Spine Health & Spinal Hygiene

Healthy sleep is vital for having enough energy, thinking clearly, and managing everyday stresses confidently. Chronic unhealthy sleep patterns and/or insomnia can lead to and contribute to various health issues. This includes daytime fatigue, irritability, difficulty concentrating, delayed reaction time, constantly getting sick, and memory problems. Sleeping health problems can get worse with every night of poor rest. Injury Medical Chiropractic and Functional Medicine Clinic provide treatment, training, and tools to realign and relax the body and restore healthy sleep.

Sleeping Health Problems

Lack of sleep disrupts and slows down nerve impulses and transmissions throughout the body. This can lead to health problems that can include:

• Excessive fatigue
• Brain fog
• Slow responses
• Physical performance problems
• Inability to remember
• Low sex drive
• Chronic illness
• Over time the risk of developing a serious medical condition increases and can include:
• Anxiety
• Depression
• High blood pressure
• Diabetes
• Weakened immune system
• Stroke
• Heart attack
• Seizures

Staying On

There is some research that insomnia is associated with hyperarousal or the state of staying on. It often starts with a stressful event that sets off the body's systems, causing the inability to relax completely. Body discomfort and pain symptoms can also present when the mind and body can't relax. The entire body can tighten/stiffen, causing aches, soreness, and pain. Continuation of sleeping health problems of the cycle leads to more stress.

Healthy Sleep Benefits

Adults need seven to nine hours of sleep every night to operate optimally. The benefits of healthy sleep include:

• Healthy immune system function.
• Thorough tissue and muscle repair.
• Remembering and recalling things comes easier.
• Improved insulin regulation, helping to manage food cravings and weight.
• Enhanced regulation of cortisol.
• Improved mood and outlook.

Chiropractic Treatment

Chiropractic care, massage, and decompression therapy can help break the cycle. Breaking the process is necessary to help the body recover and rehabilitate properly. Treatment retrains the body to relax; stretching and pulling the muscles increases blood circulation, as well as advanced and improved brain signals telling the body to relax. A chiropractor will evaluate the individuals sleeping patterns and recommend various solutions. The benefits for individuals with sleep issues include:

• Alleviates muscle tension.
• Stimulates nerve circulation and blood flow.
• Relaxes the whole body.
• Enhances central nervous system function.
• Relieves pain and discomfort.
• A chiropractor will also provide the following:
• Sleeping position recommendations.
• Postural stretches and exercises.
• Recommendations on supportive mattresses.
• Ergonomics for work, home, and bed.

Chiropractic's Evolution

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Hale, Deborah, and Katherine Marshall. “Sleep and Sleep Hygiene.” Home healthcare now vol. 37,4 (2019): 227. doi:10.1097/NHH.0000000000000803

Liu, Amy. “Sleep Training.” Pediatric annals vol. 49,3 (2020): e101-e105. doi:10.3928/19382359-20200218-01

What Are Sleep Deprivation and Deficiency?https://www.nhlbi.nih.gov/health/sleepdeprivation#:~:text=Sleep%20deficiency%20is%20linked%20to,adults%2C%20teens%2C%20and%20children.

What Makes You Sleep? https://www.nhlbi.nih.gov/health/sleep-deprivation/body-clock

How Sleep Affects Your Health https://www.nhlbi.nih.gov/health/sleep-deprivation/health-effects

Riemann, Dieter. “Sleep hygiene, insomnia, and mental health.” Journal of sleep research vol. 27,1 (2018): 3. doi:10.1111/jsr.12661

Taking it slow after spinal surgery is recommended to optimize a full recovery. What usually happens is that an individual starts feeling normal/better, so they begin to engage in a few daily activities. Then pain presents, letting the individual know that they have done too much too soon. The pain does not necessarily signal re-injuring the area, but recovery should be treated seriously. More than 50% of patients have successful spine surgery, but repeat surgeries do not tend to be quite as effective. Doing too much too early during recovery can result in severe re-injury or creating new injuries. So when can an individual get back to everyday life? 

Surgery Recovery

Recovery after back surgery is different for everyone. Low back lumbar fusion surgeries usually require more recovery time than lumbar non-fusion surgeries, like:

• Laminectomy - when the lamina portion of a vertebra is removed.
• Microdiscectomy - the removal of abnormal disc material
• Cervical spine surgeries.

Individuals who have undergone a procedure where two or more vertebrae have been surgically fused should expect a longer recovery. A typical timeline for lumbar fusion usually involves around three months. What happens is individuals want to get up and move, doing household activities almost immediately because they feel so good, but this is because of the pain medications. Strong pain medication use ends by four to six weeks. It is not until after 12 weeks or three months with post-operative chiropractic rehabilitation and physical therapy that individuals are encouraged to engage in specific physical activities that will optimize the healing process.

Taking It Slow With Certain Activities

Specific activities should not be engaged in after lumbar fusion surgery, as it requires a higher level of caution during recovery.

No Bending, Lifting, and Twisting

Bending, lifting, and twisting all require the direct use of the back muscles. Performing these movements can cause serious damage and hinder proper healing. Therefore it is recommended not to bend, lift, or twist for six weeks.

No Taking Baths or Swimming

Taking showers can be done right away with protective plastic or a sponge bath for a few days after surgery, but it is advised not to take baths or go swimming for three weeks.

No Cardiovascular Exercise

While the back may be feeling better after the spine surgery, cardiovascular exercise is not recommended for at least six to 12 weeks as it is too strenuous on the back. Light walking is fine, but the doctor and a chiropractor and physical therapist will develop a controlled, progressive exercise program for the individual. The program usually starts between 6 weeks and three months after surgery. This can include working out on an elliptical machine, a stationary bike, or easy treadmill walking.

Listening to The Body

The doctor will be clear about what can and can't be done immediately following back surgery. Therefore it is crucial to follow the instructions to avoid any complications and listen to the body. Don't push through activity or try taking on too much. Give the body and spine time to heal, taking it slow. There is time to get back to normal activities, but if re-injury or new injuries occur, rehabilitation/recovery could become the regular activity.

Body Composition

Malnutrition

Malnutrition is defined as deficiencies, excesses, or imbalances in an individual's energy intake and/or nutrients. Protein-energy deficiency is one of the most common forms of malnutrition, and this health condition has an immediate and negative impact on body composition. The deficit wreaks havoc on skeletal muscle mass as the body progressively goes into starvation mode, breaking down the protein stored in the muscle for fuel.

Micronutrient deficiency is a lack of minerals and vitamins that support vital bodily processes like cell regeneration, immune system health, and eyesight. Common examples include iron or calcium deficiencies. Micronutrient deficiency has the most significant impact on normal physiological functions, processes and can happen in conjunction with a lack of protein-energy. This is because most micronutrients are obtained from food. Nutritional deficiencies of specific micronutrients can affect processes like building and repairing muscle; protein deficiency has a more pronounced effect on body composition because lowered protein intake can lead to muscle mass loss. Malnutrition and nutritional deficiencies in adults include:

• Not enough energy to get through the day.
• Unintended weight loss.
• Physical function, including handgrip strength and physical performance, diminishes.
• Serious medical conditions can result from fluid accumulation like edema.

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

Daniell, James R, and Orso L Osti. “Failed Back Surgery Syndrome: A Review Article.” Asian spine journal vol. 12,2 (2018): 372-379. doi:10.4184/asj.2018.12.2.372

We've all seen the commercials, web ads, emails, etc about the best pillow around. Getting a good night's sleep can be a struggle these days and any type of physical aid is welcome, specifically a pillow. This is especially true of people with chronic, acute cervical neck/back and neuropathic pain. 

Stores carry various lines of pillows that all claim to be the best pillow for neck pain.

With all the different designs out there, choosing the right pillow for your way of sleeping can be a challenge. Dr. Jimenez takes a look at finding the right pillow that will help you sleep, stay asleep and wake up refreshed and with no neck/back pain.

Cervical Support

A pillow supports the:

• Neck
• Back

Throughout the sleep cycle, and therefore has a big responsibility. This guide will help you find the right one to meet your sleep needs.

Sleeping position and the pillow can play a major role in comfort or pain.

Example - Stomach sleepers usually have the most neck pain. This is because the neck is turned to the side and the spine is arched.

For relief, try sleeping either on your back or on the side. This along with a pillow that supports the neck and the natural curve of the spine.

Tips for Buying The Right One

These guidelines apply to anyone looking for a pillow that can support the spine. It should:

1. Keeps your spine naturally aligned meaning the head should rest directly over your shoulders and should not be propped up or pushed back too much
2. Can be adjusted for maximum support
3. Supports your head
4. Eliminates pressure on the cervical spine
5. Increases sleep duration
6. Hypoallergenic for those with allergies

Pillows come in all types and sizes, but don’t get it based on how it's going to look on your bed. Take into account your body size and match that to the size of the pillow. 

Picking Based On Your Sleep Position

Picking the right one for you and understanding how you sleep is important, as your sleep position can lead the way.

Stomach sleepers

Thin pillows are the way to go and sometimes not using a pillow at all could be beneficial.

Sleeping on your stomach puts more pressure on the lower back than any other sleeping position. Consider sleeping on your side/back or only sleep on your stomach for short periods then once comfortable switch to the side/back position.

Back sleepers

Thin pillows are also the way to go, but this pillow should have some lift at the bottom to help support your neck.

Memory foam is an option for back sleepers because it adjusts to your head and neck shape.

Side sleepers

A firm pillow specifically one with a gusset or a piece of material that adds strength and thickness is more structured and can keep your spine aligned.

Specialty 

With severe spine pain or if pregnant, standard pillows do not work. There are specialty pillows that can provide comfort and pain relief.

Chiropractic 

Known also as a cervical pillow, these can help if you have chronic neck or back pain that’s not allowing sleep. These are molded to your neck and keep your spine aligned during sleep, and come in a variety of styles and materials. A chiropractor can help you choose the right type and instruct you on how to use it correctly.

Pregnancy 

These also come in different types but the aim is to provide support to your growing abdomen. Pregnancy pillows also come with extra body pillows designed to fit under the abdomen and between the knees supporting the entire body.

When To Replace Your Pillow

• It is recommended that individuals should replace every 18 months to 2 years depending on how aggressively you sleep.
• Using a pillow beyond its lifespan means there is no longer support for your spine which can exacerbate and create new injuries.
• How to tell when a pillow is done its duty, fold it in half. If the pillow stays and does not return to the original position is a good indicator that it’s time for a new pillow.

El Paso, TX Chiropractic Care Neck Pain Treatment

Sleep allows your body to heal and the spine to rejuvenate. It helps you handle stress better and manage pain more effectively. It is an essential part of good health so making sure that you get good quality sleep should be a priority – and it is possible.

Herniated disc injuries and the time it takes to heal depend on the injury's cause, the severity, and where it occurred along the spine. Symptoms can last a few days to months. Chiropractic treatment, massage therapy, and decompression realign the spine and return the disc to its correct position. Still, the herniated disc signs it is returning to normal can take time as the rest of the spine and body adjust to the realignment.

Herniated Disc Signs It Is Returning To Normal

Most cases take a few weeks with healing time depending on health conditions, physical activity level, and age. However, in severe cases, a herniated disc can take up to several months to fully heal, but discomfort symptoms usually resolve sooner.

Expectations From a Healing Disc

• Resting the spine and taking it easy after the injury is recommended.
• Too much rest is not recommended as it can cause muscle stiffness.
• While the herniated disc is healing, a primary doctor may prescribe anti-inflammatories or muscle relaxants to help ease discomfort.
• A chiropractor and/or physical therapist can teach exercises and stretches to relieve pressure on nerves, loosen tight muscles, and improve circulation.

Signs The Herniated Disc Is Healing

• Most herniated discs cause significant pain in the back and neck from the nervous system, causing some of the muscles of the low back or neck to spasm to protect the area from further damage.
• Usually, the muscle spasms relax within the first days of the injury.
• After spinal decompression, neurological symptoms like the sharp, shooting pain down a nerve in the arm or leg are the first symptoms to go away.
• Then muscle weakness along the path of the nerve goes away.
• Numbness in the extremities can linger around longer.

Length of Time

• The wear and tear of adult spinal discs, combined with unhealthy posture habits, job occupation, previous injuries, etc., decrease blood circulation.
• This is why it can take some time to heal completely, as the entire blood supply needs to reset to optimal circulation.
• Nerve compression causing aches and pain sensations down the nerves can also take time.

Regular Activity

Returning to regular activities depends on the individual's case and condition. It is essential not to overdo things that can cause excessive loading of the spine before the disc has fully healed, which increases the risk of re-herniation and other injuries.

• Inactivity can slow the healing process and cause inflammation.
• Patients are encouraged to return to activities that generate gentle motion to stimulate the stabilizing muscles to function properly and increase blood circulation to the injured area.
• Individuals are recommended to:
• Learn posture improvement when walking, sitting, standing, and sleeping.
• Adjust sleep patterns.
• Incorporate anti-inflammatory nutrition during the healing process.
• Engage in light, gentle exercises.
• Keep the body hydrated.
• Avoid alcohol during the healing process.
• This provides a mechanical and biological environment that eventually becomes a personalized exercise physical therapy program.

DOC Spinal Decompression

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 your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Díez Ulloa, Máximo Alberto. "Role of Microangiogenensis in Disc Herniation Healing." Journal of investigative surgery: the official journal of the Academy of Surgical Research vol. 34,6 (2021): 685. doi:10.1080/08941939.2019.1682725

Factors that influence recovery: Mayo Clinic. February 8, 2022. "Herniated disk." https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095

Factors that influence recovery: NHS. March 22, 2021. "Slipped Disc." https://www.nhs.uk/conditions/slipped-disc/

How to speed up healing time: American Academy of Orthopaedic Surgeons. January 2022. "Herniated Disk in the Lower Back" https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/

Keramat, Keramat Ullah, and Aisling Gaughran. "Safe physiotherapy interventions in large cervical disc herniations." BMJ case reports vol. 2012 bcr2012006864. 18 Aug. 2012, doi:10.1136/bcr-2012-006864

Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487

Swartz, Karin R, and Gregory R Trost. "Recurrent lumbar disc herniation." Neurosurgical focus vol. 15,3 E10. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.10

Anterior cervical discectomy and fusion (ACDF) is a procedure that treats chronic neck conditions and is the most common spinal surgery performed in the U.S. 30 percent of Americans a year experience neck pain, chronic neck pain and radiculopathy or pain that spreads out and radiates to other parts of the body, in this case down the arms.

It’s a procedure that can work wonders, but as many as two-thirds of patients continue to manage neck pain and dysfunction after ACDF. One of the best ways of managing neck pain and dysfunction is to exercise. Research shows that a prescribed exercise program right after surgery can help lessen the pain and create less dependence on medications. A 2020 study published in SPINE suggests that patients that began therapeutic exercises right away had better results than individuals that started an exercise program after the six-week checkup/examination.

What Anterior Cervical Discectomy Fusion Treats

The procedure is performed on individuals with degenerative disc disease or a bulging or herniated disc. These conditions can cause the spinal disc to place pressure on the spinal cord and nerve roots that branch out, creating:

• Numbness
• Tingling
• Pain
• Weakness in one or both arms

Most individuals that are recommended to undergo the surgery experience symptoms that don’t respond to non-surgical therapies or medication/s. A significant symptom is hand/arm weakness and arm pain that’s worse than the neck pain.

ACDF Surgery

The ACDF procedure is broken into two parts: a discectomy and a fusion. Anterior means in front and in this case it's the front of the neck that the surgeon accesses the damaged discs. In a discectomy, the surgeon removes a portion/s or all of an intervertebral disc/s to release the pressure on the nerves. The fusion part fuses the two vertebrae together. This eliminates the painful movements. A bone graft is inserted between the vertebrae at the spot where the disc was removed. The bone graft serves as a structural scaffold that the body uses to build new tissue and cause the vertebrae to grow together.

The graft can come from three sources:

• Your own bone called an autograft, this is usually a piece of bone from the pelvis just above where the front jean pocket would be.
• Bone donation called an allograft that comes from a cadaver from a bone donor bank.
• Substitute material/s like man-made plastic, ceramic, or bioresorbable compounds.

Home Exercise Program

There are those that are of the opinion to hold off on physical therapy or exercise until about six weeks post-ACDF when recovery is established. However, the study suggests it is more effective to begin a home exercise program (HEP) as soon as possible. At this time telemedicine is the replacement for in-person physical therapy sessions but works just as well. The study examined 28 individuals' outcomes over 12-months post-operation.

The participants were divided into two groups:  Standard care and Early HEP. Both groups went through the standard postoperative care, along with medication, a cervical collar or neck brace, and restrictions of certain activities. The standard care group received physical therapy referral six weeks after surgery while the early HEP group was given a home exercise program to perform during the postoperative six-weeks.

This included walking and sleeping instructions and a range of motion/strengthening exercises. A cognitive-behavioral strategy was also given to help relax. The participants would phone-conference with a physical therapist on a weekly basis. Exercises increased in difficulty every two weeks, based on the therapists' judgment. When compared to the standard care group, the early HEP group reported a reduction in short-term neck pain and were less likely to be using pain meds/opioids twelve months after their surgery.

Recovery Tips

Recovery time after ACDF surgery typically lasts about four to six weeks. If the bone graft was from the pelvis, there could be pain, soreness, and stiffness. To minimize discomfort, try not to sit or lie down for long periods. And remember to change position or take a quick short walk down the hall, to the kitchen, etc. every 20-30 minutes. If you are referred to physical therapy combine it with the home exercise program. The therapist will teach you exercises and proper form. Exercising ten minutes every day is far more effective than doing 45 minutes once a week.

Resuming normal activities gradually is crucial. No pain, no gain does not apply when recovering from ACDF surgery. Recovery exercises can feel great. However, pain and fatigue can sneak up the next day or the following week. Gradually easing back into daily activities can help avoid major setbacks. Work, shopping, house chores, childcare, and lawn care all fall into the activity category.

A recurrence of neck pain after recovery is normal. However, discomfort can be minimized by taking a few precautions.

• Use proper form when lifting
• Keep objects close to the body
• Keep the back flat as you lift
• Maintain neutral neck position
• Be aware of your posture when sitting, standing, walking, and sleeping
• Gradually increase the exercise program
• Don't overdo it
• Address underlying fear/anxiety
• Fear of generating pain can cause tension and exacerbate or even create new pain symptoms
• Stop smoking, as it has shown to impede the fusion and heighten the risk for complications

ACDF surgery can improve quality of life. Your surgeon is responsible for performing the procedure, it’s up to the individual to follow through with an exercise program and proper ergonomics for optimal results.

Neck Pain Treatment