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

Individuals experiencing persistent pain, weakness, numbness, and tingling in the back could be suffering from nerve root encroachment. Could surgery ease nerve compression and improve symptoms for persistent and severe cases?

Surgical Decompression

The pain, weakness, numbness, and tingling associated with nerve root encroachment are usually first treated with non-surgical therapies that include:

• Anti-inflammatory medications
• Physical therapy

This can be enough to address the irritation of the spinal nerve root. But when cases become severe, surgical decompression may be recommended and necessary. It can be done in a couple of different ways.

Causes and Symptoms

Vertebrae are bones in the spine. Small openings called foramina allow a spinal nerve root to pass through on each side of the vertebra. When nerve root encroachment is present, the spinal nerve root gets compressed, pinched, and trapped, which can cause peripheral symptoms such as numbness, tingling, pain, or weakness to develop. Nerve root encroachment is typically caused by normal aging degenerative wear and tear changes in the vertebrae. (Choi Y. K. 2019) These degenerative changes can include:

• Facet joint hypertrophy
• Ligament and bone hypertrophy
• Disc disorders
• Formation of bone spurs or osteophytes.

If these degenerative changes progress, they can encroach and compress a nerve root, leading to peripheral symptoms. (Choi Y. K. 2019)

When Surgery Is Recommended

When symptoms occur, initial treatment will involve:

• Physical therapy
• Chiropractic realignment
• Massage therapies
• Rest
• Lifestyle adjustments
• Nonsteroidal anti-inflammatories - NSAIDs
• Corticosteroid injections into the spine

If conservative therapies don't fully heal or improve symptoms or there are neurological problems like difficulty with balance or walking, then surgery may be recommended. Severe pain that limits normal function is an indication for surgery, and rapidly progressive weakness of the arms and/or legs or signs of cauda equina syndrome are indications for emergency surgery.

Surgery Options

Different types of spinal surgery may be performed. A neurosurgeon will decide the best procedure for each patient based on their case, age, medical conditions, and other factors. Specific spinal surgical decompression depends on what is causing the nerve compression. In most cases, it involves removing bone or tissue to relieve nerve pressure or provide support to stabilize the joint. The most common types of surgical decompression include: (Mayo Clinic Health System, 2022)

• Laminectomy
• Discectomy
• Laminotomy
• Foraminotomy
• Fusion

Spinal surgical goals are to: (American Association of Neurological Surgeons, 2024)

• Decompress pressure on the nerve roots.
• Relieve pressure on the nerve roots.
• Maintain the stability and alignment of the spine.
• Improve the stability and alignment of the spine.

Anterior Surgery

The anterior approach to surgery means that the spine is accessed through the anterior/front of the spine. In this surgery, one or more discs and bone spurs may be removed through an incision in the front of the neck. (American Association of Neurological Surgeons, 2024) For example, an anterior cervical discectomy may alleviate pressure on one or more nerve roots in the neck. With an anterior lumbar interbody fusion, a surgeon removes a degenerative disc in the lower spinal area by going through a patient's lower abdomen. (American Association of Neurological Surgeons, 2024) After the disc is removed, a structural device, usually made of bone, fills the space where it once was. This device encourages bone healing and helps the vertebrae's bodies fuse.

Posterior Surgery

Posterior surgery means the spine is accessed through the posterior/back of the spine. An example is removing a thickened ligament, bone spur, or disc material in the neck. To do this, a small incision in the back of the neck may be made to remove part of the back of the vertebrae called the lamina. This is called a posterior cervical laminectomy. (American Association of Neurological Surgeons, 2024) A posterior lumbar interbody fusion removes a degenerative disc by going through the back. (American Association of Neurological Surgeons, 2024) Like the anterior approach, a structural device often contains bone to fill the space where the disc once was to fuse the bones.

Potential Risks

As with any surgery, it's important that the individual and their healthcare provider carefully discuss the benefits and risks. Spinal surgical decompression includes: (Proietti L. et al., 2013)

• Bleeding
• Blood clots
• Surgical site infection
• Urinary tract infection
• Lung infection
• Intestinal blockage

There are also specific risks to the area of the spine being operated on and how it is surgically approached. For example, a cervical anterior procedure may injure the esophagus, trachea, or carotid artery. Likewise, damage to the C5 nerve root/C5 palsy can occur from cervical spinal decompressive surgery. This complication causes weakness, numbness, and pain in the shoulders. (Thompson S. E. et al., 2017) The spinal cord may also be injured during surgery and result in paralysis, although this is rare. (American Association of Neurological Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

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

The Non-Surgical Solution

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

Choi Y. K. (2019). Lumbar foraminal neuropathy: an update on non-surgical management. The Korean journal of pain, 32(3), 147–159. https://doi.org/10.3344/kjp.2019.32.3.147

Mayo Clinic Health System. (2022). Decompress and stabilize: understanding types of back surgery. Speaking of Health. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/understanding-types-of-back-surgery

American Association of Neurological Surgeons. (2024). Cervical spine. https://www.aans.org/patients/conditions-treatments/cervical-spine/

American Association of Neurological Surgeons. (2024). Lumbar spinal stenosis. https://www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/

Proietti, L., Scaramuzzo, L., Schiro', G. R., Sessa, S., & Logroscino, C. A. (2013). Complications in lumbar spine surgery: A retrospective analysis. Indian journal of orthopaedics, 47(4), 340–345. https://doi.org/10.4103/0019-5413.114909

Thompson, S. E., Smith, Z. A., Hsu, W. K., Nassr, A., Mroz, T. E., Fish, D. E., Wang, J. C., Fehlings, M. G., Tannoury, C. A., Tannoury, T., Tortolani, P. J., Traynelis, V. C., Gokaslan, Z., Hilibrand, A. S., Isaacs, R. E., Mummaneni, P. V., Chou, D., Qureshi, S. A., Cho, S. K., Baird, E. O., … Riew, K. D. (2017). C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global spine journal, 7(1 Suppl), 64S–70S. https://doi.org/10.1177/2192568216688189

Individuals who have experienced spinal or back trauma, suffered fractures, are going through spinal degeneration, or are dealing with a spinal condition have an increased risk of anterolisthesis, where a vertebra slips forward relative to the vertebra below it. Can healthcare providers help prevent and treat the condition?

Anterolisthesis

The spine consists of 33 individual bones or vertebrae stacked on one another. Anterolisthesis occurs when one vertebral segment slips forward over another. The condition can be mild, asymptomatic, or cause significant pain and neurological symptoms. Many different things, including osteoarthritis, osteoporosis, trauma, or a fracture, can cause this vertebral shifting. (Cedars Sinai, 2022) Spondylolisthesis is a general term for shifting a spinal vertebra over the one below it. It includes anterolisthesis, forward moving, and the less common retrolisthesis, or backward shifting.

Grades

Anterolisthesis is typically graded using the Meyerding scale, which assigns one of five grades according to how much slippage has occurred. These grades include:

Grade 1

• 0 to 25% slippage

Grade 2

• 25 to 50% slippage

Grade 3

• 50 to 75% slippage

Grade 4

• 75 to 100% slippage

Grade 5

• More than 100% slippage or spondyloptosis

Grade 1 and 2 cases are generally mild, while grades 3, 4, and 5 are more severe. (Koslosky E., and Gendelberg D. 2020)

Symptoms

Anterolisthesis can lead to various symptoms, depending on the severity and if the surrounding spinal nerves have been affected. The most common complaints include:

• Lower back stiffness
• Lower back pain
• Shooting pain into the leg
• Weakness when standing or walking for a long time
• Cramping in the leg muscles
• Numbness or tingling in the leg that improves when sitting or bending forward (American Academy of Orthopaedic Surgeons, 2021)

Causes

Cases of anterolisthesis are also typically categorized based on what led to the condition. The most common causes include:

Degenerative anterolisthesis

• Shifting occurs when arthritis (spondylosis) causes the spine’s joints and discs to deteriorate.
• The degenerative version of the anterolisthesis is the most common, particularly in women and adults over 50.
• African Americans tend to experience this condition at a higher rate than the general population. (American Academy of Orthopaedic Surgeons, 2021)

Isthmic anterolisthesis

• Slippage is caused by a fracture in a portion of the spine called the pars, also known as a pars defect.

Congenital or Dysplastic anterolisthesis

• Slippage is caused by a condition present at birth or spinal abnormality.

Traumatic anterolisthesis

• Acute shifting of the vertebrae caused by a traumatic injury.

Pathologic anterolisthesis

• Anterolisthesis occurs because of a bone disease like osteoporosis.

Iatrogenic - Postsurgical anterolisthesis

• Slippage that occurs as a result of a prior spinal decompression surgical procedure. (Hospital for Special Surgery, 2023)

Diagnosis

Diagnosis begins with a subjective evaluation and a physical examination. During these, the healthcare provider will assess sensation, strength, and reflexes and will order one of several diagnostic tests, including:

X-rays

• Visualizes the vertebrae in the spine and their position relative to those above and below.
• Also provides a clear picture of spinal arthritis or disc degeneration.

Magnetic Resonance Imaging - MRI

• Allows the spinal cord, nerves, muscles, and discs to be assessed for compression or damage.

Computed Tomography - CT scan

• Provides a cross-sectional image of the spine in very clear detail. (American Academy of Orthopaedic Surgeons, 2021)

Treatment

Several factors determine how the condition is treated, including:

• The grade of the slippage.
• The cause.
• The symptoms.
• The presence of instability on a diagnostic test such as an X-ray.

Stable and mildly symptomatic cases are usually treated with a combination that can involve:

• Physical therapy
• Activity modification
• Bracing
• Nonsteroidal anti-inflammatory medications/NSAIDs like ibuprofen.
• Spinal injections

In more severe cases in which spinal instability or significant neurological symptoms are present, surgery may be recommended. This commonly involves a spinal decompression or fusion procedure. The technique varies based on the surgeon’s preferences and anatomy. (Koslosky E., and Gendelberg D. 2020)

Prognosis

Most individuals with this condition don’t know they have it until it is found accidentally on an X-ray or an MRI for something else. Mild cases can cause minimal symptoms and can be well-managed with conservative treatments. Cases of unstable anterolisthesis or those with neurological compression often require surgical intervention. These surgeries restore stability to the spine and alleviate any pressure on the nerves. More than 85% of individuals who need surgery have a successful outcome. (American Academy of Orthopaedic Surgeons, 2021)

Self-Care and Management

For individuals experiencing pain, numbness, or tingling from anterolisthesis, getting symptoms evaluated by a healthcare provider is an important first step. The healthcare provider may suggest one of several management strategies, which include:

Core Strengthening

• To alleviate symptoms, exercises targeting the core muscles in the hips, pelvis, abdomen, and lower back are recommended.
• Formal physical therapy may also be recommended.

Over-the-counter Meds

• A healthcare provider may suggest pain-relieving medications like ibuprofen or naproxen to reduce soreness.

Activity Modification

• Sticking to gentle, pain-free activities and avoiding excessive or repetitive extension of the spine can help prevent symptom aggravation. (American Academy of Orthopaedic Surgeons, 2021)

Injury Medical Chiropractic and Functional Medicine Clinic

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

Degenerative Disc Disease Treatment

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cedars Sinai. (2022). Anterolisthesis. https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/anterolisthesis.html

Koslosky, E., & Gendelberg, D. (2020). Classification in Brief: The Meyerding Classification System of Spondylolisthesis. Clinical orthopaedics and related research, 478(5), 1125–1130. https://doi.org/10.1097/CORR.0000000000001153

American Academy of Orthopaedic Surgeons. (2021). Adult spondylolisthesis in the low back. https://orthoinfo.aaos.org/en/diseases--conditions/adult-spondylolisthesis-in-the-low-back

Hospital for Special Surgery. (2023). Spondylolisthesis. https://www.hss.edu/condition-list_spondylolisthesis.asp

An annular fissure is caused by age-related changes to the spine, which often do not cause symptoms but can cause back pain. Can understanding the causes help individuals manage lower back pain and help healthcare providers develop an effective treatment program?

Annular Fissure

An annular fissure is a discogenic condition that affects the spine and can cause lower back pain. Also called an annular tear, it's usually a wear-and-tear condition that happens over time rather than a condition caused by trauma. It usually occurs when the fibers that make up the annulus or the tough outer covering of the intervertebral disc break or separate. To manage it, healthcare providers may recommend:

• Making lifestyle changes.
• Staying aware of how you go about daily activities and take steps to make adjustments, such as being mindful of unhealthy posture.
• Start doing exercises that help make the back stronger.
• Medical care if pain and other symptoms need to be managed.

Symptoms

Lower back pain may be a sign of an annular fissure, or there may be no symptoms. Symptoms can include:

• Pain
• Weakness
• Numbness
• Electrical sensations travel down one leg or arm if a cervical/neck tear is present.
• Numbness and weakness may be caused by the nerves getting irritated or compressed near an annular tear. (Stadnik, T. W. et al., 1998)
• These symptoms can also be similar to a herniated disc, which can be a complication of an annular fissure.
• However, studies have shown that annular tears and herniated discs often go unnoticed because they have few obvious symptoms. (Jarvik, J. G. et al., 2005)

Annulus Function

The annulus comprises several layers of tough fibers/fibrocartilage that surround, contain, and protect the soft, liquid nucleus inside the disc. The layers of the annulus fibrosus crisscross to provide support. The nucleus is a shock absorber cushions the body's weight on the spinal joints when sitting, standing, or moving. Its strength also allows the disc to buffer the jolts and jars it experiences. It also helps maintain the integrity of the intervertebral joint by supporting the space between the two vertebrae. When an annular fissure occurs, the fibers separate or tear off from insertion on the nearby spinal bone. A fissure can also be a break in the fibers of one or more layers. (Jarvik, J. G. et al., 2005)

Causes

An annular tear is not the standard term medical professionals use to describe or diagnose a fissure because the word tear suggests that trauma has led to the separation or break in the fibers. While an injury can cause an annular fissure, it’s usually caused by long-term wear and tear. (Guterl, C. C. et al., 2013) The tears are typically caused by age-related degenerative changes in the disc, which can also lead to degeneration in other areas of the spine. Wear and tear are caused by annular fissures due to an individual's daily living habits, such as sitting, standing, walking, climbing stairs, and performing other routine movements.

Treatment

While a large annular fissure is not likely to improve without treatment, a small one could heal independently. However, once an area has torn, it becomes more likely to continue tearing. (Virginia Spine Institute, N.D.) Conservative treatment is usually enough to control pain and symptoms. Physical therapy and anti-inflammatory medication are the first line of treatment. (Cheng, J. et al., 2019) Medication can be over-the-counter or prescription. Physical therapy treatment includes exercises, traction, and other therapies. If these do not help with the symptoms, the provider may suggest a steroid injection to reduce inflammation and pain. It can take three to six months to recover from degenerative disc problems if doing a standard treatment plan that includes rest, low-impact therapy exercises, and anti-inflammatory treatments. (Cheng, J. et al., 2019)

In severe cases, surgery may be recommended, including disc replacement surgery. An annular tear is not a reason to have disc replacement surgery alone; it is only when there are degenerative changes in the vertebral disc that surgery might be necessary. (Yue, J. J. et al., 2012)

Improving Body Alignment

Not paying attention and being aware of how the body performs everyday activities can, over time, set the stage for an annular fissure and other musculoskeletal injuries. However, fixing daily movement and posture habits to prevent injuries can be done through simple adjustments. For example, strengthening the core and back muscles can reduce pressure on the spine and help prevent injuries. (Camp, C. L. et al., 2016) The idea is to improve joint and overall body alignment. Activities can include:

• Strength training
• Walking
• Pilates classes
• Yoga
• Tai chi
• Somatic exercises

These activities help with muscle balance and joint alignment, which are recommended prevention strategies that physical therapists use when working with individuals who need help with spinal problems.

Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to treating injuries, improving flexibility, mobility, and agility to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Back Pain Specialist

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Stadnik, T. W., Lee, R. R., Coen, H. L., Neirynck, E. C., Buisseret, T. S., & Osteaux, M. J. (1998). Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. Radiology, 206(1), 49–55. https://doi.org/10.1148/radiology.206.1.9423651

Jarvik, J. G., Hollingworth, W., Heagerty, P. J., Haynor, D. R., Boyko, E. J., & Deyo, R. A. (2005). Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine, 30(13), 1541–1549. https://doi.org/10.1097/01.brs.0000167536.60002.87

Guterl, C. C., See, E. Y., Blanquer, S. B., Pandit, A., Ferguson, S. J., Benneker, L. M., Grijpma, D. W., Sakai, D., Eglin, D., Alini, M., Iatridis, J. C., & Grad, S. (2013). Challenges and strategies in the repair of ruptured annulus fibrosus. European cells & materials, 25, 1–21. https://doi.org/10.22203/ecm.v025a01

Virginia Spine Institute. (N.D.). Annular disc tear Understanding the Symptoms, Causes, and Treatments. https://www.spinemd.com/conditions/annular-disc-tear/

Cheng, J., Santiago, K. A., Nguyen, J. T., Solomon, J. L., & Lutz, G. E. (2019). Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5-9 years. Regenerative medicine, 14(9), 831–840. https://doi.org/10.2217/rme-2019-0040

Yue, J. J., Telles, C., Schlösser, T. P., Hermenau, S., Ramachandran, R., & Long, W. D., 3rd (2012). Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study. International journal of spine surgery, 6, 13–17. https://doi.org/10.1016/j.ijsp.2011.09.001

Camp, C. L., Conti, M. S., Sgroi, T., Cammisa, F. P., & Dines, J. S. (2016). Epidemiology, Treatment, and Prevention of Lumbar Spine Injuries in Major League Baseball Players. American journal of orthopedics (Belle Mead, N.J.), 45(3), 137–143.

Can using a self-care traction device help and be a cost-effective method of providing cervical relief at home for individuals who have neck pain?

Neck Pain Traction Device

Neck Pain Traction Device: Individuals with neck or arm pain caused by neck/cervical radiculopathy may benefit from physical therapy to manage their condition. (Alshami, A. M., and Bamhair, D. A. 2021) Physical therapy can improve neck mobility, restore function, and decrease pain.

Traction

A physical therapist may use various treatments and modalities to treat the individual's condition. Cervical traction is one treatment to help relieve neck pain and can help:

• Stretch the muscles and soft tissues in the neck.
• Separate and open up the disc and joint spaces.
• Decrease pain in the neck and arms by relieving pressure on nerves from the cervical spine. (Madson, T. J., and Hollman, J. H. 2017)

There are different neck traction techniques. The therapist may use a mechanical traction device that requires the individual to strap their head and neck to a machine that gently pulls the neck, providing relief. (Romeo, A. et al., 2018) The physical therapist may also use manual traction with their hands to help the process. This type allows the therapist to easily adjust the amount of traction force and the direction of the pull on the neck. (Romeo, A. et al., 2018)

Home Traction Devices

Cervical traction that works for individuals at the clinic may also benefit from using a traction device at home to maintain their gains. Over-the-door cervical traction may be an effective, safe, and simple way to administer neck traction in the comfort of one's home to help decrease pain. (Fritz, J. M. et al., 2014) Medical supply stores and pharmacies carry over-the-door traction devices, which can also be found online. If finding an over-the-door traction unit is difficult, the therapy clinic can help order one from a medical supplier.

Setting Up The Device

Before using a neck pain traction device, consult a physical therapist or doctor to ensure neck traction is safe and on usage. Over-the-door traction units may be built differently but comprise the main parts:

• A hook-and-pulley apparatus that hangs over the door.
• A nylon cord that’s fed through the pulley.
• A weight that could be a water bag that hangs on the end of the cord to provide traction force.
• A harness to wear on your head.

1. The traction unit must be hung over a door secured to the top and closed.
2. It is recommended that the door be a closet door so no one will open it while using the device.
3. If a closet door is not available, be sure to lock the door so that no one can open it while attached to the device.
4. A small hook with a pulley attached to it hangs on the door.
5. The harness attaches to the end of the nylon cord opposite the weighted water bag.
6. The harness goes on the head, and the chin strap should fit snugly under the chin and be secured by the hook-and-loop fasteners.
7. The two straps on either side of your head should be hooked to the end of the nylon cord, which is fed through the pulley system.
8. After strapping on the head harness, fill the water bag using the markings on the bag to indicate its weight and hang it on one end of the cord.
9. Fill the bag until the water reaches the desired mark, usually 8–15 pounds.
10. After filling the water bag, sit in a chair facing the door and hang the bag on the other end of the cord not attached to the head harness.
11. Do not drop the bag; this could cause a sudden forceful traction motion on your neck.

How Long to Use

Individuals should generally use the traction device for about 15 to 20 minutes each session and can perform several sessions per day. (American Physical Therapy Association. 2020) While using the over-the-door traction device, there should be a gentle pulling sensation in the neck, relieving the neck pain, and if there is arm pain or tingling, it should also decrease. Traction does not replace neck exercises or postural correction in treating neck pain. Be sure to follow the therapist's prescribed exercises. Active engagement is essential to treating and preventing neck pain from returning. If the pain increases while using the traction device, stop using it and consult a physical therapist or doctor. Ask a physical therapist or other neuromusculoskeletal medical professional if self-care traction is appropriate for specific conditions.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that helps individuals return to normal. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles through an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Neck Injuries

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Alshami, A. M., & Bamhair, D. A. (2021). Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial. Trials, 22(1), 716. https://doi.org/10.1186/s13063-021-05690-y

Madson, T. J., & Hollman, J. H. (2017). Cervical Traction for Managing Neck Pain: A Survey of Physical Therapists in the United States. The Journal of orthopaedic and sports physical therapy, 47(3), 200–208. https://doi.org/10.2519/jospt.2017.6914

Romeo, A., Vanti, C., Boldrini, V., Ruggeri, M., Guccione, A. A., Pillastrini, P., & Bertozzi, L. (2018). Cervical Radiculopathy: Effectiveness of Adding Traction to Physical Therapy-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Physical therapy, 98(4), 231–242. https://doi.org/10.1093/physth/pzy001

Fritz, J. M., Thackeray, A., Brennan, G. P., & Childs, J. D. (2014). Exercise only, exercise with mechanical traction, or exercise with over-door traction for patients with cervical radiculopathy, with or without consideration of status on a previously described subgrouping rule: a randomized clinical trial. The Journal of orthopaedic and sports physical therapy, 44(2), 45–57. https://doi.org/10.2519/jospt.2014.5065

American Physical Therapy Association. (2020). Physical therapy guide to cervical radiculopathy. https://www.choosept.com/guide/physical-therapy-guide-cervical-radiculopathy

For individuals who have exhausted all other treatment options for low back pain and nerve root compression, can laser spine surgery help alleviate nerve compression and provide long-lasting pain relief?

Laser Spine Surgery

Laser spine surgery is a minimally invasive surgical procedure that uses a laser to cut through and remove spinal structures that are compressing nerves and causing intense pain. The minimally invasive procedure often results in less pain, tissue damage, and faster recovery than more extensive surgeries.

How It Works

Minimally invasive procedures result in less scarring and damage to surrounding structures, often reducing pain symptoms and a shorter recovery time. (Stern, J. 2009) Small incisions are made to access spinal column structures. With open-back surgery, a large incision is made down the back to access the spine. The surgery differs from other surgeries in that a laser beam, rather than other surgical instruments, is used to cut structures in the spine. However, the initial incision through the skin is made with a surgical scalpel. Laser is an acronym for Light Amplification Stimulated by Emission of Radiation. A laser can generate intense heat to cut through soft tissues, especially those with a high water content, like spinal column discs. (Stern, J. 2009) For many spine surgeries, the laser cannot be used to cut through bone as it generates instant sparks that can damage surrounding structures. Rather, laser spine surgery is primarily used to perform a discectomy, which is a surgical technique that removes a portion of a bulging or herniated disc that is pushing against the surrounding nerve roots, causing nerve compression and sciatic pain. (Stern, J. 2009)

Surgical Risks

Laser spine surgery may help resolve the cause of nerve root compression, but there is an increased risk of damage to nearby structures. Associated risks include: (Brouwer, P. A. et al., 2015)

• Infection
• Bleeding
• Blood clots
• Remaining symptoms
• Returning symptoms
• Further nerve damage
• Damage to the membrane around the spinal cord.
• Need for additional surgery

A laser beam is not precise like other surgical tools and requires practiced mastery and control to avoid damage to the spinal cord and nerve roots. (Stern, J. 2009) Because lasers cannot cut through bone, other surgical instruments are often used around corners and at different angles because they are more efficient and allow greater accuracy. (Atlantic Brain and Spine, 2022)

Purpose

Laser spine surgery is performed to remove structures that are causing nerve root compression. Nerve root compression is associated with the following conditions (Cleveland Clinic. 2018)

• Bulging discs
• Herniated discs
• Sciatica
• Spinal stenosis
• Spinal cord tumors

Nerve roots that are injured or damaged and constantly send chronic pain signals can be ablated with laser surgery, known as nerve ablation. The laser burns and destroys the nerve fibers. (Stern, J. 2009) Because laser spine surgery is limited in treating certain spinal disorders, most minimally invasive spine procedures do not use a laser. (Atlantic Brain and Spine. 2022)

Preparation

The surgical team will provide more detailed instructions on what to do in the days and hours before surgery. To promote optimal healing and a smooth recovery, it is recommended that the patient stay active, eat a healthy diet, and stop smoking prior to the operation. Individuals may need to stop taking certain medications to prevent excess bleeding or interaction with anesthesia during the operation. Inform the healthcare provider about all prescriptions, over-the-counter drugs, and supplements being taken.

Laser spine surgery is an outpatient procedure at a hospital or outpatient surgical center. The patient will likely go home on the same day of the operation. (Cleveland Clinic. 2018) Patients cannot drive to or from the hospital before or after their surgery, so arrange for family or friends to provide transportation. Minimizing stress and prioritizing healthy mental and emotional well-being is important to lowering inflammation and aiding recovery. The healthier the patient goes into surgery, the easier the recovery and rehabilitation will be.

Expectations

The surgery will be decided by the patient and healthcare provider and scheduled at a hospital or outpatient surgical center. Arrange for a friend or family member to drive to the surgery and home.

Before Surgery

• The patient will be taken to a pre-operative room and asked to change into a gown.
• The patient will undergo a brief physical examination and answer questions about medical history.
• The patient lies on a hospital bed, and a nurse inserts an IV to deliver medication and fluids.
• The surgical team will use the hospital bed to transport the patient in and out of the operating room.
• The surgical team will assist the patient in getting onto the operating table, and the patient will be administered anesthesia.
• The patient may receive general anesthesia, which will cause the patient to sleep for the surgery, or regional anesthesia, injected into the spine to numb the affected area. (Cleveland Clinic. 2018)
• The surgical team will sterilize the skin where the incision will be made.
• An antiseptic solution will be used to kill bacteria and prevent the risk of infection.
• Once sanitized, the body will be covered with sterilized linens to keep the surgical site clean.

During Surgery

• For a discectomy, the surgeon will make a small incision less than one inch in length with a scalpel along the spine to access the nerve roots.
• A surgical tool called an endoscope is a camera inserted into the incision to view the spine. (Brouwer, P. A. et al., 2015)
• Once the problematic disc portion causing the compression is located, the laser is inserted to cut through it.
• The cut disc portion is removed, and the incision site is sutured.

After Surgery

• After surgery, the patient is brought to a recovery room, where vital signs are monitored as the effects of the anesthesia wear off.
• Once stabilized, the patient can usually go home one or two hours after the operation.
• The surgeon will determine when the individual is clear to resume driving.

Recovery

Following a discectomy, the individual can return to work within a few days to a few weeks, depending on the severity, but it can take up to three months to return to normal activities. Length of recovery can range from two to four weeks or less to resume a sedentary job or eight to 12 weeks for a more physically demanding job that requires heavy lifting. (University of Wisconsin School of Medicine and Public Health, 2021) During the first two weeks, the patient will be given restrictions to facilitate the spine's healing until it becomes more stable. Restrictions can  include: (University of Wisconsin School of Medicine and Public Health, 2021)

• No bending, twisting, or lifting.
• No strenuous physical activity, including exercise, housework, yard work, and sex.
• No alcohol in the initial stage of recovery or while taking narcotic pain medications.
• No driving or operating a motor vehicle until discussed with the surgeon.

The healthcare provider may recommend physical therapy to relax, strengthen, and maintain musculoskeletal health. Physical therapy may be two to three times weekly for four to six weeks.

Process

Optimal recovery recommendations include:

• Getting enough sleep, at least seven to eight hours.
• Maintaining a positive attitude and learning how to cope and manage stress.
• Maintaining body hydration.
• Following the exercise program as prescribed by the physical therapist.
• Practicing healthy posture with sitting, standing, walking, and sleeping.
• Staying active and limiting the amount of time spent sitting. Try to get up and walk every one to two hours during the day to stay active and prevent blood clots. Gradually increase the amount of time or distance as recovery progresses.
• Do not push to do too much too soon. Overexertion can increase pain and delay recovery.
• Learning correct lifting techniques to utilize the core and leg muscles to prevent increased pressure on the spine.

Discuss treatment options for managing symptoms with a healthcare provider or specialist to determine if laser spine surgery is appropriate. Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers. We focus on restoring normal body functions after trauma and soft tissue injuries using Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols.

The Non-Surgical Approach

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Stern, J. SpineLine. (2009). Lasers in Spine Surgery: A Review. Current Concepts, 17-23. https://www.spine.org/Portals/0/assets/downloads/KnowYourBack/LaserSurgery.pdf

Brouwer, P. A., Brand, R., van den Akker-van Marle, M. E., Jacobs, W. C., Schenk, B., van den Berg-Huijsmans, A. A., Koes, B. W., van Buchem, M. A., Arts, M. P., & Peul, W. C. (2015). Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial. The spine journal: official journal of the North American Spine Society, 15(5), 857–865. https://doi.org/10.1016/j.spinee.2015.01.020

Atlantic Brain and Spine. (2022). The Truth About Laser Spine Surgery [2022 Update]. Atlantic Brain and Spine Blog. https://www.brainspinesurgery.com/blog/the-truth-about-laser-spine-surgery-2022-update?rq=Laser%20Spine%20Surgery

Cleveland Clinic. (2018). Can Laser Spine Surgery Fix Your Back Pain? https://health.clevelandclinic.org/can-laser-spine-surgery-fix-your-back-pain/

University of Wisconsin School of Medicine and Public Health. (2021). Home Care Instructions after Lumbar Laminectomy, Decompression or Discectomy Surgery. https://patient.uwhealth.org/healthfacts/4466

Discover how PTSD can relate to severe whiplash after auto accidents. Learn more about healing and support strategies.

Introduction

Getting into a car accident is stressful enough, but when it leads to whiplash and Post-Traumatic Stress Disorder (PTSD), it’s like life decided to throw you into a blender set to “chaos.” Whiplash is a neck injury caused by the sudden jerking of your head, often during a crash. At the same time, PTSD is a mental health condition triggered by traumatic events like motor vehicle accidents (MVAs). Together, they can make recovery feel like an uphill battle. This blog post dives into why severe whiplash from MVAs can lead to PTSD, explores the clinical reasons behind this connection, and highlights how experts like Dr. Alexander Jimenez in El Paso, Texas, help patients heal both physically and emotionally.

We’ll break down the science, discuss symptoms, and explain why personal injury cases matter, especially in El Paso. With a touch of humor to keep things light—because who doesn’t need a chuckle when talking about neck pain and trauma?—this post is written for everyone to understand, at a high school reading level. Let’s get started on this journey to understanding and recovery!

Clinical Rationale for PTSD Associated with Severe Whiplash

Why Whiplash Can Lead to PTSD

Severe whiplash doesn’t just hurt your neck; it can shake up your entire system, both physically and mentally. When your head snaps back and forth in a crash, it can stretch or tear the ligaments in your neck, leading to cervical instability—a condition where your neck struggles to stay stable. Research suggests this instability can cause chronic pain and symptoms like dizziness, headaches, and even ringing in the ears (Ivancic et al., 2007). These ongoing issues can wear you down, making it harder to cope with the emotional aftermath of the accident.

The trauma of the crash itself can also trigger PTSD. Imagine reliving the moment of impact every time you hear a car horn—that’s what PTSD can feel like. Studies show that about 25.7% of people with whiplash develop PTSD, which can worsen their physical symptoms (Pedler & Sterling, 2013). The constant pain from whiplash can amplify feelings of anxiety and distress, creating a cycle where physical and mental health feed off each other’s misery.

The Brain Connection

Here’s where it gets wild: Whiplash can sometimes cause minor brain injuries, similar to a concussion, if your head moves so fast it bumps against your skull. Over half of people with severe whiplash show signs of head trauma, which can add symptoms like confusion or memory issues to the mix (Barkhoudarian et al., 2011). These brain changes might make you more vulnerable to PTSD, as your brain struggles to process the trauma while dealing with physical pain.

References

• Barkhoudarian, G., Hovda, D. A., & Giza, C. C. (2011). The molecular pathophysiology of concussive brain injury. Clinical Sports Medicine, 30(1), 33–48.
• Ivancic, P. C., Coe, M. P., Ndu, A. B., et al. (2007). Dynamic mechanical properties of intact human cervical spine ligaments. The Spine Journal, 7(6), 659–665.
• Pedler, A., & Sterling, M. (2013). Patients with chronic whiplash can be subgrouped on the basis of symptoms of sensory hypersensitivity and posttraumatic stress. PAIN, 154(9), 1628–1633. doi.org/10.1016/j.pain.2013.05.005

Role of Injuries in Whiplash Development

What Is Whiplash?

Whiplash is like your neck getting an unwanted rollercoaster ride. It happens when your head is suddenly forced forward and backward, straining the muscles, ligaments, and tendons in your neck. This is common in rear-end collisions, where the impact pushes your car forward while your head lags, then snaps back. The forces involved are no joke—research shows the head can experience forces up to 15,000 N (newtons), while the neck takes on 1,000 to 1,500 N, far exceeding what your ligaments can handle (Saari et al., 2013; Zhou et al., 2010).

Physical Injuries from Whiplash

These forces can cause a range of injuries, including:

• Cervical spine misalignment: The vertebrae in your neck can shift out of place, causing pain and stiffness.
• Nerve irritation: Pinched or inflamed nerves can lead to tingling or numbness in your arms.
• Muscle imbalances: Strained muscles, such as the trapezius or levator scapulae, can become tight or weak, leading to painful movement.
• Ligament damage: Stretched or torn ligaments can lead to cervical instability, increasing the risk of chronic pain.

If left untreated, these injuries can lead to long-term issues, like shoulder pain or reduced mobility, making recovery even tougher.

References

• Saari, A., Dennison, C. R., Zhu, Q., et al. (2013). Compressive follower load influences cervical spine kinematics and kinetics during simulated head-first impact in an in vitro model. Journal of Biomechanical Engineering, 135(11), 111003.
• Zhou, S.-W., Guo, L.-X., Zhang, S.-Q., & Tang, C.-Y. (2010). Study on cervical spine injuries in vehicle side impact. Open Mechanical Engineering Journal, 4, 29–35.

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*

What advantages does a chiropractic and nurse practitioner therapy combination provide for spinal health after a motor vehicle accident?

Benefits of Chiropractic and Nurse Practitioners for Motor Vehicle Collisions

 Motor vehicle accidents (MVCs) are one of the most common causes of spinal injuries, such as whiplash, herniated discs, and soft tissue injury. These injuries can cause a lot of discomfort and make moving hard. To treat these injuries, you often need to use various approaches to deal with both the immediate symptoms and the long-term healing. Chiropractors focus on caring for the bones and muscles, especially making adjustments to the spine and doing manual therapies. On the other hand, nurse practitioners are advanced practice registered nurses who do medical exams, write prescriptions, and help manage a person's overall health. The goal of these clinicians working together is to provide a patient-centered, all-around approach to spine health after an MVC. (Kent, R., et al., 2023)

A chiropractic and nurse practitioner team can provide a comprehensive spinal health treatment for individuals recovering from car accident injuries, focusing on pain management and mobility improvement.

1. A chiropractic and nurse practitioner team can offer a comprehensive approach to spinal health after a car accident by addressing pain, improving mobility, and facilitating faster recovery.
2. Chiropractors focus on spinal alignment and joint mobility.
3. Nurse practitioners provide broader medical oversight and patient education.
4. The team approach can lead to more effective and personalized care for individuals recovering from car accident injuries. (Riva, J. J., et al., 2010)

Principal advantages of this cooperative strategy

Multidisciplinary and Holistic Care