The lumbar spine, or lower back, takes a lot of stress and strain throughout the day. The spine provides stabilization for the entire body, and the lumbar spine bears the brunt of much of the movement and activity. This wear and tear show up as lower back pain in many people. The American Chiropractic Association estimates that 31 million Americans have low back pain at some point in their lives. The leading cause of disability is low back pain � not only in the U.S. but worldwide.
What is the Lumbar Spine?
Located in the lower back area, the lumbar region is the portion of the spine that begins below the shoulder blades, about five or six inches, at the lordosis (where it curves in toward the abdomen). Five vertebrae make up the lumbar spine, L1 through L5 � which also happen to be the largest unfused vertebrae in the entire spinal column. The lower vertebrae bear more weight than the upper vertebrae, so they are constructed to be sturdier, but are also more prone to injury and degradation.
The L5 vertebra meets the S1 (the sacrum) at the lumbosacral joint. It is this joint that provides most of the range of motion including rotational flexibility of the hips and pelvis, allowing them to swing during movement such as running and walking.
The spinal cord ends at around the L1 and many nerve roots that originate at the spinal cord form what is called the cauda equine. These nerves travel down the spine, branching out to the legs, buttocks, and feet. The appearance resembles a horse�s tail, hence the name. Because the spinal cord does not extend into the lumbar area, the chance of a problem with the lower back resulting in paralysis or damage to the spinal cord is very rare.
Lower Back Pain
The most common causes�of lower back pain are soft tissue injuries and mechanical problems. Either of these can damage the intervertebral discs, compress the nerve roots, and inhibit the�correct function of the spinal joints so that they don�t move properly. Lower back pain is most commonly caused by a pulled or torn muscle or ligament, known as a sprain or strain. These injuries can have some causes, including:
Prolonged improper posture
Improper lifting of something heavy (without using your legs)
Sports injuries, particularly those where the player sustains high impact or where a lot of twisting is involved
Lifting while twisting the spine
A fall or movement that occurs suddenly and puts a great deal of stress on the lumbar area
Chiropractic Care for the Lumbar Spine
Chiropractic care is a prevalent, effective treatment for lower back pain. A chiropractor can help patients manage their back pain through spinal adjustments and lifestyle advice. They may recommend supplements, exercise, and dietary changes. The whole-body approach to chiropractic makes it an optimal choice for many people, especially those who don�t want to take medications or undergo invasive procedures.
The chiropractic treatment itself usually involves spinal manipulation and mobilization. Spinal manipulation is the technique that most people think of when they think of chiropractic. It of a short lever, high-velocity arm thrust applied directly to the vertebra that is injured or is causing the pain. This technique typically relieves pain, improves the function of the spine, and restores the back�s range of motion. Mobilization is a low-velocity movement performed by the chiropractor to manipulate the area, stretching and moving the joints and muscles.
These techniques typically restore range of motion and flexibility to the spine while reducing pain. For people with chronic lower back pain, chiropractic care can be a game changer.
The nuclear erythroid 2-related factor 2 signaling pathway, best known as Nrf2, is a protective mechanism which functions as a “master regulator” of the human body’s antioxidant response. Nrf2 senses the levels of oxidative stress within the cells and triggers protective antioxidant mechanisms. While Nrf2 activation can have many benefits, Nrf2 “overexpression” can have several risks.
It appears that a balanced degree of NRF2 is essential towards preventing the overall development of a variety of diseases in addition to the general improvement of these health issues. However, NRF2 can also cause complications. The main cause behind NRF2 “overexpression” is due to a genetic mutation or a continuing chronic exposure to a chemical or oxidative stress, among others. Below, we will discuss the downsides of Nrf2 overexpression and demonstrate its mechanisms of action within the human body.
Cancer
Research studies found that mice that don’t express NRF2 are more inclined to develop cancer in response to physical and chemical stimulation. Similar research studies, however, showed that NRF2 over-activation, or even KEAP1 inactivation, can result in the exacerbation of certain cancers, particularly if those pathways have been interrupted. Overactive�NRF2 can occur through smoking, where continuous NRF2 activation is believed to be the cause of lung cancer in smokers. Nrf2 overexpression might cause cancerous cells not to self-destruct, while intermittent NRF2 activation can prevent cancerous cells from triggering toxin induction.
Additionally, because NRF2 overexpression increases the human body’s antioxidant ability to function beyond redox homeostasis, this boosts cell division and generates an unnatural pattern of DNA and histone methylation. This can ultimately�make�chemotherapy and radiotherapy less effective against cancer. Therefore, limiting NRF2 activation with substances like DIM, Luteolin, Zi Cao, or salinomycin could be ideal for patients with cancer although Nrf2 overactivation should not be considered to be the only cause for cancer. Nutrient deficiencies can affect genes, including NRF2. This might be one way as to how deficiencies contribute to tumors.
Liver
The overactivation of Nrf2, can also affect the function of specific organs in the human body. NRF2 overexpression can ultimately block the production of the insulin-like growth factor 1, or IGF-1, from the liver, which is essential for the regeneration of the liver.
Heart
While the acute overexpression of Nrf2 may have its benefits, continuous overexpression of NRF2 may cause long-term harmful effects on the heart, such as cardiomyopathy. NRF2 expression can be increased through high levels of cholesterol, or the activation of HO-1. This is believed to be the reason why chronic elevated levels of cholesterol might cause cardiovascular health issues.
Vitiligo
NRF2 overexpression has also been demonstrated to inhibit the capability to repigment in vitiligo as it might obstruct Tyrosinase, or TYR, action which is essential for repigmentation through melaninogenesis. Research studies have demonstrated that this process may be one of the primary reasons as to why people with vitiligo don’t seem to activate Nrf2 as efficiently as people without vitiligo.
Why NRF2 May Not Function Properly
Hormesis
NRF2 has to be hormetically activated in order to be able to take advantage of its benefits. In other words, Nrf2 shouldn’t trigger every minute or every day,�therefore, it’s a great idea to take breaks from it, by way of instance, 5 days on 5 days off or every other day. NRF2 must also accomplish a specific threshold to trigger its hormetic response, where a small stressor may not be enough to trigger it.
DJ-1 Oxidation
Protein deglycase DJ-1, or just DJ-1, also called the Parkinson’s disease protein, or PARK7, is a master regulator and detector of the redox status in the human body. DJ-1 is essential towards regulating how long NRF2 can perform its function and produce an antioxidant response. In the case that DJ-1 becomes overoxidized, the cells will make the DJ-1 protein less accessible.
This process induces NRF2 activation to expire too fast since DJ-1 is paramount for maintaining balanced levels of NRF2 and preventing them from being broken down in the cell. In case the DJ-1 protein is non-existent or overoxidized, NRF2 expression will probably be minimal, even using DIM or alternative NRF2 activators. DJ-1 expression is imperative to restore impaired NRF2 action.
Chronic Illness
If you have a chronic illness, including CIRS, chronic infections/dysbiosis/SIBO, or heavy metal build up, such as mercury and/or that from root canals, these can obstruct the systems of NRF2 and phase two detoxification. Rather than oxidative stress turning NRF2 into an antioxidant, NRF2 will not trigger and oxidative stress can remain in the cell and cause damage, meaning, there is no antioxidant response. This is a significant reason why many people with CIRS have several sensitivities and reach to numerous factors. Some people believe they may be�having a herx response, however, this reaction may only be damaging the cells farther.
Treating chronic illness, however, will permit the liver to discharge toxins into the bile, gradually developing the hormetic response of NRF2 activation. If the bile remains toxic and it’s not excreted from the human body, it will reactivate NRF2’s oxidative stress and cause you to feel worse once it’s reabsorbed from the gastrointestinal, or GI, tract. For example, ochratoxin A may block NRF2. Aside from treating the problem, histone deacetylase inhibitors can block the oxidative reaction from a number of the factors which trigger NRF2 activation but it might also prevent NRF2 from triggerring�normally, which might ultimately fail to serve its purpose.
Fish Oil Dysregulation
Cholinergics are substances which boost acetylcholine, or ACh, and choline in the brain through the increase of ACh, particularly when inhibiting the breakdown of ACh. Patients with CIRS often have problems with the dysregulation of acetylcholine levels in the human body, especially in the brain. Fish oil triggers NRF2, activating its protective antioxidant mechanism within the cells.
People with chronic illnesses might have problems with cognitive stress and acetylcholine excitotoxicity, from organophosphate accumulation, which might cause fish oil to create�inflammation within the human body. Choline deficiency additionally induces NRF2 activation. Including choline into your diet, (polyphenols, eggs, etc.) can help enhance the effects of cholinergic dysregulation.
What Decreases NRF2?
Decreasing NRF2 overexpression is best for people that have cancer, although it may be beneficial for a variety of other health issues.
Diet, Supplements, and Common Medicines:
Apigenin (higher doses)
Brucea javanica
Chestnuts
EGCG (high doses increase NRF2)
Fenugreek (Trigonelline)
Hiba (Hinokitiol / ?-thujaplicin)
High Salt Diet
Luteolin (Celery, green pepper, parsley, perilla leaf, and chamomile tea – higher doses may increase NRF2 – 40 mg/kg luteolin three times per week )
Metformin (chronic intake)
N-Acetyl-L-Cysteine (NAC, by blocking the oxidative response, esp at high doses)
Orange Peel (have polymethoxylated flavonoids)
Quercetin (higher doses may increase NRF2 – 50 mg/kg/d quercetin)
Salinomycin (drug)
Retinol (all-trans retinoic acid)
Vitamin C when combined with Quercetin
Zi Cao (Purple Gromwel has Shikonin/Alkannin)
Pathways and Other:
Bach1
BET
Biofilms
Brusatol
Camptothecin
DNMT
DPP-23
EZH2
Glucocorticoid Receptor signaling (Dexamethasone and Betamethasone as well)
GSK-3? (regulatory feedback)
HDAC activation?
Halofuginone
Homocysteine (ALCAR can reverse this homocysteine induce low levels of NRF2)
IL-24
Keap1
MDA-7
NF?B
Ochratoxin A(aspergillus and pencicllium species)
Promyelocytic leukemia protein
p38
p53
p97
Retinoic acid receptor alpha
Selenite
SYVN1 (Hrd1)
STAT3 inhibition (such as Cryptotanshinone)
Testosterone (and Testosterone propionate, although TP intranasally may increase NRF2)
Trecator (Ethionamide)
Trx1 (via reduction of Cys151 in Keap1 or of Cys506 in the NLS region of Nrf2)
Trolox
Vorinostat
Zinc Deficiency (makes it worse in the brain)
Nrf2 Mechanism Of Action
Oxidative stress triggers through CUL3 where NRF2 from KEAP1, a negative inhibitor, subsequently enters the nucleus of these cells, stimulating the transcription of the AREs, turning sulfides into disulfides, and turning them into more antioxidant genes, leading to the upregulation of antioxidants, such as GSH, GPX, GST, SOD, etc.. The rest of these can be seen in the list below:
Increases AKR
Increases ARE
Increases ATF4
Increases Bcl-xL
Increases Bcl-2
Increases BDNF
Increases BRCA1
Increases c-Jun
Increases CAT
Increases cGMP
Increases CKIP-1
Increases CYP450
Increases Cul3
Increases GCL
Increases GCLC
Increases GCLM
Increases GCS
Increases GPx
Increases GR
Increases GSH
Increases GST
Increases HIF1
Increases HO-1
Increases HQO1
Increases HSP70
Increases IL-4
Increases IL-5
Increases IL-10
Increases IL-13
Increases K6
Increases K16
Increases K17
Increases mEH
Increases Mrp2-5
Increases NADPH
Increases Notch 1
Increases NQO1
Increases PPAR-alpha
Increases Prx
Increases p62
Increases Sesn2
Increases Slco1b2
Increases sMafs
Increases SOD
Increases Trx
Increases Txn(d)
Increases UGT1(A1/6)
Increases VEGF
Reduces ADAMTS(4/5)
Reduces alpha-SMA
Reduces ALT
Reduces AP1
Reduces AST
Reduces Bach1
Reduces COX-2
Reduces DNMT
Reduces FASN
Reduces FGF
Reduces HDAC
Reduces IFN-?
Reduces IgE
Reduces IGF-1
Reduces IL-1b
Reduces IL-2
Reduces IL-6
Reduces IL-8
Reduces IL-25
Reduces IL-33
Reduces iNOS
Reduces LT
Reduces Keap1
Reduces MCP-1
Reduces MIP-2
Reduces MMP-1
Reduces MMP-2
Reduces MMP-3
Reduces MMP-9
Reduces MMP-13
Reduces NfkB
Reduces NO
Reduces SIRT1
Reduces TGF-b1
Reduces TNF-alpha
Reduces Tyr
Reduces VCAM-1
Encoded from the NFE2L2 gene, NRF2, or nuclear erythroid 2-related factor 2, is a transcription factor in the basic leucine zipper, or bZIP, superfamily which utilizes a Cap’n’Collar, or CNC structure.
It promotes nitric enzymes, biotransformation enzymes, and xenobiotic efflux transporters.
It is an essential regulator at the induction of the phase II antioxidant and detoxification enzyme genes, which protect cells from damage caused by oxidative�stress and electrophilic attacks.
During homeostatic conditions, Nrf2 is sequestered in the cytosol through bodily attachment of the N-terminal domain of Nrf2, or the Kelch-like ECH-associated protein or Keap1, also referred to as INrf2 or Inhibitor of Nrf2, inhibiting Nrf2 activation.
It may also be controlled by mammalian selenoprotein thioredoxin reductase 1, or TrxR1, which functions as a negative regulator.
Upon vulnerability to electrophilic stressors, Nrf2 dissociates from Keap1, translocating into the nucleus, where it then heterodimerizes with a range of transcriptional regulatory protein.
Frequent interactions comprise with those of transcription authorities Jun and Fos, which can be members of the activator protein family of transcription factors.
After dimerization, these complexes then bind to antioxidant/electrophile responsive components ARE/EpRE and activate transcription, as is true with the Jun-Nrf2 complex, or suppress transcription, much like the Fos-Nrf2 complex.
The positioning of the ARE, which is triggered or inhibited, will determine which genes are transcriptionally controlled by these variables.
When ARE is triggered:
Activation of the�synthesis of antioxidants is capable of detoxifying ROS like catalase, superoxide-dismutase, or SOD, GSH-peroxidases, GSH-reductase, GSH-transferase, NADPH-quinone oxidoreductase, or NQO1, Cytochrome P450 monooxygenase system, thioredoxin, thioredoxin reductase, and HSP70.
Activation of this GSH synthase permits a noticeable growth of the�GSH intracellular degree, which is quite protective.
The augmentation of this synthesis and degrees of phase II enzymes like UDP-glucuronosyltransferase, N-acetyltransferases, and sulfotransferases.
The upregulation of HO-1, which is a really protective receptor with a potential growth of CO that in conjunction with NO allows vasodilation of ischemic cells.
Reduction of iron overload through elevated ferritin and bilirubin as a lipophilic antioxidant. Both the phase II proteins along with the antioxidants are able to fix the chronic oxidative stress and also to revive a normal redox system.
GSK3? under the management of AKT and PI3K, phosphorylates Fyn resulting in Fyn nuclear localization, which Fyn phosphorylates Nrf2Y568 leading to nuclear export and degradation of Nrf2.
NRF2 also dampens the TH1/TH17 response and enriches the TH2 response.
HDAC inhibitors triggered the Nrf2 signaling pathway and up-regulated that the Nrf2 downstream targets HO-1, NQO1, and glutamate-cysteine ligase catalytic subunit, or GCLC, by curbing Keap1 and encouraging dissociation of Keap1 from Nrf2, Nrf2 nuclear translocation, and Nrf2-ARE binding.
Nrf2 includes a half-life of about 20 minutes under basal conditions.
Diminishing the IKK? pool through Keap1 binding reduces I?B? degradation and might be the elusive mechanism by which Nrf2 activation is proven to inhibit NF?B activation.
Keap1 does not always have to be downregulated to get NRF2 to operate, such as chlorophyllin, blueberry, ellagic acid, astaxanthin, and tea polyphenols may boost NRF2 and KEAP1 at 400 percent.
Nrf2 regulates negatively through the term of stearoyl CoA desaturase, or SCD, and citrate lyase, or CL.
Genetics
KEAP1
rs1048290
C allele – showed a significant risk for and a protective effect against drug resistant epilepsy (DRE)
rs11085735 (I’m AC)
associated with rate of decline of lung function in the LHS
MAPT
rs242561
T allele – protective allele for Parkinsonian disorders – had stronger NRF2/sMAF binding and was associated with the higher MAPT mRNA levels in 3 different regions in brain, including cerebellar cortex (CRBL), temporal cortex (TCTX), intralobular white matter (WHMT)
NFE2L2 (NRF2)
rs10183914 (I’m CT)
T allele – increased levels of Nrf2 protein and delayed age of onset of Parkinson’s by four years
rs16865105 (I’m AC)
C allele – had higher risk of Parkinson’s Disease
rs1806649 (I’m CT)
C allele – has been identified and may be relevant for breast cancer etiology.
associated with increased risk of hospital admissions during periods of high PM10 levels
rs1962142 (I’m GG)
T allele – was associated with a low level of cytoplasmic NRF2 expression (P = 0.036) and negative sulfiredoxin expression (P = 0.042)
A allele – protected from forearm blood flow (FEV) decline (forced expiratory volume in one second) in relation to cigarette smoking status (p = 0.004)
rs2001350 (I’m TT)
T allele – protected from FEV decline (forced expiratory volume in one second) in relation to cigarette smoking status (p = 0.004)
rs2364722 (I’m AA)
A allele – protected from FEV decline (forced expiratory volume in one second) in relation to cigarette smoking status (p = 0.004)
rs2364723
C allele – associated with significantly reduced FEV in Japanese smokers with lung cancer
rs2706110
G allele – showed a significant risk for and a protective effect against drug resistant epilepsy (DRE)
AA alleles – showed significantly reduced KEAP1 expression
AA alleles – was associated with an increased risk of breast cancer (P = 0.011)
rs2886161 (I’m TT)
T allele – associated with Parkinson’s Disease
rs2886162
A allele – was associated with low NRF2 expression (P = 0.011; OR, 1.988; CI, 1.162�3.400) and the AA genotype was associated with a worse survival (P = 0.032; HR, 1.687; CI, 1.047�2.748)
rs35652124 (I’m TT)
A allele – associated with higher associated with age at onset for Parkinson’s Disease vs G allele
C allele – had increase NRF2 protein
T allele – had less NRF2 protein and greater risk of heart disease and blood pressure
rs6706649 (I’m CC)
C allele – had lower NRF2 protein and increase risk for Parkinson’s Disease
rs6721961 (I’m GG)
T allele – had lower NRF2 protein
TT alleles – association between cigarette smoking in heavy smokers and a decrease in semen quality
TT allele – was associated with increased risk of breast cancer [P = 0.008; OR, 4.656; confidence interval (CI), 1.350�16.063] and the T allele was associated with a low extent of NRF2 protein expression (P = 0.0003; OR, 2.420; CI, 1.491�3.926) and negative SRXN1 expression (P = 0.047; OR, 1.867; CI = 1.002�3.478)
T allele – allele was also nominally associated with ALI-related 28-day mortality following systemic inflammatory response syndrome
T allele – protected from FEV decline (forced expiratory volume in one second) in relation to cigarette smoking status (p = 0.004)
G allele – associated with increased risk of ALI following major trauma in European and African-Americans (odds ratio, OR 6.44; 95% confidence interval
AA alleles – associated with infection-induced asthma
AA alleles – exhibited significantly diminished NRF2 gene expression and, consequently, an increased risk of lung cancer, especially those who had ever smoked
AA alleles – had a significantly higher risk for developing T2DM (OR 1.77; 95% CI 1.26, 2.49; p = 0.011) relative to those with the CC genotype
AA alleles – strong association between wound repair and late toxicities of radiation (associated with a significantly higher risk for developing late effects in African-Americans with a trend in Caucasians)
associated with oral estrogen therapy and risk of venous thromboembolism in postmenopausal women
rs6726395 (I’m AG)
A allele – protected from FEV1 decline (forced expiratory volume in one second) in relation to cigarette smoking status (p = 0.004)
A allele – associated with significantly reduced FEV1 in Japanese smokers with lung cancer
GG alleles – had higher NRF2 levels and decreased risk of macular degeneration
GG alleles – had higher survival with Cholangiocarcinoma
rs7557529 (I’m CT)
C allele – associated with Parkinson’s Disease
Oxidative stress and other stressors can cause cell damage which may eventually lead to a variety of health issues. Research studies have demonstrated that Nrf2 activation can promote the human body’s protective antioxidant mechanism, however, researchers have discussed that Nrf2 overexpression can have tremendous risks towards overall health and wellness. Various types of cancer can also occur with Nrf2 overactivation.
Dr. Alex Jimenez D.C., C.C.S.T. Insight
Sulforaphane and Its Effects on Cancer, Mortality, Aging, Brain and Behavior, Heart Disease & More
Isothiocyanates are some of the most important plant compounds you can get in your diet. In this video I make the most comprehensive case for them that has ever been made. Short attention span? Skip to your favorite topic by clicking one of the time points below. Full timeline below.
Key sections:
00:01:14 – Cancer and mortality
00:19:04 – Aging
00:26:30 – Brain and behavior
00:38:06 – Final recap
00:40:27 – Dose
Full timeline:
00:00:34 – Introduction of sulforaphane, a major focus of the video.
00:01:14 – Cruciferous vegetable consumption and reductions in all-cause mortality.
00:02:12 – Prostate cancer risk.
00:02:23 – Bladder cancer risk.
00:02:34 – Lung cancer in smokers risk.
00:02:48 – Breast cancer risk.
00:03:13 – Hypothetical: what if you already have cancer? (interventional)
00:03:35 – Plausible mechanism driving the cancer and mortality associative data.
00:04:38 – Sulforaphane and cancer.
00:05:32 – Animal evidence showing strong effect of broccoli sprout extract on bladder tumor development in rats.
00:06:06 – Effect of direct supplementation of sulforaphane in prostate cancer patients.
00:07:09 – Bioaccumulation of isothiocyanate metabolites in actual breast tissue.
00:08:32 – Inhibition of breast cancer stem cells.
00:08:53 – History lesson: brassicas were established as having health properties even in ancient Rome.
00:09:16 – Sulforaphane’s ability to enhance carcinogen excretion (benzene, acrolein).
00:09:51 – NRF2 as a genetic switch via antioxidant response elements.
00:10:10 – How NRF2 activation enhances carcinogen excretion via glutathione-S-conjugates.
00:10:34 – Brussels sprouts increase glutathione-S-transferase and reduce DNA damage.
00:11:20 – Broccoli sprout drink increases benzene excretion by 61%.
00:13:31 – Broccoli sprout homogenate increases antioxidant enzymes in the upper airway.
00:15:45 – Cruciferous vegetable consumption and heart disease mortality.
00:16:55 – Broccoli sprout powder improves blood lipids and overall heart disease risk in type 2 diabetics.
00:19:04 – Beginning of aging section.
00:19:21 – Sulforaphane-enriched diet enhances lifespan of beetles from 15 to 30% (in certain conditions).
00:20:34 – Importance of low inflammation for longevity.
00:22:05 – Cruciferous vegetables and broccoli sprout powder seem to reduce a wide variety of inflammatory markers in humans.
00:36:32 – Sulforaphane improves learning in model of type II diabetes in mice.
00:37:19 – Sulforaphane and duchenne muscular dystrophy.
00:37:44 – Myostatin inhibition in muscle satellite cells (in vitro).
00:38:06 – Late-video recap: mortality and cancer, DNA damage, oxidative stress and inflammation, benzene excretion, cardiovascular disease, type II diabetes, effects on the brain (depression, autism, schizophrenia, neurodegeneration), NRF2 pathway.
00:40:27 – Thoughts on figuring out a dose of broccoli sprouts or sulforaphane.
00:41:01 – Anecdotes on sprouting at home.
00:43:14 – On cooking temperatures and sulforaphane activity.
00:43:45 – Gut bacteria conversion of sulforaphane from glucoraphanin.
00:44:24 – Supplements work better when combined with active myrosinase from vegetables.
00:44:56 – Cooking techniques and cruciferous vegetables.
00:46:06 – Isothiocyanates as goitrogens.
According to research studies, Nrf2, is a fundamental transcription factor which activates the cells’ protective antioxidant mechanisms to detoxify the human body. The overexpression of Nrf2, however, can cause health issues. The scope of our information is limited to chiropractic and spinal health issues. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Every year an estimated 3.8 million people in the United States sustain mild traumatic brain injuries (MTBI) or concussions. Many of these injuries are due to sports-related activities, work related injuries, motor vehicle accidents, and military operations. It is also estimated that as many as 50% of MTBIs are never reported because the patient does not seek medical attention. This makes it difficult to get a substantial number on how many there are, but it is a prevalent condition.
The Brain and Skull
A patient does not have to hit their head to sustain an MTBI. It can be caused by whiplash even though the person never hit their head. The reason for this lies in the construction of the brain and skull.
The brain is very soft; some experts compare the texture to that of soft butter. The skull is designed to protect the brain, and it is tough. If you run your hand over your head, you may feel some lumps and bumps, it may not feel entirely even, but the surface will be smooth.
The same cannot be said for the inside of the skull. There are boney ridges on the inside that are quite sharp. The design is intended to keep the brain in place.
When the head is hit or is jolted hard enough it caused the brain to shift inside of the skull, coming into contact with those boney ridges � sometimes forcefully. This can cause damage and the result in a brain injury. The harder the jolt, the more serious the injury may be.
Symptoms of Mild Traumatic Brain Injury
Part of the problem with MTBI is that the symptoms may not show up immediately. They could emerge weeks or even months after the incident making it unlikely that the symptoms will be tracked back and connected to it.
Often, MTBI is called a �silent epidemic� because the symptoms that it causes are usually not visible and may not be immediately connected to the injury. Depression, anxiety, angry outbursts, and impaired memory are more likely to be considered a psychiatric issue instead of a neurological one. The symptoms can be debilitating just the same.
Evaluation and diagnosis of an MTBI
Chiropractors routinely treat patients with Mild Traumatic Brain Injuries. When they are presented with a patient that they know has sustained a head injury, or if they suspect a brain injury based on specific symptoms, they use the Sports Concussion Assessment Tool 2 (SCAT2) to determine the severity. The SCAT2 helps the chiropractor create evaluate the physical signs, symptoms, sideline assessment using Maddocks score, Glasgow Coma Scale, coordination, balance, and cognitive.
As they evaluate the patient, they look for specific markers that indicate the patient is experiencing worsening neurological symptoms. These include:
Loss of consciousness
Vomiting
Headaches get�worse
Increased confusion
Weakness on one side or in one leg or arm
Blurred vision
Dilated pupils
Balance or coordination problems
Chiropractic Treatment for MTBI
A head injury usually involves a neck injury as well. The chiropractor may use a variety of techniques to treat the patient, including spinal manipulation, massage, and bracing. The patient will also be advised to avoid anti-inflammatory medication, aspirin, alcohol, and sleep aids, using acetaminophen for pain as needed. If the patient needs to see another doctor or specialist, the chiropractor will refer them.
Sciatica is a collection of symptoms characterized by pain, discomfort, tingling and burning sensations, and numbness which often extends from the low back, down the buttocks and thighs, into the knee and the foot. Sciatica is caused by the compression of the sciatic nerve, the largest and longest nerve in the human body. Sciatic nerve pain can develop due to an injury and/or aggravated condition. Patients diagnosed with sciatica describe their symptoms and how these affected their daily lives. Dr. Alex Jimenez and his staff have provided pain relief to many patients experiencing sciatica. Chiropractic care can help restore the original alignment of the spine to help improve sciatica. Dr. Alex Jimenez is the non-surgical choice for a variety of health issues, including sciatica, or sciatic nerve pain.
Sciatica Pain Rehabilitation
We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.
As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.
If you have enjoyed this video and we have helped you in any way, please feel free to subscribe and recommend�us.
The ketogenic diet seems to be one of the most popular topics to reach the current diet world. The ketogenic diet, or the keto diet, is characterized as a high fat, low carb dietary regimen. With claims that you can eat all the fat you want while not feeling hungry and considering its belief to reduce your blood sugar when you have type 2 diabetes as well as help improve overall performance, the ketogenic diet appears to be the ideal nutritional standard of the modern world. However, is the ketogenic diet right for everyone? Below, we will discuss what the ketogenic diet is and describe the modified ketogenic diet, their benefits and risks.
What is the Ketogenic Diet?
The “classic” ketogenic diet was created in 1923 by Dr. Russell Wilder for the treatment of epilepsy.�The keto diet is based on the principle that by decreasing the intake of carbohydrates, the human body’s main supply of energy, it is possible to induce the cells to burn fat for fuel, maximizing weight loss. When you eat foods with carbohydrates, the body transforms these into glucose, or blood sugar, which it then uses for energy. Glucose is the easiest type of energy the body can�utilize, however, excess sugar can turn into fat. The objective of the keto diet is to limit carbohydrate intake so the body needs to break down fat instead of glucose for energy.
When this happens, fat is broken down in the liver, thus producing ketones, which can be by-products of your own metabolism. These ketones are subsequently utilized to fuel the body in the absence of sugar. The classic ketogenic diet is characterized by a 4:1 ratio of fat to protein and carbohydrates, where 90 percent of calories come from fats, 6 percent from proteins, and 4 percent from carbohydrates. Although a 4:1 ratio is regarded as the gold standard for the classic keto diet, a modified ketogenic diet can involve a 3:1 ratio. This diet is also regarded as a low glycemic treatment and results in continuous sugar and glucose levels.
What is the Modified Ketogenic Diet?
There are a variety of modifications of the ketogenic diet.The “modified” ketogenic diet is a less restrictive variant of the classic keto diet, which may be helpful for people starting out with the ketogenic diet plan or for those who simply wish to follow a less strict,�long-term�dietary regimen. With a macronutrient ratio between 2:1 -1:1, the modified ketogenic diet was created with versatility in mind to improve compliance and reduce possible gastrointestinal health issues as well as�nutritional deficiencies�which could occur with the long-term�classic ketogenic diet. Nearly all people following a modified keto diet follow the standard ketogenic diet program closely.
Other types of modified ketogenic diets consist of the cyclic ketogenic diets, also called carb cycling, and targeted ketogenic diets, that allow for alterations to carbohydrate consumption around physical activity and exercise. These alterations are generally implemented by athletes seeking to utilize the ketogenic diet to boost endurance and performance rather than by people especially focused on weight loss. As with any ketogenic diet, however, you should plan to eat less than 10 percent of your calories from carbs every day. The rest of the calories must include 20 to 30 percent protein and 60 to 80 percent fat.
How to Follow a Ketogenic Diet
There are many variations of the ketogenic�diet plan, but, to accomplish a state of ketosis, you need to tremendously lower the number of carbohydrates you consume on a regular basis. Research studies have demonstrated that the average American man over the age of 20 intakes approximately 47.4 percent of their daily calories from carbohydrates where the average American woman over the age of 20 intakes approximately 49.6 percent of their daily calories from carbohydrates. In the “classic” ketogenic diet, 80 to 90 percent of calories come from fat, 5 to 15 percent come from proteins, and 5 to 10 percent come from carbohydrates. A common modified variant of the ketogenic diet, permits 20 to 30 percent of calories to come from proteins with the exact same carbohydrate limitation.
Some of the goals of the ketogenic diet are weight loss and improved athletic endurance and performance. The ketogenic diet for weight loss is predicated on the thought that forcing the entire body into ketosis will optimize fat reduction and weight loss. Ketosis is a normal metabolic process which happens when the body doesn’t have enough sugar stores for energy. Whenever these stores are depleted, the body resorts to burning stored fat for energy rather than carbohydrates. This method creates acids called ketones, which build up in the human body and may be used for energy. Ketones are a necessary part of a healthy metabolism.
The ketogenic diet comprises more than just diet. Nutritional supplements, electrolytes, hydration and physical activity or exercise levels will also be a crucial factor in the nutritional program. Those that suffer from digestive problems normally require extra support. This is where a ketogenic expert can be greatly beneficial. Tracking ketosis is another important element of therapy. Ketosis can be quantified by three distinct approaches: Blood, urine and breath. Blood readings would be the most precise and reliable way of testing, even though it’s also the most expensive. Urine strips give a reasonable alternative, though readings may vary widely according to hydration. Though technology is advancing, breath screens have likewise varying consequences and also a higher initial cost.
The ketogenic diet, or keto diet, is a low-carbohydrate, high-fat diet which has been demonstrated to have a wide variety of health benefits. As a matter of fact, many research studies have shown how the keto diet can help with weight loss, improving overall health and wellness. Modified versions of the ketogenic diet may also be utilized to accommodate to different needs. Ketogenic diets may even provide benefits against type-2 diabetes, epilepsy, Alzheimer’s disease and cancer.� By drastically reducing carbohydrate intake and replacing it with fat, the human body enters a metabolic state called ketosis, which efficiently burns fat and turns it into energy. Dr. Alex Jimenez D.C., C.C.S.T. Insight
What are the Advantages of Ketosis?
Reaching a state of ketosis may have many advantages from treating chronic ailments to maximizing functionality. While the advantages are well documented, the underlying mechanism of activity isn’t completely known. The ketogenic diet appears to boost the capability of mitochondria, the energy plants of our cells, to provide our own bodies’ with the energy it needs in a manner that reduces inflammation and oxidative stress. Through optimizing how our body uses energy we reinforce our bodies’ capacity to undertake the ever-growing temptations of the contemporary method of living, improving overall health and wellness.
What to Expect with the Ketogenic Diet
Although the ketogenic diet may result in rapid weight loss through ketosis, the dietary program includes some health risks, such as nutrient deficiencies, heart problems, gastrointestinal health issues, such as constipation, and much more. As a result of health risks involved, specialists advise some people, like those with cardiovascular disease or even people that are at a greater risk for this, to�be careful with the ketogenic diet. Individuals with type 2 diabetes should consult their healthcare professionals. Due to the severe limitations and removal of certain food groups, such as carbohydrates, the strategy might also be hard to stick to in the long term.
If you’re planning to try out the ketogenic diet, make sure you speak with a healthcare professional to be sure to meet your nutritional requirements with the nutritional regimen. Working with an expert can help you figure out if you need to make modifications or stop using the ketogenic diet in the event that complications may occu. The scope of our information is limited to chiropractic and spinal health issues. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topic Discussion:�Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. �
We live in an extremely sleep-deprived society. According to the Centers for Disease Control (CDC), 1 in 3 people in the United States does not get enough sleep on a regular basis. Additionally, the National Sleep Foundation reports that 45 percent of adults in the US admit that insufficient or poor sleep has had an impact on their daily activities at least once in the previous week. What�s more, about a third of the people who said they slept the number of hours that doctors recommend reported experiencing poor sleep quality.
How Lack of Sleep Affects the Body
Insufficient or poor sleep has been linked to numerous health issues. People who don�t get enough sleep or their sleep quality is poor, have a higher risk of developing dangerous health conditions such as heart disease, diabetes, and obesity.
Over the long term, it has been linked to a shortened lifespan. It may be tempting to forego sleep to have a few extra hours of awake time, but the price is far too high. Your body and mind need sleep and when you deny that need you set in motion the potential for some severe impacts on your health.
Sleep is when your body and brain rest and rejuvenate. When you have adequate sleep, you will find that you are more focused and you have better mental clarity.
You will also notice increased energy and a better mood. When you don�t give your body the rest, it needs you will begin to feel drained and irritable.
You may also notice that you get sick more often as sleep is directly tied to immune function. One study even found that people who got eight hours of sleep a night were less likely to catch a cold or develop cold symptoms that those who got less than seven hours a night.
Those who got less than seven hours were three times more likely to get sick. There is no denying, sleep is essential.
Amazing Benefits of Sleep
There is no denying that sleep is vital for a healthier mind and body. This includes quality of sleep. Poor quality of sleep can be just as detrimental as not getting enough hours of sleep and can still lead to sleep deprivation. A great deal of research has been done on the effects of sleep and has shown that getting good sleep provides excellent benefits including:
Longer life
Increased production at work
Enhanced athletic performance
Less anxiety and depression
A better outlook on life
Decreased inflammation
Healthier spine
Better pain management
Improved grades
Lowered risk of certain health conditions
Better memory
Increased creativity
Reduced chance of auto accidents
Lower stress level
Better decision making
Enhanced attention or focus
Portrait of a Good Night�s Sleep
Adults should get between seven and nine hours of sleep a night, preferably uninterrupted, within 24 hours on a regular basis. There is more to a good night�s sleep than just quantity though. You should be able to fall asleep within about 20 minutes after you lie down and stay asleep.
When you wake, you should feel refreshed and alert, productive throughout most of the day � although it is normal for a person to notice a temporary decrease in energy and alertness later in the afternoon.
If your family members, friend, or spouse notice any unusual or troubling sleep behaviors such as snoring, restlessness, pauses in breathing, or nightmares it could indicate a more significant problem other than the interrupted sleep. It is well worth visiting your doctor to get help and remedy the situation because sleep is one of the essential needs your body has � and you can�t survive without it.
Neck pain is one of the most common sources of pain and chronic pain worldwide. According to the International Association for the Study of Pain, each year, around 30% to 50% of the general population experiences neck pain and approximately 15% will, at some point in their lives, have chronic neck pain. Women seem to experience it more often than men, and it is most prevalent at around middle age. Neck pain can be debilitating, impacting a person home life as well as their work performance. It can also trigger migraines and limit the range of motion. Understanding the cervical spine is integral in understanding how to manage pain in that area.
What is the Cervical Spine?
Seven vertebrae make up the cervical spine: C1 through C7. They protect the spinal cord and are part of the system that makes up the neck.
C1 is located at the base of the skull and C7 sits at the beginning of the thoracic spine. While C1 is the smallest vertebrae, each subsequent one is slightly larger as you move down the spine. This is necessary because the farther down the spine, the more weight it must bear.
The vertebrae C3 through C6 are called �typical vertebrae.� Like other vertebrae in the spine, they have a similar construction. The top vertebrae, C1 and C2, are �atypical vertebrae.� Their construction is somewhat different from typical vertebrae due to their specialized function and location.
The atlas, C1, is the only vertebrae that have more of a ring shape than a shape resembling a vertebra. It is what connects the skull to the spine and is responsible for about half of the head�s backward and forward range of motion.
The axis, C2, is the second vertebra and has a unique construction that connects it to C1 at the atlanto-axial joint. It is responsible for around half of the head�s rotation. The vertebra prominens, C7, is much larger than the vertebrae that sit above it and its shape is different to facilitate its connection to T1, at the beginning of the thoracic spine.
Neck Pain
The cervical spine has several critical functions. It houses the spinal cord and protects it, supports the head and facilitates its movement, and facilitates the flow of blood to the brain.
The human head is around 10 to 13 pounds and the cervical spine, along with an intricate network of muscles, tendons, and ligaments support it. This is what also allows flexibility to the head so that it can move up and down, backward and forwards, rotational, and side bending. This job alone puts a great deal of stress on the neck and can lead to neck pain. Common causes of neck pain include:
Whiplash (whipping the head forwards and then backward very suddenly)
Degenerative disc disease
Pinched Nerve
Age-related conditions
Spinal stenosis
Sleeping in certain positions
Neck strain
Osteoarthritis
Keeping the neck in one spot too long, such as looking down at a mobile device
Herniated disc
Neck injury
Fibromyalgia
Chiropractic Care for the Cervical Spine
A chiropractor will typically treat a patient with neck pain using cervical spinal manipulation, cervical spinal mobilization, or a combination of the two techniques. Cervical spinal manipulation is what most people think of regarding chiropractic treatment. It involves short, quick thrusts that focus on a single joint at a time, so that range of motion is returned to that area. Cervical spinal mobilization is a gentler, lower impact adjustment that does not use as much force but does move the joint to its correct position.
Other treatments the chiropractor may employ include the application of cold or heat, massage, and exercises to strengthen and stretch the neck. The doctor will carefully consider the patient, their lifestyle, habits, and current level of fitness then create a plan that is tailored specifically for them that will help them manage their pain and return flexibility and range of motion as quickly as possible.
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