Spine Health & Spinal Hygiene

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

Neck Pain Traction Device

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

Traction

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

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

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

Home Traction Devices

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

Setting Up The Device

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

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

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

How Long to Use

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

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

Neck Injuries

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

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

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

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

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

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

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

Laser Spine Surgery

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

How It Works

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

Surgical Risks

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

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

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

Purpose

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

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

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

Preparation

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

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

Expectations

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

Before Surgery

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

During Surgery

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

After Surgery

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

Recovery

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

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

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

Process

Optimal recovery recommendations include:

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

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

The Non-Surgical Approach

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

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

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

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

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

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

"For individuals trying to maintain a healthy spine, can understanding the causes and prevention of rotated vertebrae help protect the spine from harmful rotation of vertebrae?"

Spinal Rotation

Healthy spine rotation is an important aspect of injury prevention, and rotated vertebrae or a twisted spine can result from spine, nerve, or muscle disease or certain movements.

Normal Spine Twisting Capability

The spine can move in several ways. Spine movements include:

• Bending  - Rounding forward
• Extending - Arching backward
• Tilting sideways is powered by muscles that aid in twisting.

Although the spine can move in many directions, there are limits to how far it can and should go. (Xinhai Shan et al., 2013). This is especially true with twisting. The spinal column is made of 26 interconnected bones called vertebrae. When moving, each vertebrae bone moves accordingly. Rotated or twisted vertebrae, especially when bending forward like lifting heavy objects, are associated with a risk of back injuries like strain and herniated discs.

How Rotation Works

Rotation is a basic movement in which individuals can turn their spinal column. When twisting, the spine also bends to the side. The muscles involved in spine rotation include:

• The internal oblique abdominals and the external oblique abdominals don't directly attach to the spine but are the primary muscles responsible for powering spinal rotation in the lower back.
• Intrinsic muscles, including the multifidus and longissimus, contribute to twisting movement as well.
• The multifidus helps the spine twist when one side is contracted/activated and extends the lumbar spine when both sides contract.
• The multifidus helps control the movement, and the longissimus provides the movement with some extension.

Age and The Spine

As individuals age, the body accumulates tension and/or weakness in the oblique abdominal and other trunk muscles. Sedentary habits primarily bring on these changes. (Pooriput Waongenngarm et al., 2016)

• Chronically tight back and abdominal muscles impair the range of motion of the trunk, as well as twisting ability.
• Muscle weakness and tightness affect spinal movements.
• Weakened muscles can decrease support for spinal movement and decrease overall trunk stability.

Spinal Rotation and Scoliosis

Scoliosis is a common condition that causes a lateral curve of the spine. Some of the vertebrae become displaced to the side. Often, abnormal vertebral rotation underlies this displacement. Treatment often focuses on controlling vertebral rotation with medical guidance and physical therapy. (John P. Horne et al., 2014)

Over-Rotating The Spine

Many individuals over-rotate their spines with manual work, which can increase the risk of back injuries. (National Institutes of Health. 2020). Over-rotation can happen with activities like digging or shoveling.

Exercise For A Healthy Spine

A recommended way to achieve optimal rotation of the spine is with daily back exercises. (National Spine Health Foundation. 2015). An effective back exercise program will consist of movements in every direction.

• Yoga is recommended because it places emphasis on developing flexibility and strength in all directions.
• Pilates does the same.
• An injury prevention exercise program will work the hip and pelvic muscles as well.
• Individuals with a spine condition should consult their healthcare provider or physical therapist about how to exercise the spine safely, as rotation exercises could worsen back problems like bulging or herniated discs.

Core Strength For A Pain-Free Back

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 discuss the subject matter above further, 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

Shan, X., Ning, X., Chen, Z., Ding, M., Shi, W., & Yang, S. (2013). Low back pain development response to sustained trunk axial twisting. 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, 22(9), 1972–1978. https://doi.org/10.1007/s00586-013-2784-7

Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and health at work, 7(1), 49–54. https://doi.org/10.1016/j.shaw.2015.08.001

Horne, J. P., Flannery, R., & Usman, S. (2014). Adolescent idiopathic scoliosis: diagnosis and management. American family physician, 89(3), 193–198.

National Institutes of Health. (2020). Low Back Pain Fact Sheet.

National Spine Health Foundation. (2015). Breaking Down The Exercises That Break Down Your Spine.

"Various problems with the sacrum make up or contribute to a significant portion of lower back problems. Can understanding the anatomy and function help prevent and treat back injuries?"

The Sacrum

The sacrum is a bone shaped like an upside-down triangle located at the base of the spine that helps support the upper body when sitting or standing and provides pelvic girdle flexibility during childbirth. It comprises five vertebrae that fuse during adulthood and connect to the pelvis. This bone takes and endures all of the body's pressure and stress from everyday activities and movements.

Formation

Humans are born with four to six sacral vertebrae. However, fusion does not take place in all sacral vertebrae simultaneously:

• Fusion starts with the S1 and S2.
• As the individual gets older, the overall shape of the sacrum begins to solidify, and the vertebrae fuse into a single structure.
• The process usually starts in the mid-teens and finishes in the early to mid-twenties.
• It is believed to start earlier in females than males.

The timing of the fusion can be used for estimating the age and sex of skeletal remains. (Laura Tobias Gruss, Daniel Schmitt. et al., 2015)

1. The sacrum in a female is wider and shorter and has a more curved top or the pelvic inlet.
2. The male sacrum is longer, narrower, and flatter.

Structure

The sacrum is an irregular bone that makes up the back/posterior third of the pelvic girdle.  There is a ridge across the front/anterior portion of the S1 vertebra known as the sacral promontory. Small holes/foramen on both sides of the sacrum are left over after the vertebrae fuse together. Depending on the number of vertebrae, there can be three to five foramen on each side, though there are usually four. (E. Nastoulis, et al., 2019)

1. Each anterior foramen is typically wider than the posterior or dorsal/backside foramen.
2. Each sacral foramina/plural of foramen provides a channel for the sacral nerves and blood vessels.

• Small ridges develop between each of the fused vertebrae, known as transverse ridges or lines.
• The top of the sacrum is called the base and is connected to the largest and lowest of the lumbar vertebrae - L5.
• The bottom is connected to the tailbone/coccyx, the apex.
• The sacral canal is hollow, runs from the base to the apex, and serves as a channel at the end of the spinal cord.
• The sides of the sacrum connect to the right and left hip/iliac bones. The attachment point is the auricular surface.
• Right behind the auricular surface is the sacral tuberosity, which serves as an attachment area for the ligaments that hold the pelvic girdle together.

Location

The sacrum is at the level of the lower back, just above the intergluteal cleft or where the buttocks split. The cleft starts at around the level of the tailbone or coccyx. The sacrum is curved forward and ends at the coccyx, with the curvature being more pronounced in females than males. It connects to the L5 lumbar vertebra by way of the lumbosacral joint. The disc between these two vertebrae is a common source of low back pain.

1. On either side of the lumbosacral joint are wing-like structures known as the sacral ala, which connect to the iliac bones and form the top of the sacroiliac joint.
2. These wings provide stability and strength for walking and standing.

Anatomical Variations

The most common anatomical variation applies to the number of vertebrae. The most common is five, but anomalies have been documented, including individuals with four or six sacral vertebrae. (E. Nastoulis, et al., 2019)

• Other variations involve the sacrum's surface and curvature, where the curvature differs widely between individuals.
• In some cases, the first and second vertebrae do not fuse and remain separately articulated.
• Failure of the canal to completely close during formation is a condition known as spina bifida.

Function

Studies on the sacrum are ongoing, but some proven functions include:

• It serves as an anchor point for the spinal column to attach to the pelvis.
• It provides stability for the body's core.
• It acts as a platform for the spinal column to rest on when sitting.
• It facilitates childbirth, providing pelvic girdle flexibility.
• It supports upper body weight when sitting or standing.
• It provides extra stability for walking, balance, and mobility.

Conditions

The sacrum can be a main source or focal point for lower back pain. It is estimated that 28% of men and 31.6% of women aged 18 years or older have experienced low back pain in the past three months. (Centers for Disease Control and Prevention. 2020) Conditions that can cause sacrum pain symptoms include.

Sacroiliitis

• This is a common condition of sacroiliac/SI joint inflammation.
• A doctor only makes the diagnosis when all other possible causes of pain have been ruled out, known as a diagnosis of exclusion.
• Sacroiliac joint dysfunction is thought to account for between 15% and 30% of low back pain cases. (Guilherme Barros, Lynn McGrath, Mikhail Gelfenbeyn. 2019)

Chordoma

• This is a type of primary bone cancer.
• About half of all chordomas form in the sacrum, but the tumors can also develop elsewhere in the vertebral column or at the base of the skull. (National Library of Medicine. 2015)

Spina Bifida

• Individuals can be born with conditions that affect the sacrum.
• Spina bifida is a congenital condition that can arise from the malformation of the sacral canal.

Unlocking the Secrets of Inflammation

General Disclaimer *

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

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

Individuals dealing with or managing chronic back pain should incorporate swimming exercises. Swimming is a low-impact aerobic conditioning exercise that's easy on the back and healthy for the spine. When an individual struggles with back problems, they may be tempted to rest and avoid physical activity/exercise. Total rest is not recommended as it can cause the muscles that support the back to weaken or atrophy. When the muscles weaken, they cannot stabilize the spine or body correctly, which causes conditions to worsen or contribute to new injuries. Starting swimming exercises can expand the spine, relieve painful pressure or strain on the back and strengthen the muscles for spinal health.

Starting Swimming Exercises

Swimming does not impact the spine and other musculoskeletal structures because the water suspends the body.

• Swimming is a full-body, low-impact exercise which is excellent for individuals of all ages and all body shapes and sizes.
• Talk to a healthcare professional about any questions or concerns about how swimming may impact your body.
• Swimming benefits include stress relief, a strengthened musculoskeletal system, and support in heart health.

Swimming for Back Problems

Relaxes The Nervous System

• Tense muscles can cause or contribute to back problems and pain symptoms and aggravate spinal conditions.
• Swimming exercises release endorphins to relax the nervous system and tense muscles.

Relieves Pressure on Joints

• The water lightens the body relieving pressure on the joints and muscles.

Builds Muscle to Support the Spine

• The resistance and movement strengthen the whole body with the joints and spine supported.
• Swimming engages muscles not always used, specifically those needed to improve spinal stability.

Exercises for Back Relief

Checking with a physician before exercising is recommended, especially if starting a new exercise routine. When you meet with the Injury Medical Chiropractic and Functional Medicine Cline team, we can determine if starting swimming exercises would benefit you. Once cleared, here are some swimming exercises that could help bring relief:

Walking

• Walking around the pool means movement that the body needs to heal and build muscle without aggravating symptoms.

Aerobics

• Water aerobics is perfect for working on cardiovascular health needed to build strength.
• Increase mobility and flexibility.

Swimming Laps

• Start slow when swimming laps, maybe only twice a week at first.
• The different types of strokes work various muscles in the hips, chest, and back.
• Treading water is a great way to get the body used to the movements.
• A swim coach can provide tips on the proper technique and form.

Swim Exercise Tools and Accessories

Proper swimming equipment can make the exercise sessions much more enjoyable.

Swim Cap

• Swim caps protect the hair from the water's elements and keep hair from blocking the view.

Goggles

• Goggles protect the eyes and help to see better underwater.
• Look for a comfortable pair that doesn't leak.

Sun protection and clothing

• A day in the sun and water increases the risk of exposure to UV rays.

Waterproof Headphones

• For listening to music or podcasts while swimming.

Kickboard

• Many pools can provide kickboards that swimmers can borrow during their time there.
• Lean the upper body on the board and kick, focusing on lower body movements.

Pull Buoy

• Pull buoys help focus on the upper body and arm work.
• It is placed between the upper thighs to help the legs float as the individual pulls with their arms.

It is recommended to take some lessons to learn how the body moves through the water. Once a basic understanding of balance and buoyancy is met, individuals can propel through the water more efficiently.

Sciatica Secrets Revealed

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

Bartels, Else Marie, et al. “Aquatic exercise for the treatment of knee and hip osteoarthritis.” The Cochrane Database of systematic reviews vol. 3,3 CD005523. 23 Mar. 2016, doi:10.1002/14651858.CD005523.pub3

Cole, A J et al. “Spine pain: aquatic rehabilitation strategies.” Journal of Back and musculoskeletal rehabilitation vol. 4,4 (1994): 273-86. doi:10.3233/BMR-1994-4407

Ferrell, M C. “The spine in swimming.” Clinics in sports medicine vol. 18,2 (1999): 389-93, viii. doi:10.1016/s0278-5919(05)70153-8

Su, Yanlin, et al. “Swimming as Treatment for Osteoporosis: A Systematic Review and Meta-analysis.” BioMed research international vol. 2020 6210201. 15 May. 2020, doi:10.1155/2020/6210201

Wirth, Klaus, et al. “Strength Training in Swimming.” International Journal of environmental research and public health vol. 19,9 5369. 28 Apr. 2022, doi:10.3390/ijerph19095369

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

Prolonged standing can cause the pelvis to push backward, increasing the curve of the lower back/lumbar region. This increased pressure on the soft tissues surrounding the spine causes the lower back muscles to tighten and/or spasm, resulting in discomfort in the joints and nerves. Weakened core muscles and unhealthy posture/postural syndrome are the most common causes, but injury, aging, congenital malformations, or a disease/condition can also contribute to the symptoms. Injury Medical Chiropractic and Functional Medicine Clinic has a top team of professional therapists to evaluate the problem, diagnose the cause/s accurately, and develop a customized treatment and rehabilitation plan.

Prolonged Standing Back Discomfort

Back Structure

The lower back is one of the most used areas of the spine, moving around and bending during a normal day. When the body stands, the spine naturally curves both in and outwards.

• The inward curve, called lordosis, curves towards the front of the body at the lower back and neck regions.
• The outward curve, called kyphosis, curves towards the back of the body at the chest.
• When bending over while standing, the five lumbar vertebrae of the lower back change position and shift from lordosis to kyphosis when bent completely.
• When standing up from bending, the lumbar vertebrae change position again and return to the lordosis position.

Causes

The facet joints allow movement between each spine level. The standing spinal curvature can increase contact between the facet joints. As the body ages, the facet joints and discs begin to wear out, which can cause the discs and facet joints to become inflamed. Prolonged standing during normal daily activity combined with inflammation in these joints can aggravate the inflammation and cause symptoms. Regular routines and habits may contribute to low back discomfort during prolonged standing. These include:

• Sleeping on a sinking or unsupportive mattress.
• Practicing unhealthy postures that cause imbalances with proper weight distribution.
• Not wearing proper footwear and/or supportive orthotics forces the lower spine into increased curvature and can compress the facet joints.
• Not getting enough physical activity that strengthens the core.
• Improperly lifting and carrying objects.
• Excess weight makes the body heavier.

Standing Recommendations

Some recommendations may help:

• Stand for shorter periods.
• When symptoms start to present, it is recommended to change position.
• A sitting-to-standing workstation or desk that adjusts could help.
• Move around and stretch out to improve circulation and decrease muscle fatigue.
• Try placing one foot on a step while standing, limiting excessive spine curvature.
• Try back and spine support footwear.

Chiropractic

Chiropractors are experts on the musculoskeletal system. They will:

• Listen to the patient about symptoms, medical history, and occupation.
• A physical examination of muscle tone, strength, and range of motion.
• Therapeutic massage, electric muscle stimulation, and ultrasound therapy can help reduce muscle inflammation and increase circulation to injured soft tissues.
• Chiropractic adjustments will reset joints, removing pressure from the surrounding muscles and nerves.
• Targeted therapeutic strength training is recommended for core and leg muscles to improve hip flexibility.
• Non-surgical decompression or traction, either with a machine or suspension, can reverse the pressure in spinal discs.

Standing Lower Back Relief Exercises

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Hasegawa, Tetsuya, et al. “Association of low back load with low back pain during static standing.” PloS one vol. 13,12 e0208877. 18 Dec. 2018, doi:10.1371/journal.pone.0208877

Jo, Hoon, et al. “Negative Impacts of Prolonged Standing at Work on Musculoskeletal Symptoms and Physical Fatigue: The Fifth Korean Working Conditions Survey.” Yonsei medical journal vol. 62,6 (2021): 510-519. doi:10.3349/ymj.2021.62.6.510

Ognibene GT, Torres W, von Eyben R, Horst KC. Impact of a sit-stand workstation on chronic low back pain: randomized trial results. J Occup Environ Med. 2016;58(3):287-293. Abstract. https://www.ncbi.nlm.nih.gov/pubmed/26735316. Accessed March 2, 2017.

Parry, Sharon P et al. “Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers.” The Cochrane database of systematic reviews vol. 2019,11 CD012487. November 17, 2019, doi:10.1002/14651858.CD012487.pub2

Rodríguez-Romero, Beatriz, et al. “Thirty Minutes Identified as the Threshold for Development of Pain in Low Back and Feet Regions, and Predictors of Pain Intensity During 1-h Laboratory-Based Standing in Office Workers.” International journal of environmental research and public health vol. 19,4 2221. February 16, 2022, doi:10.3390/ijerph19042221

Smith, Michelle D et al. “The Influence of Using a Footstool during a Prolonged Standing Task on Low Back Pain in Office Workers.” International journal of environmental research and public health vol. 16,8 1405. April 18. 2019, doi:10.3390/ijerph16081405

Neck aches, soreness, and pain symptoms are not always neck-related. Tight thoracic or mid-back muscles can pull on the neck muscles causing various symptoms. Upper back tightness occurs anywhere from the neck's base to the bottom of the rib cage. The bones in the upper area don't move or flex as much as the neck and low back. This can lead individuals to believe there is nothing wrong with the mid-back, as there are no pain symptoms or signs of discomfort. However, individuals don't realize how tight the muscles are, which can go on for years, causing neck issues. Injury Medical Chiropractic and Functional Medicine Clinic can relieve symptoms, release, and relax tight muscles, increase circulation, and restore optimal function.

Mid-Back Muscle Tightness

The upper and middle back is the thoracic spine. The thoracic spine has twelve small bones called vertebrae. Each vertebra on the thoracic spine is connected to a pair of ribs. The ribs wrap around the body and attach to a long, flat sternum bone. This forms the rib cage. The bones in the upper back work with the ribs to stabilize the back and protect vital organs, including the heart and lungs. The tightening and pulling eventually cause neck aches that can come out of nowhere; even when not moving and looking straight ahead, there can be persistent dull achiness or stinging sensations.

Causes

Unhealthy posture, disc problems, injuries, fractures, or other issues or conditions can cause mid-back muscle tightness.

Posture

• Constant sitting or standing combined with unhealthy posture and being hunched over can cause the muscles to tighten, limiting mobility.

Holding Onto Stress

• Chronic stress can cause muscle tightening, whether it is in the low back, mid-back, neck, or elsewhere.

Hereditary

• Individual genetic makeup may make the body more susceptible to muscle tightness.
• For example, individuals with a lot of muscle tone vs. individuals with less muscle tone may experience muscle tightness more often.

Adequate Hydration

• Being properly hydrated is important for muscle and joint lubrication.
• Water provides nutrients to contracting muscles.
• This keeps the body loose and ready for movement.

Muscle Imbalance and Underlying Weakness

• Individuals that tend to work one side of the body more than the other or have repeatedly been moving in a certain way for years can cause muscle imbalances and trigger points to develop.
• If muscle tightness continues, even after stretching, it could be an underlying weakness.
• The muscles can sometimes seize up and guard, so they feel tight when they have become chronically weak and not strong enough to meet the physical demands.

Chiropractic Care

Chiropractic care involves various therapies to address the root cause fully and relieve neck aches. These include:

• Massage therapies to break up compacted muscle tissue.
• Remove trigger points.
• Relax the muscles to a pliable state.
• Perform chiropractic adjustments to realign the spine.
• Stretching and strengthening.
• Posture training that includes stretches/exercises.
• Nutritional plans to help strengthen muscles.

Thoracic Tension Release

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

Gatt, Adrianna, et al. “Anatomy, Fascia Layers.” StatPearls, StatPearls Publishing, Jul 25, 2022.

Liebsch, Christian, and Hans-Joachim Wilke. “How Does the Rib

Cage Affect the Biomechanical Properties of the Thoracic Spine? A Systematic Literature Review.” Frontiers in bioengineering and biotechnology vol. 10 904539. Jun 15, 2022, doi:10.3389/fbioe.2022.904539

Maciejewska-Skrendo, Agnieszka et al. “Genetics of Muscle Stiffness, Muscle Elasticity and Explosive Strength.” Journal of human kinetics vol. 74 143-159. 31 Aug. 2020, doi:10.2478/hukin-2020-0027

Modes RJ, Lafci Fahrioglu S. Anatomy, Back. [Updated 2022 Feb 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539746/

Page, Phil. “Current concepts in muscle stretching for exercise and rehabilitation.” International journal of sports physical therapy vol. 7,1 (2012): 109-19.

Petrofsky, Jerrold et al. “The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 27,4 (2017): 329-337. doi:10.1097/JSM.0000000000000375

Ankylosing spondylitis, or AS, is a type of inflammatory arthritis that usually impacts the spine, causing back stiffness and pain, pain in the hips, and decreased range of motion. Brain fog can also be a symptom of AS and other chronic inflammatory conditions. Brain fog can affect memory, concentration, decision-making, learning, and problem-solving. Injury Medical Chiropractic and Functional Medicine Clinic can educate on the causes of ankylosing spondylitis brain fog and how to reduce its effects.

Brain Fog

Experts do not fully understand how conditions like AS cause brain fog and how it affects the brain and central nervous system. However, they believe brain fog is linked to chronic inflammation and pain associated with the condition, along with certain factors.

Chronic Inflammation

• Inflammation occurs when the body's immune system attacks healthy cells.
• This triggers the release of inflammation-causing cytokines.
• Cytokines can interfere with normal brain function.

Ankylosing Spondylitis Chronic Pain 

• Chronic pain can cause fatigue and unhealthy sleep quality.
• Fatigue and poor sleep can worsen chronic pain, leading to intense fatigue and extreme sleep issues, becoming a vicious cycle.

Corticosteroids

• Doctors typically treat ankylosing spondylitis with corticosteroids.
• Individuals with cardiovascular risk factors have an increased risk of brain fog from the medications.

Depression

• Individuals with AS can present symptoms of depression, which has been linked to cognitive impairment.
• Depression can contribute to the development of brain fog.

Other Medical Conditions

• Thyroid Imbalances
• Fibromyalgia
• Lupus
• Sjogren's
• Chronic Fatigue Syndrome
• Anemia
• Encephalitis
• Multiple sclerosis

Other Possible Causes

• Stress
• Sleep problems
• Little to no physical activity or exercise.
• Pregnancy
• Menopause
• Antidepressants
• Chemotherapy

Effects

The effects of brain fog.

• Thoughts are blurry and difficult to recall.
• There are major lapses in concentration.
• Thinking is harder.
• There is constant confusion.
• More effort is required to maintain thoughts in short-term memory.
• Constantly forgetting what to do.

Chiropractic Care

Doctors recommend a multidisciplinary approach to manage AS brain fog. This includes:

• An anti-inflammatory nutrition plan.
• Ergonomic adjustments
• Regular physical activity and exercise.
• Mental exercises
• Concurrent treatment with a rheumatologist in combination with chiropractic care.
• Chiropractic care focuses on improving joint mobility and the function of the musculoskeletal system.
• Manual and instrument-assisted adjustments are paired with the following:
• Soft-tissue therapies
• Non-surgical spinal decompression
• Health Coaching
• Fitness Coaching
• Nutritional recommendations

Brain Cognition

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

Chiropractic. (2019). nccih.nih.gov/health/chiropractic

Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002

Creaky Joints. (September 17, 2018) “You can ease inflammatory arthritis brain fog with these 12 tips for a sharper mind.” https://creakyjoints.org/living-with-arthritis/arthritis-brain-fog/

Vitturi, Bruno Kusznir, et al. “Cognitive Impairment in Patients with Ankylosing Spondylitis.” The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques vol. 47,2 (2020): 219-225. doi:10.1017/cjn.2020.14

Zhang, Jun-Ming, and Jianxiong An. “Cytokines, inflammation, and pain.” International anesthesiology clinics vol. 45,2 (2007): 27-37. doi:10.1097/AIA.0b013e318034194e

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

Herniated Disc Signs It Is Returning To Normal

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

Expectations From a Healing Disc

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

Signs The Herniated Disc Is Healing

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

Length of Time

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

Regular Activity

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

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

DOC Spinal Decompression

General Disclaimer *

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

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

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

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

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

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

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

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

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

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

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