surgeons vol. 24,8 (2016): 527-36. doi:10.5435/JAAOS-D-15-00313

Neviaser, Andrew S, and Jo A Hannafin. "Adhesive capsulitis: a review of current treatment." The American Journal of sports medicine vol. 38,11 (2010): 2346-56. doi:10.1177/0363546509348048

Safran, Marc R. "Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve." The American Journal of sports medicine vol. 32,3 (2004): 803-19. doi:10.1177/0363546504264582

Strakowski, Jeffrey A, and Christopher J Visco. "Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder." Muscle & Nerve vol. 60,1 (2019): 1-6. doi:10.1002/mus.26505

The nervous system is a network of roads that feed into highways that connect to an interstate system. The roads are the nerves that innervate the muscles and the extremities; the interstate is the spinal cord. When the system works optimally, the nerves consistently transmit signals/messages to and from the brain without any problems. The signals travel back and forth, and the traffic flows smoothly. When the activities of these nerves and cells get disrupted, the central nervous system fails to perform basic functions that can cause musculoskeletal issues, conditions, and CNS diseases. Keeping the nervous system strong can be done by adopting ways to maintain health and function.

The Nervous System

The system regulates and coordinates body activities and is made up of two major divisions, these include the following:

• Central nervous system - consists of the brain and spinal cord.
• Peripheral nervous system - consists of all other neural elements, including the peripheral and autonomic nerves.

The principal organs of the nervous system include:

• Brain
• Spinal cord
• Eyes
• Ears
• Sensory taste organs
• Sensory smell organs
• Sensory receptors are located in the muscles, joints, skin, and other areas throughout the body.

A complex network of nerves, the nervous system reacts to internal and external stimuli through several physical actions to maintain vital bodily functions. These include:

• Heartbeat
• Breathing
• Digestion
• Body temperature
• Pain responses
• Emotions
• Support body posture.
• Strengthening the body to deal with day-to-day pressure and maintain quality of life.

Disorders

Various disorders can affect the system and can be damaged by the following:

• Blood circulation disruption
• Trauma
• Infections
• Structural Disorders like carpal tunnel syndrome and peripheral neuropathy.
• Functional Disorders could be headaches, neuralgia, and dizziness.
• Vascular Disorders
• Tumors
• Degeneration
• Autoimmune disorders

Symptoms

The most common signs and symptoms may be experienced differently and can include:

• Back pain radiates to the feet, toes, or other body areas.
• Muscle rigidity/tension.
• Weakness or loss of muscle strength.
• Muscle atrophy.
• Tingling.
• Loss of feeling.
• Persistent headaches.
• Sudden onset headaches.
• Headaches that change symptoms.
• Memory loss.
• Lack of coordination.
• Impaired mental ability.
• Double vision or loss of sight.
• Tremors and seizures.
• Slurred speech.

The symptoms of a nervous system disorder may present like other medical conditions or problems. Always see a professional healthcare provider for proper diagnosis.

Keeping the Nervous System Strong

Nutrition To Transmit Signals

Nerves need minerals, proteins, and vitamins to send electrical impulses. Foods that contain these nutrients include:

• Calcium — regulates the generated and transmitted electrical impulses. Milk, leafy greens and eggs are rich sources of calcium.
• Potassium - bananas, oranges, pomegranates, and prunes, are good sources of potassium.
• Dark chocolate contains tryptophan, an amino acid that produces and maintains neurotransmitters.
• Vitamin B — Vitamins B1, B2, and B6 assist the nerves in sending impulses from the brain to the body.

B Vitamins Provide Nerve Protection

A myelin sheath covers the nerves for protection and provides insulation for transmitting. Worn-out or damaged myelin sheaths have been associated with illnesses like Alzheimer's. Vitamin B12 helps repair damaged nerves and regenerate fibers. It is found in beef, poultry, eggs, and seafood.

Folate or vitamin B9 promotes Schwann cell proliferation, migration, and production of nerve growth factor. This vitamin is found in spinach, pomegranates, and beets.

Stretching and Breathing

Stress produces the hormone cortisol. Constant production of cortisol affects the nervous system, which can affect reflexes, concentration, and memory. Stretching the body and learning breathing exercises and relaxation techniques activates the part of the nervous system responsible for breathing and heart rate, decreasing cortisol levels.

Chiropractic Care and Functional Medicine

The spinal cord has multiple functions in restoring, rejuvenating, and keeping the nervous system strong. Chiropractic care has a highly responsive therapeutic effect on the nervous system because of its focus on the spine. Spinal decompression, traction, soft tissue manipulation, and other treatments help regulate and restore the function of the nervous system. Chiropractic benefits:

• Reduces or eliminates pain.
• Regulates respiration.
• Lowers heart rate.
• Improves the quality of sleep.
• Increases energy.
• Improves digestive function.
• Improves cognition and clarity.
• Improves balance and coordination.
• Increases flexibility and mobility.
• Reduces or eliminates headaches and migraines.

Hyperhomocysteinemia

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

Archibald, Lennox K., and Ronald G. Quisling. "Central Nervous System Infections." Textbook of Neurointensive Care 427–517. 7 May. 2013, doi:10.1007/978-1-4471-5226-2_22

Bhagavati, Satyakam. "Autoimmune Disorders of the Nervous System: Pathophysiology, Clinical Features, and Therapy." Frontiers in neurology vol. 12 664664. 14 Apr. 2021, doi:10.3389/fneur.2021.664664

Gyer, Giles, et al. "Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation." Journal of integrative medicine vol. 17,5 (2019): 328-337. doi:10.1016/j.joim.2019.05.004

Jessen, Kristján R et al. "Schwann Cells: Development and Role in Nerve Repair." Cold Spring Harbor perspectives in biology vol. 7,7 a020487. 8 May. 2015, doi:10.1101/cshperspect.a020487

Powers, Scott K et al. "Disease-Induced Skeletal Muscle Atrophy and Fatigue." Medicine and science in sports and exercise vol. 48,11 (2016): 2307-2319. doi:10.1249/MSS.0000000000000975

In cold weather, it's normal to experience cold hands and fingers. But if there is a coldness in only one finger while the rest of the hand is normal, changes to skin color, numbness, tingling, or pain symptoms could be a sign of poor circulation or an underlying medical condition. Cold fingers could indicate various problems, including overuse injuries, vitamin deficiencies, Raynaud's syndrome, hypothyroidism, anemia, arterial disease, or an autoimmune condition. Chiropractic care and massage therapy can increase circulation, release compressed nerves, relax the muscles, and restore mobility and function.

Cold Fingers

Blood circulates throughout, nourishing and maintaining body warmth. When compression, obstructions, or narrowing paths inhibit blood flow, the body cannot achieve proper circulation. Unhealthy circulation can cause several symptoms, including:

• Pins and needles sensations along the shoulder, arm, hand, and fingers.
• Weakened arm and hand muscles.
• Numbness.
• Cold finger/s.
• Muscles aches, soreness, and tightness.
• Swelling.
• Pale or bluish skin color.

Overuse Injury

Repeating one movement or motion constantly over time can lead to overuse syndrome/repetitive motion disorder in the hands and arms. Certain jobs and activities can cause overuse syndrome, including:

• Cashiers.
• Food service work.
• Graphic sign work.
• Computer work.
• Sewing work.
• Landscaping.

All of these jobs and activities can put a lot of repeated stress on the hands and arms.

Vitamin B-12 Deficiency

Vitamin B-12 is required for proper red blood cell formation and neurological function. It is found in many foods, including eggs, fish, meat, poultry, and dairy products. A vitamin B-12 deficiency can cause neurological symptoms like numbness, tingling, and coldness in the hands and feet. Other symptoms include:

• Anemia
• Fatigue
• Weakness
• Difficulty maintaining balance
• Depression
• Soreness of the mouth

A doctor requires a blood sample to test for the deficiency. A common treatment is a high dose of an oral supplement or injections for individuals that have difficulties absorbing B-12 through the digestive tract.

Raynaud's Syndrome

Raynaud's syndrome is a condition that causes some areas of the body, usually the fingers, to feel cold and numb when exposed to cold temperatures or high-stress levels. This happens because the small arteries that supply blood to the skin are experiencing spasms. During an episode, the arteries narrow, which prevents blood from circulating correctly. The fingers can change color, going from white to blue to red. When the flare-up ends, and the blood flow returns to normal, there may be tingling, throbbing, or swelling. The condition isn't usually debilitating, and treatment options often include medications that expand the blood vessels to improve circulation. These include calcium channel blockers, alpha-blockers, and vasodilators.

Hypothyroidism

Hypothyroidism is when the thyroid doesn't produce enough hormones. Hypothyroidism comes on gradually and rarely generates symptoms in the early stages. Hypothyroidism doesn't cause cold fingers but increases the body's sensitivity to cold. Other symptoms include:

• Fatigue
• Muscle weakness, tenderness, and achiness.
• Joint swelling, stiffness, and pain.
• Puffiness.
• Dry skin.
• Hoarseness.
• Weight gain.
• High or elevated cholesterol levels.
• Thinning hair and hair loss. 
• Depression.

Over time, the condition can cause complications such as obesity, joint pain, heart disease, and infertility. A doctor can detect hypothyroidism with a simple blood test. Treatment involves taking a daily dose of synthetic thyroid hormone.

Anemia

Anemia is when the blood has a lower-than-normal amount of red blood cells. It also occurs when the red blood cells lack a crucial iron-rich protein called hemoglobin. Hemoglobin assists red blood cells in delivering oxygen from the lungs to the rest of the body. A low supply of hemoglobin to carry oxygen to the hands can result in cold fingers. There may also be fatigue and weakness. Iron deficiency is what typically causes most cases. A doctor may suggest nutritional adjustments if blood work indicates low iron levels. An iron-rich nutritional plan and taking iron supplements can help relieve symptoms.

Arterial Diseases

Diseases that affect the arteries can reduce blood flow to the hands, causing cold fingers. This can be from plaque buildup or inflammation in the blood vessels. Any blockage in the blood vessels can prevent blood from circulating normally. Another arterial problem is primary pulmonary hypertension, which affects the lungs' arteries and can lead to Raynaud’s syndrome.

Chiropractic Care

Chiropractic adjustments can remove misalignments, restore proper nerve communication, increase blood flow, and correct an overactive sympathetic nervous system. Massaging the shoulders, arms, and hands relaxes the nerves, and muscles, breaks up compressed tissues, and increase blood flow. The circulation of lymphatic fluid around the body is also promoted, which carries toxins away from the muscles and tissues. To improve circulation, the following may be utilized:

• Deep tissue pressure is effective at relieving congestion and tension.
• Percussive massage to break up scar tissue.
• Non-surgical Decompression to stretch the spine and body out.
• Lymphatic drainage is designed to improve the circulation of the fluid.
• Reflexology

Carpal Tunnel Syndrome

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from 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 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, 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

Bilić, R et al. “Sindromi prenaprezanja u saci, podlaktici i laktu” [Overuse injury syndromes of the hand, forearm and elbow]. Arhiv za higijenu rada i toksikologiju vol. 52,4 (2001): 403-14.

Ernst, E. “Manual therapies for pain control: chiropractic and massage.” The Clinical journal of pain vol. 20,1 (2004): 8-12. doi:10.1097/00002508-200401000-00003

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the blood circulatory system work? 2010 Mar 12 [Updated 2019 Jan 31]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279250/

Pal, B et al. “Raynaud's phenomenon in idiopathic carpal tunnel syndrome.” Scandinavian journal of rheumatology vol. 25,3 (1996): 143-5. doi:10.3109/03009749609080004

Waller, D G, and J R Dathan. “Raynaud's syndrome and carpal tunnel syndrome.” Postgraduate medical journal vol. 61,712 (1985): 161-2. doi:10.1136/pgmj.61.712.161

Individuals dealing with aching knees is one of the most common health problems and affects people of all ages. The knee is the largest joint in the body, comprised of muscles, tendons, ligaments, cartilage, and bones. The knees support walking, standing, running, and even sitting. Constant use makes them highly susceptible to injuries and conditions. The knees are also surrounded by a complex network of nerves that transmit messages to and from the brain. Damage to the nerves from an injury or disease can create various symptoms of discomfort in and around the knee joint.

Knee Neuropathy

Causes

Knee discomfort symptoms can be brought on by injury, degenerative disorders, arthritis, infection, and other causes, including:

Rheumatoid arthritis

• This is a chronic inflammatory disorder that causes the knees to swell and causes damage to the cartilage.

Osteoarthritis

• This type of arthritis causes the cartilage to steadily wear away, causing damage to the joints and various symptoms.

Cartilage Issues

• Overuse, muscle weakness, injury, and misalignments can cause compensating postures and movements that can wear down and soften the cartilage, generating symptoms.

Several factors can increase the risk of developing knee neuropathy, including:

• Previous knee injury
• Undiagnosed and untreated knee injury
• Unhealthy Weight
• Gout
• Compromised leg muscle strength and/or flexibility

Symptoms

Symptoms associated with a knee injury or disorder can vary, depending on the severity and damage. Symptoms can include:

• Joint stiffness
• Swelling in the joint.
• Reduced movement/flexibility in the joint.
• Increased instability/feeling of weakness in the knee.
• Changes in skin color around the knee joint, like increased redness or pale discoloration.
• Numbness, coldness, or tingling in and/or around the joint.
• Pain symptoms could be a dull ache or throbbing felt throughout the knee.
• Sharp, stabbing discomfort in a specific area.

If left untreated, knee neuropathy could permanently affect the ability to walk and lead to partial or total loss of knee function and mobility. Doctors recommend taking note of the following:

• What activity/s generates symptoms?
• Where are the symptoms located?
• What the pain feels like?

Treatments available for knee pain

Chiropractic treatment offers various approaches to addressing the pain caused by nerve damage. Standard treatment includes chiropractic adjustments, therapeutic massage, non-surgical decompression, stretching, posture and movement training, and nutritional anti-inflammatory plans. Our medical team specializes in non-surgical treatments that decrease symptoms and increase strength, flexibility, mobility, and restore function.

Knee Injuries Adjustment

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 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 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, 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

Edmonds, Michael, et al. “The current burden of diabetic foot disease.” Journal of clinical orthopedics and trauma vol. 17 88-93. 8 Feb. 2021, doi:10.1016/j.jcot.2021.01.017

Hawk, Cheryl, et al. “Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline.” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181

Hunter, David J et al. “Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY.” BMC musculoskeletal disorders vol. 19,1 132. 30 Apr. 2018, doi:10.1186/s12891-018-2048-0

Kidd, Vasco Deon, et al. “Genicular Nerve Radiofrequency Ablation for Painful Knee Arthritis: The Why and the How.” JBJS essential surgical techniques vol. 9,1 e10. 13 Mar. 2019, doi:10.2106/JBJS.ST.18.00016

Krishnan, Yamini, and Alan J Grodzinsky. “Cartilage diseases.” Matrix biology: journal of the International Society for Matrix Biology vol. 71-72 (2018): 51-69. doi:10.1016/j.matbio.2018.05.005

Speelziek, Scott J A, et al. “Clinical spectrum of neuropathy after primary total knee arthroplasty: A series of 54 cases.” Muscle & nerve vol. 59,6 (2019): 679-682. doi:10.1002/mus.26473