For individuals with cervical arthritis, can physical therapies help manage symptoms and bring pain relief?

Cervical Arthritis

Cervical spondylosis, more commonly known as cervical arthritis or arthritis of the neck, refers to the wearing down of neck bones, discs, tendons, ligaments, and joints. The primary symptoms are neck pain and stiffness. However, it is also possible to have cervical spondylosis and not have any symptoms. The condition affects over 85% of individuals over age 65. (American Academy of Orthopaedic Surgeons, 2021) Treatment can consist of conservative therapies and includes physical therapies, alternative medicine therapies, at-home self care, and over-the-counter and prescription medications. Severe cases of cervical spondylosis are treated with surgery to repair damaged parts of the spine. 

Symptoms

Neck pain and headaches at the back of the head are usually the first symptoms. (Kazeminasab S. et al., 2022) The neck can also feel stiff, with worse morning symptoms that improve throughout the day.  (Johns Hopkins Medicine, 2024) Symptoms can range from mild discomfort to severe pain. As cervical spondylosis progresses, individuals can experience:

• Inability to turn the head or bend the neck.
• A clicking or grinding noise when turning the neck.
• Tenderness with pressure on the neck.
• Pain that radiates to the shoulders or shoulder blades.
• Pain and symptoms that disrupt sleep, sometimes causing waking up throughout the night.
• Symptoms that decrease with rest.

More severe symptoms include:

Cervical Bone Spurs - Osteophytes

Some with cervical spondylosis have bony growths that can place pressure on the spinal nerves (a pinched nerve) (Bon Secours, 2024). Compression of spinal nerve roots produces cervical radiculopathy, which leads to pain, tingling, and weakness that radiates into the shoulders, arms, and hands.

Cervical Myelopathy

This refers to spinal impingement that leads to spinal cord dysfunction. (Spinal cord dysfunction is a nervous system disorder with interruptions in the spinal cord's motor, sensory, and autonomic functions.) Symptoms include pain, tingling, numbness, muscle spasms, and weakness in areas below the neck. Spinal cord dysfunction can affect mobility, hand use, and bladder or bowel function control.

Causes

Where degenerative changes are commonly associated with cervical spondylosis, other conditions, and factors can lead to it and include:

Autoimmune Diseases

• Rheumatoid arthritis and psoriatic arthritis can cause chronic inflammation in the cervical spine.

Trauma

• Neck trauma, including injury and repetitive stress on the neck.
• Cervical spondylosis is commonly seen in occupations that involve neck-stressing activities, such as sports.

Age

• Wearing down of the spinal discs cartilage between the vertebrae.
• Developing cervical spondylosis increases with age, especially after 40. (Kazeminasab S. et al., 2022)

Genetics

• Genetic components have been identified in connection with cervical spondylosis, meaning that some types of arthritis that lead to spinal damage are hereditary. (Kazeminasab S. et al., 2022)

Treatment

Treatment begins conservatively, using protocols to preserve function and avoid surgery. Nonsurgical treatments include medications, physical therapy, at-home exercises, and alternative medicine. The treatment method a healthcare provider chooses will depend on how severe the spondylosis is and other factors like age, how much pain is being experienced, the cause, and overall health. The main objectives are to relieve pain, prevent long-term damage to the spinal cord and nerves, and help maintain performing daily activities. (Bon Secours, 2024)

Medications

Medicines used to treat cervical spondylosis include:

Nonsteroidal Anti-inflammatory Drugs NSAIDs

• NSAIDs, including ibuprofen and naproxen sodium, are available without a prescription to relieve pain and inflammation.
• A healthcare provider can prescribe a more powerful NSAID to help manage severe symptoms.

Corticosteroids

• A corticosteroid injection or a short course of an oral corticosteroid, like prednisone, can ease pain and reduce inflammation.

Muscle Relaxants

• If cervical spondylosis causes muscle spasms, a healthcare provider can prescribe cyclobenzaprine, a muscle relaxant, to manage symptoms.

Antidepressants

• Some types of antidepressants can ease neck pain from cervical spondylosis.

Anti-seizure Meds

• Some anti-seizure drugs can cause nerve pain resulting from damaged nerves.

Physical Therapies

• Physical therapy will help manage pain and stiffness and keep muscles loose and relaxed.
• A physical therapist will teach the patient exercises to stretch and strengthen neck and shoulder muscles.

At-Home Self Care

At-home exercises can help relieve pain, stiffness, and swelling. Some can include:

• Reducing inflammation and stress on the neck through posture training.
• At-home targeted stretches and exercises will help bring pain relief.
• Ice treatment reduces swelling.
• Heat will increase circulation.
• A neck brace may be recommended briefly to avoid muscle weakness and stiffness.

Alternative Medicine

• Chiropractic adjustments and massage therapy are alternative treatments that will help manage cervical spondylosis.
• Chiropractic adjustments can relieve neck pain and stiffness. (American Chiropractic Association, 2024)
• X-rays are done before to ensure it is safe. (Jenkins H. J. et al., 2018)
• Acupuncture can also be beneficial in reducing neck pain and increasing energy circulation. (Gu C. L. et al., 2019)
• Various therapeutic massage therapies will help relieve neck pain and stiffness. Talk to a healthcare provider before starting treatment so they can advise on whether neck massages are safe.

Surgery

A healthcare provider may recommend surgical treatment when all other treatments have failed, if neurological symptoms are severe, or if neck arthritis causes extreme pain or disability. Surgery to treat cervical spondylosis can involve removing bone spurs, part of the cervical vertebra, or a herniated disc. The removed portions of the cervical spine are fused with hardware and bone grafts.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic therapy is among the more conservative treatment options and may be tried first before proceeding with surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.

Arthritis Explained

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

American Academy of Orthopaedic Surgeons. (2021). Cervical spondylosis (arthritis of the neck). https://orthoinfo.aaos.org/en/diseases--conditions/cervical-spondylosis-arthritis-of-the-neck/

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends, and risk factors. BMC musculoskeletal disorders, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4

Johns Hopkins Medicine. (2024). Spinal arthritis (arthritis in the back or neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis

Bon Secours. (2024). Cervical osteoarthritis (arthritis in the neck). https://www.bonsecours.com/health-care-services/spine-care/conditions/cervical-osteoarthritis

American Chiropractic Association. (2024). Neck pain. https://www.acatoday.org/patients/neck-pain-and-chiropractic/

Jenkins, H. J., Downie, A. S., Moore, C. S., & French, S. D. (2018). Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropractic & manual therapies, 26, 48. https://doi.org/10.1186/s12998-018-0217-8

Gu, C. L., Yan, Y., Zhang, D., & Li, P. (2019). An evaluation of the effectiveness of acupuncture with seven acupoint-penetrating needles on cervical spondylosis. Journal of pain research, 12, 1441–1445. https://doi.org/10.2147/JPR.S199798

For individuals who enjoy walking for exercise and health, can knowing when to replace walking shoes help protect their feet and prevent musculoskeletal injuries?

Replacing Walking Shoes

The best walking shoes must be replaced to ensure musculoskeletal health and prevent injuries. Wearing worn-out shoes during prolonged standing, distance walking or running, and high-impact workouts can exacerbate lower back stiffness, soreness, and pain. Comfortable walking shoes offer substantial support and superior cushioning, working to alleviate discomfort and prevent injury. However, they break down cushioning and support with each step. When an individual walks or runs 500 miles, most athletic shoes are ready for replacement and should be recycled or saved for non-exercise purposes.

500-Miles

Most athletic shoes are built to last 350 to 500 miles. (Cook, S. D., Kester, M. A., and Brunet, M. E. 1985) Walkers' feet don't impact their feet as hard as runners', but individuals are unlikely to feel support and cushioning past 500 miles. Weight is also a factor; the more an individual weighs, the faster their shoes wear down.

• It is recommended that individuals who walk 30 minutes daily or an average of three to four hours a week replace their shoes every six months.
• Individuals who walk 60 minutes daily or seven hours weekly replace their shoes every three months.
• Replace walking shoes every three to six months or every 500 miles.

Shoe Wear

When athletic shoes are glued together, they start to wear from the factory to the stores as the adhesive dries out. The air pockets in the cushioning slowly begin to dissipate. Walking shoes are often on sale when old models are discontinued and may already be over a year old. To get the longest life, buy the current model and ask staff how long they have been on the shelf.

Shoe Care

Shoes can last longer by following a few guidelines:

Use walking Shoes only for Walking Exercise

• It is recommended not to wear them for daily use.
• Use them only for walking.
• Wearing them all day exposes them to foot moisture and bacteria, breaking them down faster.

Air Out Shoes Between Uses

• Store walking shoes where they are exposed to air so they can dry out completely between uses.
• Keeping them in a gym bag won't allow them to breathe.

Wash Shoes and Air Dry

• When washing walking shoes, use gentle soap and cold water to prevent the glue from breaking down.
• Always air dry rather than placing them in a dryer.
• Avoid heat, as this will contribute to faster glue breakdown.

Replace the Insoles

• Individuals who prefer custom insoles should replace them each time shoes are replaced.
• However, changing the insole is not a substitute for replacing the shoe.
• Cushioning insoles do not provide the same support.
• A new insole will not fix a broken-down walking shoe.

Rotate Walking Shoes

Alternate walking shoes every one to two months. The feet sense the difference when the older pair begins to break down. For individuals who walk one or more times daily, alternating shoes allow each pair to dry out fully between uses. Having two pairs of walking shoes to alternate will keep you from replacing them more frequently.

Signs It's Time

Many wait until their shoes look worn out, with holes and torn laces, before considering replacing them. Here are a few guidelines for when to replace walking shoes:

Worn Tread

• Many of today's walking shoes change color through the sole to alert the individual.
• If green turns to pink or some other combination, it's time to replace the shoes.

Overpronation or Supination

• This can lead to the heel of the shoe being worn down on one side more than the other.
• This can affect your gait, making it important to replace your walking shoe.

Wrinkles On The Side or Bottom Of The Sole

• The breakdown of support and cushioning can cause this.

Weak Ankle Support

• This is usually from the uppers being broken down around the ankle.

Wear Patterns

Where and how the soles and heels of walking shoes are worn can tell a foot and shoe professional which shoes the individual should wear. It is recommended that used shoes be taken to the shoe store. They can indicate overpronation, a neutral gait, or supination.

Risks

The risks of wearing worn-out walking shoes include:

• Lack of cushioning and support can lead to foot, knee, or leg pain.
• Injuries include plantar fasciitis and iliotibial band syndrome. (Rethnam, U., and Makwana, N. 2011)
• Individuals who notice new soreness and aches may indicate that the shoes need replacing.

Recycling

Keeping one or two pairs of used walking shoes is great for household chores. They can also be recycled or donated. Recycled walking shoes are used to make playground and track surfaces. Look for a shoe bin at a community recycling center or athletic shoe store. Shoes in decent condition can be donated to charity clothing centers.

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Custom Foot Orthotics Benefits

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cook, S. D., Kester, M. A., & Brunet, M. E. (1985). Shock absorption characteristics of running shoes. The American journal of sports medicine, 13(4), 248–253. https://doi.org/10.1177/036354658501300406

Rethnam, U., & Makwana, N. (2011). Are old running shoes detrimental to your feet? A pedobarographic study. BMC research notes, 4, 307. https://doi.org/10.1186/1756-0500-4-307

For individuals who are feeling back pain, neck pain, or shoulder pain, can using postural techniques help decrease pain and develop strategies to maintain correct posture?

Maintaining Correct Posture

Exercise and postural correction are two of the most important strategies to manage pain. (Robin McKenzie, the great spine guru PT, (May S. and Donelson R. 2008) However, it takes work to maintain correct posture as the day progresses. While working or driving, most of us forget to be mindful of our posture; we slip back into unhealthy habits of sitting slouched, to the side, forward, etc, which often leads to continued pain and movement limitations. Studies on postural correction and its effect on overall back or neck pain levels are limited. (Lederman E. 2011) However, some studies show that a forward-head posture increases stress and load on the neck. (Hansraj K. K. 2014) If an individual has pain that improves with sitting upright, checking posture as the day progresses could be beneficial. There are ways to start changing posture and maintain the change. First, visit a physical therapist, spine specialist, or chiropractor to learn how to sit or stand to manage posture problems. They can teach individuals how to attain healthy posture and manage their condition. These strategies can then be used to maintain correct posture.

Lumbar Support

A lumbar roll/support is one of the simplest ways to attain and maintain a healthy sitting posture. These specialized pillows can help maintain the forward curve in the lower back. Maintaining the lumbar lordosis curve is essential for keeping stress off the back muscles, joints, and discs. Lumbar support pillows can be found in various stores, office supply stores, or purchased online. A physical therapist PT can help train individuals to use a lumbar roll properly.

Utilize the Slouch Overcorrect Exercise

The slouch overcorrect exercise is a simple maneuver for training the body to find and maintain its neutral position. It involves slowly shifting from a slouched position to an overcorrected postural position. Once posture is overcorrected, a slight relaxation from a fully erect posture will return to sitting properly. Practicing this exercise daily can help train the body to feel the muscles, listen to the body, and maintain proper posture. The muscles have memory, and the more often the body is placed in optimal posture, the muscles memorize their healthy, pain-free positioning.

Kinesiology Tape

Kinesiology tape is a flexible cotton adhesive that facilitates muscle contractions and inhibits muscle spasms and pain. (Han J. T. et al., 2015) Using the tape is a simple way to help facilitate the postural support muscles. The tape can be applied to the middle trapezius and rhomboid muscles to help support the shoulder blades and spine. Kinesiology tape for postural control also gently pulls on the muscles when slouching to remind the individual to sit up or stand straight.

Scapular Stabilization Exercises

A physical therapist or chiropractor can help improve posture through targeted exercises. Strengthening the muscles attached to the shoulder blades can help individuals better control their posture. (Shiravi S. et al., 2019) Exercises like the prone T, I, or Y can help improve the muscles' neuromuscular recruitment to maintain correct posture.

Use an Alarm

Setting an alarm while working can help train the body to maintain correct posture. Most of us sit at a computer, desk, or workstation with proper posture, but depending on what we're working on, we eventually slouch, lean to the side, or have a forward head posture. All computers and phones have an alarm setting or app. Use the alarm or timer to go off every 20 to 30 minutes. When the alarm rings, look at your posture to recognize what you're doing, get up and move around to stretch the body, sit and readjust, reset the alarm, and continue working. As you get better at maintaining appropriate posture, you won't need the alarm anymore, and readjusting will become automatic.

Chiropractic Team

Sitting and standing with unhealthy posture can significantly cause back, neck, and shoulder pain. By visiting a chiropractic and physical therapy team and learning to attain and maintain correct posture, you can quickly relieve pain, resolve musculoskeletal issues, and prevent future pain symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Scapular Winging In-Depth

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

May, S., & Donelson, R. (2008). Evidence-informed management of chronic low back pain with the McKenzie method. The Spine Journal: official North American Spine Society journal, 8(1), 134–141. https://doi.org/10.1016/j.spinee.2007.10.017

Lederman E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. Journal of bodywork and movement therapies, 15(2), 131–138. https://doi.org/10.1016/j.jbmt.2011.01.011

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and head position. Surgical Technology International, 25, 277–279.

Han, J. T., Lee, J. H., & Yoon, C. H. (2015). The mechanical effect of kinesiology tape on rounded shoulder posture in seated male workers: a single-blinded randomized controlled pilot study. Physiotherapy theory and practice, 31(2), 120–125. https://doi.org/10.3109/09593985.2014.960054

Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P., & Khaleghi Tazji, M. (2019). Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports Health, 11(3), 272–279. https://doi.org/10.1177/1941738119835223

For individuals who sit at work for long hours, can years of practicing unhealthy posture be corrected through a step-by-step approach to ensure optimal body position while sitting?

Sitting Posture

Sitting up straight with a healthy posture requires the conscious alignment of the hips, pelvis, lower back, upper back, shoulders, neck, and head. Learning or retraining oneself to maintain correct sitting posture can relieve lower back pain, improve respiration and digestion, and reduce tension in the neck and shoulders. (Albarrati, A. et al., 2018) It starts by paying attention to posture throughout the day and correcting it whenever forward head posture, leaning, or slouching develops. Targeted exercises can also help build upper-body strength, and stretching can stabilize and strengthen the core muscles, lower back, and pelvic joints. (Albarrati, A. et al., 2018)

Sit Up Straight Guide

Sitting up straight can be uncomfortable because it is not a natural position for the body to be in for an extended time. Nowadays, work, school, appointments, and other activities require us to sit much longer than intended. The muscles also have to work against gravity, leading to muscle exhaustion, slouching, and slumping, which can cause chronic back, leg, neck, and/or shoulder pain. (Jung, K. S. et al., 2020)

Sitting up straight may seem simple, but the focus tends to be on straightening just the lower/lumbar spine. This posture is unsustainable and exhausts and stresses the upper and lower back. (Jung, K. S. et al., 2020) The whole body needs to be considered when protecting the stability and balance of the spine. Learning and maintaining the ability to sit up straight is a process that requires practice.  Find a comfortable chair to sit in, and follow these steps to achieve the optimal postural alignment (Canadian Centre for Occupational Health and Safety, 2022)

Knee Spacing

• The hips should be at a roughly 90-degree angle.

Knee Position

• The knees should be at a 90-degree angle level with the hips.
• Use a pillow to achieve the right knee position if the seat is too low.

Keep the Feet Flat on the Floor

• If feet don't reach the floor, place a footstool, box, book, or other flat object underneath them.

Sitting Bones

• Also known as the ischial tuberosities, these are two knobby bones on the underside of the pelvis.
• Feel around to find them.

Pelvis Adjustment

• Shift the body so that the sitting bones are directly under the pelvis rather than situated too far back, stressing the lower back or too far forward, leading to slumping.

Spine Check

• There should be a slight spinal curve, and one should be able to slip a hand between the lower back and the back of the chair.

Shoulder Check

• The shoulders should be level and vertically aligned with the hips.
• If the shoulder blades are pulled back or the shoulders are lifted or curled forward, relax them into a neutral position.

Head Positioning

• The head tends to tilt too far forward while sitting as work and the day progresses.
• Adjust the head position to align the neck with the upper spine.
• The head should be slightly tilted forward, with the ears aligned with the shoulders.

Check for Pain and Discomfort

• Pain may be due to structural imbalances of the spine, pelvis, or hips.
• Use a lumbar chair support or place a rolled-up towel or cushion at the lower back to keep the back straight.

Added Tips

Tools and tricks to help prevent and avoid back, hip, and neck pain.

Chairs

• All the bells and whistles for an ergonomic desk chair are unnecessary.
• Focus on features like adjustable seat height and lumbar support. The correct seat depth recommendations are deeper if tall and shallower if short. (van Niekerk, S. M. et al., 2012)

Cushions

• If sitting on a cushion or using one to bolster the back or hips, recommendations are not to go too soft.
• Cushions that are too soft allow the ability to shift from one hip to the next, often without realizing it.
• They usually eventually flatten and lose support.

Monitor Position

• There is no point in sitting straight if the monitor is too high or too low.
• The monitor should be at eye level to maintain the proper head and shoulder alignment.
• If the monitor is too low, place a box or book underneath it.
• If it is too high, raise the chair's height and place a footrest under the feet to keep them flat.

Avoid Crossing Legs or Feet

• Crossing the legs or feet places stress on the opposite hip, thigh, and knee and wears the body out faster.
• If the hips or legs are tiring prematurely, the individual is not sitting correctly or in the wrong chair.

Use Comfortable Footwear

• Maintaining flat feet on the floor while sitting is imperative.
• This is not possible in high heels or platform shoes.
• Change into a comfortable pair of flat shoes while sitting.

Take Regular breaks

• Even with an ergonomic desk chair, the body is not meant to be sitting for hours and hours.
• Get up at least every hour, walking and stretching to reactivate the muscles and circulation.

Try a Sitting-Standing Desk

• Sitting-standing desks have become more popular.
• A standing desk can ensure better body posture and reduce stress on the lower back when placed at the right height and position. (Canadian Centre for Occupational Health and Safety, 2022)

Sitting up straight requires body alignment awareness, stable core muscles, and balanced pelvis, hips, spine, shoulders, neck, and head positioning. It may take some time before these steps become normal, but they will become second nature with perseverance and practice. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Posture and Mobility

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Albarrati, A., Zafar, H., Alghadir, A. H., & Anwer, S. (2018). Effect of Upright and Slouched Sitting Postures on the Respiratory Muscle Strength in Healthy Young Males. BioMed research international, 2018, 3058970. https://doi.org/10.1155/2018/3058970

Jung, K. S., Jung, J. H., In, T. S., & Cho, H. Y. (2020). Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain. Medicina (Kaunas, Lithuania), 57(1), 3. https://doi.org/10.3390/medicina57010003

Canadian Centre for Occupational Health and Safety. (2022). Working in a sitting position - good body position. Retrieved from https://www.ccohs.ca/oshanswers/ergonomics/sitting/sitting_position.html

van Niekerk, S. M., Louw, Q. A., & Hillier, S. (2012). The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review. BMC musculoskeletal disorders, 13, 145. https://doi.org/10.1186/1471-2474-13-145

Footwear can cause lower back pain and problems for some individuals. Can understanding the connection between footwear and back problems help individuals find the right shoes to maintain back health and relieve pain?

Footwear Back Pain

The back provides the strength for physical activities. Back pain affects daily life and can have various causes. Unhealthy posture, walking, twisting, turning, bending, and reaching can contribute to back problems that result in pain. According to the CDC, 39% of adults report living with back pain (Centers for Disease Control and Prevention, 2019). Improper footwear can also contribute to back pain. Selecting footwear carefully can help bring pain relief and help maintain spinal health. Individuals can enjoy less pain and manage symptoms by choosing shoes that maintain spinal alignment and protect the feet from blunt impact.

Understanding the Back Pain-Footwear Connection

Improper footwear could be the cause of lower back pain. What impacts the bones at the bottom of the neuromusculoskeletal system radiates upward and affects the spine and back muscles. What footwear is used travels upward, impacting gait, posture, spinal alignment, and more. When back problems originate from the feet, these are biomechanical issues. Biomechanics means how the bones, joints, and muscles work together and how changes in external forces impact the body.

Movement

When the feet impact the ground, they are the first extremities to absorb shock for the rest of the body. Individuals will start to walk differently if they have a problem or change in their feet. Wearing shoes with improper support can increase the wear and tear on the muscles and joints, leading to awkward and unnatural movement. For example, consider the difference between standing on tiptoes in high heels and the natural flat-footed state. Well-cushioned shoes help absorb impact and lessen pain sensations. The pressures on each of the joints shift balance, which causes instability problems with less pressure on some and more on others. This creates an imbalance that leads to pain and joint conditions.

Posture

Maintaining a healthy posture is another factor in preventing or alleviating back pain. With the right footwear, the body can maintain a healthier stance and the right curvature throughout the spine, and it helps distribute the weight evenly. This results in decreased stress on ligaments, muscles, and joints. (Harvard Health Publishing. 2014) It’s recommended to see an orthopedist to get to the root of an individual's condition. For some, a herniated disc, sciatica, automobile collision, fall, unhealthy ergonomics, or a combination, as well as other underlying issues, may be contributing to their back pain.

Shoe Types and Their Impact on The Back

How various shoes impact posture, potentially causing or relieving back pain.

High Heels

High heels can definitely contribute to back pain. They change body posture, causing a domino effect on the spine. The body's weight is shifted to increase pressure on the balls of the feet, and the spine's alignment becomes altered. High heels also affect how the ankles, knees, and hips move when walking, balance, and how the back muscles operate, all of which can worsen back pain.

Flat Shoes

Flat shoes may not be the best choice for spinal health. If they lack arch support, they can cause the foot to roll inward, known as pronation. This can contribute to misalignment, which can strain the knees, hips, and lower back. However, they can be a decent choice if they provide arch support. When wearing flat shoes with healthy support, the weight is distributed evenly on the feet and the spine. This helps maintain correct posture, which can help prevent and/or alleviate back pain.

Sneakers, Tennis, and Athletic Shoes

Sneakers, tennis, and athletic shoes can relieve back pain with thorough cushioning and support. Choosing the right ones involves determining the activity that will be done in them. There are tennis, running, basketball, pickleball, skating shoes, and more. Research what features will be needed for the sport or activity. This could include:

• Heel cups
• Insole cushioning
• Wide base
• Other features to meet individual foot needs.

It is recommended that athletic shoes be changed every 300 to 500 miles of walking or running or with any signs of unevenness when placed on a flat surface, as worn-out soles and degraded materials can increase the risk of injury and back pain. (American Academy of Podiatric Sports Medicine, 2024).  If a certain pair puts the legs, hips, or ankles into an unnatural position or impedes regular movement, it may be time to replace them.

Choosing the Right Shoes

The ideal solution for choosing shoe wear is to get a gait analysis and a review of how you walk and run. Various healthcare professionals may offer this service to tailor each individual's search for the right shoes for back pain. In gait analysis, individuals are asked to run and walk, sometimes on camera, while a professional notes physical tendencies, like when the foot hits the ground and whether it rolls inward or outward. This provides data on affected posture, movement, pain levels, how much arch support is needed, and what type to wear to help prevent back pain. Once the analysis is complete, it will guide you on what to look for, such as what level of arch support, heel height, or material is best for you.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our programs are natural and use the body’s ability to achieve specific measured goals rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We have teamed up with the city's premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.

Benefits of Using Custom Foot Orthotics

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 they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Centers for Disease Control and Prevention. (2019). Back, lower limb, and upper limb pain among U.S. adults, 2019. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db415.htm

Harvard Health Publishing. (2014). Posture and back health. Harvard Health Education. https://www.health.harvard.edu/pain/posture-and-back-health

American Academy of Podiatric Sports Medicine. Ayne Furman, D. F., AAPSM. (2024). How do I know when it is time to replace my athletic shoes?

Learning the cause of the problem and how to effectively manage it can help individuals experiencing back spasms to quickly and safely return to previous levels of function and activity.

Back Spasm

Individuals dealing with back pain or sciatica usually describe the symptoms as the back muscles tightening or spasming. A back spasm can feel mild, like a fist pressing into one side of the spine or an intense pain that prevents the individual from sitting, standing, or walking comfortably. Bask spasms can become severe, causing difficulty maintaining normal upright posture.

What Is A Spasm

A back spasm is a sudden onset of back muscle tightness. Sometimes, the tight sensation becomes so intense and severe that it prevents the individual from moving normally. Some individuals have difficulty bending forward because of the pain and tightness.

Symptoms

Most episodes last several hours to several days. Severe cases can last about six to eight weeks, but the spasms and pain subside gradually, allowing the individual to move normally and resume normal activity. Common sensations and symptoms can include:

• Difficulty bending.
• A tight sensation in the back.
• Pulsing pains and sensations.
• Pain on one or both sides of the back.

Sometimes, the spasm can cause radiating pain in the buttocks and hips. When severe, it can be accompanied by nerve pain, numbness, and tingling that radiates down one or both legs. (Medline Plus. 2022)

Causes

Back spasms are caused by tight muscle tissue, which often results from some mechanical stress. The stress causes the muscle tissue near the spine to be pulled abnormally. As a result of the pulling, the muscle fibers become taut and painful. Mechanical causes of back spasms may include: (Merck Manual, 2022)

• Poor sitting and/or standing posture.
• Repetitive overuse injury.
• Lumbar strains.
• Lumbar disc herniations.
• Low back osteoarthritis.
• Spondylolisthesis - vertebrae shift out of position, including anterolisthesis and retrolisthesis.
• Spinal stenosis

All these can place increased stress on the anatomical structures in the spine. The lower back muscles near these structures may go into a protective spasm that can also cause a tight and painful sensation in the back. Other non-mechanical causes of low back spasms include: (Merck Manual, 2022)

• Stress and anxiety
• Lack of physical activity and exercise
• Fibromyalgia

Risk Factors

Risk factors for back spasms include: (National Institute of Neurological Disorders and Stroke, 2023)

• Age
• Job-related factors - constant lifting, pushing, pulling, and/or twisting.
• Poor sitting posture or sitting for long periods without back support.
• Lack of physical conditioning.
• Being overweight or obese.
• Psychological conditions - anxiety, depression, and emotional stress.
• Family medical history of ankylosing spondylitis.
• Smoking

Individuals can stop smoking, start exercising, or engage in positive activities to help manage stress. Individuals dealing with back spasms may need to see a healthcare provider for a proper diagnosis and treatment.

Treatment

Treatment for back spasms can include home remedies or therapies from medical providers. The treatments are designed to relieve the spasms and manage the mechanical stresses that may have caused them. Medical professionals can also show strategies to prevent spasms. Home remedies can include: (Merck Manual, 2022)

• Application of heat or ice
• Low back massage
• Postural adjustments
• Gentle stretching
• Analgesic medication
• Anti-inflammatory medication (Anuj Bhatia et al., 2020)

If self-care strategies are unable to provide relief, individuals may need to visit a medical professional for treatment. Medical treatments can include: (Merck Manual, 2022)

• Physical therapy
• Chiropractic care
• Acupuncture
• Non-surgical decompression
• Transcutaneous electrical neuromuscular stimulation
• Steroid injections
• Lumbar surgery is a last resort treatment.

Most individuals are able to manage symptoms with physical therapy or chiropractic, which includes learning exercises and posture adjustments to relieve tightness.

Prevention

Simple lifestyle adjustments can have a significant effect on back spasms. Ways to prevent back spasms can include: (Medline Plus. 2022) (Merck Manual, 2022)

• Maintaining hydration throughout the day.
• Modifying movements and bending and lifting techniques.
• Practicing postural correction techniques.
• Performing daily stretching and strengthening exercises.
• Engaging in cardiovascular exercise.
• Performing meditation or other stress management techniques.

Personal 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 studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Medline Plus. (2022). Low back pain—acute. Retrieved from https://medlineplus.gov/ency/article/007425.htm

Merck Manual. (2022). Low back pain. Merck Manual Consumer Version. https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/low-back-and-neck-pain/low-back-pain

National Institute of Neurological Disorders and Stroke. (2023). Back pain. Retrieved from https://www.ninds.nih.gov/health-information/disorders/back-pain?

Bhatia, A., Engle, A., & Cohen, S. P. (2020). Current and future pharmacological agents for the treatment of back pain. Expert opinion on pharmacotherapy, 21(8), 857–861. https://doi.org/10.1080/14656566.2020.1735353

For individuals dealing with lower back pain, it could be quadricep muscle tightness causing the symptoms and posture problems. Can knowing the signs of quadricep tightness help prevent pain and avoid injury?

Quadriceps Tightness

Quadriceps muscles are in the front of the thigh. Forces that could be creating chronic pain and posture problems could be happening at the same time are:

• Quadricep tightness causes lower back pain as the pelvis gets pulled down.
• Tight quadriceps lead to weakened hamstring muscles.
• These are the opposing muscles behind the thigh.
• Stress and pressure on the hamstrings can cause back pain and problems.
• Pelvic alignment becomes affected, causing posture problems and increased pain symptoms. (Sai Kripa, Harmanpreet Kaur, 2021)

Quadriceps Tightness Pulls the Pelvis Down

One of the four muscles in the quadriceps group:

• The rectus femoris attaches to the pelvis at the anterior superior iliac spine, which is the front part of the hip bone.
• The rectus femoris is the only muscle in the group that crosses over the hip joint, which also affects movement.
• When the quadriceps, especially the rectus femoris, become tight, they pull down on the hips.
• The pelvis tilts downward or forward, technically referred to as the anterior tilt of the pelvis. (Anita Król et al., 2017)
• The spine is between the pelvis, and if the pelvis tilts forward, the lumbar spine compensates by arching.
• A larger arch in the lower back is referred to as excessive lordosis and often causes tightness and pain in the back muscles. (Sean G. Sadler et al., 2017)

Hamstring Compensation

• When the quadriceps tighten and the pelvis gets pulled down, the back has an abnormal lift. This puts the hamstring on a consistent stretch that can cause pain symptoms.
• Healthy posture and hamstring muscle tone help maintain correct pelvic positioning in the back.
• This is correct because it helps maintain a comfortable position.
• Quadricep tightness can set off a reaction as the pelvis tilts down in front and up in the back while overly stretching the hamstrings.
• Pain and soreness are the usual result
• Lack of hamstring strength and quadriceps stretching can cause the hamstrings to lose their ability to support correct pelvic and spinal positions. (American Council on Exercise. 2015)

Knowing When Quads Are Tightening

• Individuals often don't realize their quadriceps are tight, especially those who spend most of the day sitting.
• The more time spent in a chair can cause the quadriceps and lower back muscles to tighten steadily.

Individuals can try a few tests at home:

Standing Up

• Push the hips forward.
• Push from the sitting bones so you're at the correct level.
• How far forward do the hips go?
• What is felt?
• Pain could indicate tight quadriceps.

In A Lunge Position

• With one leg forward and bent in front of the other.
• The back leg is straight.
• How far forward does the leg go?
• What is felt?
• How does the front of the hip on the back leg feel?

Standing Bent Leg

• Stand with the front leg bent and the back leg straight.
• Discomfort in the back leg could mean tight quadriceps.

In A Kneeling Position

• Arch the back
• Grab the ankles
• Modify the position to adjust for any pain or joint issues.
• If you have to prop yourself up or modify the pose to reduce pain, it could be tight quadriceps.

1. Helping to understand the condition can help in communication with a healthcare provider.
2. A healthcare provider and/or physical therapist can conduct a posture evaluation examination to test the quadriceps.

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions

General Disclaimer *

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

Kripa, S., Kaur, H. (2021). Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy, 26(34). https://doi.org/doi: 10.1186/s43161-021-00052-w

Król, A., Polak, M., Szczygieł, E., Wójcik, P., & Gleb, K. (2017). Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. Journal of back and musculoskeletal rehabilitation, 30(4), 699–705. https://doi.org/10.3233/BMR-140177

Sadler, S. G., Spink, M. J., Ho, A., De Jonge, X. J., & Chuter, V. H. (2017). Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies. BMC musculoskeletal disorders, 18(1), 179. https://doi.org/10.1186/s12891-017-1534-0

American Council on Exercise. (2015). 3 Stretches for Opening Up Tight Hips (Fitness, Issue. https://www.acefitness.org/resources/everyone/blog/5681/3-stretches-for-opening-up-tight-hips/

Postural orthostatic tachycardia syndrome is a medical condition that causes lightheadedness and palpitations after standing. Can lifestyle adjustments and multidisciplinary strategies help reduce and manage symptoms?

Postural Orthostatic Tachycardia Syndrome - POTS

Postural orthostatic tachycardia syndrome, or POTS, is a condition that varies in severity from relatively mild to incapacitating. With POTS:

• The heart rate increases dramatically with body position.
• This condition often affects young individuals.
• Most individuals with postural orthostatic tachycardia syndrome are women between the ages of 13 and 50.
• Some individuals have a family history of POTS; some individuals report POTS began after an illness or stressor, and others report it began gradually.
• It usually resolves over time.
• Treatment can be beneficial.
• Diagnosis is based on assessing blood pressure and pulse/heart rate.

Symptoms

Postural orthostatic tachycardia syndrome can affect young individuals who are otherwise healthy and can begin suddenly. It usually happens between the ages of 15 and 50, and women are more likely to develop it than men. Individuals can experience various symptoms within a few minutes of standing up from a lying or seated position. The symptoms can occur regularly and daily. The most common symptoms include: (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)

• Anxiety
• Lightheadedness
• A feeling like you're about to pass out.
• Palpitations - sensing rapid or irregular heart rate.
• Dizziness
• Headaches
• Blurred vision
• Legs turn to reddish-purple.
• Weakness
• Tremors
• Fatigue
• Sleep problems
• Trouble concentrating/brain fog.
• Individuals may also experience recurrent episodes of fainting, usually without any trigger/s other than standing up.
• Individuals can experience any combination of these symptoms.
• Sometimes, individuals cannot handle sports or exercise and may feel light-headed and dizzy in response to mild or moderate physical activity, which can be described as exercise intolerance.

Associated Effects

• Postural orthostatic tachycardia syndrome can be associated with other dysautonomia or nervous system syndromes, like neurocardiogenic syncope.
• Individuals are often co-diagnosed with other conditions like:
• Chronic fatigue syndrome
• Ehlers-Danlos syndrome
• Fibromyalgia
• Migraines
• Other autoimmune conditions.
• Bowel conditions.

Causes

Usually, standing up causes blood to rush from the torso to the legs. The sudden change means less blood is available for the heart to pump. To compensate, the autonomic nervous system sends signals to the blood vessels to constrict to push more blood to the heart and maintain blood pressure and a normal heart rate. Most individuals do not experience significant changes in blood pressure or pulse when standing up. Sometimes, the body is unable to perform this function correctly.

• If blood pressure drops from standing and causes symptoms like lightheadness, it is known as orthostatic hypotension.
• If the blood pressure remains normal, but the heart rate gets faster, it is POTS.
• The exact factors that cause postural orthostatic tachycardia syndrome are different in individuals but are related to changes in:
• The autonomic nervous system, adrenal hormone levels, total blood volume, and poor exercise tolerance. (Robert S. Sheldon et al., 2015)

Autonomic Nervous System

The autonomic nervous system controls blood pressure and heart rate, which are the areas of the nervous system that manage internal bodily functions like digestion, respiration, and heart rate. It is normal for blood pressure to drop slightly and the heart rate to speed up a little when standing. With POTS, these changes are more pronounced.

• POTS is considered a type of dysautonomia, which is diminished regulation of the autonomic nervous system.
• Several other syndromes are also thought to be related to dysautonomia, like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome.
• It isn't clear why the syndrome or any of the other types of dysautonomia develop, but there seems to be a familial predisposition.

Sometimes the first episode of POTS manifests after a health event like:

• Pregnancy
• Acute infectious illness, for example, a severe case of influenza.
• An episode of trauma or concussion.
• Major surgery

Diagnosis

• A diagnostic evaluation will include a medical history, a physical examination, and diagnostic tests.
• The healthcare provider will take blood pressure and pulse at least twice. Once while lying down and once while standing.
• Blood pressure measurements and pulse rate lying down, sitting, and standing are orthostatic vitals.
• Typically, standing up increases the heart rate by 10 beats per minute or less.
• With POTS, heart rate increases by 30 beats per minute while blood pressure remains unchanged. (Dysautonomia International. 2019)
• The heart rate stays elevated for over a few seconds upon standing/usually 10 minutes or more.
• Symptoms happen frequently.
• Lasts more than a few days.

Positional pulse changes are not the only diagnostic consideration for postural orthostatic tachycardia syndrome, as individuals can experience this change with other conditions.

Tests

• Some experts use a tilt-table test for the initial diagnosis and monitor therapy. (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)
• During this test, blood pressure and pulse are measured several times when lying on a table and when the table is moved to an upright position.

Differential Diagnosis

• There are various causes of dysautonomia, syncope, and orthostatic hypotension.
• Throughout the evaluation, the healthcare provider may look at other conditions, like dehydration, deconditioning from prolonged bed rest, and diabetic neuropathy.
• Medications like diuretics or blood pressure medication can cause similar effects.

Treatment

Several approaches are used in managing POTS, and individuals may require a multidisciplinary approach. The healthcare provider will advise regularly checking blood pressure and pulse at home to discuss the results when going in for medical checkups.

Fluids and Diet

• Drinking non-caffeinated fluids can keep the body hydrated.
• A healthcare provider can calculate the right amount of fluids that are needed each day.
• Overnight dehydration is common, so it is especially important to drink fluids first thing in the morning, preferably before getting out of bed and standing.
• It is also important to maintain adequate sodium levels. (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)

Exercise Therapy

• Exercise and physical therapy can help the body learn to adjust to an upright position.
• Because it can be challenging to exercise when dealing with POTS, a targeted exercise program under supervision may be required.
• An exercise program may begin with swimming or using rowing machines, which do not require upright posture. (Dysautonomia International. 2019)
• After a month or two, walking, running, or cycling may be added.
• Studies have shown that individuals with POTS, on average, have smaller cardiac chambers than individuals who don't have the condition.
• Regular aerobic exercise has been shown to increase cardiac chamber size, slow heart rate, and improve symptoms. (Qi Fu, Benjamin D. Levine. 2018)
• Individuals must continue an exercise program for the long term to keep symptoms from returning.

Medication

• Prescription medications to manage POTS include midodrine, beta-blockers, pyridostigmine - Mestinon, and fludrocortisone. (Dysautonomia International. 2019)
• Ivabradine, used for the heart condition of sinus tachycardia, has also been used effectively in some individuals.

Conservative Interventions

Other ways to help prevent symptoms include:

• Sleeping in the head-up position by elevating the head of the bed off the ground 4 to 6 inches utilizing an adjustable bed, blocks of wood, or risers.
• This increases the blood volume in circulation.
• Performing countermeasure maneuvers like squatting, squeezing a ball, or crossing the legs. (Qi Fu, Benjamin D. Levine. 2018)
• Wearing compression stockings to prevent too much blood from flowing into the legs when standing can help avoid orthostatic hypotension. (Dysautonomia International. 2019)

Conquering Congestive Heart Failure

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center (GARD). (2023). Postural orthostatic tachycardia syndrome.

Sheldon, R. S., Grubb, B. P., 2nd, Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., Sutton, R., Sandroni, P., Friday, K. J., Hachul, D. T., Cohen, M. I., Lau, D. H., Mayuga, K. A., Moak, J. P., Sandhu, R. K., & Kanjwal, K. (2015). 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart rhythm, 12(6), e41–e63. https://doi.org/10.1016/j.hrthm.2015.03.029

Dysautonomia International. (2019). Postural Orthostatic Tachycardia Syndrome

Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic neuroscience: basic & clinical, 215, 20–27. https://doi.org/10.1016/j.autneu.2018.07.001

For individuals trying to achieve healthy posture, could using posture awareness training be effective in treatment and prevention?

Posture Awareness

Spinal curves help support the body's weight, movement, and balance. Five areas include the neck, upper back, lower back, sacrum, and coccyx. The bottom of the spine or sacrum rests between the two hip bones that comprise the pelvis. Because of this location, the movements made with the pelvis significantly affect the spine. (Ibrahim Alkatout, et al., 2021) When the pelvis moves, the spine moves.

• Posture-related back pain and associated symptoms are often caused by a weakened strength and flexibility ratio between the opposing muscle groups that hold the body upright.
• Achieving healthy posture requires technique and consistent practice for maintaining a healthy pelvis and low back curve. (DeokJu Kim, et al., 2015)
• Finding the low back curve and exploring how it responds when moving the pelvis is important to effective posture awareness training.

Lower Back Curve Awareness Exercise

One important thing to do to increase postural awareness is to become aware of the low back curve. (Arkadiusz Łukaz Żurawski, et al., 2020)

Sit On a Firm Chair or Stool

• So that the weight is planted into the seat in a balanced way.

Hold Onto the Arms of the Chair

• If the chair doesn't have arms, hold onto the edge of a desk/workstation or the sides of the chair seat.
• This will support the back when moving the pelvis.
• Maintaining core abdominal strength is key to preventing back injury. (Erika Zemková, Ludmila Zapletalová. 2021)

Movement

• Tilt the pelvis forward.
• In this position, notice the slightly exaggerated arch in the lower back and the increase in lower back muscle tension.
• A moderate amount of this increase and exaggeration is normal.

Relax Back to the Start Position

Sitting upright with the hip bones/top of the pelvis directly above the bottom.

• Next, tilt the pelvis back.
• The abs may have to work hard to support this position
• Use your hands against the chair for support.
• Check the lumbar curve area, noticing if it has flattened out.
• Notice the tension in the back muscles.
• Is it a little looser? This is normal.

Relax Back to the Start Position

• Sitting upright.
• Repeat the sequence again.
• This time, when in the forward position, pause briefly and slide a hand between the lower back and the back of the chair or the wall.
• When in the backward position, there will be little to no space between the lower back and the seatback or wall.

Problems

• If there are problems moving the pelvis back and forth, imagine a basket or bowl of fruit.
• The pelvis has a round shape and is open at the top, like a bowl or basket.
• Imagine the fruit is placed toward the front of the bowl, and the weight brings the bowl/pelvis forward.
• To go back, imagine the fruits are placed toward the back.
• The weight causes the bowl to roll backward.
• This may help to get the rhythm of the movement.

This posture awareness exercise can be used as a posture muscle builder by doing it with the back against the wall.

• A more challenging position for this exercise is standing against a wall.
• Keep the heels against the baseboard to really work the abs.
• Start with sitting and gradually to standing.

Foot Motion and Posture

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

Kim, D., Cho, M., Park, Y., & Yang, Y. (2015). Effect of an exercise program for posture correction on musculoskeletal pain. Journal of physical therapy science, 27(6), 1791–1794. https://doi.org/10.1589/jpts.27.1791

Alkatout, I., Wedel, T., Pape, J., Possover, M., & Dhanawat, J. (2021). Review: Pelvic nerves - from anatomy and physiology to clinical applications. Translational neuroscience, 12(1), 362–378. https://doi.org/10.1515/tnsci-2020-0184

Żurawski, A. Ł., Kiebzak, W. P., Kowalski, I. M., Śliwiński, G., & Śliwiński, Z. (2020). Evaluation of the association between postural control and sagittal curvature of the spine. PloS one, 15(10), e0241228. https://doi.org/10.1371/journal.pone.0241228

Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International journal of environmental research and public health, 18(10), 5400. https://doi.org/10.3390/ijerph18105400

Ankylosing spondylitis is an inflammatory arthritis that causes changes in posture that occur over time. Can exercise and maintaining spinal alignment help improve posture problems?

Ankylosing Spondylitis Posture Improvement

Ankylosing spondylitis/AS is an autoimmune arthritis that primarily affects the spine. It can also spread to other joints of the body and affect the internal organs. Back pain problems are a common side effect of the condition and depending on the severity of damage to the spine, it can have a serious impact on posture.

Affects Posture

The condition usually first affects the sacroiliac joints at the bottom of the spine where they attach to the pelvis. As the condition progresses it works its way to the upper spine. The spine consists of 26 vertebrae/bones stacked on top of each other.

• Ankylosing spondylitis can cause the bones to fuse together. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
• The condition causes kyphotic deformity - rounding of the upper back, and the lower back flattening.
• As the disease progresses, the spine becomes immobilized in a stooped-over position and causes significant difficulty with daily tasks.
• A stooped posture can place pressure on the internal organs and lead to breathing difficulties.
• The condition leads to balance problems which increase the risk of falls. (Alessandro Marco De Nunzio, et al., 2015)

Posture Improvement Tips

Standing and Walking

 When standing or walking try to remember to:

• Maintain a straight spine.
• Line up the ears, shoulders, hips, knees, and ankles in a straight line.
• Squeeze the shoulder blades together and down toward the back pockets.
• Relax the arms at the sides.
• Look straight ahead.
• Tuck the chin back slightly.

Sitting

The natural curves of the spine need support for proper posture when sitting. Try these tips when at a desk or at a table:

• Position the height of the chair so the hips and knees are bent at 90-degree angles.
• Place the feet flat on the floor or use a footstool based on chair height.
• Place a lumbar support pillow or rolled-up towel behind the lower back.
• Position the screen monitor at eye level to keep the upper back straight.
• Keep the keyboard and mouse close to the body to prevent overreaching which can increase the rounding of the shoulders and upper back.

Lying Down

Ankylosing spondylitis can make lying down uncomfortable. To support the spine while lying down try to:

• Sleep on a semi-firm mattress or type like memory foam to conform to the body.
• Place a pillow between the knees to maintain a straight spine when lying on the side.
• Use a specialized pillow to prevent placing the upper back in a rounded position.

Posture Exercises

For individuals with ankylosing spondylitis stretching and strengthening exercises can help improve body posture. Individuals are recommended to talk to their healthcare provider before beginning an exercise program.

Chin Tucks

• Sit up straight.
• Squeeze the shoulder blades together.
• Rest the arms at your sides.
• Look straight ahead, pull the chin back and in until the stretch is felt along the muscles of the neck.
• Hold for three to five seconds and relax.
• Repeat 10 times.

Corner Stretch

• Stand facing a corner.
• Raise the arms to shoulder height.
• Place one forearm flat against each wall.
• Stagger the feet.
• Slowly shift weight over the front leg and lean in toward the corner.
• Stop once the stretch is felt across the chest.
• Hold for 10 to 20 seconds and relax.
• Repeat three times.

Scapular Squeezes

• Sit up straight with arms resting at the sides.
• Squeeze the shoulder blades together like they are holding an object between them.
• Hold for three seconds and relax.
• Repeat 10 times.

Maintaining spinal alignment will help decrease back pain that occurs with AS.

• Targeted exercises can help stretch tight muscles and strengthen the muscles responsible for maintaining spinal alignment.
• Maintaining healthy posture when sitting, standing, and sleeping can help prevent deformities in the spine.
• Regular physical activity can help combat stiffness and help maintain overall strength.

For an individualized exercise program, see a physical therapist or chiropractor on incorporating posture exercises to help prevent complications from developing.

Arthritis

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

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

De Nunzio, A. M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V., Peluso, R., Di Minno, M. N., & Pappone, N. (2015). Ankylosing spondylitis and posture control: the role of visual input. BioMed research international, 2015, 948674. https://doi.org/10.1155/2015/948674

Can musculoskeletal therapies treat individuals with upper crossed syndrome to relieve pain, improve posture, and strengthen the muscles in the neck, shoulders and chest?

Upper Crossed Syndrome

Upper crossed syndrome is a condition in which the muscles of the shoulders, neck, and chest become weak and tight, and is usually brought on from practicing unhealthy posture. Symptoms typically include:

• Neck stiffness and pulling sensations.
• Jaw tension and/or tightness
• Upper back tension, lack of flexibility, stiffness, and aching soreness.
• Neck, shoulder, and upper back pain.
• Tension headaches
• Rounded shoulders
• Hunched spine

Upper Crossed Syndrome and Posture

• The condition affects healthy posture by creating imbalanced muscles between the upper back and chest.
• The tight short muscles in the upper chest get overly stretched and remain in a semi-contracted state pulling on the back muscles.
• This causes the muscles in the upper back, shoulders, and neck to get pulled and weaken.
• The result is a hunched back, forward shoulders, and protruded neck.
• The specific muscles affected include the trapezius and the levator scapula/side of the neck muscles. (Hospital for Special Surgery. 2023)

Individuals having back pain lasting two weeks or longer are recommended to consult a spine specialist or healthcare provider to examine and determine the cause of the pain symptoms. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)

Lingering Pain

• The imbalances in muscle activation and movement and unhealthy posture all contribute to the symptoms.
• The syndrome is characterized by chronic stiffness, tension, pain, and increasing immobility of the chest and shoulder muscles.
• Over time the tightness and pulling, combined with weakness can lead to shoulder joint damage. (Seidi F, et al., 2020)

Causes

There are certain activities and jobs that can contribute to the development and worsening of the syndrome. Factors that worsen symptoms include: (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023) - (Seidi F, et al., 2020)

• Physical trauma/injury to any of the muscle regions.
• Occupations with high amounts of physical exertion, heavy lifting, and injury risks.
• Practicing incorrect postures and positioning.
• Jobs requiring extended periods of sitting and/or standing.
• Inactivity and/or sedentary lifestyle.
• Over athletic activity.
• Smoking.

However, the syndrome is preventable and manageable.

Therapies

Working with a chiropractor and physical massage therapy team can help determine and develop a personalized treatment plan that is the most effective and suitable. A chiropractic and physical therapist will provide several options, which can include: (Cedars-Sinai. 2022) - (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023) - (Bae WS, et al., 2016)

• Bracing
• Massage therapy to increase circulation, relax, and retrain the muscles.
• Chiropractic adjustments for spinal realignment and posture retraining.
• Non-surgical mechanical traction and decompression therapy.
• Kinesiology taping - recovery and preventive. 
• Posture retraining.
• Muscle movement training.
• Exercises targeting soft tissues and joints.
• Core strengthening.
• Steroid injections to a specific area.
• Prescription anti-inflammatory medication for pain symptoms - short-term.

1. Individuals may be advised by the chiropractic therapy team to avoid too much bed rest and to limit or avoid activities that can cause pain or worsen symptoms. (Cedars-Sinai. 2022)
2. Studies have shown chiropractic spinal manipulation effectively reduces neck, spine, and low back pain symptoms. (Gevers-Montoro C, et al., 2021)

Self Management

There are ways to self-manage upper-crossed syndrome and associated symptoms. Common techniques include: (National Institute of Neurological Disorders and Stroke. 2023) - (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)

• Practicing correct posture.
• Increasing or decreasing physical activity as recommended by the therapy team.
• Using ice or heat packs to relieve pain and increase circulation to promote muscle rehabilitation and healing.
• Using topical pain creams or gels.
• Over-the-counter nonsteroidal - NSAIDs, like Advil or Motrin and Aleve.
• Muscle relaxants to relieve tension short-term.

Enhance Your Lifestyle

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

Hospital for Special Surgery. Move with the purpose to combat upper and lower crossed syndromes.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back pain.

Seidi, F., Bayattork, M., Minoonejad, H., Andersen, L. L., & Page, P. (2020). Comprehensive corrective exercise program improves alignment, muscle activation, and movement pattern of men with upper crossed syndrome: a randomized controlled trial. Scientific reports, 10(1), 20688. https://doi.org/10.1038/s41598-020-77571-4

Bae, W. S., Lee, H. O., Shin, J. W., & Lee, K. C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. Journal of physical therapy science, 28(5), 1636–1639. https://doi.org/10.1589/jpts.28.1636

National Institute of Neurological Disorders and Stroke. Back pain.

Cedars-Sinai. Back and neck pain.

Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piché, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Frontiers in pain research (Lausanne, Switzerland), 2, 765921. https://doi.org/10.3389/fpain.2021.765921

Sitting at a desk or standing at a workstation in the same position for hours at a time every day or night can strain the body's neuromusculoskeletal system. This causes hunching of the shoulders which leads to body tension, headaches, and neck, shoulder, back, leg, and foot pain. Taking regular breaks to move and stretch out provides various benefits that include pain symptom relief, increased circulation, improved posture, increased energy, muscle relaxation, and improve overall health. Here we look at stretches for sitting and standing jobs.

Stretches For Sitting and Standing Jobs

Sitting or standing for too long can affect an individual's health. The body is made to move and not remain in one position for long periods. Standing and sitting for a prolonged period of time increases the risk for chronic conditions, sleep disorders, digestion issues, weight gain, obesity, heart disease, cancer, and diabetes. To help break the cycle of staying in one position, experts recommend taking movement breaks for one to three minutes every 30 to 45 minutes, or at least once an hour.

Individuals are encouraged to find ways to set up a job/work system where they are not limited to just sitting or standing but have a balance where they can move around, do some desk work, move some more, and so on where the body is regularly engaging all the muscles and not only using a few that often leads to overworked muscles and overcompensating postures that lead to injuries. This can be using a standing desk, taking quick short walks, or doing some stretches. Movement loosens up the body and helps maintain mental focus.

Flexibility Breaks

The following stretches for sitting and standing jobs are recommended to be done as often as possible to develop healthy habits.

• Set an alarm for every 45 to 55 minutes and perform the stretches.
• Hold each stretch for at least 15-30 seconds.
• Avoid exercises or stretches that cause discomfort or pain.

Chest Stretch

Many individuals begin to hunch forward. Therefore, it is essential to stretch the pectoral/chest muscles and shoulders. Individuals with shoulder problems or injuries should avoid this stretch.

• Stand with the feet shoulder-width apart.
• The stretch can be performed seated in a chair.
• Move the arms behind the body and, if possible, interlock the fingers together.
• Straighten the arms and gently lift the hands up until you feel a stretch in the chest.
• Hold for 10 to 30 seconds.
• Repeat 5-10 times.
• Individuals can also use a resistance band and hold it overhead.
• Individuals can put their forearms on either side of a doorway, and gently press forward until the stretch is felt in the chest.

Upper Back Stretch

The upper back stretch will help get circulation moving in all the muscles between the shoulder blades as well as the traps and the shoulders.

• Begin in a seated or standing position.
• Stretch the arms straight out.
• Place one hand on top of the other.
• Reach away with your arms.
• Relax and gently bend the head down.
• Imagine the arms curving up and over an imaginary sphere.
• Hold the stretch for 10 to 30 seconds.

Neck Stretch

​Tension in the neck can lead to headaches and upper back pain. Forward head posture is common when working at a desk/workstation, which places extra weight and stress on the neck muscles. The head can weigh up to 11 pounds. Staying aware of posture and regular stretching can provide relief.

• Start in a sitting position, with the back straight and the shoulders back.
• Reach down and grab the side of the chair with your hand.
• Gently pull on the chair, while tilting the head in the opposite direction, feeling the stretch down the side of the neck and shoulder.
• Hold for 10 to 30 seconds and repeat on the other side.
• Repeat five to 10 times on each side.

Inner Thigh Stretch

Stretching the inner thigh is important for the hips and groin. This stretch helps open the hips and gets rid of tightness and tension in the lower body.

• In a seated position, widen the legs, toes outward, and lean forward with the elbows on the thighs.
• Keep the back straight and the abs contracted.
• Gently press forward while using the elbows to push the thighs out until a stretch is felt in the inner thighs.
• Hold for 10 to 30 seconds.
• Repeat as many times as necessary to get a thorough stretch.

Regular stretching will help to improve the range of motion and help the muscles move more efficiently. Stretching may also help individuals reach or maintain a healthy weight for improved posture.

Benefits of Stretching

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

Cooley D, Pedersen S. A pilot study of increasing non-purposeful movement breaks at work as a means of reducing prolonged sitting. J Environ Public Health. 2013;2013:128376. doi:10.1155/2013/128376

Daneshmandi H, Choobineh A, Ghaem H, Karimi M. Adverse effects of prolonged sitting behavior on the general health of office workers. J Lifestyle Med. 2017;7(2):69-75. doi:10.15280/jlm.2017.7.2.69

Fathollahnejad, Kiana, et al. “The effect of manual therapy and stabilizing exercises on the forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study.” BMC musculoskeletal disorders vol. 20,1 86. 18 Feb. 2019, doi:10.1186/s12891-019-2438-y

Feldman, Anatol G. “The Relationship Between Postural and Movement Stability.” Advances in experimental medicine and biology vol. 957 (2016): 105-120. doi:10.1007/978-3-319-47313-0_6

Korakakis, Vasileios, et al. “Physiotherapist perceptions of optimal sitting and standing posture.” Musculoskeletal Science & Practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004

Lurati AR. Health issues and injury risks associated with prolonged sitting and sedentary lifestyles. Workplace Health Saf. 2018;66(6):285-290. doi:10.1177/2165079917737558

Nakphet N, Chaikumarn M, Janwantanakul P. Effect of different types of rest-break interventions on neck and shoulder muscle activity, perceived discomfort and productivity in symptomatic VDU operators: A randomized controlled trial. Int J Occup Saf Ergon. 2014;20(2):339-53. doi:10.1080/10803548.2014.11077048

Sanders, Martha J, and Claudia Michalak Turcotte. “Posture makes perfect.” Today's FDA: official monthly journal of the Florida Dental Association vol. 25,2 (2013): 62-5.

Shaghayegh Fard, B et al. “Evaluation of forward head posture in sitting and standing positions.” 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. 25,11 (2016): 3577-3582. doi:10.1007/s00586-015-4254-x

For individuals with aches and pains after walking, the first thing to check is posture. How an individual holds their body is important in walking effortlessly and comfortably. Improving walking posture will make it easier to breathe and walk farther and faster. Injury Medical Chiropractic and Functional Medicine Clinic can treat back problems, restore mobility, and retrain individuals on achieving and maintaining healthy posture.

Walking Posture

Sitting for extended periods weakens neck and back muscles and decreases spinal mobility, making it more difficult to maintain a healthy walking posture. Improving and maintaining healthy walking posture can go a long way regarding the body's health.

Benefits

The benefits include:

• Strengthened core, back, leg, and buttock muscles.
• Improved balance and stability.
• Easier breathing.
• Increased energy levels.
• Improved walking speed, distance, and gait.
• Back and hip discomfort symptoms prevention.
• Decreased risk of injury and falling.

Set Up Posture

• Stand up straight.
• Engage the core.
• Relax shoulders.
• Keep the chin parallel to the ground.
• Eyes forward.
• Minimize leaning forward or backward.
• Spend the first 15 seconds of walking focusing on posture.
• Once a rhythm is achieved, periodically check yourself to ensure you stay consistent with proper posture until it becomes normal.

Stand up Straight

• Visualize standing tall and straight.
• Resist the temptation to slouch or arch the back.

Control Leaning Forward or Back

• Leaning strains the back muscles when sitting, standing, and walking.
• Leaning slightly forward from the ankles when walking up a hill.
• Going downhill, leaning slightly forward, or maintaining a straight back is okay.

Keep Eyes Forward

• Avoid looking down.
• The focus should be about 20 feet ahead.
• Maintaining a forward visual path allows individuals to see anything from the side.

Keep Chin Parallel to the Ground

• This reduces strain on the neck and back.
• A proper chin position maintains forward focus rather than down.

Shoulders Back and Relaxed

• Shrug and allow the shoulders to fall and relax slightly back.
• Loosening up the shoulders helps relieve tension and...
• Positions the shoulders to use healthy arm motion while walking.
• Shrug and re-loosen at intervals during the walk to ensure the shoulders stay relaxed.

Engage Core Muscles

• The core muscles help resist slouching and leaning.
• Keep the stomach pulled in slightly.
• Take deep, full breaths to maintain a healthy walking posture.

Maintain Neutral Pelvis

• Ensure the hips are not tilting forward or back while walking.
• Practice sticking out the buttocks, tucking them in, and finding a natural middle.
• The middle is the healthy balance that will keep you from arching the back muscles and spine.

Devices

• Resist the urge to engage with the phone or activity monitor while walking and looking down.
• Only look when necessary and then mindfully regain posture.
• Some activity monitors have vibration alerts to reduce the need to look down.
• Utilize earbuds or headphones for making and taking calls and other tasks.
• Certain earbuds or headphones allow for voice commands, so you don't have to look at the phone.

Chiropractic Realignment and Retraining

Maintaining proper posture is a gradual process. A chiropractor can correct years of practicing unhealthy postures like forward head issues or chronic slouching and realign the spine to restore optimal function.

• A chiropractic therapy team will work on bones and muscles in specific body regions.
• Massage will relax the muscle tissues to restore correct balance.
• Chiropractic techniques will realign the neck, spine, hips, and pelvis.
• Decompression therapy may be used to stretch the body. 
• Strengthening and stretching exercises will maintain adjustments.
• Posture retraining will teach individuals to stay aware of their spinal position and help create healthy habits.

Regular posture checks, whether at work, school, just walking around doing errands, or exercising, will help the body learn proper positioning until it becomes second nature.

Revitalize and Rebuild

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.