PODCAST: Ryan Welage and Alexander Jimenez, both medical students at the National University of Health Sciences, discuss the several new approaches that they developed in order to help people continue to engage and participate in exercise from the comfort of their own homes. Using their advanced understanding of functional medicine, biomechanics, and nutrition, they undertake explaining simple methods and techniques for complex movement protocols. Moreover, Alexander Jimenez and Ryan Welage discuss how diet can be an essential element in overall health and wellness. Dr. Alex Jimenez offers additional guidelines with the Functional Fitness Fellas, among further advice. – Podcast Insight
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Dr. Alex Jimenez RN, DC, MSACP, CCST
Be sure to talk with your provider before taking or combining dietary and herbal supplements with prescription meds or over the counter medications. Individuals with chronic back/neck pain but want to get away from medication/s, and pain relievers, dietary and herbal supplements could be an option. There are dietary supplements as well as, herbal supplements that although used in nutrition, also have added benefits for pain and inflammation relief.
Individuals have found herbs and supplements to be helpful in reducing and alleviating their pain. It is important to understand that these are not a cure-all that will take the pain away or the depression that accompanies chronic spine-related conditions. These are made to help to manage back pain symptoms.
Nutrition and Dietary
A healthy diet includes plenty of fruit, vegetables, and whole grains which keeps the body in top form. Antioxidant foods like green leafy vegetables and berries help in fighting inflammation. Dietary and herbal supplements that research has found helpful in reducing inflammation and pain are listed. However, we must point out that several of these supplements can increase the risk of bleeding. Therefore have a discussion with your health care provider before taking any type of supplement.
Supplements
Omega-3 fatty acids
Flaxseed and Fish Oils
Omega-3 fatty acids can increase the risk of bleeding and conflict with blood-thinning medications like warfarin coumadin and aspirin.
Glucosamine/Chondroitin
Studies show these supplements can help relieve arthritis pain but have not been studied as a treatment for back pain.
Glucosamine and chondroitin can interfere with blood-thinning medications like warfarin coumadin and aspirin.
It can increase the risk of bleeding, so do not take this without consulting a health care provider
It can interact/interfere with antibiotic meds
Do not take if have a peptic ulcer
Herbal Supplements
Herbal supplements have been used by many cultures for health and dietary benefits for a very long time. These supplements are literally made from herbs/plants valued for their flavor, scent, and medicinal qualities. Examples of herbal supplements for pain include:
Cayenne reduces pain signal intensity
Devil’s claw relieves inflammation
Eucalyptus clears chest congestion
Benefits of Herbs
People prefer dietary and herbal supplements instead of standard/traditional drugs and medications for a variety of reasons.
Some because they provide pain relief without the side effects associated with medications. An example is white willow bark, that has been used for years for its anti-inflammatory benefits. And it doesn’t upset the stomach the way medications the way aspirin does.
Some prefer herbal supplements because they are natural.
Herbs come in pill, capsule, tablets, teas, and liquid extracts.
Turmeric
Reduces inflammation and pain
Turmeric can increase the risk of bleeding, especially for those taking blood-thinning medication
Devil’s claw
Reduces pain
Can increase the risk of bleeding and interact with diabetes meds
Can affect the heart and can cause issues for those with gallstones
Willow bark
Relieves pain
Do not take if taking aspirin or blood-thinning meds
Do not take if are allergic to aspirin or salicylates
Do not give to children under eighteen
Capsaicin cream
Reduces pain and inflammation
It is one of the main components in chili peppers
Things to Remember
Dietary and herbal supplements do not have to be approved by the U.S. Food and Drug Administration before they are sold.
Herbs can have medication-like effects on the body
Products sold as dietary supplements and promoted as a treatment, prevention, and/or cure for a disease or condition is considered an unapproved and illegal drug
While dietary supplements and herbal supplements are primarily used to help nutritional needs, these supplements can serve medicinal purposes. Explore alternatives from conventional medications with herbal supplements, as this could be an option. Check with your health care provider before taking supplements if you are pregnant, nursing a baby, or have a chronic medical condition like diabetes, hypertension, or heart disease.
Recognizing and understanding common and not so common neck and lower back spinal Stenosis symptoms can help in getting an early diagnosis and beginning a preventative treatment plan. Symptoms develop when the spinal canal begins to narrow. The nerve roots become compressed/pinched causing:
Neural irritation
Inflammation
Pain
The low back and neck are commonly affected by this age-related and progressivedisorder. Symptoms can inhibit the ability to move without discomfort, pain, and neurological issues like tingling sensations and numbness that spreads out or radiates into other parts of the body.
Low Back Spinal Stenosis Symptoms
The most common symptom of spinal Stenosis is pain in the:
Low back
Buttock area
Back of the thigh that gets worse when standing and walking
These symptoms are called neurogenic claudication. Some individuals with low back spinal stenosis experience symptoms only when standing or moving/walking around. Discomfort usually eases up when bent forward and goes away when the individual sits down. Example: Grocery shopping feels a lot better when leaning forward on the handle of the cart, with pain reduced. This is common for people with spinal stenosis in the low back. Pain that goes away and reduces when bending forward, sitting down, or lying down is common of low back spinal Stenosis.
Understanding that claudication is not neurogenic or pseudo claudication is important. The symptoms of claudication are similar to pseudo claudication, however, the cause is different. Claudication is caused by the blood not circulating properly in the leg muscles. Other symptoms are low back pain and low back spreading pain or radiculopathy.
Better known as sciatica, lumbar radiculopathy involves:
Pain
Numbness
Weakness
Tingling/numbing sensations that travel down from the low back into the buttock/s and leg/s.
Some individuals experience pain in both legs, with one leg having worse pain than the other.
Bowel/Bladder emergency:
There can be severe cases of lumbar spinal Stenosis where the nerves that control the bladder or bowel can get compressed, leading to partial or complete incontinence. If there are problems controlling the bladder or bowel seek immediate medical attention.
Neck Spinal Stenosis Symptoms
Spinal Stenosis symptomsin the neck can cause cervical radiculopathy. This can include pain along with:
Tingling sensations
Numbness
Weakness
These symptoms may radiate downward from your neck into one or both shoulders, arms, and/or hands. The pain caused by cervical spinal Stenosis has been described as:
Acute
Episodic
Occasional
Chronic
The intensity can go from mild to severe along with other symptoms that include:
Headache/s
Balance issues with a higher risk of falling
Fine Motor skills like writing, buttoning up a shirt/blouse, computer keyboarding skills can become affected
With severe cervical spinal stenosis, symptoms can be associated with cervical myelopathy. Cervical myelopathy happens when the spinal canal narrows so much that it compresses the spinal cord in the neck. Pinched nerves in the neck can affect the shoulders, arms, and hands. Myelopathy can affect both the arms and legs.
Symptoms of cervical myelopathy can include:
Neck pain
Stiffness
Tingling sensations
Numbness
Weakness
Clumsiness
Balance issues
Difficulty walking
Bowel and Bladder problems
Sexual dysfunction
Symptoms Don’t Always Present
Imaging studies like MRI and CT scans can detect a spinal disorder from an individual that has no symptoms. This is why imaging tests are performed to confirm a diagnosis. This is supported by results from the physical/ neurological exams, medical history, and symptoms.
Those who have undergone an x-ray or other imaging test for a non-spinal related issue could have discovered they have spondylosis, osteophytes, and a herniated disc. However, they never knew it because they showed no symptoms. Spinal Stenosis of the spine is usually an age-related and gradual process of physical change. It can take time for symptoms to show themselves. If you have neck or low back pain symptoms that are becoming worse, speak with your doctor.
Bertolotti syndrome is something has not been heard of when it comes to lower back pain, but diagnostic work has uncovered a common congenital condition. Back pain is experienced at some point by all of us. Around two-thirds of the population will develop low back pain in their life, and more than half will develop chronic low back pain or pain that has lasted more than six months. Low back pain can be challenging in finding the root cause. Diagnostic work is required through� X-rays and MRIs. These tests can identify a lesser-known cause of mechanical low back pain called Bertolotti syndrome.
Bertolotti Syndrome
This congenital condition’s name comes from Italian physician Mario Bertolotti. It is in 10 to 20 percent of the population, �with or with no lower back pain. Bertolotti syndrome happens when the last lumbar vertebra, known as the lumbosacral transitional vertebra/LSTV. This vertebra and the sacrum become fused together or create a false joint due to an enlarged transverse process.
This can be bony bumps on the vertebrae where muscles and ligaments attach to the lumbosacral transitional vertebra. When the LSTV and sacrum fuse together, known as sacralization or pseudo-joint, it does not generate pain. It�s just the way that an individual’s anatomy has been since birth. Only when it causes lower back pain that it is called Bertolotti syndrome.
Causes
Low back pain that leads to inflammation and reactive muscle spasms brought on from Bertolotti syndrome can be caused by:
Asymmetrical structures of the lumbar vertebrae. If the LSTV is fused to the sacrum and iliac bone, these are the wings of the pelvis, which can place unwanted stress on the sacroiliac joint, which can cause pain that is felt above the buttocks.
A�pseudo-joint does not have the cushion or lubrication between the bones like real joints to absorb shock. This causes bone-on-bone grinding, which can be quite painful and can lead to osteoarthritis. This can also generate added stress on the discs of the pseudo-joint.
Sacralization fusion can decrease the spine�s mobility. This can speed up the wear and tear of the vertebrae and shock-absorbers of the intravertebral discs.
Added non-equal force/s on the muscle tissues that surround the lower back. This can be caused by the spine not being properly�aligned causing muscle imbalance/s and fatigue. Both sides of the back can be affected, but when tightness and muscle spasms in the low back and pelvis present, it’s usually only on one side.
Symptoms
Most individuals usually never know they have a sacralization or pseudo-joint. These are often found accidentally from an X-ray for something unrelated. But when symptoms present they can vary from person to person and usually appear in adulthood�in the 20s or 30s.
These include:
Low back pain that is localized and does not spread/radiate down the legs
Pain or discomfort in or around the sacroiliac joint
Stiffness that comes out of nowhere or difficulty moving a certain way with pain present
Symptoms improve once the individual sits or lays down
Diagnosis
Bertolotti syndrome can be diagnosed based on medical history, physical exam, and X-rays. A physical exam can include a recreation of the movement/s that triggered the pain/discomfort. An X-ray of the low back and pelvis will reveal any bony abnormalities.
Treatment
Bertolotti syndrome can be effectively managed with non-invasive treatments. These� include:
Improperly and overdoing repetitive rotation/s and extension/s through work or just movements that have become second nature are injuries just waiting to happen. Lifestyle changes and re-learning how to move properly will ease the strain on the affected area.
Over the counter pain medication/s like�Advil, Aleve, or Tylenol.
Chiropractic/Physical therapy can help build low back areas and increase mobility.
Local anesthetic and spaced out intervals of corticosteroid injections to the affected nerve/s to reduce inflammation.
Platelet-rich plasma (PRP) uses the body�s platelets to reduce pain, inflammation, and healing the damaged joints through an injection.
Prolotherapy treatment uses concentrated local anesthetic and dextrose injected into the low back area to enhance the body�s natural healing.
Radiofrequency ablation uses heat to numb the affected nerves around a pseudo-joint so that pain reduces.
Surgery is the last resort and is usually done to eliminate a pseudo-joint. It can also consist of reducing or removing an elongated transverse process�and can be performed as a same-day or outpatient procedure.
If you or someone you know is dealing with some form of idiopathic low back pain and doctors can’t seem to pinpoint the cause. Bertolotti syndrome could be a suspect, therefore it’s best to seek a spine specialist near you that can help.
Tendonitis can be a painful condition that occurs when tendon/s that connect bone/s to muscle/s become damaged/injured. This can be from overuse of the particular tendon/s or using them in an improper fashion. Whatever the case, the result is inflammation, pain, and swelling. With injury/s where the tendon is stressed/strained to the point of injury, the soft tissue around the area can also be affected. More than 4 million�people�a year in the U.S. seek some form of medical treatment for�tendonitis symptoms.
Common types include:
Achilles tendonitis
Runner�s knee
Golfer’s elbow
Jumper’s knee
Pitcher�s shoulder
Swimmers shoulder
Tennis elbow
Other tendons in the body can also experience symptoms. Symptoms usually occur at the point where the tendon attaches to the bone and include:
Pain as a dull ache, especially when moving the limb or joint
Tenderness
Moderate swelling
The�wrist,�fingers, Achilles tendon, and ankle can all become inflamed from the condition. Primary care physicians are the ones to usually diagnose the injury. Once there is a definitive diagnosis, a non-surgical non-invasive treatment plan is the first recommended option. If these do not work then surgical procedures could be discussed. Chiropractic care is a first-line option that many physicians recommend.
Proper Rehabilitation Makes a Difference
This is usually from improper or incomplete healing.�Many individuals resume normal activities/chores as soon as the pain goes away. This is a mistake, as this is the time when continued care for the injury needs to be observed to heal completely. For this reason, tendonitis tends to recur. This inflames the area of the original injury which can then become aggravated, causing more pain. But more importantly, this aggravation can lead to a re-injury in the same area, which can be more severe the second time around. Chiropractic can help the tendon heal completely and help prevent re-injury to the area.
Chiropractic
Tendonitis symptoms can resemble other conditions, therefore the first step is confirmation. A doctor may use X-rays, MRIs, or CAT scans to make a positive diagnosis. A chiropractor will work with the patient in developing a treatment plan that is effective, and customized to the patient�s needs. The core of the treatment is focused on the root cause of the problem, and not just alleviating the symptoms.
With severe inflammation, a chiropractor will utilize inflammation reducing techniques like bracing, rest, ice, electrical muscle stimulation, ultrasound, low-level laser therapy, massage, and physical therapy. The focus is to loosen the tendon/s to reduce inflammation so that the treatment can continue to the next phase. Once the inflammation is under control, a chiropractor might start:
Massage
Physical therapy
Joint manipulation
Strength exercises
If the individual has limited joint mobility then joint manipulation and adjustments could be the best option.
Treatment Plan
Initial pain often subsides or even disappears after the first two to three weeks. This does not mean that the injury is fully healed. Many patients mistakenly believe that once the pain is gone the condition is gone. This is not true. Inflammation could decrease over the first three weeks, however, complete healing takes around six weeks and longer.� Scar tissue forms during this time which is how the body repairs the injury.
Once the injury is repaired the scar tissue has to be broken down so the area can regain mobility and flexibility. A chiropractor will use specialized techniques to break down the scar tissue. This could also�include massage and ultrasound to help in the process.�Mild stretching exercises could also be incorporated into the plan. As the tissues heal fully then a therapeutic exercise regiment can continue in the aid in breaking down the scar tissue further. These exercises will work the muscles but do not involve the tendons.
Better Health
Tendon inflammation can be healed completely and chiropractic care can help in achieving this. Chiropractic medicine takes the entire body approach, which means that everything is connected in some way. So if there is a form of pain in one place, it does not mean that that spot is where the source of the pain is coming from. It could be somewhere completely different, and so the chiropractor is going to work both areas and possibly others to alleviate the cause and not just alleviate the symptoms. Chiropractic medicine also includes diet, supplemental help, and lifestyle choicesthat can help the healing process and overall health. Once treatment is complete the individual can typically return to normal activities without the risk of re-injury and re-inflammation.
PODCAST: Dr. Alex Jimenez, chiropractor in El Paso, TX, and Victoria Hahn discuss the fasting-mimicking diet and the ProLon Fasting Mimicking Diet program developed by Dr. Valter D. Longo. The ProLon Fasting Mimicking Diet is a high-fat, low-calorie intermittent fasting diet that may promote fat loss and reduce blood sugar, inflammation, and cholesterol, similar to other fasting methods. Valter D. Longo is an Italian-American biogerontologist and cell biologist known for his research studies on the role of fasting and nutrient response genes on cellular protection aging and diseases as well as for proposing that longevity is regulated by similar genes and mechanisms in many eukaryotes. Only a few research studies have been carried out to date regarding the fasting-mimicking diet and more research is needed to validate its benefits. �- Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
Burning, numbness, tingling, and pain can be felt in the back, lower back, legs, and feet. A lot of times these symptoms spread out/radiate from one part of the body into another area. Sciatica is an example of pain that radiates into an extremity, in this case, the back of the leg. Nerves originate from the spine and are divided/separated into sensory and motor nerves. The sensory nerve/s give the sensation to the skin known as dermatomes. Dermatomal patterns act as a map on the body.
Example: Dermatomes on the torso of the body react to the thoracic spinal nerve roots, the arms react to the cervical spine nerve roots, and the legs react to the lumbar spinal nerve roots.
Dermatome Location – Corresponding Spine Level
Shoulders – C4, C5
Inner/Outer Forearms – C6, and T1
Thumbs and Little Fingers – C6, C7, C8
Front of Thighs – L2
Middle, Sides of Both Calves – L4, L5
Little Toes – S1
A physician might use a piece of cotton, a swab, pin, or paperclip to test the symmetrical feelings in the arms and legs. Abnormal responses could be a sign of a nerve root problem.
Tendon Reflexes
Most individuals have experienced a physician tapping the knees with a rubber hammer. The normal response is a kick. This is a reflex, which is an involuntary muscular response generated by the hammer tapping the tendon. When the reflex responses do not present, this could mean that the spinal cord, nerve root, peripheral nerve, or muscle has been injured/damaged in some way. Absent reflexes are also clues to other conditions/injuries. An abnormal reflex response could also be caused by a disruption of the sensory (feeling) or motor (movement) nerves and sometimes both. Determining where the neural problem might be, a physician will test reflexes in various parts of the body.
Reflex Tested Areas – Corresponding Spine Level
Upper Arm Biceps – C5-C6 Cervical Spine
Forearm Distal Radius – C6-C7
Elbow Triceps – C7
Abdominal – T8, T9, T10, T11, T12, Thoracic
Knees/Thighs Patellar, Quadriceps – L3, L4 Lumbar
Ankles – S1 Sacral
Neurological Exams for Neck/Back Pain
Muscle Strength/Tone
Muscle strength and tone measurements are another way to diagnose nerve deficits. Depending on the symptoms/condition/injury/s there are different ways to evaluate muscle strength:
Stepping on a stool
Standing on the heels
Standing on the toes
Hopping in place
Performing knee bends
Gripping an item in each hand
Muscle strength is graded and recorded in the patient’s chart.
A physician will test the body’s muscle tone by passively flexing and extending the arms and legs. Normal muscle tone will respond with a slight resistance to passive motion. Other movements test for proximal (trunk/torso) and distal (distant) weakness. Muscle symmetry is also taken into account.
Neurological Tests
If necessary a spine specialist might order neurological studies like a Nerve Conduction Study (NCS) or Electromyogram (EMG), to measure nerve performance.
Imaging Studies
MRI and/or CT scans of the spine can be ordered to help the spine specialist/chiropractor make a correct diagnosis, as well as help in creating a plan of treatment.
Conclusion
A neurological exam, along with a mechanical examination consisting of movement of the arms, legs, and torso, can significantly help doctors in making the correct diagnosis. Examination results are then correlated with the patient�s history, illness, and diagnostic studies. Once the diagnosis is made an appropriate treatment plan is discussed. This will begin with non-surgical strategies but if those fail, then surgical intervention could be considered.
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