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Relief from Neurogenic Claudication: Treatment Options

Relief from Neurogenic Claudication: Treatment Options

Individuals experiencing shooting, aching pain in the lower extremities, and intermittent leg pain could be suffering from neurogenic claudication. Can knowing the symptoms help healthcare providers develop an effective treatment plan?

Relief from Neurogenic Claudication: Treatment Options

Neurogenic Claudication

Neurogenic claudication occurs when spinal nerves become compressed in the lumbar or lower spine, causing intermittent leg pain. Compressed nerves in the lumbar spine can cause leg pain and cramps. The pain usually worsens with specific movements or activities like sitting, standing, or bending backward.  It is also known as pseudo-claudication when the space within the lumbar spine narrows. A condition known as lumbar spinal stenosis. However, neurogenic claudication is a syndrome or group of symptoms caused by a pinched spinal nerve, while spinal stenosis describes the narrowing of the spinal passages.

Symptoms

Neurogenic claudication symptoms can include:

  • Leg cramping.
  • Numbness, tingling, or burning sensations.
  • Leg fatigue and weakness.
  • A sensation of heaviness in the leg/s.
  • Sharp, shooting, or aching pain extending into the lower extremities, often in both legs.
  • There may also be pain in the lower back or buttocks.

Neurogenic claudication is different from other types of leg pain, as the pain alternates – ceasing and beginning randomly and worsens with specific movements or activities. Standing, walking, descending stairs, or flexing backward can trigger pain, while sitting, climbing stairs, or leaning forward tends to relieve pain. However, every case is different. Over time, neurogenic claudication can affect mobility as individuals try to avoid activities that cause pain, including exercise, lifting objects, and prolonged walking. In severe cases, neurogenic claudication can make sleeping difficult.

Neurogenic claudication and sciatica are not the same. Neurogenic claudication involves nerve compression in the central canal of the lumbar spine, causing pain in both legs. Sciatica involves compression of nerve roots exiting from the sides of the lumbar spine, causing pain in one leg. (Carlo Ammendolia, 2014)

Causes

With neurogenic claudication, compressed spinal nerves are the underlying cause of the leg pain. In many cases, lumber spinal stenosis – LSS is the cause of pinched nerve. There are two types of lumbar spinal stenosis.

  • Central stenosis is the main cause of neurogenic claudication. With this type, the central canal of the lumbar spine, which houses the spinal cord, narrows, causing pain in both legs.
  • Lumbar spinal stenosis can be acquired and develop later in life due to spine deterioration.
  • Congenital means the individual is born with the condition.
  • Both can lead to neurogenic claudication in different ways.
  • Foramen stenosis is another type of lumbar spinal stenosis that causes the narrowing of spaces on either side of the lumbar spine where nerve roots branch off the spinal cord. The associated pain is different in that it is either in the right or left leg.
  • The pain corresponds to the side of the spinal cord where the nerves are being pinched.

Acquired Lumbar Spinal Stenosis

Lumbar spinal stenosis is usually acquired due to the degeneration of the lumbar spine and tends to affect older adults. The causes of the narrowing can include:

  • Spinal trauma, such as from a vehicle collision, work, or sports injury.
  • Disc herniation.
  • Spinal osteoporosis – wear-and-tear arthritis.
  • Ankylosing spondylitis – a type of inflammatory arthritis that affects the spine.
  • Osteophytes – bone spurs.
  • Spinal tumors – non-cancerous and cancerous tumors.

Congenital Lumbar Spinal Stenosis

Congenital lumbar spinal stenosis means an individual is born with abnormalities of the spine that may not be apparent at birth. Because the space within the spinal canal is already narrow, the spinal cord is vulnerable to any changes as the individual ages. Even individuals with mild arthritis can experience symptoms of neurogenic claudication early on and develop symptoms in their 30s and 40s instead of their 60s and 70s.

Diagnosis

Diagnosis of neurogenic claudication is largely based on the individual’s medical history, physical examination, and imaging. The physical examination and review identify where the pain is presenting and when. The healthcare provider may ask:

  • Is there a history of lower back pain?
  • Is the pain in one leg or both?
  • Is the pain constant?
  • Does the pain come and go?
  • Does the pain get better or worse when standing or sitting?
  • Do movements or activities cause pain symptoms and sensations?
  • Are there any usual sensations while walking?

Treatment

Treatments can consist of physical therapy, spinal steroid injections, and pain meds. Surgery is a last resort when all other therapies are unable to provide effective relief.

Physical Therapy

A treatment plan will involve physical therapy that includes:

  • Daily stretching
  • Strengthening
  • Aerobic exercises
  • This will help improve and stabilize the lower back muscles and correct posture problems.
  • Occupational therapy will recommend activity modifications that cause pain symptoms.
  • This includes proper body mechanics, energy conservation, and recognizing pain signals.
  • Back braces or belts may also be recommended.

Spinal Steroid Injections

Healthcare providers may recommend epidural steroid injections.

  • This delivers a cortisone steroid to the outermost section of the spinal column or the epidural space.
  • Injections can provide pain relief for three months to three years. (Sunil Munakomi et al., 2024)

Pain Meds

Pain medications are used to treat intermittent neurogenic claudication. These include:

  • Over-the-counter analgesics like acetaminophen.
  • Nonsteroidal anti-inflammatory drugs or NSAIDs like ibuprofen or naproxen.
  • Prescription NSAIDs may be prescribed if needed.
  • NSAIDs are used with chronic neurogenic pain and should only be used when required.
  • The long-term use of NSAIDs can increase the risk of stomach ulcers, and the overuse of acetaminophen can lead to liver toxicity and liver failure.

Surgery

If conservative treatments are unable to provide effective relief and mobility and/or quality of life are affected, surgery known as a laminectomy may be recommended to decompress the lumbar spine. The procedure may be performed:

  • Laparoscopically – with small incisions, scopes, and surgical instrumentation.
  • Open surgery – with a scalpel and sutures.
  • During the procedure, facets of the vertebra are partially or completely removed.
  • To provide stability, the bones are sometimes fused with screws, plates, or rods.
  • Success rates for both are more or less the same.
  • Between 85% and 90% of individuals undergoing the surgery achieve long-lasting and/or permanent pain relief. (Xin-Long Ma et al., 2017)

Movement Medicine: Chiropractic Care


References

Ammendolia C. (2014). Degenerative lumbar spinal stenosis and its imposters: three case studies. The Journal of the Canadian Chiropractic Association, 58(3), 312–319.

Munakomi S, Foris LA, Varacallo M. (2024). Spinal Stenosis and Neurogenic Claudication. [Updated 2023 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK430872/

Ma, X. L., Zhao, X. W., Ma, J. X., Li, F., Wang, Y., & Lu, B. (2017). Effectiveness of surgery versus conservative treatment for lumbar spinal stenosis: A system review and meta-analysis of randomized controlled trials. International journal of surgery (London, England), 44, 329–338. doi.org/10.1016/j.ijsu.2017.07.032

Kinesiology Tape for Sacroiliac Joint Pain: Relief and Management

Kinesiology Tape for Sacroiliac Joint Pain: Relief and Management

For individuals experiencing sacroiliac joint/SIJ dysfunction and pain, could applying kinesiology tape help bring relief and manage symptoms?

Kinesiology Tape for Sacroiliac Joint Pain: Relief and Management

Kinesiology Tape For Sacroiliac Joint Pain

A lower back ailment that is common during pregnancy. The pain is usually on one or both sides of the back, just above the buttocks, that comes and goes and can limit the ability to bend, sit, and perform various physical activities. (Moayad Al-Subahi et al., 2017) The therapeutic tape provides support while allowing for movement and may help treat and manage sacroiliac joint/SIJ pain by:

  • Decreasing muscle spasms.
  • Facilitating muscular function.
  • Increasing blood circulation to and around the pain site.
  • Decreasing muscle trigger points.

Mechanism

Some studies have found that taping the SI joint has benefits that include:

  1. One theory is it helps lift and hold the overlying tissues off of the SI joint, which helps decrease the pressure around it.
  2. Another theory is that lifting the tissues helps create a pressure differential under the tape, like non-surgical decompression, allowing increased circulation to the tissues surrounding the sacroiliac joint.
  3. This floods the area with blood and nutrients, creating an optimal healing environment.

Application

A sacroiliac joint on the right and left sides connects the pelvis to the sacrum or the lowest part of the spine. To apply the kinesiology tape correctly, locate the lowest part of the back within the pelvic area. (Francisco Selva et al., 2019) Ask a friend or family member for help if you can’t reach the area.

Blog Image  Treating Sacroiliac DiagramTaping steps:

  • Cut three strips of tape, each 4 to 6 inches long.
  • Sit in a chair and bend the body slightly forward.
  • If someone is helping, you can stand and slightly bend forward.
  • Remove the lift-off strip in the middle and stretch the tape to expose several inches, leaving the ends covered.
  • Apply the exposed tape at an angle over the SI joint, like making the first line of an X, just above the buttocks, with full stretch on the tape.
  • Peel the lift-off strips from the ends and adhere them with no stretching.
  • Repeat the application steps with a second strip, adhering at a 45-degree angle to the first strip, making the X over the sacroiliac joint.
  • Repeat this with the final strip horizontally across the X made from the first two pieces.
  • There should be a tape pattern of star shape over the sacroiliac joint.
  1. Kinesiology tape can stay over the sacroiliac joint for three to five days.
  2. Watch for signs of irritation around the tape.
  3. Remove the tape if the skin becomes irritated, and consult your primary healthcare provider, physical therapist, or chiropractor for other treatment options.
  4. Some individuals with specific conditions should avoid using the tape and get confirmation that it’s safe.
  5. Individuals with severe sacroiliac pain where self-management is not working should see a healthcare provider, physical therapist, and or chiropractor for an evaluation and to learn therapeutic exercises and treatments to help manage the condition.

Sciatica During Pregnancy


References

Al-Subahi, M., Alayat, M., Alshehri, M. A., Helal, O., Alhasan, H., Alalawi, A., Takrouni, A., & Alfaqeh, A. (2017). The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. Journal of physical therapy science, 29(9), 1689–1694. doi.org/10.1589/jpts.29.1689

Do-Yun Shin and Ju-Young Heo. (2017). The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility. The Journal of Korean Physical Therapy, 307-315. doi.org/https://doi.org/10.18857/jkpt.2017.29.6.307

Selva, F., Pardo, A., Aguado, X., Montava, I., Gil-Santos, L., & Barrios, C. (2019). A study of reproducibility of kinesiology tape applications: review, reliability and validity. BMC musculoskeletal disorders, 20(1), 153. doi.org/10.1186/s12891-019-2533-0

Mayonnaise: Is It Really Unhealthy?

Mayonnaise: Is It Really Unhealthy?

For individuals who want to eat healthier, can selection and moderation make mayonnaise a delicious and nutritious addition to a low-carbohydrate diet?

Mayonnaise: Is It Really Unhealthy?

Mayonnaise Nutrition

Mayonnaise is used in various recipes, including sandwiches, tuna salad, deviled eggs, and tartar sauce. It is often considered unhealthy, as it is mostly fat and, as a result, calorie-dense. Calories and fat can quickly add up when not paying attention to portion sizes.

What Is It?

  • It is a blend of different ingredients.
  • It combines oil, egg yolk, an acidic liquid (lemon juice or vinegar), and mustard.
  • The ingredients become a thick, creamy, permanent emulsion when blended slowly.
  • The key is in the emulsion, combining two liquids that would otherwise not naturally come together, which turns the liquid oil into a solid.

The Science

  • Emulsification happens when an emulsifier – the egg yolk – binds the water-loving/hydrophilic and oil-loving/lipophilic components.
  • The emulsifier binds the lemon juice or vinegar with the oil and does not allow separation, producing a stable emulsion. (Viktoria Olsson et al., 2018)
  • In homemade mayonnaise, the emulsifiers are mainly the lecithin from the egg yolk and a similar ingredient in mustard.
  • Commercial mayonnaise brands often use other types of emulsifiers and stabilizers.

Health

  • It contains health-promoting properties, such as vitamin E, which improves heart health, and vitamin K, which is important for blood clotting. (USDA, FoodData Central, 2018)
  • It can also be made with healthy fats like omega-3 fatty acids, which maintain brain, heart, and skin health.
  • It is mostly an oil and high-fat calorie-dense condiment. (H R Mozafari et al., 2017)
  • However, it is mostly unsaturated fat, which is a healthier fat.
  • To maintain nutrition goals in mind when selecting mayonnaise.
  • For individuals on a low-fat or low-calorie diet, portion control is important.

Oil

  • Almost any edible oil can be used to make mayonnaise, making the oil the biggest factor in the recipe’s healthfulness.
  • Most commercial brands are made with soy oil, which some nutrition experts believe can be problematic because of the high levels of omega-6 fats.
  • Canola oil has a lower omega-6 content than soy oil.
  • Individuals who make the mayonnaise can use any oil, including olive or avocado oil.

Bacteria

  • The concern about bacteria comes from the fact that homemade mayonnaise is usually made with raw egg yolks.
  • Commercial mayonnaise is made with pasteurized eggs and is produced in a way that keeps it safe.
  • The acids, vinegar, or lemon juice can help keep some bacteria from contaminating the mayonnaise.
  • However, a study found that homemade mayonnaise may still contain salmonella bacteria despite the acidic compounds. (Junli Zhu et al., 2012)
  • Because of this, some prefer to pasteurize an egg in 140°F water for 3 minutes before making the mayonnaise.
  • Regardless of the type of mayonnaise, food safety guidelines should always be followed (United States Department of Agriculture, 2024).
  • Mayonnaise-based dishes should not be left outside refrigeration for more than two hours.
  • Opened commercial mayonnaise should be stored in the refrigerator after opening and discarded after two months.

Reduced-Fat Mayonnaise

  • Many nutritionists recommend reduced-fat mayonnaise for individuals on a low-calorie, low-fat, or exchange diet. (Institute of Medicine (US) Committee on Dietary Guidelines Implementation, 1991)
  • While reduced-fat mayonnaise has fewer calories and less fat than regular mayonnaise, the fat is often replaced with starches or sugar to improve texture and flavor.
  • For individuals watching carbohydrates or sugar in their diet, check the nutrition label and ingredients before deciding on the right mayonnaise.

Body In Balance: Chiropractic, Fitness, and Nutrition


References

Olsson, V., Håkansson, A., Purhagen, J., & Wendin, K. (2018). The Effect of Emulsion Intensity on Selected Sensory and Instrumental Texture Properties of Full-Fat Mayonnaise. Foods (Basel, Switzerland), 7(1), 9. doi.org/10.3390/foods7010009

USDA, FoodData Central. (2018). Mayonnaise dressing, no cholesterol. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/167736/nutrients

Mozafari, H. R., Hosseini, E., Hojjatoleslamy, M., Mohebbi, G. H., & Jannati, N. (2017). Optimization low-fat and low cholesterol mayonnaise production by central composite design. Journal of food science and technology, 54(3), 591–600. doi.org/10.1007/s13197-016-2436-0

Zhu, J., Li, J., & Chen, J. (2012). Survival of Salmonella in home-style mayonnaise and acid solutions as affected by acidulant type and preservatives. Journal of food protection, 75(3), 465–471. doi.org/10.4315/0362-028X.JFP-11-373

United States Department of Agriculture. Food Safety and Inspection Service. (2024). Keep Food Safe! Food Safety Basics. Retrieved from www.fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/steps-keep-food-safe

Institute of Medicine (U.S.). Committee on Dietary Guidelines Implementation., Thomas, P. R., Henry J. Kaiser Family Foundation., & National Cancer Institute (U.S.). (1991). Improving America’s diet and health : from recommendations to action : a report of the Committee on Dietary Guidelines Implementation, Food and Nutrition Board, Institute of Medicine. National Academy Press. books.nap.edu/books/0309041392/html/index.html
www.ncbi.nlm.nih.gov/books/NBK235261/

Acupuncture for Chronic Fatigue: Research and Findings

Acupuncture for Chronic Fatigue: Research and Findings

For individuals dealing with chronic fatigue syndrome, can incorporating acupuncture with other treatment protocols help regain functionality and improve quality of life?

Acupuncture for Chronic Fatigue: Research and Findings

Acupuncture For Chronic Fatigue Syndrome

Research is looking at how acupuncture can help manage symptoms of chronic fatigue. These studies focused on specific acupoints and techniques and how they affected certain symptoms or abnormalities linked to the condition. The researchers found that acupuncture may help manage and alleviate some symptoms (Qing Zhang et al., 2019). However, they were still unable to determine the mechanisms of how acupuncture exactly works.

Symptom Relief

Various studies showed that acupuncture could improve physical and mental fatigue symptoms, including:

There Were Also Improvements In

Other studies Found How Acupuncture Helped In

Treatments Vary by Study

  • One case study showed improvements in groups of athletes who were put through a series of exhaustive physical exercises and short-term rest. One group of athletes was treated with acupuncture on selected acupoints while the others were given an extended rest. Analysis was applied to the metabolic profiles of urine samples collected from the athletes at three points: before the exercises, before and after the acupuncture treatment, or taking extended rest. The results indicated that the recoveries of disturbed metabolites in the athletes treated with acupuncture were significantly faster than in those who only took extended rest. (Haifeng Ma et al., 2015)
  • Researchers said studies involving acupuncture alone or in combination with other treatments appear to show that it is effective at lessening fatigue. (Yu-Yi Wang et al., 2014) However, further studies are needed to confirm the benefits. This is a significant change from a review that found limited evidence for the effectiveness of alternative treatments for relieving chronic fatigue symptoms. (Terje Alraek et al., 2011)
  • Another review of alternative therapies found acupuncture and certain meditation techniques showed the most promise for future investigation. (Nicole S. Porter et al., 2010)
  • Another study compared prednisone, a steroid, with an acupuncture technique called coiling dragon and an additional treatment called cupping. It suggested that acupuncture and cupping treatments surpassed the steroid regarding fatigue. (Wei Xu et al., 2012)
  • Another study found that needling with heat application or moxibustion produced better results than standard acupuncture regarding physical and mental fatigue scores. (Chen Lu, Xiu-Juan Yang, Jie Hu 2014)

From Consultation to Transformation: Assessing Patients In A Chiropractic Setting


References

Zhang, Q., Gong, J., Dong, H., Xu, S., Wang, W., & Huang, G. (2019). Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 37(4), 211–222. doi.org/10.1136/acupmed-2017-011582

Frisk, J., Källström, A. C., Wall, N., Fredrikson, M., & Hammar, M. (2012). Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 20(4), 715–724. doi.org/10.1007/s00520-011-1134-8

Gao, D. X., & Bai, X. H. (2019). Zhen ci yan jiu = Acupuncture research, 44(2), 140–143. doi.org/10.13702/j.1000-0607.170761

Mandıroğlu, S., & Ozdilekcan, C. (2017). Impact of Acupuncture on Chronic Insomnia: A Report of Two Cases with Polysomnographic Evaluation. Journal of acupuncture and meridian studies, 10(2), 135–138. doi.org/10.1016/j.jams.2016.09.018

Zhu, L., Ma, Y., Ye, S., & Shu, Z. (2018). Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2018, 2890465. doi.org/10.1155/2018/2890465

Ma, H., Liu, X., Wu, Y., & Zhang, N. (2015). The Intervention Effects of Acupuncture on Fatigue Induced by Exhaustive Physical Exercises: A Metabolomics Investigation. Evidence-based complementary and alternative medicine : eCAM, 2015, 508302. doi.org/10.1155/2015/508302

Wang, Y. Y., Li, X. X., Liu, J. P., Luo, H., Ma, L. X., & Alraek, T. (2014). Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complementary therapies in medicine, 22(4), 826–833. doi.org/10.1016/j.ctim.2014.06.004

Alraek, T., Lee, M. S., Choi, T. Y., Cao, H., & Liu, J. (2011). Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC complementary and alternative medicine, 11, 87. doi.org/10.1186/1472-6882-11-87

Porter, N. S., Jason, L. A., Boulton, A., Bothne, N., & Coleman, B. (2010). Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of alternative and complementary medicine (New York, N.Y.), 16(3), 235–249. doi.org/10.1089/acm.2008.0376

Lu, C., Yang, X. J., & Hu, J. (2014). Zhen ci yan jiu = Acupuncture research, 39(4), 313–317.

The Power of Instrument-Assisted Soft Tissue Mobilization

The Power of Instrument-Assisted Soft Tissue Mobilization

Can physical therapy with instrument-assisted soft tissue mobilization or IASTM improve mobility, flexibility, and health for individuals with musculoskeletal injuries or illnesses?

The Power of Instrument-Assisted Soft Tissue Mobilization

Instrument Assisted Soft Tissue Mobilization

Instrument-assisted soft tissue mobilization or IASTM is also known as the Graston technique. It is a myofascial release and massage technique used in physical therapy where the therapist uses metal or plastic tools to improve soft tissue mobility in the body. The ergonomically shaped tool is gently or vigorously scraped and rubbed across the injured or painful area. The rubbing is used to locate and release tightness in the fascia/collagen covering the muscles and the tendons. This helps reduce pain and improve movement.

Massage and Myofascial Release

Instrument-assisted soft tissue mobilization rehabilitation helps:

  • Improve soft tissue mobility.
  • Release of restrictions in tight fascia.
  • Decrease muscle spasms.
  • Improve flexibility.
  • Increased circulation to the tissues.
  • Relieve pain. (Fahimeh Kamali et al., 2014)

Individuals often develop tissue tightness or restrictions in the muscles and fascia after an injury. These soft tissue restrictions can limit the range of motion – ROM and can trigger pain symptoms. (Kim J, Sung DJ, Lee J. 2017)

History

The Graston technique of instrument-assisted soft tissue mobilization was developed by an athlete who created their instruments to treat soft tissue injuries. The practice has grown with input from medical experts, trainers, researchers, and clinicians.

  • Physical therapists use different types of tools to perform IASTM.
  • These massage instruments comprise various types for specific massage and release.
  • The Graston company designs some of the tools.
  • Other companies have their version of metal or plastic scraping and rubbing tools.
  • The objective is to help release soft tissue and myofascial restrictions to improve body movement. (Kim J, Sung DJ, Lee J. 2017)

How It Works

  • The theory is that scraping the tissues causes microtrauma to the affected area, activating the body’s natural inflammatory response. (Kim J, Sung DJ, Lee J. 2017)
  • The body activates to reabsorb the tightened or scar tissue, causing the restriction.
  • The therapist can then stretch the adhesions to alleviate pain and improve mobility.

Treatment

Certain conditions respond well to instrument-assisted soft tissue mobilization, including (Kim J, Sung DJ, Lee J. 2017)

  • Limited mobility
  • Decreased muscle recruitment
  • Loss of range of motion – ROM
  • Pain with movement
  • Excessive scar tissue formation

Augmented soft tissue mobilization or ASTM techniques can treat certain injuries and medical conditions that include:

  • Musculoskeletal imbalance/s
  • Ligament sprains
  • Plantar fasciitis
  • Myofascial pain
  • Tendonitis and tendinopathy
  • Scar tissue from surgery or trauma (Morad Chughtai et al., 2019)

Benefits and Side Effects

Benefits include: (Kim J, Sung DJ, Lee J. 2017)

  • Improved range of motion
  • Increased tissue flexibility
  • Improved cell activity at the site of injury
  • Reduced pain
  • Reduced scar tissue formation

Side effects may include:

Research

  • A review compared hands-on myofascial release to instrument myofascial release for chronic low back pain. (Williams M. 2017)
  • Little difference was found between the two techniques for pain relief.
  • Another review compared IASTM to other methods for treating pain and function loss. (Matthew Lambert et al., 2017)
  • The researchers concluded that IASTM could positively affect blood circulation and tissue flexibility and reduce pain.
  • Another study examined the use of IASTM, pseudo-fake ultrasound therapy, and spinal manipulation for patients with thoracic/upper back pain. (Amy L. Crothers et al., 2016)
  • All groups improved over time with no significant negative events.
  • The researchers concluded that instrument-assisted soft tissue mobilization is no more or less effective than spinal manipulation or pseudo-ultrasound therapy for thoracic back pain.

Every case is different, and musculoskeletal conditions respond differently to various treatments. For any questions or concerns, contact your primary healthcare provider to determine if IASTM is an appropriate treatment that can help.


From Injury To Recovery


References

Kamali, F., Panahi, F., Ebrahimi, S., & Abbasi, L. (2014). Comparison between massage and routine physical therapy in women with sub acute and chronic nonspecific low back pain. Journal of back and musculoskeletal rehabilitation, 27(4), 475–480. doi.org/10.3233/BMR-140468

Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of exercise rehabilitation, 13(1), 12–22. doi.org/10.12965/jer.1732824.412

Chughtai, M., Newman, J. M., Sultan, A. A., Samuel, L. T., Rabin, J., Khlopas, A., Bhave, A., & Mont, M. A. (2019). Astym® therapy: a systematic review. Annals of translational medicine, 7(4), 70. doi.org/10.21037/atm.2018.11.49

Williams M. (2017). Comparing pain and disability outcomes of instrumental versus hands-on myofascial release in individuals with chronic low back pain: a meta-analysis. Doctoral dissertation, California State University, Fresno. repository.library.fresnostate.edu/bitstream/handle/10211.3/192491/Williams_csu_6050D_10390.pdf?sequence=1

Matthew Lambert, Rebecca Hitchcock, Kelly Lavallee, Eric Hayford, Russ Morazzini, Amber Wallace, Dakota Conroy & Josh Cleland (2017) The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review, Physical Therapy Reviews, 22:1-2, 76-85, DOI: 10.1080/10833196.2017.1304184

Crothers, A. L., French, S. D., Hebert, J. J., & Walker, B. F. (2016). Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropractic & manual therapies, 24, 16. doi.org/10.1186/s12998-016-0096-9

The Role of Acupuncture in Managing Ulcerative Colitis Symptoms

The Role of Acupuncture in Managing Ulcerative Colitis Symptoms

For individuals dealing with ulcerative colitis, can acupuncture treatment benefit those with UC and other GI-related issues?

The Role of Acupuncture in Managing Ulcerative Colitis Symptoms

Acupuncture For Ulcerative Colitis

Acupuncture has been used to treat symptoms related to pain and inflammation. Studies suggest it may help reduce inflammation and symptoms like diarrhea and abdominal pain, which could benefit individuals with inflammatory bowel disease. Individuals with ulcerative colitis, an inflammatory bowel disease/IBD affecting the large intestine, may find acupuncture beneficial in managing symptoms, including pain and gastrointestinal symptoms. (Crohn’s and Colitis Foundation, 2019)

  • There are 2,000 acupoints in the body connected by pathways known as meridians. (Wilkinson J, Faleiro R. 2007)
  • The pathways connecting the acupoints generate energy, which contributes to overall health.
  • A disruption to the energy flow can cause injury, illness, or disease.
  • When acupuncture needles are inserted, energy flow and health are improved.

Benefits

Acupuncture can be used for the relief of various conditions. Studies have shown that acupuncture can reduce inflammation and disease activity in individuals with an IBD, like UC and Crohn’s disease. It can help with: (Gengqing Song et al., 2019)

  • Pain symptoms
  • Gut microbiome imbalances
  • Gut motor dysfunction
  • Intestinal barrier function
  • Anxiety
  • Depression

Studies suggest the use of acupuncture with heat, known as moxibustion, can improve several GI symptoms including (Crohn’s and Colitis Foundation, 2019)

  • Bloating
  • Abdominal pain
  • Constipation
  • Gas
  • Diarrhea
  • Nausea

It is effective in the treatment of digestive issues that include: (Johns Hopkins Medicine. 2024)

  • Gastritis
  • Irritable bowel syndrome/IBS
  • Hemorrhoids
  • Hepatitis

Reduces Pain and Inflammation

  • Acupuncture treatment works by releasing endorphins, which help reduce pain. (Harvard Medical School. 2016)
  • Applying pressure to acupoints triggers the central nervous system.
  • This is believed to cause the release of chemicals that stimulate the body’s healing mechanisms. (Johns Hopkins Medicine. 2024)
  • Studies have also found acupuncture can trigger the production of cortisol.
  • This hormone helps control inflammation. (Arthritis Foundation. N.D.)
  • Studies found the use of acupuncture along with moxibustion reduced inflammation in individuals with Crohn’s disease and ulcerative colitis. (Crohn’s and Colitis Foundation, 2019)

Stress and Mood

Chronic conditions like ulcerative colitis can cause feelings of depression and/or anxiety. Acupuncture may be used to address symptoms related to stress and mood and can benefit emotional health issues that include: (Johns Hopkins Medicine. 2024)

  • Insomnia
  • Anxiety
  • Nervousness
  • Depression
  • Neurosis – mental health condition characterized by chronic distress and anxiety.

Side Effects

Acupuncture is considered a safe practice. The most common side effects are: (GI Society. 2024)

  • Bruising
  • Minor bleeding
  • Increased pain
  • Fainting can occur due to needle shock.
  • Needle shock can cause dizziness, feeling faint, and nausea. (Harvard Medical School. 2023)
  • Needle shock is rare but more common in individuals:
  • Who are regularly nervous.
  • Who are nervous around needles.
  • Who are new to acupuncture.
  • Who have a history of fainting.
  • Who are extremely fatigued.
  • Who have low blood sugar.

For some, GI symptoms may worsen before they improve. It is recommended to try at least five sessions as this is part of the healing process. (Cleveland Clinic. 2023)  However, individuals should contact their doctor if symptoms become severe or last more than two days. (GI Society. 2024) Individuals considering acupuncture to help manage symptoms of ulcerative colitis should speak with their healthcare provider to help determine the appropriate treatment and where to start.


Gastro-Intestinal Dysfunction Treatment


References

Crohn’s and Colitis Foundation. (2019). Acupuncture in Inflammatory Bowel Disease. IBDVisible Blog. www.crohnscolitisfoundation.org/blog/acupuncture-inflammatory-bowel-disease

Wilkinson J, Faleiro R. (2007). Acupuncture in pain management. Continuing Education in Anaesthesia, Critical Care and Pain. 7(4), 135-138. doi.org/10.1093/bjaceaccp/mkm021

Johns Hopkins Medicine. (2024). Acupuncture (Health, Issue. www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Song, G., Fiocchi, C., & Achkar, J. P. (2019). Acupuncture in Inflammatory Bowel Disease. Inflammatory bowel diseases, 25(7), 1129–1139. doi.org/10.1093/ibd/izy371

Harvard Medical School. (2016). Relieving pain with acupuncture. Harvard Health Blog. www.health.harvard.edu/healthbeat/relieving-pain-with-acupuncture

Arthritis Foundation. (N.D.). Acupuncture for Arthritis. Health Wellness. www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis

Harvard Medical School. (2023). Acupuncture: what is it? Harvard Health Publishing Harvard Medical School Blog. www.health.harvard.edu/a_to_z/acupuncture-a-to-z#:~:text=The%20most%20common%20side%20effects,injury%20to%20an%20internal%20organ.

Cleveland Clinic. (2023). Acupuncture. Health Library. my.clevelandclinic.org/health/treatments/4767-acupuncture

GI Society. (2024). Acupuncture and Digestion. badgut.org. badgut.org/information-centre/a-z-digestive-topics/acupuncture-and-digestion/

The Benefits of Moderate Exercise for Body and Mind

The Benefits of Moderate Exercise for Body and Mind

“Can understanding moderate exercise and how to measure the amount of exercise help expedite individuals’ health goals and well-being?”

The Benefits of Moderate Exercise for Body and Mind

Moderate Exercise

Various physical activity guidelines recommend regular, moderate exercise for achieving and maintaining health and wellness. Getting the minimum, moderate weekly physical activity can help prevent disease, increase mental well-being, support weight loss and maintenance, and improve quality of life.

What Is It?

  • Anything that gets the heart pumping and beating faster is considered moderate exercise. (U.S. Department of Health and Human Services, 2018)
  • Moderate-intensity cardiovascular exercise includes – brisk walking, yard work, mopping, vacuuming, and playing various sports that require consistent movement.
  • When engaged in moderate exercise, individuals should breathe harder but still be able to carry a conversation. (American Heart Association, 2024)
  • The talk test is a way to monitor whether the exercise is at moderate intensity.

Benefits

Regular moderate exercise can help (American Heart Association, 2024)

  • Decrease the risk of developing conditions like heart disease, type 2 diabetes, and dementia.
  • Improve sleep and help with sleep disorders.
  • Improve brain functions like memory, focus, and processing.
  • With weight loss and/or maintenance.
  • Improve bone health.
  • Reduce depression, anxiety, and other mental health symptoms.

How Much Exercise?

The prescription for moderate exercise includes:

  • 30 minutes a day for five days a week, or two hours and 30 minutes per week. (U.S. Department of Health and Human Services, 2018)
  • Physical activity needs to continue for at least 10 minutes to be considered an exercise session.
  • Individuals can break up their 30 daily minutes into two to three shorter sessions, each 10 minutes long.
  • As the ability to exercise increases, aim to increase moderate activities.
  • Individuals will reap even more health benefits if they increase moderate aerobic exercise time to 300 minutes or five hours weekly. (U.S. Department of Health and Human Services, 2018)

Measuring Exercise

  • A moderate level of activity noticeably increases heart and breathing rate.
  • Individuals sweat but can still carry on a conversation.
  • Individuals can talk but can’t sing.
  • Individuals will feel the exercise but are not huffing and puffing.
  • Individuals can use different scales to measure exercise intensity.

Heart Rate

  • A moderate-intensity heart rate is 50% to 70% of an individual’s maximum heart rate. (Centers for Disease Control and Prevention, 2022)
  • An individual’s maximum heart rate varies by age.
  • A heart rate chart or calculator can determine an individual’s maximum heart rate.
  • To measure heart rate mid-exercise, individuals can take their pulse or use a heart rate monitor, app, fitness tracker, or smartwatch to ensure they stay at a moderate intensity.

MET

  • M.E.T. stands for Metabolic Equivalent for Task and refers to the amount of oxygen the body uses during physical activity.
  • Assigning METs to an activity allows individuals to compare the amount of exertion an activity takes.
  • This works for individuals with different weights.
  • During moderate physical activity, breathing and heart rate increase, and the body burns around 3.5 to 7 calories a minute.
  • The actual number burned depends on your weight and fitness level.
  • The body uses 1 MET for basic functions like breathing.
  • Grades of activity:
  • 1 MET – Body at rest
  • 2 METs – Light activity
  • 3-6 METs – Moderate activity
  • 7 or more METs – Vigorous activity

Perceived Exertion Scale

Individuals can also check their activity level using the Borg Rating of Perceived Exertion scale/RPE. (Centers for Disease Control and Prevention, 2022) Using this scale involves monitoring how an individual feels about how hard their body is working during physical activity. The scale starts at 6 and ends at 20. A perceived exertion between 11 and 14 is considered moderate physical activity.

  • 6 – No exertion – sitting still or sleeping
  • 7-8 – Extremely light exertion
  • 9-10 – Very light exertion
  • 11-12 – Light exertion
  • 13-14 – Somewhat hard exertion
  • 15-16 – Heavy exertion
  • 17-18 – Very heavy exertion
  • 20 – Maximum exertion

Examples

Many activities are counted as moderate-intensity exercise. Choose some appealing and learn to add them to a weekly routine.

  • Ballroom dancing
  • Line dancing
  • Gardening
  • House chores that get the heart pumping.
  • Softball
  • Baseball
  • Volleyball
  • Doubles tennis
  • Brisk walking
  • Light jogging
  • Walking or jogging on a treadmill
  • Using an elliptical trainer
  • Bicycling under 10 miles an hour on ground level
  • Leisurely swim
  • Water aerobics

Mobility Challenges

  • Individuals with mobility issues can achieve moderate intensity using a manual wheelchair or a handcycle and swimming or water aerobics.
  • Individuals who can use their legs but can’t tolerate walking or jogging can try bicycling or swimming.

Getting More Exercise

There are different ways to incorporate and increase moderate physical activities. These include:

10-minute Activity Bursts

  • Walk briskly for at least 10 minutes at a time.
  • Walk at an easy pace for a couple of minutes.
  • Pick up the pace for 10 minutes.
  • Try to walk during work breaks or lunch and/or before or after work.

Walking Workouts

  • Individuals can walk indoors, outdoors, or on a treadmill.
  • Proper posture and walking techniques make it easier to achieve a brisk pace.
  • Once comfortable walking briskly for 10 minutes, begin to extend walking time.
  • Try different walking workouts that offer fast walks, jogging intervals, and/or adding hills or treadmill inclines.

New Activities

  • Individuals are recommended to experiment with various exercises to find what works for them.
  • Consider roller skating, blading, or skateboarding to increase heart rate.

Moderate physical activity will get and keep the body in shape. Individuals should not become distressed if they can only do a little at first. Allow time to build endurance and gradually make time each day for enjoyable physical activities.


Transform Your Body


References

U.S. Department of Health & Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition. Retrieved from health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. (Healthy Living, Issue. www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Centers for Disease Control and Prevention. (2022). Target heart rate and estimated maximum heart rate. Retrieved from www.cdc.gov/physicalactivity/basics/measuring/heartrate.htm

Centers for Disease Control and Prevention. (2022). Perceived exertion (Borg Rating of Perceived Exertion Scale). Retrieved from www.cdc.gov/physicalactivity/basics/measuring/exertion.htm