For individuals with peanut allergies, can finding a peanut alternative be as satisfying as a real creamy or crunchy peanut butter sandwich?
Peanut Butter Sandwich Alternatives
For individuals who are unable to have a peanut butter sandwich due to an allergy, there are healthy satisfying alternatives. Tree nut butter, seed butter, and deli meats can all satisfy sandwich cravings and provide nutrition. Here are a few healthy, nutritious alternatives to try out:
Sunflower Seed Butter and Jam, Jelly, or Preserves
It can be substituted for a PBJ with jam, jelly, and preserves.
Ham and Cheese, Grainy Mustard on Rye Bread
Getting ham and cheese from the deli can potentially have cross-contamination with allergens during slicing and packaging.
Prepackaged and sliced ham and cheese is a safer bet in terms of allergens.
It is recommended to read the ingredient label for potential allergens, as processing in facilities can have cross-contamination issues. (William J. Sheehan, et al., 2018)
Turkey, Tomato, Lettuce, and Hummus on Whole Grain Bread
The same is true for turkey and is recommended to buy prepackaged and sliced.
Check the ingredients for possible allergens.
Hummus is made from chickpeas/garbanzo beans and tahini/ground sesame seeds.
Hummus comes in a variety of flavors that can be used as a dip or spread.
Although chick peas’ are a member of the legume family, hummus can be tolerated with peanut allergies. (Mathias Cousin, et al., 2017)
Check with a healthcare provider if unsure.
Pita Pocket with Salad and Hummus
Pita pockets are great with hummus stuffed with vegetables.
This is a delicious crunchy pocket sandwich loaded with protein, fiber vitamins, and minerals.
Cashew butter on a hot English muffin with raisins on top for a boost of iron is reminiscent of a cinnamon roll.
Pumpkin Seed Butter and Honey Sandwich
Pumpkin butter is made from the orange flesh of the pumpkin.
Pumpkin seed butter is made by roasting pumpkin seeds and grinding them to a butter consistency.
The seed butter can be spread on bread and drizzled with some honey on top for a nutritious and delicious snack.
There are tasty healthy peanut butter alternatives that can be mixed, matched, and reinvented into various satisfying sandwiches. Individuals are recommended to consult their healthcare provider or a dietician or nutritionist to find what works for them.
Smart Choices, Better Health
References
Lavine, E., & Ben-Shoshan, M. (2015). Allergy to sunflower seed and sunflower butter as a proposed vehicle for sensitization. Allergy, asthma, and clinical immunology: Official Journal of the Canadian Society of Allergy and Clinical Immunology, 11(1), 2. doi.org/10.1186/s13223-014-0065-6
U.S. Department of Agriculture: FoodData Central. Seeds, sunflower seed butter, with salt added (Includes foods for USDA’s Food Distribution Program).
Sheehan, W. J., Taylor, S. L., Phipatanakul, W., & Brough, H. A. (2018). Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. The journal of allergy and clinical immunology. In practice, 6(6), 1825–1832. doi.org/10.1016/j.jaip.2018.08.001
Gorrepati, K., Balasubramanian, S., & Chandra, P. (2015). Plant-based butters. Journal of food science and technology, 52(7), 3965–3976. doi.org/10.1007/s13197-014-1572-7
Cousin, M., Verdun, S., Seynave, M., Vilain, A. C., Lansiaux, A., Decoster, A., & Sauvage, C. (2017). Phenotypical characterization of peanut-allergic children with differences in cross-allergy to tree nuts and other legumes. Pediatric allergy and immunology: Official publication of the European Society of Pediatric Allergy and Immunology, 28(3), 245–250. doi.org/10.1111/pai.12698
Almond Board of California. Nutrient comparison chart for tree nuts.
American Academy of Allergy, Asthma and Immunology. Everything you need to know about a tree nut allergy.
How does innovated non-surgical treatment help assist individuals with cervical spinal pain to reduce headaches?
Introduction
Do you or your loved ones often experience headaches that don’t disappear? Do you often feel your shoulder and neck muscles ache after looking down at your cell phone? Or do you feel aches after being slouched for an extended period? Many of these scenarios correlate with referred pain in the cervical spinal region, which can develop into neck pain. The neck region is located in the upper body portion and provides mobility for the head without pain and discomfort. The neck region also has surrounding muscles and ligaments that support the spine and protects the thyroid and spinal cord. However, just like the back region, it is susceptible to pain as many individuals can overstretch the neck muscles, and it can cause referred pain to the shoulders and head, leading to pain-like symptoms that can lead to a life of disability. However, non-surgical treatments can minimize the pain and help strengthen the surrounding muscles in the neck region. Today’s article focuses on how cervical spinal pain connects with headaches and how decompression can reduce headaches while relieving neck pain. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce cervical spinal pain associated with headaches, causing many musculoskeletal issues in the upper body portion. We also inform them that non-surgical treatments can help relieve headaches and provide relief to the neck region. We encourage our patients to ask amazing educational questions for our associated medical providers about their symptoms correlating with cervical spinal pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer
Cervical Spinal Pain & Headache Connection
Throughout the world, neck pain (cervical spinal pain) is the second most common problem that can affect many individuals throughout their lives. It can lead to a life of disability and pain if not treated immediately. Many individuals often experience non-specific neck pain, as it can be through a postural or mechanical basis that can cause muscle strain in the surrounding muscles or compress the spinal canal to cause headaches that can last throughout the entire day. (Binder, 2008) Additionally, neck pain, like back pain, is a multifactorial disease with common risk factors like lack of physical activity, duration of computer usage, and perceived stress. (Kazeminasab et al., 2022) Many of these risk factors are normal as they can also affect the surrounding muscles in the lower back region and shoulder region, as many people often do repetitive motions that can naturally be overstretched and cause pain-like issues to the neck region. With neck pain connected with headaches, it can cause overlapping risk profiles and be costly. Neck pain associated with headaches can be a frequent and expensive occupational health problem as symptoms of pain, disability, reduced life quality, and, for adults, time lost for work. (Ben Ayed et al., 2019)
The correlation between headaches and neck pain is that the spinal canal is compressed from traumatic forces that can lead to cervicogenic headaches. Cervicogenic headaches usually aggravate neck mobility, thus reducing the ROM of the neck. (Verma, Tripathi, & Chandra, 2021) This can lead to many individuals suffering from migraine-like headaches and muscle stiffness in the upper regions of the body. When many individuals are dealing with headaches associated with cervical spinal pain, many will find treatments to mitigate the pain-like symptoms affecting the upper body region.
The Benefits Of Stretching-Video
When it comes to neck pain, it can be either acute or chronic depending the factors that cause it or the severity of the pain. Many individuals sought treatment that can alleviate the pain in the upper regions that are non-surgical and beneficial to their health and well-being. Non-surgical treatments can help stretch the tight and short muscles in the neck region and can reduce headaches affecting the person. Additionally, having the neck muscles professionally stretched by a massage therapist can relieve the neck and reduce headaches. The video above explains the benefits of stretching and describes how many people don’t stretch their bodies often to prevent pain-like issues from reoccurring in the future.
Spinal Decompression For Cervical Pain
Non-surgical treatments are excellent when it comes to reducing neck pain. When relieving neck pain, healthcare professionals must use the best available evidence to enhance clinical decision-making and improve the quality of care for people with neck pain. (Misailidou et al., 2010) Spinal decompression can help many people with neck pain by reducing the issues through gentle spinal traction. What spinal decompression does for the cervical spine is that it can realign the disc that is aggravating the neck region and causing headaches by stretching the surrounding muscles. This causes muscle improvement for the neck as it can change the patient’s pain outcome. (Youssef et al., 2019) Additionally, spinal decompression is safe, cost-effective, and gentle on the spine as it can be combined with other therapies to mitigate any residual pain that can relieve the neck and back. (Flynn, 2020) Many people who incorporate spinal decompression as part of their routine can benefit from their outcome as they return to their routine.
References
Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. www.ncbi.nlm.nih.gov/pubmed/31133629
Flynn, D. M. (2020). Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments. American Family Physician, 102(8), 465-477. www.ncbi.nlm.nih.gov/pubmed/33064421
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4
Misailidou, V., Malliou, P., Beneka, A., Karagiannidis, A., & Godolias, G. (2010). Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med, 9(2), 49-59. doi.org/10.1016/j.jcm.2010.03.002
Verma, S., Tripathi, M., & Chandra, P. S. (2021). Cervicogenic Headache: Current Perspectives. Neurol India, 69(Supplement), S194-S198. doi.org/10.4103/0028-3886.315992
Youssef, J. A., Heiner, A. D., Montgomery, J. R., Tender, G. C., Lorio, M. P., Morreale, J. M., & Phillips, F. M. (2019). Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Spine J, 19(10), 1714-1729. doi.org/10.1016/j.spinee.2019.04.019
The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?
Quadriceps Q – Angle Injuries
The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:
One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.
Injuries
Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.
Patellofemoral Pain Syndrome
An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)
Chondromalacia of the Knee
This is the wearing down of the cartilage on the underside of the kneecap.
An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.
Chiropractic Treatment
Strengthening Exercises
ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.
Stretching Exercises
Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.
Foot Orthotics
Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.
Knee Rehabilitation
References
Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6
Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507
Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12
Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5
Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition?
What Not To Do Temporomandibular Joint Disorder
Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check.
Chewing Gum
Gum chewing is not recommended for individuals with TMJ.
The jaw is one of the most used joints in the body.
Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
Resting sore muscles and joints is the first step in injury recovery.
Eating Chewy and Hard Foods
Chewy and hard foods make the jaw have to work overtime.
Avoid eating hard foods like chewy candies, hard and chewy breads, vegetables like corn on the cob, and fruits like apples.
These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.
Chewing Only On One Side
Many individuals chew their food on only one side of the mouth.
This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
Stay aware of chewing habits and make sure to utilize both sides of the mouth.
Individuals with dental issues or tooth pain are recommended to see a dentist.
Non-Functional Jaw Activities
Going through each day, individuals tend to do things unconsciously or out of habit.
For example, individuals:
Reading or writing might chew on a pen or pencil.
Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
These activities can place stress on the joint, worsen the condition, and extend the healing process.
Resting on The Chin
Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
This position can be comfortable, but it can affect the jaw.
This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
Breaking the chin resting habit can allow the joint to relax and heal correctly.
Teeth Clenching
Bruxism is the medical term for clenching the teeth.
This can occur during the day or during sleep.
Teeth clenching is often brought on by stress and can place incredible pressure on the jaw’s muscles and worsen TMJ.
A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)
Slouching
The function of the jaw is closely related to body posture.
The jaw operates optimally when the head is above the cervical spine and the posture is upright.
Slouching can change how the jaw muscles work and the way the jaw opens and closes.
Part of physical therapy for TMJ is working on posture adjustments and training.
This can involve strengthening the back and shoulder muscles and setting up posture reminders.
Sitting and standing correctly can keep the jaw operating properly.
Postponing Treatment
Many with musculoskeletal issues and symptoms wait for the pain to go away.
Individuals having problems with their jaw should not wait to get treatment.
TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)
Treatment
Treatment can involve:
Initial treatment focuses on pain relief and jaw function opens and closes improvement.
A guard can help with night teeth grinding/bruxism.
Anti-inflammatory treatments.
In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
Follow recommendations on what not to do and avoid certain activities.
Quick Patient Initiation
References
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. doi.org/10.11607/jop.1151
Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. doi.org/10.1371/journal.pone.0059980
Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. doi.org/10.2147/JMDH.S178507
Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon’s perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. doi.org/10.1111/adj.12593
Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477
Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. doi.org/10.5125/jkaoms.2018.44.2.43
Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. doi.org/10.11607/jomi.te20
In individuals with herniated discs, how does non-surgical decompression compare to traditional surgery repair the spine?
Introduction
When many individuals begin to add unnecessary pressure on their backs, it can lead to damaging results to their spine. The spine is the backbone of the body, allowing the upper and lower sections to be mobile and stabilizing the axial weight overload without the person feeling pain or discomfort. The spinal structure is surrounded by muscles, soft tissues, ligaments, nerve roots, and joints that support the spine. In between the spinal facet joints and structure are flat discs that absorb the shock and pressure from the axial overload. However, when unwanted stress starts to compress the disc, it can lead to the development of herniation. Depending on the location, it can cause pain-like symptoms like lower back and neck pain or sciatica. Other times, herniated discs can be due to natural degeneration, where the spinal disc height decreases, and it can crack under pressure, leading to disc dehydration, which, to this point, causes spinal issues to many individuals, thinking they are experiencing referred pain in different body locations. Coincidentally, many people can find the relief they seek through non-surgical treatments to restore the disc height and repair herniated discs. Today’s article focuses on the casing effects of herniated discs and how spinal decompression, a form of non-surgical treatment, can help reduce pain-like symptoms associated with herniated discs. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce herniated disc pain, causing many musculoskeletal issues. We also inform them that non-surgical treatments can help mitigate the referred pain-like symptoms related to herniated discs and restore disc height in their spines. We encourage our patients to ask amazing educational questions for our associated medical providers about their referred pain correlating with herniated discs. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
The Changing Effects Of Herniated Discs
Have you experienced unwanted pain in your upper and lower extremities after a long work day? What about experiencing pain within your spines that are causing symptoms of numbness or tingling sensations in your hands, feet, or legs? Or are you dealing with excruciating lower back pain that is affecting your ability to work? Many individuals don’t realize that the pain-like symptoms they are experiencing are not low back, neck, or shoulder pain, but they correlate to herniated discs in their spines. Herniated discs are when the nucleus pulposus (inner disc portion) starts to protrude out of its original position from the intervertebral space. (Dydyk, Ngnitewe Massa, & Mesfin, 2023) Herniated discs are one of the common causes of lower back pain, and often, many individuals will remember what caused the herniation in their spine.
Some of the effects that lead to disc herniation are that many people will carry heavy objects constantly from one location to another, and the shifting weight can cause the disc to be continuously compressed and thus lead to herniation. Additionally, when the intervertebral disc starts showing signs of stiffness, it can result in abnormal spinal motion. (Haughton, Lim, & An, 1999) This causes morphologic changes within the intervertebral disc and causes it to be dehydrated. The chondroitin sulfation of the proteoglycan in the disc goes through changes in the disc itself, and when degeneration is associated with herniated discs, it can lead to musculoskeletal disorders. (Hutton et al., 1997)
The Root Cause Of Pain- Video
When degenerative changes start to affect the intervertebral discs, it can lead to intervertebral height loss, abnormal pain signaling, and nerve root entrapment associated with disc disruption. (Milette et al., 1999) This causes a cascading effect as the outer annulus of the spinal disc is cracked or ruptured, causing pain to the spine. When the outer annulus of the spinal disc starts to have nerve ingrowth in the affected discs, which then leads to individuals dealing with musculoskeletal disorders associated with pain. (Freemont et al., 1997) Many people will seek non-surgical therapies when finding treatment to alleviate the pain caused by herniated discs due to their cost-effectiveness and how it’s safe for their spine. Chiropractic care, massage therapy, spinal decompression, and traction therapy are available treatments that can be used in a personalized, inclusive treatment care plan to mitigate any pain the person is dealing with. The video explains how these treatments can use functional wellness principles to identify where the pain is located and treat any health issues with any potential underlying causes.
Spinal Decompression Reducing Herniated Disc
Regarding non-surgical treatments reducing herniated discs, spinal decompression can help mitigate the pain affecting the spine’s mobility. Spinal decompression utilizes mechanical traction to gently stretch the spine and allow the herniated disc to return to its original position. Spinal decompression incorporates negative pressure, which helps the nutrients increase the disc’s regenerative factors. (Choi et al., 2022) This allows the facet joints and aggravated nerves to have reduced pressure and increased disc space height. At the same time, spinal decompression can be combined with physical therapy to reduce the pain-like symptoms associated with herniated discs and provide beneficial results. (Amjad et al., 2022) Some of the beneficial factors related to spinal decompression include:
Pain improvement in the upper and lower extremities
Spinal range of motion
Muscle endurance restored
Joint ROM restored
When many individuals become more mindful of how different factors are causing spinal issues, they can make small routine changes in their daily lives, and that can reduce the chances of pain from returning. This allows them to enjoy life fully and continue their health and wellness journey.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. doi.org/10.1155/2022/6343837
Freemont, A. J., Peacock, T. E., Goupille, P., Hoyland, J. A., O’Brien, J., & Jayson, M. I. (1997). Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet, 350(9072), 178-181. doi.org/10.1016/s0140-6736(97)02135-1
Haughton, V. M., Lim, T. H., & An, H. (1999). Intervertebral disk appearance correlated with stiffness of lumbar spinal motion segments. AJNR Am J Neuroradiol, 20(6), 1161-1165. www.ncbi.nlm.nih.gov/pubmed/10445464
Hutton, W. C., Elmer, W. A., Boden, S. D., Horton, W. C., & Carr, K. (1997). Analysis of chondroitin sulfate in lumbar intervertebral discs at two different stages of degeneration as assessed by discogram. Journal of Spinal Disorders, 10(1), 47-54. www.ncbi.nlm.nih.gov/pubmed/9041496
Milette, P. C., Fontaine, S., Lepanto, L., Cardinal, E., & Breton, G. (1999). Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine (Phila Pa 1976), 24(1), 44-53. doi.org/10.1097/00007632-199901010-00011
For individuals with pelvic pain, how does MET treatment strategies reduce muscle weakness in the hips region?
Introduction
The pelvis’s main job is to ensure that the person’s body weight is distributed evenly for everyday movement within the upper and lower body. At the same time, the core muscles, ligaments, and joints surround the skeletal structure of the pelvis, which provides normal function while protecting the vital organ systems within the pelvic region. When normal or traumatic factors start to affect the body’s pelvic area, many individuals will often mistake the pain for low back pain, and the core muscles surrounding the pelvic bone can become weak and lead to pelvic pain. At the same time, normal factors like improper posture can cause anterior pelvic tilt and develop into other musculoskeletal disorders with overlapping risk profiles. When pelvic pain affects the lower extremities, it can also lead to reproductive issues that can cause even more stress to the individual. Luckily, many people opt for non-surgical treatments to reduce pelvic pain and its associated musculoskeletal condition by strengthening the weakened core muscles and reducing muscle weakness. Today’s article examines how referred pain symptoms affect the pelvis and how non-surgical treatments like MET therapy can reduce muscle weakness correlating with pelvic pain. Additionally, we communicate with certified medical providers who incorporate our patient’s information to reduce muscle weakness associated with pelvic pain. We also inform them that MET therapy can help mitigate the referred pain-like symptoms related to pelvic pain. We encourage our patients to ask amazing educational questions for our associated medical providers about their pelvic pain. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
Referred Pain Symptoms Affecting The Pelvis
Have you noticed that you are taking more frequent trips to the bathroom and that your bladder still feels full? Do you experience muscle stiffness within your lower back or pelvic region from excessive sitting at your desk during work? Or do you notice that you are experiencing weak core muscles affecting your workout routine? These scenarios are associated with pelvic pain and can cause issues within the lower body extremities, affecting the person’s performance when doing normal activities. Pelvic pain is a multifactorial musculoskeletal disorder that can affect the corresponding body systems to induce referred pain. (Grinberg, Sela, & Nissanholtz-Gannot, 2020) Pelvic pain can cause referred pain to the gastrointestinal, pelvic musculoskeletal, and nervous systems, which then causes anatomic malfunction to the pelvic floor muscles. Pelvic pain can easily be mistaken for low back pain since the lumbar spine creates stressors for the muscles surrounding the pelvis.
When the pelvis is affected by mechanical stressors associated with the lumbar spine, it can cause pelvic dysfunction and causes the individual to be unbalanced when in motion. At the same time, the pelvic muscle structures will be overworked, leading to hip and joint destabilization, causing them to be weak. (Lee et al., 2016) When the pelvic muscle structures begin to destabilize, it can lead to sciatic nerve entrapment to the lower extremities, which leads to overlapping risk profiles for musculoskeletal disorders. When the surrounding pelvic muscles begin to entrap the pelvic nerve roots causing radiating pain down the legs. (Kale et al., 2021) However, there are ways to reduce referred pain affecting the pelvic region and restore muscle strength.
Sciatica, Causes, Symptoms, & Tips- Video
Since pelvic pain is a multifactorial musculoskeletal disorder that can lead to the development of referred pain to the lower body extremities, many individuals often think it is low back pain or sciatica. Referred pain is when pain affects a body location instead of where the source originated. Not treated immediately causes nerve entrapment, muscle weakness, and chronic pain within the reproductive and urinary organs. Many individuals seek non-surgical treatments to alleviate the pain and restore muscle strength to the body’s pelvic region. Non-surgical treatments like MET(muscle energy techniques) can help restore muscle strength to the pelvis through soft tissue stretching. Pain specialists specializing in MET therapy, like chiropractors and massage therapists, use hands-on maneuvers to relax, elongate, stretch, and massage the affected tight muscles and reduce any tender points that may have developed over time. (Grinberg et al., 2019) MET therapy can help stretch the pelvic stabilizing muscles. It can be combined with physical therapy and chiropractic care to realign the body and reduce nerve entrapment caused by pelvic pain. Check out the video above to learn more about the causes of sciatica and how non-surgical treatments may be the answer to alleviate pain.
MET Treatment Strategies For Pelvic Pain
MET therapy can reduce the effects of pelvic pain by including soft tissue manipulation methods to use controlled isometric and isotonic contraction to improve the normal physiologic function of the surrounding pelvic muscles and decrease pain and help stabilize the alternating structures within the pelvic region. (Sarkar, Goyal, & Samuel, 2021) MET therapy can also encourage self-regulating influences to reduce pain within the pelvic area, resulting in a greater range of motion. (Chaitow, 2009)
MET Treatment Reducing Muscle Weakness
MET therapy can also be part of a personalized health plan that can help restore muscle strength in the core and stabilize muscle within the pelvis. The positive effects of the combination of MET therapy and exercise, it can be more effective in reducing pain while improving physical function. (Hu et al., 2020) This allows the pelvis to realign itself and help stretch the shortened muscles. MET therapy can help restore low extremity function and improve a person’s quality of life. (Danazumi et al., 2021) MET therapy is an excellent way to stretch out tired muscles and restore pelvic function, as it can make individuals more mindful of their bodies while reducing the chances of pelvic pain associated with musculoskeletal disorders reoccurring again in the lower extremities.
Danazumi, M. S., Yakasai, A. M., Ibrahim, A. A., Shehu, U. T., & Ibrahim, S. U. (2021). Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome. J Osteopath Med, 121(8), 693-703. doi.org/10.1515/jom-2020-0327
Grinberg, K., Sela, Y., & Nissanholtz-Gannot, R. (2020). New Insights about Chronic Pelvic Pain Syndrome (CPPS). Int J Environ Res Public Health, 17(9). doi.org/10.3390/ijerph17093005
Grinberg, K., Weissman-Fogel, I., Lowenstein, L., Abramov, L., & Granot, M. (2019). How Does Myofascial Physical Therapy Attenuate Pain in Chronic Pelvic Pain Syndrome? Pain Res Manag, 2019, 6091257. doi.org/10.1155/2019/6091257
Hu, X., Ma, M., Zhao, X., Sun, W., Liu, Y., Zheng, Z., & Xu, L. (2020). Effects of exercise therapy for pregnancy-related low back pain and pelvic pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore), 99(3), e17318. doi.org/10.1097/MD.0000000000017318
Kale, A., Basol, G., Topcu, A. C., Gundogdu, E. C., Usta, T., & Demirhan, R. (2021). Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report. Int Neurourol J, 25(2), 177-180. doi.org/10.5213/inj.2040232.116
Lee, D. W., Lim, C. H., Han, J. Y., & Kim, W. M. (2016). Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis. The Korean Journal of Pain, 29(4), 274-276. doi.org/10.3344/kjp.2016.29.4.274
Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. doi.org/10.31616/asj.2019.0300
Should individuals with existing gastrointestinal problems eat bananas?
Bananas
Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
Bananas can make the stomach hurt due to:
Irritable bowel syndrome (IBS)
Cramping
Gas
Bloating
Other gastrointestinal (GI) problems.
Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.
Stomach Pain
Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
Some individuals can experience bloating and gas after eating them.
One reason is because of their soluble fiber content.
Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
Bananas also contain sorbitol – a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)
Irritable Bowel Syndrome – IBS
Bananas can be a common trigger food for individuals with IBS.
Bananas are also high in fructose/simple sugar especially when they have overripened.
Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
Ripe bananas are considered to be high in FODMAPS – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual’s diet. (UW School of Medicine and Public Health. 2019)
Most can tolerate small amounts of fructose found in fruits like bananas.
If you’re eating bananas that are too green or unripe, you may also experience stomach discomfort.
Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.
U.S. Food and Drug Administration. Sorbitol.
Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. doi.org/10.1016/j.nurpra.2015.12.007
Johns Hopkins Medicine. 5 foods to avoid if you have IBS.
Monash University. Bananas re-tested.
Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013
Family Medicine Austin. Banana allergy.
UW School of Medicine and Public Health. Fructose-restricted diet.
Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. doi.org/10.3390/foods7020018
The Johns Hopkins Guide to Diabetes. What is resistant starch?
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