Mobility & Flexibility - Joint Movement

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

Periscapular Bursitis

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

Normal Scapula Function

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

Scapular Bursa

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

Inflammation

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

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

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

Causes

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

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

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

Treatment

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

Rest

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

Ice

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

Physical Therapy

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

Anti-Inflammatory Medications

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

Cortisone Injections

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

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

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

Surgery

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

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

Scapular Winging in Depth

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

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

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

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

Non-radiographic axial spondyloarthritis or nr-axSpA and non-radiographic ankylosing spondylitis/AS are related. However, non-radiographic axial spondyloarthritis can present AS symptoms with active inflammation of the spine and sacroiliac/SI joints, causing back and hip pain but does not reveal joint damage on X-rays or MRIs. Injury Medical Chiropractic and Functional Medicine Clinic can explain what it means to have non-radiographic axial spondyloarthritis, how it can be managed, and what to do to prevent it from turning into ankylosing spondylitis.

Non-Radiographic Axial Spondyloarthritis

Non-radiographic axial spondyloarthritis means there are early AS symptoms but have not developed enough joint inflammation or damage to show up on an X-ray or other form of imaging. Early evidence of joint inflammation includes blurring of the joint edges and localized regions of joint erosion. It can be difficult for physicians to see these subtle changes on an x-ray.

Ankylosing Spondylitis

• Ankylosing spondylitis, or AS, is a form of inflammatory arthritis that affects joints in the spine and elsewhere.
• It is a chronic, inflammatory, autoimmune disease.
• Medical research is still ongoing to determine the exact cause, but a genetic component is believed to be contributing factor.
• Around 85% of individuals with ankylosing spondylitis have inherited the HLA-B27 gene, which is associated with multiple autoimmune conditions.
• In the early stages, individuals will present lower back pain around the sacroiliac joints or the joints that connect the spine to the pelvis.
• Later stages have more obvious X-ray findings, like the fusing of the sacroiliac joints and the lower spine that takes place over time.
• Joint inflammation can progress, causing permanent joint damage and spine rigidity.
• Most individuals with the condition can manage their symptoms with NSAIDs, chiropractic care, physical and massage therapy, and range of motion exercises.

Stage 1

• There is no evidence of spinal inflammation on x-rays.
• MRI provides more detailed images of bones and may reveal bone marrow edema or accumulation of fluid in the structures of the spinal bones and joints.
• Individuals with non-radiographic axial spondyloarthritis, you are here.

Stage 2

• There is visible inflammation of the spinal joints on the x-ray.
• The sacroiliac joints between the spine and the pelvis are the most affected.

Stage 3

• Chronic inflammation of the joints has caused bone loss and permanent joint damage, resulting in spine rigidity.

Symptoms of Non-Radiographic Axial Spondyloarthritis

There are differences between back pain associated with muscle strain and arthritis. Back pain symptoms include:

• Starts to present before age 40.
• It has a gradual onset and can go unnoticed for years.
• Improves with movement or activity.
• Eases up throughout the day.
• Starts up in the evening when resting.

Other symptoms include:

• Joint stiffness
• Swollen fingers
• Heel pain
• Bilateral buttock discomfort and pain

Slowing Progression

Progression from non-radiographic axial spondyloarthritis to ankylosing spondylitis occurs in 10% - 20% of individuals over a two-year period. Progression factors include genetics, gender, degree of joint damage, and level of inflammatory markers at the time of diagnosis.

• Early diagnosis and treatment can slow the progression before significant joint damage with anti-inflammatory therapy, rheumatological therapy, and targeted exercise.
• Work with a specialist like an orthopedic spine specialist and rheumatologist that understands the disorder and is up to date on the most recent treatment modalities.
• A rheumatologist will perform diagnostic tests, including spine X-rays, genetic blood work, and serum inflammatory markers.
• Individuals with non-radiographic axial spondyloarthritis should expect to have serial X-rays to gauge the progression of the disease.
• Staying healthy and active is recommended to slow the progression of nr-AxSpA and AS.
• Recent medical advances and lifestyle adjustments can slow the progression in most cases.

axSpA

General Disclaimer *

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please 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

Six tips for living well with ankylosing spondylitis. Available at https://www.mayoclinic.org/diseases-conditions/ankylosing-spondylitis/in-depth/6-tips-for-living-well-with-ankylosing-spondylitis/art-20478753. Accessed 11/07/2022.

Ankylosing spondylitis. Mayo Clinic. Available at https://www.mayoclinic.org/diseases-conditions/ankylosing-spondylitis/symptoms-causes/syc-20354808. Accessed 11/05/2022.

D. J. Pradeep, A. Keat, K. Gaffney, Predicting outcome in ankylosing spondylitis, Rheumatology, Volume 47, Issue 7, July 2008, Pages 942–945, https://doi.org/10.1093/rheumatology/ken195

Kucybała, Iwona, et al. "Radiologic approach to axial spondyloarthritis: where are we now and where are we heading?." Rheumatology international vol. 38,10 (2018): 1753-1762. doi:10.1007/s00296-018-4130-1

Michelena, Xabier, López-Medina, Clementina, and Helena Marzo-Ortega. "Non-radiographic versus radiographic axSpA: what's in a name?"." National Center for Biotechnology Information. October 14, 2020. https://doi.org/10.1093/rheumatology/keaa422

Swift D. Ankylosing spondylitis: disease progression varies widely. Medpage Today. Accessed 11/05/2022.Available at https://www.medpagetoday.com/rheumatology/arthritis/49096

The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:

• Repetitive overuse in a job or doing a task/chore that requires constant
• Bending
• Pulling
• Pushing
• Reaching
• Twisting
• Kneeling
• A result of poor technique in sports or similar physical activities.

Chiropractic treatment, along with exercises, can help prevent and relieve this pain.

Symptoms of lat pain

The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:

• Lower, middle, and upper back
• Back of the shoulders
• The base of the shoulder blade
• Lower arms
• Inside of the arms, extending down to the fingers

In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:

• Extends their hands forward and out in front
• Raises their hands above their head
• Tosses or throws an object

Damage or injury to the latissimus dorsi

Tissue damage or injury can cause other symptoms to present. These include:

• Tingling in the lower arms
• Breathing causes aching and/or pain
• Tendonitis in the middle and/or lower back

If the source of the back pain cannot be identified, or if it is accompanied by:

• Fever
• Breathing problems
• Abdominal pain
• Consult a doctor as these could be symptoms of a more serious condition.

Uses and Causes

The lat muscles are used in everyday activities. These include:

• Picking up objects like grocery bags
• Opening heavy doors
• Chest expansion for breathing
• Pushing against the armrests of a chair to stand up
• Using handrails to climb stairs

For sports or working out, the lats are used in:

• Weightlifting exercises using the upper body
• Bench-presses
• Rowing
• Swimming
• Throwing

Common causes of pain include:

• Overusing the muscles
• Using poor techniques
• Exercising without warming up

Risk of injury

Individuals that are at risk of developing this injury include those that:

• Are continually reaching overhead
• Regularly chop wood
• Perform regular shoveling
• Move furniture or other heavy objects
• Regularly practice poor posture

Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:

• Golfers
• Baseball pitchers
• Gymnasts
• Swimmers
• Tennis players

Exercises that can help bring relief

Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.

Back bow

This pose is known as the superman pose. To perform:

• Lay facedown on the floor
• Extend the legs so they are straight
• Stretch arms away from the body, so they are in front of the head
• Use the back to raise the shoulders
• Extend the arms and legs upward
• Hold the position for 10 seconds

Pelvic raise/lift

To perform this exercise:

• Lay flat on your back with the arms at the sides
• Bend the knees like for a sit-up with the heels close to the buttocks
• Keeping the hands and feet in place
• Lift the pelvis upward
• Slowly lower back to the floor

Prevention

Individuals can prevent lat pain with lifestyle adjustments. These include:

• Using proper technique and posture during work, sports, and exercise
• Staying aware to not overuse the muscles
• Staying hydrated
• Warming up and cooling down thoroughly before and after a workout, sports, physical activities
• Regular stretching
• Applying ice and heat before and after work, sports, and physical activities
• Chiropractic care
• Physical therapy massage

Body Composition

Nutrition and Recovery Advantage

Two important steps to achieve optimal health include:

Nutrition

Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesis after exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.

Recovery

For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.

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*

References

Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
https://www.ajronline.org/doi/abs/10.2214/AJR.04.1247

Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb

Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
http://www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20

George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581

Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4

Foam rollers have come a long way. When back pain presents these cylindrical objects can bring much-needed relief. These foam tubes are used by fitness enthusiasts, athletes, but can also produce major benefits for individuals that are not athletic. This is especially true for individuals that are experiencing back pain and stiffness. The benefits that foam rollers can provide for back pain have been shown to have a positive impact on the thoracolumbar fascia or muscles of the back and improved mobility/flexibility.

Foam Roller

A foam roller is a therapeutic tool that provides a form of deep-tissue self-massage. There are a variety of models for general and specific purposes.

• There are high-density rollers that are stiff
• Lower-density rollers that are soft and spongy
• Some are hollow with a cushioned coating
• Some have a solid inside
• They have different sizes from compact 18-inch rollers to three feet or longer

Foam rollers can be used by anyone. The main objective for using a foam roller is to assist with self-massage in and around the areas that can't be reached with the hands. Specifically for the back. It is important to be aware of the sensations that develop. Knowing the difference between soreness from loosening tight muscles and pain indicating that something is wrong.

Foam Roller Beneficial for Back Pain

As it does help with back pain, it is important to be aware of the areas of the body being rolled and how the foam rolling is done. Issues that often present include:

• Tightness in the lower back
• Pain accompanied with muscle spasms, or both
• Pain in the pelvis and hips caused by too much sitting or over-exercising

To relieve back pain, it is recommended to foam roll in combination with other therapeutic modalities like stretching. For focusing on a specific area like the lower back, it is recommended to roll out the glutes, the top of the glutes, and muscles around the spine, but not directly on the spine.

Foam-rolling regimen

• Keep the roller in a visible area where it can be used regularly. Individuals often keep them next to the bed, living room, kitchen area, etc. This allows for instant tension release. An example is some individuals foam roll right before bed to help with sleep.
• Learn other foam rolling techniques. Incorporate with various stretches.
• Foam roll when necessary. It does not have to be a daily routine and can be used as needed.
• For individuals that would like to make foam rolling part of a regular routine, one-two times a week is fine. Try for 5 to 10 minutes each session.
• However, foam rolling is not limited to the back. Rolling other areas can help as well.

Consult a doctor or doctor of chiropractic before using a foam roller

Pregnant women or individuals with diabetes should see a physical therapist or chiropractor to develop a custom-tailored rolling program. Individuals should not foam roll an acute injury. It is recommended to wait a few days for the inflammation to reduce. If any numbness or tingling is experienced, stop and contact a medical professional.

Body Composition

Aerobic Training Strengthens The Heart

A strong, efficient heart leads to a long healthy life. Aerobic exercise strengthens the heart and makes it more efficient at circulating blood. The chamber of the heart/left ventricle pumps blood to the rest of the body. When engaged in aerobic exercise the heart literally becomes larger and delivers more blood with each pump. This results in improved capacity for cardiac output.

When the heart is bigger, stronger, and pumps more blood, it does not have to beat as rapidly. A lower resting heart rate is associated with a reduced risk of cardiovascular disease. An increase in blood volume happens with aerobic exercise. Making it stronger and more efficient will lighten the heart’s load by decreasing the resistance it has to go through.

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 musculoskeletal system’s injuries or disorders. 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, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Intro: Journal of Bodywork and Movement Therapies. (January 2017) “Do exercises with the Foam Roller have a short-term impact on the thoracolumbar fascia? – A randomized controlled trial” https://www.sciencedirect.com/science/article/abs/pii/S1360859216300912

Is a Foam Roller Beneficial for Back Pain? Journal of Sport Rehabilitation. (January 2014) “Effect of Foam Rolling and Static Stretching on Passive Hip-Flexion Range of Motion” https://journals.humankinetics.com/view/journals/jsr/23/4/article-p296.xml

Sarcopenia means the loss of muscle tissue/mass from the natural aging process. Something that all of us are going through. However, when chronic back pain is involved it can speed up the natural process, which can lead to various health issues. Keeping the body fit and the spine healthy is the objective with approaches that can be utilized and employed to help maintain muscle mass.

By the time an individual turns 30, the muscles are large and strong. But going into the 30s, individuals begin to lose muscle mass and function. Individuals that are physically inactive can lose up to 5% of muscle mass every ten years after 30. Even those who are regularly active, still lose some muscle. Sarcopenia typically kicks-in around age 75-80. However, it could speed up as early as 65. It becomes a factor in bone frailty and increases the risk of falls and fractures in older adults.

Muscle Tissue Changes and Back Pain

Loss of muscle mass causes individuals to have a lesser degree of strength and function. As the decline continues, mobility lessens, and disability increases. With less muscle strength individuals become perfect candidates for falls/injury/s and become more prone to weight pain.

Body composition shifts can play a major role in issues like spinal stenosis and degenerative disc disease. Bone density also decreases with age increasing the risk of mobility issues. This means less activity which can make back pain worse and keeps the degenerative cycle going. The back pain intensifies, physical function is very limited, and low bone mineral density brings down an individual's quality of life.

Symptoms and Causes

Symptoms include:

• Weakness
• Loss of stamina

With reduced activity muscle mass becomes further shrunk. Sarcopenia is seen more often in individuals that are inactive. However, it is also seen in individuals that are physically active on a regular basis. This suggests that there are other factors involved. Researchers think these could be:

• The ability to turn protein into energy is decreased
• There are not enough calories/protein per day to maintain muscle mass
• A reduction in the nerve cells that are responsible for sending signals from the brain to the muscles when moving, contracting, extending, etc
• Low concentration of certain hormones, including:

1. Growth hormone
2. Testosterone
3. Insulin-like growth factor

Prevention

Because it can affect younger individuals as well, specifically those who are leading sedentary lifestyles and are overweight, prevention is the key. It is a domino effect that:

• Starts with reduced activity
• That leads to weight gain
• Causing even less activity

When the body's muscles are not being used they begin to atrophy. Fortunately, the loss can be reversible to a certain degree. Helping to build the muscle mass back up and help prevent sarcopenia is the goal.

Recommended Approaches

Strength training 

Muscles need a degree of stress to grow, which is then followed by recovery. Low-impact training programs/exercises performed at least two to three days per week can help keep the muscles healthy and in top form.

General physical activity

Exercise does not have to only be a regimented training form. Being active means keeping the body moving and mobile on a regular basis. This can be gardening, vacuuming, taking a walk around the neighborhood, parking far away when shopping to walk more, taking the stairs instead of the elevator. Anything that involves moving the body regularly and keeps the muscles active will help in the prevention process.

Protein

There is a wasting syndrome known as Cachexia. There is a connection between protein consumption and muscle mass. Older adults are at risk of low protein intake because they do not synthesize amino acids as effectively as they used to. Whey protein is recommended specifically because it creates and maintains high concentrations of amino acids in the blood. Other protein choices include:

• Greek yogurt
• Peanut butter
• Eggs
• Nuts
• Seeds
• Beans
• Lean animal proteins

Resistance Training

Sarcopenia prevention will promote better back/general health for every age group. However, it is crucial for those who are experiencing accelerated muscle loss like individuals over 50 and especially after 60. Resistance/strength training or some form of physical activity done on a regular basis can significantly slow the decline.

But heavy-weights are not necessary. Older individuals might believe weight training means they have to lift heavy with fewer reps and more weight. It is actually the opposite, with more reps and lighter weight. An example could be doing 20 reps with a 5-pound weight instead of 5 reps with a 20-pound weight. The total amount of weight being lifted is the same in both cases.

This approach benefits the individual because of the less load/strain on the bones and joints. It also allows older individuals to do more sessions per week, keeping the active overall. Those experiencing sarcopenia, and with lumbar stenosis, to do exercises that challenge the muscles without adding additional pressure on the joints. This could be:

• Walking in a swimming pool
• Cycling
• Pilates
• Yoga

Bodyweight/calisthenic exercises like pushups, squats, and wall slides can also be beneficial. The focus should be on regular activity that can progress slowly, and promotes tone without risk of injury. Muscle tone is maintained by activity and is essential for everyone. Get a routine, keep moving and the body will benefit greatly.

Chiropractic CrossFit Rehabilitation

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*

Studies reveal that swimming and aquatic exercises can help in relieving back pain. Done properly it is a highly recognized form of cardio exercise as well as injury recovery and rehabilitation, especially when dealing with back pain. Other types of cardiovascular exercise/s are great and are recommended for individuals with back pain that is already being managed. This could be light walking and mild aerobics.

However, those in severe pain and more than likely not in the best shape, cardio can be hard on the body. Swimming is great for all body types, those with weight issues that contribute to their back pain, those that have trouble moving, the young, elderly plus it burns calories, builds muscle, and is very refreshing.

Swimming has been utilized as a non-impact form of exercise and is recommended for individuals in injury recovery, surgery, and for those where performing high-impact exercise/s like running would be painful and dangerous. The buoyancy or upthrust of the water counters gravity decreasing the compression on the spine.

Aqua or hydrotherapy allows cardio activity without increasing or worsening pain, which is very therapeutic. Regular cardiovascular exercises/activities are beneficial for pain reduction. Figuring out and determining the right exercise/stroke for the patient's specific ailment and length of time those exercises should be done without causing fatigue or increased pain is the objective.

Strengthening the paraspinal muscles is essential to help with spinal support and reducing back pain. Utilizing the up-thrust of the water, enables patients to exercise these muscle groups more efficiently and effectively.

Preparation

Wherever the swimming therapy will take place, it is vital that the individual feels comfortable at the location, in the water, knows how to swim as this puts an individual at ease, not worrying about their surroundings and able to focus completely on their therapy/rehab.

If an individual is not a confident swimmer, the therapy can be done in shallow water or a rehabilitation pool and if cleared with a doctor taking swimming lessons with back pain in mind could be part of a therapy program. Once confident in the water warm-up in the shallow end or do some walking/cycling before actual swimming.

Therapeutic Strokes

Strokes for the therapeutic workout will be determined by the doctor, specialist, chiropractor, therapist, etc. These strokes are recommended to protect the spine while keeping pain at bay. Although individual cases are completely unique, and a doctor/therapist could recommend other strokes, the safest strokes found for back pain are the freestyle and the backstroke.

Strokes like the butterfly or breaststroke cause a natural extension/arch in the low back, which can be quite painful. So a patient does not have to lift their heads, which could cause them to arch their backs as well, could benefit using a center snorkel.

Regimen Frequency, Length

Like all forms of exercise, especially when dealing with back pain moderation is the way to go avoiding repetitive/overuse injuries. Soreness after the workout that goes away within a few hours is normal. But if the soreness lasts to the next day, this could the body warning the patient they are doing too much. For swimming, therapists usually recommend three days a week 20 to 30-minute workout. With activity response being used as a guide to progress or decrease the intensity or volume of the exercise. A gradual increase in activity until the patient reaches a workout regimen that fits:

• Age
• Condition level
• Physical ability

Considerations

When swimming or performing any exercise/s the benefits are completely dependent on the individual and back condition. It is difficult to determine how well therapeutic swimming will work, as every individual and the condition/s they are dealing with are different. Individuals with arthritis or spinal stenosis have been shown to do well using hydrotherapy because of decreased spinal compression. Each patient might have to make certain adjustments based on their condition and the doctor's, chiropractor, specialist's treatment plan.

For example, someone with cervical spine arthritis or stenosis could have a difficult time lifting their head to breathe. In this case, they could be instructed to swim using only the backstroke or using a customized stroke so they don't have to lift the head. Every patient needs to try and see what works for their specific condition. What works for one patient, may not work for another. Find out if swimming could be a treatment option for your back condition. With this in mind, finding a form of aqua/swimming exercise that suits you can be achieved.

Back Pain Management 

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*

Being able to hike with back pain is a blessing for individuals that love being outdoors. Enjoying nature and being able to get away from all the stress and tension is something we all can use. Hiking is an excellent physical activity that cleanses the mind, body, and spirit. Not to mention the great exercise benefits that come with it.

The time spent going up and down hills following trails, etc. can feel unbelievable until pain symptoms start to present. Those with back pain know and understand that there are certain activities that can kick in the pain. If hiking has been stopped in its tracks because of back pain, or, if just about to start hiking for the first time, here is some advice to reduce and alleviate back pain during and after a hiking session.

Hike The Right Way

Dr. Alex Jimenez D.C. is a spine injury specialist at Injury Medical Chiropractic Clinic. He believes at its core, hiking is very beneficial to individuals with back pain.

Hiking is a great activity for those with back pain because it increases muscular circulation improving soft tissue flexibility in the spine along with other muscle groups. Hiking helps strengthen spinal support muscles, improves flexibility and posture. The result is minimized pain on all levels. Walking on different uneven terrain/s contributes to improved balance and synergistic muscle activity of the back, legs, and core, and the small muscles of the feet. However, there is an incorrect way to hike with back pain.

If done incorrectly hiking can have a negative detrimental impact on the body. Proper technique and form need to be followed. For example, a backpack that is improperly worn or not correctly sized for the body type could lead to imbalance. This could lead to improper form and injuries. Poor posture during a hike places added pressure on the:

• Joints
• Spine
• Ligaments
• Tendons

This could easily result in muscle/tendon injuries. With some preparation, a few tips and being aware of your surroundings will help you to become a hiking pro in no time, with reduced, improved, and possibly no back pain after a while of doing this great activity. Here are some words of wisdom when it comes to hiking and back pain.

Proper Backpack

A poor-fitting backpack will easily lead to increased back pain and even other ailments like shoulder and neck pain issues. A proper backpack should have the straps around the waist and across the back to evenly distribute the weight. Visit a sports/outdoor store to get correctly fitted for a backpack.

Stretching Out

Getting and staying loose before and after a hike is very important. Before a hike improves circulation and loosens the muscles, in turn, reducing the stress on the joints. Stretching after a hike reduces muscle fatigue and soreness that can amplify and exacerbate back pain along with any other body soreness.

Trekking Poles

Using trekking poles can be beneficial and quite helpful for individuals with back pain. Trekking poles can help avoid poor posture by keeping the body in an upright position. This helps reduce back pain experienced during and after a hike.

 Body Care

Hiking successfully means that the body needs to be fully functional and fueled before even stepping on the trail. Fueling the body with nutritious snacks like bananas, dried fruit, and trail mix will keep the body's energy supply going. And above all stay hydrated with plenty of water. Also, focus the workout on developing upper body and core strength to prevent injury.

Don't forget to listen to what your body is telling you. Individuals with back pain need to listen to their bodies making sure not to overdo it, as well as, with any type of exercise, to adjust to your specific pain tolerance level. If unable to limit distance or time, then make sure to take frequent breaks. This will help avoid placing unnecessary strain on the spine.

Recovery Time

The body needs a proper amount of time between hikes to recover properly. If there is still soreness and pain, WAIT until the body is no longer sore before trekking to the next trail. The amount a person can hike depends on the individual, overall strength, and how fast their body recovers between hikes. It is different for everyone.

Assistance

As the journey commences, whether going for pain-free or less painful hiking, remember that it's ok to have others help get you there. Getting help from a veteran hiker will definitely benefit proper form and posture. Hiking with an experienced partner can also help avoid poor hiking techniques that can worsen back pain or even create new injuries.

Consult a local chiropractor, or spine, and pain specialist if you are unsure about hiking and are experiencing ongoing back pain. They will help develop a customized/personalized treatment plan with the focus on decreasing and controlling the pain and improving the body's overall function to be able to participate in physical recreational activities.

Car Accident Doctors & Chiropractors

Be sure to talk with your provider before taking or combining dietary and herbal supplements with prescription meds or over the counter medications. Individuals with chronic back/neck pain but want to get away from medication/s, and pain relievers, dietary and herbal supplements could be an option. There are dietary supplements as well as, herbal supplements that although used in nutrition, also have added benefits for pain and inflammation relief.

Individuals have found herbs and supplements to be helpful in reducing and alleviating their pain. It is important to understand that these are not a cure-all that will take the pain away or the depression that accompanies chronic spine-related conditions. These are made to help to manage back pain symptoms.

Nutrition and Dietary

A healthy diet includes plenty of fruit, vegetables, and whole grains which keeps the body in top form. Antioxidant foods like green leafy vegetables and berries help in fighting inflammation. Dietary and herbal supplements that research has found helpful in reducing inflammation and pain are listed. However, we must point out that several of these supplements can increase the risk of bleeding. Therefore have a discussion with your health care provider before taking any type of supplement.

Supplements

Omega-3 fatty acids

• Flaxseed and Fish Oils
• Omega-3 fatty acids can increase the risk of bleeding and conflict with blood-thinning medications like warfarin coumadin and aspirin.

Glucosamine/Chondroitin

• Studies show these supplements can help relieve arthritis pain but have not been studied as a treatment for back pain.
• Glucosamine and chondroitin can interfere with blood-thinning medications like warfarin coumadin and aspirin.

Methylsulfonylmethane MSM

• MSM can help relieve arthritis pain.

Bromelain

• This is an enzyme that can reduce inflammation
• It can increase the risk of bleeding, so do not take this without consulting a health care provider
• It can interact/interfere with antibiotic meds
• Do not take if have a peptic ulcer

Herbal Supplements

Herbal supplements have been used by many cultures for health and dietary benefits for a very long time. These supplements are literally made from herbs/plants valued for their flavor, scent, and medicinal qualities. Examples of herbal supplements for pain include:

• Cayenne reduces pain signal intensity
• Devil's claw relieves inflammation
• Eucalyptus clears chest congestion

Benefits of Herbs

People prefer dietary and herbal supplements instead of standard/traditional drugs and medications for a variety of reasons.

• Some because they provide pain relief without the side effects associated with medications. An example is white willow bark, that has been used for years for its anti-inflammatory benefits. And it doesn't upset the stomach the way medications the way aspirin does.
• Some prefer herbal supplements because they are natural.

Herbs come in pill, capsule, tablets, teas, and liquid extracts.

Turmeric

• Reduces inflammation and pain
• Turmeric can increase the risk of bleeding, especially for those taking blood-thinning medication

Devil's claw

• Reduces pain
• Can increase the risk of bleeding and interact with diabetes meds
• Can affect the heart and can cause issues for those with gallstones

Willow bark

• Relieves pain
• Do not take if taking aspirin or blood-thinning meds
• Do not take if are allergic to aspirin or salicylates
• Do not give to children under eighteen

Capsaicin cream

• Reduces pain and inflammation
• It is one of the main components in chili peppers

Things to Remember

• Dietary and herbal supplements do not have to be approved by the U.S. Food and Drug Administration before they are sold.
• Herbs can have medication-like effects on the body
• Products sold as dietary supplements and promoted as a treatment, prevention, and/or cure for a disease or condition is considered an unapproved and illegal drug

While dietary supplements and herbal supplements are primarily used to help nutritional needs, these supplements can serve medicinal purposes. Explore alternatives from conventional medications with herbal supplements, as this could be an option. Check with your health care provider before taking supplements if you are pregnant, nursing a baby, or have a chronic medical condition like diabetes, hypertension, or heart disease.

The FASTING MIMICKING DIET & STRESS HORMONES

Yoga has gained popularity because of its ability to reduce back pain, relax tight muscles, relieve stress and exercise in a safe calm environment. Developed thousands of years ago, the practice of breathing, posing and stretching offers a variety of important health benefits. As a chiropractor, I’m often asked about the practice of yoga. Those with back pain or have undergone spine surgery want to know if yoga can help them improve their physical and psychological health.

• Reduced stress
• Improved blood pressure
• Increased flexibility
• Increased stamina
• Greater balance
• Improved breathing techniques

In addition to the normal exercise benefits yoga offers, the practice serves as therapy for a variety of injuries and health conditions. Yoga embodies the physical, emotional, and spiritual wellness, and touches upon other forms of traditional exercise. The concept that yoga heals the body in its entirety mirrors chiropractic care. These foundations offer enormous benefits to those dealing with a variety of injuries and conditions. By incorporating yoga, individuals are able to reap amazing rewards.

A regular exercise plan needs to include a little cardio as there are huge benefits from pumping the heart rate up. Minimal loading exercises, like biking, and swimming are great. Pain can be managed by participating in cardiovascular exercises, however, yoga’s gentleness can complement the healing process.

Here are a few reasons:

Prepares the body for healing

Practicing yoga stretches and elongates the body's muscles, releasing tension and stress. It can serve to warm up the body and clear the mind, so a chiropractor can get to the root problem. Yoga complements chiropractic treatment by preparing the body to heal itself.

Strengthens joints and ligaments

Dealing with a health condition or injury is frustrating and can seem like it takes forever to heal. Implementing yoga into a recovery plan helps strengthen joints and ligaments, which aids in promoting healing and cutting down the time it takes to get better. Yoga works on the body as a whole and promotes greater well-being from head to toe. A stronger body offers more productivity than one that is stiff, sore, and unhealthy.

Increases range of motion

Depending on the individual's specific condition, individuals may need a few visits to prepare their bodies before the main issue can be addressed. Yoga sessions increase a body's flexibility and help with the range of motion in the neck, back, hips, and other joints.

Prevents injury/s

Yoga provides a continual way for individuals dealing with chronic conditions to manage and reduce pain, inflammation, and other symptoms. Yoga combined with chiropractic keeps the body aligned, balanced, muscles stretched, de-stressed, and the joints working properly.

Both also serve to keep posture correct, and ligaments strong. All of this creates a body that is less susceptible to future injury, illness, and stress. Individuals enjoy increased mobility for a lot longer without changing lifestyles.

The Best Way to Start

There are many different types of yoga. Most sessions usually last an hour and include breathing exercises, meditation and holding poses/postures that stretch and tone muscle groups.

To help visualize how yoga can help the spine, here's an analogy:

Think of the spine like a cookie ice cream sandwich with the ice cream in-between and a gummy band wrapped around. The cookies represent the vertebrae, the ice cream is the disc cushion in between and the gummy band represents the ligament and muscles surrounding the area.

The tighter the gummy band is, the more it compresses the cookies and applies pressure to the ice cream. When stretching the gummy band, it loosens the pressure on the cookies and reduces the load/compression of the ice cream.

Exercise is crucial for recovery and rehabilitation. Yoga is a gentle way to get you back on your feet. It promotes circulation, relaxation, strength, and flexibility. Pure plane movements meaning moving forward then backward in basic movements are essential until the body becomes more flexible. Move carefully forward, sideways and cautiously backward.

• At the beginning no movements combining bending and twisting.
• The muscles need to adapt and become comfortable with these movements at first. Therefore, hold poses for at least 30 seconds without bouncing minimizing potential injury.

Certified instructor

Ask your doctor or chiropractor if they can recommend a certified yoga instructor; preferably with 500 hours of instruction. Search for small class sizes and a teacher that closely monitors movements and poses closely. It is important that the instructor be aware and make gentle adjustments or offer modifications to participants as needed.

Restorative Flow

Start off with a type known as Restorative Flow. It restores the flow from one part of the body to another with slow controlled movements/poses that emphasize stretching and correct breathing.

Listen to Your Body

When healing from injury/s, take it slow. Listen to your body and let it guide your movements so that it feels safe and comfortable. Do not push beyond. For most, a beginner or restorative Yoga class is best. Ask about modifying the poses so that the bending and twisting combinations/advanced postures are taken out so as not to overload the joints.

If you are on a budget consider purchasing an instructional DVD. DVD's offer program variations of 20 to 60 minutes and are highly educational and easy to follow. Stretching pain/soreness is okay, but sharp pain is not.

Yoga could be an answer to many of the body's issues, whether dealing with current conditions or just want to stay healthy in a new way check out the basics of yoga. Chiropractic coupled with yoga offers great benefits to those dealing with medical conditions or injury. Ask your chiropractor for an evaluation, and if adding yoga to your health program will help.

Chiropractic Massage Therapy 

Members of the military perform physically and psychologically demanding jobs every day. Research has found that conservative medical care, like chiropractic treatment, can absolutely help with back pain.

A study has shown that chiropractic treatment brought serious relief to female veterans with back pain. 

Causes

The causes of back pain can be viewed as being mechanical, organic or idiopathic. Spinal conditions can be congenital or from birth and can be an acquired disorder that develops later in life.

• Mechanical pain is triggered by spinal movement and involves spinal structures, like the facet joints, intervertebral discs, vertebral bodies, ligaments, muscles or soft tissues.
• Organic pain is attributed to disease, like spinal cancer.
• Idiopathic means the cause is unknown.

Back Pain & Female Veterans

Low back pain is a musculoskeletal condition and for female veterans has become a chronic condition. For these women, the condition seems to stem from repeated and prolonged deployments as contributors/causes to more prolonged injuries.

Female veterans had a higher rate of service-related disability compared to male veterans.

Having to live with a disease or chronic condition can impact the quality of life significantly. It can result in short- or long-term disability, it affects individuals financially from time off work and reroutes those financial resources to health care needs.

Chiropractic Research

Researchers reviewed 70 female veterans that utilized chiropractic treatment for their back pain.

The average patient was:

• Around 35-40-years old

Veteran patients were included in the study by:

1. Visiting a chiropractic clinic over a 7-year period
2. Between 18 - 70 years old during treatment
3. Needed at least two treatments

Treatments included: 

Flexion-distraction therapy

This is gentle intermittent traction, along with manual pressure applied to the back.

Myofascial release

Massage therapy to muscles, joints, ligaments.

Spinal manipulative therapy

This involves the chiropractor’s hands performing a high-velocity thrust to regions within the low back.

Spinal mobilization

Similar to spinal manipulative therapy, but with gentler repetitive motions around the affected area.

These treatments were applied alone or in combination, guided by:

• The nature of the back pain complaint
• Response
• Pain severity
• Patient's preference
• The patient's tolerance of the various treatments

To help measure how effective the treatment was, the research team used the Back Bournemouth Questionnaire.

Pain is a complex biological process that involves both physical and mental health factors.

The test is one way to understand the multi-dimensional nature of pain.

Other factors to consider, specifically with military veterans were other health conditions like:

• Post-traumatic stress disorder
• Military sexual trauma

By comparing the patients Back Bournemouth Questionaire results at the beginning of treatment and then at the end, researchers found that these patients’ low back pain improved by 85% with chiropractic treatment.

The American College of Physicians Clinical Practice Guidelines includes and stresses that doctors refer patients first to a chiropractor/physical therapist and undergo spinal manipulation as the recommended non-drug treatment for back pain before recommending medications or surgery.

The guidelines focus on:

• Exercise
• Stress reduction
• Integrative therapies

Chiropractic spinal manipulation treatment has been shown to effectively treat back pain for everyone. 

We focus on what works for you and strive to create fitness and better the body through researched methods and total wellness programs. These programs are natural and use the body’s own ability to achieve goals of improvement. To all of our veterans, we thank you for your service.

Reduce Back Pain with *FUNCTIONAL FOOT ORTHOTICS* El Paso, TX.

• Approximately 80 percent of the population will experience some type of back pain sometime throughout their lifetime.
• Custom-made functional foot orthotics can help support and promote the natural alignment of the spine.

Ever wonder what goes through your chiropractors head when treating your moderate back pain? Alexander Jimenez doctor of chiropractic uses a patient as an example. Dr. Jimenez shares his thought process through the treatment of a patient with moderate low back pain. All the way through the first appointment through to the recovery process.

Patient's Background

• Louis is a 47-year-old programmer who plays tennis regularly, especially tournaments.
• However, low back pain has put Louis' game on hold as he’s not able to manage the pain with the regular heating pad, ice, and over-the-counter pain reliever.
• His primary physician referred him to Dr. Jimenez.

Louis' is referred to chiropractic care

Dr. Jimenez: Louis' primary physician referred him to me instead of a spine surgeon because first, the pain is not yet serious enough for surgery. And so there was a window to treat with a non-invasive approach. Secondly, I specialize in sports medicine and so maximize conservative, non-operative techniques/methods.

The United States has 5 times the surgical rate of other countries, so going to a non-operative spine specialist/chiropractor is the best approach at the beginning before the pain becomes severe/acute/chronic. 

Louis' first appointment, medical history, and current back pain

Dr. Jimenez: Once I went through his medical history, I saw it was pretty straightforward. So I dug deeper into other areas of Louis' lifestyle.

I asked about:

• Diet
• Physical activity
• Emotional well-being
• Smoking status

Also, a factor, his occupation was contributing to his pain. He’s a programmer, so spends a lot of time sitting at a desk.  Sitting for prolonged periods and usually improperly/poor posture are two of the worst things you can do to your spine.

Sitting for a long time without moving around causes the hip muscles to get tight, and glutes and spine muscles to weaken.

Louis sits most of the day working and spends the weekend if not doing house chores, then playing tennis. Just imagine using weakened muscles during the week and then jumping into a sports activity on the weekend will definitely cause pain.

Louis said that his pain would worsen when serving, hitting a forehand and bending over to pick up a ball. The pain would ease down once he was resting and sleeping.

Louis' physical exam

Dr. Jimenez: With the physical examination, I looked at

• Alignment
• Motion
• Inflexibilities (not just the spine but the hips and lower extremities)
• Muscular imbalances
• Weaknesses

I saw that Louis had a flattened lumbar lordosis, meaning the gentle curve in his low back was now flat. Restricted motion in one direction— or a flexion. And weakness in the buttock muscles and hips, and tightness in the lower extremity muscles.

Pushing on certain areas along his spine, presented tenderness in the mid to lower lumbar spine and joint areas.

Initial treatment for Louis' moderate low back pain

1. Chiropractic
2. Physical therapy
3. Exercises
4. Stretching
5. Re-education - proper sitting/standing
6. Diet
7. Foot orthotics if necessary

The best initial treatment is to work chiropractically on the muscular imbalances of the spine and lower extremities that are affecting the body's biomechanics. 

Other exams?

Dr. Jimenez: If necessary, a functional movement screening examination.

This test is used in sports medicine to check for imbalances from the feet all the way up to the neck.

After this, Louis would be tested to see if foot orthotics could help and receive specially designed exercises from a physical therapist to address the muscular imbalances.

Radiographic, CT, or MRI imaging

Dr. Jimenez: Many believe that imaging tests are essential to the diagnostic process.

My goal for Louis and all my patients is to get them pain-free, functional and back to health.

Are imaging tests important?

Dr. Jimenez: Imaging tests are important when there are neurologic discoveries/complaints, like muscle weakness, sensory loss, and immobility, as this can indicate the need for surgery.

Imaging tests are helpful for guiding targeted treatment like an epidural injection.

And if your doctor believes there is something serious, e.g., a spinal tumor, infection, then get an imaging test right away.

Louis' diagnosis

Dr. Jimenez: Because Louis' pain worsened while playing tennis and then ease during sleep, I diagnosed him with mechanical low back pain.

This type of back pain comes on through mechanical activities or applying a load to the spine.

Non-mechanical low back pain is pain that exists all the time.

Thought process while developing Louis' treatment plan

Dr. Jimenez: The treatment plan is focused on controlling pain and inflammation.

I first recommended chiropractic treatment, physical therapy/massage, and heat/ice compress.

After completing the course of treatment I suggested Louis take naturally derived supplements:

• Turmeric
• Bromelain
• High-dose omega 3's

This would help reduce inflammation.

They have been proven to be effective without the serious side effects of both over-the-counter and prescription medications.

Louis and I also discussed his diet

I recommended cutting back on carbohydrate and processed sugar intake thus curbing inflammation and upped healthy fat consumption of and natural sugars that are found in nuts and berries.

I taught Louis proper basic movement techniques, including positioning himself at work and stretches to do throughout the day.

I suggested that Louis work with a fitness physical therapist to build strength and flexibility, that would take shape in 4 to 6 weeks.

After a few sessions, the goal is to be able to do the exercises without help.

Return to tennis

Dr. Jimenez:  Very soon, as long as, he uses his natural anti-inflammatory supplements and follows through with regular chiropractic/physical therapy.

Slow and steady is the key to pain relief. Jumping into a tennis set before finishing treatment would set him back and possibly cause new injuries.

I recommended he start by playing non-competitive tennis and just rally after completing the treatment and then take a day or 2 to see how it feels.

Taking it slow should bring back full strength within 2 months after the initial visit.

Preventive tips:

A proper tennis swing should put minimal force on the spine.

• Tennis professionals start and stop, jump, slide, dive and run, run, run. That is where a significant overload of the lower back occurs and all the energy goes right into the spine.
• The key to a proper swing is to rotate the hips, take the proper arm swing, and hit through the ball.
• If you don’t have proper hip rotation, your body will pay for it through the spine.
• Bending at the hips and knees when picking up balls will greatly reduce stress on your low back.
• Work with a tennis pro that can teach you proper swing and specific tennis training especially movement.

This will help you play well, alleviate/avoid back pain and enjoy the game.

Low Back Pain Chiropractic Care | El Paso, Tx

 David Garcia developed moderate low back pain which gradually affected his quality of life. As his painful symptoms worsened, David Garcia was unable to walk and his low back pain became unbearable. He first visited Dr. Alex Jimenez, a chiropractor in El Paso, TX, after a recommendation from his sister. Dr. Jimenez was able to provide David Garcia with the help he deserved for his low back pain, restoring his quality of life. David Garcia describes the wonderful service Dr. Alex Jimenez and his staff have given him to offer him relief from his painful symptoms and he highly recommends chiropractic care as the non-surgical choice for moderate low back pain, among other health issues.

NCBI Resources

A chiropractor is the ideal medical professional to consult with for any unexplained pain in the musculoskeletal system. They are highly qualified professionals that their specialty is treating conditions like moderate lower back pain and they are very affordable. 31 million Americans experience moderate low back pain at any given time. This condition affects many, but finding the exact cause can be a challenge. Chiropractors are spinal specialists that are trained to not only alleviate pain but also find and help correct the cause of the problem.

According to the American Chiropractic Association (ACA), around 31 million Americans deal with some form of low back pain. If you are suffering from back pain, you are not alone. 

Fortunately, there are steps you can take to lessen the pain. Taking care of yourself – including maintaining a healthy weight and regular exercise – can help prevent back pain. But when you do experience back pain, chiropractic treatment and stretching can ease your symptoms.

Preparing For Stretching

Before we get to the stretching, we recommend preparing for your stretching session so you can stretch comfortably and safely. Tips for stretching include:

• Ease into it. Stretching should be done gently and smoothly, traveling from stationary to a position slowly and carefully. Avoid bouncing, which can tear muscles.
• Stretching should not hurt. You should not feel significant pain when you stretch. As you move into your stretch, listen to your body and stop before you start to feel pain. Stretching should feel good, not painful.
• Wear comfortable clothing. Wear loose clothing that will allow you the full range of motion.
• Choose an area to stretch that is flat and clean. Choose an area that will be comfortable and well-suited for your activity.
• Use padding when necessary. If you are going to be stretching on a hard surface, a little padding can make things much more comfortable.
• Hold each stretch 15-30 seconds, and repeat at least 2 times. Holding a stretch lets the muscles elongate, and repeating the stretch improves your results. Repeat the stretch four times for maximum benefit.
• Modify to fit your needs. Everyone must work within their limitations. When you try a stretch and you find it is not working for you, try to modify it to suit your needs. You can find modifications to most popular stretches online.

3 Stretches that Are Great For Back Pain

1. Child’s Pose

The name Child’s Pose comes from yoga, where this stretch is often used to begin each session of stretching. Child’s Pose is so popular because it is gentle and effective, and just about anyone can do it.

To do Child’s Pose, get down on your hands and knees. To begin with, place your knees slightly wider than hip-width. Flatten the tops of your feet to the floor, toes pointing behind you. Slowly move your hips back over your feet. Once you have rested your buttocks on your ankles, stretch your arms out in front of you. Feel your lower back stretch out as you hold the pose.

2. Knees to Chest

Lying on your back, use your hands to pull your knees up to your chest, rounding out your back in the process. You can interlace your fingers to hold your knees in position. If you like, hug your knees more tightly to your chest and rock left to right. To enhance the stretch, slowly bring your chin towards your chest.

3. Spinal Twist

Lying on your back, stick each hand out to the side of your body to create a T shape. Bring the right knee up to your chest while keeping the left leg straight on the floor. Use your left hand to gently pull your knee higher, then pull the knee across your body to the left. Try to keep your right shoulder on the floor. Repeat on the left side.

Contact Us for Customized Stretches for Back Pain

If you are suffering from back pain, please schedule an appointment to meet with our chiropractic team. We can help design a custom stretching plan to help you ease your back pain.

Injury Medical Chiropractic Clinic

The human body is an intricate machine, and everything is connected so when something goes wrong in one area, it can cause problems in other areas. The back carries a lot of the stress in the body so when there is a problem with the hips, knees, or a foot dysfunction, the spine can bear at least some of the brunt of the pain and other effects.

Particularly true with foot dysfunction is when the mechanics of the foot are off, which can throw off the alignment of the entire body. Overpronation and oversupination in the foot can lead to severe and chronic back pain.

What is Pronation and Overpronation?

Pronation describes the way that the foot rolls inward during its normal motion. The foot turns inward, flattening out, as the heel’s outer edge strikes the ground.

For the foot to function correctly, there must be a significant degree of pronation. However, excessive pronation, or overpronation, can cause injury and damage to the foot and ankle. It creates the arch in the foot to flatten, and the ligaments, tendons, and muscles under the foot overstretch.

What is Supination and Oversupination

Supination describes the way the foot rolls outward during its normal motion. It occurs during the push off part of the gait, mainly when running when the heel lifts. The heel leaves the ground, and the action carries through as weight transfers to the forefront and toes. It moves the body in a forward direction.

When there is excessive supination or oversupination, it strains the tendons and muscles that provide stabilization for the ankle. Causing the ankle to roll, causing injury to the ankle including overpronation sprain, a torn tendon, or ligament rupture.

Conditions and Injuries Caused by Overpronation and Oversupination

Overpronation and oversupination can cause a variety of injuries and conditions that affect not only the feet and ankles, but also the knees, hips, and back as well. Some of the more common injuries and conditions include:

• Flat feet or posterior tibial tendon dysfunction
• Ankle Sprains
• Achilles tendinitis
• Arch pain
• Plantar fasciitis
• Corns
• Shin splints
• Heel pain
• Tight calves
• Calluses
• Knee pain
• Patellar tendonitis
• Hip pain
• Tight hip flexors
• Back pain
• Sciatica
• Herniated disks

How Foot Problems can Cause Back Pain

Foot Dysfunction can very easily cause a domino effect that extends all the way to the back. The feet are the foundation of the body and when there is a problem with the way they function it can cause the entire body to shift out of alignment.

For instance, overpronation of the foot causes a series of internal changes that extend up through the leg. The femur may rotate causing hip pain and inflammation of the sacroiliac joint which leads to back pain. Other misalignments in the body that are caused by foot problems can also lead to chronic lower back pain as well.

Chiropractic to Treat Foot Problems

Chiropractic seeks to find the cause of the conditions it is used to treat, including pain, instead of just treating symptoms. Because of this, the chiropractor will work to find the cause of the pain, in this case, overpronation and overpronation, and correct it – or the effects of the condition – in addition to treating the back pain.

Typically, overpronation and oversupination, are caused by muscle imbalances in the foot, ankle, and lower leg. Improper shoes, misalignment in the body, and other issues can cause these muscle imbalances. The chiropractor will work with the patient to find the cause of the foot problem so that can be corrected, then work to the damage or injury done.

Foot Dysfunction & Back Pain Treatment Chiropractor

Spinal Stenosis Walking Issues: Stenosis means a narrowing. Spinal stenosis can happen in any spine region, but the neck and lower back are the most common locations. The spinal canal becomes narrower and can cause the nerves to become compressed, pinched, and irritated and can extend from the lumbar spine through the hips, buttocks, legs, and feet. Individuals with lumbar spinal stenosis may have difficulty walking caused by sensations of discomfort like numbness, electrical shocks, and pain, requiring the need to lean forward to relieve pressure and symptoms. Additionally, symptoms are likely to worsen the longer the walk. Chiropractic treatment can treat spinal stenosis because it corrects and re-aligns the spine, thus reducing pressure on the spinal cord, joints, and nerve roots.

Spinal Stenosis Walking Issues

The spine is made up of interlocking vertebrae. The regions are cervical, thoracic, lumbar, and sacral bones with a foramen opening. These openings form the protective tunnel/spinal canal surrounding the spinal cord. The spinal cord is a group of nerves that run through the tunnel. The narrowing suffocates the nerves supplying the lower extremities that can influence walking activity.

Symptoms

There may be no symptoms with early lumbar spinal stenosis. Most individuals develop symptoms gradually and may begin to notice them while walking or standing. These can include:

• Lower back pressure sensations when standing upright or walking.
• Leg numbness, tingling, weakness, burning, and/or cramping.
• Muscle weakness.
• Persistent pain in the back, hips, buttocks, or legs while walking.
• Difficulty lifting the top part of the foot - known as drop foot.
• Loss of sensation in the feet.
• A weak foot that drops/slaps down when walking.
• Loss of sexual ability.
• In more serious cases, severe numbness, bladder problems, and inability to stand.

Individuals begin to lean forward when symptoms start, bringing relief by reducing the pressure on the nerves. However, constantly leaning forward leads to other posture and health problems.

Diagnosis

A doctor or chiropractor will ask questions about symptoms and medical history and perform a complete physical examination to diagnose lumbar spinal stenosis. During the physical examination, a healthcare provider will look for signs, such as loss of sensation, weakness, and abnormal reflexes.

Tests:

• X-rays of the lumbar spine may show bone growths called spurs that push on spinal nerves and/or narrowing of the spinal canal.
• Imaging tests - A CT or MRI scan can provide a detailed look at the spinal canal and nerve structures.
• Other studies include - bone scans, myelogram, which is a CT scan that uses a color dye, and EMG, which is an electrical test of muscle activity.

Chiropractic Treatment

Chiropractic care combined with physical therapy is a tried-and-true treatment for spinal stenosis. A chiropractic treatment plan can include targeted and passive exercise programs. Targeted exercises involve strengthening the core and back muscles. Passive treatments include hot and cold therapy, massage, decompression, and electrical stimulation. The objective of chiropractic therapy is to:

• Strengthen muscles in the core and legs
• Correct posture and body mechanics.
• Improve mobility.
• Maintain ability to perform day-to-day activities.
• Recommend stretches.
• Educate on how to keep the spine and back muscles safe.
• Train on using devices like a back brace, cane, or walker properly.
• Advise about shoe inserts and splints.
• Suggest work and home environment modifications, such as ergonomics and cushions.

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

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to 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

Conway, Justin, et al. “Walking assessment in people with lumbar spinal stenosis: capacity, performance, and self-report measures.” The spine journal: official North American Spine Society journal vol. 11,9 (2011): 816-23. doi:10.1016/j.spinee.2010.10.019

Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234

Macedo, Luciana Gazzi, et al. “Physical therapy interventions for degenerative lumbar spinal stenosis: a systematic review.” Physical therapy vol. 93,12 (2013): 1646-60. doi:10.2522/ptj.20120379

Tomkins-Lane, Christy C et al. “Predictors of walking performance and walking capacity in people with lumbar spinal stenosis, low back pain, and asymptomatic controls.” Archives of physical medicine and rehabilitation vol. 93,4 (2012): 647-53. doi:10.1016/j.apmr.2011.09.023

With a growing belly and changes in connective tissue, many pregnant women are unable to stay comfortable. A pregnancy chiropractor is safe and effective in helping manage pain in the back, hips, legs, joints and establish pelvic balance. This can provide the baby with space to grow and move throughout the pregnancy and lead to faster, easier labor and delivery. Relief and better symptom management are possible with a pregnancy chiropractor.

Chiropractic Is Safe During Pregnancy

Before engaging in any treatment during pregnancy, consult a doctor. For the most part, non-invasive chiropractic is considered safe for healthy, low-risk pregnancies and even higher-risk pregnancies once cleared by a doctor. Because pregnant women cannot take medications or undergo other invasive treatment options for pain, chiropractic treatment is recommended for sore, tight muscles, irritability, and pain management.

How A Pregnancy Chiropractor Can Help

What a chiropractor can offer includes:

• Restore pelvic balance.
• Improve mechanics for standing, sitting, and walking that could otherwise cause pain.
• Pain management through therapeutic massage and adjustments.
• Spinal alignment is restored.
• Improved blood perfusion.
• Energy levels improve.
• Reduce symptoms of nausea.
• Better positioning and movement for the baby.
• Optimize the pelvic position to allow for an easier birth; evidence indicates a shorter labor time thanks to an optimal pelvic position.

Clinic Appointment

The pregnancy chiropractor begins with an initial consultation. Here the patient asks questions, discusses any concerns, along with a full assessment of medical history. They will suggest various treatment options to restore the body to its optimal balance. The chiropractor will continually monitor the patient to tailor the treatments to their specific needs and achieve the most relief.

Body Composition

Impact of Breastfeeding and Body Composition

It turns out that breastfeeding and weight loss are showing that there could be a relationship. A study suggested that breastfeeding could eliminate weight gain during six months. These findings are corroborated by another study comparing body fat loss between exclusively breastfeeding and mixed feeding mothers. The researchers found that exclusively breastfeeding promotes more significant body fat loss than mixed feeding among mothers during the first 12 weeks after childbirth. A weight loss of approximately about a pound per week between 4 and 14 weeks after delivery in overweight, lactating women who were exclusively breastfeeding showed no adverse effect on the growth and development of their newborns.

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*

References

Bernard, Maria, and Peter Tuchin. “Chiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study.” Journal of chiropractic medicine vol. 15,2 (2016): 129-33. doi:10.1016/j.jcm.2016.04.003

Borggren, Cara L. “Pregnancy and chiropractic: a narrative review of the literature.” Journal of chiropractic medicine vol. 6,2 (2007): 70-4. doi:10.1016/j.jcme.2007.04.004

Weis, Carol Ann et al. “Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review.” Journal of manipulative and physiological therapeutics vol. 43,7 (2020): 714-731. doi:10.1016/j.jmpt.2020.05.005

Individuals typically don't think about their spine as they go through their everyday lives, bending, reaching, twisting, lifting, etc. However, it is through all of these movements/motions that spinal misalignments can occur causing discomfort, pain, and health problems. This happens gradually, with individuals learning how to live with the misalignment, accepting it as a normal part of life. Spinal misalignments, known as subluxations, are common but can be resolved through chiropractic treatment.

Spinal Misalignment

The spine needs to stay strong, stable, and able to support the musculoskeletal system to keep the body upright and protect the central nervous system. When the spine is properly aligned the body stays strong and mobile. When the spine is misaligned, it can cause dysfunction of the central nervous system. Chiropractic is highly effective and a non-invasive way to improve the body's health. An individual will want to know if their spine is out of alignment to know what to do and what to avoid when back pain presents. Symptoms that the spine is out of alignment includes:

Headaches, Back, and/or Joint Pain

Headaches, joint pain, and backaches can be misalignment symptoms and are the most common. Many individuals learn to live with chronic headaches and migraines but do not realize that chiropractic treatment can help to reduce, or in a case like this, can eliminate them. Back pain, especially low back pain is another symptom of misalignment. However, there can be a variety of causes, like a herniated disc, degenerative disc disease, a chiropractor will alleviate the pain without medication or surgery. A chiropractor will find the root cause and correct any misalignments.

The Heels of Shoes Wear Out Unevenly

This is a symptom that can come from cheap shoes, but often it is from a misaligned pelvis/pelvic tilt. What happens is the hips are shifted out of their proper position, which causes the feet to land on the ground unevenly.

Stiffness and/or Inability To Turn The Head or Hips

If the neck is stiff or there is difficultness, pain when turning, or you can hear the neck crack when turning, this is a sure symptom of cervical misalignment. The same is true with the hips. A subluxation can also cause muscles to tighten or damage the connective tissues, like the ligaments or tendons. Individuals can get used to feeling this way, but it can lead to losing the full range of motion along with pain, stiffness, and inability to perform certain tasks.

Joint Stiffness, Aches, and Pains

Trying to push through back stiffness, along with aches and pains is not healthy. Improper ergonomics and postures could be caused by spinal misalignment or could worsen a subluxation causing further injury. A chiropractor will:

• Educate on proper ergonomics
• Show how to improve posture
• Perform adjustments
• Recommend anti-inflammatory supplements
• Perform physical therapeutic massage to eliminate stiffness, alleviate pain, and relieve stress.

Numbness or Tingling in Hands or Feet

This is a sure symptom that of a misaligned spine. Numbness and/or tingling sensations often indicate pinched/compressed nerves. The compression or irritation can result in pain or the aforementioned sensations. A chiropractor will ease the pressure on the nerves, allowing for proper circulation, bringing back the full sensation to the affected area/s.

Body Composition

Fiber Health Benefits

Fiber health benefits include lowering the risk of developing diseases like diabetes, obesity, hypertension, and more. It is also beneficial for those who have diabetes to improve insulin sensitivity. Adding more fiber to your diet can enhance weight loss goals. Fruits and vegetables are the highest-fiber foods available.

Fiber and Gut Health

The beneficial bacteria that live in the gut thrive from fruit and vegetable fiber. Because the body does not absorb fiber, the bacteria ferment the fiber. Anti-inflammatory fatty acids are released as a by-product of this process and help to protect the health of the gut. They can also help with appetite regulation.

Fiber-Rich Fruits and Veggies

• Apples
• Bananas
• Oranges
• Strawberries
• Raspberries
• Mango
• Guava
• Dark-colored vegetables
• Potatoes

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 musculoskeletal system’s injuries or disorders. 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*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Czaprowski, Dariusz et al. “Non-structural misalignments of body posture in the sagittal plane.” Scoliosis and spinal disorders vol. 13 6. 5 Mar. 2018, doi:10.1186/s13013-018-0151-5

Formica, M et al. “ALIF in the correction of spinal sagittal misalignment. A systematic review of the literature.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 30,1 (2021): 50-62. doi:10.1007/s00586-020-06598-y

Granacher, Urs et al. “Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults.” Gerontology vol. 59,2 (2013): 105-13. doi:10.1159/000343152

The Atlas vertebra is named for the mythological figure who held the world on their back/neck. The vertebrae are located at the top of the spine, where the cranium and spine connect. More than just a foundation for support, the vertebrae could be the most important vertebrae of the body. It consists of a complex bundle of nerves, vertebral arteries, and is the point where the entire weight of the cranium makes contact.

The myth requires Atlas to be careful while holding the world carefully and confidently at all times, otherwise it will come crashing down. The key is being able to balance it perfectly. The vertebra has the same job to hold the head up properly and maintain posture. If not problems with balance and alignment will begin to develop, and affect the entire spine.

The Atlas Vertebra

Balance

The Atlas vertebrae's role in maintaining balance is based on its ability to adjust to the weight of the head. The actual vertebra is wider than the other cervical vertebrae. This creates a center of gravity that is reinforced through proper posture. It distributes the weight of the head (10-12lb) evenly to centralize the weight and is supported by the natural curvature of the spine.

If the center of gravity shifts, the Atlas vertebra will tilt in that direction as well. This creates instability in the cervical spine and can increase the amount of weight the spine is taking and trying to redistribute. This creates spinal issues and leads to everything from poor posture, overcompensation that leads to injury.

Shifting Causes

Disruption to the vertebra and its ability to balance can come from a variety of causes and can occur as a result of chronic and acute conditions. Some include:

• Auto accidents, sports, work injuries can cause cervical soft tissue damage
• Dislocation of cervical vertebrae below the Atlas results in instability
• Poor posture/s make individuals overcompensate to one side of the body straining muscles, ligaments, tendons causing pain and other issues
• Herniated, bulging, and slipped discs

Unbalanced effects

Spinal issues range from simple neck pain and soreness to full-on chronic pain. Because the Atlas can alter the balance of the entire spine, combined with cranium support, issues can be localized and referred creating further complications. 

Addressing the root problems requires a comprehensive chiropractic approach. Chiropractic will assess the position of the spine and determine the degree to which Atlas has shifted out of place. An adjustment treatment plan makes it possible to undo the widespread damage.

Body Composition

Muscle Loss

Individuals do not realize that muscle loss occurs throughout their lifetime. This is because muscles, like other tissues in the body, must go through cell turnover and protein synthesis. This means that the body is constantly breaking down protein in the muscles and rebuilding them.

Skeletal muscle can be developed with proper nutrition and includes consuming a proper amount of protein to provide the necessary amino acids and from physical activity. The reverse is also true, if an individual becomes less physically active and/or their diet no longer supports the development of increased muscle tissue, the body enters a catabolic/tissue-reducing state known as muscle atrophy.

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*

References

Woodfield, H Charles 3rd et al. “Craniocervical chiropractic procedures - a précis of upper cervical chiropractic.” The Journal of the Canadian Chiropractic Association vol. 59,2 (2015): 173-92.

Back discomfort and pain could be caused by hip issues and could be resolved with hip replacement. According to a recent study, a total hip replacement solved back pain in four out of five individuals dealing with spinal discomfort and pain. When the hip/s are stiff or cannot move normally, this places added pressure on the spine. Studies show that low back pain was resolved in 82% of individuals after a total hip replacement known as total hip arthroplasty or THA. The body is designed as a fluid chain with fluid motion connecting the neck all the way down to the toes.

When a region like the hip tightens/stiffens, it generates added stress/pressure on the other areas of the body, which in this case happens to be the lower spine. Individuals with mild arthritis of the spine are able to experience increased pain reduction than individuals with severe arthritis. An insight into the relationship between the hips and low back that can lead to accurate diagnoses and optimal treatment plans.

Hip Issues

The hip/s move with the lower back during activities like walking, sitting, bending, etc. Tight muscles, normal wear-and-tear, and osteoarthritis can reduce hip movement, forcing the lower back to make awkward and poor posture causing adjustments. Individuals usually relieve the painful position by increasing the curve of their lower back.

If an individual has severe arthritis of the hip, they put a lot of stress and pressure on the low back that often results in low back pain. Advanced hip osteoarthritis is the breakdown of joint cartilage and the most common type of arthritis. Individuals with this type experience low back pain 50% of the time, and even higher depending on the individual's condition. 80% to 90% of individuals with hip or knee arthritis, unfortunately, develop low back arthritis.

There is not yet a clear reason as to why this occurs. It is theorized that some osteoarthritis risk factors like obesity and high-impact/force activities can be modified with lifestyle adjustments. Other risk factors that include injury, trauma, age, and congenital conditions like hip dysplasia, cannot be avoided. Hip osteoarthritis isn’t the only hip issue that can also cause lower back pain. Other hip issues.

Sacroiliac joint dysfunction

The sacroiliac joint connects the sacrum to the pelvis. It is a shock absorber between the upper body, the pelvis and can stiffen with time. Sacroiliac joint pain affects around 15% to 25% of individuals with low back pain. It worsens when climbing stairs, getting up from a seated position or running. Symptoms include:

• Low back pain
• Pain in buttock/s
• Groin pain
• Stiffness
• Instability

Piriformis syndrome

About 200,000 individuals each year are affected with piriformis syndrome and is often misdiagnosed as symptoms resemble sciatica. What happens is the piriformis muscle, which connects the sacrum to the top of the femur, tightens/irritates the sciatic nerve. Symptoms are often mistaken for sciatica with pain in the buttocks, numbness, and tingling that travels down the back of the leg and into the feet.

Diagnosis

A doctor or chiropractor will use a combination of diagnostic tools. This typically includes a physical exam, X-rays with other specific tests to help identify the source of pain. What typically happens is a patient will undergo a hip and lumbar spine X-ray, but the thoracic spine, pelvis, and hip areas are missed. Getting the middle segment is critical to see how the spine and hips are working together. It is critical to understand the hip-spine connection. All spine patients should have X-rays of the hips to make sure any problems don't go undetected. The overlap of symptoms with these two areas could be overlooked.

If necessary a diagnostic injection into the hip joint can help precisely locate the pain source. This can be done at the clinic or doctor's office using ultrasound or X-ray to guide the needle. If no pain relief results from the injection, hip replacement is still not considered because the pain could be coming from the spine. A critical part of the diagnosis is not just imaging. One of the most important parts is getting a thorough history of symptoms. X-rays and MRI show what the problem could be, however, the symptoms could coming from another area.

Treatment Options

Before total hip replacement is considered there are nonsurgical approaches to be considered. All diagnoses should start with conservative treatment. Physical therapy, chiropractic, gait training, and core strengthening can optimize the spine to better manage hip issues and arthritis. Conservative therapies could also include:

• Weight loss
• Activity modification like walking instead of running
• Anti-inflammatory medication
• Cortisone injections

Total hip replacement is the last option for individuals experiencing pain, difficulty walking, and limited mobility. The procedure removes the damaged cartilage and bone from the hip joint. This includes the head of the thighbone along with the socket where it fits and replaces it with artificial parts.

Conclusion

Get a second opinion. Individuals are encouraged to educate themselves as much as possible on the condition. The hip and spine is a complex relationship. The most important information for patients is that they understand along with their doctor where the pain is coming from, the hip, spine, or both.

Reduce Plantar Fasciitis Foot Pain

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*

Self-care practice when back pain flares up is a way for individuals to give themselves self-therapy attention in the midst of crazy schedules. It’s never been more important than now to be able to take care of oneself when back or any type of pain presents. For a few minutes, daily physical and mental health activities can make a difference.

Self-care is the ability to self-manage pain and take care of our constantly changing needs daily. Regular self-care is essential to our families, and friends well being. Pain is emotionally and physically taxing on the body. It brings and encourages mental/emotional and physical balance, which helps, especially when there is a condition that causes pain.

There is a connection between self-care and chronic pain that is being studied currently. Studies are finding that individuals practicing self-care in addition to regular medical care have significant reductions in pain and reduction in disability. So, alleviate back pain with a few self-care tips.

Hot Bath

Hydrotherapy better known as a hot bath can provide pain relief. Adding Epsom salt for these baths contains magnesium which can help relax muscles and the body.

Self-Massage

Self-massage is a great way to care for oneself. Applying gentle pressure to painful spots or use massage devices like foam rollers and tennis balls to massage the pain away.

Music Therapy

Music can be an effective way to ease back pain. Research has shown that music can be a complementary treatment when addressing chronic pain. It helps especially when an individual is experiencing back pain along with a low/negative mood.

More Sleep

Poor sleep has been proven to increased back pain. Getting the proper amount of sleep is essential in addressing pain. Healthy sleep hygiene and bedtime routines will significantly help with the body’s recovery, healing, and general health.

Yoga

Yoga stretching is highly effective in relieving and avoiding/preventing back pain completely. Poses like the cat, cow, triangle, and child’s pose will generate relief along with improving balance.

Healthy Diet

Diet and lifestyle changes have been proven to reduce inflammation, which can cause chronic pain. Go with whole foods that are minimally processed. This will help reduce inflammation. Healthy weight along with healthy body mass keeps the spine healthy and free of the added stress from the weight. Therefore a sensible diet is the single most important factor in weight loss.

Connection

Isolation can exacerbate pain. Loneliness can be a significant risk factor in the development of pain, and with time, depression, and fatigue. Simply reaching out and connecting with loved ones, friends, co-workers, etc, could help in soothing the pain away.

Mindfulness

Mind-body therapy as a method to treat pain has been proven in various studies. Individuals taking part have reported significantly lower pain than those who only received traditional medical care. What happens is you are training your mind senses to be present and focused on what you are doing, the surroundings, etc, and not focusing, and getting lost in the pain. However, sitting down and meditating is not for everybody.

Drink the Proper Amount of Water

Hypohydration, which is not enough water can increase pain. Therefore, drink up.

Stretching

Stretching will definitely decrease pain and allow for practicing mindfulness. It doesn't matter when the stretching happens so long as, the individual sticks with it and continues development to further their ability and flexibility. Core abdominal exercises are very helpful for back pain and strengthening.

Go Outside

Many of us know that getting out in nature feels good mentally and physically, and it can actually relieve pain, too. Nature therapy or ecotherapy has shown to improve the psychological and physiological symptoms associated with chronic pain. Connecting to nature can have tremendous benefits for optimal health.

Heat Therapy

Heat, whether from a topical agent or heating pad can soothe the mind and spine. Check with a doctor before trying any type of heat treatment.

Frequent Breaks

Taking breaks is essential for the mind in keeping stress levels balanced. This can lessen back pain. Just a few minutes to stop whatever and take a few minutes for yourself and your health. Taking proper physical and mental rests throughout the day to stretch out, move around, and do something else. This will help keep things open and fresh, as opposed to going through the same thing over and over with less than optimal results. The mind needs to reflect.

Go Easy

Go easy on yourself, this is probably the most important form of self-care. If the pain is too intense, do not force yourself to work through it. Use the various techniques mentioned and go slowly, with the fundamentals of combating pain and chronic pain. Slow down whenever you feel the need.

 Lower Back Pain Chiropractic Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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. The provider(s) Licensed in Texas& New Mexico*

Staying at home means it can be tough to see a doctor, chiropractor, spine specialist, or neurosurgeon to handle back pain, especially when it tends to flare up at the most inconvenient times. There are still options, here’s what to do. What options are available when you want to see a doctor about back pain, but getting to the clinic can be a challenge.

Fortunately, there are a variety of tools to handle back pain that can provide some relief.

• Ice is a great place to start to relieve pain.
• Hot/Warm baths combined with Epsom salt
• Microwavable hot packs can help
• Over-the-counter pain medications like Motrin are one of the best medicines for non-traumatic back pain inflammation.

Heat Packs/Heat Therapy

Heat therapy promotes vasodilation and draws nutrient-rich blood into the targeted tissues. Increased blood flow delivers oxygen and nutrients and cell waste is removed. The warmth decreases muscle spasms, relaxes tense muscles, relieves pain, and increases range of motion.

Superficial heat is available in different forms, which include:

• Hot and moist compresses
• Dry or moist heating pads
• Hydrotherapy
• Commercial chemical/gel packs

Remember heat packs in any form should be wrapped in a towel to prevent burns, as a punctured heat pack should be discarded, as the chemical agent/gel can burn skin.

Cold Packs/Cold Therapy 

Cold therapy produces vasoconstriction. This slows blood circulation, which reduces inflammation, muscle spasms, and pain. Superficial cold is also available in different forms, which include:

• Commercial cold packs
• Ice cubes
• Iced towels/compresses
• Hydrotherapy.

The application of cold therapy is usually less than 15 minutes, as the effects of cold are known to last longer than heat. Cold packs or ice should never be applied directly to the skin.

A towel, should be placed between the cold object and the skin surface to prevent any skin and nerve damage. A punctured cold pack should be discarded, as the chemical agent/gel will also burn the skin.

Telemedicine

It might be hard to believe that a virtual video visit can work to handle back pain. On a video call, a chiropractor is unable to physically palpate the sore areas and measure the range of motion and strength. However, this should not discourage you from scheduling a virtual appointment.

Telemedicine, without a physical examination, can be highly beneficial. A chiropractor can start the process of ordering tests, like MRI, X-ray, etc. Even if the pain is tolerable, meaning the kind that doesn’t need medicine or imaging tests, this should not be an excuse to skip an orthopedic visit.

With telemedicine, a chiropractor can still give advice, show back stretches, exercises, order back pain supplements, and talk about the risks and benefits of treatments available to try on your own.

Physical Therapy

With chronic low back pain, chances are your chiropractor suggested physical therapy or PT. Now is the time to bring back those PT exercises, especially with a back-pain flare-up.

Low-back pain or any back pain for that matter with no neurological issues, could mean that a stretching and exercise program is all that is needed. Find out if your chiropractor or a physical therapist offers other options:

• Patient portal communication or e-visits.
• Uploads of illustrated handouts describing how to do various stretches and exercises.
• Remote evaluation. The individual submits pictures or a video of their movements for personalized feedback, which the chiropractor or physical therapist evaluates and provides.

Get Active

Evidence shows that being active is better than resting. Moving increases the blood flow to the muscles, which helps with muscle spasms, trigger points, tense muscles/ligaments, and other issues.

Pilates

Pilates focuses on controlled movement, breathing, and stretching. A review found Pilates can be a highly effective and beneficial approach to handle back pain and related discomfort. Check out beginner Pilates videos. Be sure to avoid any move/s that cause pain, worsens the existing pain, or generate new pain.

Yoga

A review found that yoga can help improve mobility and decrease pain. If this is a new practice, start with gentle yoga or restorative yoga.

Walking

Going for a walk is easy, accessible, and is beneficial for the spine. Walking can be as effective as non-drug interventions in decreasing pain and discomfort in chronic low-back pain. Simple movements along with rollers and massagers can handle back pain as well. These include:

• Self-massage with a tennis ball
• Foam rolling
• Hand-held massager
• Stretching
• McKenzie Method, comprised of gentle stretching exercises

These strategies and approaches can become the methods and techniques for the relief of existing back-pain in the absence of a doctor, chiropractor, or physical therapist.

Chiropractors & Sciatica

The way a person walks is known as gait. A problem with gait can indicate pain in a patient as well as serious conditions like diabetes and arthritis. An individual's gait can be very telling revealing problems in the:

• Feet
• Ankles
• Knees
• Hips
• Spine

It is a diagnostic tool for a variety of conditions, injuries, and syndromes including autism. When it comes to chiropractic, an individual's gait can offer important information regarding the root of the complaints, allowing for a more well-rounded, whole-body approach. If you think that the way you walk or moves does not matter, think again, as it could save you from developing back problems in the long run.

Gait Analysis

Gait analysis consists of a set of tests designed to provide a comprehensive evaluation of an individual's gait. It is a study of human movement/motion that involves observing the individual and using specialized instruments that measure body movements, muscle activity, and body mechanics.

It is an assessment tool to provide insight into creating a treatment plan for people who have conditions or injuries that affect their ability to walk. It is utilized in sports biomechanics to help athletes gain optimal movement and for identifying problems with movement or posture, especially those with injuries. During the analysis, the individual may be asked to walk in a certain pattern or on a treadmill, that is usually connected to a computer, while the chiropractor/therapist looks at them from different angles.

Cameras are placed at different points to capture various views/perspectives including the front, back, and sides. The individual might have markers placed at certain points on the body like the knee, ankle, pelvis, etc. As the person moves, the computer captures data of the movement with a three-dimensional calculation of each marker. It generates a model to assess the movement of the skeletal structure, resulting in a detailed analysis of each joint’s movement.

Factors that Affect Gait

There are factors that affect an individual's gait and that information is necessary for the analysis to be accurate. Age, gender, height, and weight of the individual is vital because men and women move differently and as individual age their body structure changes. Excess weight or physique can affect an individual's posture and gait.

Shoes or not wearing shoes will also affect gait, as the terrain individuals walk on, and articles they carry, like a purse or backpack, changes how we walk. Other factors include:

• Body proportion
• State of mind
• Emotions
• Stress level
• Personality type
• Pathological factors such as
• Neurological diseases
• Psychiatric disorders
• Trauma
• Musculoskeletal issues

This is also measured and factored into the analysis data that includes the patients:

• Length of stride
• Cadence
• Hip angle
• Foot angle
• Step length
• Walking
• Motion speed

Advantages of a Gait Analysis

Getting a gait analysis can be very helpful because it can provide invaluable insight into how your body is aligned and how it moves. It is a great diagnostic tool for identifying health issues related to the gait, spine, and feet and can also help provide early detection of health issues before the onset of symptoms.

If your chiropractor recommends you get a gait analysis it could be they suspect that something is going on, or it could mean they want a more thorough examination to provide optimal care. If you have any concerns talk with your chiropractor and ask them any questions that you have prior to the analysis, as stress and anxiety can put tension on the muscles and body, thus affecting the results.

Reduce Excessive Foot Pronation and Posture with Custom Foot Orthotics

Back soreness, pain, and discomfort can make walking even moving a challenge, but through assistive devices, you can keep moving. If a spinal condition affects your ability to walk or if you have recently undergone surgery, a cane or walker can help maintain your independence.

Canes and walkers are designed in a simple fashion, but come with amazing benefits: They improve:

• Balance
• Prevent falls
• Takes stress/pressure off the spine

There are all kinds and styles of assistive walking devices. Here are a few tips to help you select the best cane or walker.

Which To Get Cane or Walker

There are options when it comes to choosing but with so many options knowing which is the best for your condition can be challenging.

Talk with your health provider, which could be a primary physician, nurse, chiropractor, physical therapist, or other health care professionals familiar with your medical history and discuss which device would suit your condition and lifestyle the best.

Canes and walkers each have their pros and cons depending on the condition/s. Some considerations to think about when choosing between a cane and a walker:

• What is the purpose of the device?

Canes are ideal for problems that occur on one side of the body like sciatica, which often affects one leg, and walkers are ideal for pain that occurs on both sides like weakness in both of the legs.

• Which should I get to support my weight?

Canes can support up to 25 percent of your weight, and walkers can support up to 50 percent.

• What is the amount of stability you need in the device?

Walkers have the most stability, but there are four-point canes that can also support proper balance and spine safety.

• What amount of flexibility do you need in the device?

If you want perhaps the flexibility to go up and downstairs a cane may be a better choice, as walkers should not be used on stairs.  

Considerations and Questions

Once you’ve decided on what type, then it's time to decide which type to buy and make sure it is the correct model and style for you. A health care provider can help you find the right model that suits your needs, fits correctly and will educate and show you how to properly use it. Considerations to think about when buying a cane or walker. 

Canes

Canes fall into three categories:

1. Standard: The simplest type of cane and comes with a comfortable T-shaped handle. This helps with balance, but these aren't able to bear as much weight.
2. The Offset: A cane that can support more weight than a standard model comes with a flat grip for those with a weak grip and an upper shaft that can bend outward.
3. Multi-legged: Multiple-legged canes offer maximum stability, perfect for preventing slips, and falls. The only issue could be is that because of the multiple legs means it can be a little awkward at first. But once you get the hang of it

Questions for a Cane

What grip should I go with?

There’s no right or wrong grip. This all comes down to you and what feels the most comfortable as you move around. But, larger grips work better for those with joint problems, and the foam grip style or a type of memory foam that shapes to your hand seems to be the current trend.

What if the grip I chose is not the correct one?

If numbness, tingling, or pain begins to present in your hand/s when using the device or after, consult your doctor, chiropractor or physical therapist.

Where are Canes available?

Canes can be purchased at medical supply stores and pharmacies. But they can also be purchased online, which is extremely helpful if the model you want is not available at the store.

Where to learn how to properly use the cane?

Talk to your chiropractor, physical therapist or doctor who can give you tips and guidelines on how to use the device. They will also help make sure that the cane fits correctly.

Working with a health care professional to achieve the right fit can be highly beneficial. If the grip does not feel right, it's not comfortable, or if it's too long/short, the cane ends up doing more harm than good. A therapist/chiropractor will make sure everything is right.

Walkers

Walkers fall into three models:

1. Standard: These walkers have four legs with rubber ends and provide quality support and stability. But, because there are no wheels it needs to be picked up to move around.
2. Front-wheel walker: This type has two wheels in the front and two solid legs in the rear. This type does not need to be picked up and requires less effort.
3. Four-wheeled walkers: These move the easiest, but they can be difficult to get used to placing all your weight because of the easy rolling. Although they do have breaks and wheel adjustments to control the wheel speed, it can take some getting used to and training. Some models come with a seat.

Questions for a Walker

What grip should I go with?

Walker grips are usually made of hard plastic, non-slip rubber, or flexible memory foam. Again it’s all up to you to decide which is the most comfortable.

Preparing the home for a walker

Walkers can get snagged on rugs or bump into the furniture so it’s a good idea to set up your home and move the furniture/objects to help accommodate your movement.

Where can I purchase a walker?

Walkers are available at medical supply stores and pharmacies. They can also be purchased online.

How can I learn how to properly use my walker?

Using a walker can be a little uncomfortable at first. Movements that were easy, like sitting to standing might need to take some time to get the feel of it. But with time and practice, it will become second nature. Talk to your doctor or chiropractor/physical therapist about the right way to use your walker. They can help you develop a strategy and technique to improve mobility.

Spine Pain Won't Slow You Down

Mobility assistive devices, like canes, and walkers can help you move around after an accident, spine surgery, or a chronic spine condition and allow you to maintain your freedom.

Our uplifting southwest community surrounded by its infinite beauty is a fantastic place to live and enjoy our families; it is, therefore, our mission to help each of our patients to live, to love, to matter and to thrive pain-free in this beautiful special place.

El Paso, TX Chiropractic Treatment for Shoulder Pain

NCBI Resources

As you move into your senior years, you may expect some discomfort and loss of mobility. Aging is hard on the body. But it is important to understand that there are things you can do to feel better. Regular exercise, a healthy diet, and chiropractic care can all make your senior years active and thriving.

Sacroiliac joint dysfunction is known to cause low back pain, but diagnosing can be hard for some doctors. Especially those that do not have a great deal of experience in sacroiliac joint pain.

However, chiropractors specialize in this area as the SI joint is an important part of the musculoskeletal system.

SI joint dysfunction and pain can involve one or both joints.

Other terms associated with SI joint dysfunction are sacroiliitis or degenerative sacroiliitis.

Low back pain may be SI joint-related, so how to start the conversation with your doctor?

Things to Remember Before Appointment

Diagnosing sacroiliac joint-related pain begins before your first appointment with a doctor or chiropractor.

Three things to do before your appointment can help make the visit highly productive.

I. Know your medical history

• If you have an existing spinal condition, it can definitely affect SI joint dysfunction
• Any recent trauma, like an auto accident or fall?
• Pregnant?

Think about these before, because they can help a doctor identify links or cause of Sacroiliac joint dysfunction.

II. Know the symptoms

Make it a point to know the symptoms so you can explain them in full detail.

• Dull pain
• Achy
• Stiff

If you need to, write them down. 

Common symptoms:

• Low back pain

Pain that travels through:

• Hips
• Buttocks
• Thighs
• Groin
• Pain when pressing on the Sacroiliac joints 
• Stiffness or electrical burning sensations in the pelvis

Know when the symptoms get worse and when they go away. For example:

The pain usually increases when:

• Standing
• Walking for extended periods
• Climbing stairs
• Getting/rising up from a seated position

And the pain usually goes away when lying down.

III. Write down questions for your doctor.

Think about what you want your doctor to understand and the pain you are going through.

Write down questions and take them with you.

This questions could be like:

1. Is this pain caused by a sacroiliac joint problem?
2. Why rule out sacroiliac joint dysfunction?
3. How long does it take for the treatment/s to take effect?   
4. Is the treatment plan for long sustained relief or short-term relief?

The Appointment

Ask your doctor to examine you for sacroiliac joint dysfunction.

Low back pain research shows the sacroiliac joint, is a definite cause of low back pain.

This problem affects  30-34% of patients with low back pain.

A doctor can diagnose sacroiliac joint dysfunction based on medical history and a physical exam.

The physical exam, which can include performing specific maneuvers/movements to re-create the pain in a controlled manner, to help confirm a diagnosis.

Physical tests can initiate sacroiliac joint pain and help diagnose low back pain that is being caused by sacroiliac joint dysfunction.

• Distraction
• Thigh Thrust
• F.A.B.E.R - Flexion Abduction External Rotation
• Compression
• Gaenslen's maneuver
• Fortin finger test, which means pressing down near the sacroiliac joints

If three out of five tests produce pain, then more than likely you have sacroiliac joint dysfunction.

Dialogue with your doctor/chiropractor

It’s normal to feel overwhelmed during a doctor's visit, especially if you have a condition that is hard-to-diagnose.

Talk with your doctor, their voice should not be the only one heard, this is your body and your health that's at stake.

Your information is essential to help with an accurate diagnosis.

If your doctor doesn't feel comfortable or feels they don't have enough experience in diagnosing sacroiliac joint pain, then ask for a referral to a spine specialist/chiropractor that is comfortable and does have the experience in diagnosing sacroiliac joint pain.

There are a number of treatments for sacroiliac joint dysfunction, including pain medication, epidural steroid injection, and surgery. However, chiropractic care is non-invasive and does not have the unpleasant, sometimes harmful side effects of pain meds. It is safe and effective and treats the entire body instead of just the part that hurts.

Low Back Pain Chiropractic Care | El Paso, TX.

David Garcia developed low back pain which gradually affected his quality of life. As his painful symptoms worsened, David Garcia was unable to walk and his low back pain became unbearable. He first visited Dr. Alex Jimenez, a chiropractor in El Paso, TX, after a recommendation from his sister. Dr. Jimenez was able to provide David Garcia with the help he deserved for his low back pain, restoring his quality of life. David Garcia describes the wonderful service Dr. Alex Jimenez and his staff have given him to offer him relief from his painful symptoms and he highly recommends chiropractic care as the non-surgical choice for low back pain, among other health issues.

Sciatica is a combination of electrical surges that run down the back, into the legs, and into the feet.  Accompanied with this is back pain, limited movement, inability to stand or sit normally, and walk or sleep properly.

Here are two people that went through this and describe their inability to engage in everyday activities.

• Ms. Torres discusses how her back pain started during pregnancy.
• Mr. Espinoza discusses how his back pain started with his job as a truck driver.

Dr. Alex Jimenez treated these individuals, that would like to share their experience and would like to recommend Dr. Jimenez and his team as the official sciatica relief chiropractor of El Paso, Texas.

El Paso Chiropractic Clinic

Our services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Treatment, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries. 

As El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

We want you to live a life filled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.

Only the best for you…

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David Garcia developed low back pain which gradually affected his quality of life. As his painful symptoms worsened, David Garcia was unable to walk and his low back pain became unbearable. He first visited Dr. Alex Jimenez, chiropractor in El Paso, TX, after a recommendation from his sister. Dr. Jimenez was able to provide David Garcia with the help he deserved for his low back pain, restoring his quality of life. David Garcia describes the wonderful service Dr. Alex Jimenez and his staff have given him to offer him relief from his painful symptoms and he highly recommends chiropractic care as the non-surgical choice for low back pain, among other health issues.

Non-Surgical Care 

We are blessed to present to you El Paso’s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Treatment, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

We want you to live a life filled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.

I assure you, I will only accept the best for you…

If you have enjoyed this video and we have helped you in any way, please feel free to subscribe and recommend us.

Recommend: Dr. Alex Jimenez – Chiropractor

Health Grades: http://www.healthgrades.com/review/3SDJ4

Facebook Clinical Page: https://www.facebook.com/dralexjimene...

Facebook Sports Page: https://www.facebook.com/pushasrx/

Facebook Injuries Page: https://www.facebook.com/elpasochirop...

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Information: Dr. Alex Jimenez – Chiropractor

Clinical Site: https://www.dralexjimenez.com

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