Could incorporating standing lumbar flexion exercise into a daily routine help decrease pain and improve overall spinal mobility for individuals with low back pain?
Standing Lower Back Flexion Exercise
A chiropractic physical therapy team visit can help determine which exercises are best for an individual’s injury or condition and teach them what to stop doing if they have low back pain. Exercise and proper posture can decrease discomfort and improve mobility for individuals with low back pain. (Suh, J. H. et al., 2019) Sometimes, exercises that bend backward are recommended, while other times, flexion or forward bending movements are the best way to manage lower back pain. Many find the standing Williams lumbar flexion exercises maneuver helpful for low back pain. (Amila A, Syapitri H, Sembiring E. 2021)
Benefits
Individuals with certain diagnoses may benefit from spinal flexion. These diagnoses include:
Be sure to speak with a healthcare provider to understand the diagnosis and low back symptoms, and work with a physical therapist to be sure that forward flexion of the spine is the correct exercise for your back.
When To Avoid Lumbar Flexion
Some should avoid excessive forward bending, which could cause further damage or injury to the spine. Reasons to avoid flexion include:
Neurological signs such as difficulty urinating or controlling bowel movements (Howell E. R. 2012)
Before starting this or any other exercise program for your spine, check with a healthcare provider or physical therapist.
How to Perform
Gradually progressing with other gentle lumbar flexion exercises before full-standing lumbar flexion is recommended. These include performing a week or two of lumbar flexion lying down, followed by a couple weeks of lumbar flexion seated. Once these exercises are easy to perform and pain-free, progress with lumbar flexion standing postures.To perform, follow these steps:
Stand with your feet shoulder-width apart.
Slowly bend forward by sliding your hands down the front of your thighs.
Reach down as far as possible and let your lower back bend forward.
Grab your ankles and gently pull into more forward flexion to increase the backstretch.
Hold the end position for a second or two, then slowly return to the starting position.
As you exercise, be sure to monitor changes in symptoms. Pain worsening in the back or traveling down your leg indicates that you should stop the exercise (Spine-health, 2017). If the pain decreases in your leg or centralizes to your back, continue the exercise. Standing lumbar flexion can be repeated for 10 repetitions a couple of times daily. It can help decrease low back or leg pain symptoms and stretch tight hamstrings and back muscles. (Montefiore Pediatric Orthopedic and Scoliosis Center, 2003)
Injury Medical Chiropractic and Functional Medicine Clinic
Exercise can also prevent future lower back problems. Standing back flexion, postural correction, regular physical activity, and exercise are tools for keeping the spine healthy. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
What Causes Disc Herniation?
References
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
Amila A, Syapitri H, Sembiring E. (2021). The effect of William Flexion Exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv., 4(1), 28-36. doi.org/https://doi.org/10.35654/ijnhs.v4i1.374
Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. doi.org/10.1136/bmj.h6234
Sfeir, J. G., Drake, M. T., Sonawane, V. J., & Sinaki, M. (2018). Vertebral compression fractures associated with yoga: a case series. European journal of physical and rehabilitation medicine, 54(6), 947–951. doi.org/10.23736/S1973-9087.18.05034-7
Howell E. R. (2012). Conservative management of a 31 year old male with left sided low back and leg pain: a case report. The Journal of the Canadian Chiropractic Association, 56(3), 225–232.
Can individuals add sparkling water to their diet to help lower blood sugar and aid with weight loss?
Sparkling Water
Sparkling water is generally considered a healthy drink with health benefits. It is refreshing, increases hydration, improves digestion, and may even help with weight loss (Takahashi A. 2025) (University of Chicago Medicine, 2023). This is nothing new. A previous study suggested that carbonated water makes the body feel full. The carbonation in sparkling water can trick the stomach into feeling fuller, potentially reducing overall calorie intake by curbing snacking between meals, which could prevent overeating and weight gain. (Wakisaka S. et al., 2012) However, a new report suggests carbonated water may help with weight loss by enhancing glucose/sugar uptake and metabolism. (Takahashi A. 2025) But further research is needed.
Lower Blood Sugar Levels
The report compared the effects of carbonated water to hemodialysis, a treatment that filters blood for individuals with kidney failure. (Takahashi A. 2025) Hemodialysis turns the blood alkaline, enhancing glucose absorption and metabolism. (EurekAlert, 2025)
Researchers assume that the carbon dioxide (CO2) absorbed after drinking sparkling water and the CO2 supplied during hemodialysis behave similarly. Carbonated water may consume glucose in the blood near the stomach, temporarily lowering blood sugar levels. However, the researchers suggested that follow-up continuous glucose monitoring (CGM) studies to measure blood sugar levels before and after drinking carbonated water would be necessary to validate the effect.
This does not mean that after drinking sparkling water, there will be major changes to an individual’s weight. Something metabolically is probably happening, but it’s still barely being discovered. The impact of CO2 in carbonated water is not a standalone solution for weight loss. (Takahashi A. 2025)
Adding To A Diet
If sparkling water can help manage blood glucose, it could also affect how the body stores fat. Over time, high blood sugar levels can overwhelm the body, and excess sugar becomes stored as body fat instead of being stored properly for energy use, causing weight gain. (Centers for Disease Control and Prevention, 2024) But for the most part, according to the research, the carbon dioxide in sparkling water may help to prevent this by stimulating glycolysis, or the process the body uses to break down glucose for energy and keep blood sugar levels low. (National Cancer Institute, N.D) (Takahashi A. 2025) Further research is needed to confirm and understand how sparkling water can proficiently and effectively work for weight loss.
Carbonated water alone is unlikely to contribute to significant weight loss. However, sparkling water can be a useful tool for weight loss as part of a healthy lifestyle (Takahashi A. 2025). A balanced diet and regular exercise are still essential for effective weight management.
Weight Gain
Some researchers have questioned whether sparkling water can lead to weight gain. A study on rats and humans found a link between drinking carbonated water and increased levels of the hunger-stimulating hormone ghrelin. (Eweis D. S., Abed F., & Stiban J. 2017) This could lead to increased appetite and higher calorie consumption, but more research is needed, as sleep, physical activity levels and hydration also impact hormones.
Individuals interested in including carbonated water in a balanced diet should check the labels for the caloric content, added sugars, and sugar alcohols, like xylitol or erythritol, which can cause gas or bloating. It is ideal if the label says water and carbonation; the fewer ingredients, the better.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Wakisaka, S., Nagai, H., Mura, E., Matsumoto, T., Moritani, T., & Nagai, N. (2012). The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. Journal of nutritional science and vitaminology, 58(5), 333–338. doi.org/10.3177/jnsv.58.333
EurekAlert. (2025). Fizzy water might aid weight loss by boosting glucose uptake and metabolism. BMJ Nutrition Prevention & Health. doi.org/10.1136/bmjnph-2024-001108
Eweis, D. S., Abed, F., & Stiban, J. (2017). Carbon dioxide in carbonated beverages induces ghrelin release and increased food consumption in male rats: Implications on the onset of obesity. Obesity research & clinical practice, 11(5), 534–543. doi.org/10.1016/j.orcp.2017.02.001
Could individuals who are having headaches with neck pain need emergency treatment or need to get started with sustained physical therapy?
Headaches and Neck Pain
Headaches and neck pain are two very common symptoms. They often occur together and signal common health issues, including fatigue, sinus headaches, and migraines. The combination can also occur due to serious health issues such as a concussion or meningitis. Causes of headaches with neck pain range from various causes, such as not getting enough sleep, having the neck in an awkward position, or having a hangover, to life-threatening issues like fluid buildup in the brain. It is recommended that individuals see a healthcare provider as soon as possible to rule out any life-threatening issues. Discuss the symptoms of neck pain with headache, what can cause these symptoms, and discuss treatment and prevention.
Symptoms
Symptoms are similar to what they feel like when they occur alone. Headache can present as:
A feeling of fullness in the head
Head soreness
Sharp head pain
Throbbing head pain
Pounding head pain
Neck pain can present as:
Pain in the back of the neck
Pain and/or aching of the upper back and/or shoulders
Associated Symptoms
Additional symptoms are common. Symptoms associated with headaches and neck pain include:
Neck stiffness
Trouble concentrating
Exhaustion or sleepiness
Aching throughout the body
Nausea
Dizziness
Vertigo – feeling like the room is spinning.
Photophobia – discomfort when looking at bright lights.
A feeling of numbness or tingling down the arm
Generally, associated symptoms suggest a more severe cause and can help a healthcare provider make a diagnosis.
Emergency Help
New symptoms of headache or neck pain can indicate a serious condition. If you develop these symptoms together, get prompt medical attention.
Causes
There are a variety of medical conditions that can cause headaches and neck pain. Both of these conditions are caused by irritation of sensory nerve fibers. Sometimes, head or neck pain can spread to other areas because the sensory nerves of these structures are so close together. (Côté P. et al., 2019) Additionally, a medical condition like an infection can affect the other due to proximity. Causes of headaches with neck pain include:
Headaches
Sinus headaches, tension headaches, and cervicogenic headaches are usually associated with head pain, but they can also involve neck pain. (Côté P. et al., 2019)
Migraine
Migraines are commonly associated with headaches and often cause neck pain as well.
In addition, they can cause nausea and body aches.
Fatigue
Being tired commonly leads to temporary headaches and neck pain until thorough rest is achieved.
Alcohol Consumption and/or a Hangover
For many, drinking can trigger a headache.
This is a common migraine trigger, but it can also trigger headaches for those who don’t have migraines.
Muscle Strain
Prolonged or recurrent positions that strain the neck muscles, like lifting or sitting at a desk, can cause aching or pain that involves both the head and neck. (Houle M. et al., 2021)
Injuries
Trauma such as whiplash or falling can cause soreness in the head and neck.
Bruises or other injuries may be present.
Severe injuries can cause damage to the skull, brain, spine, spinal nerves, or spinal cord.
Concussion
A concussion often causes trouble concentrating, persistent headaches, and neck pain.
Usually, these symptoms improve within a few weeks after a mild concussion.
Meningitis
Inflammation or infection of the lining around the brain and spinal cord causes pain or tenderness in the head, back, and neck.
Neck stiffness and fever are commonly associated symptoms.
Pinched Nerve
Arthritis is a common cause of pressure on spinal nerves.
A pinched nerve in the upper spine can cause pain in the head and neck and tingling down the arm.
Herniated Disc
Degenerative arthritis or trauma can cause a spinal disc to press on a nerve and possibly on the spinal cord.
This may cause loss of sensation or weakness of the arm.
Subarachnoid Hemorrhage
This is a serious condition caused by bleeding of a blood vessel in the brain.
Irritation and inflammation can cause severe head and neck pain, possibly with seizures and loss of consciousness.
Hydrocephalus
Fluid can accumulate around the brain, causing pain-inducing pressure.
Causes include obstruction of cerebrospinal fluid flow due to brain tumors, brain infections, or congenital malformations. (Langner S. et al., 2017)
Increased Intracranial Pressure
Pressure on the brain and the brain’s blood vessels can cause pain.
Causes of pressure within the skull include hydrocephalus, head trauma, brain tumors, or swelling from a stroke.
Severe cases can cause lethargy or loss of consciousness.
Brain or Spine cancer
Cancer of the brain or within the spine can cause pain affecting the head and neck, often with other symptoms, like loss of vision.
Treatment
Talk to a healthcare provider about the following treatments. Treating headaches with neck pain includes methods that address symptoms and methods that treat the underlying cause. The medications used for headaches with neck pain often reduce both symptoms, but this depends on the cause. Treatments that can relieve both headaches and neck pain when they occur together include:
Getting proper sleep to alleviate fatigue.
Rest and rehabilitation after a concussion or another injury.
Physical therapy to keep muscles flexible and relaxed.
Fluids for meningitis treatment and antibiotics for bacterial meningitis.
Surgical procedures for a tumor or subarachnoid hemorrhage.
A surgical procedure to relieve hydrocephalus.
Headache Treatment
You can do a few things to relieve your headaches, and although they won’t directly take away your neck pain, your headache relief might also decrease your neck pain. These include:
Avoiding loud noises
Cranial massage
Applying gentle cranial pressure
Avoiding bright lights as much as possible
Using specialized migraine sunglasses
Neck Pain Treatment
Some treatments that can specifically treat neck pain include:
Injury Medical Chiropractic and Functional Medicine Clinic
Knowing whether a serious problem is causing headaches and neck pain can be difficult. The more dangerous conditions don’t necessarily cause more severe pain. This is why getting medical attention is crucial if you have these symptoms together. If you frequently have both headaches and neck pain, it can have a substantial impact on your quality of life. There are ways to manage the symptoms, including preventative measures such as physical therapy, exercises, and avoiding triggers. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Tension Headaches
References
Côté, P., Yu, H., Shearer, H. M., Randhawa, K., Wong, J. J., Mior, S., Ameis, A., Carroll, L. J., Nordin, M., Varatharajan, S., Sutton, D., Southerst, D., Jacobs, C., Stupar, M., Taylor-Vaisey, A., Gross, D. P., Brison, R. J., Paulden, M., Ammendolia, C., Cassidy, J. D., … Lacerte, M. (2019). Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England), 23(6), 1051–1070. doi.org/10.1002/ejp.1374
Houle, M., Lessard, A., Marineau-Bélanger, É., Lardon, A., Marchand, A. A., Descarreaux, M., & Abboud, J. (2021). Factors associated with headache and neck pain among telecommuters – a five days follow-up. BMC Public Health, 21(1), 1086. doi.org/10.1186/s12889-021-11144-6
Langner, S., Fleck, S., Baldauf, J., Mensel, B., Kühn, J. P., & Kirsch, M. (2017). Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 189(8), 728–739. doi.org/10.1055/s-0043-108550
Petersen, S. M., Jull, G. A., & Learman, K. E. (2019). Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case-control study. The Journal of manual & manipulative therapy, 27(4), 245–252. doi.org/10.1080/10669817.2019.1572987
Can coconut be a healthier alternative food option for individuals trying to improve their health and wellness?
The Coconut
Located in the tropical regions around the world, especially in Southeast Asia, the Pacific islands, sunny coastal states in the U.S., and India, the coconut (Cocos nucifera L.) is a monoecious perennial palm that has many uses for people who are looking for alternatives in their dietary needs. Known as the “tree of life,” the coconut has numerous utilities that people can incorporate from food, medicine, and household products. (Beveridge et al., 2022) The outer coconut husk is used in household items, while the coconut fruit is used for food and medicinal purposes, from antibacterial and antioxidant to containing microminerals and nutrients. (DebMandal & Mandal, 2011) This tropical fruit can be used in baked goods, skin products, and food dishes and can help restore the body’s electrolytes. We associate with certified medical providers who inform our patients of the importance of incorporating healthy foods like coconut into a healthy diet. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily dietary intake to feel good. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Nutritional Facts
With coconut being a versatile fruit, it has many nutritional benefits. It is classified as a medium-chaired saturated fat absorbed by the body differently and can help reduce LDL-Cs (low-density lipoproteins, reduce cardiovascular diseases, and improve cognitive function. (Hewlings, 2020) When it comes to the nutritional facts of eating one piece of coconut is about:
1 piece of coconut: 45g
Calories: 159
Total Fats: 15g
Saturated fat: 13g
Cholesterol: 0mg
Sodium: 9mg
Potassium: 160mg
Total Carbohydrate: 7g
Dietary fibers: 4.1
Sugar: 2.8g
Protein: 1.5g
Coconuts are high in saturated fats and medium-chain fatty, so they can cross the blood-brain barrier and be absorbed, transported, and utilized for energy production for the body. They can also provide beneficial properties to the gut microbiome. (Fan et al., 2022) At the same time, if people drink the water from the coconut, its nutritional facts include:
1 cup of coconut water: 240g
Calories: 45
Total Fats: 0.5g
Saturated fat: 0.4g
Cholesterol: 0mg
Sodium: 252mg
Potassium: 600mg
Total Carbohydrate: 9g
Dietary fiber: 2.6g
Sugar: 6g
Protein: 1.7g
Food As Medicine- Video
The Health Benefits Of The Coconut
With the coconut tree being “the tree of life,” the fruit has many beneficial properties for health and wellness. For instance, using coconut oil for cooking has many advantages, such as being resistant to oxidation and polymerization due to its high saturated fatty acid content, being consumed at low levels, and reducing cardiovascular diseases. (Schwingshackl & Schlesinger, 2023) At the same time, when people start to use coconut oil for part of their cooking, they will notice that their body weight decreases. (Duarte et al., 2022). Below are other beneficial properties when people start incorporating coconut into their diet.
Replenish Electrolytes
Many people starting to work out or are physically active can utilize coconut water to replace sports drinks to replenish their electrolytes. When a person is exercising and sweating profusely, water and sodium levels are depleted, thus compromising the cardiovascular system’s ability to maintain a person’s exercise performance. (O’Brien et al., 2023) Hence, drinking coconut water can help rehydrate the body and replenish those electrolytes. At the same time, incorporating a bit of citrus fruit can provide extra health benefits and enhance the flavor of coconut water.
Reduces Blood Sugar
Coconuts can also help lower blood sugar levels, and for diabetic individuals, it can help reduce their blood glucose to healthy levels, regulate their carbohydrate metabolism, and improve their antioxidant capacity to reduce any comorbidities associated with diabetes. (Dai et al., 2021) Additionally, many diabetic individuals can substitute regular sugar with coconut sugar as it has a high nutritional value and a low glycemic index that can be beneficial to moderate glucose absorption. (Saraiva et al., 2023)
Adding Coconut To Your Diet
Many people can incorporate coconut into their diet by eating the fruit, drinking the coconut water, and utilizing it for smoothies and baked goods. By adding coconut to a healthy diet, many people can get their healthy fats in moderation, their electrolytes replenished, and enjoy eating clean, healthy foods. Making small changes by incorporating foods that have antioxidants into a healthy diet can help many people eat healthier and have more energy. At the same time, when people incorporate physical activity with their diet, they will begin to notice small positive changes in themselves and their bodies, thus leading happy, healthier lives.
References
Beveridge, F. C., Kalaipandian, S., Yang, C., & Adkins, S. W. (2022). Fruit Biology of Coconut (Cocos nucifera L.). Plants (Basel), 11(23). doi.org/10.3390/plants11233293
Dai, Y., Peng, L., Zhang, X., Wu, Q., Yao, J., Xing, Q., Zheng, Y., Huang, X., Chen, S., & Xie, Q. (2021). Effects of coconut water on blood sugar and retina of rats with diabetes. PeerJ, 9, e10667. doi.org/10.7717/peerj.10667
DebMandal, M., & Mandal, S. (2011). Coconut (Cocos nucifera L.: Arecaceae): in health promotion and disease prevention. Asian Pac J Trop Med, 4(3), 241-247. doi.org/10.1016/S1995-7645(11)60078-3
Duarte, A. C., Spiazzi, B. F., Zingano, C. P., Merello, E. N., Wayerbacher, L. F., Teixeira, P. P., Farenzena, L. P., de Araujo, C., Amazarray, C. R., Colpani, V., & Gerchman, F. (2022). The effects of coconut oil on the cardiometabolic profile: a systematic review and meta-analysis of randomized clinical trials. Lipids Health Dis, 21(1), 83. doi.org/10.1186/s12944-022-01685-z
Fan, L., Zhu, X., Sun, S., Yu, C., Huang, X., Ness, R., Dugan, L. L., Shu, L., Seidner, D. L., Murff, H. J., Fodor, A. A., Azcarate-Peril, M. A., Shrubsole, M. J., & Dai, Q. (2022). Ca:Mg ratio, medium-chain fatty acids, and the gut microbiome. Clin Nutr, 41(11), 2490-2499. doi.org/10.1016/j.clnu.2022.08.031
Hewlings, S. (2020). Coconuts and Health: Different Chain Lengths of Saturated Fats Require Different Consideration. J Cardiovasc Dev Dis, 7(4). doi.org/10.3390/jcdd7040059
O’Brien, B. J., Bell, L. R., Hennessy, D., Denham, J., & Paton, C. D. (2023). Coconut Water: A Sports Drink Alternative? Sports (Basel), 11(9). doi.org/10.3390/sports11090183
Saraiva, A., Carrascosa, C., Ramos, F., Raheem, D., Lopes, M., & Raposo, A. (2023). Coconut Sugar: Chemical Analysis and Nutritional Profile; Health Impacts; Safety and Quality Control; Food Industry Applications. Int J Environ Res Public Health, 20(4). doi.org/10.3390/ijerph20043671
Schwingshackl, L., & Schlesinger, S. (2023). Coconut Oil and Cardiovascular Disease Risk. Curr Atheroscler Rep, 25(5), 231-236. doi.org/10.1007/s11883-023-01098-y
Excessive alcohol consumption: what is alcoholic peripheral neuropathy?
Alcoholic Peripheral Neuropathy
Alcoholic peripheral neuropathy (ALN) is a condition that damages the nerves in the body due to chronic alcohol consumption. It can cause sensory, motor, and autonomic dysfunction, which can lead to disability. This damage prevents the nerves from communicating information. Most symptoms generally start as mild but typically worsen over time as the neuropathy progresses. The most common symptoms are: (National Library of Medicine, 2023)
Numbness or tingling sensation in the extremities
Pain or a burning sensation in the extremities
Difficulty walking
Difficulty urinating
Difficulty talking or swallowing
Affected nerves include the peripheral and autonomic nerves, which help regulate internal body functions. Around 46% of chronic alcohol users will eventually develop the condition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Causes
The exact cause of alcoholic neuropathy is unclear. But it is directly related to heavy and long-term alcohol consumption. (Julian T., Glascow N., Syeed R., & Zis P. 2019) It is believed overconsumption of alcohol can directly harm and hinder the nerves’ ability to communicate information. Unhealthy nutritional habits are often associated with it as well. Research shows that decreased thiamine/B vitamin plays a role, while others suggest an overall dietary deficiency may play a role. (Julian T., Glascow N., Syeed R., & Zis P. 2019) However, alcoholic neuropathy can also occur without the presence of malnutrition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Neuropathy Development and Progression
Alcoholic peripheral neuropathy develops depending on many factors, including the amount of daily/nightly alcohol consumed, age and overall health, nutritional intake, and other individual factors. In most cases, the neuropathy takes several years or decades to develop, depending on the amount of alcohol consumed.
Pain or burning sensation in the arms, legs, or feet.
Symptoms that occur in the arms and legs typically affect both sides.
Cramps, aches, or weakness of the muscles.
Constipation or diarrhea.
Nausea and vomiting.
Difficulty urinating or incontinence.
Difficulty walking.
Difficulty talking or swallowing.
Heat intolerance.
Erection difficulties.
Most symptoms begin as mild and usually worsen over time as the neuropathy progresses. Alcoholic neuropathy affects individuals who consume excessive amounts of alcohol over a long time. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Healthcare providers will collect data involving past medical history and all current symptoms.
Physical Exam
This exam looks at other medical conditions contributing to symptoms, like diabetes or high blood pressure.
Neurological Exam
This is a noninvasive exam to determine the location and extent of neurological damage.
Healthcare providers may ask patients several questions and have them complete a series of small movements to check neurological function.
Blood and Urine Tests
These tests can detect diabetes, liver and kidney problems, infections, vitamin deficiencies, and other conditions that can cause neuropathic conditions.
Chronic alcohol use can also affect how the body stores and uses vitamins necessary for healthy nerve function. Vitamin levels that a healthcare provider may check include: (National Library of Medicine, 2023)
Vitamin A
Biotin
Folic acid
Niacin, or vitamin B3
Pyridoxine, or vitamin B6
Pantothenic acid
Liver Disease
Individuals with chronic liver disease often have neuropathy. The severity and stage are associated with a higher incidence of neuropathy. (Pasha MB, Ather MM, Tanveer MA, et al. 2019)
Treatment
Alcoholic neuropathy is not reversible, even when quitting drinking. However, individuals with the condition can make healthy changes to minimize symptoms and receive help for chronic alcohol use. The first step is stopping alcohol consumption. (Chopra K., & Tiwari V. 2012) Talk to a healthcare provider about what options are available. Treatment can include:
In-patient or outpatient rehab
Therapy
Medication
Social support from groups like Alcoholics Anonymous
A combination of treatments will likely be utilized. Other treatment options involve symptom management and preventing further injuries and may include:
Physical therapy
Keeping the head elevated while sleeping.
Orthopedic splints to maintain limb function and positioning.
Wearing compression stockings.
Adding vitamins and supplements.
Eating extra salt for those without hypertension
Medications to reduce pain and discomfort.
Intermittent catheterization or manual expression of urine for those with difficulty urinating.
Individuals with neuropathy may have reduced sensitivity in the arms and legs. If this occurs, additional steps need to be taken to prevent other injuries, that include (National Library of Medicine, 2023)
Wear special footwear to prevent foot injuries.
Checking feet daily for wounds.
Prevent burns by ensuring that bath and shower water is not too hot.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Julian, T., Glascow, N., Syeed, R., & Zis, P. (2019). Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. Journal of Neurology, 266(12), 2907–2919. doi.org/10.1007/s00415-018-9123-1
Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362. doi.org/10.1111/j.1365-2125.2011.04111.x
For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?
Frozen Shoulder Stages
A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.
Stage 1
Pre-Freezing – 1 month to 3 months
Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)
Root Cause
A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)
Stage 2
Freezing – 10 weeks to 8 months
The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)
Stage 3
Frozen – 4 months to 12 months
The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.
Stage 4
Thawing – 5 months to 2 years
In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.
Treatment
Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)
Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)
Prognosis
The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Motion Key To Healing
References
Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. doi.org/10.1067/j.cpradiol.2024.03.005
Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. doi.org/10.11622/smedj.2017107
Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. doi.org/10.5435/JAAOS-D-17-00606
Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. doi.org/10.1177/1758573216676786
Can individuals incorporate nutritional snacks to consume before and after to have an effective workout and abundant energy?
How Can Exercise Help The Body?
When many people start thinking about their health and how to improve it, they usually begin exercising and eating healthier around the last week before the new year to jumpstart their health and wellness journey. These small changes can help the body tremendously as environmental factors like stress, physical inactivity, and various lifestyles can negatively impact the body, thus leading to stress and environmental factors. For individuals dealing with musculoskeletal disorders or autoimmune disorders, exercises and a healthy diet filled with nutritional foods can help mitigate pain-like symptoms and overlapping risk profiles. For individuals with low back pain, core stabilization exercises can help reduce pain and disability while improving core muscle activation to strengthen weak muscles. (Nayyab et al., 2021) As a non-surgical therapy, everyone can exercise for the body, which can help many people reduce any chronic diseases and issues they are dealing with. (Vina et al., 2012) At the same time, a person can exercise at any fitness level by incorporating the right amount of healthy snacks before and after a good workout. We associate with certified medical providers who inform our patients of the importance of having healthy snacks before and after working out to replenish the body and have energy throughout the day. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to restore energy through healthy snacking. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Secrets of Optimal Wellness- Video
Pre- & Post Workout Benefits
When starting to work out, it is important to ensure that the body is properly fueled with the proper carbohydrates, proteins, and healthy fats that can be converted into energy to perform any exercise routines at full capacity. For athletic individuals, nutrition is closely connected with physical activity and the timing of when the body uses that energy. (Januszko & Lange, 2021) Hence, it is important for individuals starting to work out to consume enough energy through nutritional foods in a pre-workout environment. Pre-workout supplementation can help significantly improve greater changes in body composition and strength. (Cabre et al., 2022) Pre-workouts have benefited from increasing energy, enhancing strength and endurance, and reducing muscle fatigue through supplementation and healthy snacks that give people energy. Post-workouts can help with muscle recovery, and post-workout snacks can help maintain the body’s energy levels throughout the day.
Pre-Workout Snacks
Many dietary supplements for pre-workouts can help with health and performance improvement as they help increase muscle mass and strength while providing energy when exercising. (Brisebois et al., 2022) At the same time, incorporating carbohydrates can provide glycogen energy stored in the liver to provide muscle energy. (Henselmans et al., 2022) It is important to note that eating an hour before working out can give beneficial results. Some of the snacks many people can make and eat before working out include:
Chocolate milk with banana
Frozen grapes
Granola bar
Pretzels
Post Workout Snacks
It is important to restore and maintain that energy in the body when it comes to post-workout snacks after an intense workout. Many athletic and non-athletic individuals can incorporate nutritional carbohydrates and proteins to improve their physiological and biochemical adaptations to promote faster recovery and maintain the body’s hydration status. (Baroni et al., 2023) For instance, coconut water can be an alternative to sports drinks to replenish the body’s electrolytes. (O’Brien et al., 2023) Some of the post-workout snacks that are packed with protein and healthy carbs include:
Smoothies made with fruits, Greek yogurt, and protein powders
Chocolate milk with almonds
Crackers with string cheese
Cottage cheese
References
Baroni, L., Pelosi, E., Giampieri, F., & Battino, M. (2023). The VegPlate for Sports: A Plant-Based Food Guide for Athletes. Nutrients, 15(7). doi.org/10.3390/nu15071746
Brisebois, M., Kramer, S., Lindsay, K. G., Wu, C. T., & Kamla, J. (2022). Dietary practices and supplement use among CrossFit(R) participants. J Int Soc Sports Nutr, 19(1), 316-335. doi.org/10.1080/15502783.2022.2086016
Cabre, H. E., Gordon, A. N., Patterson, N. D., & Smith-Ryan, A. E. (2022). Evaluation of pre-workout and recovery formulations on body composition and performance after a 6-week high-intensity training program. Front Nutr, 9, 1016310. doi.org/10.3389/fnut.2022.1016310
Henselmans, M., Bjornsen, T., Hedderman, R., & Varvik, F. T. (2022). The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review. Nutrients, 14(4). doi.org/10.3390/nu14040856
Januszko, P., & Lange, E. (2021). Nutrition, supplementation and weight reduction in combat sports: a review. AIMS Public Health, 8(3), 485-498. doi.org/10.3934/publichealth.2021038
Nayyab, I., Ghous, M., Shakil Ur Rehman, S., & Yaqoob, I. (2021). The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. J Pak Med Assoc, 71(5), 1319-1325. doi.org/10.47391/JPMA.596
O’Brien, B. J., Bell, L. R., Hennessy, D., Denham, J., & Paton, C. D. (2023). Coconut Water: A Sports Drink Alternative? Sports (Basel), 11(9). doi.org/10.3390/sports11090183
Vina, J., Sanchis-Gomar, F., Martinez-Bello, V., & Gomez-Cabrera, M. C. (2012). Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol, 167(1), 1-12. doi.org/10.1111/j.1476-5381.2012.01970.x
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