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Chronic Pain and Nutritional Habits

Chronic Pain and Nutritional Habits

Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.

At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, a health coach, and a nutritionist to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.

Chronic Pain and Nutritional Habits

Salt, Sugar, and Fat Affects the Body

A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.

Changing unhealthy eating habits is up to the individual.

Individuals can be advised to cut back or cut out unhealthy diet choices; however, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.

Nutrition Discussion

Chronic pain associated with inflammation linked to a poor diet is the first step in the diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.

The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen in stages. An example could be:

  • Having one cheeseburger and not two.
  • Having a burger without cheese.
  • Eating a burger without the buns.
  • Switching to a plant-based burger.
  • There are many options to be explored to improve eating habits in small steps.

Willpower also has to be addressed in a controlled and supportive setting. This is where the whole team comes in. Many individuals’ eating habits are part of who they and adjusting them can be an uphill challenge. To educate on:

  • Methods of accountability
  • Keeping a journal
  • Having the family or friends eat healthy with them
  • These are techniques and methods to increase willpower to make healthy changes.

Body Composition


Foods Can Support Body Detoxing

The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:

  • Neutralize oxidative stress
  • Lower inflammation
  • Increase immunity
  • Strengthen the musculoskeletal system
  • Foods and nutrients that detoxify can be a part of a healthy lifestyle.
References

Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015

Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346

Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421

Stress Management and The Body’s Health

Stress Management and The Body’s Health

More individuals are reporting extreme levels of stress. Studies indicate that an increasing number of individuals are feeling worried, anxious, or depressed regularly from various stressors. Maintaining the body’s health includes:

  • Following a balanced diet
  • Getting enough exercise
  • Taking vitamins or supplements to ensure the body gets what it needs for optimal function.

However, research has found that a sudden increase in stress, specifically stress associated with anger, can trigger:

This type of stress can affect individuals that did not know they had heart disease. Intense short-term stress can have dangerous effects on the body’s health, leading to chronic stress. Chronic stress continues at a low level for weeks, months, or years. It can significantly change the way the body functions. Stress management is very important for overall well-being. Learning how to handle stress properly is the goal.

Stress Management and The Body's Health

Poor Stress Management

When stress hits it triggers the brain to release various hormones. These hormones increase heart rate and raise blood pressure. This comes from evolution that helped early humans escape from predators and stay safe from different types of physical danger. This same stress reaction is what we go through, however, it is not to escape danger but to deal with work, family, school, commuting, and social issues, etc. And when the stress response happens on a regular basis it can have serious and long-term effects on the body’s ability to function properly. Stress includes mental, behavioral, and physical symptoms. The effects of stress that are most familiar are related to mood. Mood changes that can result from chronic low-level stress include:

  • Feelings overwhelmed
  • Increased anxiety
  • Generalized anxiety that is not connected with anything specific
  • Unmotivated or unfocused
  • Sadness
  • Depression
  • Irritability
  • Impatience
  • Unusually quick to anger
  • Restlessness

These mood changes can be tied to changes in behavior. The following behaviors are associated with increased stress levels:

  • Alcohol and/or drug abuse
  • Starting or increasing tobacco use
  • Eating changes – undereating or overeating
  • Withdrawing from friends and family
  • Avoiding social interaction
  • Little to no physical activity

Physical effects that are associated with long-term stress.

Chronic stress that lasts for a long period can affect the whole body. The immune system, digestive system, sleep cycles, etc. Physical symptoms include:

  • Tension in the neck and back
  • Persistent headaches
  • Stomach aches
  • Constant fatigue, even after waking up
  • Sleeping pattern changes
  • Insomnia
  • Muscle pain
  • Changes in libido
  • Being more prone to infections because of a weakened immune system
  • Chest pain

Learning Healthy Stress Management

Mental health is now an important part of living a healthy life. Stress comes from all kinds of different places. We can’t always change these moments, but we can change our reactions to reduce the negative effects and results. To manage stress, it is important to know what is causing it.

  • It could be an argument with a boss, co-worker, family member, or significant other.
  • Work deadlines
  • School grades, teachers, kids, etc
  • Bills
  • Repairs

Clearly identifying the main stressors will help individuals anticipate them and form a plan. There are different ways of dealing with it. The different strategies need to be researched and tried by individuals to see what works for them. Think about what helps the mind and body relax and unwind. A few recommended ways include:

  • Watching favorite shows or movies
  • Listening to music
  • Breathing techniques
  • Spend time with friends or family
  • Make time for yourself to do something you love – alone time
  • Unplug from devices like phones, tablets, or computer
  • Play a sport
  • Practice yoga
  • Physical activity
  • Take a nature hike
  • Write, paint, sculpt, knit, sew, crafts, make music, play instrument/s – real media or digital
  • Meditate and practice mindfulness techniques

These are strategies that can be incorporated into regular daily life. Be sure to set time aside to focus on mental wellbeing. Learn to recognize the signs when getting overwhelmed. Don’t hesitate to ask for help when needed. This can be a support system or mental health professional. This is to empower individuals to take better care of themselves in both body and mind.


Body Composition


Setting Attainable Goals

Individuals that have trouble achieving health goals might want to look at the goals themselves. Individuals typically have a general idea of their fitness journey. However, it is hard to reach those goals without a map. Losing weight or getting healthy is the goal but these goals are not measurable. This is too broad that can be different things to different people. Trying to accomplish a vague goal makes it hard to plan, making it happen, or seeing progress. A recommended strategy for goal setting is to use the SMART system. The acronym stands for:

  • Specific
  • Measurable
  • Attainable
  • Realistic
  • Timed

When goals fall into these parameters, it provides a clear picture of what is trying to get accomplished and the ability to plan accordingly. An example could be: An individual will work out at home or the gym for one hour, five days a week for one month. This is a specific and measurable goal when compared to I’m going to work out more. This provides clear guidelines of what needs to happen to achieve success.

References

Bailey, Ryan R. “Goal Setting and Action Planning for Health Behavior Change.” American journal of lifestyle medicine vol. 13,6 615-618. 13 Sep. 2017, doi:10.1177/1559827617729634

Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395

Jamison, J R. “Stress management: an exploratory study of chiropractic patients.” Journal of manipulative and physiological therapeutics vol. 23,1 (2000): 32-6. doi:10.1016/s0161-4754(00)90111-8

Jamison, J. “Stress: the chiropractic patients’ self-perceptions.” Journal of manipulative and physiological therapeutics vol. 22,6 (1999): 395-8. doi:10.1016/s0161-4754(99)70085-0

Quadriceps Thigh Strain: Chiropractic

Quadriceps Thigh Strain: Chiropractic

The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.

Quadriceps Thigh Strain: Chiropractic

Quadriceps Strain

Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:

  • Exhaustion
  • Muscle weakness
  • The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
  • Consistent sprinting and/or kicking
  • Previous strain and/or injury

The quadriceps is made up of four muscles.  One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.

Symptoms and Injury Grades

Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:

  • Pain
  • Swelling
  • Bruising
  • Muscle tenderness
  • For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.

Grades categorize the severity of the strain:

  • Grade 1 presents with mild discomfort in the thigh with no loss of strength.
  • Grade 2 presents with moderate pain, swelling, and some loss of strength.
  • Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
  • Grade 3 is where surgery is required.

Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.

Injury causes

Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.

Treatment

In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:

  • Rest
  • Ice
  • Compression
  • Elevate
  • The leg needs to be rested every 2-3 hours in 20-minute sessions.
  • A bandage can provide added support.
  • For slight tears and strains, it is recommended to stretch the quadriceps gently.
  • This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
  • Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.

Chiropractic Physical Therapy Rehabilitation

After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.

  • Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
  • Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
  • Following correct post-injury-care, exercises, and physical therapy.
  • Healing time can be 4- 6 weeks.

Body Composition


Strength Training: The Inverted Row

This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:

  • Lie flat on your back.
  • Grab a stable barbell or set of straps that are above you.
  • Pull your upper body up as high as possible while keeping the back straight.
  • Squeeze the shoulder blades together at the top.
  • Complete as many reps as possible.
  • Once enough strength and endurance have been built, try a pullup.
References

Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5

Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003

Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015

A Teenagers Spine During Development

A Teenagers Spine During Development

Poor spinal health in adolescence can lead to chronic pain in adulthood. Teenagers, just like adults, can experience back pain from accidents, sports injuries, a sedentary lifestyle, part-time jobs, chores, etc. However, sitting too long in school along with heavy backpacks can also contribute to compromised spinal health. Chiropractic professionals can help these young individuals address and prevent spinal issues/injuries to maintain a healthy spine.A Teenagers Spine During Development

Teenagers Spine Issues

If discomfort or pain is present, much push through, as they and their spines are young. There are common spinal dysfunctions that teens and parents should be aware of. These include:

Disc injuries

Teenagers can put a serious strain on the spine from various forms of physical activity, jumping, dancing, and playing. This pressure gets transmitted through the spine. During a teenager’s development, this can result in permanent disc damage.

Scoliosis

A spinal deformity or exaggerated curvature of the spine is common and affects young children and teens. It usually happens during the growth spurt just before puberty. This is why it is important to have a teenager’s spine checked regularly and analyzed for signs/symptoms of scoliosis.

Spondylolysis

This condition is often associated with sports injuries. It happens when teenagers overextend/overreach their backs. It’s most common in gymnastics, weight lifting, tennis, football, diving, and other similar sports.

Protection and Prevention

There are several ways that parents and healthcare providers can help teenagers make healthy decisions to achieve and maintain optimal spinal health.

Sitting less, moving more.

Children are taught to sit from a very young age. In school, watching t.v., or doing homework, teenagers spend more time sitting than their bodies should. Teenagers need to stand, walk and move around just like adults to protect their spines from degeneration and injury.

Maintaining healthy posture

Teens who learn how to maintain proper posture at a young age can maintain it for the rest of their life. Learning proper posture at a young age.

Sports safety

Playing sports is healthy. However, there is a risk associated with teen sports. Although they are taught to play safely, encourage them to continue to educate themselves about sports injuries and know how to address them.

Chiropractic Support

At Injury Medical Chiropractic and Functional Medicine Clinic, we’re committed to helping young adults and adolescents overcome and prevent spinal injuries that could turn into chronic pain conditions. We are continually developing our chiropractic, and physical therapy treatment approaches to achieve optimal results.


Body Composition


Sleep and Growth Hormone In Children

Growth hormones primarily control growth. The hypothalamus and the pituitary gland regulate this hormone. Sleep plays an important role in the proper function of these glands. A review showed that:

  • Growth hormone levels rise and peak at the onset of deep sleep
  • Multiple but smaller peaks were seen during other sleep stages
  • Individuals that have a delay in the onset of deep sleep have delayed peaks in growth hormone levels

For children to grow properly, they need to have adequate levels of growth hormone. This means they need to have a sufficient amount of sleep. The proper amount of sleep is vital for healthy body composition. A study measured the body composition of preschool-aged children. The study found that children who had proper sleep levels had less overall fat mass and reduced body fat. Children and teenagers need to get the proper amounts of sleep for their bodies to grow healthily.

References

Clement, R Carter et al. “What are normal radiographic spine and shoulder balance parameters among adolescent patients?.” Spine deformity vol. 8,4 (2020): 621-627. doi:10.1007/s43390-020-00074-9

Driehuis, Femke et al. “Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique, and outcomes.” PloS one vol. 14,6 e0218940. 25 Jun. 2019, doi:10.1371/journal.pone.0218940

Manansala, Christian et al. “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” Complementary therapies in clinical practice vol. 35 (2019): 301-307. doi:10.1016/j.ctcp.2019.03.013

Yoga Has Been Shown To Help Reverse Scoliosis

Yoga Has Been Shown To Help Reverse Scoliosis

A non-invasive method of treating scoliosis. Yoga Has Been Shown To Help Reverse Scoliosis. Scoliosis is the lateral curvature of the spine. The spine bends inward toward the front of the body at the neck region and lower back region. This curve is known as lordosis and bows outward in the middle-back region. This is known as kyphosis. If the spine curves to the side, this could indicate curvature that could be scoliosis. It can be painful and often can affect an individual’s appearance once the measurement goes beyond 25 – 30 degrees. One shoulder is usually higher than the other, and clothing cannot fit properly. If the curve goes beyond 60 degrees, it can affect breathing and cardiac function.

Yoga Has Been Shown To Help Reverse Scoliosis

Idiopathic Causes Unknown

This condition can consist of various components, especially with more intense curves. The ribs can shift backward on the side where the curve bulges. Most cases consist of adolescent idiopathic (without a known cause) scoliosis. Because the cause is unknown, there are not a variety of effective treatment besides surgery. Physicians carefully keep an eye for:

  • Curves under 25 degrees.
  • Bracing between 25 and 45 degrees.
  • Consider surgery for intense curvature.

Curves in individuals typically appear between 12 and 20 years old.

Yoga Shown To Reverse Scoliosis

Individuals are recommended to do just one yoga pose daily. However, depending on the type and severity of the curves, it could be more than one. They are asked to perform the pose for 5 minutes or less, depending on the condition. A yoga therapist, chiropractor, and physical therapist can generate significant spinal improvement. This could mean that a curve of 30 degrees could be reduced to around 18 degrees in 10-12 months. Individuals that do the poses at least 4 times a week have shown 80-90% improvement. The pose can be done at work during breaks, etc.

The biggest advantage of this technique is that it is non-invasive; it can help individuals with developing curves, reversing the curvature early. Most curves do not reach the point of surgery. In late adolescence and teen years, the spine is still quite flexible. This can help accelerate the effectiveness of the yoga pose to straighten the spine. The technique reduces the curve from worsening. X-rays will show if the curvature has improved or not. Patients could be asked to do the pose/s twice or more daily depending on the direction the condition is taking.


Body Composition


Gluten Effects

Gluten causes digestive issues for individuals that have celiac disease or autoimmune thyroid disease. Individuals with these conditions could experience a variety of uncomfortable and/or painful effects. These symptoms can vary based on their presentation. They fall into classifications.

Classical Celiac Disease

With classical celiac disease, symptoms include:

  • Diarrhea
  • Discolored stools
  • Constipation
  • Abdominal bloating and pain
  • Weight loss

However, these symptoms are more common in children than adults. In adults, symptoms are more similar to non-classical celiac disease.

Non-Classical Celiac Disease

With non-classical celiac disease, severe digestive symptoms may not present as classic celiac disease symptoms but develop other symptoms. These include:

Silent Celiac Disease

Silent celiac disease is less visible. Individuals might not see any symptoms. However, damage to the intestines is still happening from gluten consumption.

Autoimmune Thyroid Disease

Autoimmune Thyroid Disease or ATD. Autoimmune thyroid disease includes conditions like Hashimoto’s disease. This affects the thyroid gland and causes:

  • Extreme fatigue
  • Sensitivity to cold
  • Hair loss
  • Body aches
  • Joint aches
  • Negative health effects

Studies have shown that gluten-free helps alleviate symptoms.

References

Loren M. Fishman, M.D., B.Phil. (oxon). Healing Yoga. (New York: W.W. Norton, 2014).

Loren M. Fishman, M.D., B.Phil. (oxon). “Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial.” Global Advances in Health and Medicine. February 24, 2021. https://journals.sagepub.com/doi/full/10.1177/2164956120988259

Fishman LM, Groessl EJ, Sherman KJ, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis.” Global Advances in Health and Medicine. September 1, 2014. https://journals.sagepub.com/doi/10.7453/gahmj.2013.064

Adult Scoliosis: Diagnosis, Measurements, and Chiropractic

Adult Scoliosis: Diagnosis, Measurements, and Chiropractic

Scoliosis in adolescents and teens can be corrected with proper bracing, adjustments and lead a normal life. For adult scoliosis correcting the problem is more difficult. Fortunately, cases of adult scoliosis are rare. Scoliosis cases that follow from childhood into adulthood require a comprehensive diagnosis to determine severity. Thoracolumbar scoliosis adult-onset scoliosis requires an understanding of the catalysts to develop an effective treatment plan. Chiropractors use a full range of diagnostic tools to measure the severity of adult scoliosis.

Adult Scoliosis: Diagnosis, Measurements, and Chiropractic

Diagnosis

Adult scoliosis is the presentation of abnormal curvature of the spine. It can happen in the thoracic, lumbar spine, or both. This can have varying degrees of severity. Severe adult scoliosis can be apparent through visual assessment and examination. Cases that are not as obvious require utilizing diagnostic tools. These include:

Imaging

X-rays will show any asymmetry that is associated with scoliosis. This asymmetry can be present in the hips or shoulder and is usually qualified by spinal misalignment.

Walking Gait Examination

Inspecting how worn out an individual’s shoe/s are and having them perform various walking tests can reveal problems with gait. In adults, this can present instability. For example, having problems with balance or fast-twitch muscle response.

Neuromotor Exams

These exams are general and first performed to get a baseline diagnosis for the presence of adult scoliosis. Tests look at the left and right coordination along with the sense of touch capabilities. This measures the severity of the improper spinal curvature and how much it has affected the development of an individual’s motor functions. It is also done in the context of how it’s affecting the body’s biomechanics. Following these exams are quantitative tools/techniques for measuring the severity of adult thoracolumbar scoliosis. These include:

Cobb Angle Measurement

This tool determines the maximum degree of spinal curvature variation and provides a context for severity.

King Classification Tool

This examines the vertebral alignment to determine the spinal variance in specific vertebrae from the neutral center position.

Lenke Classification Tool

This spinal exam relies on measurements of three positions and looks for flexibility.

Combined Approaches

When assessing adult scoliosis, this is important to understand and helps determine how to proceed with treatment. The body is no longer in development as an adolescent. This means bracing does not come with a one-size-fits-all approach. Chiropractic can help with the assessment modalities used to investigate adult scoliosis cases. These measurement and analyses tools are often used in combination to develop a complete picture of what is going on.


Body Composition


Fill Up With Prebiotics

Individuals can help their gut bacteria thrive in the digestive tract by consuming prebiotics. Prebiotics are a form of soluble fiber. The body cannot digest these prebiotics, but gut bacteria can. Recommended sources of fiber-rich prebiotics can be found in nutrient-dense foods like:

  • Leeks
  • Garlic
  • Onions
  • Fruits
  • Legumes
  • Raw chicory

A diet with various fiber types has been shown to reduce the risk of obesity and prevent weight gain. Resistant starches like plantains, green bananas, and cooled potatoes have increased beneficial bacteria in the colon. Barley, oats, and wheat bran are insoluble high-fiber grains that are also recommended sources.

References

Aebi, Max. “The adult scoliosis.” 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. 14,10 (2005): 925-48. doi:10.1007/s00586-005-1053-9

Haenen, Daniëlle et al. “A diet high in resistant starch modulates microbiota composition, SCFA concentrations, and gene expression in pig intestine.” The Journal of nutrition vol. 143,3 (2013): 274-83. doi:10.3945/jn.112.169672

Lowe, Thomas et al. “The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems.” Spine vol. 31,19 Suppl (2006): S119-25. doi:10.1097/01.brs.0000232709.48446.be

Bursitis Types

Bursitis Types

Bursitis types: This is a condition that affects the bursae, which are the small, fluid-filled sacs that provide cushion for the:

  • Muscles
  • Tendons
  • Bones near joints

The bursae make it easier for tissues to slide over each other. The body has around one hundred and sixty bursae. However, only a few become clinically affected. These include the:

  • Wrist
  • Elbow
  • Shoulder
  • Hips
  • Knees
  • The base of the big toe and heel

The condition typically presents near joints constantly being used repetitively, like a job, sports, house/yard chores, etc. What happens is one or more of the bursae sacs become inflamed, resulting in pain.

Bursitis Types

Causes

  • Inflamed or irritated bursae typically cause it from overuse or intense/vigorous activity.
  • It can also be caused by bacterial infection.
  • Arthritis and gout can also cause bursitis.
  • Another cause is age.
  • As tendons age, they can tear easily, lose their elasticity, and can’t take too much stress.

Intense physical activities can lead to bursitis. These include:

  • Gardening
  • Typing
  • Working with a computer mouse
  • Throwing
  • Golf
  • Tennis
  • Manual tasks
  • Carpentry

These types of activities can lead to incorrect posture, overuse, and injury/damage.

Symptoms

The main symptom is pain in and around the affected area that worsens with movement. Depending on the severity of the strain and the length of time it has been going on, the pain can be intense with active and passive movements. Other symptoms include:

  • Tenderness
  • Stiffness
  • For some individuals, it can present as acute, with the intensity increasing.
  • This happens when movement aggravates the condition.

Bursitis Types

Four major types include:

  • Prepatellar
  • Trochanteric
  • Olecranon
  • Retrocalcaneal

Prepatellar Bursitis

Prepatellar is an inflammation of the sac situated between the skin and the patella/kneecap. The most common causes are trauma from a fall and direct pressure/friction from repetitive kneeling. This is one of the bursitis types that can get infected. Overproduction of liquid places pressure on the other areas of the knee, causing swelling. Most individuals report swelling and knee pain just over the front of the knee.

Trochanteric Bursitis

This bursitis type goes over the lateral area of the hip. There is a distinctive tenderness and aching pain. This type is more common for individuals with arthritis conditions and fibromyalgia. This condition is also seen after surgery, mainly osteotomies. The bursa can become inflamed in case of injury or overuse. It tends to affect middle-aged or older folks. Common causes include:

  • Muscle tears
  • Hip injuries
  • Tight hip or leg muscles
  • Disc disease of the low back
  • Leg-length inequality
  • Improper walking technique from a minor injury or strain
  • Overuse of the gluteal muscles
  • Flat feet
  • Improper footwear

Olecranon Bursitis

Olecranon is a common bursitis type. It is diagnosed by the appearance of swelling over the elbow. The swelling happens just behind the olecranon process of the ulna. The bursa can become infected. This bursitis does cause blood to rupture out, and fluid could be present. Individuals are advised to avoid leaning or resting on the elbows.

Retrocalcaneal Bursitis

This is characterized by pain in the Achilles tendon. Chronic inflammation of the bursa is brought on by friction, supination, and overpronation.  The flexibility of the calf muscles can be significantly reduced. Severe pain and swelling of the posterior soft tissue in front of the Achilles tendon are common symptoms. This bursitis type is often accompanied by mid-portion insertional tendinosis.

Risk Of Getting Bursitis

Anybody at any age can develop bursitis, but older individuals, specifically those in their forties and beyond, are more susceptible. This comes from all the wear and tear of the muscles and bones.

Risk Factors

  • Overpronation of the foot
  • Leg length deviation
  • Osteoarthritis
  • Obesity
  • Tight hamstring muscles
  • Incorrect physical training
  • Not stretching properly

Body Composition


When Inflammation Becomes Permanent

When white blood cells cause inflammation, it’s signaling that the body’s immune system works properly. The process works like this:

  • Inflammation activates
  • White blood cells attack the foreign invader
  • The invader is neutralized
  • The inflammation deactivates

This is how the body’s defense system naturally works. But, white blood cells are not the only type of cell that emit cytokines. Adipocytes or fat cells are another type of cell that can emit cytokines and cause inflammation. Scientists have learned that fat is an active endocrine organ that secretes various proteins and chemicals, including inflammatory cytokines. The body stores excess calories as fat to be used later for energy. When the body keeps adding more adipose tissue, cytokines are released by the fat cells, triggering inflammation. Obesity is characterized as a state of low-grade, chronic inflammation. Increased fat cells place the body in a constant state of stress activating immune responses. This means the body is in a constant state of inflammation with the immune system switch permanently on.

References

Aaron, Daniel L et al. “Four common types of bursitis: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 19,6 (2011): 359-67. doi:10.5435/00124635-201106000-00006

Coelho, Marisa et al. “Biochemistry of adipose tissue: an endocrine organ.” Archives of medical science: AMS vol. 9,2 (2013): 191-200. doi:10.5114/aoms.2013.33181

Khodaee, Morteza. “Common Superficial Bursitis.” American family physician vol. 95,4 (2017): 224-231.

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