Individuals that have undergone spine surgery or spinal fusion for extreme low back pain caused by degeneration, herniated disks, sciatica, and other injuries could benefit from gentle chiropractic therapy post-surgery. Spinal fusion surgery is one of the last options after non-invasive treatment/s aren’t providing relief like:
Massage
Physical therapy
Chiropractic
Medications
However, many patients still experience pain/discomfort after the surgery and wonder which rehabilitation treatment options are available to them. Is chiropractic care still an option after major spinal surgery? Doctors will warn patients about the risks of receiving chiropractic treatment after surgery. This is true with high-velocity low-amplitude spinal adjustments/manipulation.
But incorporating gentle chiropractic therapy could benefit individuals still experiencing back pain after surgery. However, an individual needs to be adequately healed prior to beginning treatment. At Injury Medical Chiropractic and Functional Wellness Clinic, we regularly consult with patients post-surgery about the effectiveness of spinal rehabilitation therapy.
After the surgery wait time
Spinal fusion surgeryremoves the discs between two or more vertebrae and fuses the bones together with screws and plates. The objective is to correct conditions like herniated discs and degenerative disc disease by immobilizing the spine in that area. It can take three months for the vertebrae to fuse together and create a complete immobilized graft. Once the graft is complete, physical therapy is brought in to strengthen the muscles around the graft. Patients are told to avoid any twisting and bending motions, or the graft could break.
How gentle chiropractic therapy can help
Spinal fusion surgery is not guaranteed to cure the problem causing an individual’s back pain. Gentle chiropractic therapy can help by therapeutically massaging the area/s keeping the muscles loose and flexible. Gentle manipulations are utilized to adjust or realign bones in the spine and other areas of the body. Because chiropractic treatment can involve intricate spinal manipulations, many individuals that have undergone back surgery can be hesitant to consider chiropractic treatment.
Discuss the possibility of receiving chiropractic therapy with a physician to determine whether the surgical graft is strong enough to withstand gentle spinal manipulations. A patient post-surgery is at greater risk of injury if they are not healed correctly before receiving chiropractic treatment. If the graft is adequately healed and a physician feels that the body is strong enough to endure mild spinal manipulations, reach out to a chiropractor to discuss treatment options.
Body Composition Clinic
Benefits of a cheat day
Cheat days can be a highly useful tool to help motivate sticking to a diet plan. Cheat days can help build a positive relationship with food. The goal is to see one’s favorite dessert/comfort food as a reward and not a coping mechanism. However, cheat days not a license to binge eat.
Binge eating can lead to eating-related issues and hurt an individual’s ability to self-regulate. Binge eating does not boost the body’s metabolism, but it can have the opposite effect. After a binge, the body’s system is overloaded with a rush of calories, sugar, and fat. In addition to causing hormone and energy levels to fluctuate, the excess of calories promotes:
Fat storage
Inflammation
Digestive discomfort
Bloating
Constipation
Cheat day frequency
Ultimately, cheat days depend on how well an individual self-regulates and what their short and long-term goals are. However, it can become very easy for a cheat day to become a cheat weekend, to a cheat week, and so on. Next thing an individual is back to old unhealthy eating habits. The objective is to understand what helps maintain motivation and develop a sustainable, long-term plan.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Perrucci, Rachel M, and Christopher M Coulis. �Chiropractic management of post-spinal cord stimulator spine pain: a case report.� Chiropractic & manual therapies�vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0
Fernandez, Matthew et al. �Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.� The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society�vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y
O’Shaughnessy, Julie et al. �Chiropractic management of patients post-disc arthroplasty: eight case reports.��Chiropractic & osteopathy�vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7
The human body is a complex system, that requires consistent development in all areas. When it comes to weight loss being too strict can cause the body to rebel. Examples are individuals that have lost weight, then put it right back on, or get stuck in a plateau. The objective is to step off the weight loss rollercoaster and embrace weight-loss strategies that work. Here, we explore a few evidence-based weight loss strategies that focus on long-lasting success.
Improve insulin sensitivity
When consuming carbohydrates, it is broken down into sugar.
The body needs a certain amount of sugar to function. However, it is a narrow safety range. If the level gets too high for too long, cellular damage happens. The role of insulin is to guide the excess sugar/glucose into the cells. However, more individuals are experiencing high blood insulin levels, called hyperinsulinemia. Possible symptoms can include:
Sugar cravings
Unusual weight gain
Frequent hunger
Excessive hunger
Unable to concentrate
Anxiety or feelings of panic
Lack of focus
Extreme fatigue
Insulin rises because the blood sugar does. It�s dangerous to let glucose levels stay elevated, which is why more insulin gets produced to bring the blood sugar down. Given enough time constant hyperinsulinemia can result in a condition called insulin resistance, where the cells become resistant to the effects of insulin and are less effective.
Insulin sensitivity and weight loss
A high level of insulin in the blood can trigger weight gain and make losing it difficult. Results of high insulin:
Stress and stress eating could be contributing to an expanding waistline. Examples could be eating a favorite meal while barely being conscious of the process or the inability to resist a chocolate bar after a long, distressing day. Research published in the Journal of Health Psychology found that stress-related eating has a preference for calorie-dense and highly tasty foods. And when stress levels rise, food cravings rise, triggering fat gain.
Reducing stress
There are a variety of techniques that can help the mind and body relax turning off the stress response. Here are some science-based favorites:
Proper sleep means sound sleep eight hours each night. Many individuals have convinced themselves that five or six hours is enough. Unfortunately, research shows otherwise. In a study published in PLOS Medicine, researchers studied the effects of short sleep duration on hormones that lessen or increase hunger, and on body mass index or BMI. They found the participants with short sleep had reduced leptin and elevated ghrelin which increases appetite and can contribute to weight gain.
Improving sleep quality
Developing a healthy sleep routine
Have the same sleep and waking time
Time to wind down
Meditate a little before sleep
Take a warm bath 90 minutes before bed
Avoid blue light at least 90 minutes before going to sleep
Limit caffeine intake as it can negatively affect sleep even when taken six hours before sleep
Avoid/limit alcohol in the evenings
Regular physical activity can help release stress and tension, tiring the body out so sleep comes naturally
30 to 40-minute endurance sessions a week are plenty. However, for some individuals, exercising too close to bedtime can have the opposite effect. Therefore, take note of whether this would be a problem.
High-Intensity Interval Training
There are a variety of approaches to exercising. But there is one evidence-based approach that has been proven to:
An increased amount of muscle increases the basal metabolic rate or BMR. This increases the body’s ability to burn fat and lose weight. A loss of lean body mass lowers resting energy expenditure and increases fatigue and injury risk. For individuals trying to lose weight the metabolic decline triggered by a loss of lean body mass can cause regaining the fat previously lost. What this means is that when muscle mass drops so does metabolism along with the ability to keep the weight off.
When muscle mass increases the body can easily burn fat, making it possible to achieve and maintain a healthy weight. It�s important to remember that as the body’s muscle mass increases the body needs more energy to nourish and support this new tissue. This means that higher calories are allowed, as not having enough calories becomes counterproductive. Muscle mass increase can be achieved by:
A healthy diet will help build muscle
Strength and resistance training
Taking protein supplements
Weight loss strategies takeaway
With the right approaches, permanent weight loss is possible. Instead of deprivation, focus on science-backed approaches that work:
This will make sticking to the weight loss strategies easier and will contribute to a happy, healthy life.
Body Composition
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Chao, Ariana et al. �Food cravings mediate the relationship between chronic stress and body mass index.��Journal of health psychology�vol. 20,6 (2015): 721-9. doi:10.1177/1359105315573448
Taheri, Shahrad et al. �Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index.��PLoS medicine�vol. 1,3 (2004): e62. doi:10.1371/journal.pmed.0010062
Spinal decompression surgery could be a treatment option discussion with a doctor to relieve nerve pain brought on by a spinal condition or disorder. Everything to know about the procedures straight from the experts.
Spinal Decompression Surgery Types: Laminectomy or Laminotomy
Both procedures involve the vertebrae�s lamina, which is an arch of bone that protects the spinal canal.
In a laminectomy, the lamina is removed almost entirely.
In a laminotomy, it is a partial removal.
Despite the removal, the large muscles of the back provide sustained protection for the nerves below. Therefore, the spinal nerves are still safe and secure following the procedures. Which one is right depends on the situation.
A laminectomy is usually performed to treat an arthritic condition of the spinal canal like spinal stenosis.
Laminotomy is used almost exclusively to remove a herniated disc.
A laminectomy removes more bone and sometimes the inner edge of the facet joint.
Ultimately, a surgeon will determine which of the two procedures is best for the individual’s needs and condition.
Decompression Surgery
Spinal stenosis or the narrowing of the spinal canal is usually caused by arthritis and overgrowth of the discs and joints. Similar compression issues respond well to non-surgical treatment. But sometimes surgery is necessary to treat uncommon but potentially severe cases. These include patients with:
Bowel or bladder problems caused by the pressure on the spinal nerves
Leg weakness that gets worse
Inability to walk or move for long periods and distance
The objective of spinal decompression surgery is to create space around the spinal cord and surrounding nerves by removing the compressing structure/s. When the cord and/or nerve/s are compressed, physical and neurological symptoms are experienced down the nerve�s pathway. This includes:
Tingling
Numbness
Electric shock sensations
Radiating/spreading pain
Weakness
Once the compressed nerves have space to relax and move around symptoms subside.
Laminectomy process
Lumbar laminectomy is the most common procedure to treat spinal stenosis in the low back.
It also helps treat herniated discs by allowing the surgeon to easily access the discs to repair any damage.
The surgeon removes the lamina and ligaments that have thickened and are causing problems to create more space in the canal.
The surgery enlarges the spinal canal so that pressure is relieved.
By removing the source of the pressure, the pain caused by the compressed nerves is alleviated.
An open laminectomy creates an incision of a couple of inches and exposes the spine.
The muscles of the spine and back are cut through to expose the bone.
Another technique that surgeons utilize is operating through a tube.
They’ve adapted these techniques to be able to decompress both the right and the left sides although they are only operating on one side.
Both procedures, minimal and traditional accomplish the same goals.
The difference is the minimally invasive approach involves one or more tiny incisions also known as skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them.
The traditional approach requires a larger incision and instruments that retract, separate and cut tissues.
Laminectomy surgery
Laminectomies are performed under general anesthesia using a posterior approach/lying face down during the procedure.
It can be open or minimally invasive sometimes called a microlaminectomy.
In an open laminectomy, the surgeon makes an incision near the affected spinal area.
Once the incision is made, a retractor will move the skin, fat, and muscles to the side so the surgeon can access the spine.
Next, they remove or trim the lamina and thickened ligaments to enlarge the space surrounding the compressed nerves.
Once done, the retractor is removed and the incision is closed with sutures.
Minimally invasive surgery or MIS is performed using special instruments like endoscopes and tubular retractors.
These instruments allow for smaller incisions and less cutting.
They will also use special eyewear to have a detailed view of the surgical field.
Sometimes, the surgeon uses an endoscope or a microscope focused down the tube to perform the surgery.
The portion of the lamina is removed, along with any bone overgrowths/osteophytes and ligament tissue.
The tubular retractors are taken out so the soft tissue moves back into place, and the incision is closed with dissolving sutures.
Other spinal procedures performed alongside
Laminectomies and laminotomies are typically not performed together. However, a surgeon could perform both if the surgery affects multiple levels of the spine. They can also be combined with other spinal surgeries, that include:
Foraminotomy
A foraminotomy is also a decompression procedure. But instead of removing part or all the lamina, the surgeon accesses the nerves through the spine�s foramen or the passageway that nerves pass through on both sides.
Discectomy
This decompression surgery involves the removal of all or part of the damaged intervertebral disc and is utilized for herniated discs.
Spinal fusion
Fusion is often performed after spinal decompression surgery, as the space that was created by removing spinal structure/s can cause instability to the spine.
Candidates for spinal decompression surgery
Both are common procedures performed by neurosurgeons and orthopedic spine surgeons. Laminectomies are considered one of the most effective treatments for spinal stenosis and spinal canal issues like:
Tumors
Certain types of infections and abscesses
Spinal issues involving bowel/bladder dysfunction
The primary reason for laminectomy is spinal stenosis, most common in individuals over the age of 60.
Other considerations and conditions include:
Non-invasive treatments that don’t improve the condition that includes medication, massage, and physical therapy
Ask questions about the procedure to ensure you are comfortable with the operation. Here are some questions:
What are the risks associated?
Will the surgery relieve all symptoms?
Not having the surgery risks?
What is recovery like?
Recovery
Open or micro, recovery does take time. Following the doctor�s instructions carefully are essential to make a full, healthy recovery.
Individuals should be careful for about a month following the surgery. But does not mean laying down or being sedentary. Movement is crucial to recovery.
The patient should not stay in bed or lie on the sofa.
Wait a week or two before beginning physical therapy if necessary.
Most will have a weak core, poor posture, and poor body mechanics, the goal is to help develop and strengthen these areas.
Things to help with recovery include:
Ice/cold packs will help reduce swelling and pain.
Try not to sit for too long, as sitting is the least comfortable position after back surgery.
Body mechanic awareness means avoiding too much bending or lifting and using the right body mechanics when bending or lifting.
Especially before surgery. Quitting entirely or at least for at least six weeks before surgery will make recovery easier and healthier.
Losing weight
Speak with a doctor about weight. Just 5 pounds can make a significant difference during recovery.
Blood sugar
For individuals with diabetes, having an A1C under eight before surgery is ideal.
Every patient�s recovery is different. Recovery time depends on:
The complexity of the surgery
Personal medical history
Health issues
Recovery typically takes about two to four weeks after the surgery. However, it depends on the reason/s for the surgery.
Questions
Post-laminectomy syndrome
Post-laminectomy syndrome PLS also known as failed back surgery syndrome is a condition where an individual continues to have pain after surgery. Individuals still having symptoms after should speak with their doctor to determine the next phase of treatment.
How long before exercise?
Returning to the gym or getting into an exercise routine will take some time. It is important to follow the doctor�s recommendations and complete the full course of physical therapy before regular exercise activity can resume. Discuss workout plans with the doctor to determine the best timeline for the spine.
Full recovery?
Returning to some activity is possible around four weeks after surgery. Full recovery takes longer as each patient�s recovery is unique. Depending on the complexity of the surgery, most return to all activities within 6 to 9 months.
Body Composition Spotlight
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
The world of health and fitness has evolved with all kinds of technical jargon and terminology that can require a guide to get a handle on things. It can become confusing and terms like Lean Body Mass and Lean muscle can get mixed up. Body composition analysis allows an individual to understand their body in a much clearer way with insight into the body’s health. Here we break down this technical terminology to get a basic understanding of how it is relevant to the body’s health. Think of this as a combination glossary, and action guide. �
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Guide to Basic Body Composition
Percent Body Fat Body/Fat Percentage
Percent Body Fat is a reflection of how much of the body’s weight is made up of fat.
It is calculated by dividing the weight of body fat mass by total weight.
It helps to track progress whether trying to lose weight or gain muscle.
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Takeaway
This percentage can be applied to set percent body fat ranges.
The healthy ranges are around 10-20% percent body fat for men and 18-28% for women.
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Lean Body Mass/Fat-Free Mass Guide
Lean Body Mass is sometimes used interchangeably with Fat-Free Mass.
Lean Body Mass is the weight of everything in the body that is not fat.
This includes muscles, organs, bones, and body water.
Lean Body Mass plus Body Fat Mass make up entire body weight.
If the Lean Body Mass value is in pounds subtract this number from total body weight to get an approximation of Body Fat Mass.
Divide this number by body weight, results are percent body fat.
Lean Body Mass is closely related to the total number of calories the body needs every day.
The Lean Body Massforms the core of the body’s metabolism, and this number can be used to help determine unique dietary needs.
No more basing nutrition off the 2,000-calorie diet. This is a poor one-size-fits-all approach to food intake.
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Skeletal Muscle Mass Guide
Skeletal muscle is one of four major muscle typesand governs all the movements that are consciously controlled. Everything from texting to deadlifting a barbell.
It is the muscle group that grows/builds when exercising.
Increased Skeletal Muscle Mass translates into increased strength.
When trying to build up the body and grow in size, this is the value to track and watch increase over time.
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However, muscle is not just for strength.
Muscle is made up primarily of protein and can act as protein storage.
When the body is under severe stress like a traumatic injury, the recovery process is triggered and needs added protein, up to four times the amount.
When the body is not able to get the proper amount of protein from a normal diet, the body begins to get what it needs from the protein storage/muscles.
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Basal Metabolic Rate/BMR
The Basal Metabolic Rate, or BMR, is the number of calories that the body needs to maintain Lean Body Mass. It is a significant component of overall metabolism.
An individual with more Lean Body Mass will have a higher Basal Metabolic Rate.
This is the reason why a 250-pound athlete needs to eat more than a 150-pound sedentary adult. Because the athlete has more Lean Body Mass.
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BMR can help make a healthy diet plan designed for fat loss or muscle gain by helping understand how much energy/calories from food the body needs.
Using the TDEE as a baseline an individual can develop a nutritional plan based on body composition goals.
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Body Water Guide
Body Water includes all the water in the body. This means everything from:
The water in the blood
Water in the organs
The water inside the bones
Body water can be subdivided into two types:
Intracellular
Extracellular
Intracellular means inside the cells and includes the water in the organs, muscles, composing 2/3 of total body water.
The remaining 1/3 is extracellular outside the cells and includes the water in the blood.
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Takeaway
When the body is generally healthy it maintains a healthy balance of intracellular to extracellular water with a ratio of around 3:2.
When the balance becomes unbalanced or falls apart water monitoring becomes important.
For example, individuals with severe health problems, like kidney ailments/failure, are unable to rid the body of extracellular water. This causes a buildup of water and requires removal through procedures like dialysis.
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Dry Lean Mass
Lean Body Mass includes everything that�s not body fat and includes body water.
When all the water has been taken out what remains is known as Dry Lean Mass.
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Lean Body Mass – Body Water = Dry Lean Mass
This amounts to the protein content of the muscles and the mineral content of the bones.
Most Dry Lean Mass will be found in these areas.
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Takeaway
Water monitoring can help track real, physical changes in the body.
Lean Body Mass contains body water, and body water levels can be influenced by different factors like a recent workout or being low on carbohydrates.
Changes in body water are considered technical changes in Lean Body Mass.
When building muscle, the body is actually building new physical protein stores and reflects in Dry Lean Mass.
An increase in Lean Body Mass can signal muscle growth, or not.
However, an increase in Dry Lean Mass is a more favorable indicator that there is muscle growth.
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Visceral Fat
Two major categories of body fat.
Subcutaneous fat is the fat under the skin and is the type that can be seen.
The second type is called visceral fat.
This fat collects inside the abdomen and wraps around the internal organs.
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Takeaway
Just because it cannot be seen does not mean it is not there.
If it is there it is something definitely worth knowing about.
This is because visceral fat is not just extra pounds but an active organ that secretes harmful hormones into the body that triggers never-ending inflammation.
The more visceral fat, the greater risk of inflammation.
Inflammation over time places added stress on the heart that can lead to cardiovascular problems.
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Get Tested Today
Hopefully, this guide has clarified some of the common body composition terminology. This is a basic overview designed to provide essential information about body composition and how it applies. A general understanding can help in making healthy lifestyle choices, like deciding to lose weight or dietary adjustments.
Body Health
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Westerterp, Klaas R. �Exercise, energy balance, and body composition.� European journal of clinical nutrition�vol. 72,9 (2018): 1246-1250. doi:10.1038/s41430-018-0180-4
Borga, Magnus et al. �Advanced body composition assessment: from body mass index to body composition profiling.��Journal of investigative medicine: the official publication of the American Federation for Clinical Research�vol. 66,5 (2018): 1-9. doi:10.1136/jim-2018-000722
Individuals with ankylosing spondylitis have a new treatment option that was previously used for rheumatoid arthritis. It is a medication that belongs to a class known as JAK inhibitors. Ankylosing spondylitis combines joint pain with reduced mobility. Ankylosing spondylitis is different because in severe cases, the bones in the spine can fuse together, literally reducing mobility.
The disease typically begins with pain and stiffness in the back. This is usually after some time of inactivity. Symptoms start before the age of 45 and develop gradually. There is no cure for ankylosing spondylitis but there are treatments that can improve symptoms and put the condition into remission. Ankylosing spondylitis treatment is the most successful when addressed early before irreversible damage to the joints begins.
Janus Kinase Inhibitors
Janus kinase inhibitors have traditionally been used to treat:
Rheumatoid arthritis
Psoriatic arthritis
Ulcerative colitis
The medication works by decreasing the immune system�s activity. Janus kinase inhibitor drugs affect several cellular compounds that are important in the development and progression of ankylosing spondylitis. Currently, there are only three Janus kinase inhibitor medications available in the United States and FDA-approved to treat rheumatoid arthritis:
Xeljanz
Rinvoq
Olumiant
Each of the approved inhibitors targets specific enzymes
Current Ankylosing Spondylitis Treatments
Janus kinase inhibitors are not given to individuals right away. However, it could be an option if first and second-line treatments are not working. Treatments usually consist of:
First-Line Treatments
NSAIDs
Nonsteroidal anti-inflammatory medications are the most commonly used to treat ankylosing inflammation, pain, and stiffness.
Chiropractic
Chiropractic physical therapy is a major part of ankylosing spondylitis treatment keeping the spine flexible and as healthy as possible. A chiropractic/physical therapy team design and develop specific exercises to fit individual needs, which include:
Stretching and Range-of-motion exercises help maintain flexibility in the joints
Sleeping and walking posture adjustment exercises
Abdominal and spinal exercises to maintain a healthy posture
If nonsteroidal anti-inflammatory medications do not relieve symptoms, then biological medications could be prescribed. This class of medications includes:
Tumor necrosis factor blockers work by targeting cell protein that is part of the immune system, known as tumor necrosis alpha. This protein causes inflammation in the body, and the blockers suppress it.
Interleukin 17 Inhibitors
Interleukin 17 in the body’s immune system defends against infection. It uses an inflammatory response to fight infections. The IL-17 inhibitors suppress the inflammatory response and help reduce symptoms.
Other Treatment Options
Lifestyle Adjustments
Following a medical treatment plan is often combined with diet and lifestyle adjustments that are recommended to help with the condition, these include:
Most individuals with ankylosing spondylitis do not require surgery. However, a doctor could recommend surgery if there is joint damage, the hip-joint needs to be replaced, or if the pain is severe.
Inhibitor Potential
Studies are ongoing in the treatment of ankylosing spondylitis. The drug is currently in Phase 3 trials for the treatment of adults. The trial results have shown patients with active ankylosing spondylitis showed improvement in:
Fatigue
Inflammation
Back pain
The study enrolled adults with active ankylosing spondylitis who took at least two NSAIDs that were ineffective at treating symptoms. Most of the participants were men, average age of 41, and no prior usage of biologic disease-modifying antirheumatic drugs.
Janus kinase could become a standard treatment
There is still not enough research to make a prediction, but the data is promising. The inhibitors seem to be a safe option when used in a properly screened, well-matched setting that includes regular monitoring. The inhibitors appear to be effective and have the advantages of being taken orally and working fast.
Body Composition
Osteoarthritis and weight loss
Being obese has shown to be a high-risk factor for the development of osteoarthritis. This is not only from the effects of extra weight on the body’s joints but also as a result of the inflammatory effects of adipose tissue. The lower back, hips, and knees, bear the majority of the body’s weight.
An excess amount of adipose tissue on the body’s midsection and legs has been shown to negatively impact the weight-bearing joints. Promoting Lean Body Mass and encouraging weight loss lowers the risk of osteoarthritis and improves an individual’s quality of life. Exercise is regarded safe for individuals with osteoarthritis and should be incorporated to improve body composition, reduce Body Fat Mass, improve Lean Body Mass and maintain a healthy weight.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Hammitzsch A, Lorenz G, Moog P. Impact of Janus Kinase Inhibition on the Treatment of Axial Spondyloarthropathies. Frontiers in Immunology 11:2488, Oct 2020; doi 10.3389/fimmu.2020.591176.�www.frontiersin.org/article/10.3389/fimmu.2020.591176, accessed Jan 21, 2021.
van der Heijde D, Baraliakos X, Gensler LS, et al. Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomized, placebo-controlled, phase 2 trial.�Lancet.�2018 Dec 1;392(10162):2378-2387. doi: 10.1016/S0140-6736(18)32463-2. Epub 2018 Oct 22. PMID: 30360970.�pubmed.ncbi.nlm.nih.gov/30360970/�accessed Jan 19, 2021.
Making small adjustments to achieve a healthy lifestyle is not as difficult/complex as some may think. Here are some golden nutritional recommendations for longevity, and a healthy lifestyle. Understanding these golden suggestions is a first step towards developing and maintaining sustainable changes. Our health coach and nutritionist can develop an optimal customized nutritional program that is focused on teaching individuals how to promote lifelong transformations and become more connected with mind and body.
Vitamins
Consume plenty of fruits and vegetables at least six+ portions every day to ensure the body absorbs essential micronutrients, vitamins, minerals, phytochemicals, and fiber. A golden recommendation is to count the fruit and vegetable colors instead of calories. Eating the food rainbow is an ideal way to get a variety of vitamins.
Red foods
These foods contain phytochemicals and help reduce the risk of diabetes and heart disease. These include:
Tomatoes
Red peppers
Red onions
Strawberries
Cherries
Watermelon
Orange and yellow foods
These are packed with Vitamin A and Vitamin C to promote healthy skin and vision.
Pumpkin
Sweet potatoes
Carrots
Lemons
Are all ways to obtain orange and yellow nutrients.
Green foods
These are high in Vitamin K, antioxidants, and folates highly beneficial to bone health. These include:
Kale
Broccoli
Peas
Kiwi
Green grapes
Brussels sprouts
Blue and purple foods
These contain antioxidants that help with heart disease and protect the body’s cells. Included are:
Added sugars and refined flour have none of the essential fiber and micronutrients the body needs to feel full. Whole grains are fiber-rich. This helps increase feeling full and satisfied, which helps block sugar cravings. Go for whole wheat flour instead of refined flour. Limit sugar intake by using the natural sweetness of fruits. Add fruits to meals to increase the sweetness if necessary.
Plenty of Water
Drinking half of an individual’s body weight is essential each day. 10-12 ounces of water before a meal will help increase full satisfaction and make an individual more aware of the body�s hunger cues. Golden suggestion, use a reusable water bottle can help keep track of water intake throughout the day.
12/12 Meal Schedule
Schedule the three main meals within a 12-hour window to avoid snacking throughout the day. The body needs to rest, digest, and reset between meals and overnight.
Stop Eating 3 Hours Before Sleeping
The body’s metabolism starts to slow down around 7-8 p.m. Research shows this timeframe falls in line when the body starts to tire and wind down. Allow the body to rejuvenate cells instead of wasting energy on digesting calories that don’t get burned for energy while sleeping.
Daily Physical Activity
Daily exercise contributes to overall health and longevity. Regular exercise can help in the treatment of chronic illnesses and the prevention of cardiovascular diseases. Every day try to complete 50-60 minutes of low-impact physical activity, and 15-20 minutes of moderate-high intensity cardio. Each week make two of the 20-minute workouts to strength training.
After Workout Snacks
Recovery snacks 15-minutes after a workout will help keep cravings down. These include a healthy carbohydrate, lean protein, and healthy fat. 1-2 hours after a workout have the next balanced meal.
No Devices With Meals
Electronic devices distract from the body’s natural hunger cues. Screens should be put away during meals to pay attention to the food and proper consumption. Watching TV or scrolling through social media has been shown to increase calorie intake.
Plenty of Sleep
Sleep deprivation alters the body’s hormones that control/regulate hunger cues. When the body loses sleep, the body begins to crave more food more often. Even after the body has had the necessary nutrients. A golden recommendation is to develop a relaxing nighttime routine that will enhance the length and quality of sleep. The goal is for 8-10 hours of sleep a night.
Stress Reduction
Incorporate stress-reducing activities into a regular routine. Constant stress on the body can contribute to cardiovascular disease. Activities help take the mind off thoughts, memories, and events that cause stress and worry. These include:
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Braude L, Stevenson RJ. Watching television while eating increases energy intake. Examining the mechanisms in female participants. Appetite. 2014;76:9-16. doi:10.1016/j.appet.2014.01.005
Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol. 2008;51(13):1237-1246. doi:10.1016/j.jacc.2007.12.024
Eckel-Mahan K, Sassone-Corsi P. Metabolism, and the circadian clock converge. Physiol Rev. 2013;93(1):107-135. doi:10.1152/physrev.00016.2012
Vina J, Sanchis-Gomar F, Martinez-Bello V, Gomez-Cabrera MC. Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol. 2012;167(1):1-12. doi:10.1111/j.1476-5381.2012.01970.x
Mental strategy exercises for chronic pain relief and improvement. Living with chronic pain is difficult especially if a doctor is saying that it is all taking place in an individual’s head. However, the pain is very real and happening in the brain, literally. Neuroimagingstudies show that certain areas of the brain become active when chronic pain presents. This is not the only way to know the brain’s role in how an individual experiences pain. What is also known is:
Anxiety, depression, and pain activate similar areas of the brain.
Certain psychiatric drugs used to relieve pain can also alter an individual’s mental state.
Chronic pain can lead to depression.
Clinical depression can cause physical symptoms, including back pain.
A health care provider could recommend/suggest psychological support for chronic pain. Psychological help and mental strategy exercises for chronic pain are not about how to reduce the pain, but more on how to reduce the dominance, interference, and impact of the pain and getting a healthy quality of life back. Consider a few evidence-based, psychological approaches to reduce back pain.
Cognitive-behavioral therapy
Cognitive-behavioral therapy or CBT trains an individual to modify specific thoughts and behaviors. Experts consider this approach a gold standard of psychological interventions for pain. It helps:
Reduce pain
Improves function
Improves quality of life
Individuals work on:
Pain coping strategies
Relaxation skills
Setting goals
Shifting perspectives on pain
A study found that two years after a two-week, intensive course of cognitive-behavioral therapy, patients took fewer pain meds than they did before the therapy.
Mindfulness meditation
Meditation is not all about sitting with crossed legs, hands resting on the knees, although this is a recommended pose for meditative purposes. A modern approach can be done anywhere, in any position that�s comfortable and will help soothe back pain. By oneself or with help from a therapist mental strategies can include
A study suggests that mindfulness meditation can be highly beneficial for older adults that are not as able to get an adequate amount of physical activity to improve pain levels. A group of older adults that participated in eight weeks of a mindfulness program, which consisted of four days a week for 30 minutes per session physical function and pain reduction improved.
Mindfulness stress reduction
Mindfulness stress reduction is a program that teaches individuals meditation techniques, that include basic stretches and postures. It teaches how to separate the physical and psychological aspects of pain. Medical centers across offer this treatment option for a range of disorders, including chronic back pain. It helps reduce pain intensity and improves function in individuals with arthritis as well as back and neck pain from various causes. It has also been found to be effective for fibromyalgia, which can cause intense widespread pain. A study found that mindfulness stress reduction improved:
Wellbeing
Pain episodes
Sleep problems
Fatigue in participants with fibromyalgia
More than half reported significant improvement
Acceptance and commitment therapy
Acceptance and commitment therapy or ACT teaches acceptance and mindfulness strategies with commitment and behavior mental strategies, to change the way pain is experienced. Numerous studies along with the American Psychological Association validate this approach as an established treatment for chronic pain.
Changing expectations
In one study several chiropractic patients who expected their back pain to improve were 58% more likely to improve than those who did not expect favorable outcomes. This mental strategy of manifesting a positive outcome through the power of positive thinking and beliefs about pain influence an individual’s actions.
For example, when thinking that physical activity will cause back pain, individuals are less likely to be active. This is known as fear avoidance. For most individuals with back and neck pain, gentle physical activity is essential because avoiding it will worsen the pain. Having the right mental strategy can go a long way in battling chronic pain, at Injury Medical Chiropractic and Functional Medicine Clinic we can help individuals experiencing/dealing with chronic pain.
Body Composition
Depression and physical health
Depression is debilitating and, in severe cases, a life-threatening disease that affects over 16 million people nationwide. Depression causes are not always clear and can be brought on by:
Biological factors – genetics
Individual brain chemistry
Certain medications
Stress
Unhealthy diet/nutrition
Mental illness and becoming overweight or obese often happen in conjunction, whether as a result of each other or from common risk factors that include:
Smoking
Poor diet
Lack of physical activity
Alcohol consumption
Prescribed medications for depression and anxiety disorders are have been shown to be successful in maintaining mental health. However, a side effect of these medications is weight gain. Like genetics, being educated on the potential side effects will help in reducing the risk of, and controlling weight gain when taking medication.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Pain and Therapy.�(Jun 2020) �Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.��www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/Journal of Psychosomatic Research. (Jan 2010) �Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.�
European Journal of Pain.�(Jan 2019.) �Beliefs about back pain and pain management behaviors, and their associations in the general population: A systematic review.��www.ncbi.nlm.nih.gov/pmc/articles/PMC6492285/
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