Spine Health & Spinal Hygiene

Enhanced Surgical Recovery (ESR) for spine surgery is changing how patients heal. When it is done well—with strong pre-op education, nutrition support, multimodal pain control, and early movement—it can cut opioid use, shorten hospital stays, and reduce readmissions. Integrative chiropractic care and nurse practitioners (NPs) fit naturally into this model, and newer tools such as virtual reality (VR) can further accelerate recovery.

Below is a clear overview of how ESR/ERAS works for spine surgery, how chiropractic and NPs strengthen the pathway, and how VR can be used to improve strength, function, and long-term outcomes.

What Is Enhanced Surgical Recovery (ESR/ERAS) in Spine Surgery?

Enhanced Surgical Recovery (ESR), also known as Enhanced Recovery After Surgery (ERAS), is a structured, evidence-based care pathway that follows the patient from pre-op clinic to home recovery. It is designed to:

• Reduce the body’s stress response to surgery

• Protect organ function

• Get patients walking, eating, and healing faster

• Lower complications, opioid use, and readmission rates

Classic ERAS principles include:

• Preoperative counseling and education

• Nutrition optimization and minimal fasting

• Carbohydrate drinks up to 2 hours before anesthesia

• Standardized multimodal analgesia (non-opioid + opioid only as needed)

• Early mobilization after surgery PMC+1

Large reviews show that ERAS programs across surgical specialties reduce complications, length of stay (LOS), and readmissions by combining these elements into a single, well-coordinated pathway.PMC+1

Why ESR Matters Specifically for Spine Surgery

Spine surgery—especially lumbar fusion and deformity correction—carries high risks of:

• Severe post-operative pain

• Prolonged bed rest and deconditioning

• High opioid requirements

• Longer hospital stays and readmissions

Studies of ERAS-style protocols for lumbar fusion report:

• >50% reduction in in-hospital opioid use

• Earlier ambulation and catheter removal

• Better 3-month pain scores compared with pre-ERAS care.Norton Healthcare Provider

At specialized spine centers using ESR protocols, patients show:

• Less than 2% requiring IV narcotics

• Average LOS shortened by about one day

• Readmission rates under 5%, compared with a ~7% national average hcadam.com

This is where integrative chiropractic care, nurse practitioners, and VR technology can layer on additional benefits.

Core ESR Components That Cut Opioids, Shorten Stays, and Reduce Readmissions

Strong Preoperative Education and Expectation Setting

Patients do better when they know what is coming. ERAS pathways emphasize pre-op counseling so patients understand:

• What their pain is likely to feel like

• How multimodal pain control will work

• When they are expected to get out of bed and walk

• What to do at home to stay on track

The AANA (American Association of Nurse Anesthesiology) highlights patient/family education as a core ERAS element and notes that patient-centered, multidisciplinary pathways improve satisfaction and shorten hospital stay.AANA

Helpful pre-op education topics for spine surgery ESR:

• How multimodal pain management reduces opioids

• Why early walking is critical for preventing clots and stiffness

• How nutrition and hydration affect pain, energy, and wound healing

• What “red flag” symptoms require an urgent call or ER visit

When patients are treated like partners, they are more likely to follow the pathway, which lowers complications and readmissions.

Nutrition Optimization and Carbohydrate Loading

Poor nutrition is a known risk factor for post-surgical complications, longer stays, and delayed healing. ERAS protocols call for:

• Screening for malnutrition and anemia

• Treating deficits before surgery whenever possible

• Avoiding long fasting periods

• Providing carbohydrate drinks up to 2 hours before anesthesia to maintain energy and reduce insulin resistance PMC

In spine ESR programs:

• Patients often receive a pre-surgery carb drink to avoid prolonged fasting and support early mobilization and healing.hcadam.com

Pre-op nutrition steps that help spine ESR succeed:

• Nutrition assessment (weight loss, albumin levels, appetite)

• Iron and B-vitamin support for anemia, when present

• Guidance on protein intake and hydration

• Clear instructions on when to stop solid food vs clear fluids

Optimizing nutrition reduces wound problems, infections, and readmissions, and supports faster rehabilitation.

Multimodal, Opioid-Sparing Analgesia

One of the most powerful ESR tools is multimodal analgesia—using several non-opioid and regional techniques to control pain so fewer opioids are needed. Key elements include:

• Scheduled acetaminophen and NSAIDs (if safe)

• Gabapentinoids for neuropathic pain in select patients

• Regional/local anesthetic blocks at incision sites

• Short-acting opioids only as “rescue,” not as the mainstay of therapy PMC+1

A major review of ERAS pathways shows that multimodal regimens:

• Reduce opioid requirements

• Lower opioid-related side effects

• Contribute to shorter hospital stays and fewer complicationsPMC+1

In the Reston Hospital ESR spine program, patients receive a pre-op oral multimodal regimen (muscle relaxer, anti-inflammatory, long-acting pain medication, Tylenol, and a nerve pain medication as appropriate). After ESR implementation:

• <2% of patients required IV narcotics

• Pain was better controlled by pre-emptive and scheduled non-opioid medications hcadam.com

Multimodal pain strategy staples for spine ESR:

• Pre-emptive oral non-opioid medications

• Local anesthetic at the surgical site (e.g., TAP block or wound infusion)

• Strict protocols for when opioids are started, tapered, and stopped

• Patient education about non-drug pain tools (positioning, ice, breathing, VR, etc.)

Minimally Invasive Techniques and Early Tube Removal

ESR protocols encourage:

• Shorter incisions when possible

• Minimally invasive approaches

• Limiting drains and catheters

• Removing tubes early to support mobilization and reduce infection risk PMC+1

These steps:

• Decrease surgical stress

• Reduce pain

• Support earlier walking and oral intake

• Shorten LOS and lower infection-related readmissions

Early Mobilization and Structured Physical Therapy

Getting spine patients moving quickly—usually the day of surgery—is a pillar of ESR.AANA+1

For example:

• The Norton Healthcare ERAS lumbar fusion study found that ERAS patients ambulated earlier, had catheters removed sooner, and used fewer opioids. Norton Healthcare Provider

• Reston’s ESR program reports that over 96% of spine patients walk within hours of surgery, contributing to shorter stays and better overall outcomes.hcadam.com

Early mobilization elements often include:

• Sitting at the edge of the bed on surgery day

• Walking with assistance in the hall

• Early use of walkers and braces as ordered

• Basic leg pumps and ankle circles in bed

This is the perfect place for integrative chiropractic care and later-phase VR-based rehab to build on the foundation once the surgeon clears more active movement.

How Integrative Chiropractic Care Strengthens ESR for Spine Surgery

Chiropractic care is not applied directly to fresh surgical levels, but it plays a powerful supportive role before and after spine surgery when integrated correctly.

Post-surgical rehabilitation articles highlight that combining musculoskeletal treatments (exercise rehab + manual therapy) can improve posture, joint mobility, and nervous system regulation, speeding recovery. Active Health and Wellness Center+1

Pre-Hab: Preparing the Spine and Body Before Surgery

Before surgery, an integrative chiropractor can:

• Assess posture and movement patterns

• Improve core stability and hip mobility

• Address compensatory areas above and below the planned surgical site

• Teach safe movement patterns (log-rolling, proper bending, basic neutral spine positioning)

Pre-hab goals:

• Go into surgery with better muscle strength and flexibility

• Reduce chronic joint restrictions that could slow rehab

• Teach “spine sparing” techniques, and patients will need post-op

As a dual-credentialed chiropractor and nurse practitioner, Dr. Alexander Jimenez, DC, APRN, FNP-BC, uses pre-hab strategies in personal injury and spine cases to prepare patients for procedures and create a smoother post-operative recovery, blending functional movement work with medical risk assessment. El Paso, TX Doctor Of Chiropractic

Post-Op: Gentle, Targeted Chiropractic Support After Surgeon Clearance

Once the fusion or decompression is stable and the surgeon gives clearance (often 3–6 months after fusion), chiropractic care can help by focusing on:

• Regions above and below the fusion to reduce overload

• Gentle, low-force adjustments away from the surgical segment

• Soft tissue techniques to reduce muscle guarding and scar-related stiffness

• Posture retraining and core strengthening in coordination with physical therapy Active Health and Wellness Center+1

Benefits may include:

• Less pain in non-surgical segments

• Better range of motion

• Reduced risk of compensatory problems like sacroiliac dysfunction or upper-back strain

• Improved walking, sitting, and lifting tolerance

Chiropractic as a Non-Opioid Pain and Function Tool

Within ESR, chiropractic care becomes one more non-opioid pain strategy, alongside:

• Physical therapy and exercise

• Mind–body tools (breathing, relaxation, VR)

• Nutrition and sleep optimization

This integrative approach aligns with ERAS principles of multimodal, opioid-sparing pain control and early mobilization.PMC+1

The Central Role of Nurse Practitioners in Spine ESR

Nurse practitioners are natural “connectors” in ESR pathways. ERAS guidance specifically highlights the value of nurse-led coordination and ERAS coordinators for education, data tracking, and pathway adherence.AANA

Pre-Op Optimization and Education

NPs can:

• Perform detailed pre-surgical assessments

• Screen for malnutrition, anemia, diabetes, smoking, and other modifiable risks

• Arrange lab work, nutrition referrals, and pre-hab consults

• Explain ESR expectations and answer patient questions

In many hospitals, NPs act as ERAS coordinators, rounding on patients, checking compliance (ambulation, diet, pain scores, narcotic use), and closing gaps in the pathway.AANA

In-Hospital and Early Post-Op Management

During hospitalization and early follow-up, spine ESR NPs typically:

• Titrate multimodal analgesia and monitor for side effects

• Guard against unnecessary opioid escalation

• Encourage early mobilization and oral intake

• Reinforce spine precautions and home instructions

They also identify early red flags (fever, new weakness, uncontrolled pain, wound problems) and coordinate fast responses, helping prevent readmissions.

Long-Term Rehab, Telemedicine, and Integration with Chiropractic

On the outpatient side, NPs can:

• Provide telemedicine check-ins to monitor pain, function, and medication use

• Gradually taper opioids, while adding non-drug strategies (heat, stretching, VR sessions, meditation, topical medicines)

• Coordinate referrals to integrative chiropractic care and physical therapy

• Communicate with the surgeon, physical therapist, chiropractor, and primary care provider to keep everyone aligned

Clinicians like Dr. Jimenez, who practice as both DC and APRN, are uniquely positioned to blend ESR principles with chiropractic post-op rehab and telehealth follow-ups to support safe, sustained recovery after spine surgery. El Paso, TX Doctor Of Chiropractic

How Virtual Reality (VR) Can Be Used to Boost Strength, Reduce Pain, and Improve Recovery

Virtual reality is emerging as a powerful, non-drug adjunct for surgical recovery. VR programs use immersive visual and audio environments to:

• Distract from pain

• Reduce anxiety

• Guide graded movement in a fun, game-like way

Systematic reviews of VR in orthopedic and back-pain rehab show that immersive VR can:

• Lower pain and anxiety scores

• Reduce opioid use in some post-operative settings

• Improve adherence to rehabilitation exercises

• Enhance balance, mobility, and muscle strength in orthopedic patients PMC+2Semantic Scholar+2

VR-assisted rehab for postsurgical patients has been shown to improve function, mobility, balance, and range of motion while reducing pain compared with conventional therapy alone.Lippincott Williams & Wilkins Journals+2MDPI+2

Where VR Fits in a Spine ESR Pathway

Pre-Op Phase: Education and Anxiety Control

VR can:

• Walk patients through a virtual “tour” of what to expect on surgery day

• Offer guided relaxation or breathing programs to lower pre-op anxiety

• Practice basic movements (using avatars) that will be required after surgery, like getting out of bed safely

This supports the ERAS emphasis on patient education and psychological readiness.AANA+1

Immediate Post-Op: Pain and Anxiety Reduction

In the early post-op period (while still in the hospital), short VR sessions can:

• Provide immersive distraction (e.g., calming ocean scenes or interactive games)

• Decrease perceived pain intensity

• Lower anxiety and help patients tolerate early movement and breathing exercises

Reviews of VR in postoperative orthopedic populations report meaningful reductions in acute pain and anxiety, with some studies showing reduced opioid use compared with standard care alone. Semantic Scholar+2MDPI+2

Early Rehab: Guided Strengthening and Balance Training

Once the surgeon and ESR team allow more active rehab, VR-based physical therapy can:

• Deliver graded core and leg exercises in a game-like setting

• Use motion sensors to track posture and movement quality

• Train balance and gait with real-time feedback

• Adjust difficulty based on patient performance

Systematic reviews of VR in orthopedic rehab and chronic low back pain show improvements in pain, balance, and strength, often equal or superior to conventional rehab, with excellent patient engagement and adherence.PMC+2advrehab.org+2

Long-Term Recovery: Treating Fear of Movement and Building Confidence

For some spine patients, fear of movement and chronic pain linger long after surgery. VR programs that combine:

• Graded exposure

• Relaxation

• Cognitive-behavioral strategies

have been shown to reduce fear of movement and improve function in patients with low back pain.PMC+1

This is especially powerful when coordinated with:

• NP-led medication tapering

• Chiropractic and physical therapy

• Sleep, nutrition, and stress-management support

Best Practices for Using VR Safely and Effectively After Spine Surgery

To fit VR into an ESR spine pathway:

Screening and Safety

• Screen for motion sickness, seizures, or severe vertigo

• Start with short sessions (5–10 minutes) and progress gradually

• Respect the surgeon’s movement restrictions (e.g., no trunk rotation early on)

Program Design

• Use calm, low-intensity visual scenes early, then progress to active games

• Focus early on breathwork, relaxation, and gentle reaching or seated movements

• Gradually introduce core and leg work as bracing and healing allow

• Tailor programs for each patient’s surgery type (fusion vs decompression)

Team Integration

• NPs can prescribe and monitor VR use, tracking pain scores and opioid needs

• Physical therapists and chiropractors can suggest specific movements and limits

• Data from VR sessions (time active, range of motion, balance scores) can feed into the record to show progress

Putting It All Together: Example ESR-Style Spine Surgery Pathway with Chiropractic, NPs, and VR

Below is a simplified example of how an integrated spine ESR pathway might look:

4–6 Weeks Before Surgery

• NP Visit

  • Full risk assessment (nutrition, anemia, diabetes, smoking)

  • Labs and medical optimization

  • ESR education (multimodal pain, early walking, VR options)

• Chiropractic Pre-Hab (If appropriate)

  • Posture, gait, and movement screening

  • Core and hip strengthening within pain tolerance

  • Instruction in safe transfers and spine-neutral positions

• VR (Optional)

  • Anxiety-reduction and expectations education

  • Gentle avatar-based movement practice

Day of Surgery and Hospital Stay

• In OR / PACU

  • Pre-emptive multimodal analgesia + local/regional blocks

  • Defined opioid-sparing protocol

• Post-Op Day 0–1

  • Early sitting and walking, guided by PT and nursing

  • Oral multimodal medications (acetaminophen, NSAID, nerve pain medicines as appropriate)

  • Short VR sessions for distraction and relaxation (if stable)

• NP and ESR Team

  • Daily rounding to review:

    • Pain scores and opioid use

    • Ambulation status

    • Diet progression

    • Foley and drain removal

  • Adjust medications and address barriers to movement

Weeks 1–6 After Discharge

• Telemedicine NP Visits

  • Monitor pain, function, and wound status

  • Taper opioids strategically

  • Reinforce walking and home exercises

• Home or Outpatient PT

  • Progressive strengthening, posture, and gait training

• VR at Home or Clinic

  • Guided low-impact virtual exercises within surgeon-approved limits

  • Pain distraction sessions when needed

  • Balance training and simple game-based tasks to keep patients active

3–6 Months and Beyond

• Surgeon Clears Active Manual Care

  • An integrative chiropractor focuses on:

    • Adjacent-level mechanics

    • Scar tissue mobility (soft tissue work)

    • Pelvis and hip alignment to protect the fusion

  • Continued strengthening and movement retraining

• NP, Chiropractor, PT, and Patient

  • Collaborate on long-term goals: return to work, sports, or higher-level activity

  • VR may shift to more advanced motor control and fitness-oriented programs

This type of integrated ESR pathway—supported by chiropractors, NPs, and VR—can lock in the benefits observed in spine ERAS research: lower opioid use, shorter stays, fewer readmissions, and stronger, more confident patients.Norton Healthcare Provider+2hcadam.com+2

Say Goodbye to Pain with Chiropractic Care | El Paso, Tx

References

American Association of Nurse Anesthesiology. (n.d.). Enhanced recovery after surgery. Retrieved from https://www.aana.com/practice/clinical-practice/clinical-practice-resources/enhanced-recovery-after-surgery/ AANA

Active Health Center. (2025, July 31). Rehabilitation after surgery: Integrating chiropractic care into recovery. Retrieved from https://activehealthcenter.com/rehabilitation-after-surgery-integrating-chiropractic-care-into-recovery/ Active Health and Wellness Center

Dr. Alex Jimenez, DC, El Paso, TX chiropractor – Personal injury specialist. (n.d.). Retrieved from https://dralexjimenez.com/ El Paso, TX Doctor of Chiropractic

Liu, H. W., et al. (2025). Virtual reality–assisted rehabilitation for patients… American Journal of Physical Medicine & Rehabilitation. Retrieved from https://journals.lww.com/ajpmr/fulltext/2025/11000/virtual_reality_assisted_rehabilitation_for.2.aspx Lippincott Williams & Wilkins Journals

Melnyk, M., Casey, R. G., Black, P., & Koupparis, A. J. (2011). Enhanced recovery after surgery (ERAS) protocols: Time to change practice? Canadian Urological Association Journal, 5(5), 342–348. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3202008/ PMC

Norton Healthcare. (2021, July 22). Study finds Enhanced Recovery After Surgery (ERAS) protocols help recovery after lumbar fusion. Retrieved from https://nortonhealthcareprovider.com/news/eras-protocol-spine-surgery/ Norton Healthcare Provider

Reston Hospital Center. (n.d.). Enhanced surgical recovery – Center for Scoliosis and Spinal Deformity. Retrieved from https://www.hcadam.com/api/public/content/f42a4095a6f9451baa991b5a56cad568?v=4786eda4&download=true hcadam.com

Shen, M. R., & Waljee, J. F. (2019). Enhanced recovery after surgery protocols: Can they reduce postoperative opioid use? Annals of Surgery, 270(6), e72. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7042977/ PMC

Vuong, T., et al. (2024). Virtual reality as a pain control adjunct in orthopedics. Cureus. Retrieved from https://pdfs.semanticscholar.org/b230/d5d86e943e28fd9d5b1921d07ed92b2a9a52.pdf Semantic Scholar

Esteban-Sopeña, J., et al. (2024). Effectiveness of virtual reality on postoperative pain: A systematic review. Life, 14(3), 289. Retrieved from https://www.mdpi.com/2075-1729/14/3/289 MDPI

Jeyaraman, M., et al. (2024). Enhancing orthopedic rehabilitation: The emergence and role of virtual reality. Journal of Clinical Orthopaedics and Trauma. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11043980/ PMC

Nagpal, A. S., et al. (2022). Virtual reality in the management of chronic low back pain: A scoping review. Pain Practice. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8915689/ PMC

Garofano, M., et al. (2025). Remote rehabilitation and virtual reality interventions in chronic low back pain. Technologies, 13(5), 186. Retrieved from https://www.mdpi.com/2227-7080/13/5/186 MDPI

New York City Spine. (2025, January 2). How a chiropractor can aid spinal fusion recovery. Retrieved from https://newyorkcityspine.com/how-a-chiropractor-can-aid-spinal-fusion-recovery/ New York City Spine

Enhance your spinal and back health with swimming. Discover routines that promote flexibility and strengthen your core.

Introduction

Hey there, back pain battlers and wellness warriors! Ever wish you could glide through life with a spine that feels as free and fluid as a dolphin in the ocean? If back pain’s been cramping your style, it’s time to make a splash with chiropractic care and swimming—two powerhouse allies for a healthier, happier spine. Swimming is like a vacation for your back, offering a low-impact way to strengthen your muscles and ease pain, while chiropractic care is like your spine’s personal mechanic, keeping everything aligned and running smoothly. In this epic, science-packed guide (over 5,000 words of pure back-saving goodness), we’ll dive into how chiropractic care and swimming team up to boost spinal health, explore the awesome benefits of swimming for your musculoskeletal system, and share aquatic exercises to soothe back pain. We’ll also cover swimming tools that make these exercises a blast. With insights from Dr. Alexander Jimenez, DC, APRN, FNP-BC, a top El Paso expert in integrative care, we’ll uncover how advanced diagnostics pinpoint back issues and guide personalized recovery plans. Think of this as your ultimate guide to swimming your way to a stronger, pain-free back—with a splash of humor to keep things fun. Let’s dive in!

Why Swimming Is a Game-Changer for Back Health

Swimming is like a superhero workout for your back—it’s gentle, effective, and feels like a refreshing escape. Unlike high-impact activities like running, swimming uses water’s buoyancy to support your body, reducing stress on your spine and joints while strengthening muscles (Becker, 2009). Here’s why swimming is a top pick for spinal health, backed by science:

• Low-Impact Exercise: Water supports up to 90% of your body weight, taking pressure off your spine and joints (Pendergast et al., 2015). This makes it ideal for those with back pain or conditions like herniated discs or sciatica.
• Full-Body Workout: Swimming engages your core, back, glutes, and legs, strengthening the muscles that support your spine without jarring it (Cole & Becker, 2004).
• Improved Flexibility: The fluid movements of swimming stretch your spine and muscles, increasing range of motion and reducing stiffness (Becker, 2009).
• Pain Reduction: Water’s buoyancy and resistance reduce muscle tension and inflammation, easing chronic back pain (Waller et al., 2009).
• Better Posture: Swimming strengthens postural muscles, helping correct misalignments that contribute to back pain (Cole & Becker, 2004).
• Stress Relief: Swimming triggers endorphin release, reducing stress and tension that can tighten back muscles (Boecker et al., 2008).
• Cardiovascular Boost: It improves heart health, enhancing blood flow to spinal tissues for faster healing (Lee et al., 2014).

Humor break: Swimming for your back? It’s like giving your spine a relaxing day at the spa while secretly making it stronger!

Swimming’s benefits are amplified when paired with chiropractic care, which fine-tunes your spine to keep you moving pain-free. Let’s explore how chiropractic care supports your back and enhances your swimming routine.

Chiropractic Care: Your Spine’s Best Friend

Think of chiropractic care as your spine’s personal cheerleader, keeping it aligned and ready to tackle any challenge—whether it’s a swim session or daily life. Chiropractors like Dr. Alexander Jimenez focus on correcting spinal misalignments (subluxations) and optimizing musculoskeletal function, which is crucial for swimmers and anyone with back pain (Haldeman, 2000). Here’s how chiropractic care supercharges your back health:

• Spinal Alignment: Adjustments correct subluxations, relieving pressure on nerves and reducing back pain caused by poor alignment (Brolinson et al., 2018).
• Reduced Muscle Tension: Chiropractic techniques like myofascial release relax tight muscles, easing pain and improving mobility (Brantingham et al., 2009).
• Injury Prevention: By improving joint mobility and muscle balance, chiropractic care prevents injuries that could flare up during swimming (Hoskins & Pollard, 2010).
• Enhanced Recovery: Adjustments boost blood flow and reduce inflammation, speeding recovery from back pain or injuries (Brolinson et al., 2018).
• Improved Biomechanics: Proper alignment enhances your swimming form, making strokes more efficient and reducing strain on your spine (Jimenez, 2016).

Dr. Jimenez uses advanced diagnostics to get to the root of back pain. With MRI and CT scans, he identifies spinal issues or soft-tissue damage. Functional assessments evaluate movement patterns, and lab tests check for inflammation or nutritional deficiencies that could worsen pain (DrAlexJimenez.com, n.d.). For complex cases, dual-scope procedures (combining endoscopy and arthroscopy) provide a real-time view of spinal or joint health, guiding precise treatments (NYS DOH, 2013). His approach ensures your spine is ready to make a splash without pain holding you back.

Humor: Chiropractic care? It’s like giving your spine a high-five and a tune-up so it can swim like a champion!

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Say goodbye to back pain with chiropractic care and spinal manipulation. Discover how it can transform your back health today.

Introduction

Back pain is a widespread issue affecting millions of people worldwide, impacting their daily lives, work, and overall well-being. Whether it’s a dull ache in the lower back or sharp pain radiating down the leg, back pain can range from mildly uncomfortable to severely debilitating. Fortunately, nonsurgical treatments like chiropractic care, spinal manipulation, targeted exercises, and complementary therapies such as massage and acupuncture offer effective solutions for managing and alleviating back pain. This comprehensive guide examines the clinical rationale behind chiropractic care and spinal manipulation, the factors that contribute to back pain, and how integrative, patient-centered approaches can promote natural healing and prevent long-term issues. Drawing on scientific research and clinical insights from experts like Dr. Alexander Jimenez, DC, APRN, FNP-BC, from El Paso, Texas, this article provides actionable information to help you understand and effectively address back pain.

Understanding Back Pain: A Global Health Concern

Back pain is one of the leading causes of disability worldwide, affecting approximately 11% of the global population (Gevers-Montoro et al., 2021). It ranks as the fourth leading cause of years lost to disability, creating significant personal, social, and economic burdens (Gevers-Montoro et al., 2021). For many, back pain is not a one-time event but a recurrent condition characterized by periods of relief interspersed with flare-ups (Von Korff et al., 1996). Low back pain, in particular, is highly prevalent, with studies estimating that 66% to 75% of patients continue to experience at least mild pain one month after seeking treatment, and about one in three report moderate to severe pain after a year (Von Korff et al., 1996).

Most cases of back pain are classified as non-specific, meaning no single structural or pathological cause can be identified (Gevers-Montoro et al., 2021). This makes diagnosis and treatment challenging, as the pain often stems from a combination of factors, including musculoskeletal imbalances, lifestyle habits, and psychological stressors. Chronic low back pain, defined as pain persisting for more than three months, can significantly impact quality of life, limiting mobility and daily activities (Petrozzi et al., 2020).

Why Back Pain Matters

Back pain affects people of all ages, but its prevalence increases with age, with a minority of individuals over 65 experiencing it (Borenstein, 2001). It can result from acute injuries, such as lifting heavy objects incorrectly, or chronic conditions, including poor posture and sedentary lifestyles. The impact of back pain extends beyond physical discomfort, often leading to emotional distress, reduced productivity, and increased healthcare costs. Understanding the causes and effective treatments is crucial for managing this condition and preventing long-term disability.

Factors Contributing to Back Pain

Back pain is multifactorial, meaning it arises from a complex interplay of physical, lifestyle, psychological, and social factors. Below are some of the primary contributors to the development of back pain, supported by research and clinical insights.

1. Musculoskeletal Factors

• Muscle Imbalances and Weakness: Weak or imbalanced muscles, particularly in the core and paraspinal muscles, can lead to poor spinal support, increasing the risk of pain and injury (Alrwaily et al., 2019). For example, weak core muscles may fail to stabilize the spine during movement, placing undue stress on the vertebrae and discs.
• Herniated Discs: A herniated disc occurs when the soft inner material of an intervertebral disc protrudes through its outer layer, potentially compressing nearby nerves. This can cause localized back pain or radiating pain (sciatica) (Borenstein, 2001).
• Spinal Misalignments: Misalignments or subluxations in the spine can disrupt normal biomechanics, leading to pain and restricted movement (Personal Injury Doctor Group, 2017).
• Degenerative Conditions: Conditions such as spinal stenosis or osteoarthritis can narrow the spinal canal or degrade joint cartilage, leading to pain and stiffness (Borenstein, 2001).

2. Lifestyle Factors

• Sedentary Behavior: Prolonged sitting, especially with poor posture, can weaken back muscles and increase pressure on the spine, contributing to pain (Lis et al., 2015).
• Physical Inactivity: Lack of regular exercise can lead to reduced muscle strength and flexibility, increasing the likelihood of back pain (Alrwaily et al., 2019).
• Obesity: Excess body weight places additional strain on the spine, particularly the lower back, exacerbating pain (Borenstein, 2001).
• Improper Lifting Techniques: Lifting heavy objects without proper form can strain back muscles or cause acute injuries like sprains or disc herniations (Von Korff et al., 1996).

3. Psychological and Social Factors

• Stress and Anxiety: Psychological stress can lead to muscle tension, particularly in the back and neck, exacerbating pain (Pinheiro et al., 2016).
• Fear-Avoidance Beliefs: Fear of pain or reinjury can lead to reduced physical activity, which may worsen symptoms and contribute to chronicity (Alrwaily et al., 2019).
• Work-Related Factors: Jobs requiring repetitive motions, heavy lifting, or prolonged sitting increase the risk of back pain. Lower work ability is also a predictor of worse outcomes in chronic low back pain (Petrozzi et al., 2020).

4. Medical and Genetic Factors

• Previous Injuries: A history of back injuries can predispose individuals to recurrent pain or chronic conditions (Von Korff et al., 1996).
• Genetic Predispositions: Genetic factors, such as variations in genes related to disc degeneration, may influence susceptibility to back pain (Borenstein, 2001).
• Comorbid Conditions: Conditions like depression or fibromyalgia can amplify pain perception and complicate recovery (Pinheiro et al., 2016).

5. Environmental and Occupational Factors

• Poor Ergonomics: Inadequate workstation setups, such as non-ergonomic chairs or desks, can contribute to back strain (Lis et al., 2015).
• High Physical Demands: Occupations involving heavy lifting, bending, or twisting increase the risk of back pain and injury (Petrozzi et al., 2020).

Understanding these factors is essential for tailoring effective treatment plans. Chiropractic care, combined with spinal manipulation and other nonsurgical approaches, addresses many of these contributors to promote healing and prevent recurrence.

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Chiropractic care can provide significant benefits for scoliosis. Find out how it can help manage symptoms effectively.

Introduction

Welcome to a deep dive into the world of scoliosis, spinal health, and the magic of chiropractic care! If your spine has been acting like it is auditioning for a role in a twisty-turny movie, you are in the right place. We are here to unpack how chiropractic care, particularly through the expertise of Dr. Alexander Jimenez, DC, APRN, FNP-BC, can help manage scoliosis, ease spinal pain, and tackle those pesky overlapping risk profiles that mess with your musculoskeletal system. Think of this as your friendly guide to keeping your spine happy, with a sprinkle of humor to keep things light—like imagining your spine as a slightly confused Slinky trying to find its way back to straight. Let us get started!

Understanding Scoliosis: The Spine’s Unexpected Plot Twist

Scoliosis is like the spine deciding to take a scenic detour instead of sticking to the straight-and-narrow highway. It is a condition where the spine curves sideways in an “S” or “C” shape, often diagnosed in adolescents but possible at any age. According to the El Paso Back Clinic, scoliosis affects about 3% of the population, with causes ranging from idiopathic (a fancy word for “we do not understand why”) to congenital issues or conditions like Marfan syndrome or cerebral palsy (El Paso Back Clinic, n.d.).

Symptoms and Impact

Imagine your spine throwing a curveball that leaves you with uneven shoulders, a protruding shoulder blade, or hips that look like they are practicing for the uneven bars in gymnastics. Scoliosis symptoms include:

• Chronic back pain or stiffness: Like your spine is complaining about its new shape.
• Reduced flexibility: Bending over feels like your spine is saying, “Nope, not today!”
• Breathing difficulties: In severe cases, the curve can squish your lungs a bit.
• Low self-esteem: Visible deformities can make teens feel like they are starring in a drama they did not sign up for.

These symptoms can make daily activities, such as sitting through a long class or carrying a backpack, feel like a daunting task. The severity of the curve, measured in degrees (10–24° is mild, 25–49° is significant, and 50°+ is severe), determines how much it impacts your life (Ideal Spine, n.d.).

Risk Profiles

Scoliosis does not just mess with your spine’s alignment; it brings along friends like disc degeneration, nerve compression, and muscle imbalances, which can lead to:

• Chronic pain: From irritated nerves or strained muscles.
• Herniated discs: The spine’s cushions are getting squished the wrong way.
• Poor posture Can Lead to fatigue and more strain.
• Organ dysfunction: Severe curves can press on lungs or other organs, making breathing or digestion trickier.

These overlapping risk profiles are like a domino effect—one issue in the spine can trigger a cascade of musculoskeletal problems. Nevertheless, do not worry; chiropractic care is here to help catch those dominoes before they fall!

References

• El Paso Back Clinic. (n.d.). Scoliosis Center. Retrieved from https://elpasobackclinic.com/scoliosis-center/
  Ideal Spine. (n.d.). Scoliosis and Chiropractic Care. Retrieved from https://idealspine.com/scoliosis-and-chiropractic-care/

The Spine: Your Body’s Superhighway

Your spine serves as the main highway for your nervous system and provides structural support for your entire body. It is divided into five sections, each with a unique role in keeping you moving, grooving, and not falling over like a wobbly Jenga tower. Let us break it down:

Cervical Spine (Neck, C1–C7)

• What it does: This top section supports your head (which weighs about as much as a bowling ball—10–12 pounds!). It enables you to nod, shake your head, and monitor your blind spots while driving. It also protects the spinal cord, sending nerve signals to your brain, arms, and upper body.
• When it is not functioning properly, misalignments in this area can lead to neck pain, headaches, or even tingling sensations in your arms. Scoliosis in the cervical spine (rare but possible) can make turning your head feel like a rusty hinge.

Thoracic Spine (Upper/Mid Back, T1–T12)

• This middle section of the spine anchors your rib cage and protects your heart and lungs. It is less mobile than the cervical spine and is designed for stability to keep your torso upright. It functions similarly to a stoic middle child, keeping everything in place.
• When the lumbar spine is misaligned, scoliosis often manifests in this area, leading to uneven shoulders or a hump. This can lead to back pain, breathing issues, or fatigue from poor rib mechanics.

Lumbar Spine (Lower Back, L1–L5)

• What it does: The lumbar spine handles the heavy lifting, supporting your upper body’s weight and allowing you to bend, twist, and lift. It is the powerhouse of the spine, built for strength.
• What happens when it is off: Scoliosis or misalignments here can cause lower back pain, sciatica (nerve pain shooting down your legs), or difficulty standing for long periods. It is like your spine is saying, “I am tired of carrying all this weight!”

Sacral Spine (Sacrum, S1–S5, fused)

• What it does: The sacrum connects your spine to your pelvis, forming a sturdy base for your hips. It is like the foundation of a house, keeping everything stable while you walk, run, or dance.
• What happens when the sacrum is misaligned: Issues in this area can lead to hip pain, an uneven gait, or pelvic imbalances, which may ripple up to affect the rest of the spine.

Coccygeal Spine (Tailbone, 4 fused vertebrae)

• What it does: The tiny tailbone is a vestige of where tails are in animals. It anchors ligaments and muscles for sitting and balance. It plays a crucial role in enabling you to endure a tedious lecture.
• What happens when it is off: A misaligned or injured tailbone can make sitting painful and affect pelvic floor muscles, leading to discomfort during movement.

Scoliosis or other spinal issues disrupt these sections, causing nerve signals to be delayed, muscles to strain, and joints to wear out more quickly. This is where chiropractic care swoops in like a traffic cop to clear the road!

References

• El Paso Back Clinic. (n.d.). Scoliosis Center. Retrieved from https://elpasobackclinic.com/scoliosis-center/

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Discover the significance of chiropractic care for herniated discs in achieving optimal health and regaining your strength.

Chiropractic Care for Herniated Discs: A Natural Path to Relieving Low Back Pain

Oh, cara mia, does your lower back cry out in agony, turning each step into a dramatic waltz with pain? If a herniated disc has you feeling like you are starring in a spine-chilling episode of The Addams Family, fear not! Chiropractic care, with its gentle adjustments and soothing spinal decompression, offers a non-invasive approach to ease your low back pain and restore your zest for life. In this comprehensive, informative guide, we will unravel the mysteries of herniated discs in the lumbar spine, explore their impact on daily routines, and highlight the clinical expertise of chiropractic care, with insights from Dr. Alexander Jimenez, a renowned expert in El Paso, Texas.

This post, crafted for a high school reading level, will weave in a touch of Gomez Addams’ flamboyant humor to keep things lively—because who says learning about back pain cannot be a passionate tango? We will cover the clinical rationale behind chiropractic interventions, supported by scientific studies and expert insights, while emphasizing Dr. Jimenez’s role in personal injury cases. Let us step into the dance of healing!

What is a Herniated Disc? The Spine’s Rebellious Jelly Donut

Picture your spine as a grand stack of vertebrae, each cushioned by a soft, squishy intervertebral disc—like a jelly donut nestled between gothic pillars. These discs, with their tough outer layer (annulus fibrosus) and gel-like core (nucleus pulposus), absorb shocks and keep your spine flexible. Nevertheless, when the annulus tears, the nucleus can bulge or burst out, creating a herniated disc. It is as if you squeezed that donut too hard, and the jelly staged a breakout!

In the lumbar spine (your lower back), herniated discs are common because this region bears the brunt of your body’s weight. They often occur between the ages of 30 and 50, when discs lose moisture and elasticity due to aging (Personal Injury Doctor Group, 2017). A sudden twist, heavy lifting, or even a theatrical sneeze can trigger the tear—oh, the drama! The herniated disc material may press on nearby nerves, causing sharp, shooting pain (radiculopathy) or sciatica, where pain radiates down your leg like a fiery fandango.

The progression of a herniated disc follows stages: protrusion (bulging but intact), prolapse (more pronounced bulging), extrusion (material breaks through but stays connected), and sequestration (material fully detaches). Early stages may cause mild aches, but advanced cases can lead to numbness, weakness, or, in rare cases, cauda equina syndrome—a medical emergency affecting bladder and bowel control. Mon dieu, what a plot twist!

To keep it light: Imagine your disc as a mischievous poltergeist, slipping out to cause chaos. However, with chiropractic care, we will coax it back into place with the charm of Gomez wooing Morticia.

References

Personal Injury Doctor Group. (2017). Herniated Discs: Definition, Progression, and Diagnosis. https://personalinjurydoctorgroup.com/2017/04/03/herniated-discs-definition-progression-diagnosis/

American Academy of Orthopaedic Surgeons. (n.d.). Herniated disk in the lower back. OrthoInfo. https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/

Shokri, P., Zahrai, A., Viskochil, G. A., & Bowden, A. E. (2023). Lumbar Disc Herniation: Diagnosis and Management. The American Journal of Medicine, 136(7), 645-651. https://pubmed.ncbi.nlm.nih.gov/37072094/

The Lumbar Spine’s Starring Role in Herniated Discs

The lumbar spine, with its five vertebrae (L1 to L5), is the backbone’s powerhouse, supporting your torso and enabling twists and bends. It is like the sturdy foundation of the Addams Family mansion—grand but prone to creaks under strain. Intervertebral discs are thicker in this area to handle heavy loads, but when they herniate, trouble ensues.

A herniated disc can compress nerve roots exiting the spinal canal, disrupting signals and causing pain, tingling, or weakness. For example, a herniation at L4-L5 or L5-S1 may compress the sciatic nerve, triggering sciatica that feels like a lightning bolt down the leg (Shokri et al., 2023). Historically, French neurologists T. Alajouanine and D. Petit-Dutaillis in 1930 clarified how disc material causes nerve root compression, building on earlier discoveries (Oppenheimer et al., 2019). Their work was a breakthrough, akin to uncovering a hidden passage in a Gothic estate.

In discogenic back pain, often linked to herniated discs, degenerative changes spark inflammation and instability. Factors such as genetics, repetitive strain, or even oxidative stress can sensitize nerves, turning mild discomfort into a chronic condition (Ito & Creemers, 2019). The lumbar spine’s weight-bearing role makes it vulnerable; poor posture or heavy lifting can accelerate disc wear, leading to herniation and instability. It is as if your spine is staging a revolt, refusing to cooperate with your daily dance.

Oh, the tragedy! Your lumbar spine, once a noble performer, now groans like Gomez after a particularly wild tango. However, fear not—chiropractic care can restore its rhythm.

References

Oppenheimer, J. H., DeCastro, I., & McDonnell, D. E. (2019). Nerve root compression by lumbar disc herniation: A French discovery? Orthopaedics & Traumatology: Surgery & Research, 105(2), 335-338. https://pubmed.ncbi.nlm.nih.gov/30799172/

Ito, K., & Creemers, L. (2019). Discogenic back pain: Literature review of definition, diagnosis, and treatment. JBMR Plus, 3(5), e10180. https://pubmed.ncbi.nlm.nih.gov/31131347/

Shokri, P., Zahrai, A., Viskochil, G. A., & Bowden, A. E. (2023). Lumbar Disc Herniation: Diagnosis and Management. The American Journal of Medicine, 136(7), 645-651. https://pubmed.ncbi.nlm.nih.gov/37072094/

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Addressing back pain from motor vehicle accidents is crucial. Discover effective strategies for recovery and maintaining a healthy back.

Introduction

Imagine cruising down the highway, feeling as carefree as Herman Munster behind the wheel of his quirky, gothic Drag-U-La car from The Munsters. Life seems grand—until, out of nowhere, crash! A motor vehicle accident (MVA) turns your joyride into a painful ordeal. Suddenly, your back is screaming louder than Herman’s hearty laugh. Back pain is one of the most common complaints following MVAs, affecting countless individuals each year. Whether it’s a minor fender-bender or a major collision, the sudden forces involved can wreak havoc on your spine, leaving you with discomfort that ranges from a nagging ache to debilitating pain.

Understanding why back pain occurs after MVAs and how to address it is crucial for recovery. This blog post dives deep into the clinical reasons behind MVA-related back pain, exploring the mechanics of these injuries, their symptoms, diagnosis, and treatment options. We’ll spotlight the expertise of Dr. Alexander Jimenez, a distinguished chiropractor and functional medicine expert in El Paso, Texas, who helps accident victims get back on their feet—without needing Herman’s oversized boots. We’ll also highlight the critical role of personal injury cases in securing compensation and how proper car seat design can prevent or lessen back pain. To keep things light, we’ll sprinkle in a bit of Munster-style humor, but rest assured, we’ll get serious when it matters most.

The Mechanics of Back Injuries in MVAs

Car accidents are like an unexpected plot twist in a Munsters episode—sudden, jarring, and often leaving you worse for wear. The forces involved in an MVA, whether it’s a rear-end collision, a side impact, or a rollover, can place immense stress on the spine and surrounding tissues. Let’s break down how these accidents lead to back injuries, with a nod to the science behind it.

Types of Collisions and Their Impact

• Rear-End Collisions: These are the classic “whiplash” accidents. The sudden backward-then-forward motion of the head and neck can strain the cervical and upper thoracic spine. This motion often extends to the lower back, causing muscle strains or ligament damage.
• Frontal Collisions: When your car slams into something head-on, your body may be thrust forward against the seatbelt, compressing the spine. This can lead to injuries like herniated discs or vertebral fractures.
• Side-Impact Collisions: T-bone accidents can twist the torso, stressing the lumbar spine and potentially causing sprains or facet joint injuries.
• Rollover Accidents: These are the most chaotic, with multiple impacts that can lead to severe spinal injuries, including fractures or dislocations (Tennessee Injury Attorney).

Ligament Injuries and Chronic Pain

Ligaments, the tough bands that stabilize joints, are particularly vulnerable in MVAs. Research indicates that ligaments can tear or stretch during sudden trauma, resulting in long-term issues. The healing process forms scar tissue that’s less elastic and weaker than the original ligament, with viscoelastic properties recovering to only 10-20% of normal and failure loads at about 50% of normal (Akeson et al., 1988; Frank et al., 1988). This inferior healing can cause joint instability, leading to chronic back pain as the spine struggles to maintain proper alignment. It’s like trying to fix Herman’s creaky old car with duct tape—it might hold for a while, but it’s not the same as the original parts.

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Investigate the relationship between musculoskeletal ligaments and automobile accidents to enhance safety and injury awareness.

Introduction

Ligamentous injuries are a significant concern in musculoskeletal health, particularly when they stem from motor vehicle accidents (MVAs). These injuries can disrupt daily life, causing pain, reduced mobility, and long-term complications like chronic neck or back pain. In the upper body quadrant—encompassing the neck, shoulders, arms, and upper back—ligaments play a critical role in maintaining stability and enabling movement. When injured, they can lead to debilitating conditions that require expert care. This guide examines the structures, functions, and physiology of musculoskeletal ligaments, the impact of motor vehicle accidents (MVAs), and the clinical rationale for their management, drawing on insights from Dr. Alexander Jimenez, a distinguished chiropractor in El Paso, Texas. With over 30 years of experience, Dr. Jimenez specializes in non-invasive treatments and serves as a vital resource for personal injury victims, bridging the gap between medical care and legal documentation. To keep things engaging, we will sprinkle in a touch of dark humor—think Wednesday Addams smirking at the chaos of a car crash—but we will conclude with a serious note to emphasize the importance of professional care.

Understanding Ligamentous Injuries

Structure and Function of Ligaments

Ligaments are dense bands of collagenous tissue that connect bones across a joint, acting like the body’s internal scaffolding. In the upper body quadrant, they stabilize joints such as the cervical spine (neck), shoulder (glenohumeral joint), and elbow, allowing for controlled movement while preventing excessive motion. Ligaments vary in size, shape, and orientation, with unique bony attachments called insertions that are critical for joint stability during movement (Frank, 2004).

Microscopically, ligaments consist of fibroblasts surrounded by a matrix, with collagen bundles aligned along their long axis. These bundles display a “waviness” or crimp, which allows elongation under load without damage. Biochemically, ligaments are about two-thirds water and one-third solid, with 75% of the solid component being collagen (mostly type I, with smaller amounts of types III, VI, V, XI, and XIV). Other components include proteoglycans, elastin, and proteins like actin and laminin. Collagen is synthesized as procollagen, which forms fibrils and fibers through cross-links that enhance its strength (Frank, 2004).

Physiology and Healing Challenges

When ligaments are injured, they undergo a complex healing process with three phases: hemorrhage with inflammation, matrix and cellular proliferation, and remodeling. Imagine a ligament tear like a snapped rubber band in a horror movie—chaotic and messy. Initially, the torn ends retract, a blood clot forms and inflammation brings in cellular infiltration. In the proliferative phase, fibroblasts produce a disorganized “scar tissue” matrix, rich in type III collagen and defects such as blood vessels and fat cells. Over weeks, collagen aligns, but abnormalities persist, such as increased type III collagen, smaller fibril diameters, and altered proteoglycan levels (Frank, 2004).

The remodeling phase attempts to restore a ligament-like matrix; however, differences persist, including increased vascularity, abnormal innervation, and incomplete resolution of matrix flaws. Functionally, healed ligaments recover to within 10-20% of normal viscoelastic properties but are weaker, less stiff, and absorb less energy before failure. Long-term healing depends on factors such as the initial gap size, the extent of contact between the torn ligament ends, and the degree of joint movement. Strategies such as controlled motion, surgical repair, or tissue engineering are employed, but complete healing remains elusive (Frank, 2004).

References

• Frank, C. B. (2004). Ligament structure, physiology, and function. Journal of Musculoskeletal & Neuronal Interactions, 4(2), 199-201.

General Disclaimer *

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

For individuals experiencing back pain, can lying in the supine position help bring relief?

Supine Position

The supine position describes the body's position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It's commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)

Medical Uses

Examinations

• Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)

Procedures

• It's also used for various procedures, such as lumbar punctures and injections. (Steris Healthcare, 2025)

Surgery

• Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures. 
• It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)

Overall Health

Natural Position

• Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.

Back Pain Relief

• Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)

Acid Reflux

• However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)

Sleep Apnea

• The supine position can worsen sleep apnea in some individuals.

Clinical Uses

• A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
• If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
• This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
• Many bed exercises begin in this position for rehabilitation.

Back Care

Here are a few recommendations to relieve low back pain using the supine position.

• First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
• Start breathing and relaxing, allowing the tension to drain out of the muscles.
• In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
• At that point, the fingertips should feel the transverse abdominal muscle engage.
• Release and repeat 10 times.

After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.

For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.

Variations

Lawn Chair Position

• This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.

Frog-Leg Position

• The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)

Injury Medical Chiropractic & Functional Medicine Clinic

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

Thoracic Spine Pain

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, and 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. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

ScienceDirect. (2009). Supine Position. Morrey's The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5

Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.

STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.

MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position

Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf

The Cobb angle is a mathematical measurement tool for assessing the curvature of the spine. Along with physical exams and other tests, how is it used to evaluate scoliosis and kyphosis of the spine?

Cobb Angle

The Cobb angle is used to quantify the curvature of the spine, particularly in conditions like scoliosis. It measures the degree of side-to-side spinal curvature, a deformity called scoliosis. The angle's size helps determine what kind of treatment is needed. Monitoring may be all that's necessary for mild curvature. With severe scoliosis, treatment may require spinal fusion surgery. Named for orthopedic surgery pioneer John Robert Cobb, it describes the distance a scoliotic curve may deviate from being straight. (Botterbush K. S. et al., 2023) Generally, it takes at least 10 degrees of deviation from straight before scoliosis is confirmed.

X-Ray and Interpretation

An X-ray is taken to measure the Cobb angle, with side and back views. The healthcare provider or examiner then views the X-rays and locates the most affected vertebra in the curve, the apical vertebra. In a scoliotic curve, the apical vertebra is the spinal bone with the greatest degree of rotation, taking the biggest curve away from the center of a normal spine column.

Visualizing the Angle

The apical vertebra is where two lines drawn from the X-rays meet. Two lines are drawn along the edge of the top and bottom bones of the curve. The lines extend out as follows:

• On the top bone, the line starts on the high side, continues along the top edge, and then slopes down according to the angle of the vertebra. (Jin, C. et al., 2022)
• On the bottom vertebra, the line starts on the low side, continues along the bottom edge, and slopes upward.
• The Cobb angle is found by measuring the angle of the two intersecting lines where they meet.

Then, the top and bottom vertebrae of the side-to-side curve are identified to create a number for the Cobb angle. These bones have the most tilt but the least rotation and displacement and are located above and below the apical vertebra. Computer software is commonly used to calculate the Cobb angle. (Jin, C. et al., 2022) Treatment is based on the following:

• Angle size
• Gender: Scoliosis is more common and likely to progress in females
• Probability of progression (National Scoliosis Foundation, 2015)

10 Degrees Cobb Angle 

Scoliosis is diagnosed when the Cobb angle reaches 10 degrees or more. However, this is not generally considered a significant curvature (American Association of Neurological Surgeons, 2024). In around 80% of cases, the scoliosis is considered idiopathic or without congenital or other underlying causes.

Less Than 25 Degrees Cobb Angle

If a scoliotic curve is less than 25 degrees, individuals may only need to visit their healthcare provider periodically so long as the scoliosis is monitored. These are mild cases, often without symptoms, but there is a chance that the curvature can progress. This usually means reassessing the Cobb angle every four to six months in a growing child or adolescent. (National Scoliosis Foundation, 2015) A 5-degree or more progression can change the diagnosis and treatment. (Jin, C. et al., 2022)

Between 25 and 40 Degrees Cobb Angle

A Cobb angle of 25 to 40 degrees usually requires wearing a back brace and intensive physical therapy. These treatments aim to help halt the curve's progression. Braces are generally worn 16 to 23 hours daily (National Scoliosis Foundation, 2015). The healthcare provider will provide a referral for physical therapy. Many report excellent results with the Schroth or other scoliosis-specific exercise methods. A study found that core stabilization exercise programs can decrease Cobb angles in adolescents with idiopathic scoliosis. (Ko K. J. & Kang S. J. 2017)

Scoliosis in Adults

Scoliosis is diagnosed in adults, usually in those who have had the condition, treated or not, that was identified in their youth. A study that followed various cases for 20 years found disease progression occurred in 40% of adults but was usually less than one degree per year. However, degenerative scoliosis can also occur in individuals aged 65 and older. (American Association of Neurological Surgeons, 2024)

40 Degrees or More Cobb Angle

Surgery may be recommended once the Cobb angle reaches 40 to 50 degrees. A spinal fusion is often used to force the curve to stop developing. In adults, surgery may be needed if the angle reaches 50 degrees and they experience complications, such as nerve damage or bowel/bladder dysfunction. Risk factors in adults include older age, a history of smoking, and a diagnosis of other conditions, including being overweight. (American Association of Neurological Surgeons, 2024)

Variations

Variations occur in measuring scoliosis, and it is important to understand the difference between a change in scoliosis and a change in the tools or measurement. Equipment errors, imaging errors, and the subjective reading of the healthcare provider can change the values. (Jin, C. et al., 2022) Scoliosis measurement software and intelligent medical devices continue to improve how scoliosis is evaluated and treated. Physical exams, symptoms, and careful monitoring of changes in posture or function are still critical to an accurate diagnosis. The healthcare provider will explain the Cobb angle and other test results.

Injury Medical Chiropractic & Functional Medicine Clinic

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

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 they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Botterbush, K. S., Zhang, J. K., Chimakurty, P. S., Mercier, P., & Mattei, T. A. (2023). The life and legacy of John Robert Cobb: the man behind the angle. Journal of neurosurgery. Spine, 39(6), 839–846. https://doi.org/10.3171/2023.7.SPINE23146

Jin, C., Wang, S., Yang, G., Li, E., & Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel, Switzerland), 22(9), 3258. https://doi.org/10.3390/s22093258

National Scoliosis Foundation. (2015). Scoliosis Media & Community Guide. https://www.scoliosis.org/nsf2/wp-content/uploads/2015/06/ScoliMediaGuide_9June3.pdf

American Association of Neurological Surgeons. (2024). Scoliosis. https://www.aans.org/patients/conditions-treatments/scoliosis/

Ko, K. J., & Kang, S. J. (2017). Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. Journal of Exercise Rehabilitation, 13(2), 244–249. https://doi.org/10.12965/jer.1734952.476

Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?

Straight Leg Test

The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what's causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they'll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.

• Potential causes include a herniated disc or spondylolysis and a stress fracture in the spine. (Casiano V.E. et al., Back Pain. 2023)
• Some studies suggest the straight leg test helps diagnose sciatica and other causes. (Pesonen J. et al., 2021)

Purpose

The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what's happening. It is a manual exam, and the healthcare provider will:

• Position the patient
• Moves the patient
• Create pressure to see how well the patient can resist it

This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)

During the Test

Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:

• Tight hip or back muscles
• Back muscle spasms
• Slipped disc
• Spinal instability

Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:

• The patient lies on their back with their legs straight.
• The provider will ask the patient to turn one of the legs in.
• This tells them what hip position affects the lower back symptoms.
• They'll then ask you to bring the leg toward the body's center.
• Then, they'll lift the straight leg until the patient experiences symptoms.
• Pain suggests a herniated disc.
• If there is no pain, this also provides valuable information.
• The procedure is repeated with the other leg.

Modifications

It's important to let the examiner know about any limitations. The straight leg raise test can be modified if the patient cannot lift their leg while it's straight or if they have difficulty lying on their back, which can also help avoid injury during the test.

Variations

The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they'll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic work with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Injury to Recovery with Chiropractic Care

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to 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

Casiano, V. E., Sarwan, G., Dydyk, A. M., & Varacallo, M. A. (2025). Back Pain. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844200

Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-021-04649-z

Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2

Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. https://doi.org/10.1016/j.apmr.2016.06.019

Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. https://doi.org/10.5704/MOJ.1511.012

Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. https://doi.org/10.1186/1757-1146-6-46

Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. https://doi.org/10.1097/BRS.0000000000001867

Camino Willhuber, G. O., & Piuzzi, N. S. (2025). Straight Leg Raise Test. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30969539

Can acupuncture be an effective treatment for anxiety and panic disorders in addition to other treatments, like therapy and/or medication?

Acupuncture For Anxiety and Panic Disorders

Considered one of the most popular types of alternative medicine, acupuncture has grown in popularity as a way to treat a variety of mental health conditions, including depression, post-traumatic stress disorder (PTSD), and other anxiety disorders. With the growth in popularity, more research has been focused on treatment for panic and anxiety symptoms. (Pilkington K. 2010)

• Acupuncture can enhance personal wellness.
• Acupuncture is generally safe and has few side effects.
• It can help reduce physical and mental symptoms like tension, pain, and rapid heart rate.

Other alternative medicine practices include yoga, therapeutic massage, herbal medicines, and aromatherapy.

Traditional Chinese Medicine

Acupuncture is a healing technique originating from traditional Chinese medicine (TCM). The practice is based on the concept that medical conditions and mental health disorders are caused by an imbalance in the energy and circulation of the body's vital life energy, known as chi or qi (National Institute for Complementary and Integrative Health, 2022). When the body and mind function properly, energy flows optimally through the channels/meridians at certain points throughout the body. Like tight or spasming muscles, energy or circulation becomes congested in different meridian pathways, leading to disease or disorders. The goal of acupuncture is to restore the health and balance of these channels.

How It Works

During acupuncture treatment sessions, small needles are placed along specific body areas, known as acupuncture points. These areas are where energy blockage occurs. The needles, which come in various thicknesses and lengths, stimulate and open blocked energy channels. Experts have conceptualized acupuncture from a neuroscience perspective, where nerves, muscles, and connective tissues are stimulated, and neurochemicals are released.

• Acupuncture can help regulate the nervous system.
• It can stimulate the body's feel-good hormones and reduce stress hormones.
• It can help deactivate the analytical brain, which is responsible for anxiety and worries.

Acupuncture is recognized by the National Institutes of Health (NIH) for treating pain management and other medical conditions. (National Institute for Complementary and Integrative Health, 2022)

Effectiveness

Clinical trials examining acupuncture for anxiety and panic disorders have shown some positive results. (Pilkington K. 2010) Acupuncturists and medical professionals are still not clear exactly why it may help with anxiety, but some research has noted that acupuncture appears to have a calming effect. More research studies are needed to prove the effectiveness of acupuncture for anxiety disorders. (Kim Y. K. 2019)

Getting Treated

What it can help with:

• Agoraphobia
• Generalized anxiety disorder (GAD)
• Panic disorder
• Phobias
• Selective mutism
• Separation anxiety disorder
• Social anxiety disorder

If you are interested in treating your anxiety and panic symptoms through acupuncture, the first step is to consult your main healthcare provider. Professional acupuncture practitioners are on websites, including the National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncture. The use of acupuncture continues to rise, making it more readily available. Since it has been evaluated for effectiveness and is available through many hospitals, some insurance policies may cover some acupuncture treatments.

Injury Medical Chiropractic and Functional Medicine Clinic

Acupuncture can help relieve symptoms of anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Discovering The Benefits of Chiropractic Care

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to 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

Pilkington K. (2010). Anxiety, depression, and acupuncture: A review of the clinical research. Autonomic neuroscience : basic & clinical, 157(1-2), 91–95. https://doi.org/10.1016/j.autneu.2010.04.002

National Institute for Complementary and Integrative Health. (2022). Acupuncture: Effectiveness and Safety. Retrieved from https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety

Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3. https://doi.org/10.30773/pi.2019.01.08

What is the recommended way to choose a mattress for individuals with back pain?

Back Pain Mattress

When choosing a back pain mattress, one size does not fit all in selecting one for those with spine pain. Several other factors play a role, as well. However, whether a firm or soft mattress is the best option for individuals whose back pain keeps them up at night, most health experts say the choice is yours and that the mattress that makes you feel most comfortable is likely the best option. The research says that medium firmness provides the most painless sleep. A review gathered information from 24 controlled trials where participants used soft, medium-firm, firm, or custom-inflated mattresses. The results showed that medium-firm and self-adjusted mattresses were best for sleep comfort, quality, and spinal alignment. (Radwan A. et al., 2015)

Medical Status

Selecting the back pain mattress best suited to your spinal condition is more than just how hard or soft the mattress is. Individuals and their healthcare providers should thoroughly review their medical history to tailor the mattress to their needs. Before purchasing a mattress, check the following:

• Age
• Medical history
• Injuries current and past
• Current diagnosis or diagnoses
• Disease and/or Conditions
• Sleeping preferences

For example, symptoms of spinal stenosis tend to present themselves when one is standing and walking but not when lying down. For this reason, mattress firmness is not a big issue only for people with spinal stenosis. However, it must be taken into consideration for those who have degeneration along with spinal stenosis.

Individuals with spinal arthritis without stenosis, disc problems, or non-specific back pain need to consider the relative firmness or softness of the back pain mattress. People with these conditions do better with more support, i.e., a firmer mattress. While everyone needs some back support when they sleep, those who have undergone multiple back surgeries often need less. The tissues have been altered and may be stiffer after several surgeries. In this case, a softer mattress may be more suitable and comfortable.

Mattress Age

Mattress springs break down over time, which makes the bed softer. This can aggravate the spine and back muscles. Based on this, investing in a new mattress makes sense, or pain and stiffness can worsen with the current one. While this will vary among individuals, medical research may help shed some light: A study measured the comfort and quality of sleep for 27 participants with low back pain and stiffness. The participants recorded their sleep comfort and quality in their beds for 21 days and then with a new prescribed mattress and bedding system, which they used for 12 weeks. The study found that the participants showed significant and progressive improvement in back pain and stiffness on the new mattresses and improved sleep quality significantly. (Jacobson B. H. et al., 2010)

Sleeping Position

The position usually slept in makes a difference in the support needed for the back pain mattress. Some recommendations for back sleepers, side and fetal position sleepers, and stomach sleepers:

Side Sleepers

• Most people are side sleepers.
• They sleep in the fetal position with their knees drawn up toward their chest.
• This position tends to place pressure on the hips and shoulders.
• For side and fetal sleepers, a slightly softer mattress is recommended.
• The foam the mattress is made of conforms to the body, especially in the thoracic and lumbar regions of the spine.

Stomach Sleepers

• For the stomach sleeper, soft mattresses can irritate the back.
• A soft mattress encourages the abdomen to sink into the bed.
• The resulting position is known to increase the arch in the lower back and cause pain.
• A medium-firm surface is good for stomach sleepers.
• The idea is to derive support from the chosen mattress without the abdominal sinking.
• The sinking effect is amplified if you have a large abdomen.
• For thin individuals, sinking may be less of an issue.

Back Sleepers

• For support, place a thin, rolled towel or pillow under the knees and lower back of those who sleep on their backs.
• A pillow/s under these areas will help support them and provide more comfort.

Researchers divided the participants according to their usual sleep position. They were assigned to a medium-firm mattress with foam and latex layering based on their preferred sleep position. The participants rated their sleep comfort and quality daily for three months. The researchers found that the new mattresses improved back pain and stiffness. For this reason, they concluded that sleep surfaces relate to sleep discomfort and that replacing a mattress with one uniquely suitable to your spinal condition can reduce and relieve pain. (Jacobson B. H. et al., 2010)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right back pain mattress ultimately comes down to personal preference. Individuals should try various mattresses and see which one they like best. Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Chiropractic Care Can Transform Pain Into Relief

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Radwan, A., Fess, P., James, D., Murphy, J., Myers, J., Rooney, M., Taylor, J., & Torii, A. (2015). Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep health, 1(4), 257–267. https://doi.org/10.1016/j.sleh.2015.08.001

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. https://doi.org/10.1016/j.apergo.2010.05.004

While some disc herniations don't cause symptoms, individuals who are overweight with a herniated disc may experience obesity pressure symptoms such as pain, weakness, numbness, or tingling. Can implementing a physical therapy and weight loss treatment program help individuals find relief?

Obesity Pressure

Obesity is one major factor that can contribute to a herniated disc and chronic back pain. When the body has to carry added weight, it can lead to obesity pressure on the intervertebral discs and affect posture and spine position. Researchers have found that other factors, such as inflammation or metabolic changes associated with obesity, can also be involved. (Sheng B. et al., 2017) For individuals who are overweight, weight loss combined with physical therapy can help resolve a herniated disc and can significantly increase herniated disc prevention. (Tokmak M. et al., 2015)

Spine Problems

According to Dr. Alexander Jimenez, owner and head chiropractor at Injury Medical Chiropractic and Functional Medicine Clinic, "When the position of the pelvis and lumbar spine shift out of alignment and become altered, it can profoundly contribute to advanced wearing away of outer fibers in the back region of the discs. These outer fibers house and protect the soft material that cushions and absorbs shock in the spine. Over time, the obesity pressure wear and tear on the fibers can cause chronic pain and microscopic radial tears, leading to a complete rupture." A rupture causes the soft material to leak, irritate, and inflame surrounding nerve roots. Most herniated discs occur between the sides and back of the vertebra.

Movement Problems

• Obesity makes movement difficult, often causing symptoms like shortness of breath and/or early fatigue and exhaustion even with minimal physical activity.
• Physical therapy and exercise help relieve obesity and disc herniation.
• However, the obesity pressure and herniation pain can make it hard to participate in cardiovascular exercises on a regular basis.

Diagnosis Complications

• Obesity can interfere with the diagnosis and treatment of spinal diseases.
• This is because weight restrictions and certain imaging tests, like a spinal MRI, can be difficult or impossible to obtain.
• A physical examination might not be able to identify signs of nerve compression if an individual is obese. These factors can delay diagnosis.

Disc Position and Posture

Obesity is not the only thing that places pressure on the discs. An individual's body position significantly influences the health of the shock-absorbing cushions. Sitting generates the most pressure, followed by standing, while lying on your back places the least strain on the discs and, depending on the injury, may help relieve symptoms.

• Symptoms depend on the location of the herniation.
• The two most common locations are the cervical spine/neck area and the lumbar spine/lower back.
• Disc herniations in the neck can affect the arms.
• Disc herniations in the lower back affect the buttocks and legs.

Injury Medical Chiropractic and Functional Medicine Clinic

See a healthcare provider if you're experiencing any of these symptoms. If it is a herniated disc causing symptoms, you might be started on 6 weeks of conservative treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Weight Loss Techniques

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Sheng, B., Feng, C., Zhang, D., Spitler, H., & Shi, L. (2017). Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. International journal of environmental research and public health, 14(2), 183. https://doi.org/10.3390/ijerph14020183

Tokmak, M., Altiok, I. B., Guven, M., Aras, A. B., & Cosar, M. (2015). Spontaneous Regression of Lumbar Disc Herniation After Weight Loss: Case Report. Turkish neurosurgery, 25(4), 657–661. https://doi.org/10.5137/1019-5149.JTN.9183-13.1

A sudden hit or fall can cause the spine to undergo rapid flexion, extension, rotation, and compression. These forces can strain muscles and ligaments (resulting in whiplash), shift or tear discs (leading to herniation), crack vertebrae (causing fractures), or bruise the spinal cord. At the same time, rapid acceleration–deceleration and twisting can make the brain move inside the skull, stretching delicate nerve fibers and causing concussions or diffuse axonal injury (DAI). A team-based, integrative plan—starting with emergency evaluation when needed, followed by coordinated medical care, chiropractic care for alignment and mobility, and targeted rehabilitation—can reduce pain, protect nerves, and support a safer recovery (Mayo Clinic, 2024; NINDS, 2025; Weill Cornell Medicine Neurological Surgery, n.d.). Mayo Clinic+2NINDS+2

The Forces That Injure the Spine

During a crash, work incident, sports impact, or hard fall, the body absorbs high-speed changes in motion. The neck and back are forced through:

• Flexion/extension (whiplash-type motion)

• Axial compression (head or torso driven straight down)

• Rotation and side-bending (twisting)

These motions can injure soft tissues (such as strains/sprains), shift or tear discs, and fracture vertebrae. High-energy events, especially those involving the cervical spine (neck), can cause serious injury patterns even with milliseconds of extreme extension or compression (StatPearls; MDPI, 2024). NCBI+1

Common structural results

• Muscle and ligament injury: neck/back pain, stiffness, spasm (Mayo Clinic – back pain). Mayo Clinic

• Disc injury: annular tears and herniations that irritate spinal nerves, causing radiating arm or leg pain, numbness, or weakness (Mayo Clinic – herniated disk). Mayo Clinic

• Fractures: from compression, flexion, or hyperextension forces; patterns vary by level (StatPearls cervical fractures). NCBI

• Spinal cord injury (SCI): disruption of motor, sensory, and autonomic pathways below the level of injury, ranging from weakness and numbness to paralysis (Mayo Clinic; NINDS; StatPearls). Mayo Clinic+2NINDS+2

Why Whiplash-Style Motion Also Threatens the Brain

When the body stops or turns suddenly, the brain can continue to function. This relative motion causes the brain to collide with the inner skull and shear long nerve fibers (axons). That is why crashes, sports hits, and falls can cause concussions or DAI, even without a direct head blow. Research links rotational acceleration—especially twisting—to diffuse axonal damage (NINDS TBI report; Meaney & Smith, 2011; Stemper et al., 2014; Lota et al., 2022). PubMed Central+3NINDS+3PubMed Central+3

What this looks like clinically

• Concussion: headache, dizziness, fogginess, light/noise sensitivity, sleep changes, and slowed thinking.

• Diffuse axonal injury: more severe stretching of axons; can present with prolonged confusion, loss of consciousness, or lingering cognitive and balance problems (NINDS; NCBI Bookshelf—DAI). NINDS+1

Secific Spine Injuries Triggered by High-Impact Events

A. Soft-Tissue Strains and Sprains (Whiplash Spectrum)

Rapid flexion–extension injures the neck’s supporting structures. Symptoms include neck pain, stiffness, and headaches; most recover with guided care, but some develop persistent symptoms if alignment and movement remain restricted (Mayo Clinic; UT Southwestern overview of spine disorders and diagnostics). Mayo Clinic+1

B. Disc Herniation and Nerve Root Irritation

A sudden load can push disc material posteriorly or posterolaterally, pressing on a nerve root. Sciatica or arm pain, numbness, and weakness can follow. MRI helps confirm level and severity (Mayo Clinic—herniated disk; UT Southwestern—MRI/CT/X-ray role). Mayo Clinic+1

C. Fractures—Including “Hangman’s” Fracture (C2)

A Hangman’s fracture is a bilateral break through the pars interarticularis of C2 from extreme hyperextension and sudden deceleration (e.g., high-speed car crash, diving). Stability varies; neurologic risk depends on the degree of displacement and canal compromise (StatPearls). NCBI+1

Other cervical and subaxial fractures emerge from axial loading, hyperflexion, hyperextension, or combined mechanisms—common in high-impact accidents (StatPearls). NCBI

D. Spinal Cord Injury (SCI)

SCI can occur at the moment of impact or secondarily as swelling, bleeding, or bone fragments compress the cord. Effects include motor/sensory loss, bowel/bladder changes, spasms, burning pain, and breathing difficulty in higher cervical injuries (Mayo Clinic; NINDS; Weill Cornell Neurosurgery). Mayo Clinic+2NINDS+2

E. Blunt Cerebrovascular Injury (BCVI)

High-energy neck trauma can injure the carotid or vertebral arteries, risking stroke. Hyperextension with rotation—exactly the posture seen in some collisions—can damage the vertebral artery. Incidence is about 1–2% of all blunt trauma admissions and up to 9% in severe head injuries; identifying risk patterns and screening with CT angiography can be lifesaving (StatPearls—Vertebral Artery Injury; Brommeland et al., 2018; Shafafy et al., 2017). NCBI+2PubMed+2

Sports and Work Settings: Who’s at Risk?

Sports that load the head/neck—football, ice hockey, wrestling, diving, skiing/snowboarding, rugby, cheerleading—carry a higher risk for catastrophic cervical injury, often via axial compression to the crown (Boden & Jarvis, 2008). Heavy labor, ladder falls, and high-force tasks also increase risk at work. Pediatric patterns differ: kids sustain cervical injuries in MVAs, falls, and sports, with similar force mechanisms (MDPI, 2024). PubMed+1

How These Spine Forces Link to Head Injury

A sudden neck motion doesn’t stay “local.” The cervical spine anchors the head. When the neck whips or compresses, the head undergoes both rotational and linear accelerations, which stress the brain tissue. Studies show rotational acceleration produces widespread shear and DAI-like changes; translational impacts can also concentrate shear at the corpus callosum and brainstem—areas often affected in concussion and DAI (Meaney & Smith, 2011; Nishimoto & Murakami, 1998). PubMed Central+1

Warning Signs That Need Emergency Care

Seek immediate medical evaluation (call emergency services) for any of the following after a crash, fall, or on-field collision:

• Neck or back pain with numbness/weakness, loss of bowel or bladder control, or progressive neurologic changes

• Loss of consciousness, repeated vomiting, severe or worsening headache, slurred speech, seizures, confusion, or focal weakness

• Difficulty breathing, chest heaviness, or sudden severe neck pain after high-energy trauma (consider BCVI risk)

These signs align with common SCI and TBI red flags, warranting imaging (X-ray/CT/MRI) as guided by clinicians (Mayo Clinic—SCI, Diagnosis & Treatment; NINDS; UT Southwestern diagnostics). UT Southwestern Medical Center+3Mayo Clinic+3Mayo Clinic+3

Diagnosis: Linking Structure to Symptoms

History & Exam. Clinicians correlate the mechanism of injury with neurologic and musculoskeletal findings.

Imaging.

• CT: excellent for fractures and emergency screening.

• MRI: best for discs, ligaments, cord bruising/edema, and subtle brain injuries (vs. CT for acute bleeding).

• CTA (CT angiography): evaluates suspected BCVI.
  These choices reflect mainstream trauma pathways, as outlined by the Mayo Clinic (SCI Diagnosis), UT Southwestern diagnostics, and the BCVI literature. Mayo Clinic+2UT Southwestern Medical Center+2

Integrative, Team-Based Care: Where Chiropractic Fits

Big picture: Effective recovery pairs medical safety with restoring motion and control. In Dr. Alexander Jimenez’s integrative practice, plans typically combine nurse practitioner oversight, chiropractic to improve joint motion and reduce nociceptive drive, targeted rehab (vestibular, balance, postural, and strength), and collaboration with primary care, neurology, neurosurgery, and physical therapy when indicated (Jimenez, 2025a; 2025b). El Paso, TX Doctor Of Chiropractic+1

What chiropractic can contribute (within a coordinated plan)

• Spinal adjustments or mobilization (as appropriate): restore segmental mobility, reduce mechanical pain, and improve proprioceptive input that supports balance and head–neck control (Jimenez, 2025a; NWHSU/Chiropractic Economics commentary on chiropractic and TBI). El Paso, TX Doctor Of Chiropractic+1

• Soft-tissue therapies: ease muscle guarding and improve tolerance for movement (Jimenez, 2023; supportive clinical overviews). El Paso, TX Doctor Of Chiropractic

• Neuromotor rehab: cervical stabilization, vestibular/ocular drills, postural retraining, and graded aerobic work to rebuild balance and stamina (Jimenez, 2025c). El Paso, TX Doctor Of Chiropractic

• Care coordination and safety: screening for red flags, referring for imaging and specialist input when symptoms point to fracture, SCI, BCVI, or intracranial injury (Mayo Clinic; NINDS). Mayo Clinic+1

Note: For fractures, SCI, or vascular injury, acute management is medical/surgical first. Manual therapies are contraindicated until cleared. Chiropractors practicing in integrated teams routinely follow these safety pathways (Mayo Clinic; Weill Cornell Medicine). Mayo Clinic+1

Putting It Together: A Practical Step-By-Step Path

Step 1 — Rule out emergencies.
Any red flag (see Section 6) → ER evaluation. Imaging as indicated (CT/MRI/CTA). Stabilize the spine if fracture or SCI is suspected (trauma protocols). Authoritative guidance emphasizes the importance of early stabilization and transfer processes for high-mechanism injuries. NCBI

Step 2 — Calm the acute phase.
Rest within reason, control pain as medically advised, and perform gentle range-of-motion exercises only after clearance. Early over-activity can flare symptoms; no spinal manipulation where instability or acute cord/vascular injury is suspected (Mayo Clinic—SCI care). Mayo Clinic