For individuals looking to improve their gut health, can learning about the supportive digestive organs help with how digestion works and how it can be affected by inflammatory bowel disease/IBD?
Supportive Digestive Organs
Most people are familiar with food movement from the mouth through the esophagus, stomach, small intestine, and large intestine. However, digestion begins in the mouth with the formation of saliva, and the supportive digestive organs provide the necessary fluids to digest food and used by the body. The digestive tract runs from the mouth to the anus in one long, continuous tube. Several supportive digestive organs assist digestion but are not considered part of the digestive tract, including the salivary glands, pancreas, liver, and gallbladder.
Salivary Glands
The salivary glands produce saliva passed through ducts and into the mouth. Saliva is a clear liquid containing various substances important for digestion and the beginning of the food breakdown process (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). Saliva is important to digestion because it aids chewing, contains antibodies, and helps keep the mouth clean. Infections, mumps, obstructions, Sjogren’s syndrome, and cancer are diseases and conditions that can affect the salivary glands.
Pancreas
Behind the stomach is the pancreas, which is important to digestion because it is where digestive enzymes and hormones are produced. Digestive enzymes help break down food (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). The pancreas also creates Insulin, a hormone that helps balance blood sugar levels. Individuals with Type 1 diabetes are unable to make insulin and need insulin shots to balance sugar levels. Individuals with Type 2 diabetes also need insulin because their body is either resistant to insulin or their pancreas does not respond correctly. (American Diabetes Association, 2024) Glucagon is another hormone produced in the pancreas to raise blood sugar when the levels are very low. For individuals who have diabetes, glucagon can increase blood sugar levels too high. Insulin and glucagon work together to regulate blood sugar. (American Diabetes Association, 2024) Some diseases and conditions affecting the pancreas include pancreatitis, cancer, and cystic fibrosis.
Liver
The liver is one of the largest organs. Its functions include creating bile, storing nutrients and glycogen, converting toxins into harmless substances, and/or enabling their removal. Bile is passed through ducts that run from the liver to the duodenum of the small intestine. Blood circulates through the digestive tract and liver, where vitamins and nutrients are processed and stored (Johns Hopkins Medicine, 2024). The liver is also the body’s detox organ, helping remove byproducts produced by alcohol and medications. The liver also helps break down old or damaged blood cells and produces substances to help with blood clotting. (Johns Hopkins Medicine, 2024) Diseases and conditions of the liver include cirrhosis, hepatitis, hemochromatosis, and cancer.
Gallbladder
The gallbladder is a much smaller organ located just under the liver. This supportive digestive organ stores bile after it is made in the liver. After eating, the small intestine releases a special hormone called cholecystokinin, which prompts the gallbladder to send bile through ducts and into the small intestine. Once in the small intestine, the bile breaks down the fat from the food. Conditions that can affect the gallbladder include gallstones. Surgery to remove the gallbladder, known as a cholecystectomy, is common. Some individuals may initially need to make adjustments to their diet after surgery. (Johns Hopkins Medicine, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Individuals who engage in sports and physical activities that involve lunging forward while running or jumping can sustain a plantaris muscle injury. Can understanding the anatomy of the back of the leg and the symptoms help diagnose and treat plantar muscle injuries?
Plantaris Muscle
The plantaris muscle is a long, narrow muscle in the calf that runs along the back of the leg. It’s part of the Triceps Surae, a group of muscles in the calf that, along with the gastrocnemius and soleus muscles, makes up the bulk of the back of the leg. It is located in the superficial posterior compartment of the leg. Strains or tears of the plantaris muscle at the back of the leg can cause pain and swelling, similar to a calf strain or Achilles tendon tear. Individuals may feel immediate pain, cramping, and other symptoms.
Anatomy
The gastrocnemius and soleus muscles are the major muscles, with the soleus located deeper in the leg. Together, they form the Achilles tendon, which blends into a tendon in the back of the heel and attaches to the heel bone/calcaneus. When the calf muscles contract, they point the foot downward, propelling the body forward when walking, running, and sprinting. The plantaris muscle and tendon sit more or less in the center of the calf, between the two heads of the gastrocnemius. Around 7% to 20% of the population are born without plantaris muscles. There are variations, such as having a double- or triple-headed plantaris muscle. (Olewnik Ł. et al., 2020) However, individuals that do not have the muscle or have a variation have not been shown to affect long-term or short-term mobility.
Symptoms
Plantaris muscle ruptures are the most common injury and occur often during running or jumping. (Spang C. et al., 2016) Many who sustain this injury are athletes who have to lunge forward. Common symptoms include:
Swelling and bruising in the back of the calf area.
Cramping in the calf muscle.
Spasm sensations of the calf muscle.
Symptoms of a plantaris muscle strain are less severe, with the common signs being tightness and pain during and after physical activity.
Diagnosis
Plantaris muscle tears differ from Achilles tendon tears because the foot can be pointed downward following the rupture, whereas an Achilles tear cannot. Plantaris ruptures can also be confused with a blood clot in the large veins of the calf, called deep vein thrombosis/DVT. (Rohilla S. et al., 2013) Tests like MRI or ultrasound can be performed to confirm or exclude a plantaris rupture. Both can be useful for verifying whether the injury is a strain or tear and identifying other possible causes of calf pain.
Treatment
Treatment is typically non-surgical. While the injuries can cause pain and disability, the symptoms almost always resolve with conservative treatments and therapies. Rest, ice, compression, and elevation are the first line used and may be all that is needed for a muscle strain. Short-term use of NSAIDs may be recommended for a strain or tear to reduce pain and inflammation. (Morelli K. M. et al., 2018) If the pain is profound or there is a tear, patients may require short-term immobilization or the use of a crutch for the pain to subside. With the assistance of a physical therapist, sports chiropractor, and athletic trainer, gradual increases in mobility and strength can be obtained. Symptoms usually gradually resolve over several weeks. Full recovery may take up to eight weeks, depending on the severity of the injury.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop customized treatment programs through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Control Foot Motion with Custom Orthotics
References
Olewnik, Ł., Zielinska, N., Karauda, P., Tubbs, R. S., & Polguj, M. (2020). A three-headed plantaris muscle: evidence that the plantaris is not a vestigial muscle?. Surgical and radiologic anatomy : SRA, 42(10), 1189–1193. doi.org/10.1007/s00276-020-02478-8
Spang, C., Alfredson, H., Docking, S. I., Masci, L., & Andersson, G. (2016). The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. The bone & joint journal, 98-B(10), 1312–1319. doi.org/10.1302/0301-620X.98B10.37939
Rohilla, S., Jain, N., & Yadav, R. (2013). Plantaris rupture: why is it important?. BMJ case reports, 2013, bcr2012007840. doi.org/10.1136/bcr-2012-007840
Morelli, K. M., Brown, L. B., & Warren, G. L. (2018). Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. The American journal of sports medicine, 46(1), 224–233. doi.org/10.1177/0363546517697957
Individuals who have sustained trauma to the knee area from work, physical activity, or a motor vehicle collision can experience significant pain and mobility impairment. Can physical therapy help heal and strengthen the PLC?
Posterolateral Corner Knee Injury
The posterolateral corner, or PLC, comprises muscles, tendons, and ligaments in the back of the knee that help support and stabilize the outside region. The primary role of the PLC is to prevent the knee from excessive amounts of rotation or bowing/turning outward. (Chahla J. et al., 2016) Posterolateral corner injuries can cause significant pain and can dramatically impact an individual’s ability to walk, work, or maintain independence. Treatment options will depend on the severity of the injury.
The Posterolateral Corner
The posterolateral corner comprises multiple structures that support and stabilize the outside of the knee. The structures are subdivided into primary and secondary stabilizers. The primary group includes:
The primary role is to prevent the knee from excessively turning outward, so the grouping provides secondary assistance in preventing the lower leg bone/tibia from shifting forward or backward on the thighbone/femur. Occasionally, one or several posterolateral corner structures can be sprained, strained, or torn.
How Injury Occurs
An injury occurs when a direct blow to the inner portion of the front of the knee causes the leg to bow outward. A posterolateral corner injury may also be sustained without contact, for example, if the knee hyperextends or buckles away from the other leg into a varus/bow leg position. Because the knee usually moves during a PLC, concurrent sprains or tears to the anterior cruciate ligament/ACL or posterior cruciate ligament/PCL are also common. (Chahla J. et al., 2016) Other situations that can also cause PLC injuries include automobile crashes and falls from elevated surfaces. (Shon O. J. et al., 2017) When this type of trauma causes a posterolateral corner injury, bone fractures are also common.
Symptoms
Depending on the severity of the injury, multiple symptoms may be present, including:
For individuals who suspect that they have sustained a PLC injury or have any of the symptoms listed, it is critical to be seen by an orthopedic specialist or emergency room physician. A healthcare provider will properly evaluate the leg and develop the appropriate treatment.
Diagnosis
Diagnosis begins with a comprehensive examination. In addition to looking for the symptoms noted, a healthcare provider will move the legs in different directions to assess for any instability. The dial test may be performed, which involves having the patient lie on their stomach while the healthcare professional assesses the side-to-side rotation in the leg to check for excessive motion. (Shon O. J. et al., 2017) Imaging is frequently ordered to determine which anatomical structures are affected more accurately. X-rays can help rule out concurrent fractures and check for excessive laxity in the knee area. MRIs are also useful for visualizing the various tendons and ligaments, helping the healthcare provider look closely at any sprains or tears that may have occurred. However, MRIs may be less accurate in diagnosing PLC injuries after 12 weeks, so they should be obtained as soon as possible. Based on this evaluation, the injury may be classified using the following system (Shon O. J. et al., 2017)
Grade 1
0 to 5 degrees of rotational or varus/bowing instability.
Incompletely torn posterolateral corner.
Grade 2
6 to 10 degrees of rotational or varus/bowing instability.
Incompletely torn posterolateral corner.
Grade 3
Eleven or more degrees of rotational or varus/bowing instability.
Completely torn posterolateral corner.
Treatment
The care received after a posterolateral corner injury can vary depending on the structures involved and the overall severity.
Nonsurgical
Nonsurgical treatment is typically reserved for isolated grade 1 or 2 PLC injuries. (Shon O. J. et al., 2017) Depending on which structures are affected, a stabilizing brace may be worn, and crutches are often needed to decrease the strain on the knee. Physical therapy is also commonly prescribed and focuses on the following goals:
Gradually reintroducing specific movements like running and jumping.
Surgery
Non-surgical treatment tends not to work with grade 3 injuries. If surgery is not performed, individuals may also suffer from chronic knee instability or develop long-term osteoarthritis. (Chahla J. et al., 2019) Surgical treatment is often recommended for grade 3 injuries. The damaged primary stabilizers are surgically reconstructed using a graft from another body region. Surgical repairs may also be performed on any secondary stabilizers to improve stability. (Chahla J. et al., 2019) Any other ligament injuries, such as ACL, PCL, or concurrent fractures, will also be addressed. Following the procedure, individuals immobilize their knee with a brace and do not place weight on the affected leg to protect the surgical area. Depending on the surgeon’s recommendations, this can last six weeks or more. Physical therapy is also initiated after a surgical procedure. Though rehabilitation progresses slowly, the goals are often the same as when treating milder PLC injuries. Returning to work, sports, and/or physical activity after surgery may take six months of therapy or more. (Shon O. J. et al., 2017)
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improve flexibility, mobility, and agility, relieve pain, and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Knee Injury Rehabilitation
References
Chahla, J., Moatshe, G., Dean, C. S., & LaPrade, R. F. (2016). Posterolateral Corner of the Knee: Current Concepts. The archives of bone and joint surgery, 4(2), 97–103.
Shon, O. J., Park, J. W., & Kim, B. J. (2017). Current Concepts of Posterolateral Corner Injuries of the Knee. Knee surgery & related research, 29(4), 256–268. doi.org/10.5792/ksrr.16.029
Chahla, J., Murray, I. R., Robinson, J., Lagae, K., Margheritini, F., Fritsch, B., Leyes, M., Barenius, B., Pujol, N., Engebretsen, L., Lind, M., Cohen, M., Maestu, R., Getgood, A., Ferrer, G., Villascusa, S., Uchida, S., Levy, B. A., Von Bormann, R., Brown, C., … Gelber, P. E. (2019). Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(8), 2520–2529. doi.org/10.1007/s00167-018-5260-4
The levator scapulae muscles could be overstretched for individuals experiencing upper back, shoulder, and neck pain. Can physical therapies help relieve pain and retrain the muscles to function properly?
Levator Scapulae Muscles
The levator scapulae muscles stretch along the spine across the upper back and neck. They originate from the cervical vertebrae C1 to C4 and attach to the inside top edge of the scapula. (Chotai P. N. et al., 2015) They elevate the shoulder blades, tilt the head, and work with other muscles to stabilize the spine and influence neck motion and upper back posture. The shoulder blade/scapula is the flat, triangular-shaped bone that sits on top of the upper part of the rib cage. Where the levator scapulae attaches, the muscles raise the shoulder blade, a movement called elevation, and indirectly rotates the scapula’s bottom tip downward towards the spine. These shoulder blade movements are part of the shoulder joint’s larger flexion and abduction movements.
Flexion occurs when moving the arm forward and up, and abduction occurs when moving the arm out to the side.
The levator scapulae muscles contract during flexion and/or abduction,
The muscles also contract when moving the neck in side bending, lateral flexion, rotation, or twisting.
Symptoms
Neck and shoulder pain are common problems for office workers, truck drivers, and others who sit most of the day for their jobs. It can worsen when there is no spinal support for maintaining correct alignment. Poorly designed work chairs may contribute to chronic muscle tension and spasms, plus they may contribute to muscle weakness. One of the primary functions of the levator scapulae muscles is to keep the shoulder blade in a position that supports a vertical alignment of the head and to prevent forward head posture. (Yoo W. G. 2018)
However, the shoulder blade is an extremely movable bone. Maintaining stability and correct neck posture is not easy. The levator scapulae muscles may not be strong enough to keep the shoulder blade where it’s supposed to be for healthy posture, and instead, they become overstretched. When muscles are overstretched, they often become taut to try to maintain some form of stability. It can feel like muscle tension because the muscles shorten, but there is a difference. The situation can worsen if one slouches, has no lumbar support, and/or the desk or steering wheel is too high or too low, which may force the shoulder blade upward or downward.
Pain Relief
The levator scapulae muscles are two of several shoulder muscles that may contribute when neck pain presents. This is why a qualified, licensed health professional should diagnose any pain or dysfunction in the area. Physical therapy can help get the body back on track. (Yoo W. G. 2018) Treatment may consist of restoring muscle strength and flexibility in the shoulder, neck, and upper back muscles and developing better posture habits. Physical therapy exercises, particularly those that address upper back posture, can help reduce the stress placed on the levator scapulae muscles and can help decrease kyphosis, often a precursor to forward head posture. Stretching, strengthening, and posture lessons will help relieve pain and increase the physical functioning of the upper body. Other tips for avoiding and relieving muscle pain include:
Stretching regularly by gently rotating the neck and shoulders.
Applying heat to promote relaxation.
Regular massage therapy.
Adjusting chairs and/or monitor height to align with a straight line of sight.
Not carrying heavy bags, especially on one shoulder.
Avoiding side sleeping without proper head support.
Injury Medical Chiropractic Clinic
Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
The Natural Way to Heal: Non-Surgical Chiropractic Care for Pain Relief
References
Chotai, P. N., Loukas, M., & Tubbs, R. S. (2015). Unusual origin of the levator scapulae muscle from mastoid process. Surgical and radiologic anatomy : SRA, 37(10), 1277–1281. doi.org/10.1007/s00276-015-1508-6
Yoo W. G. (2018). Effects of thoracic posture correction exercises on scapular position. Journal of physical therapy science, 30(3), 411–412. doi.org/10.1589/jpts.30.411
For individuals experiencing piriformis syndrome. Can knowing the causes and what it feels like help in diagnosis and treatment?
Managing Piriformis Syndrome
Piriformis syndrome is where spasms occur in the piriformis muscle located in the buttocks. These muscle spasms can cause pain and numbness in the buttocks and the back of the leg. (Cedars Sinai, 2022)
What Is It?
Piriformis syndrome is an irritation of the sciatic nerve from the piriformis muscle. Although the piriformis muscle is small compared to other muscles around the hip and thigh, it supports the hip joint’s external rotation or turning out. The sciatic nerve supplies the lower extremities with motor and sensory functions. The piriformis tendon and sciatic nerve cross each other behind the hip joint in the deep buttock. Both are about one centimeter in diameter. The piriformis muscle spasms can irritate the sciatic nerve, causing sciatica symptoms. (Cedars Sinai, 2022)
Triggers
A piriformis syndrome diagnosis means the piriformis tendon binds or spasms around the sciatic nerve, causing irritation and symptoms. Many doctors and specialists support the theory that when the piriformis muscle and its tendon tighten, this can cause compression and pinch the nerve. This can decrease blood circulation and irritate the nerve due to pressure. (Cass S. P. 2015) Many doctors also believe that piriformis syndrome occurs from anatomic variation of the muscle and tendon. It is thought this muscle-tendon variation irritates the nerve in some, leading to sciatica symptoms.
How It Feels
Common signs and symptoms experienced include (Cass S. P. 2015)
Pain in the buttocks.
Pain behind the hip.
Electric shock pains traveling down the back of the lower extremity.
Numbness in the lower extremity.
Tenderness with pressure that often causes pain when sitting.
Some develop symptoms abruptly, while others gradually increase in symptoms in the back of their thighs.
Most who are diagnosed with piriformis syndrome are generally active individuals who experience increasing difficulty with certain types of physical activity.
Testing
There are no specific tests that accurately diagnose piriformis syndrome. Doctors will order tests, including MRI and nerve conduction studies. Because it can be difficult to diagnose, there are likely many misdiagnosis cases. This means that some with the condition don’t have a piriformis diagnosis. In addition, some with vague hip pain may receive this diagnosis even if they don’t have the condition. (Cass S. P. 2015) An injection is often administered into the piriformis muscle when the diagnosis is uncertain. (Jankovic D. et al., 2013) Performing an injection can help determine the specific location of the discomfort. When an injection is given into the piriformis muscle or tendon, it is administered by ultrasound guidance to ensure the needle delivers medication to the correct location. (Bardowski E. A., and Byrd J. W. T. 2019)
Differential Diagnosis
Some other conditions with buttock pain can have similar symptoms. Other causes can include:
Radiculopathy/Sciatica
Herniated discs
Hip bursitis
Spinal stenosis
The diagnosis of piriformis syndrome is given when these diagnoses are eliminated as possible causes of pain.
Treatment
Managing piriformis syndrome is quite general, and it is often difficult to recover from. Common treatment and management suggestions include the following. (Jankovic D. et al., 2013)
Rest
Avoiding activities that cause symptoms for at least a few weeks.
Physical Therapy
Focuses on stretching and strengthening the hip rotator muscles.
Anti-inflammatory Medication
To decrease inflammation around the tendon.
Deep Massage
Used to relax the piriformis muscle and help release the compressed nerve.
Cortisone Injections
It can help decrease inflammation and swelling.
Botulinum Toxin Injection
It can paralyze the piriformis muscle to reduce pain and discomfort.
In severe cases, surgery can be performed to loosen the piriformis tendon, known as a piriformis release (Cass S. P. 2015). This surgical procedure is recommended when conservative treatments have been tried for at least six months and other causes of pain have been evaluated and ruled out. Recovery takes several months.
The goal of managing piriformis syndrome is to improve the range of motion and flexibility around the hip and diminish inflammation around the sciatic nerve. Working with a professional chiropractic team can help relieve pain, return individuals to normal function, and expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. doi.org/10.1249/JSR.0000000000000110
Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. doi.org/10.1007/s12630-013-0009-5
Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. doi.org/10.1016/j.eats.2019.07.033
An annular fissure is caused by age-related changes to the spine, which often do not cause symptoms but can cause back pain. Can understanding the causes help individuals manage lower back pain and help healthcare providers develop an effective treatment program?
Annular Fissure
An annular fissure is a discogenic condition that affects the spine and can cause lower back pain. Also called an annular tear, it’s usually a wear-and-tear condition that happens over time rather than a condition caused by trauma. It usually happens when the fibers that make up the annulus or the tough outer covering of the intervertebral disc break or separate. To manage it, healthcare providers may recommend:
Making lifestyle changes.
Staying aware of how you go about daily activities and take steps to make adjustments, such as being mindful of unhealthy posture.
Start doing exercises that help make the back stronger.
Medical care if pain and other symptoms need to be managed.
Symptoms
Lower back pain may be a sign of an annular fissure, or there may be no symptoms. Symptoms can include:
Pain
Weakness
Numbness
Electrical sensations travel down one leg or arm if a cervical/neck tear is present.
Numbness and weakness may be caused by the nerves getting irritated or compressed near an annular tear. (Stadnik, T. W. et al., 1998)
These symptoms can also be similar to a herniated disc, which can be a complication of an annular fissure.
However, studies have shown that annular tears and herniated discs often go unnoticed because they have few obvious symptoms. (Jarvik, J. G. et al., 2005)
Annulus Function
The annulus comprises several layers of tough fibers/fibrocartilage that surround, contain, and protect the soft, liquid nucleus inside the disc. The layers of the annulus fibrosus crisscross to provide support. The nucleus is a shock absorber cushions the body’s weight on the spinal joints when sitting, standing, or moving. Its strength also allows the disc to buffer the jolts and jars it experiences. It also helps maintain the integrity of the intervertebral joint by supporting the space between the two vertebrae. When an annular fissure occurs, the fibers separate or tear off from insertion on the nearby spinal bone. A fissure can also be a break in the fibers of one or more layers. (Jarvik, J. G. et al., 2005)
Causes
An annular tear is not the standard term medical professionals use to describe or diagnose a fissure because the word tear suggests that trauma has led to the separation or break in the fibers. While an injury can cause an annular fissure, it’s usually caused by long-term wear and tear. (Guterl, C. C. et al., 2013) The tears are typically caused by age-related degenerative changes in the disc, which can also lead to degeneration in other areas of the spine. Wear and tear are caused by annular fissures due to an individual’s daily living habits, such as sitting, standing, walking, climbing stairs, and performing other routine movements.
Treatment
While a large annular fissure is not likely to improve without treatment, a small one could heal independently. However, once an area has torn, it becomes more likely to continue tearing. (Virginia Spine Institute, N.D.) Conservative treatment is usually enough to control pain and symptoms. Physical therapy and anti-inflammatory medication are the first line of treatment. (Cheng, J. et al., 2019) Medication can be over-the-counter or prescription. Physical therapy treatment includes exercises, traction, and other therapies. If these do not help with the symptoms, the provider may suggest a steroid injection to reduce inflammation and pain. It can take three to six months to recover from degenerative disc problems if doing a standard treatment plan that includes rest, low-impact therapy exercises, and anti-inflammatory treatments. (Cheng, J. et al., 2019)
In severe cases, surgery may be recommended, including disc replacement surgery. An annular tear is not a reason to have disc replacement surgery alone; it is only when there are degenerative changes in the vertebral disc that surgery might be necessary. (Yue, J. J. et al., 2012)
Improving Body Alignment
Not paying attention and being aware of how the body performs everyday activities can, over time, set the stage for an annular fissure and other musculoskeletal injuries. However, fixing daily movement and posture habits to prevent injuries can be done through simple adjustments. For example, strengthening the core and back muscles can reduce pressure on the spine and help prevent injuries. (Camp, C. L. et al., 2016) The idea is to improve joint and overall body alignment. Activities can include:
Strength training
Walking
Pilates classes
Yoga
Tai chi
Somatic exercises
These activities help with muscle balance and joint alignment, which are recommended prevention strategies that physical therapists use when working with individuals who need help with spinal problems.
Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to treating injuries, improving flexibility, mobility, and agility to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Back Pain Specialist
References
Stadnik, T. W., Lee, R. R., Coen, H. L., Neirynck, E. C., Buisseret, T. S., & Osteaux, M. J. (1998). Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. Radiology, 206(1), 49–55. doi.org/10.1148/radiology.206.1.9423651
Jarvik, J. G., Hollingworth, W., Heagerty, P. J., Haynor, D. R., Boyko, E. J., & Deyo, R. A. (2005). Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine, 30(13), 1541–1549. doi.org/10.1097/01.brs.0000167536.60002.87
Guterl, C. C., See, E. Y., Blanquer, S. B., Pandit, A., Ferguson, S. J., Benneker, L. M., Grijpma, D. W., Sakai, D., Eglin, D., Alini, M., Iatridis, J. C., & Grad, S. (2013). Challenges and strategies in the repair of ruptured annulus fibrosus. European cells & materials, 25, 1–21. doi.org/10.22203/ecm.v025a01
Cheng, J., Santiago, K. A., Nguyen, J. T., Solomon, J. L., & Lutz, G. E. (2019). Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5-9 years. Regenerative medicine, 14(9), 831–840. doi.org/10.2217/rme-2019-0040
Yue, J. J., Telles, C., Schlösser, T. P., Hermenau, S., Ramachandran, R., & Long, W. D., 3rd (2012). Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study. International journal of spine surgery, 6, 13–17. doi.org/10.1016/j.ijsp.2011.09.001
Camp, C. L., Conti, M. S., Sgroi, T., Cammisa, F. P., & Dines, J. S. (2016). Epidemiology, Treatment, and Prevention of Lumbar Spine Injuries in Major League Baseball Players. American journal of orthopedics (Belle Mead, N.J.), 45(3), 137–143.
Can incorporating lemongrass into a diet help individuals manage anxiety, colds, fever, inflammation, and insomnia?
Lemongrass
Lemongrass, or lemongrass or citronella, is a tall grass-like herb commonly used in Southeast Asian cooking. The lower stalks and bulbs of the plant have a fresh, clean, lemony scent that is sometimes added to marinades, teas, curries, and broths. In addition to its flavoring use, lemongrass’s essential oils are used for medicinal purposes, supported by scientific evidence.
Benefits
Lemongrass has been shown to help with common ailments, such as anxiety, colds, fever, inflammation, and insomnia. It can be eaten, rubbed on the skin, or inhaled as an aromatherapy treatment. When taken orally, it is often used to calm stomach discomfort and other gastrointestinal issues, including cramps and vomiting. (DeFilipps, R. A. et al., 2018) When used as a tea, it protects the stomach lining by treating stomach ailments, indigestion, and gastric ulcers. (Khan, Nida. 2020) Lemongrass or oil is applied to the skin to treat headaches and musculoskeletal pain. As an aromatherapy treatment, the oil extract may be inhaled to treat muscle pain, infections, colds, and flu symptoms. Consumed it can help treat:
Musculoskeletal pain
Sleeplessness
Rheumatism
Cough
Common cold
Fever
Anxiety
Hypertension
Diabetes
Epilepsy
Cancer prevention
However, a few studies support certain lemongrass benefits. Research has suggested that lemongrass oil added to a hair tonic may reduce dandruff. However, more studies are needed to confirm. (Chaisripipat, W. et al., 2015)
Essential Oil
Lemongrass essential oil has been studied and has been found to contain significant bioactive compounds that include:
Citral
Isoneral
Isogeranial
Geraniol
Geranyl acetate
Citronellal
Citronellol
Germacrene-D
Elemol
These compounds contain antifungal, antibacterial, antiviral, anticancer, and antioxidant properties. (Mukarram, M. et al., 2021) Research also shows that essential oils can be therapeutic agents for treating inflammatory skin conditions and help reduce dandruff because of their antimicrobial and anti-inflammatory properties. They can also inhibit the growth of the fungi associated with causing dandruff. (Khan, Nida. 2020)
Nutrition
One tablespoon of fresh lemongrass provides around five calories, most from carbohydrates/fiber and protein. (U.S. Department of Agriculture, 2018) It is a source of fiber, carbohydrates, and vitamins A, B, and C, strengthening the body’s immune system, repairing tissue damage, and promoting cell division. It also contains:
Magnesium – Necessary for protein synthesis, glycolysis, and muscle activity,
Selenium – Necessary for cognitive function and fertility.
Phosphorus – Necessary for DNA/RNA and cell membrane synthesis.
Zinc for wound healing, growth, and development. (Khan, Nida. 2020)
Minerals include:
Calcium – 3 milligrams
Potassium – 34 milligrams
Manganese – 0.2 milligrams
Magnesium – 2.9 milligrams
Iron – 0.4 milligrams
It also provides small amounts of vitamins, including A and C, folate, and niacin. However, lemongrass-flavored oil contains significantly more calories because it usually combines cooking oil with lemongrass extract.
Preparation and Storage
Lemongrass is becoming easier to find in stores. When choosing lemongrass, look for firm green stalks with healthy-looking bulbs attached. Some stores may sell the stalks with a good portion of the top removed. This is fine, as many recipes require using the bottom of the stalk or the bulb. To use lemongrass in teas, soups, broth, or other liquids, crush the stalks’ bottom area to release the aromatic oil. Then, immerse the pieces in the liquid to release the oils. Remove the stalks before eating or drinking the beverage. In other recipes, chopping or mincing the bulb or lower area of the stalks may be necessary before adding to a curry, salad, marinade, or stir-fry. Lemongrass can be wrapped in plastic and refrigerated for two to three weeks or frozen for up to 6 months.
Potential Side Effects
Lemongrass is safe for most when consumed in typical amounts in food. However, some concerns may arise when using it for medicinal purposes.
Used topically, lemongrass may cause skin irritation.
Additionally, consuming high amounts of lemongrass may cause dizziness, drowsiness, dry mouth, excess urination, and increased appetite. (Memorial Sloan Kettering Cancer Center, 2022)
High amounts of essential oil can damage liver and stomach mucous membranes, and excessive tea intake may also affect kidney function. (Memorial Sloan Kettering Cancer Center, 2022)
It is recommended that pregnant women should avoid lemongrass.
Additionally, individuals undergoing chemotherapy should avoid lemongrass because it may interfere with the actions of some chemotherapeutic agents.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. Our providers use an integrated approach to create customized care programs for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Khan, Nida. (2020). Therapeutic benefits of lemongrass and tea tree. Annals of Civil and Environmental Engineering. 4. 027-29. 10.29328/journal.acee.1001022.
Mukarram, M., Choudhary, S., Khan, M. A., Poltronieri, P., Khan, M. M. A., Ali, J., Kurjak, D., & Shahid, M. (2021). Lemongrass Essential Oil Components with Antimicrobial and Anticancer Activities. Antioxidants (Basel, Switzerland), 11(1), 20. doi.org/10.3390/antiox11010020
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