by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Chiropractic, Chronic Back Pain, Integrative Functional Wellness, Integrative Medicine, Wellness
Doctor of Chiropractic, Dr. Alexander Jimenez examines people that see�a chiropractor and their reduced�usage of opioids and other types of drugs.
The draft Guidance for Prescribing Opioids for Chronic Pain, issued in December 2015 by the U.S. Centers for Disease Control and Prevention, included �many complementary and alternative therapies (e.g., manipulation, massage, and acupuncture)� among its recommended non-pharmacologic approaches. However, when the final Guidance was released three months later, manipulative therapy and its 75,000 licensed chiropractic practitioners was not directly referenced. A recent study from James �Jim� Whedon, DC, MS, pictured, suggests that the CDC harmed its mission with its excision of explicit reference to manipulation. Patients using chiropractors were less likely to use prescription opioids.
Whedon is currently a researcher at the Southern California University of Health Sciences, and is co-chair of the Research Working Group of the Academic Collaborative for Integrative Health. He is a relatively rare resource in the integrative health community, as a specialist in diving into huge data sets of insurers and seeking to extract useful information. Whedon is a veteran of arguably the most important research center in this type of work, The Dartmouth Institute at the Geisel Medical School at Dartmouth College.
Whedon�s research began with awareness that �little is known about the comparative effectiveness of non-pharmacological care for low back pain as a strategy for reducing the use of opioid analgesics.� What is well known, as Whedon shared in his poster and presentation at the 2016 conference of the Academy of Integrative Health and Medicine, is that patients with such pain are swimming in opioid prescriptions. Whedon�s presentation included a Baskin-Robbins-like list of 39 opioid varieties. He postulated that opioid use would be less likely among those receiving chiropractic care.
Association Between Utilization Of Chiropractic For Back Pain & Use Of Prescription Opioids
Preliminary results of a health claims study,� Whedon reports what he found through examining the New Hampshire All Payer Claims Database.� Of roughly 33,000 adults registered as having low back pain, slightly over a third saw a chiropractor. Of these, 38 percent had at least one opioid prescription. Of those who did not see a chiropractor, 61 percent had at least one opioid prescription.
The core question that interested Whedon was how many prescription fills the two sets of insured patients received. Those whose opioid prescription was integrated with chiropractic care had an average of 3.9 fills. Those who did not receive chiropractic manipulative therapy averaged 8.3 fills per patient. He estimated that the average per person opioid charges were $88 for those using chiropractors. The figure was $140, or 60 percent higher for those not using chiropractic care.
Whedon�s conclusions were, first, that the likelihood of filling a prescription for a high-risk drug of any type was 27 percent lower. Secondly, the likelihood of filling a prescription for an opioid analgesic was 57 percent lower in the chiropractic-using population.
�These are preliminary results,� Whedon cautioned. �We intend to analyze the data further, applying robust methods to reduce the risk of bias that can result from other differences between people who use chiropractic care and those who do not.�
Comment: While Whedon takes care to note that �no causal inferences can be made,� the associations should be of real interest to the CDC and other policy makers. A follow-up study might attempt to compare the whole costs of the chiropractic-using population and those who didn�t.� These costs could include, on the one hand, the cost of chiropractic treatment, and on the other, the costs of other medications or treatment that may be prescribed for those on longer-term opioid treatment who may end up cycling into the addiction.
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by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Fitness, Health, Wellness
Boxing is all the rage right now—everyone from models like Gigi Hadid and Ashley Graham to celebs like J.Lo and Demi Lovato have picked up the powerful workout as their go-to way to stay fit. And they’re definitely on to something. Boxing is great way to up your heart rate and tone your body from head to toe.
It’s no coincidence that so many people who love boxing rock killer physiques. Boxing (as well as the challenging conditioning work that goes along with training) strengthens and sculpts the entire body. That’s because boxing isn’t just about aggressively throwing punches—it’s an amazing total-body workout that tightens and tones everything from your arms to your core.
RELATED: 5 Heart-Pumping Samba Dance Moves That Burn Fat
That said, stepping into a boxing gym or class can be a bit intimidating if you’re a total newbie. So Health teamed up with two-time boxing world champion Chris Algieri to get the lowdown on must-know boxing basics. Watch this video to learn everything from how to get in fighter stance, throw a 1-2 punch (also known as a jab-cross), and master other classic moves, such as upper cuts and hooks. Whether you’re a boxing novice or just looking to perfect your form, here’s what you need to know for a total knockout workout.
by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | UTEP (Local) RSS
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The Conference USA champion UTEP men�s golf team learned on Thursday morning that it will be one of eight squads participating in the Sammamish (Wash.) NCAA Regional May 15-17.� The regional will be contested at the Aldarra Golf Club with 54-hole stroke play as the format.
�I think it could be a great place for us to go,� UTEP coach Scott Lieberwirth said.� �We haven�t been out to that golf course, and I don�t think many teams have.� [Regional host] Washington has never hosted an event out there, so it�s going to be a new experience for any team besides Washington.� I think that�s good in that we don�t have any teams with an advantage over another.� I think it bodes well for us going back to cool season grass, something that most of our team has grown up with and is familiar with.� I think that�s a definite positive for us.�
UTEP is seeded eighth in the regional and will be joined by top seed USC, no. 2 seed Kent State, no. 3 seed Texas A&M, no. 4 seed Florida State, no. 5 seed Washington, no. 6 seed Alabama, no. 7 seed San Diego State, no. 9 seed Penn State, no. 10 seed Michigan, no. 11 seed Michigan State, no. 12 seed Seattle, no. 13 seed Marquette and no. 14 seed Bryant.
�That�s maybe the drawback of going to this region in that at least in the top five lines, it�s statistically the toughest region having #1 [USC], #12 [Kent State] and #13 [Texas A&M] in that field,� Lieberwirth said.� �We have seen USC.� They are awesome.� We know Texas A&M has had an extremely strong year.� Washington, the host, is also very dangerous, especially on their home golf course.� Alabama has come back and played really well later on this spring.� We will definitely have our hands full.�
A total of 81 teams earned NCAA Regional bids and are disbursed among six regionals.� The top five teams in each regional will advance to the NCAA Championship at Rich Harvest Farms in Sugar Grove, Ill. May 26-31.
�In the end, it is going to come down to how we execute and if we do a good job of that, I think we are going to position ourselves to get to the championship,� Lieberwirth said.� �There�s nothing different.� It�s still the same game we have played all year.� The stakes are higher so it�s about managing our options, not getting ahead of ourselves and being patient, moreso this tournament than in any other tournament we�ll play.�
UTEP is participating in NCAA Regionals for the 14th time, and the first time since 2004.� The Miners are tying to advance to the NCAA Championship for the first time since 1995.
�I�ll tell our guys to have fun.� We don�t really have anything to lose at this point,� Lieberwirth said. ��There are some higher ranked teams that sometimes play with a lot of pressure because of an expectation of getting to the national championship.� We need to just go play golf and forget about any expectation. �We�ll add the scores up at the end.� And I think we do a pretty good job of that as a team in general, not really looking at leaderboards, not looking at where we�re placed, let�s just play well for us and if we have a good tournament, we�re going to be in that mix.�
by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Anti Aging
Researchers say they’ve found an enzyme in mice associated with obesity and a loss of exercise capacity in midlife, suggesting that the discovery could eventually lead to new weight-loss medications.
The team at the U.S. National Heart, Lung, and Blood Institute (NHLBI) gave one group of mice a drug that inhibits the activity of the enzyme called DNA-PK. Another group of mice wasn’t given the drug. Both groups were fed a high-fat diet.
The group that received the inhibitor had 40 percent less weight gain than the other group, according to the study in the journal Cell Metabolism.
The findings challenge current ideas about why people gain weight as they age, the researchers said.
“Our society attributes the weight gain and lack of exercise at midlife [approximately 30-60 years] primarily to poor lifestyle choices and lack of willpower,” said study lead author Dr. Jay Chung, head of the institute’s Laboratory of Obesity and Aging Research.
The researchers said the average weight gain between age 20 and 50 is about 30 pounds, even though the amount of food a person consumes generally decreases during this time.
Chung and his colleagues looked for biochemical changes in animals during midlife and found that DNA-PK increases in activity with age. Also, the researchers said the enzyme helps the conversion of nutrients to fat.
“This study shows that there is a genetic program driven by an overactive enzyme that promotes weight gain and loss of exercise capacity at midlife,” Chung said in a NHLBI news release.
“Our studies indicate that DNA-PK is one of the drivers of the metabolic and fitness decline that occurs during aging, which makes staying lean and physically fit difficult and increases susceptibility to metabolic diseases like diabetes. The identification of this new mechanism is very important for improving public health,” he said.
Obesity is linked with a number of chronic diseases, including type 2 diabetes and heart disease.
“The study opens the door to the development of a new type of weight-loss medication that could work by inhibiting DNA-PK activity,” Chung said.
However, it’s important to note that research that seems promising in animals doesn’t always translate well to humans.
For now, middle-aged people fighting obesity need to focus on calorie reduction and increased exercise, the researchers recommended.
by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Diets, Fitness
The idea that diet could have a role to play in preventing the signs of asthma is starting to gain ground, with studies highlighting certain deficiencies in patients or warning against the consumption of certain foods. On World Asthma Day, May 2, Relaxnews spoke to Dr. Bertrand Delaisi, a pediatric pulmonologist at Clinique Marcel Sembat in Boulogne-Billancourt, France, for an overview of what’s currently known on the subject.
The prevalence of asthma has increased considerably in recent decades, in parallel with changes in lifestyles and dietary habits, tending towards diets rich in carbohydrates and fat, and low in fiber.
As well as pollutants, allergens, passive smoking and air pollution, allergy specialists are increasingly interested in how diet can promote or modify the development of asthma on a physiopathological level.
Eating ham, cured sausage or smoked meats at least four times a week could aggravate the symptoms of asthma over time, concludes a study carried out by researchers at Inserm, the French National Institute of Health and Medical Research, published in January in the medical journal Thorax.
On the contrary, consuming fiber may influence the gut flora and could reduce inflammation in the bronchial tubes. A diet rich in fruit and vegetables and vitamin C — and especially vitamin D (calf’s liver, soy, egg yolks) — could, therefore, help limit the risks of asthma, according to Dr. Bertrand Delaisi, a pediatric pulmonologist at Clinique Marcel Sembat in Boulogne-Billancourt, France.
The same goes for omega-3 fatty acids, present in oily fish and other foods (walnuts, canola oil), which can relieve inflammation, including in the respiratory airways. People whose diets are rich in omega-3 have a lower risk of suffering from asthma than those whose intake is limited. They could also be beneficial to people who already suffer from the condition.
Foods containing quercetin could reduce the frequency of asthma attacks, as this antioxidant flavonoid is an anti-inflammatory. Studies carried out in vitro found that quercetin inhibited the liberation of inflammatory substances by mast cells, which play a role in allergic reactions, mirroring certain anti-asthma medications. This antioxidant is found in onions, mustard oil, tea and apples.
An estimated 300 million people worldwide suffer from asthma.
by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Chiropractic, Lower Back Pain, Sciatica
Doctor of Chiropractic, Dr. Alexander Jimenez looks at high heels at what they do to the back.
Ladies, ever wonder why you suffer from regular bouts of lower back pain?� Achy hips?� How about crazy tight leg muscles?� Don�t blame it on your cycling class, or too many squats or, the trainer you only see once or twice a week.� Look down.� Are you wearing high heels?� Bingo!� You�ve heard high heels are bad for you.� But it�s not just because they cause all kinds of pain and trauma to your feet.� High heels are also messing up your physical fitness. �They throw you out of proper postural alignment causing your joints and spine to take on more�wear and tear, which means aches and pains.
Is it possible to still look rockin� and save your joints? �My suggestion is more Athleisure-wear. �I know some fashion hard-liners say, no way will I walk around in yoga pants on a weekday!� But we�ve come a long way since those flare-leg, fold-over yoga pants.
Let�s chat for a moment about the evils of high heels.
First there�s the obvious.� They make your feet hurt.� Blisters, calluses and swelling are par for the course.� And pointy toes, fuhgeddaboutit!� I�m sure they were invented by someone on the Marquis de Sade�s payroll.� Second, they can lead to foot injuries like plantar fasciitis (usually from a bone spur that makes your heels hurt), hammertoes, bunions, and neuromas.� �Then there�s the domino effect.
Not only do high heels make your feet hurt, but problems with the feet can travel up the leg and cause injuries in the back, knees and hips. �Your knees take on extra pressure from the weight being pushed forward onto the balls of the feet. �Walking in this position makes your hip flexors and calf muscles short and tight. �And it doesn�t stop there.� Back problems are incredibly common in women who don�t give up their high heels.
Back Problems are incredibly common in women who don�t give up their high heels
Here�s why:
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- Postural changes:�The S-curve of your spine has cushiony discs in between the vertebrae that act as a shock absorbers to protect them from stress. Like when you�re bending or jumping. �Wearing heels causes the lower back to arch more than normal because the body weight is pushed forward.� To compensate, the upper body has to lean back to maintain balance.� This puts extra stress on the discs. ��Spending hours with your body in funky alignment can lead to muscle spasms and back pain. �Tight hamstring muscles, which�attach to back of the pelvis and lower back, can also make your back ache.
- Anatomical changes: Wearing high heels on a daily, or very regular basis, over years, can actually cause anatomical changes to your body.� In addition to the extra strain on your back and knees, the calf muscles can also shorten and the tendons can get tighter and thicker.
And It Can Get Even Nastier If You Get One Of These Spine Injuries:
- Spondylolisthesis: it�s a mouthful, but is a common injury that can happen in the lower back from too much hyperextension (arching the back).� It�s when one vertebra slips forward over another.
- Foraminal stenosis: I have this one congenitally and it sucks. This is a spine and nerve issue that occurs when anatomical abnormalities reduce the spaces the nerves travel through as they exit the spinal column.� The spaces are called foramina, and when they get blocked, the nerves get squeezed.� The pain can radiate through the buttocks and down the legs.� Symptoms are shooting pains, numbness, tingling, muscle weakness, spasms and, or cramping.
- Sciatica: �The sciatic nerve is the longest one in the body. �It runs from the bottom of the lumbar spine all the ways down the legs. �When the sciatic nerve gets compressed it causes radiating pain, tingling, numbness and muscle weakness down the leg and can The pain can travel all the way to the bottom of the foot.
What Can You Do? �My Case for Athleisure-Wear To Combat Back Pain
It�s time for stuffy office attire to retire. �Comfy clothes and flat shoes can be very chic. �Have you seen the boards on Pinterest?� Thanks to this hopefully permanent fashion style, my jeans and heels spend more time in my closet than on my body.� Leggings and cute kicks are my go to�s.� Night out?� No prob.� I reach for my sleek workout leggings, a ruched top or off the shoulder top with some high heel sneaks (they�re wedges so not nearly as bad for you). �I also discovered these by Bluprint which I put to the test at 2 huge conventions where I walking and standing for hours on end.� The soles made of memory foam � like those beds!
My podiatrist friend, Steven Rosenberg, DPM has been preaching the need for comfy shoes to his female clients for years. �(Fortunately for his practice, not everyone listens!) �Dr. Steve says, wearing shoes designed more for comfort can help you live more pain-free. ��Because comfort shoes are made of�soft cushiony materials�with soft foam innersoles, those are what you should turn to for shopping, walking or standing for long periods of time to avoid�blisters, muscle spasms or arch cramps.� � He also says to check for arch support in your shoes. �If there�s none, you can buy ones to put inside.
Even after reading this, you may still not be willing to give up high heels for good. �Me either.� I still get glammed up once in a while.
Here Are Some Tips For When You Must:
- Wear them for as little time as possible.
- Try to opt for heels around 2� high
- Steer clear of pointy toes.
- Buy shoes with leather insoles to so your foot doesn�t slide.
- Buy arch inserts or use orthotics to support your arches.
- Vary your footwear so you�re not wearing high heels every day.
- Gradual or lower slopes are a little better, go for platforms or wedges instead of stilettos
- Thicker heels are better than spiky heels
- Stretch and strengthen the overworked muscles.
Here�s How:
- Stretch your leg muscles and hip flexors before and after wearing heels.� For the calves, stand on a step and let one heel hang down until you feel a stretch.
Try this convenient device, the foot rocker by Vive.� It stretches the calf and the sole of the foot relieving pain from plantar fasciitis.
Front of the hip and thigh stretch for before and after wearing high heels
Hamstring stretch for before and after wearing high heels
- Massage and stretch the muscles in the soles of your feet.� Roll your foot on a golf ball before and after wearing heels and, get regular foot massages.
- Strengthen and increase the range of motion in your ankles and feet.� Put a rag on the floor.� Using your foot, write the letters of the alphabet.� Also put a bunch of marbles on the floor.� Pick one or a few of them up using just your foot.� Put them down about 6 inches away without lifting your foot off the floor.� Try that 10 times.� If you don�t have marbles, you can do it with a hand towel.
So next time you�re shopping for shoes, think about your foot fitness first. �Look for fashion that keeps you closer to the ground and that will hopefully keep you farther away from the doctor.
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by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Athletes, Fitness, PUSH-as-Rx
PUSH as Rx owner and exercise physiologist, Daniel Alvarado opens up about what PUSH as Rx means to him and what they have to offer.
- Crossfit
- Weight Loss
- Strength Conditioning
- Athletic Training (Any Sport)
- Cardiovascular
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- Nutrition
