Spine Health & Spinal Hygiene

Intercostal muscles are the muscles within the rib cage, commonly called the intercostals, which connect the ribs and make up the chest wall. An intercostal muscle strain refers to an injury between two or more ribs. If these muscles become overstretched, restricted, or suffer damage, it can cause inflammation and significant pain in the middle and upper back. Intercostal muscle strain is a common injury in athletes and physically demanding jobs. Chiropractic care and massage therapy can realign the vertebrae with the ribs and loosen and relax the muscles to increase circulation and restore mobility and function.

Intercostal Muscle Strain

The intercostal muscles have different layers attached to the ribs to help build the chest wall and assist in breathing. There are 11 intercostal muscles on each side of the rib cage. Each set is located between connected ribs in the upper and mid-back and consists of the following:

External

• These are the outermost intercostals, responsible for expanding the chest during breathing to help inhale air and allow full deep breaths. 
• The external intercostals originate at the lower edge of a rib and run diagonally to attach to the upper edge of the rib below.
• They are found in the rib cage's back, sides, and front.

Internal

• These sit directly underneath the externals and help collapse the chest during breathing to exhale.
• The muscle fibers run perpendicular to the external intercostals, moving diagonally from front to back along the ribs, and are in the entire rib cage.

Innermost

• These sit directly underneath, run parallel to the internal intercostals, and run from the back of the rib cage to each side.
• The veins, arteries, and nerves lie between the internal and innermost intercostals.

When an intercostal muscle gets twisted, overused, or stretched too far, it can tear, causing muscle strain. Often radiating pain along the rib cage is experienced that extends to the back.

Causes

An intercostal muscle strain often occurs as the result of an injury or overexertion of the muscles. Common causes include:

• Trauma to the rib cage, such as from a fall or automobile collision.
• Impact trauma from sports or physical activities.
• Over twisting the torso beyond its normal range of motion from lifting weights, sports, yoga postures, or dance positions.
• Repeatedly reaching overhead for work or tasks like cleaning or painting.
• Lifting heavy objects above shoulder height.
• Repetitive torso movements.
• A sudden increase in physical activity that the body is not used to can also lead to intercostal muscle strain.
• This can happen when a lack of conditioning or unhealthy postures weaken muscles.

Symptoms

The signs and symptoms can vary, depending on the severity and cause. Symptoms can include:

• Intercostal muscle spasms.
• Mobility difficulties.
• Inflammation, swelling, and sensitivity in the affected area.
• Stiffness and tension, causing upper back pain.
• Upper back and rib pain.
• Tenderness in the area between the ribs.
• Muscle rigidity when bending or twisting the upper body.
• Gradual worsening pain after repetitive movements.
• Worsening pain when coughing, sneezing, or breathing in deeply.
• Severe and sudden pain, particularly if caused by direct trauma to the chest or back.

Chiropractic

Diagnosis involves the individual's medical history and a physical exam to check for movement limitations and assess affected and sensitive areas. Once the inflammation is reduced, chiropractic and physical therapy will focus on the following:

• Pain relief treatment.
• Breathing exercises.
• Posture training.
• Stretching under supervision.
• Strengthing exercises.
• Most cases fully heal within 6 to 8 weeks.

Rib Muscle Injury

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

De Troyer, A et al. "Mechanics of intercostal space and actions of external and internal intercostal muscles." The Journal of clinical investigation vol. 75,3 (1985): 850-7. doi:10.1172/JCI111782

Lord, Michael J, and William G Carson Jr. "Multiple Rib Stress Fractures." The Physician and sports medicine vol. 21,5 (1993): 80-91. doi:10.1080/00913847.1993.11947575

Morrison W. What is an intercostal muscle strain? Medical News Today. Jan 2020

Page P. Current Concepts in Muscle Stretching for Exercise and Rehabilitation. International Journal of Sports Physical Therapy. 2012;7(1):109-119.

Park, Kyung-hee, et al. "Difference in selective muscle activity of thoracic erector spinae during prone trunk extension exercise in subjects with slouched thoracic posture." PM & R: the Journal of Injury, Function, and Rehabilitation vol. 7,5 (2015): 479-84. doi:10.1016/j.pmrj.2014.10.004

Tran H. Causes of Intercostal Muscle Strain. Spine-health. October 2017

Yoo, Won-Gyu. "Effect of a combined thoracic and backward lifting exercise on the thoracic kyphosis angle and intercostal muscle pain." Journal of physical therapy science vol. 29,8 (2017): 1481-1482. doi:10.1589/jpts.29.1481

Yoo, Won-Gyu. "Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain." Journal of physical therapy science vol. 25,11 (2013): 1509-10. doi:10.1589/jpts.25.1509

When the body is correctly aligned, the shoulders are the same height, and face forward. Uneven shoulders are when one shoulder begins to raise higher than the other. It usually starts with a slight difference but can turn into a more severe imbalance causing discomfort, tightness, and pain in the neck, shoulders, hips, and back. Chiropractic treatment can bring the body back into balance and alignment through various techniques and therapy modalities.

Misaligned Uneven Shoulders

Several factors can lead to uneven shoulders. Misalignments can be caused by:

• Often the shoulder on the dominant side tends to be slightly lower.
• Constantly using one hand or side for everything.
• Carrying a heavy bag on the dominant shoulder.
• Structural issues or muscular skeletal imbalances in other areas of the body.

For example, if the ankle or hip gets injured, it can cause an individual to bring their body out of alignment to adjust to how they position themselves and move. Other common causes include:

• Overuse of the shoulders
• Tight upper back muscles
• Unhealthy posture
• Uneven hips
• Pinched nerve
• Weak muscles
• Flat feet
• Sedentary lifestyle
• Varying leg length
• Osteoporosis
• Scoliosis
• Shoulder injuries
• Incorrect sleeping position or sleeping on one side
• Sports like tennis, golf, and baseball have an increased risk of causing misaligned, uneven shoulders and posture imbalances.

Symptoms

Uneven shoulders can result in discomfort, tightness, and stiffness in the neck, shoulders, and lower back.

• Continued tightness and pulling in the higher shoulder.
• Rounded shoulders
• Headaches
• Head misalignment
• Hip misalignment
• Shifting pelvis
• Bursitis
• Tendonitis

Chiropractor

A chiropractic massage and functional medicine team will bring the shoulders back into normal alignment.

• Therapeutic myofascial release massage will release tension, relax the muscles, and increase flexibility.
• Chiropractic adjustments
• Spinal decompression therapy
• Stretches and muscle-building exercises to balance the shoulders.
• Lifestyle adjustment instructions for switching shoulders when carrying bags, using armrests, using the phone, using a mouse, and using ergonomic chairs.
• Posture training includes learning to stay aware of one's posture throughout the day when standing or sitting and completing regular activities.
• Learning to use the non-dominant arm to balance the workload.
• Incorporating relaxation, meditation, and breathing techniques relieve stress, tension, and tightness.

Shoulder Pain Treatment 

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make 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

Burbank, Kelton M et al. "Chronic shoulder pain: part I. Evaluation and diagnosis." American family physician vol. 77,4 (2008): 453-60.

Foroozan Mahmoodi et al. The effect of corrective exercises on the pain and degree of uneven shoulder deformity https://rsr.basu.ac.ir/article_625_en.html

Mayo Clinic Staff. (2017). Stress management. mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

Mitchell, Caroline, et al. "Shoulder pain: diagnosis and management in primary care." BMJ (Clinical research ed.) vol. 331,7525 (2005): 1124-8. doi:10.1136/bmj.331.7525.1124

Pu Chu, Eric Chun, and Kevin Hsu Kai Huang. "Bridging the gap between observation and brace treatment for adolescent idiopathic scoliosis." Journal of family medicine and primary care vol. 6,2 (2017): 447-449. doi:10.4103/jfmpc.jfmpc_52_17

Spinal cord injuries or SCI's don't just happen from intense force/high-energy trauma like hard falls or auto accidents. Non-traumatic spinal cord injuries are more common. However, traumatic spinal cord injuries tend to get the most attention. This can cause problems as it can delay treatment for individuals with a non-traumatic injury. Awareness is vital because spinal cord disorders tend to not get recognized for their impact on overall health.

Non-traumatic Spinal Cord Injury

Non-traumatic spinal cord injuries is an umbrella term that includes several disorders, like:

• Degenerative cervical myelopathy
• Degenerative spondylosis
• Rheumatoid arthritis
• Paget's disease
• Multiple sclerosis
• Metastatic cancer
• Developmental disorders like Spina Bifida and cerebral palsy
• Transverse myelitis
• Amyotrophic lateral sclerosis or Lou Gehrig's disease
• Friedreich's ataxia

Understanding these disorders helps determine a correct diagnosis. Degenerative cervical myelopathy or DCM is the most common form of a non-traumatic spinal cord injury. It is a slow progressive injury that causes continued compression usually brought on by spondylosis or osteoarthritis of the spine's joints. DCM can have a devastating effect on the quality of life if not diagnosed and treated as it can have a ripple effect by raising the risk of falls, leading to a traumatic spinal cord injury. Being aware can help in preventing the damage.

Other Causes and Complications

Other causes for non-traumatic spinal cord injury include:

• Nerve damage
• Blood supply loss to the spinal cord
• Compression from a tumor or blood clot
• Infection
• Spinal abscess
• Atherosclerosis

One of the most significant risk factors is age. This is due to an increased risk of conditions like osteoarthritis and hypertension as individuals get older, which is why individuals with a non-traumatic spinal cord injury are, on average, older than individuals that suffer a traumatic spinal cord injury. Weakness, instability, and loss of muscle control are common complications that can develop as the non-traumatic spinal cord injury progresses. Other complications that can present include:

• Chronic pain
• Sleep disturbance
• Constipation
• Urinary incontinence
• Urinary tract infections
• Impotence
• Pressure ulcers/bed sores if immobilized
• Possible blood clots that can lead to deep vein thrombosis
• Depression and anxiety

Treatment

With a traumatic spinal cord injury, treatment depends on the severity of the injury. With non-traumatic spinal cord injuries, treatment depends on what type of condition is involved. The primary treatment for non-traumatic spinal cord injuries typically involves various forms of rehabilitation to minimize further damage to the spinal cord. Surgery may be necessary if the spine needs to be decompressed.

Body Composition

Extracellular Water and Intracellular Water

Extracellular Water - ECW

• Extracellular is the water located outside the body's cells.
• The water in the blood falls into this category.
• Around 1/3 of the body's fluid is attributed to ECW, and this water is found in the interstitial fluid, transcellular fluid, and blood plasma.
• This water is important because:
• It helps control the movement of electrolytes.
• Allows oxygen delivery to the cells.
• Clears waste from metabolic processes.

Intracellular Water - ICW

• Intracellular is the water located inside the body's cells.
• It comprises 70% of the cytosol, which is a mix of water and other dissolved elements.
• It makes up the other 2/3 of the water inside the body.
• Intracellular water is important because:
• It helps in cellular processes.
• Allows molecules to be transported to the different organelles inside the cell.
• Picks up where the extracellular water leaves off by continuing the pathway for fuel/energy to be transported to the cells.

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

Badhiwala, Jetan H et al. “Degenerative cervical myelopathy - update and future directions.” Nature reviews. Neurology vol. 16,2 (2020): 108-124. doi:10.1038/s41582-019-0303-0

Handbook of Clinical Neurology (2012) "Spinal Cord Injury." https://www.sciencedirect.com/topics/medicine-and-dentistry/non-traumatic-spinal-cord-injury

Milligan, James et al. “Degenerative cervical myelopathy: Diagnosis and management in primary care.” Canadian family physician Medecin de famille canadien vol. 65,9 (2019): 619-624.

Physical Management in Neurological Rehabilitation (2004) "Spinal cord injury." https://www.sciencedirect.com/topics/medicine-and-dentistry/non-traumatic-spinal-cord-injury

Chiropractic treatment/care is a recommended pain relief option for musculoskeletal automobile, sports, personal - injuries, strains, sprains, pain, and rehabilitation. An initial chiropractic examination is similar to a standard examination administered by health care providers. What an individual can expect at their first consultation includes:

• Condition or pain symptoms
• Medical history 
• Physical examination
• Initial exams last around 45 minutes or more.
• Follow-up appointments are shorter.

Online Conference or Phone Call

Some chiropractors offer individuals an initial interview over a video conference and/or phone call. It is focused on discussion with topics like the chiropractors:

• Types of insurance taken
• Cost
• Types of forms to fill out
• Philosophy
• Expertise
• Specialization areas
• Approaches
• Techniques
• Individual's preferences

Initial Clinic Visit

The initial in-office clinical exam generally includes:

Patient History and Symptoms

The patient will be asked to fill out forms that can also be filled out online before the visit, saving a patient time if they so choose. This provides background information about symptoms and conditions in preparation for the in-person chiropractic consultation. Questions include:

• Did the pain start as a result of an auto, sports, personal, work injury?
• How did the pain start - activities, sports, work, etc.?
• When did the pain start - a few days, weeks, months, years?
• Where is the pain located?
• Does the pain spread out to other areas?
• Is the pain dull, sharp, burning, or throbbing?
• Does the pain come and go, or is it constant?
• What activities or body positions make it better and/or worse?
• Patients are also asked to provide information on pre-existing medical conditions, family medical history if necessary, prior injuries, and previous and current treatments provided by other medical professionals.

Physical Examination

A chiropractic examination includes:

• Reflexes
• Respiration
• Blood pressure
• Pulse

Certain orthopedic and neurological tests can also be used. These include:

• Range of motion
• Neurological integrity
• Muscle strength
• Muscle tone
• Walking gait
• Posture analysis

Diagnostic Studies

Based on the medical history and physical exam results, diagnostic studies could help reveal pathologies and identify structural abnormalities to diagnose more accurately. X-rays are the most commonly used during an initial chiropractic exam and are used to:

• Diagnose recent trauma
• Diagnose bone fractures
• Study spinal deformities

An MRI scan is recommended for soft tissue damage like a herniated disc, torn muscle/s, or nerve compression.

Patient Diagnosis after the Chiropractic Exam

All the findings from the medical history, physical exam, and diagnostic tests help the chiropractor form a diagnosis. Once the diagnosis is established, the chiropractor will discuss personalized treatment options.

Body Composition

Heart Disease

Many factors can contribute to heart disease, and research has pointed to inflammation caused by obesity as one of the most significant factors to its development. The main contributor is cytokines produced by excess body fat. Cytokines cause inflammation in the walls of the arteries causing damage and increasing pressure. Blood pressure is the force of blood pushing against the walls of the vessels. High blood pressure means that the heart is not pumping blood effectively, and the heart begins to enlarge. An enlarged heart is a significant risk factor that can lead to heart failure if interventions are not taken to repair the damage.

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

Jenkins HJ, Downie AS, French SD. Current evidence for spinal x-ray use in the chiropractic profession. Chiropr Man Therap. 2018; 26:48.

Wang, Zhaoxia, and Tomohiro Nakayama. “Inflammation, a link between obesity and cardiovascular disease.” Mediators of inflammation vol. 2010 (2010): 535918. doi:10.1155/2010/535918

Weeks, William B et al. “Public Perceptions of Doctors of Chiropractic: Results of a National Survey and Examination of Variation According to Respondents' Likelihood to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply in Local Health Care Markets.” Journal of manipulative and physiological therapeutics vol. 38,8 (2015): 533-44. doi:10.1016/j.jmpt.2015.08.001

Chiropractic manipulation under anesthesia also known as M.U.A is a non-invasive stretching and musculoskeletal manipulation technique. This type of chiropractic treatment can offer relief from chronic and constant back pain along with other types of pain that have not responded well or at all to conservative non-surgical care. Chiropractic manipulation under anesthesia breaks up adhesions/internal scar tissue that could be a result of an injury or previous surgery, helping restore the normal range of motion and reduce pain. This technique is utilized to treat:

• Back pain
• Neck pain
• Joint pain
• Muscle spasms
• Long-lasting pain syndromes

Adhesions can grow around:

• Spinal joints
• Nerve roots
• Inside the surrounding muscles

This can result in restricted:

• Movement
• Limited flexibility
• Pain

Undergoing chiropractic manipulation under anesthesia while sedated means the body is in a highly relaxed state. This sedation allows the chiropractor to adjust the bones, joints into proper alignment and stretch the muscles without the individual’s voluntary/reflexive resistance. And the sedation allows the chiropractor to use less force making the procedure painless.

Manipulation Under Anesthesia Specialists

This type of manipulation is a specialty procedure. It is only performed by trained and certified physicians in the fields of:

• Chiropractic medicine
• Orthopedics
• Physical therapy and rehabilitation
• Osteopathy

Advantages to MUA treatment

There are individuals with pain that respond well to regular chiropractic manipulation, physical therapy, or exercise. However, depending on their condition, relief might only last for a few days or weeks. This is where manipulation under anesthesia could be more successful in improving the range of motion and relieve pain. Manipulation under anesthesia has been performed for more than sixty years. It can be cost-effective and safer than invasive treatment like spine surgery. It is recognized and covered by most insurance and workers’ compensation plans.

Determining if MUA is right for the individual and their condition

Manipulation under anesthesia is not for all individuals with back pain. Just like any other type of recommended treatment, a doctor will very carefully consider the individual’s medical history, symptoms, previous treatments, and effectiveness. MUA is only recommended for patients that meet the procedure’s criteria. Combined with an individual's complete medical history, a doctor will also perform a physical and neurological examination. Test results will confirm the patient’s diagnosis and determine if anesthetic manipulation can help relieve pain and other symptoms. Tests can include:

• X-ray
• MRI
• CT scan
• A musculoskeletal sonogram uses sound waves to produce images of muscles, tendons, ligaments, and joints
• EKG - electrocardiogram is a test that checks for problems with the heart’s electrical activity
• Nerve conduction velocity test sees how fast electrical signals move through the nerve/s
• Pregnancy test

Consideration for individuals with:

• Pinched or entrapped nerve
• Chronic/Persistent neck or back pain
• Painful, restricted range of motion
• Failed back surgery syndrome
• Chronic sprains and strains
• Acute muscle spasms
• Fibromyalgia
• Chronic spinal disc conditions
• Fibrous adhesion/s

Not an appropriate treatment for individuals with:

• Uncontrolled diabetic neuropathy
• Spinal cord compression
• Morbid obesity
• Any type of cancer
• Acute or healing bone fracture/s
• Osteomyelitis vertebral bone infection
• Acute inflammatory arthritis
• Metastatic bone disease
• Severe osteoporosis
• Acute inflammatory gout
• Tuberculosis of the bone
• Co-existing medical problems could mean an individual may not be able to undergo any procedure that requires sedation
• Another reason why a patient’s complete medical history is vital

Procedure

This procedure is usually performed in an ambulatory surgery center that is a modern health care facility that is focused on providing same-day surgical care, for diagnostic and preventive procedures or at a hospital. An anesthesiologist administers the medicine/s. The patient could be sedated but not unconscious or general anesthesia meaning complete unconsciousness. The choice of sedation depends on a variety of factors, like the patient’s diagnosis and how severe the condition is. The anesthesiologist can recommend a specific type of medicine or a cocktail of medications for the patient's comfort during and after.

Once sedated, the chiropractor utilizes specialized techniques to stretch, adjust and mobilize the affected areas of the spine and body. The manipulations free up fibrous adhesions or scar tissue in one or more areas of the spine and surrounding tissues. The procedure usually takes 15 to 30 minutes. The individual will be awakened and then is carefully monitored in a recovery area. Many report an immediate reduction in pain and a broader range of motion after the procedure. There is usually temporary muscle soreness, similar to the soreness after an intense workout.

Recommended aftercare

Before being discharged, the patient is provided instructions about aftercare therapy. Instructions may include:

• At-home warm-up movements
• Physical therapy rehabilitation
• Passive stretching
• Electrical stimulation
• Cryotherapy or cold therapy to reduce inflammation and pain

Sessions necessary

Depending on the diagnosis and response to the initial session, manipulation under anesthesia could be performed on consecutive days or two to four days sequentially. With each session, the chiropractor adjusts a little more, incrementally helping achieve the desired increase in movement and pain reduction/alleviation.

Physical therapy, exercise, and stretching

Three to six weeks after the procedure individuals continue with physical therapy to help prevent back pain from returning and any fibrous adhesions/scar tissue that was broken up from reforming. Exercise and stretching will help strengthen and stabilize the abdominal and spinal muscles and prevent pain from returning.

InBody

Malnutrition

Malnutrition is defined as a lack of uptake or intake of nutrition that can affect body composition in a negative way. These complications can affect how the body responds to diet and exercise. An important nutrient that elderly individuals might not get enough of is protein. Trouble chewing, food cost, and trouble cooking are all factors that limit elderly individual’s access to protein, which can lead to sarcopenia.

That is because protein requirements for the elderly are usually higher than younger individuals. This comes from age-related changes in the metabolism that includes a decreased response to protein intake. This means that an older individual needs to consume more protein to achieve the same anabolic effect. 

Micronutrient deficiency is a lack of nutrients, like minerals and vitamins. These support important bodily processes like cell regeneration, immune system function, and vision. A common example is iron and calcium deficiencies. This type of deficiency has the greatest impact on normal physiological functions that can occur in conjunction with protein-energy deficiency as most micronutrients are acquired from food.

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

https://pubmed.ncbi.nlm.nih.gov/?term=manipulation+under+anesthesia+chiropractor

Back or disc pain is becoming increasingly common for individuals of all ages. The spinal discs are prone to injury because of the extreme amount of pressure/stress placed on the lower back and neck. Fortunately, most cases of back pain heal on their own, while others can cause long-term chronic pain that can be difficult to manage, without proper treatment.

Different types of pain can be caused by problems with the spinal discs. The spinal discs are elastic sections of the spine that sit between the vertebrae. They are made up of materials called annulus fibrosus on the outside and a gel-like material called nucleus pulposus on the inside.

These discs are flexible, which allows for a range of motion to the spine and body shock absorption to increase comfort when in motion. When an individual visits a chiropractor, the practitioner will not know the exact cause of the pain, but only that it hurts around a certain area. Our spinal experts will help individuals understand the different types of ailments or conditions that could be affecting the spine. Then a customized treatment plan can be developed.

Disc problems

Spinal disc pain has two major sources of pain related to spinal discs: They are disc degeneration and nerve root pain. They are most common in the neck and the lower back. Individuals need to be informed of the difference to understand what is happening with the spine and potential treatment options to alleviate the pain and heal the problem.

Degenerative disc disease

Degenerative disc disease is when the spinal discs begin to dry out and deteriorate. The discs start to shrink and can tear, which leaves that segment with little or no cushioning. This can cause pain, as well as inflammation of the surrounding muscles and joints. Disc degeneration usually presents with low levels of consistent pain and occasional severe flare-ups.

A chiropractor can utilize spinal manipulation to restore alignment, function, and mobility of the affected joint. Massages stretches and exercises will help alleviate the tension in the surrounding muscles along with strengthening them for better support.

Nerve root pain

Nerve root pain does not take place within the disc but is usually caused by a bulging or herniated disc. This condition can be called a slipped disc or pinched nerve, affect the nerves that are in close proximity to the neck and lower vertebrae.

The pain can lead to numbness, tingling, and weakness along the path of the nerve, and radiate out to the arms and legs. A bulging disc is when the spinal disc progressively protrudes through a narrow opening.

This can irritate any nearby nerve roots causing inflammation and pain. If the disc herniates or breaks through then the outer protective material tears, letting the cushion/gel leak out and come in contact with the nerve root/s, which could also cause pinching and inflammation. Treatment for a bulging or herniated disc includes:

• Spinal manipulation
• Corrective exercises
• Physical therapy
• Massage
• Diet adjustments

These treatments can help realign the disc/s, moving them away from any nerves, and minimizing inflammation.

Proper Identification and Diagnosis

Spinal disc problems can be similar in their pain and symptoms. For example, degenerative disc disease can weaken the spinal discs to such a degree that nerve root pain follows creating a dual combination of pain. The conditions require various approaches and treatment methods often done in combination. However, they require a proper diagnosis to create a proper and custom treatment program for every individual. This will ensure the root cause of the disc pain is properly identified and handled. Call us to learn more.

Low Back Pain Treatment

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Browning, J E. “Chiropractic distractive decompression in the treatment of pelvic pain and organic dysfunction in patients with evidence of lower sacral nerve root compression.” Journal of manipulative and physiological therapeutics vol. 11,5 (1988): 426-32.

Reduce stress, reduce pain. Life creates stress, and while some stress can be good, too much causes health problems. Everyone experiences stress. However, now it is becoming a new normal in today’s hectic, fast-paced, high-pressure society. Most individuals equate stress with high blood pressure, heart attacks, or stroke. However, neck and back pain, insomnia, and weight gain can be stress-related, as well. And a lot of stress can make already-existing back/neck pain worse.

73% of individuals report experiencing stress-related psychological symptoms including anxiety and depression. These are not accurate numbers because most do not seek help for their stress issues. Stress symptoms should not be taken lightly. It is important to address the symptoms and find ways to reduce stress. Chiropractic is an effective stress reliever.

Stress

Financial pressures, kids, long work weeks, and medical problems are common anxieties. Prolonged stress can become chronic, which results in muscle tension that can feel stiff, achy and uncomfortable. Stress can develop into neck or back pain.

Stress is the state of:

• Emotional
• Mental
• Pressure
• Tension

That results from difficulties, adverse situations, or extremely demanding circumstances. The very nature of stress by definition makes it very subjective. A "stressful" situation for one person might not phase another. This makes it difficult to pin down a precise definition.

More often, the term stress is more often used to describe the set of symptoms that are caused by stress and those symptoms can be as varied as the people who experience them. 

Symptoms

Stress symptoms can affect the entire body physically and mentally. Common symptoms include:

• Anxiety
• Chest pain
• Depression
• Fatigue
• Gastrointestinal problems
• Irritability
• Lower back pain
• Muscle tension
• Overeating
• Headache
• Restlessness
• Sleep problems
• Unable to focus
• Undereating

Health

Technically, stress itself does not have a negative impact on health. Some individuals deal with situations that others would consider to be stressful, yet they never exhibit symptoms. This speaks to the subjective nature of stress. Different people experience different symptoms and are a combination of stress symptoms, how the person handles those symptoms that adversely affect health.

Ultimately, stress symptoms can lead to some very serious conditions including:

• Heart disease
• Hypertension
• Diabetes
• Obesity
• Cancer/s

Psychologically, it can lead to social withdrawal and social phobias and is directly linked to alcohol and drug abuse. 

Tips

These can help you reduce stress, and reduce pain.

Vital Signs

• Get a medical checkup if possible through Telemedicine and talk to a doctor/therapist about your stress, along with medical history. Side effects from medications (prescription or over-the-counter), herbal products, or other supplements can cause restlessness, insomnia, and anxiety.
• Physical therapy combines pain-relieving non-invasive treatments with therapeutic exercise, posture correction, and preventive body mechanics.
• Consider conversational therapy with a stress counselor, psychologist, or support group online.

Get Moving

• Yoga and relaxation movements help reduce stress and stretch muscles. Viniyoga blends breathing and movement together to quiet body and mind. These movements are less precise and adapted to a person's physical condition. Talk to a doctor about trying yoga or other stretches.
• Swimming combined with a sauna or steam bathing can relieve stress-induced pain.
• Take frequent stretch breaks to loosen up tight neck or back muscles.
• Go for short walks at break or lunchtime to get the circulation going.

Learn to Relax

• Kick back, put your feet up, and empty your mind of everything.
• Wrap an ice pack and hot pack (or hot water bottle) individually in towels. Apply the ice pack for 10 minutes and then the hot pack for 5 minutes. Alternate several times.
• Massage, aromatherapy and spa treatments you can do at home.
• Aromatic massage oils containing eucalyptus can help ease muscle pain.
• Meditation or visualization therapy combines meditation practices that focus on breathing and calming the mind.
• Visualization techniques combine imagery with breathing exercises.

Take Control of the Little Things

• Break up problems into smaller manageable pieces and work on resolving the easier parts first.
• Learn your limits, how to delegate responsibility and not take the entire load on your shoulders so as not to get overwhelmed.
• Allow yourself to fail, we all have to fail in order to learn in order to apply what was learned.

Eat and Drink for Life

• Make mealtime less stressful. Pick nourishing foods, eat slowly, and savor each other's company.
• Caffeinated coffee, soda, and other drinks do not help reduce stress or promote restful sleep.
• Avoid drinking at night because it can make falling and staying asleep a challenge.
• Proper sleep or naps can help relieve stress.

Dealing with Stress Is Good for Your Back

We may not be able to control life's stressors, but don't let everyday demands interfere with your health. Incorporate exercise, relaxation techniques, and healthy foods to reduce stress and pain and promote stress prevention.

Reduce stress reduce pain with chiropractic

Chiropractic cannot get rid of stress, but it can help relieve stress symptoms. The more stress the body endures, the more sensitive it becomes to pain and physical imbalances. Chiropractic helps by bringing the body back into balance, aligning the spine, and relieving pain.

The simple act of aligning the spine helps relieve stress in the body that you may not even be aware of. The physical stress of a misaligned spine can exacerbate symptoms and make a person more susceptible to stressful stimuli in their environment. Chiropractic helps to improve circulation which is essential in relieving muscle tension and helps shuts down the fight or flight response allowing the body to rest and heal.

Migraine Pain Treatment

Everyone needs to take care of their back/spine because it is what holds us up as long as we keep it straight and strong. Strengthening the core can help prevent a weak and misaligned spine from getting worse and helps to eliminate pain. 

Back safety should be priority one, as it affects all aspects of your life. Not only are you protecting your back, but are preventing future injury. From the time you wake until bedtime, here are some tips for changes in sleeping position, and getting in and out of a car.

We all need to pay attention to proper body positioning and body mechanics, as it will pay off in the long run.

Getting In and Out of Bed

This is usually the time when the pain starts and can make the rest of the day miserable. Here are a few tips that can help.

• Lean forward from your hips, not from your back.
• Try not to arch your back.
• Push your upper body off the bed with your elbows and hands and swing both legs to the floor.
• Keep your back straight.
• Try not to bend at the waist.

Position for Sleeping

Sleep is very important. Finding a comfortable position while sleeping can be tough, especially with back pain. Using quality pillows in the right way can help provide comfort, support for your neck and back and keep you asleep.

• Sleeping on your back is optimal but you should bend your legs and place a pillow under your knees allowing for optimal blood circulation.
• Do not sleep on your stomach, as this places pressure on the pelvis and the lower back because there is no support underneath. If you must sleep like this try to keep it for a short while before changing position and place a pillow or two underneath for support.
• A firm mattress can help keep your spine in line. But talk to a doctor or chiropractor to find out what style of mattress would benefit your back.
• Rotate your mattress every three months and flip it over twice a year.

Take Care When Entering/Exiting an Automobile

Getting in and out of a car can be a tough challenge when dealing with back pain. Here are a few tips to help.

• When getting in or out move the seat back as far as it goes, hold onto the side of the car, back of the seat, or the dashboard for support when lifting yourself out or when easing into the seat.
• Bend at the knees, not the back and avoid twisting and turning to reach for objects, etc.
• The use of proper body mechanics keeps the muscles working properly.
• Use both arms and legs when raising and lowering yourself in and out of the seat.
• Keep your body aligned and only turn your body as much as needed.

The key is to be aware of your posture and safety awareness.

Daily living including sports and household chores should be done with overall and spinal safety in mind.

Whatever positions work for you and your regular activities bending, retrieving, lifting, and carrying objects, using correct techniques combined with proper posture will take care of your neck and back.

Chronic Pain Relief | El Paso, Tx (2020)

NCBI Resources

Chiropractic can take care of your spine which means it is good for your overall health. While many people think that its only purpose is to treat back pain, chiropractic focuses on total body wellness. All too often problems within the body are interrelated. For instance, back pain could be the result of an altered gait due to an ankle injury.  A misaligned neck could cause a headache due to awkward sleep positions (or even the wrong pillow).

There are those that can predict approaching storms, and weather change based on the way, their joints behave.

Similarly, individuals with chronic back pain can at times sense a change in how they feel when the weather shifts.

The connection between weather and back pain is not fully understood but here are a few beliefs on why people feel pain based on the season/weather.

There is not a great deal of research on weather's effects on spinal conditions. said Dr. Alexander Jimenez, D.C. in El Paso, Texas.

Some spinal conditions have been shown to have a clear link to cold weather. An example is sciatica patients that would experience worsened pain when the weather would shift.

Chiropractor Alexander Jimenez breaks down how weather can affect back pain and explains six ways to help weather-related back pain.

Weather and Osteoarthritis

Dr. Jimenez talks of a study that examined joint pain differences between older people with osteoarthritis that were weather-sensitive versus those who also had osteoarthritis but were not weather-sensitive.

More than two-thirds said weather affected their osteoarthritis pain

Researchers found that weather sensitivity and pain:

• More prevalent among women
• People with anxiety conditions

Weather and season change alters how we feel mentally and emotionally.

That link is definitely true between depression and back pain.

Dr. Jimenez sees the shift in spine health from the hot summer months into the cold ones and that is when the health problems peak.

Winter brings cloudier weather, and that increases melatonin from the brain, which causes drowsiness and less energy.

Sunlight increases serotonin, which causes feelings of happiness.

Cold, dark, winter weather can deplete energy and makes people stay indoors. This is not good because being outside, involved in activity and exercise definitely helps with joint pain.

Staying inside and not moving will worsen pain and possibly lead to severe conditions.

When the seasons begin to change, it also brings to realization the holiday season, which can cause all kinds of:

• Anxiety
• Stress
• Tension

The holiday season can cause major stress, and the changes in weather are a reminder of that upcoming stress.

Theories

A common theory suggests that when the temperature drops it affects the viscosity of the synovial fluid in the joints.

This could be one of the reasons why people with spinal joint pain experience flare-ups during the cold shift.

Dr. Jimenez says that the structures within your:

• Joints
• Tendons
• Ligaments
• Muscles
• Connective tissues

All have different densities and react differently to temperature changes.

In the cold, some connective tissues are looser than others.

So those that are tighter take longer to warm up, and if not then there is a perfect set-up for joint dysfunction.

Another theory is that barometric pressure is what causes the pain. This theory supports people with joint pain that can tell when it’s about to rain.

Some rheumatologists believe the joint capsule and tissues around the joint are like a balloon.

The barometric pressure squeezes this balloon, causing the balloon to expand/inflammation that causes pain.

Moving to Warmer Climate

• Mental
• Emotional
• Physical

Factors play into how pain affects the individual and moving to a sunny place is not necessarily the answer.

Dr. Jimenez says that warmer climates have been thought to be healthier for various conditions.

In a sunny climate, one is likely to be in the sun, being active physically/mentally,  getting plenty of vitamin D, which is good for bones and joints and makes for a good mood all around.

But moving to a warm climate isn’t always an option, so lifestyle changes can do the trick.

Clinical treatments, like infrared sauna, can bring the sun's benefits during dark winter days.

People with chronic pain have said they feel pain-free and relaxed after sitting in an infrared sauna.

An infrared sauna does not give off ultraviolet rays, but healthy light.

The light penetrates into the tissues, warms the body, and makes the connective tissue stretchier and looser, which moves easier and doesn't hurt.

6 Tips

There is no need to move to a sunny climate.

Dr. Jimenez says you can minimize the weather’s effects with these tips:

Diet

Dr. Jimenez recommends reducing consumption of inflammation-inducing foods like:

• Red meats
• Fried foods
• Sugars
• Processed starches

Quitting smoking tobacco is essential for finding pain relief.

Proper Hydration

Alcoholic beverages dehydrate and can worsen depression and anxiety.

Dr. Jimenez says drinking plenty of water is important for the spine, and is often overlooked by the senior community.

Older adults don't have an active thirst like a young person, and can, therefore, dehydrate rapidly.

Stay Warm

Layer clothing or keep the house warm.

Keep a humidifier running with the heater to prevent respiratory problems caused by the dry heat.

Get Into The Sun Regularly

Natural light helps wards off depression, and it improves productivity in the workplace

Exercise

Physical activity plays a huge part in particularly with low back conditions, walking, which he said engages the postural muscles in the spine.

Dr. Jimenez personally sees the benefits of this: When I’m working out, I don’t feel my hip pain. And I continue because I know that I'm strengthening my body for the better, especially since I help others with their pain.

Hobbies Can Help

A hobby creates a diversion from the pain and releases endorphins, the body's natural painkillers.

A hobby allows you to focus on something else besides the pain.

Depression and Chronic Pain | El Paso, Tx

Chronic pain caused by injuries and/or aggravated conditions can often be one of the main causes of depression in patients. When painful symptoms cause patients to struggle with their everyday physical activities, their mental health can be tremendously affected. Chiropractic care utilizes spinal adjustments and manual manipulations which can help restore the original integrity of the spine. Patients describe how chiropractic care has helped them recover their quality of life and they highly recommend Dr. Alex Jimenez, chiropractor, as the non-surgical choice for chronic pain and depression, among a variety of other common health issues.

The spine is comprised of vertebrae, small bones that are stacked on top of each other with impact cushioning discs between each one. These bones act as joints, allowing the spine to bend and twist in a variety of ways.

However, it is not intended to be naturally bent, twisted, or curved. The natural state of a healthy spine is somewhat straight with slight curves running front to back so that a side view would reveal them.

They gently curve, sloping slightly inward at the small of the back, and again slightly at the neck. The pull of gravity, combined with body movement, can put a great deal of stress on the spine and these slight curves help absorb some of the impact.

Viewing the spine from the back, you should see something completely different – a spine that runs straight down, top to bottom with no side to side curves. This doesn’t always happen though.

Sometimes there are abnormalities of the spine and it causes a misalignment of the natural curvatures or some curvatures may be exaggerated. These unnatural curvatures of the spine are characterized by three health conditions called lordosis, kyphosis, and scoliosis.

Three different conditions for three different types of spinal curvatures

Each of these three spinal curvature disorders affects a certain area of the spine in a very specific way.

• Hyper or Hypo Lordosis – This spinal curvature disorder affects the lower back, causing the spine to curve inwards or outwards significantly.
• Hyper or Hypo Kyphosis – This spinal curvature disorder affects the upper back, causing the spine to bow, resulting in that area rounding or flattening abnormally.
• Scoliosis – This spinal curvature disorder can affect the entire spine, causing it to curve sideways, forming a C or S shape.

What are the symptoms of spinal curvature disorders?

Each type of curvature exhibits its own set of symptoms. While some symptoms may overlap, many are unique to the specific curvature disorder.

• Lordosis
  • A “swayback” appearance where the buttocks stick out or are more pronounced.
  • Discomfort in the back, typically in the lumbar region
  • When lying on a hard surface on the back, the lower back area does not touch the surface, even when attempting to tuck the pelvis and straighten the lower back.
  • Difficulty with certain movements
  • Back pain
• Kyphosis
  • A curve or hump to the upper back
  • Upper back pain and fatigue after sitting or standing for long periods (Scheuermann’s kyphosis)
  • Leg or back fatigue
  • The head bends far forward instead of being more upright
• Scoliosis
  • Hips or waist are uneven
  • One shoulder blade is higher than the other
  • The person leans to one side 

What are the causes of spinal curvature disorders?

Many different health issues can cause the spine to become misaligned or to form a spinal curvature. Each of the spinal conditions mentioned is affected by different conditions and situations.

• Lordosis
  • Osteoporosis
  • Achondroplasia
  • Discitis
  • Obesity
  • Spondylolisthesis
  • Kyphosis
• Kyphosis
  • Arthritis
  • Tumors on or in the spine
  • Congenital kyphosis (abnormal development of the vertebrae while the person is in utero)
  • Spina bifida
  • Scheuermann's disease
  • Spine infections
  • Osteoporosis
  • Habitual slouching or poor posture

Scoliosis is still a bit of a mystery to doctors. They are not certain what exactly causes the most common form of scoliosis that is typically seen in children and adolescents. Some of the causes that they have pinpointed include:

• Hereditary, it has a tendency to run in families
• Infection
• Birth defect
• Injury

Chiropractic for spinal curvature disorders

Spinal manipulations for spinal curvature disorders have been shown to be very effective. Chiropractic helps restore the spine’s natural balance even if the patient has one of these types of conditions.

There are screenings available for both children and adults to identify any spinal curvatures in their early stages through your chiropractor. Early detection of these disorders is crucial in identifying them before they become too serious.

Spine Treatment Chiropractor | El Paso, Tx (2019)