Accidents and Injuries

For individuals experiencing lower back pain can understanding the anatomy and function of the multifidus muscle help in injury prevention and in the development of a highly effective treatment plan?

Multifidus Muscle

The multifidus muscles are long and narrow on either side of the spinal column, which helps stabilize the lower region of the spine or lumbar spine. (Maryse Fortin, Luciana Gazzi Macedo 2013) Sitting too much, practicing unhealthy postures, and lack of movement can progress to the multifidus muscle weakening or atrophy, which can lead to spinal instability, vertebral compression, and back pain. (Paul W. Hodges, Lieven Danneels 2019)

Anatomy

Known as the deep layer, it is the innermost layer of the three muscle layers of the back and controls the movement of the spine. The other two layers, known as the intrinsic and superficial, are responsible for the thoracic cage/rib cage and shoulder movement. (Anouk Agten et al., 2020) The multifidus has attachment points at:

• The thoracic spine of the middle back.
• The lumbar spine of the lower back.
• The iliac spine - the base of the wing-shaped iliac bone of the pelvis.
• Sacrum - series of bones at the base of the spine connected to the tailbone.
• When standing or moving, the multifidus muscle works with the transversus abdominus and pelvic floor muscles to stabilize the lumbar spine. (Christine Lynders 2019)

Muscle Function

The main function is to stabilize the lower back, but it also helps extend the lower spine whenever reaching or stretching. (Jennifer Padwal et al., 2020) Because the muscle has numerous attachment points and is serviced by a specific branch of nerves known as the posterior rami, it allows each vertebra to work individually and more efficiently.

• This protects against spinal deterioration and the development of arthritis. (Jeffrey J Hebert et al., 2015)
• The multifidus muscle works with two other deep muscle groups to stabilize and move the spine. (Jeffrey J Hebert et al., 2015)
• The rotatores muscle enables unilateral rotation, turning from side to side, and bilateral extension or bending backward and forward.
• The semispinalis muscle above the multifidus allows extension and rotation of the head, neck, and upper back.
• The multifidus muscle ensures spinal strength because it has more attachment points to the spine than the other layers, which reduces spinal flexibility and rotation but increases strength and stability. (Anouk Agten et al., 2020)

Lower Back Pain

A weak multifidus muscle destabilizes the spine and provides less support to the vertebra. This adds pressure on muscles and connective tissues between and adjacent to the spinal column, increasing the risk of lower back pain symptoms. (Paul W. Hodges, Lieven Danneels 2019) The loss of muscle strength and stability can cause atrophy or wasting away. This can cause compression and other back problems. (Paul W. Hodges et al., 2015) Back problems associated with multifidus muscle deterioration include (Paul W. Hodges, Lieven Danneels 2019)

• Herniated discs - also bulging or slipped discs.
• Nerve entrapment or compression pinched nerve.
• Sciatica
• Referred pain - nerve pain originating from the spine felt in other areas.
• Osteoarthritis - wear-and-tear arthritis
• Spinal osteophytes - bone spurs
• Weak abdominal or pelvic floor muscles can compromise the core, increasing the risk of chronic lower back pain and injury.

Individuals are recommended to consult a physical therapist and chiropractor who can help develop the appropriate treatment, rehabilitation, and strengthening plan based on age, injury, underlying conditions, and physical abilities.

Can Core Exercises Help with Back Pain?

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Fortin, M., & Macedo, L. G. (2013). Multifidus and paraspinal muscle group cross-sectional areas of patients with low back pain and control patients: a systematic review with a focus on blinding. Physical therapy, 93(7), 873–888. https://doi.org/10.2522/ptj.20120457

Hodges, P. W., & Danneels, L. (2019). Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. The Journal of orthopedic and sports physical therapy, 49(6), 464–476. https://doi.org/10.2519/jospt.2019.8827

Agten, A., Stevens, S., Verbrugghe, J., Eijnde, B. O., Timmermans, A., & Vandenabeele, F. (2020). The lumbar multifidus is characterized by larger type I muscle fibers compared to the erector spinae. Anatomy & cell biology, 53(2), 143–150. https://doi.org/10.5115/acb.20.009

Lynders C. (2019). The Critical Role of Development of the Transversus Abdominis in Preventing and Treatment Low Back Pain. HSS journal: The Musculoskeletal Journal of Hospital for Special Surgery, 15(3), 214–220. https://doi.org/10.1007/s11420-019-09717-8

Padwal, J., Berry, D. B., Hubbard, J. C., Zlomislic, V., Allen, R. T., Garfin, S. R., Ward, S. R., & Shahidi, B. (2020). Regional differences between superficial and deep lumbar multifidus in patients with chronic lumbar spine pathology. BMC musculoskeletal disorders, 21(1), 764. https://doi.org/10.1186/s12891-020-03791-4

Hebert, J. J., Koppenhaver, S. L., Teyhen, D. S., Walker, B. F., & Fritz, J. M. (2015). The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test. The Spine Journal: official North American Spine Society journal, 15(6), 1196–1202. https://doi.org/10.1016/j.spinee.2013.08.05

Hodges, P. W., James, G., Blomster, L., Hall, L., Schmid, A., Shu, C., Little, C., & Melrose, J. (2015). Multifidus Muscle Changes After Back Injury Are Characterized by Structural Remodeling of Muscle, Adipose and Connective Tissue, but Not Muscle Atrophy: Molecular and Morphological Evidence. Spine, 40(14), 1057–1071. https://doi.org/10.1097/BRS.0000000000000972

The NHTSA records show that rear-end collisions are the most common and make up 30% of all traffic accidents, crashes, and collisions. Rear-end collisions can come out of nowhere. One moment a driver is waiting at a stop or light, and suddenly they are catapulted forward by the intense force of another vehicle/s resulting in serious and sustaining injuries that can impact an individual's physical capabilities. Rear-end collision injuries most commonly affect the neck and back. This is because of the excessive force and intense shifting and whipping the body goes through. Chiropractic care, massage, and decompression therapy can realign the body, relax the muscles, release compressed nerves, expedite recovery, and restore mobility and function.

Rear-End Collision Injuries

Rear-end collision injuries can range from mild to serious, and what seems like a minor pull can result in a severe injury. The most common injuries include:

• Contusions
• Neck and spinal injuries
• Whiplash
• Concussion
• Traumatic brain and other head injuries.
• Facial injuries
• Dental injuries
• Lacerations
• Broken bones
• Crushed or fractured ribs
• Punctured lungs
• Internal bleeding
• Paralysis
• Pre-existing conditions such as degenerative disc disease can worsen.

Collision Types

A rear-end collision can occur in several ways. The most common types include:

Tailgating

• When drivers in the rear follow another motorist too closely, and the lead motorist slows down or has to stop quickly, the rear driver hits the vehicle because there was not enough adequate time and distance to stop.

Slow Speed Collisions

• Slow-speed/low-impact collisions or fender benders can result in spinal injuries and concussions.
• They can also lead to facial and head injuries from sudden airbag deployment.

Vehicle Pile-Ups

• A single rear-end collision on a busy street or interstate highway can cause a chain reaction of multiple-vehicle collisions.
• These accidents can cause devastating injuries.

Causes

Causes that can take attention away from the road include:

• Speeding
• Distracted driving - Talking or texting.
• Tailgating
• Looking at something like an accident while driving by.
• Unsafe lane changes
• Drowsy or fatigued driving
• Construction site hazards
• Poor weather conditions
• Parking lot accidents

Chiropractic Care

Symptoms of rear-end collision injuries may not immediately present following an accident. It can take 24 to 48 hours for discomfort symptoms to come on and sometimes longer. The adrenaline rush allows the individual not to experience the physical symptoms, which is why individuals think they're fine when they are not.  Ignoring signs increases the risk of permanent injury. A herniated disc, for example, left untreated, can lead to permanent nerve damage. 

Chiropractic treatment for rear-end collisions is one of the most effective options available. A chiropractor manipulates the spine to realign the spinal cord, allowing the body to decrease inflammatory cytokine production, which reduces the inflammatory response. Specific techniques and various tools can realign individual vertebrae, restore joint flexibility, and break up the scar tissue so the areas can heal faster.

The Spine In A Rear-End Auto Accident

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, 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

Chen, Feng, et al. "Investigation on the Injury Severity of Drivers in Rear-End Collisions Between Cars Using a Random Parameters Bivariate Ordered Probit Model." International journal of environmental research and public health vol. 16,14 2632. 23 Jul. 2019, doi:10.3390/ijerph16142632

Davis, C G. "Rear-end impacts: vehicle and occupant response." Journal of manipulative and physiological therapeutics vol. 21,9 (1998): 629-39.

Dies, Stephen, and J Walter Strapp. "Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis." The Journal of the Canadian Chiropractic Association vol. 36,3 (1992): 139–145.

Garmoe, W. "Rear-end collisions." Archives of physical medicine and rehabilitation vol. 79,8 (1998): 1024-5. doi:10.1016/s0003-9993(98)90106-x

Whiplash-associated disorders, or WAD, describe injuries sustained from sudden acceleration/deceleration movements. It is a common outcome after a motor vehicle collision but can also be caused by sports injuries, falls, or assaults. Whiplash refers to the mechanism of the injury, while WAD refers to the presence of symptoms like pain, stiffness, muscle spasm, and headaches. A WAD prognosis is unpredictable, with some cases remaining acute with a full recovery, while others progress to chronic conditions with long-term symptoms and disability. Early intervention recommendations include rest, chiropractic care and physical rehabilitation, massaging and stretching exercises, and an anti-inflammatory diet.

Whiplash Associated Disorders

Cervical hyperextension injuries happen to drivers and passengers of moving, slow-moving (less than 14 miles per hour), and stationary vehicles when struck from behind.

• The individual's body is thrown forward, but the head does not follow the body and instead whips forward, resulting in hyperflexion or extreme forward movement of the neck.
• The chin limits forward flexion, but the momentum can be sufficient to cause cervical distraction and neurological injuries.
• When the head and neck have reached maximum flexion, the neck snaps back, resulting in hyperextension or extreme backward movement of the neck.

Pathology

Most WADs are considered soft tissue-based injuries with no fractures.

Stages

The injury goes through stages:

Stage 1

• The upper and lower spine experiences flexion in stage one.

Stage 2

• The spine takes on an S-shape while extending and eventually straightens, causing lordosis.

Stage 3

• The entire spine is hyperextending with an intense force that causes the facet joint capsules to compress.

Symptoms

Whiplash-associated disorders can be classified through grades by the severity of symptoms, including neck pain, stiffness, occipital headache, cervical, thoracic, and lumbar back pain, upper-limb pain, and paraesthesia.

Grade 0

• No complaints or physical symptoms.

Grade 1

• Neck complaints but no physical symptoms.

Grade 2

• Neck complaints and musculoskeletal symptoms.

Grade 3

• Neck complaints and neurological symptoms.

Grade 4

• Neck complaints and fracture and/or dislocation.
• Most cervical fractures occur predominantly at C2 or C6, or C7.
• Most fatal cervical spine injuries occur at the craniocervical junction C1 or C2.

Affected Spinal Structures

Some symptoms are thought to be caused by injury to the following structures:

• Cervical Spine
• Nerve roots
• Spinal ligaments
• Facet Joint Capsule
• Facet joints
• Intervertebral discs
• Cartilage
• Paraspinal muscles causing spasms

Causes of pain can be from any of these tissues, with the strain of the injury causing secondary edema, hemorrhage, and inflammation.

Joints

• Zygapophyseal joints
• Atlanto-axial joint
• Atlanto-occipital joint
• Intervertebral discs
• Cartilaginous endplates

Adjacent Joints

• Temporomandibular joint
• Shoulder complex
• Thoracic spine
• Ribs

Spinal Muscles

Ligaments

• Alar ligament
• Anterior atlanto-axial ligament
• Anterior atlanto-occipital ligament
• Apical ligament
• Anterior longitudinal ligament
• Transverse ligament of the atlas

Bones

• Atlas
• Axis
• Vertebrae C3-C7

Nervous Systems Structures

• Nerve roots
• Spinal cord
• Brain
• Sympathetic nervous system

Vascular System Structures

• Internal carotid artery
• Vertebral artery

Peripheral Vestibular System

Chiropractic Care

A chiropractor will identify areas of restricted joint motion, muscle tension, muscle spasm, intervertebral disc injury, and ligament injury.

• They will analyze posture, and spinal alignment, check for tenderness, tightness, and how well the spinal joints move.
• This will allow the chiropractic physical therapy team to understand the injured body mechanics and how the spine is operating to make a thorough diagnosis.
• The doctor will order imaging tests like an x-ray or an MRI to evaluate any degenerative changes that may have existed before the whiplash injury.
• Once the injury has been accurately diagnosed, the chiropractor will design a personalized treatment plan.

Spinal Adjustments

• Spinal manipulation is applied to areas of the spine that are out of alignment to realign the spine and activate the healing process.
• Flexion-distraction technique is a gentle technique that uses slower, less intense pushing motions on the discs used to treat disc herniations that often occur after a whiplash injury.
• Instrument-assisted manipulation utilizes special instruments to apply various forces or massage settings to the area.
• Targeted spinal manipulation targets specific areas to rework, release, and rebuild the structures.
• Massage Therapy stimulates the affected muscles to relax them from their tense state.
• A treatment plan may utilize:
• Instrument-assisted therapy
• Trigger point therapy
• Resistance-based stretches to rehabilitate soft tissue damage.

Our chiropractic team is ready to help you feel your best so you can return to normal activities and get on with your life.

Automobile Injuries and Chiropractic

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 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

Pastakia, Khushnum, and Saravana Kumar. "Acute whiplash associated disorders (WAD)." Open access emergency medicine: OAEM vol. 3 29-32. 27 Apr. 2011, doi:10.2147/OAEM.S17853

Ritchie, C., Ehrlich, C. & Sterling, M. Living with ongoing whiplash-associated disorders: a qualitative study of individual perceptions and experiences. BMC Musculoskelet Disord 18, 531 (2017). https://doi.org/10.1186/s12891-017-1882-9

https://www.sciencedirect.com/topics/medicine-and-dentistry/whiplash-associated-disorder

Sterling, Michele. "Whiplash-associated disorder: musculoskeletal pain and related clinical findings." The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949

Wong, Jessica J et al. "Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration." The spine journal: official Journal of the North American Spine Society vol. 16,12 (2016): 1598-1630. doi:10.1016/j.spinee.2015.08.024

Woodward, M N et al. "Chiropractic treatment of chronic 'whiplash' injuries." Injury vol. 27,9 (1996): 643-5. doi:10.1016/s0020-1383(96)00096-4

Spinal disc deterioration from aging is normal, but health issues or injuries can advance the degenerative process. Disc protrusions are related to herniated discs but are the mildest form of the condition and are a common form of spinal disc deterioration that can cause neck and back issues. However, individuals may have a small protruding disc that can go undetected unless it irritates or compresses the surrounding nerves. Chiropractic care, decompression, and massage therapy can realign the disc back into position, relieving discomfort and pain. 

Disc Protrusion

A disc is like a sturdy soft rubber shock absorber/cushion with added gel inside. The gel acts as a shock absorber. When the gel begins to protrude out slightly, this is a disc protrusion. Once a protruding disc begins to develop, it usually remains in that position. The disc can sometimes reabsorb on its own and realign back into position, but there is no way of knowing that will happen or how long it will take. With age and/or injuries, the body's parts change. The spine's discs dehydrate and lose elasticity weakening the discs and making them more vulnerable to herniation stages:

First Stage

• Following natural weakening can be classified as a disc protrusion when the disc's core begins pushing into the spinal column.
• Disc protrusions can be tiny or push out an entire side of the disc.

Second Stage

• Disc deterioration often consists of a bulging disc when the core pushes out farther around the circumference beyond the disc's outer layer, called the annulus fibrosus, creating the telltale bulge.
• A bulging disc involves more than 180 degrees of the disc's circumference.

Third Stage

• The third stage is a herniated disc, meaning the disc's outer wall has torn, allowing the inner gel to leak out, usually irritating the surrounding nerves.

Fourth Stage

• The fourth stage is sequestration, a herniated disc in which a piece of the nucleus breaks free of the vertebral disc fragments and falls into the spinal canal.

Types

A disc protrusion is one type of disc herniation that pushes out but remains connected. Different types compress and irritate the discs differently and produce various symptoms, including:

Paracentral

• This is the most common, where the disc protrusion jams the space between the central canal and the foramen.

Central

• This is where the disc protrusion impinges into the spinal canal, with or without spinal cord compression.

Foraminal

• The disc intrudes into the foramen, the space through which nerve roots branch off the spinal cord and exit the vertebrae.

Symptoms, Diagnosis, and Chiropractic Care

Individuals with a disc protrusion can have symptoms similar to sciatica, which includes back, buttock, and leg discomfort, numbness, and pain sensations.

• Treatment for disc protrusion will be based on the individual's symptoms.
• A chiropractor will take a detailed medical history and perform a physical examination.
• A spinal MRI test could be ordered depending on the injury or condition.
• A customized treatment plan will be developed to fit the individual's medical needs.

Most disc protrusions improve after a few weeks of rest, avoiding strenuous activities, activity modification, an anti-inflammatory diet, and gentle exercises that the chiropractic team will provide.

True 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

Fardon, David F et al. "Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology." The spine journal: official journal of the North American Spine Society vol. 14,11 (2014): 2525-45. doi:10.1016/j.spinee.2014.04.022

Mysliwiec, Lawrence Walter, et al. "MSU classification for herniated lumbar discs on MRI: toward developing objective criteria for surgical selection." 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. 19,7 (2010): 1087-93. doi:10.1007/s00586-009-1274-4

https://www.ninds.nih.gov/low-back-pain-fact-sheet#3102_7

Urban, Jill P G, and Sally Roberts. "Degeneration of the intervertebral disc." Arthritis research & therapy vol. 5,3 (2003): 120-30. doi:10.1186/ar629

The thoracic spine, also known as the upper or middle back, is designed for stability to anchor the rib cage and protect the organs in the chest. It is highly resistant to injury and pain. However, when thoracic back pain does present, it is usually from long-term posture problems or an injury. Thoracic back pain is less common than lower back and neck pain, but it does affect up to 20% of the population, particularly women. Treatment options include chiropractic for quick and long-term pain relief.

Thoracic Back Pain and Soreness

The thoracic area is vital for various functions related to:

• Breathing mechanics
• Optimal arm function
• Organ protection
• Trunk support
• Nervous tissue health

Common reasons for experiencing thoracic back pain include:

• A direct hit or high-impact injury from a fall.
• Sports injury.
• Automobile accident.
• Unhealthy postures that put the spine in chronic misalignment, causing strain.
• Repetitive overuse injury from bending, reaching, lifting, twisting.
• Poor core or shoulder mechanics, causing muscle imbalance.
• Muscular irritation, the large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate.
• De-conditioning or lack of strength.
• Joint dysfunction can come from a sudden injury or natural degeneration from aging. Examples include facet joint cartilage tear or joint capsule tear.

Upper back pain usually feels like a sharp, burning pain localized to one spot or a general achiness that can flare up and spread out to the shoulder, neck, and arms.

Types of Upper Back Pain

These include:

• Myofascial pain
• Spine degeneration
• Joint dysfunction
• Nerve dysfunction
• General spinal misalignments

Depending on what specific tissues are affected, pain can occur with breathing or arm use. It is recommended to have a healthcare professional perform an examination and get an accurate diagnosis. A chiropractor understands the delicate balance and functions that the thoracic spine provides and can develop a proper treatment plan.

Chiropractic

Treatment options will depend on the symptoms, underlying dysfunctions, and individual preferences. ​Recommendations for treatment often include:

• Spine adjustments to improve alignment and nerve integrity.
• Posture training to maintain spinal alignment.
• Therapeutic massage.
• Exercise training to restore muscular balance.
• Non-invasive pain-relieving techniques.
• Health coaching.

Body Composition

Plant-Based Diets for Weight Loss

Individuals who follow vegan, vegetarian, and semivegetarian diets have reported and shown they are less likely to be overweight or obese. This can indicate that reducing intake of meat and animal products is beneficial for weight loss. Studies have found that individuals who follow a vegan diet may lose more weight than individuals on a more conventional weight loss diet, even with similar calories consumed, and often have significant improvements in blood sugar and inflammation markers.

Plant-Based Protein and Muscle Gain

Some plant-based proteins are just as effective as animal protein at promoting muscle gain. A study found that supplementing rice protein following resistance training had similar benefits to whey protein supplementation. Both groups had:

• Decreased fat mass
• Increased lean body mass
• Skeletal muscle hypertrophy
• Improved power and strength

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

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Cichoń, Dorota et al. “Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women.” Ortopedia, traumatologia, rehabilitacja vol. 21,1 (2019): 45-55. doi:10.5604/01.3001.0013.1115

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

Jäger, Ralf et al. “Comparison of rice and whey protein isolate digestion rate and amino acid absorption.” Journal of the International Society of Sports Nutrition vol. 10,Suppl 1 P12. 6 Dec. 2013, doi:10.1186/1550-2783-10-S1-P12

Joy, Jordan M et al. “The effects of 8 weeks of whey or rice protein supplementation on body composition and exercise performance.” Nutrition journal vol. 12 86. 20 Jun. 2013, doi:10.1186/1475-2891-12-86

Medawar, Evelyn et al. “The effects of plant-based diets on the body and the brain: a systematic review.” Translational psychiatry vol. 9,1 226. 12 Sep. 2019, doi:10.1038/s41398-019-0552-0

Newby, PK et al. “Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women.” The American journal of clinical nutrition vol. 81,6 (2005): 1267-74. doi:10.1093/ajcn/81.6.1267

Pope, Malcolm H et al. “Spine ergonomics.” Annual review of biomedical engineering vol. 4 (2002): 49-68. doi:10.1146/annurev.bioeng.4.092101.122107

Video gaming has grown to over 150 million individuals in the United States playing. Around 60% of Americans play video games every day, with the average gamer being 34 years old. Playing video games for an extended amount of time takes a toll on the body. Individuals are experiencing the same kind of pains and aches from sitting and standing all day at work or school. Sitting positions, holding the controllers, and the different accessories can impact the nerves, muscles, and Posture. E-sports professionals understand the physical toll their bodies take with constant practice, tournaments, clinics, etc. They do cardiovascular conditioning, strength train, and stretch to improve their gaming abilities and also take into account:

• The correct sitting position.
• Ergonomic chairs.
• Screen height.
• Ergonomic controllers.
• Hand/wrist supports.
• Take regular breaks.

Taking steps can prevent strain, injuries and minimize the risk of long-term damage. If strain and injuries are present, professional chiropractic treatment can help alleviate the pain, rehabilitate/strengthen the muscles, ligaments, tendons, and recommend exercises and stretches.

Video Gaming Posture

Proper Posture is vital to maintaining spinal as well as overall health. Poor Posture is the most common cause of back and neck pain.

Video Gaming Positions

Common gaming positions include the couch slouch where the gamer is slumped back into the couch with their feet up. This can lead to low back pain and sciatica. The full-on position is where the individual leans forward, elbows on their knees, head tilted forward, and staring up at the screen. Hours in these positions cause the neck, back, and other body areas to stiffen, generating soreness from the restricted movement. Many gamers use ergonomic gaming chairs. They have found that using the gaming chair improves Posture, eliminating the forward head and rounded shoulders. Gaming chairs can provide the health benefit of sitting correctly, reducing and eliminating neck and back tension or strain.

Injuries and Health Issues

Common musculoskeletal issues caused by excessive gaming and lack of movement include:

• Eyestrain
• Headaches
• Neck pain
• Elbow, arm, wrist  pain
• Thumb pain
• General hand pain
• Carpal tunnel syndrome
• Postural stress
• Back pain

Chiropractic Treatment

Shoulder Massage

The intensity of gaming can cause the shoulders to tense up and stiffen. When using the controller, the shoulders can slightly lift, building up lactic acid, interrupting blood circulation, causing an accumulation of unwanted toxins inflaming trigger points. A chiropractic massage will release tightened muscles, provide relaxation, and increase the blood flow.

Hand and Wrist Treatment

The most used body parts for video games include the hands and wrist. Individuals grip the controllers or constantly use the keyboard and mouse. No matter what form of input is used, prolonged use can cause hand and wrist injuries. Injuries include:

• Inflammation
• Hand muscle aches

Chiropractic focuses on specific areas to help treat the body through a hand and wrist massage. Advanced techniques include electrical muscle stimulation to help stimulate and loosen the muscles. A chiropractor will recommend stretches and exercises, and hand/wrist supports, guards, or special gloves to alleviate muscle pains while still playing.

Neck and Back Adjustments

Poor posture can result in a misaligned spine or back muscle spasms. During extended game sessions, pain and fatigue can begin to present. A chiropractic adjustment can realign the muscles and set them back in place. The tissue surrounding the neck may thicken and focus on a specific area. Leaning too far forward or using a heavy gaming headset can result in a forward head posture placing a constant strain on the neck. Chiropractic adjustments will loosen the tissue and release any tension. Stretches and exercises will be recommended as well.

Recommendations

• Set up the gaming station correctly.
• The monitor or TV should be directly in front and around eye level, taking the strain off the neck.
• Support the low back by maintaining the normal curve known as lordosis.
• Use a lumbar support pillow or a small pillow behind the low back to prevent strain and pain.
• Take frequent breaks every hour, take 10 minutes to get up, walk around, and stretch.
• Physical activity/exercise 30-60 minutes a day to improve health.
• Healthy diet

Body Composition

Body Composition

Body composition refers to how various substances in the body are proportioned. A few examples of the components that make up the body include:

• Water
• Protein
• Fat
• Minerals

All of these components generate balance in the body. When individuals exercise, they begin to notice changes in their body composition. For individuals that exercise regularly, it is vital to track weight gain, weight loss, and changes in body composition. This is to ensure that they aren't losing muscle mass. As individuals exercise, muscle fibers are torn. During the recovery process, muscles are rebuilt. Overtraining can lead to muscle mass reduction because the body cannot catch up and rebuild the number of muscle fibers, eventually leading to lost muscle.

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

Emara, Ahmed K et al. "Gamer's Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports." Current sports medicine reports vol. 19,12 (2020): 537-545. doi:10.1249/JSR.0000000000000787

Geoghegan, Luke, and Justin C R Wormald. "Sport-related hand injury: a new perspective of e-sports." The Journal of hand surgery, European volume vol. 44,2 (2019): 219-220. doi:10.1177/1753193418799607

McGee, Caitlin, et al. "More Than a Game: Musculoskeletal Injuries and a Key Role for the Physical Therapist in Esports." The Journal of orthopedic and sports physical therapy vol. 51,9 (2021): 415-417. doi:10.2519/jospt.2021.0109

McGee, Caitlin, and Kevin Ho. "Tendinopathies in Video Gaming and Esports." Frontiers in sports and active living vol. 3 689371. 28 May. 2021, doi:10.3389/fspor.2021.689371

Zwibel, Hallie et al. "An Osteopathic Physician's Approach to the Esports Athlete." The Journal of the American Osteopathic Association vol. 119,11 (2019): 756-762. doi:10.7556/jaoa.2019.125

While bruising, soreness, and scrapes are common, whiplash and chronic whiplash injuries may not show for several days or weeks. While today's vehicles are safer than ever, they can still only do so much when it comes to the body and musculoskeletal health. Being involved in an automobile accident, even a light tap can give a sudden jolt to the spine that although the individual might not have felt anything like discomfort or pain, it was enough to shift the disc/s out of place or set them up to shift out of place. No one wants to be involved in a car or motorcycle accident, but regardless of good driving habits, or how advanced the safety features on the vehicle might be, the average driver will be involved in three to four automobile accidents in their life.

Whiplash

Whiplash and chronic whiplash injuries are common in motor vehicle accidents. More than 3 million Americans will see a doctor and a chiropractor for automobile accidents and whiplash effects. It only takes a 2.5 mph hit to cause an injury. And whiplash doesn't only happen when hit from behind, there are several ways an individual can be subjected to whiplash, including being T-boned, amusement park rides, and falling off a bicycle or a horse.

Symptoms

Most whiplash symptoms develop in the first twenty-four hours, but this is not always the case. Common symptoms include:

• Neck pain
• A stiff neck
• Intense neck pain when moving, rotating
• Headaches that start at the base of the head
• Loss of range of motion
• Dizziness
• Fatigue
• Shoulder pain
• Arm pain
• Upper back pain
• Low back pain
• Blurred vision
• Anxiety
• Nausea
• Depression
• Difficulty with concentration
• Memory difficulties
• Sleep disorders

Facts and Stats

Most individuals realize they have whiplash a day or two after, but for others, it can take a few weeks or even months to present. Whiplash is classified by degree or grade:

Grade 0

The individual has no complaints and there are no symptoms/signs of physical injury.

Grade 1

There is neck pain but there are no physical signs of injury.

Grade 2

There are signs/symptoms of musculoskeletal damage and neck pain is presenting.

Grade 3

There are signs/symptoms of neurological damage and neck pain is presenting.

The average amount of time most individuals stay home from work is around 40 days. However, when whiplash pain lasts longer than a few weeks, it is deemed to be chronic whiplash.

Chronic Whiplash

Some individuals with whiplash experience painful symptoms for years. This is true of those that avoid or refuse medical attention and learn to live with it.

Treatment Options

There are very effective methods for treating whiplash and chronic whiplash injuries. Depending on the extent of the injury/s, developing the right treatment/rehabilitation plan requires individual consultation with a chiropractor to discuss options that can include:

Pain Relief

The pain can be excruciating. Over-the-counter pain relievers like ibuprofen for temporary relief. However, the individual will need extended treatment to ensure it does not become chronic pain.

Neck Brace

Neck braces help limit the pain, but should not be worn for more than three or four days. If worn for too long the neck muscles are prevented from gaining the strength needed to support the head.

Don't Sit For Too Long

Avoid keeping the head in any one position for too long. This includes sitting in bed, watching TV, or working at a desk. This places a large amount of pressure and stress on the neck, making the pain even more severe and longer-lasting.

Sleeping Properly and Comfortably

For many, it can be difficult to get into a comfortable position when sleeping. Sleeping on the back with the head turned to one side can worsen the pain. Try a high-quality ergonomic pillow that allows the individual to sleep on their side and takes the pressure off of the neck.

Spinal Alignment

Whiplash can cause the spine to shift out of alignment. This can lead to additional problems in the back or shoulders. It’s always a good idea to see a chiropractor that specializes in motor vehicle accident injuries to realign the spine and neck, as well as for rehabilitation to strengthen the muscles and prevent further injuries. See a chiropractor for an evaluation of the injuries and develop a customized treatment plan that works for the individual's condition.

Everyone is different

Some individuals can be stiff and sore for a few days and then are okay with not much pain. Some individuals experience severe pain immediately after the wreck, while others have no pain for days or even weeks. Both scenarios are pretty common. Soft tissue injuries can be very deceiving. Some don’t experience any pain for months after the accident. Many don’t think they need to see a doctor or chiropractor because there is no pain or symptoms. However, underneath serious problems could be getting ready to present including:

• Constant headaches
• Numbness or pins and needles in the hands or arms
• Pain between the shoulder blades
• Poor posture
• Chronic muscle tension
• Painful spasms
• Degeneration of the discs
• Painful inflamed arthritis
• The quick development of arthritis
• Sore, tight, or inflexible muscles
• Sleep disturbances
• Fatigue
• Dizziness

Body Composition

A decrease in physical activity

Physical inactivity is a primary factor in the progression of sarcopenia. Resistance exercise can help maintain muscle mass and help build muscular strength. Individuals that are more sedentary can exacerbate the effects of sarcopenia.

A decrease in motor neurons

Aging is accompanied by motor neuron loss resulting from cell death. This leads to a decrease in muscle fiber. This decrease in muscle fibers leads to:

• Impaired performance
• A reduction in functional capacity
• A decreased ability to perform everyday tasks

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

How the Neck Works: UpToDate. (2020) “Patient education: Neck pain (Beyond the Basics). https://www.uptodate.com/contents/neck-pain-beyond-the-basics

Symptoms: PLOS ONE. (2018) “Thoracic dysfunction in whiplash-associated disorders: A systematic review.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865734/

Causes: Mayo Clinic. (N.d.) “Whiplash.” https://www.mayoclinic.org/diseases-conditions/whiplash/symptoms-causes/syc-20378921

Mental strategy exercises for chronic pain relief and improvement. Living with chronic pain is difficult especially if a doctor is saying that it is all taking place in an individual's head. However, the pain is very real and happening in the brain, literally. Neuroimaging studies show that certain areas of the brain become active when chronic pain presents. This is not the only way to know the brain's role in how an individual experiences pain. What is also known is:

• Anxiety, depression, and pain activate similar areas of the brain.
• Certain psychiatric drugs used to relieve pain can also alter an individual's mental state.
• Chronic pain can lead to depression.
• Clinical depression can cause physical symptoms, including back pain.

A health care provider could recommend/suggest psychological support for chronic pain. Psychological help and mental strategy exercises for chronic pain are not about how to reduce the pain, but more on how to reduce the dominance, interference, and impact of the pain and getting a healthy quality of life back. Consider a few evidence-based, psychological approaches to reduce back pain.

Cognitive-behavioral therapy

Cognitive-behavioral therapy or CBT trains an individual to modify specific thoughts and behaviors. Experts consider this approach a gold standard of psychological interventions for pain. It helps:

• Reduce pain
• Improves function
• Improves quality of life

Individuals work on:

• Pain coping strategies
• Relaxation skills
• Setting goals
• Shifting perspectives on pain

A study found that two years after a two-week, intensive course of cognitive-behavioral therapy, patients took fewer pain meds than they did before the therapy.

Mindfulness meditation

Meditation is not all about sitting with crossed legs, hands resting on the knees, although this is a recommended pose for meditative purposes. A modern approach can be done anywhere, in any position that’s comfortable and will help soothe back pain. By oneself or with help from a therapist mental strategies can include

• Incorporating breathing techniques
• Guided imagery
• Intense focus on thoughts and feelings

A study suggests that mindfulness meditation can be highly beneficial for older adults that are not as able to get an adequate amount of physical activity to improve pain levels. A group of older adults that participated in eight weeks of a mindfulness program, which consisted of four days a week for 30 minutes per session physical function and pain reduction improved.

Mindfulness stress reduction

Mindfulness stress reduction is a program that teaches individuals meditation techniques, that include basic stretches and postures. It teaches how to separate the physical and psychological aspects of pain. Medical centers across offer this treatment option for a range of disorders, including chronic back pain. It helps reduce pain intensity and improves function in individuals with arthritis as well as back and neck pain from various causes. It has also been found to be effective for fibromyalgia, which can cause intense widespread pain. A study found that mindfulness stress reduction improved:

• Wellbeing
• Pain episodes
• Sleep problems
• Fatigue in participants with fibromyalgia
• More than half reported significant improvement

Acceptance and commitment therapy

Acceptance and commitment therapy or ACT teaches acceptance and mindfulness strategies with commitment and behavior mental strategies, to change the way pain is experienced. Numerous studies along with the American Psychological Association validate this approach as an established treatment for chronic pain.

Changing expectations

In one study several chiropractic patients who expected their back pain to improve were 58% more likely to improve than those who did not expect favorable outcomes. This mental strategy of manifesting a positive outcome through the power of positive thinking and beliefs about pain influence an individual's actions.

For example, when thinking that physical activity will cause back pain, individuals are less likely to be active. This is known as fear avoidance. For most individuals with back and neck pain, gentle physical activity is essential because avoiding it will worsen the pain. Having the right mental strategy can go a long way in battling chronic pain, at Injury Medical Chiropractic and Functional Medicine Clinic we can help individuals experiencing/dealing with chronic pain.

Body Composition

Depression and physical health

Depression is debilitating and, in severe cases, a life-threatening disease that affects over 16 million people nationwide. Depression causes are not always clear and can be brought on by:

• Biological factors - genetics
• Individual brain chemistry
• Certain medications
• Stress
• Unhealthy diet/nutrition

Mental illness and becoming overweight or obese often happen in conjunction, whether as a result of each other or from common risk factors that include:

• Smoking
• Poor diet
• Lack of physical activity
• Alcohol consumption

Prescribed medications for depression and anxiety disorders are have been shown to be successful in maintaining mental health. However, a side effect of these medications is weight gain. Like genetics, being educated on the potential side effects will help in reducing the risk of, and controlling weight gain when taking medication.

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

Pain and Therapy. (Jun 2020) “Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/

Journal of Psychosomatic Research. (Jan 2010) “Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.”

European Journal of Pain. (Jan 2019.) “Beliefs about back pain and pain management behaviors, and their associations in the general population: A systematic review.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492285/

Getting workers’ compensation for a back/spinal injury can be a daunting and overwhelming task. There are plenty of questions, and we have answers from both medical and legal professionals. Anyone can be affected by back pain at work.

• Truck drivers
• Manual laborers
• Construction workers
• Hairstylists
• Automotive technicians
• Teachers
• Healthcare workers
• Foodservice workers
• Hospitality workers
• Office workers

Work-related back injuries can be prevented by paying attention to posture, taking standing/moving breaks, stretching out, and lifting properly. However, if back pain at work stems from a work injury individuals could be entitled to workers’ compensation benefits.

Workers’ Compensation

Workers' compensation is an insurance program that helps with and provides benefits and medical care for workers that have been injured or fallen ill resulting directly from their job. This means if an individual is injured at work, employers have negotiated to free themselves of a majority of the liability by paying for the treatment and recovery.

Companies that employ five-hundred or more are able to manage their own workers’ compensation program. However, most workers’ compensation programs are managed by state governments. Every state has its own workers’ compensation program that employers pay into. The federal government handles the federal workers’ compensation program for federal employees. The program is funded by the employer with the cost not affecting an individual's paycheck.

Workers’ Compensation Coverage

Compensation programs are different throughout the country. Typically workers’ compensation pays for:

• Initial emergency department
• Urgent care visit
• Diagnostic testing recommended by the emergency department
• Follow-up physician
• Surgical intervention
• Rehabilitation

Under workers’ comp back injury treatment/s are completely covered, meaning an individual does not have to meet a deductible or pay premiums, copayments, or coinsurance. Individuals continue to receive regular health insurance benefits from the employer. This could require a deductible, premiums, copays, and coinsurance. This is for the treatment of other health issues while receiving workers’ compensation care.

If an individual is unable to work because of a workers' comp back injury, a worker can expect to be paid a base salary after taxes while being treated. Those whose salary is dependent on overtime creates a disadvantage. Workers’ compensation can mean a pay cut for these individuals. Workers’ comp pay depends on the state. Usually, there is a wage rate set by the state.

High Risk for Back Injury on the Job

Employees that are involved in physical labor like construction, factory work, and healthcare work have a higher risk of getting a back injury on the job. These injuries are often the result of:

• Improper lifting techniques
• Repetitively turning
• Twisting while lifting
• Holding something heavy
• Lifting heavy objects above the head
• Using the back muscles instead of the hips and legs when lifting bending of the knees and bringing heavy objects close to the core

Truck drivers also have a higher risk of back injuries. Sitting for long periods and reduced physical activity contributes to the back muscles losing their strength, endurance, and cardiovascular ability. Then when unloading the cargo the stress on the spine is doubled.

Injury Report

A back injury should be reported to the supervisor or the company’s human resources department. Depending on the state, there is a statute of limitations to file an injury claim. For example, an individual has one year from the date of injury to file a workers’ compensation claim with the supervisor or human resources department. However, it is best to report the injury and seek medical attention as soon as possible after being injured at work. The longer the wait, the more the employer could dispute the legal validity of a workers’ compensation claim.

Injury Qualification

If injured at work, assume the injury will be covered by workers’ compensation. However, it is not always completely clear. An individual could be injured at a work-related cookout or working from home and trip down the stairs. These are gray areas and are very new as more people working from home. These kinds of workers’ comp claims are now starting to be seen. Whatever the event, report injury/s to the employer. If the situation is untraditional, there could be some back and forth with the employer.

Spine Specialist Referal

To receive work comp treatment patients with back injuries will be referred to an occupational therapy clinic. An occupational therapist or clinic will set up the treatment. This could include:

• Chiropractic
• Medication
• Physical therapy
• Hydrotherapy
• MRI
• CT scan
• X-rays

For many that could be enough to get them back to work. If the initial treatments fail an individual could be referred to a spine specialist to set up an optimal treatment plan. A spine specialist could recommend additional therapy, medication, diagnostic imaging, spinal injections, or surgery.

Occupational therapy usually goes on for four to six weeks before the individual is referred to a spine specialist. This all depends on the situation. Individuals can be referred immediately for specific spinal treatment or be told to wait for a specific time. It all depends on the medical situation.

Employer and the Spine Specialist

In most states, employers will request a copy of the treatment plan and spine surgeon’s clinical notes written about the case during office or telemedicine appointments. Doctors have to provide clinic notes and treatment plans to the human resources departments along with the workers’ compensation insurance carrier.

Consistent, active communication goes on between the primary doctor, the company’s human resources department, and the insurance carrier. Note that workers’ compensation is exempt from HIPAA privacy regulations. Employers and the workers’ compensation insurance carrier have access to medical records related to the back injury. But medical information unrelated to the injury is restricted.

Obtaining Workers’ Compensation From a Doctor

Generally, no. Obtaining Workers’ comp is between the individual and their employer, not the doctor. Sometimes doctors are asked to determine if an individual's injury/s are work-related. This involves going through medical records but these requests are rare.

Benefits Duration

It depends on the case and where an individual lives. Every state is its own system. In some states, treatment can be ongoing for as long as treatment is needed and is consistent. What is highly recommended is meeting with a workers’ compensation attorney in your state when beginning the process to learn your rights and the process. This can help in preventing issues from popping up like an employer pressuring a worker to come back before a doctor has cleared them to return.

Making Most of Workers’ Comp

Keep appointments and be compliant with the doctor's treatment plan and recommendations. Be transparent with the doctor. Not telling them exactly what is happening will not help in their recovery. If there is an improvement from the treatment/s fantastic, but if there are minimal to no improvements be as descriptive as possible about what is happening and what does work. The goal is to work with a clinical team that can get an individual better back to work and normal activities.

Chiropractic Care Lower Back 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*

Minimally invasive spine surgery known as M.I.S.S is an option to traditional open surgical procedures, as well as an alternative when non-surgical approaches are working but the pain or condition is becoming worse, regardless. These are performed to treat a variety of spinal disorders like:

• Bone spurs
• Degenerative disc disease
• Herniated disc
• Scoliosis
• Spinal instability
• Spinal stenosis
• Spinal tumors

Minimally invasive surgery can offer potential benefits. These include

• A small/tiny incision/s
• Minimal cutting through soft tissues like ligaments, and muscles
• Outpatient option/s
• Reduced post-operative pain
• Quicker recovery

The Focus of Spine Surgery

There are two main goals when it comes to spine surgery or rather the goal/focus of the surgery. These are decompressing and stabilizing the spine.

Decompression of the spine

Spinal decompression involves removing any tissue/s that are compressing/pinching the nerve structures like a spinal nerve root or the spinal cord itself. Bone spurs and fragments from a herniated disc are the types of tissue/s that can cause neural compression.

Stabilization of the spine

An abnormal movement of one or more levels/segments of the spinal cord can cause back pain, neck pain, or both. Surgeries that are meant to stabilize and stop these abnormal movements utilize spine instrumentation combined with fusion.

Spine Surgery Techniques

Minimally invasive spine surgery techniques include:

• Percutaneous or through the skin
• Mini-open or small incision procedure/s

Rather than cutting through soft tissues, a tubular retraction instrument generates a tunnel that expands and passes between the muscle/s to access the spine's column. Then an endoscope or a tiny video camera goes in and around the area, projecting a visualization of what's happening on a monitor during the procedure.

This is the surgeon's/team's eyes as they work to repair the damage. The surgery is run through the tubular retraction system along with any specially designed instruments that are needed. Types of surgical procedures performed with minimally invasive surgery include:

• Discectomy
• Microdiscectomy
• Foraminotomy
• Microforaminotomy
• Microlaminectomy
• Microlaminotomy

The micro means that the surgery is done using a special microscopic camera to view the disc/s and nerve/s. Imaging scans, systems, and image-guidance technologies, like fluoroscopy, which is a real-time x-ray are utilized during the surgery pinpointing the key aspects of the patient’s spinal anatomy. The surgical imaging shows 2D and 3D views, which guides the placement of any instrumentation, like pedicle screws.

Disorders Treated with Minimally Invasive Surgery

Degenerative disc disease

Degenerative disc disease is known as DDD often develops progressively in older adults and affects the intervertebral discs. The normal wear and tear of cellular age-related changes in the body can cause the spine's discs to:

• Stiffen
• Lose Flexibility
• Loss of Strength
• Loss of Height
• Lose shape, along with the ability to absorb/distribute the forces associated with moving

These structural changes increase the risk of disc herniation and subluxations.

Herniated discs

A herniated disc also called a slipped, bulging, and ruptured disc. This happens when the soft gel cushion of a disc breaks through the protective outer layer. Other than the damaged disc, the loose interior gel can also irritate and inflame the nerves causing back pain.

Scoliosis

Scoliosis is an abnormal sideways curve of the spine that can cause progressive spinal deformity. A scoliotic curve can look like an “S” or “C.” Most cases have no known cause, and while the condition is more commonly associated with children, adults can develop scoliosis, as well.

Spinal stenosis

Spinal stenosis happens when the spinal nerve roots and the spinal cord become compressed/pinched. These nerves branch off the spinal cord and exit the spinal canal through passageways called neuroforamen. Nerve and spinal cord compression can cause symptoms like:

• Pain
• Weakness
• Tingling sensations
• Numbness
• Sometimes, pain can travel into the arms or legs

Spine Surgery Risks

With any spine surgery there are potential risks and complications that can occur. Here are some possible complications that can happen during and after surgery, with both open and minimally invasive procedures.

• Bleeding
• Blood clots
• Failed fusion pseudarthrosis/non-union
• Nerve damage
• Symptoms come back
• Infection/s 

Candidate for Surgery

Minimally invasive spine surgery does offer many benefits:

• Tiny incision
• Less pain
• Reduced risk
• Faster recovery

Let's not forget that M.I.S.S is still surgery. Less than 5% of people with back or neck pain need spine surgery and, surgery is the last resort for treating pain and symptoms caused by a spinal condition/disorder.

It is only when non-surgical treatments like chiropractic, acupuncture, physical therapy, medication, or spinal injections do not reduce symptoms in 3 to 6 months. This is when you qualify to be a candidate for spine surgery. There are certain types of spinal disorders that require urgent or immediate surgical intervention.

Talk with your doctor, chiropractor, or spine specialist about the pain, the symptoms, and compare the results of the different therapies/treatments and go from there. With any type of surgery there are many considerations to discuss before making a decision to treat back or neck pain and if minimally invasive surgery could be an option.

Lower Back Pain Chiropractor

In today's workforce, many jobs place workers at a higher risk for a back injury. The list is pretty extensive and may surprise you! Individuals that have suffered a  neck or back injury at work know the cost goes beyond lost wages. The impact of these injuries on employees, employers, and the economy is staggering.

In a report published by the Bureau of Labor Statistics, there were 2.8 million cases of non-fatal occupational injuries and in 2018.  Of these cases, more than 50% lost time from work, transferred to a different job, or restricted work activity. Not all of these cases were spine-related injuries. However, 880,000 cases were back pain-related injuries.

The World Health Organization's International Labour Office says that the problem is global.

Musculoskeletal diseases are a very common part of 270 million non-fatal work/job accidents where employees missed at least 3 workdays.

Risky Jobs

Occupational safety experts gather all kinds of information that they factor. This includes job requirements, work environment, and work station set up. In compiling the list of risky occupations, here are some of the criteria:

• Heavy physical work
• Forceful lifting movements
• Bending
• Twisting
• Awkward work postures
• Whole-body vibration
• Static work postures like standing/sitting but never changing position compounds the risks to workers.

Two occupations that lead the list of jobs placing workers at the highest risk are construction and nurses/nursing home workers. Workers in both of these jobs tend to share the under-reporting of work-related injuries. This happens as the employees fear they will lose their job and cannot afford to take any time off.

Construction Workers

Employees at a construction site are repeatedly lifting, bending, carrying, pulling, and tugging. These repetitive movements lead to overuse injuries and back strain/sprains are a common part of this. More than 30% of workers have to miss job time. Those that must climb ladders or work on scaffolds have a greater risk of falling. This is where some serious spinal injuries can occur, causing disability and sometimes being fatal.

Nurses/Nursing Workers

Nursing homes and employment opportunities are growing from elderly population growth. These workers are at high risk for back pain and spine injury. This comes from transferring patients' from their beds, bathtub, and bathroom facilities. All these actions require lifting, carrying, holding, pulling, pushing, and turning. The Bureau of Labor Statistics reports nearly all back and shoulder injuries are the result of moving patients.

Warehouse Workers

This is another job that requires lifting, along with using forceful movements, bending, twisting, carrying, and placing the body in awkward positions. Sometimes these workers have to drive a truck or an industrial vehicle that creates whole-body vibration. Continual exposure to vibration can cause backache and soreness that can lead to lost work time.

Dentists and Surgeons

Both of these professions involve prolonged standing, stooping, bending, and awkward body positioning. Not to mention the mental strain that diverts the doctor's attention to proper posture and body mechanics that results in injury and pain.

Landscapers

The American Chiropractic Association puts landscapers in the top 10 list of jobs that cause back pain. This job puts these workers at a greater risk for cumulative trauma disorders. All the tasks that a landscaper has to do that include hedge trimming, tree pruning, and planting. These actions/movements involve lifting, reaching, bending, and stooping. This is a perfect set up for an overuse back injury.

Hand tools that get used over and over can cause painful conditions like carpal tunnel syndrome and thoracic outlet syndrome. Thoracic outlet syndrome is when the nerves and blood vessels become compressed between the neck and shoulder.

Store Cashier

Grocery and retail store cashiers require workers to stand in one place for a long time. This along with the repetitive motions of scanning, typing, opening, closing combined with bagging and lifting bags over and over can cause neck, shoulder, back, leg and foot pain. Over half of checkout workers complain of back pain.

Other High-Risk Jobs

• Airline crews meaning pilots, baggage handlers,
• Factory workers
• Bakers
• Bus
• Cab drivers
• Cable and telephone line installers
• Carpenters
• Electricians
• Hairstylists
• Plumbers
• Carpet installers/cleaners
• Dry cleaners
• Medical technicians
• Farmers
• Firefighters
• Police
• Maintenance workers
• Automotive technicians
• Office personnel
• Professional athletes

Job Injury Prevention

We may not be able to instantly change our occupation, but there are steps to help prevent neck and back injuries. The key is workplace ergonomics and safety. Be proactive to help reduce workplace risk for neck and back injury and share what you learn with co-workers.

Heel Spurs Treatment | El Paso, Tx (2020)

NCBI Resources

Injuries that are caused by repetitive movements often develop gradually. This is the time when the symptoms are mild and come and go, so the individual just works through it and doesn’t think about it. It’s not until the symptoms get very painful and debilitating that the individual realizes that something is wrong, and then they seek medical attention. Don’t wait, as soon as you feel a tingle, slight pinch, or a little soreness and you feel that it stems from your work’s repetitive movements, get in touch with a doctor or chiropractor before it becomes excruciating.

Sometimes low back pain comes out of nowhere, but that sudden twinge in the lower back does have a cause. With some cases, there’s a trigger, like picking up a heavy object/furniture from an awkward position.  But sometimes it can be a mystery and a challenge to diagnose.

It is important to know the cause of lower back pain to figure out the proper treatment plan.

Otherwise, one could receive treatment for the wrong diagnosis and possibly exacerbate the existing injury.

Why do I need to know what triggers my back pain

Knowing what triggers back pain is the first step toward prevention and how to treat it.

Muscle spasms can stop you cold, and so I'm sure you don’t want another one.

Acute Back Pain

Acute low back pain typically comes on suddenly and lasts for a short time.

It often resolves on its own with self-care and a little time.

Back pain that lasts longer than three months, is considered chronic.

Chronic back pain can be more complex and require doctor/spine specialist-directed treatment, like physical therapy.

Lower Back Pain Is Common

Over 90 percent of adults will have some type of low back pain during their life.

It happens to be the number one cause of job disability globally and the leading contributor to missed work.

Lower back pain happens more often, compared to mid or upper back pain because of the location and all of the movement.

The lower back supports the upper body's weight.

The low back known as the (lumbar spine) absorbs and distributes all of the forces and stress when we move:

• Walking
• Standing
• Rest
• Sitting
• Sleeping

Spinal and abdominal muscles that are weakened heighten injury risk.

These factors combined make the lower back vulnerable to painful spinal conditions.

Common Triggers

When the lumbar spine:

• Muscles
• Tendons
• Ligaments

And other connective tissues get:

• Pulled
• Strained
• Sprained

Is when lower back pain happens.

Small tears in the disc can also contribute to back pain.

Basically, any number of activity and non-activity can cause damage to the spinal discs depending on the movement.

A study published in Arthritis Care & Research saw 999 people from 300 clinics in Australia, to examine their pain triggers.

The most common triggers include:

Manual tasks performed in an awkward posture

This includes:

• Lifting boxes with the back and not bending the knees
• Lifting something too heavy
• Moderate physical activity
• Vigorous physical activity

High intense strength training, long bike rides without proper conditioning, handling people or animals, and picking up children can be triggers and cause injury.

Other triggers include:

• Overstretching
• Twisting
• And Trauma

From:

• Falls
• Vehicle accidents
• Sports 

Triggers You Might Not Know About

Although we don't think about it being Distracted can increase the odds of low back pain.

When we're not paying attention,  we are more likely to lift and carry something too far from our body or distribute the weight unevenly.

Feeling tired and Fatigued is associated with lower back pain.

Getting the proper amount of sleep is vital to restore our bodies to optimal performance.

When we don't sleep the right amount of hours we make our bodies more susceptible to injury.

Treatment

Thankfully most cases are not serious and typically resolve within a few days to, four weeks healing on its own.

But if not, then there are these conservative treatments that can help you feel better and speed up healing.

Continue to Move Around

Depending on how much pain your body will allow, keep doing regular activities and exercise, as best as you can.

Activity increases blood flow, that moves oxygen and minerals/nutrients through the body.

Activity and movement help reduce muscle tension and inflammation.

Heat/Ice

This will not cure a strain or sprain, but they do help in pain reduction.

Heat helps loosen tight muscles.

This can be done by making warm compresses by soaking a towel in hot water.

Fold it to the size you need and wrap it around your lower back up to 20 minutes.  Then rest, massage and re-apply.

Therapy

Physical and manual therapies like:

• Chiropractic care
• Therapeutic UltraSound 
• Massage can bring temporary relief from short-term back pain.

If the pain is intense and interferes with daily activities, a chiropractor/physical therapist can offer exercises and stretches to:

• Improve posture
• Increase mobility
• Correct muscle imbalances

Acute lower back pain can stop you cold with its intensity.

Understanding triggers can take steps to maintain a healthy spine and avoid unpleasant surprises.

Medication

Both acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain.

These need to be taken, specifically as directed by your doctor. We've seen the opioid crisis going on and now this type of treatment is now a last resort. Various medical associations are now pushing towards natural and alternative therapies before turning to medication.

Prolonged use of NSAIDs (Aleve, Advil) can be associated with an upset stomach, kidney damage and gastrointestinal conditions and bleeding, among other conditions.

*BACK PAIN* Rehabilitation | El Paso, Tx (2019)

Back pain is one of the most common health issues frequently diagnosed by healthcare professionals. Approximately 80 percent of the population will experience some type of back pain throughout their lifetimes. Because back pain can occur due to a wide array of health issues, diagnosis is essential to follow-up with the proper treatment approach. Dr. Alex Jimenez, chiropractor or doctor of chiropractic in El Paso, TX, utilizes chiropractic care to help treat back pain. Patients describe how their back pain affected their quality of life, and how Dr. Jimenez helped them improve their overall health and wellness with chiropractic. Patients highly recommend Dr. Jimenez and his staff as the non-surgical choice for back pain, among other common health issues.

Denise was unfortunately involved in an automobile accident that resulted in lower back pain. When she realized that she could not sit or sleep for lengthy periods of time without having debilitating symptoms, Denise discovered chiropractic care with Dr. Alex Jimenez at El Paso, TX. After she received therapy for her automobile accident injuries, Denise experienced relief from her symptoms and she managed to participate in her regular activities once more. As a result of the education and maintenance Dr. Alex Jimenez supplied, Denise recovered her initial health and overall wellness.

Lower Back Pain Chiropractor Treatment 

Back pain is one of the most common health issues today, with approximately nine out of ten adults undergoing it at any time in their lifetime, where about five working adults will develop it annually. Some quote that about 95 percent of Americans will experience back pain at some point in their lifetime. It is undoubtedly the typical cause of chronic pain, since it's also a substantial contributor of missed work and handicap. In the USA alone, severe cases of lower back pain would be the fifth most frequent reason for doctor visits and triggers 40 percent of missed days off work. What's more, according to statistics, back pain is the only top cause of disability worldwide. 

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, Sport 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 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.

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A joint is where two bones meet. The two sacroiliac or SI joints connect the spine, pelvis, and hips. This strong joint balances and transmits stress from the upper body to the pelvis and legs. The joints can suffer a sprain causing pain and discomfort symptoms. There can also be the feeling of tightness wrapping around the waist and dull aching across the low back as the surrounding muscles tighten up as a form of protection, also known as muscle guarding. A correct diagnosis is vital to avoid any potentially serious complications. Chiropractors are experts on neuromusculoskeletal problems and can treat, heal, and strengthen the body through various MET, mobilization, and manipulation techniques.

Sacroiliac Sprain

The main function is to balance the upper and lower body forces. The sacroiliac joints are surrounded by muscle, connective tissue, nerves designed to withstand large stresses and a complex system of ligaments, further strengthening the joints.

Injury Causes

Sacroiliac sprains can be caused by direct trauma to the pelvis from a fall or automobile collision or jobs and sports that involve a lot of bending and twisting. However, sometimes there is no distinct cause. Common causes include:

• Repetitive microtrauma is excessive/repetitive movements like prolonged twisting, bending, or lifting at work, home, physical activities, and sports.
• The joint can be pushed out of alignment.
• Muscular imbalance or weakness in the muscles surrounding the sacroiliac joints can cause problems to develop over time, presenting little or no symptoms.
• The tissues around a sacroiliac joint also can be stretched or torn.
• Trauma such as a fall or road traffic accidents
• Problems with the hips, knees, and feet can generate increased pressure on the joint, which can become painful over time due to repetitive strain.
• Pregnancy hormones released to promote pelvis relaxation can increase the risk of SI sprain injury.

Excessive stress on the joint can cause microscopic damage to the ligaments surrounding the joint. The joint then becomes inflamed and presents with pain and sensations of discomfort. The body responds by contracting the muscles to prevent further damage. However, the muscle spasms may not stop, resulting in more pain. Referred pain is common from the muscles that go into spasm, with the most affected being the piriformis, gluteal/buttock, and psoas muscles.

Signs and Symptoms

• Tenderness over the affected joint and area.
• Pain symptoms on one or both sides above the joints and into the buttocks.
• Standing or working with increased weight on one leg increases pain symptoms.
• Pain after lifting or twisting that develops a little while later.
• Pain travels to the back of the leg, front of the thigh, and the groin.
• Pain gets worse when sitting and bending forward.
• Lying down eases the symptoms.
• Most cases report no loss of strength, tingling, or numbing sensations.

Chiropractic Treatment

Chiropractic treatment will relieve the pain symptoms, but there are stages of treatment, each with specific goals before moving to the next.

• The objective of the initial stage is to decrease pain and inflammation.
• The second stage is stabilizing and restoring proper musculoskeletal function.
• Rehabilitation and targeted stretches and exercises will be introduced as the treatment continues.
• In the maintenance stage, there should be no pain, and the individual should be able to perform normal daily activities and return to normal life.
• Recovery time for a sacroiliac sprain can be 4-6 weeks but can take months to heal completely.

Chiropractic Approach for Pain 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 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

BIDWELL, A M. “Treatment of sacroiliac sprain by manipulation.” The Medical World vol. 65,1 (1947): 14-6.

Evans, P. “Sacroiliac sprain.” American family physician vol. 48,8 (1993): 1388; author replies 1390.

LeBlanc, K E. “Sacroiliac sprain: an overlooked cause of back pain.” American family physician vol. 46,5 (1992): 1459-63.

Sun, Chao, et al. “Cost and outcome analyses on the timing of first independent medical evaluation in patients with a work-related lumbosacral sprain.” Journal of Occupational and environmental medicine vol. 49,11 (2007): 1264-8. doi:10.1097/JOM.0b013e318156ecdb

There is a multitude of reasons why back muscles tighten and stiffen up. Muscles pull the bones and joints. Overuse and/or injuries can pull the bones, joints, and tendons out of place, thus causing the muscles to stay in a flexed or stretched position, the inability for the muscles to relax and return to their normal position, resulting in symptoms of discomfort, stiffness, and pain. Individuals can have reoccurring bouts of tight muscles, eventually becoming chronic. Chronic muscle tension can pull the spine out of alignment even if there is no specific injury. The Injury Medical Chiropractic and Functional Wellness Team can relieve tight back muscle tension and restore positioning, mobility, and function.

Muscles are the Key

Muscles make the body move and greatly impact the skeletal and nervous systems. When a muscle is overstretched or pulled, there is not just injury to the muscles but the potential for injury to the bones and tendons in the area. This, in turn, can pinch nerves and cause problems with the nervous system, especially in pain signal transmissions.

Symptoms

Symptoms will depend on the cause and severity. The most common include:

• Constant or chronic muscle achiness, soreness, stiffness, and tightness.
• Even after stretching or flexing, there is a dull aching or pain.

More serious symptoms may include:

• Electrical or burning sensations
• Sharp or stabbing pain.
• Weakness in the legs or arms
• Tingling or numbness in the legs, arms, or chest.
• Chest discomfort symptoms.

Causes

Aging

The older a person is, the more likely they will experience back discomfort symptoms. Back issues most likely occur in 30- to 50-year-olds.

• The aging process naturally wears the body.
• Thinning bones
• Muscle mass reduction
• Fluid loss between joints in the spine.
• All these can cause back issues and problems.

Unhealthy posture

Constant pressure on the spine can lead to general back discomfort symptoms. Practicing unhealthy posture can generate this pressure. The muscles and ligaments must work harder to keep the body balanced because the muscles are out of position, and the other muscles can't perform their job properly. Overworking and overuse lead to tight back muscles, aches, and pain.

Muscle sprain or strain

Sprains are the tearing or stretching of ligaments. Strains are the tearing or stretching of muscles and tendons. Lifting heavy objects without proper form can easily cause a back sprain or strain. Sprains and strains can also occur after an awkward, sudden, or jerking movement.

Herniated disc

A herniated, slipped, or ruptured disc puts pressure on a nerve/s. This can stress the surrounding muscles causing tension to build up.

Fall or other injuries

Tight back muscles can result from the following:

• A fall
• Vehicle accident
• Force Trauma
• Sports accident

Weight gain

Added weight stresses and pulls the body down. This causes unhealthy posture and muscle tension.

Chiropractic Functional Wellness

Usually, tight muscles can be relieved with a hot bath or cold therapy. Reoccurring bouts of, or chronically tense back muscles, are signals that something is wrong and should not be ignored. Chiropractic care can release and relax tight back muscles and get them back into a natural state by re-aligning the spine through tissue manipulation, decompression, massage, and adjustments. The various treatment methods will relieve the discomfort, pain, tension, and realign the spinal column, and strengthen the body. When spinal components are put back into their proper place, the surrounding muscles no longer need to provide a counter-balance to the misalignment and begin to relax. Chiropractors can also recommend ways to improve posture and strengthen muscles to incur less wear and tear.

Chiropractic Back Therapy

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, 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

Furlan, Andrea D et al. "Complementary and alternative therapies for back pain II." Evidence report/technology assessment,194 (2010): 1-764.

Geneen, Louise J et al. "Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews." The Cochrane database of systematic reviews vol. 4,4 CD011279. 24 Apr. 2017, doi:10.1002/14651858.CD011279.pub3

Mayo Clinic Staff. (2017). Back pain: Symptoms. mayoclinic.org/diseases-conditions/back-pain/basics/symptoms/con-20020797

Miake-Lye, Isomi M et al. "Massage for Pain: An Evidence Map." Journal of alternative and complementary medicine (New York, N.Y.) vol. 25,5 (2019): 475-502. doi:10.1089/acm.2018.0282

Nahian, Ahmed, et al. "Osteopathic Manipulative Treatment: Facial Muscle Energy, Direct MFR, and BLT Procedure – for TMJ Dysfunction." StatPearls, StatPearls Publishing, 12 September 2022.

Rahman Shiri, Jaro Karppinen, Päivi Leino-Arjas, Svetlana Solovieva, Eira Viikari-Juntura, The Association Between Obesity and Low Back Pain: A Meta-Analysis, American Journal of Epidemiology, Volume 171, Issue 2, 15 January 2010, Pages 135–154, https://doi.org/10.1093/aje/kwp356

Back injuries from vehicle collisions vary from person to person. Common injuries may include strains, sprains, herniated discs, and fractures, and individuals dealing with certain spinal conditions like spinal stenosis may cause the medical condition to accelerate. Still, the force and physical impact the body absorbs during a crash, no matter how minor the accident or how safe the car is, will cause bodily aches and pains with the potential for other spinal conditions. Chiropractic care, massage, decompression, and traction therapy can relieve symptoms and restore mobility and function.

Back Injuries From Vehicle Collisions

Depending on how the impact affects the spine, problems can present in various areas of the back. The violent motion can sprain, strain, and fracture spinal components. Even minor incidents can impact mobility. Symptoms can stem from inflammation, compressed nerves, or fractures. Any damage can have long-lasting effects on the vertebrae, nerve roots, and back muscles. A vehicle collision can affect the following:

• Lumbar vertebrae - lower back
• Thoracic vertebrae - middle/upper back
• Cervical vertebrae - neck

Each area consists of bones, tissues, muscles, nerves, tendons, and ligaments extending from the neck to the pelvis.

• The most common back injuries are to the neck and lower back, where the most movement and shifting occurs, often causing nerve damage.
• The central placement and rigid structure make middle back injuries less common.
• Upper back injuries that connect the rib and chest region can affect breathing.
• Soft tissue injuries might not show up immediately.

Symptoms

After a vehicle collision, it's common to feel sore all over. The symptoms can range from manageable discomfort to complete immobility. Individuals may experience the following:

Muscle spasms

• The muscle may repeatedly twitch, feel like hard knots, and feel tender to the touch.
• Muscle spasms can vary in pain levels from mild to debilitating.

Stiffness

• Individuals may not feel as flexible because of the muscle tension that activated during the crash to protect the body.
• Stiffness can go away after light stretching or continue throughout the day.

Burning or Shooting Pain

• A burning or shooting pain may travel down the back and buttocks through the back of one or both legs.
• It can be mild, dull aches and pains that go away quickly or last for days.
• Changing positions, such as sitting up after waking up or standing up after sitting, can cause sharp acute pain.
• Facet disease may cause neck or shoulder pain.

Discomfort When Walking or Standing

• Certain physical activities can cause a throbbing sensation or mild pain when attempting to perform various tasks.

Tingling and/or Numbness

• Tense muscles can pinch nerves leading to sensations of tingling or numbness in the legs, feet, arms, or hands.

Head Issues

• Headaches, dizziness, or disorientation can present.

Spinal Disorders

Back injuries from vehicle collisions can result in a degenerative disc disorder months or years later. It can also speed up health issues individuals didn't know they had before the crash. As the body ages, previous damage combined with degeneration can result in:

• Pinched nerves
• Sciatica
• Bulging discs
• Herniated discs
• Spinal stenosis
• Degenerative disc disease
• Foraminal stenosis
• Spondylolisthesis
• Spinal osteoarthritis
• Bone spurs
• Degenerative scoliosis

Discogenic pain

• Damage to spinal discs causes discogenic pain, often sharp impulses or shooting sensations.
• Individuals can experience symptoms in different ways:
• Some individuals feel better when standing, sitting, or lying down, while the positions or motions worsen the symptoms for others.

Chiropractic Care and Therapies

Chiropractic treatment can rule out critical issues and expedite recovery time. Benefits include:

Pain Symptom Relief

• Chiropractic relieves pain in the affected areas and throughout the body.
• Massaging and decompression release endorphins.

Inflammation Alleviation

• Micro-tears within the muscles and ligaments are common and cannot be found through a standard x-ray.
• Spinal adjustments can bring the spine back into alignment, producing natural anti-inflammatory properties to assist with discomfort and heal the tears.

Scar Tissue Breakdown

• Muscles can get scarred, causing stiffness and soreness.
• Chiropractic massage targets these areas and breaks down the build-up quicker than if it was left to heal on its own.
• Less scar tissue means faster recovery.

Range of Motion and Mobility Restored

• Back injuries can result in restricted mobility.
• It may be difficult to turn or move when the muscles are inflamed.
• Mobilizing the spine through adjustments restores the proper range of motion.

Decreased Medication Use

• Prescription pain medications can turn into dependency.
• Chiropractic adjustments can ensure that the injury is healed and the pain is not just masked.

Long-Term Benefits

• Receiving chiropractic care can help prevent minor injuries from worsening into serious and chronic conditions.

Post Whiplash Symptoms

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

Erbulut, Deniz U. "Biomechanics of neck injuries resulting from rear-end vehicle collisions." Turkish neurosurgery vol. 24,4 (2014): 466-70. doi:10.5137/1019-5149.JTN.9218-13.1

National Spinal Cord Injury Statistical Center. (2020) "Spinal Cord Injury: Facts and Figures at a Glance." https://www.nspine injurysc.uab.edu/Public/Facts%20and%20Figures%202020.pdf

Rao, Raj D et al. "Occupant and Crash Characteristics of Elderly Subjects With Thoracic and Lumbar Spine Injuries After Motor Vehicle Collisions." Spine vol. 41,1 (2016): 32-8. doi:10.1097/BRS.0000000000001079

Rao, Raj D et al. "Occupant and crash characteristics in thoracic and lumbar spine injuries resulting from motor vehicle collisions." The spine journal: official journal of the North American Spine Society vol. 14,10 (2014): 2355-65. doi:10.1016/j.spinee.2014.01.038

Injury Medical Spinal Decompression: Spinal decompression therapy/treatment can be surgical or non-surgical, with differences in the procedure, recovery time, and results. Individuals who experience compression-related problems can have severe and prolonged spinal conditions that can lead to various health issues. Individuals experiencing persistent or chronic neck, back, or leg pain should know the differences between surgical and non-surgical spinal decompression. Spinal decompression aims to relieve pressure on the discs and reduce stress on the nerves to eliminate the pain associated with compression on the spine, restoring optimal circulation and improving spinal function.

Surgical Procedure

• It is invasive, must be performed by a surgeon, and can have a recovery time of up to 6 weeks.
• Surgery is usually suggested as a last resort after alternative therapies have not succeeded or when the compression is so severe that surgery is the only option.
• Surgical spinal decompression is directed towards removal to reduce pressure instead of adjusting or stretching the discs.
• In cases of severe nerve compression, surgery can be an effective option.
• Risks include infection, damage to the spinal cord, and blood clots.

Types of Spinal Decompression Surgery

Types of surgeries; spinal fusion could be necessary to stabilize the spine. Common types of back surgery:

Discectomy

• This procedure removes a portion of the disc to relieve pressure on nerves.

Laminotomy

• The procedure removes a small portion of the bone or a section of the bony arch to increase the size of the spinal canal and relieve pressure.

Laminectomy

• The procedure removes the entire bony arch or lamina to increase the size of the spinal canal and relieve pressure.

Foraminotomy

• This procedure removes bone and other tissue to widen the openings for the nerve roots to pass through.

Osteophyte Removal

• The procedure involves removing bony growths.

Corpectomy

• The procedure removes a vertebral body along with discs.

Injury Medical Spinal Decompression

Surgery for a damaged/injured spine is not always necessary. Treatment regimes vary depending on each individual’s medical condition. Non-surgical motorized spinal decompression is a non-invasive back treatment that uses a mechanized decompression table to slowly and gently stretch the spine. The therapy gradually relieves the pressure on the compressed nerve root/s resulting in reduced or complete alleviation of pain.

Non-Surgical Spinal Decompression Treats

• Neck pain
• Back pain
• Sciatica
• Injured, damaged, or diseased nerve roots
• Damaged discs
• Deteriorated discs
• Bulging or Herniated discs
• Osteoarthritis
• Facet Joint Syndrome

Benefits

• Painless
• Non-invasive
• Sessions only take 30-45 minutes
• Feel immediate results

Decompression Program

An Injury Medical Spinal Decompression program incorporates:

Injury Medical Spinal Decompression Sessions

• Decompression treatment sessions last about 30-45 minutes for 4-6 weeks.
• The sessions are conducted in the chiropractor's office.

Post Decompression Treatment

• This is necessary to ensure that the injured areas are fully relaxed and conditioned for chiropractic manual adjustments.
• Massage therapy
• Percussive massage
• Cold laser
• Heat and/or ice
• These treatments facilitate blood and nerve circulation.

Chiropractic Adjustments

• Chiropractic adjustments enhance decompression by fine-tuning mechanical and structural misalignments.

Health Coaching

Supplements and essential vitamins:

• Support, repair, and restore the discs
• Decrease inflammation
• Increase healing

Core Strengthening/Postural Rehabilitation 

• Core exercises are recommended to strengthen the muscles and soft tissues.
• Posture exercises

Oxygen, water, and nutrients circulate abundantly, promoting healing as the discs re-hydrate, and are re-nourished, improving and enhancing spine function. Individuals can enjoy increased levels of mobility, strength in the spine and muscles, and more flexibility.

Descompresión Espinal Con La DRX9000

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care 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 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

American Spinal Decompression Association: "Spinal Decompression Therapy."

Daniel, D.M. Chiropractic and Osteopathy, 2007.

Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the official journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x

O'Hara K, editor. Decompression: a treatment for back pain. Vol. 11. National Association of Healthcare Professionals; 2004. pp. 1-2.http://www.naohp.com/menu/publications/mccu/bibliography.htm#10 [Google Scholar]

Any job-related back injury can significantly complicate an individual's life. Dealing with the pain, trying to figure out how to get things done while in recovery, and workers' compensation to protect individuals who are injured on the job, getting them healthy without the stress of worrying about losing money from missing work.

Job-Related Injury

According to the Occupational Safety and Health Administration or O.S.H.A, a job-related injury is one that either contributed to or is caused by something in the work environment that injures an individual or exacerbates/worsens a previous injury. This is a general overview of the definition, and there are some exceptions. For example, being at the place of work as a general public citizen and not working when an injury happens will not be covered. If not sure whether a back injury is job-related, it's better to be cautious and report the incident as soon as it happens.

Common Back Injuries

Back injuries are the most common job-related injuries. Back injuries are the number one reason individuals cannot work, whether they hurt their back at home or on the job. The Bureau of Labor Statistics found that nearly 40% of all musculoskeletal injuries that resulted in lost workdays were because of back injuries. The most common back injuries include:

• Sprains
• Strains
• Herniated Discs
• Whiplash
• Spinal Cord Injuries
• Vertebral Fractures

Compensation

Every state's workers' compensation program is different; however, the basic components are the same throughout. This means that if a workers' compensation claim is approved and an individual cannot work because of their injury, they can expect to receive a regular base salary during treatment, rehabilitation, and recovery. Individuals also continue to receive medical coverage through the company, while the workers' compensation fund should pay for treatment and diagnostics related to the injury.

When A Back Injury Occurs at Work

When a back happens at work, inform the employer as soon as possible. Do not be embarrassed or feel as it is not a big deal to seek workers' compensation.  It is an insurance program for both the individual and the employer. An employer pays into the state's workers' compensation program for limited liability when employees get injured. Individuals don't pay for the program, but it protects the individual in case something happens.

Letting an injury go untreated might not be anything at first, but months and years later, it can come back and be worse than when it first happened, causing greater damage, added medical costs, and procedures that the individual has to pay for out of their pocket. 

Once an individual knows they have a back injury, it is recommended to seek treatment as soon as possible to prevent worsening the injury or create new ones and develop a treatment, rehabilitation, and strengthening program. If an individual needs emergency care, tell the doctors about the work injury and precisely what happened. Emergency medical care should be sought out when:

• There is a loss of function in any of the limbs.
• There is a persistent numbness with the back pain.
• There is nausea, dizziness, or vomiting after the injury.
• There is a fever with back pain.
• Loss of consciousness.
• Loss of bowel or bladder control.

If the injury is not immediate and progresses gradually, but suspect that it is from work, it should be reported and examined by a medical professional.

Treatment

Proper treatment for a back injury depends on the severity of the injury. Those that prefer non-invasive, medication-free treatment are able to recover with chiropractic or physical therapy. Chiropractic doctors are experts in the spine and the musculoskeletal system. Chiropractic treatment is safe, proven, and can help relieve the pain, restore function, to get back to work safely.

Body Composition

Resistance Exercise

Resistance workouts are made to stress the muscles resulting in muscle gain. Resistance exercise makes the body adapt by growing the muscles to make them more capable of handling intense forces without strain. The stress of resistance exercise causes the muscle fibers to tear at the cellular level. Then, special muscle cells, known as satellite cells, jump into action to repair, rebuild, and grow the muscle. These types of exercises include high-intensity workouts or compound exercises that increase muscle growth. However, there needs to be a healthy balance between workouts and rest to support healthy hormone levels and maximize muscle gain.

Hormones

There are three primary hormones that stimulate muscle hypertrophy. They are:

• Insulin-like growth factor 1 IGF-1
• Growth hormone GH
• Testosterone

Muscle protein synthesis is a critical process in muscle hypertrophy and happens after weight training. The hormones signal to the muscle to repair and rebuild after workout sessions. GH is released in high quantities during sleep, which is why proper sleep is needed to help reach body composition goals. When nutrition, workouts, and hormonal effects are combined, muscle-building happens. Figuring out the right balance is essential for reaching health goals.

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

Burton, A K, and E Erg. "Back injury and work loss. Biomechanical and psychosocial influences." Spine vol. 22,21 (1997): 2575-80. doi:10.1097/00007632-199711010-00021

https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.5

https://www.bls.gov/opub/ted/2018/back-injuries-prominent-in-work-related-musculoskeletal-disorder-cases-in-2016.htm

Marjorie L Baldwin, Pierre Côté, John W Frank, William G Johnson, Cost-effectiveness studies of medical and chiropractic care for occupational low back pain: a critical review of the literature, The Spine Journal, Volume 1, Issue 2, 2001, Pages 138-147, ISSN 1529-9430, https://doi.org/10.1016/S1529-9430(01)00016-X.(https://www.sciencedirect.com/science/article/pii/S152994300100016X)

Randall, Sara. "1. Avoiding back injury." The practicing midwife vol. 17,11 (2014): 10, 12-4.