Find essential information on whiplash, including signs, prevention tips, and recovery strategies for optimal health.
Introduction
An abrupt impact, whether from a vehicle accident, sports injury, or fall, may cause symptoms that start off as a small shock and progress to crippling pain and functional impairment. Whiplash is one such ailment that often lacks recognition due to its intricacy. Although it is often linked to rear-end crashes, whiplash is a complex injury that, if ignored, may have long-term consequences for the musculoskeletal system and cervical spine. Have you had shoulder and neck stiffness before? Do you have persistent, chronic headaches? Or does it seem like your neck’s range of motion is limited? We’ll talk about whiplash’s frequent origins, symptoms, effects on the cervical spine and musculoskeletal system, and evidence-based therapy options to lessen the pain-like symptoms in today’s post.
What Is Whiplash?
Whiplash is a type of neck injury associated with a rapid back-and-forth head-and-neck motion, mimicking the crack of a whip, hence the name. This causes persistent physical complaints and disability, and complaints when left untreated. (Mayou & Radanov, 1996) Medically, it is categorized under cervical acceleration-deceleration (CAD) injuries. This abrupt motion can damage muscles, ligaments, intervertebral discs, and even the neural structures of the cervical spine.
Common Causes Of Whiplash
While motor vehicle accidents are the most recognized cause, many mechanisms can precipitate a whiplash injury:
Even minor collisions at speeds as low as 5–10 mph can produce enough force to cause whiplash symptoms in vulnerable individuals.
Symptoms of Whiplash
When individuals are experiencing whiplash, the symptoms can appear immediately or may be delayed for 24–72 hours post-injury. Additionally, whiplash injuries are considered soft tissue injuries to the neck with various clinical symptoms that vary in severity and may include: (Chen et al., 2009)
Neck pain and stiffness
Reduced range of motion
Shoulder and upper back pain
Headaches, especially originating at the base of the skull
Jaw pain or temporomandibular joint (TMJ) dysfunction
Dizziness or visual disturbances
Tingling or numbness sensations in the arms (cervical radiculopathy)
Fatigue and cognitive issues (“whiplash-associated disorders” or WAD)
How Whiplash Affects the Cervical Spine and Musculoskeletal System
Whiplash is more than just a soft tissue injury, as it impacts several interconnected systems:
1. Cervical Spine
The rapid motion during a whiplash injury can lead to:
Cervical facet joint irritation
Intervertebral disc compression or herniation
Muscle strain or ligamentous sprain
Altered cervical lordosis, leading to chronic postural imbalances
This causes pain, stiffness, and tenderness in the neck area due to injuries within the bony, muscular, and ligamentous regions. (Alektoroff & Papanagiotou, 2021)
2. Musculoskeletal Dysfunction
Whiplash often initiates a cascade of biomechanical issues:
Myofascial pain syndromes, especially in the trapezius, levator scapulae, and sternocleidomastoid muscles
Compensatory thoracic or lumbar strain
Poor proprioception and neuromuscular control
Chronic trigger points and fibrotic tissue development
The longer these musculoskeletal imbalances persist, the more likely they will evolve into chronic pain syndromes and central sensitization.
Why Choose Chiropractic?-Video
Diagnosing Whiplash
Diagnosis is largely clinical, supported by a thorough history and physical exam. Imaging may be required to rule out more severe pathology:
X-rays: To rule out fractures or malalignment
MRI: For soft tissue or disc pathology
CT scans: If fracture or serious trauma is suspected
Functional assessments: Range of motion, palpation, neurologic evaluation
Evidence-Based Treatments for Whiplash
Treatment for whiplash should be multimodal and individualized, focusing on restoring function, reducing inflammation, and promoting healing. (Bussieres et al., 2016)
1. Chiropractic Care
Chiropractic adjustments can offer significant benefits in managing whiplash-associated disorders:
Myofascial release and soft tissue mobilization: Target muscle tension, trigger points, and fascial restrictions.
Postural retraining and ergonomic correction: Essential for long-term resolution.
Additionally, chiropractic patients experienced significant improvements in neck pain and function.
2. Physical Therapy
Individuals dealing with neck pain associated with whiplash can benefit from physical therapy to improve neck pain and disability. (Chrcanovic et al., 2022) Rehabilitative exercises are fundamental:
Neck range-of-motion drills
Isometric strengthening
Scapular stabilization and postural correction
Proprioceptive neuromuscular facilitation (PNF)
3. Functional Medicine Approach
From a functional medicine standpoint, addressing systemic inflammation, nutritional deficiencies, and stress response can enhance recovery:
Magnesium and B-complex supplementation for nerve healing
Sleep optimization and cortisol balance
4. Other Complementary Treatments
Acupuncture: Improves blood flow and pain modulation while alleviating pain and promoting relaxation. (Moon et al., 2014)
Gua Sha or cupping therapy: Relieves muscular tension
Dry needling: Effective for persistent trigger points
Manual lymphatic drainage: For patients experiencing edema or prolonged inflammation
Recovery and Prognosis
With consistent and proper treatment, many individuals recover within a few weeks. However, approximately 30–50% of individuals may develop chronic symptoms if not properly managed early on. Factors predicting prolonged recovery include:
High initial pain intensity
Poor coping mechanisms
History of prior neck injury
Psychosocial stressors
Early intervention using a holistic, integrative care model offers the best outcomes in preventing chronic whiplash-associated disorders.
Final Thoughts
Beyond the common “neck strain” classification, whiplash is a complicated neuromusculoskeletal injury that requires careful consideration by both patients and medical experts. Accurate diagnosis and successful treatment depend on an understanding of the complex effects on the cervical spine, neurology, and musculoskeletal function. Reducing symptoms and improving quality of life may be achieved by combining non-surgical treatments as part of a personalized treatment strategy.
Injury Medical & Personal Injury Clinic
We associate certified medical providers who understand the importance of assessing individuals with whiplash associated with their necks. When asking important questions to our associated medical providers, we advise patients to incorporate customized treatment plans for their pain associated with whiplash. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer
References
Alektoroff, K., & Papanagiotou, P. (2021). [Whiplash injury of the cervical spine]. Radiologe, 61(8), 710-713. doi.org/10.1007/s00117-021-00877-5 (Schleudertrauma der Halswirbelsaule.)
Bussieres, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., Hendrickson, B., Hincapie, C., Page, I., Passmore, S., Srbely, J., Stupar, M., Weisberg, J., & Ornelas, J. (2016). The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther, 39(8), 523-564 e527. doi.org/10.1016/j.jmpt.2016.08.007
Chen, H. B., Yang, K. H., & Wang, Z. G. (2009). Biomechanics of whiplash injury. Chin J Traumatol, 12(5), 305-314. www.ncbi.nlm.nih.gov/pubmed/19788851
Chrcanovic, B., Larsson, J., Malmstrom, E. M., Westergren, H., & Haggman-Henrikson, B. (2022). Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis. Scand J Pain, 22(2), 232-261. doi.org/10.1515/sjpain-2021-0064
Moon, T. W., Posadzki, P., Choi, T. Y., Park, T. Y., Kim, H. J., Lee, M. S., & Ernst, E. (2014). Acupuncture for treating whiplash associated disorder: a systematic review of randomised clinical trials. Evid Based Complement Alternat Med, 2014, 870271. doi.org/10.1155/2014/870271
Learn everything about histamine intolerance and its effects on your health. Discover symptoms and dietary tips to manage it.
Introduction
How often does eating cause discomfort or a burning feeling in your stomach? After consuming a certain dish, does your skin get heated and irritated? Or have you seen that your upper muscles begin to hurt as a result of your frequent sneezing? A histamine assault that affects the body and immune system may be the cause of these circumstances for many people. The function of histamine in the body, its symptoms, the reasons of histamine intolerance, and potential dietary strategies to lessen histamine-related bodily responses will all be covered in today’s article.
What Is Histamine?
The immune system serves as the body’s first line of defense against any external invaders found within the human body. The human body needs histamine to function. As a chemical messenger, it functions as a neurotransmitter in the brain and aids in controlling inflammatory and immunological responses as well as the production of stomach acid. In addition to being present in many foods, it is naturally created by mast cells, basophils, and certain neurons. Throughout the body, histamine attaches itself to histamine receptors (H1, H2, H3, and H4). (Patel & Mohiuddin, 2025) These receptors mediate the following processes:
Vasodilation, or blood vessel widening
Secretion of gastric acid
Contraction of smooth muscles
Signaling in the nervous system
Activation of the immune system
To put it briefly, histamine is necessary for preserving homeostasis and protecting the body from infections. But balance is essential. Excess histamine causes symptoms that are frequently confused with allergies, gastrointestinal issues, or hormone imbalances, particularly when the body is unable to effectively break it down.
What Is Histamine Intolerance
An actual allergy is not histamine intolerance. Rather, it describes a diminished capacity of the body to metabolize histamine, frequently as a result of low levels of the enzymes histamine-N-methyltransferase (HNMT) and diamine oxidase (DAO), which are both involved in this process. (Comas-Baste et al., 2020) Histamine builds up when these enzymes are compromised or overloaded, leading to a series of symptoms that can be transient, sporadic, or chronic, contingent on hormone levels, gut health, food consumption, and environmental circumstances.
Symptoms of Histamine Intolerance
Since histamine intolerance impacts several systems, it is frequently challenging to identify when a patient is receiving treatment. This is because histamine is a strong inflammatory mediator linked to allergic reactions that alters the body’s tissues and arteries. (Branco et al., 2018) The following symptoms can range in severity from mild to severe:
Dermatological:
Flushing or redness of the skin
Hives (urticaria)
Eczema or unexplained itching
Gastrointestinal:
Bloating, gas, or abdominal pain
Diarrhea or constipation
Nausea or vomiting
Heartburn (due to increased stomach acid)
Respiratory:
Nasal congestion or a runny nose
Asthma-like symptoms
Difficulty breathing (in severe cases)
Cardiovascular:
Low blood pressure
Dizziness or lightheadedness
Rapid or irregular heartbeat
Neurological:
Headaches or migraines
Anxiety
Insomnia or sleep disturbances
Brain fog or difficulty concentrating
Reproductive:
Menstrual irregularities
Worsened symptoms during estrogen surges (e.g., ovulation, PMS)
If symptoms improve with a low-histamine diet or DAO supplementation, this may point toward histamine intolerance.
Causes and Risk Factors of Histamine Intolerance
1. Enzyme Deficiency
The most direct cause is a deficiency or dysfunction in the enzymes DAO (in the gut) or HNMT (in tissues), which are responsible for breaking down histamine.
2. Gut Dysbiosis
When the gut microbiome becomes imbalanced with environmental factors, it can lead to increased histamine production by certain bacteria and reduced DAO activity, especially in cases of:
Small Intestinal Bacterial Overgrowth (SIBO)
Inflammatory bowel disease (IBD)
Leaky gut syndrome
This is because gut bacteria play a crucial role in the body, providing food digestion and immune activation, and regulating the entero-endocrine signaling pathways to ensure the body works properly. (Dicks, 2022)
3. Genetic Polymorphisms
Variants in genes encoding DAO or HNMT enzymes may reduce their function, increasing susceptibility to histamine intolerance.
4. Nutritional Deficiencies
Vitamin B6, copper, and vitamin C deficiency—all cofactors for DAO activity—can impair histamine metabolism.
5. Medications
Several medications are known to block DAO or trigger histamine release, such as:
NSAIDs (ibuprofen, aspirin)
Antidepressants (SSRIs, MAO inhibitors)
Muscle relaxants
Diuretics
Certain antibiotics
6. Hormonal Fluctuations
Estrogen can inhibit DAO, which explains why many women experience worsened histamine symptoms during PMS, pregnancy, or estrogen-dominant conditions like PCOS or endometriosis.
Fighting Inflammation Naturally-Video
High-Histamine Foods to Avoid
To manage histamine intolerance, a low-histamine diet is often a first-line approach. Common high-histamine or histamine-liberating foods include:
This is because environmental factors like eating various foods can lead to food intolerances, thus causing histamine accumulation. (Jochum, 2024)
Foods That May Help Reduce Histamine Reactions
A well-structured anti-histamine diet should include foods that are low in histamine and support DAO activity and gut health. A low histamine diet can reduce the chances of histamine reactions by eliminating foods that contain histamine and cause responses in the body. (Sanchez-Perez et al., 2021) Here are some food categories that may help minimize histamine burden:
1. DAO-Supportive Nutrients
Vitamin C: Bell peppers, broccoli, kiwi, strawberries
These help stabilize mast cells and reduce histamine release:
Quercetin-rich foods: Apples (peeled), onions, kale, green tea
Turmeric: Contains curcumin, which has mast-cell-stabilizing properties
Ginger: Helps with nausea and inflammation
Holy basil (tulsi): Adaptogen and natural antihistamine
3. Gut-Healing Foods
Bone broth (if tolerated; avoid long cooking times to reduce histamine)
Fresh meats and poultry (cooked and eaten immediately)
Non-citrus fruits like pears, blueberries, and watermelon
Gluten-free whole grains (quinoa, rice, millet)
Functional Medicine Approach to Histamine Intolerance
When finding a holistic approach for reducing histamine intolerance, many healthcare professionals can devise a customized treatment plan to assess the individual. Histamine intolerance often exists alongside broader systemic dysfunctions such as:
Chronic stress
Heavy metal toxicity
Hormonal imbalance
Environmental triggers
Autoimmune conditions
In addressing histamine intolerance, it’s important to:
Identify underlying triggers using functional lab testing (e.g., gut microbiome panels, food sensitivity testing, genetic SNP analysis).
Rebuild DAO capacity with nutrient repletion and, if necessary, temporary DAO supplementation.
Support detoxification pathways, especially the liver and gut.
Heal the gut barrier through probiotics (non-histamine producing), prebiotics, and anti-inflammatory foods.
Final Thoughts: Empowering Healing Through Nutrition and Insight
Histamine intolerance may have a significant impact on many people’s quality of life, although it is often misdiagnosed or ignored. Many people find great comfort by comprehending the symptoms, identifying the underlying causes, and implementing thoughtful food and lifestyle adjustments. Like any chronic illness, bio-individuality is important. One person’s triggers could be quite harmless to another. Trial and error, close observation, and sometimes expert advice are all common steps on the road to recovery. A personalized holistic treatment plan may help people with histamine intolerance regain equilibrium and enhance their overall health.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of assessing individuals with histamine intolerances affecting their bodies. When asking important questions to our associated medical providers, we advise patients to incorporate small changes in their routine to reduce the chances of aggravating histamine symptoms from affecting the body. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Branco, A. C. C. C., Yoshikawa, F. S. Y., Pietrobon, A. J., & Sato, M. N. (2018). Role of Histamine in Modulating the Immune Response and Inflammation. Mediators of Inflammation, 2018, 1-10. doi.org/10.1155/2018/9524075
Comas-Baste, O., Sanchez-Perez, S., Veciana-Nogues, M. T., Latorre-Moratalla, M., & Vidal-Carou, M. D. C. (2020). Histamine Intolerance: The Current State of the Art. Biomolecules, 10(8). doi.org/10.3390/biom10081181
Sanchez-Perez, S., Comas-Baste, O., Veciana-Nogues, M. T., Latorre-Moratalla, M. L., & Vidal-Carou, M. C. (2021). Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content? Nutrients, 13(5). doi.org/10.3390/nu13051395
Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?
Bone Growth Stimulator
Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.
How They Work
Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)
They come in various shapes, sizes, and technologies depending on the location of the fracture.
The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.
Electrical Stimulation
Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.
Ultrasound Stimulation
They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.
Implantable vs. External
Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.
The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.
Effectiveness
Studies of bone stimulator effectiveness suggest two benefits:
Less pain is associated with the bone healing process.
Faster fracture healing.
However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)
While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.
When Stimulation is Necessary
Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)
Nonunion Fractures
When a fracture doesn’t heal within the expected timeframe.
Open fractures
Stress fractures
Scaphoid bone fractures
Talus fractures
Failed Fusions
When a spinal fusion hasn’t been successful.
High-Risk Patients
For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications
Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. doi.org/10.1038/srep31724
Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. doi.org/10.4103/0019-5413.50844
Can incorporating sauerkraut into one’s diet help promote healthy gut bacteria?
Sauerkraut
Sauerkraut, a fermented cabbage food, is a great source of probiotics and fiber, both of which can contribute to gut health. It’s a living food containing various microbial strains and can help improve digestion, reduce inflammation, and improve overall gut health. (Shahbazi R. et al., 2021)
Fermented foods like sauerkraut have live cultures that promote the growth of beneficial probiotics, bacteria that provide powerful health benefits. Probiotics also help make foods more digestible, increasing the gut’s ability to absorb the vitamins and minerals they contain. A study found that fermented cabbage may help protect intestinal cells from inflammatory damage more than raw cabbage. (Wei L., & Marco M. L., 2025)
Homemade sauerkraut likely contains more live cultures than store-bought since processing may destroy some of the healthy bacteria. (National Institutes of Health Office of Dietary Supplements, 2023) Depending on which supplement is chosen, sauerkraut may have a greater diversity of probiotic strains. This is because an oral supplement has a known quantity and strain of probiotics. Individuals who want to add probiotics to their diet for potential gut health benefits should take a food-first approach, which is generally recommended over oral supplements. (National Institutes of Health, 2025)
Look at the Benefits
Probiotics
Sauerkraut contains lactic acid bacteria, which are beneficial bacteria that can help support the immune system and reduce inflammation. (Healthline, 2023)
Fiber
Sauerkraut is a robust source of fiber, which aids in digestion and can help you feel full longer.
Digestion
The probiotics in sauerkraut can improve digestion by promoting a healthy gut microbiome. (Medical News Today, 2023)
Consult with a doctor before adding sauerkraut to your diet if you are taking monoamine oxidase inhibitors (MAOIs).
Start small and learn how you like to eat sauerkraut, which can be as a condiment, side dish, or sandwich ingredient.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. 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. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
Shahbazi, R., Sharifzad, F., Bagheri, R., Alsadi, N., Yasavoli-Sharahi, H., & Matar, C. (2021). Anti-Inflammatory and Immunomodulatory Properties of Fermented Plant Foods. Nutrients, 13(5), 1516. doi.org/10.3390/nu13051516
Wei, L., & Marco, M. L. (2025). The fermented cabbage metabolome and its protection against cytokine-induced intestinal barrier disruption of Caco-2 monolayers. Applied and environmental microbiology, e0223424. Advance online publication. doi.org/10.1128/aem.02234-24
Find useful information on perimenopause, including potential symptoms and expert tips to cope effectively.
Introduction
Regarding one’s health and well-being, many people often become aware of how their bodies are naturally changing. This may include both male and female hormonal changes as well as the normal skeletal deterioration that occurs inside the joints. Andropause is the period of time when male testosterone levels begin to diminish. Menopause is the natural aging process that begins for women when their levels of the hormones progesterone and estrogen start to decline. Nevertheless, women experience perimenopause prior to menopause taking place. This article will discuss the definition and symptoms of perimenopause, its effects on the musculoskeletal system, and strategies for managing these problems.
What Is Perimenopause?
Do you experience mental fogginess, where you can’t remember what you were doing? How often do your joints ache after doing a simple errand? Or how frequently does your bladder feel full that you constantly need to go to the bathroom? Many of these issues are associated with hormonal changes within the body. For women, perimenopause is a transformative menopausal stage that usually occurs in women in their 40s and early 50s, which is widely recognized for hormonal shifts and reproductive changes in the body.
Additionally, perimenopause usually starts when a woman is dealing with a persistent difference in their menstrual cycle length after 12 months. (Lega & Jacobson, 2024) This is due to the ovarian hormone production of estrogen and progesterone fluctuating unpredictably.
Common Symptoms Of Perimenopause
When it comes to perimenopause, it can affect women differently with its symptoms. Since hormones during perimenopause fluctuate unpredictably. This is because for women, ovarian hormones like estrogen play an important role in maintaining health and homeostasis by modulating the body’s nervous, endocrine, and immune function. (Priyanka & Nair, 2020) Some of the other symptoms that are included with perimenopause are:
Menstrual irregularities: Skipped, prolonged, or heavy periods
Additionally, since perimenopausal symptoms vary from woman to woman, perimenopause can also affect the musculoskeletal system in the body.
Assessing Hormone Therapy- Video
How Perimenopause Affects The Musculoskeletal System
The musculoskeletal system’s various muscles, tissues, andligaments allow the body to be mobile and flexible without pain. However, environmental factors like physical inactivity, poor dietary habits, andchronic issues affect the musculoskeletal system, leading to overlapping risk profiles affecting the body. For perimenopausal women, their musculoskeletal system is affected by fluctuating estrogen hormone levels. When it comes to perimenopause, the musculoskeletal system will begin to develop various issues that can affect the body over time. When a woman is going through perimenopause, their bone mineral density is reduced as well as their muscle mass due to the decline of estradiol. (Wright et al., 2024) This causes the musculoskeletal system to develop:
Increased joint stiffness (especially in the morning) and muscle pain
Osteopenia and osteoporosis
Sarcopenia (loss of muscle mass)
This is due to hormones being associated with inflammation. When a woman has low or fluctuating estrogen hormone levels, it can lead to developmental changes in their pain perception in their muscles. The hormone estrogen is responsible for inhibiting the actions of inflammatory mediators in osteoblasts and stromal cells to ensure that bone mass is reabsorbed into the skeletal system. When perimenopause naturally occurs in the body, estrogen levels decline, and the development of musculoskeletal issues starts to appear.
Managing Perimenopausal Symptoms
Now, when it comes to managing perimenopausal symptoms, many women can start researching non-surgical treatments and incorporating various techniques to help manage the symptoms and reduce any pain from musculoskeletal issues associated with perimenopause. Below are some therapeutic options for perimenopausal women to manage their symptoms and restore their musculoskeletal system.
Hormone Therapy
For many women, hormone replacement therapy remains the gold standard for treating moderate to severe vasomotor and musculoskeletal symptoms. Hormone therapy for perimenopausal women can help restore estrogen production to the body and accelerate skeletal growth. (Moustakli & Tsonis, 2023) Estrogen therapy can:
Reduce joint and muscle pain
Slow bone density loss
Improve overall well-being
Note: HRT is not suitable for everyone, particularly those with a history of breast cancer, thromboembolic disease, or certain cardiovascular conditions. Always conduct a thorough risk-benefit analysis.
Exercise & Nutrition
For perimenopausal women, proper nutrition and exercise can help manage the perimenopausal symptoms and maintain muscle tone. Incorporating nutritional foods with high protein, calcium, and vitamin D can help maintain skeletal muscle mass and regulate proper hormone functioning. (Erdélyi et al., 2023) Combined with exercises, itcan help strengthen weak muscles, improve bone density, and promote flexibility while retaining the joint’s range of motion. Exercises like tai chi are excellent for perimenopausal women as they combine meditation through slow and gentle movements that can lower fracture risk, improve muscle strength, and restore balance functionality. (Li et al., 2023)
Manual Therapies
Many women find relief with:
Acupuncture: Shown to help reduce chronic pain affecting the joints and provide anti-inflammatory effects to the musculoskeletal system. (Zhao et al., 2023)
Mind-body therapies: Meditation, cognitive-behavioral therapy (CBT) to address mood swings and insomnia
Chiropractic and physical therapy: Effective in managing musculoskeletal discomfort
Final Thoughts
For many women, the perimenopause is a normal time of life, and it significantly affects musculoskeletal health. Women may handle this shift with fortitude and resiliency if they remain proactive with lifestyle changes, medical treatments, and routine monitoring. In order to help women feel strong and supported throughout their perimenopausal journey, a customized treatment plan that honors their individual needs might be helpful.
Injury Medical & Functional Wellness Clinic
We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal issues related to perimenopause. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce pain-like symptoms related to the musculoskeletal system. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, 16(1), 27. doi.org/10.3390/nu16010027
Li, J., Guo, J., Wang, X., Zhang, X., Zhang, Y., Bu, M., Yao, X., & She, Y. (2023). Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int, 34(11), 1853-1866. doi.org/10.1007/s00198-023-06830-7
Moustakli, E., & Tsonis, O. (2023). Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals. Medicina (Kaunas, Lithuania), 59(12). doi.org/10.3390/medicina59122094
Priyanka, H. P., & Nair, R. S. (2020). Neuroimmunomodulation by estrogen in health and disease. AIMS Neurosci, 7(4), 401-417. doi.org/10.3934/Neuroscience.2020025
Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. doi.org/10.1080/13697137.2024.2380363
Zhao, F.-Y., Zheng, Z., Fu, Q.-Q., Conduit, R., Xu, H., Wang, H.-R., Huang, Y.-L., Jiang, T., Zhang, W.-J., & Kennedy, G. A. (2023). Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Frontiers in Public Health, 11. doi.org/10.3389/fpubh.2023.1120567
Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?
Muscles Retighten
Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.
Muscle memory: The body’s natural tendency to return to its previous state of tension.
This includes all the unhealthy postures/positioning
Delayed inflammatory response.
The body’s natural healing process
How muscles respond to manipulation
The need for ongoing maintenance of muscle health
After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)
Causes
Causes for muscles to retighten.
Underlying Issues
If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
In that case, the muscles may return to their original state after a few days or weeks.
Delayed Onset Muscle Soreness (DOMS)
For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)
Delayed Inflammatory Response
Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)
Muscle Memory
The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.
Muscle Guarding
The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage.
This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)
Muscle Health Maintenance
Regular Maintenance
Muscles need consistent care to maintain their optimal state of health and function.
Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.
Individual Variation
Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)
Massage Treatment
Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.
Type of Massage
Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)
Muscle Fiber Manipulation
Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.
Dehydration
Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)
Lactic Acid Buildup
During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness.
If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. doi.org/10.1097/rnj.0000000000000151
Can pace running help runners concentrate on other things, like breathing, form, or mental toughness?
Pace Running
Running is a sport many participate in and doesn’t require any equipment—only quality running shoes. Running in races comes with various physical and mental challenges. Some runners enjoy running in races and marathons but want to perfect their abilities and techniques, become more consistent, finish in a certain time, or pass a personal record. This is where pace running or working with a pace runner can help achieve those goals.
What is a Pace Runner?
A pace runner, or pacer, is an experienced runner who can run at a set pace for a long time. The pacer sets the speed so the runner can focus on running. Pacers run in races or marathons to help set the pace for a runner or runners. There are different reasons why professional and amateur runners work with a pace runner. Professional runners often use pace runners to work on techniques and help reach new levels in their running, while amateur runners can work on improving their overall running abilities. There are three typical types of pacers.
Race Pacer
Pacers wear or carry signs to make it easier for the runners and can often run split times.
A split time is the time it takes to run a certain distance.
Typically, these pacers will run at an even pace.
Many marathons will have pace groups that run at a specific speed or pace throughout the race.
The pace groups will have runners running a set time so other runners can key off these runners.
There are typically set paces for a 3-hour marathon time up to a 6-hour marathon time.
Runners can use pacers to help them reach their goals without relying on technology, such as a smartwatch or GPS, to determine if they maintain the correct speed throughout the race.
Distance Pacer
Professional and non-professional runners who run long distances or ultramarathons may also use a pace runner to set a specific tempo.
Ultramarathons are any race with a distance longer than the standard marathon of 26.2 miles.
Because some ultramarathons can be as long as 50 to 100 miles, runners who choose to have a pacer often have several pacers at different sections to motivate them and help set the rhythm.
Record Pacer or Rabbit
A record pacer, also known as a rabbit, is a pacer who helps a professional runner set a new record.
A rabbit often leads the race for a predetermined distance at a predetermined pace.
Some races have multiple pacers at various distances.
How Are Pacers Used?
There are different reasons for having a pacer, but they are based on the runner’s goals.
A runner being paced runs directly behind a pacer or pacers.
A pacer can run any pace requested, but typically, the pace groups run at an even pace or with a slight negative split.
A negative split is when a runner runs the race’s second half faster than the first half.
How Do They Help?
A pacer can be helpful because it takes more energy to lead a race than to sit back and follow another runner.
The pacer is responsible for timing and establishing the tempo so runners only have to focus on running.
A pacer does more work setting the pace, which allows the runner being paced to relax and not stress about hitting the pace.
A study focused on elite athletes who used pacers. It found that running together at a realistic speed helped optimize and achieve finishing time goals. (Casado A. et al., 2021) However, not all elite events allow pacers to participate. Some championship events, like the Olympics and NCAA Championships, do not allow pacer runners.
Benefits
Benefits of running with a pacer.
Prevent Running Too Fast
When a race begins, runners can take off and start too fast.
Starting too quickly can negatively impact the runners, like losing energy and stamina.
A pacer can help start the race with a steady pace, keeping them from going out too fast or expending too much energy.
Maintain an Even Pace
Maintaining an even pace can be difficult throughout a long race or a marathon.
Having a pacer can relieve some stress and pressure.
A pacer can keep the runners on an even pace or negative splits versus going out too fast and losing energy.
Focus on the Race
Pacers help the runners stay focused on the race without worrying about how they are running or maintaining the right speed.
A pacer can help keep runners relaxed.
Motivating
Pacers can help motivate runners.
The pace runners may encourage individuals along the way and help them stay motivated to keep working toward their goal, especially when the hard parts come.
Disadvantages
Running with a pacer can sometimes be more stressful than beneficial, especially for amateur runners. A pacer or pace group can be helpful, but it also can create more stress for some amateur runners.
Sometimes, individuals realize the pacer is running too quickly for what they can handle.
Anxiety can present as not being able to keep up.
Other times, runners underestimate their abilities and run more slowly than their bodies can handle.
However, runners don’t have to stay with a pace group just because they started with them.
Individuals can run ahead.
Or if the group is too fast, the runner can slow down and join the slower-paced group behind them.
The key is to listen to your body and do what feels right.
Becoming a Pacer
An experienced runner who wants to be a pacer for a race can contact a running organization about becoming a pace runner.
Individuals need to be able to have consistent racing times.
Be able to run at a set speed for a long duration.
Most pacers will contact the race organization to apply for a certain pace.
Some pacers enjoy the thrill of running in a race and helping other runners meet their goals.
The runner’s goals and the type of event also influence who the pacer is.
Injury Medical Chiropractic & Functional Medicine Clinic
Individuals can talk to local running experts or a running coach. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. We can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Difference of Using Custom Foot Orthotics
References
Casado, A., Hanley, B., Jiménez-Reyes, P., & Renfree, A. (2021). Pacing profiles and tactical behaviors of elite runners. Journal of Sport and Health Science, 10(5), 537–549. doi.org/10.1016/j.jshs.2020.06.011
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