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Body Awareness, Position, Movement, and Chiropractic Adjusting

Body Awareness, Position, Movement, and Chiropractic Adjusting

Individuals do not have a poor posture on purpose. It becomes a habit that just goes on until discomfort or pain present. Body awareness is known as proprioception. Proprioception is known as muscle sense or joint position sense. This is the subconscious nature of the body’s understanding of its position in space and the ability to position ourselves comfortably. Achieving proper and healthy posture means there needs to be a constant mindset of staying aware of how the body is positioned. Then regular adjustments of body position are required to maintain healthy body awareness and from getting into bad habits. To illustrate this consider walking forward in complete darkness. The body knows its relative position even without seeing and understands its existence in space. This is a function of the brain.  
11860 Vista Del Sol, Ste. 128 Body Awareness, Position, Movement, and Chiropractic Adjusting
 
It is part of the subconscious and so have little to no control over it. Because of this individuals begin to lapse into poor poster habits. An example tilting the head when looking forward or all the way down when checking the phone. Over time, these bad habits contribute to spinal misalignment. This is where chiropractic can help individuals realize their proprioception tendencies and actively relearn and strengthen positive body awareness and break away from negative postural habits.  

Body Awareness Habits

Laying the groundwork for correction of body awareness involves understanding the body’s unconscious habits and the damage that is occurring. Chiropractic is highly effective for outlining what is happening with the help of radiological imaging and spinal curvature benchmarks. Once an individual begins to understand how their posture and spine health are being affected, they can make adjustments to combat this. This requires constant vigilance by the individual to actively realize and correct proprioception.  
 

Optimal Body Exercises

For individuals that have engaged in dysfunctional habits for years, a chiropractor may recommend optimal loading exercises. This process involves teaching how to better balance the body for optimal posture development. For example, a chiropractor will have a patient strengthen a weak leg that is shifting the body’s weight to the other dominant leg that results in unbalanced weight distribution causing hip and back pain. Another example of optimal loading may include executing a series of motions/movements with the non-dominant side. The goal of optimal loading is to train the brain to balance the body in a healthier fashion, instead of reverting to a bad habit.  
11860 Vista Del Sol, Ste. 128 Body Awareness, Position, Movement, and Chiropractic Adjusting
 

Ergonomics

Ergonomics can also help correct dysfunctional proprioception. They can help to address specific defaults of the subconscious. For example, the positioning of a computer screen at the correct height and angle can improve the habit of turning or tilting the head. Another example is utilizing custom foot orthotics to balance the feet and prevent pronation. A chiropractor can determine exactly where the ergonomic intervention will have a significant effect in correcting dysfunctional proprioception.  
 

Chiropractic Relief

Chiropractic postural adjustments, optimal loading exercises, and ergonomics are all recommended tools in rehabilitating and preventing bad posture habits. Injury Medical Chiropractic and Functional Medicine Clinic will explore every possible approach to help patients understand and overcome the body�s bad habits, and help them achieve optimal spine health.

Body Composition


 

Muscles get weaker with too much sitting

When sitting the gluteal muscles, abdominal muscles, and legs become dormant. Sitting for extended periods day after day causes these muscles to begin to degenerate. Metabolism is linked with body composition. Having more muscle increases metabolism and helps the body burn more calories. Any muscle loss, especially from the lower body which is the largest muscle group, can lead to progressive fat gain if the diet is not adjusted. With time gradual muscle loss from the lower body can hurt functional strength, and older age increases the risk of falls and affects the quality of life.  

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*  
References
Corliss J. Too much sitting linked to heart disease, diabetes, premature death. Harvard Health Blog. www.health.harvard.edu/blog/much-sitting-linked-heart-disease-diabetes-premature-death-201501227618. Published January 22, 2015. Accessed January 7, 2017. Ergonomics for Prolonged Sitting. UCLA Spine Center Web site. spinecenter.ucla.edu/ergonomics-prolonged-sitting. Accessed January 7, 2017. Florido R, Michos E. Sitting Disease: Moving Your Way to a Healthier Heart.�U.S. News & World Report. health.usnews.com/health-news/patient-advice/articles/2015/09/14/sitting-disease-moving-your-way-to-a-healthier-heart. Published September 14, 2015. Accessed January 7, 2017.
Achieving Better Sleep With Chronic Back Pain

Achieving Better Sleep With Chronic Back Pain

Achieving better sleep with back pain through strategies that will address the pain. The spine is an amazing but highly complicated structure. It is made up of:
  • Bones
  • Joints
  • Ligaments
  • Muscles
All support the body’s weight, protect vital organs and nerve structures while maintaining flexibility. When the spine gets:
  • Injured
  • Strained
  • Sprained
This can make standing up, lying down, and sleeping a consistently painful experience.  
11860 Vista Del Sol, Ste. 128 Achieving Better Sleep With Chronic Back Pain
 

Achieving Sleep Solutions

The connection between sleep disturbance in individuals who suffer from acute or chronic back pain is high. Fortunately, back pain does not have to ruin the sleep experience. There are strategies to achieve better sleep. These include:
  • Adjusting sleep positions
  • Improving sleep hygiene
  • Better understanding the source of pain

Sleep Positions

When back pain presents, finding a comfortable position leads to endless tossing and turning. But sleeping in the wrong position can worsen chronic/acute back pain, or create new injury and pain. Here are some options for alleviating pain:  
 

Back sleeping

Sleeping on the back is the best position anatomically, especially for back pain. It evenly distributes the body’s weight putting less strain on the back. For optimal results, use a soft pillow with minimal height to keep the spine aligned with the neck through the low back. Placing a pillow under the legs can also reduce stress on the low back. Back sleeping is also not recommended for pregnant women in their second or third trimester. This is because the weight can press against the spine causing strain. It can also press on the main vein that carries blood back to the heart from the lower extremities. This can interfere with circulation causing dizziness. For this stage sleeping on the side is recommended.

Side sleeping

Sleeping on the side is considered a safe position for those with back pain. However, this is only if the mattress has proper support. Side sleepers need a mattress that maintains spinal alignment. Any strain while sleeping translates into backaches. Side sleepers should also utilize a pillow with enough height to hold their heads so that the spine stays aligned. To keep the mid-spine from sinking into the mattress, place a pillow in the waist area below the ribcage above the pelvis. This will maintain a neutral position. Using a pillow between the legs and slightly with the knees up toward the torso in a relaxed position along with a body pillow for extra comfort and support.

Stomach sleeping

Stomach sleeping is strongly discouraged by a majority of medical professionals, including the American Chiropractic Association. This is because this flattens the natural curve of the spine, straining the low back placing unnecessary pressure on the neck from twisting the head for prolonged periods. If stomach sleeping is a must use a pillow with a very little height so that the neck stays aligned with the backbone. Also, place a thin pillow under the pelvis, this gives the lower back more support.  
11860 Vista Del Sol, Ste. 128 Achieving Better Sleep With Chronic Back Pain
 

Achieving Pain-Free Sleep

Here are some other strategies for achieving pain-free sleep.

Mattress quality

Mattress quality affects healthy sleep, especially when it comes to back pain. Older, sagging mattresses lose performance factors needed to support the lower back, relieve pressure points, and maintain spinal alignment. Newer mattresses with memory foam, latex, or a hybrid with a core of innerspring, have been proven to help back pain and achieve better sleep.

Getting in and out of bed

Getting into and out of bed can be a challenge. There are techniques that limit movement and put minimal pressure on the back, reducing back pain. One technique works by sitting on the edge of the bed and then leaning to the right or left making sure to keep the spine aligned and ease down onto the mattress. Bring the knees up so the body is entirely on its side. Then, in one smooth movement, gently roll onto the back. To get out of bed do the same steps reversed. Because getting into and out of bed requires sitting or lying on the edge of the mattress, make sure the mattress has enough edge support so it won�t sag when sitting.

Healthy sleep habits

Adopting healthy sleep habits ensures proper sleep. Establish a consistent sleep schedule going to bed and waking up at around the same time every day, including weekends. Schedule at least 7-9 hours of sleep every night. Establish a relaxing nighttime routine around half an hour to an hour before sleep to help release any tension.
  • Take a warm bath
  • Practice yoga or meditation
  • Listen to gentle music
  • Read a little
  • Avoid electronic devices
  • Don�t drink caffeinated drinks from mid-afternoon on
  • Drink warm caffeine-free tea to help the body calm down before sleep
  • Sleep in an environment that is cool, dark, and comfortable
 

Back Pain Types

Pain can be severe or persistent. Understanding the source is one of the first steps toward knowing how to treat and manage it.

Posture

The bones and muscles can slip out of alignment with poor posture and not switching positions to allow the muscles, and bones to relax and recover. This can lead to:
  • Muscle tightness
  • Headaches
  • Back pain upper to lower
  • Muscle fatigue
  • Tingling
  • Numbness

Muscle Strain

Muscle strains happen when the muscles or attaching tendons get damaged. This can happen when lifting something heavy or working out too hard. However, it can also happen during regular activities if the muscles are not warmed up. Muscle strain can cause swelling, bruising/redness, and pain in the muscle/s even when resting.

Nerve Pain

Nerve pain can is unpredictable. Nerve-related back pain usually involves the sciatic nerve. When the sciatic nerve becomes irritated, inflamed, pinched, or compressed, the pain can be felt in the low back and radiate down the leg to the foot.

Fractures and Bone Spurs

Bone pain is usually caused by a fracture or bone spur. Fractures cause a deep ache. Bone spurs, or bony growths that appear on the edge of a bone, often along the spine. If bone spurs press on the nerves, it can cause:
  • Weakness
  • Numbness
  • Tingling in the arms or legs
  • Muscle spasms and cramps
The main cause of bone spurs is joint damage.

Medical Emergency

Sometimes back pain requires a visit to a medical professional to rule out more serious causes, like fractures, tumors, or infections of the spine. Symptoms to look out for include:
  • Fever could indicate an infection
  • Trauma, like a fall, could indicate a fracture
  • A diagnosis of osteoporosis could mean a fracture has occurred
  • Numbness or tingling could indicate nerve irritation/inflammation damage
  • History of cancer
  • Foot drop condition and needing to lift the foot higher to prevent dragging, which could be a sign of a nerve or a muscle condition
  • Pain that presents only at night when sleeping
  • Unexplained weight loss can accompany infection or tumors
  • Advanced age increases the risk for infections, tumors, and abdominal issues

Better Sleep

Around 80% of the world�s population will experience backache, and back pain at some point. When the spine’s bones, joints, ligaments, and muscles become injured, strained, or sprained, it can interfere with sleep. Try some of these strategies to help reduce the pain so sleeping well and waking up refreshed can be achieved.

Body Composition


 

Increase Movement with Exercise

One reason the body could be holding on to extra weight could be from high cortisol levels. Cortisol increases when stressed. Stress can derail exercise routine, diet, and sleep, increasing the chances of becoming overweight/obese. With exercise, the body releases endorphins or hormones that help reduce pain and stress. Exercise does not mean intense gym workouts. It can be as simple as taking small parts of the day, moving around to get the blood flowing, and muscles, tendons, ligaments stretched out. For example, if an individual uses the elevator or escalator regularly, take the stairs instead. Or take a short walk. All it takes is small and consistent adjustments to achieve health.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Cochrane Database of Systematic Reviews. (2010.) �Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica.��pubmed.ncbi.nlm.nih.gov/20556780/ National Library of Medicine. MedlinePlus. (Updated April 30, 2020.) �Back Pain.��medlineplus.gov/backpain.html
Chiropractic Physical Therapy For Knee Pain

Chiropractic Physical Therapy For Knee Pain

Chiropractors don’t only work on the spine. Doctors of chiropractic are trained to treat the entire musculoskeletal system. They could be called joint specialists. Chiropractic physical therapy can help with knee pain. They can help bring knee pain relief in several ways by treating the root cause/s. A chiropractor will perform:

  • Knee adjustments
  • Hip adjustments
  • Posture analysis
  • Gait analysis
  • Weight distribution analysis

There are also a number of chiropractic physical therapy modalities to help with pain, swelling, and arthritis. Knee pain causes can vary. A chiropractor can determine the underlying cause, relieve the pain, and help prevent future injury.

Chiropractic and The Body’s Musculoskeletal System

Many think that treating knee pain comes down to surgery or painkillers. Surgery can be the best option for some, but it is always best to exhaust conservative treatments, which chiropractic physical therapy is one of the most effective. Pain medication can be appropriate but with the addictive potential about they are best avoided unless absolutely necessary. Chiropractic offers an alternative to pain medications and even surgery for certain cases.

Causes For Common Knee Pain Issues

Here are some of the most common causes of knee pain along with the ways a chiropractor can help to relieve the pain and treat the underlying issue. Treatment plans vary depending on the specific circumstances/conditions. �

11860 Vista Del Sol, Ste. 128 Chiropractic Physical Therapy For Knee Pain

Knee Bursitis

Bursitis is inflammation of the fluid-filled sac located in the joints between bones, tendons, and muscles. The sacs are called bursae and are essential in proper joint function. They help reduce friction during the course of regular joint movement/function. Knee bursitis is commonly caused by overuse and misalignment. It can be caused while:

  • Walking
  • Running
  • Kneeling
  • Stretching the knee
  • It can also cause swelling around the front of the kneecap

Chiropractic Treatment

The reduction of pain and swelling are the first steps of chiropractic physical therapy. This is achieved with:

  • Therapeutic massage
  • Ultrasound
  • Hot and cold therapy
  • Cold laser therapy

Once the pain and swelling are addressed then the cause of the inflamed bursa can be determined. This is done through adjustments of the knee, hips, or spine to help correct the issue and promote proper recovery and prevention.

Patellar Tendonitis

Tendonitis means there is damage or irritation to a tendon. Patellar tendonitis occurs in the tendon that connects the kneecap to the shin. This is common for individuals who run and jump regularly like athletes. Overweight individuals have an increased risk for patellar tendonitis because of the extra stress placed on the knees. This is often a result of repeated overuse and happens gradually. It can be the result of trauma to the knee as well. The pain happens just below the kneecap and increases with physical activity. �

Chiropractic Treatment

Most often rest is the first option. Chiropractic physical therapy can recommend wearing a knee brace during the treatment. They will also teach the patient proper stretching and warm-up exercises to prevent tendonitis.

Osteoarthritis

Chiropractic is effective at reducing arthritis pain and inflammation throughout the body. Osteoarthritis can make everyday activities like walking and kneeling difficult or impossible. Chiropractic is designed to help reduce pain increase blood/nerve circulation that will promote healthy joint function and movement. �

11860 Vista Del Sol, Ste. 128 Chiropractic Physical Therapy For Knee Pain

Chiropractic Treatment

Chiropractic will help osteoarthritis through:

  • Massage
  • Ultrasound
  • Laser therapy
  • All can help reduce pain and inflammation in the knees joints
  • Hands-on stretching
  • Adjustments can also help to improve the range of motion and joint function

This is important because knee pain can lead to increased pressure on the joints in the lower back, causing discomfort/pain as well.

Knee Valgus

Knee valgus also known as knock knee, is an inward tilt of the knees. It is easy to see when squatting or kneeling, but it can also happen when walking or standing. Young children tend to develop knee valgus but grow out of it by the time they are 10 years of age. However, if the knees remain bowed into the teenage years and beyond, it can cause issues in the hips, glutes, and back. Knee valgus can also be the result of:

  • Weak muscles in the legs, hips, or glutes
  • Tight muscles in the legs, hips, or glutes
  • Determining the exact cause is essential to address it and develop a treatment plan to correct the issue.

Chiropractic Treatment

Chiropractic specializes in the musculoskeletal system and a doctor of chiropractic knows what to look for. A chiropractor can address the issue through adjustments of the spine, hips, and knees. Hands-on clinic exercises and at-home exercises will be incorporated to correct the issues. These exercises combined with chiropractic will address structural and postural issues. �

Other Knee Pain Causes

Chiropractic can also address and recommend treatments for other knee conditions. These include:

11860 Vista Del Sol, Ste. 128 Chiropractic Physical Therapy For Knee Pain

Chiropractic Adjustments for Pain Relief, Function, and Prevention

Problems with the hips and spine can contribute to knee pain, as well as issues with the foot, ankle, or pelvis. Chiropractors perform a thorough examination of all the joints, tendons, and muscles that could be contributing to the pain. They will look at a full medical history and other details like:

  • Overall health
  • Diet
  • Lifestyle habits
  • Job
  • Exercise and/or sports activities
  • Injuries
  • Posture
  • Walking gait

With this information, the chiropractor will develop a customized plan unique to the individual’s needs and situation. Waiting for the pain to go away is not the best option. Chiropractic is safe, non-invasive, and offers a thorough approach to treating knee pain.


Body Composition Testimonial


 

Difficulty Moving

Lack of adequate muscle can cause difficulty moving like taking the elevator becoming a necessity, getting tired more easily, and getting in and out of a car can become a challenge. These are all possible experiences that can come as a result of losing muscle. Around 19% of women and 10% of men aged 65 years or older are unable to kneel. With no balance to kneel and pick something up means trouble. What to do to prevent massive muscle loss.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Hott, Alexandra et al. �Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial.��The American journal of sports medicine�vol. 47,6 (2019): 1312-1322. doi:10.1177/0363546519830644

Bhagat, Madhura et al. �Immediate effects of Mulligan’s techniques on pain and functional mobility in individuals with knee osteoarthritis: A randomized control trial.��Physiotherapy research international: the journal for researchers and clinicians in physical therapy�vol. 25,1 (2020): e1812. doi:10.1002/pri.1812

Getting Up In The Morning With Back, Neck Pain Chiropractic Brings Relief

Getting Up In The Morning With Back, Neck Pain Chiropractic Brings Relief

For individuals getting up with pain and stiffness in the back, neck, shoulders practically every morning becomes frustrating and depressing. For most, the pain wears off throughout the day but having to deal with it at the start of the day. Dr. Jimenez of Injury Medical Chiropractic and Functional Medicine Clinic offers some suggestions for pain reduction and prevention.  
11860 Vista Del Sol, Ste. 128 Getting Up In The Morning With Back, Neck Pain Chiropractic Brings Relief
 
The body spends around a third of each night sleeping because it is a vital part of life. Sleeping means it is time to relax and prepare for the next day. For many, sleeping can be uncomfortable and can be a cause of back and neck pain when getting up. There are steps an individual can take to ensure that correct sleep is achieved while preventing neck and back pain.  

Sleep Position Is Important

Sleeping in a position that maintains the natural curves of the spine is essential. It is recommended not to sleep on the stomach, as this places the spine in an unnatural position and allows the pelvis and lower back to sink into the mattress with no support. This position can also cause neck pain and headaches when getting up. If this is a position that can’t be changed from years of practice, place a pillow under the stomach and or pelvis to keep the lower back and pelvis straight.
  • Sleeping on the side or back is highly recommended.
  • Side sleepers should also place a pillow between the knees.
  • Back sleepers should place a pillow underneath the knees.
  • Placing a pillow between and underneath the knees gives the spine proper support to maintain the natural curves.
 

Check How The Bed Is Set Up

Make sure the bed/sleeping equipment is set up correctly. For example, most pillows do not provide the proper amount of neck support. This can cause neck soreness even if sleeping in the recommended side and back positions. If getting up with neck pain or headaches a cervical pillow can bring relief. A cervical pillow is designed to support the natural curves of the neck while sleeping and places the neck in the proper position. Cervical pillows are designed for side and back sleepers, but make it difficult to sleep on your stomach, which is an added perk to using them.  
Getting Up In The Morning With Back, Neck Pain Chiropractic Brings Relief
 
Using the proper mattress is equally important. The type of mattress being slept on can be a significant contributor to back and neck pain. Individuals that use a medium-firm mattress have less back pain compared to individuals that use too firm or too soft mattresses. Research has shown that mattresses should be replaced every 10 years. Mattresses that are 10 years old and beyond are shown to be a possible cause of back pain while you sleep.  

Getting Up and Out of Bed In A Way That Doesn’t Cause Pain

Getting up and out of bed properly will help as well. Most individuals sit up, twist their back to get into a standing position and use the back to stand. This is like lifting with the back and not the legs, which will cause back pain and a possible spinal injury like a herniated disc.
  • The recommended way to get up and out of bed after waking is to roll onto the side and use the arm to push up and off from the side-lying position.
  • From this position, scoot to the very edge of the bed and get up using the legs, and not the back.
Implementing these suggestions into your routine can be a great way to decrease pain while sleeping and increase getting up without experiencing stiffness, soreness, and feeling refreshed.

The Body’s Composition


 

Muscle Mass and Workout Recovery

Looking at muscle mass and the intake of certain nutrients into the evening can be beneficial. Protein intake is essential in muscle formation and muscle recovery after working out or engaged in physical activity. Research has shown that a little protein before sleep helps stimulate muscle protein synthesis. In a study, ingested proteins were shown to cause a rise in circulating amino acid levels, increased whole-body protein rates, and improved net protein balance. Following exercise, the muscles need to be able to recover properly and protein intake is essential. To achieve weight management goals, an individual must achieve a healthy amount of Lean Body Mass. Lean Body Mass is based on Skeletal Muscle Mass, and protein intake is essential.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Improving Sleep: Special Health Report. Boston, MA: Harvard Medical School; 2015. Bolash R, Drerup M. How to Beat Insomnia When You Have Chronic Pain. Cleveland Clinic Web site. health.clevelandclinic.org/2015/12/managing-insomnia-for-those-with-chronic-pain/. Published December 18, 2015. Accessed April 18, 2017. What is Sleep? American Sleep Association Web site. www.sleepassociation.org/patients-general-public/what-is-sleep/. Accessed April 18, 2017.
Getting Better Sleep with Inflammatory Spinal Arthritis

Getting Better Sleep with Inflammatory Spinal Arthritis

Inflammatory spinal arthritis can cause significant joint pain and severely damage sleep quality. Any of the following conditions can cause individuals to experience sleep problems:
  • Spondylosis (osteoarthritis)
  • Rheumatoid arthritis
  • Ankylosing spondylosis
  • Juvenile idiopathic arthritis
Dr. Jimenez from Injury Medical Chiropractic and Functional Medicine Clinic gives insight into how inflammatory spinal arthritis can disrupt healthy sleep, along with some tips to help individuals with joint pain restore healthy sleep.  
11860 Vista Del Sol, Ste. 128 Getting Better Sleep with Inflammatory Spinal Arthritis
 

Inflammatory Spinal Arthritis and Sleep

First, it is not just the joint pain of arthritis that is causing sleep problems. Research is discovering that more factors could be at play. A study in the journal SLEEP examined how individuals with chronic pain, including osteoarthritis slept. What was revealed was a strong connection between chronic pain and insomnia. Insomnia can lead to added joint pain because poor sleep can trigger inflammatory pathways that worsen arthritis pain. Plus a poor night of sleep can heighten an individual’s perception of pain the next day. Arthritis pain does not just impact the sleep of adults, but young individuals with juvenile idiopathic arthritis can also struggle with getting healthy sleep. Sleep, pain levels, and mood are strongly related.  
 

Sleep Tips

Achieving quality sleep and a well-rested body can be done. Things to consider to help secure a healthy sleep.  

Medication interference/side effects

Corticosteroids could be part of the sleep problem, as corticosteroid treatment has been linked to insomnia. If struggling to fall asleep, talk with a doctor about altering any prescribed medication regimen before sleep like taking aspirin or a nonsteroidal anti-inflammatory NSAID medication in its place.  

Adjust sleep position to joint pain

If the neck is sore/aching rest the head on a flat pillow so the cervical spine is in a neutral position. For low back joint pain, individuals might find relief by sleeping on their back or side with the knees and hips flexed at a 90-degree angle. For hip joint stiffness, sleeping on the side with a pillow between the legs is recommended.  
 

A firm mattress and support pillow

A firm mattress will support the body and help reduce pain. The right pillow/s are also important for healthy sleep. A lumbar and cervical pillow can help cushion tender areas.  

Readjust chores

Joint pain first thing in the morning needs time to adjust. For morning physical chores try to reschedule for later on in the day or if possible the night before. This could be fixing lunches, picking out clothes, preparing breakfast, or packing the work case, tools, etc. The extra time will reduce morning stress and allow the body to gently adjust.  
11860 Vista Del Sol, Ste. 128 Getting Better Sleep with Inflammatory Spinal Arthritis
 

Wake up and stretch

With joint pain in the morning, some gentle stretching can help. Doing some stretches before even getting out of bed will help minimize pain and allow the body to gradually prepare for movement. Follow the stretch session up with a hot shower to loosen stiff joints.  
 

Increase Sleep Quality

Sleep problems can affect anyone even those that don’t have inflammatory spinal arthritis/joint pain. There could be other issues causing sleep problems unrelated to joint pain. If still not getting quality sleep, talk to a rheumatologist about available options.

Body Composition

 

Osteoarthritis and Exercise

Obesity is a significant risk factor in the development of osteoarthritis. This is not only from the effects of extra weight on the body’s joints but also as a result of the pro-inflammatory effects of adipose tissue. The hips and knees are the weight-bearing joints. Excessive adipose tissue on the midsection and legs have been shown to negatively impact these weight-bearing joints. Promoting Lean Body Mass and encouraging weight loss can potentially lower the risk of osteoarthritis and improve the quality of life. Gentle exercise is regarded as safe for individuals with osteoarthritis and is a key component to improve body composition, reduce body fat mass, improve lean body mass and maintain a healthy weight. Improving body composition and utilizing exercise in weight management can have a direct and positive effect on joint health.  

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*  
References
Myers W. 9 Ways to Rise and Shine With Osteoarthritis. Everyday Health.�http://www.everydayhealth.com/osteoarthritis/ways-to-rise-and-shine-with-osteoarthritis.aspx. Last updated September 25, 2014. Accessed April 18, 2017. Watson S. Why Osteoarthritis Could Disrupt Your Sleep�and Your Partner�s. Arthritis Foundation. www.arthritis.org/living-with-arthritis/comorbidities/sleep-insomnia/osteoarthritis-and-sleep.php. Accessed April 18, 2017.
Chiropractic Shoulder Impingement Mobility Treatment

Chiropractic Shoulder Impingement Mobility Treatment

The shoulder is subject to different irritations, injuries, and conditions. Shoulder impingement is a common ailment but is often confused with other shoulder problems. Properly treating impingement syndrome needs proper diagnosis first. Most shoulder impingement cases do not require surgery. Conservative treatment like chiropractic focuses on pain reduction while increasing the range of motion. This is achieved with manual manipulation, soft tissue therapy, cold laser therapy, and spinal adjustments for shoulder posture realignment.  
 

Shoulder Impingement Symptoms

Shoulder impingement often gets confused with a pinched nerve or a rotator cuff tear. The symptoms can be similar, but the treatment options differ. This is why it�s important to know the specific shoulder issue presenting. This can be done by recognizing the symptoms and performing a shoulder impingement self-exam. Symptoms include:
  • Pain when lifting the arm straight out.
  • Pain when lifting the arm overhead.
  • Pain along the outside of the shoulder, the front, back, or side.
  • Dull throbbing pain.
  • Trouble sleeping specifically individuals that sleep with their arm over their head.
 
11860 Vista Del Sol, Ste. 128 Chiropractic Shoulder Impingement Mobility Treatment
 

Shoulder Impingement Self Exams

There are self-exams at home to help determine if it is in fact shoulder impingement. These exams are just to get a better idea, but a professional chiropractic diagnosis is recommended.  

Exam 1

  • Take the hand of the affected arm and place it on the opposite shoulder, creating a V shape at the elbow.
  • Keeping the hand on the opposite shoulder, raise the elbow straight out in front bringing it up toward the face.
  • If pain presents in the shoulder while moving the elbow up, then shoulder impingement could be a possibility.

Exam 2

  • Stand up with hands down at the sides.
  • Turn the hand of the affected shoulder inward, so the thumb faces back instead of forward.
  • Keep the thumb pointing backward, raise the arm straight up in front and over the head.
  • Note if there is any discomfort or pain.
  • Bring the hand back down to the side.
  • Next, turn the hand so that the palm is facing forward.
  • Again, raise the arm in an arc, ending above the head.
  • If pain presents while raising the arm with the thumb back, but feel relief with the palm facing forward, it is likely a shoulder impingement.
 
11860 Vista Del Sol, Ste. 128 Chiropractic Shoulder Impingement Mobility Treatment
 

Chiropractic Relief

If there is some sort of impingement different treatment options exist. Many doctors treat shoulder impingement with injections and pain management. Studies show that conservative treatment, like chiropractic, have shown positive results for shoulder impingement cases. Chiropractic improves joint function and mobility while treating the underlying root cause. A chiropractor will use a multi-approach depending on the cause. A combination of adjustments, anti-inflammatory protocols, and active release techniques can be used.  

Chiropractic Adjustment

One of the first things chiropractors look at is the spine. This is because poor posture, and slumping shoulders, can be a major contributor to impingement. Chiropractors perform a posture assessment and, if necessary a spinal adjustment to achieve proper alignment is the beginning to get the body back in balance.  

Anti-Inflammation Protocols

Next, is the shoulder itself. Deep tissue massage and anti-inflammation techniques like cold laser therapy or ultrasound can relieve pain, and reduce inflammation. Once the pain has decreased, the chiropractor will move on to active release techniques.  

Active Release Technique

Usually the result of the muscles or tendons becoming inflamed and irritated, the active release technique is used to separate any scar tissue from the soft tissue. The active release technique is performed with a combination of movement and manipulation. This increases healing through proper blood flow and circulation.  
 

Healing Naturally

Here is an example of a potential treatment plan. All treatment plans are different depending on:
  • Individual health
  • Activity level
  • Medical history
  • Age
  • Injury

Rest and Pain Reduction

  • The first step in healing is rest. Individuals will be recommended to cease any overhead arm activity and any activity that causes inflammation of the shoulder.
  • Pain reduction treatment. This could be:
  1. Ultrasound
  2. Laser therapy
  3. Massage
  4. Other forms of pain relief and inflammation reduction

Adjustments/Alignment

  • Chiropractic adjustments performed on the upper cervical spine, upper back, and shoulder area will address the overall cause.
  • Posture assessments will determine if the spine needs adjusting and if it is a cause of the impingement.

Stretching Exercises

 
 

Rehab Protocol

The stretches and exercises are an essential part of the healing process. The specific exercises will depend on the individual’s specific treatment plan but are made to be gentle on the body without any special equipment. If you have any questions call our chiropractic and physical therapy clinic to talk to a trained professional.

Body Composition


 

Strength Training

Strength training is defined as a technique/method of improving the body’s muscular strength. This is achieved by gradually increasing the resistance force through the use of free weights, machines, or body weight. This means the body gets stronger and more capable of performing regular, work, and sports activities without experiencing weakness, fatigue, discomfort, and pain. Examples could include:
  • Carrying groceries or children
  • Moving furniture, household objects, etc.
  • Running
  • Jumping
  • Other physical activities
Strength training has numerous benefits, including:
  • Increased physical performance
  • Improved blood pressure
  • Improved metabolism
  • Reduced fat mass
  • Increased bone strength/density
  • Improved cognitive ability
  • Prevention and management of type 2 diabetes
  • Improved cholesterol levels
  • Reduction of pain associated with chronic conditions

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Garving, Christina et al. �Impingement Syndrome of the Shoulder.��Deutsches Arzteblatt international�vol. 114,45 (2017): 765-776. doi:10.3238/arztebl.2017.0765 www.healthline.com/health/active-release-technique#benefits
Spinal Misalignments Pain And Discomfort Root

Spinal Misalignments Pain And Discomfort Root

When spinal misalignments happen the body experiences soreness, inability to rotate the neck, or after sitting/standing in one position for too long hip and leg discomfort/pain. This is why spinal alignment is so crucial to healthy living. These examples help to illustrate the delicate balance required in the spine to maintain optimal health, stay pain-free, prevent injury, and the ability to conduct everyday chores/responsibilities without the fear and anxiety of setting off pain symptoms.
11860 Vista Del Sol, Ste. 128 Spinal Misalignments The Root Of Pain And Discomfort

Understanding how pain is processed

Pain is a complex sensation. Neural pain receptors, also known as nociceptors detect harmful stimulation/s in the form of:
  • Body Temperature changes
  • Mechanical forces and pressure on the body
  • Chemical changes in the body brought on by inflammation or cell damage
How the signal transmits from the stimulated nerve and how it is perceived depends on the upper levels of neural activity in the body. Specifically, the spinal cord, brainstem, and the brain. Examples of pain perceptions:
  • Beliefs
  • Mood levels
  • Stress levels
  • General health
  • Other sensations the body could be experiencing
  • Previous pain generating experiences – auto accident, work injury, etc.

Spinal Misalignments and Balance

Pain is essential for alerting the body when engaged in activities, and body positions that can cause damage to the tissues like poor postures, work/sports/personal injuries, inflammatory foods, etc. The nerves’ pain pathways can experience overstimulation when the system is overloaded.
Excessive stimulation can be brought on by chronic inflammation, mood disorders, and poor health. One overlooked issue with the perception of pain is the health/effectiveness of the actual neural pathways. The nerve’s energy is affected by spinal misalignments. Proper nerve health and circulation are crucial for the body to transmit proper pain signals. Spinal misalignments can be brought on by:
  • Chronic poor posture
  • Injury
  • Other imbalances in the body
  • Can lead to major dysfunction of the nerves pathways
The longer the pain and discomfort go on the more intense/severe the issues can become. This is when pain and discomfort become chronic leaving individuals feeling hopeless, frustrated.

Symptoms

The spine does more than provide stability. Any type of spinal misalignments will affect the rest of the body as well. Possible symptoms that the spine is out of alignment includes:
  • Chronic headaches
  • Frequent illnesses
  • Fatigue
  • Lower back pain
  • Neck pain
  • Hip pain
  • Knee pain
  • Numbness/tingling in the hands or feet
  • Walking gait abnormalities causing one shoe to wear out quicker than the other
11860 Vista Del Sol, Ste. 128 Spinal Misalignments The Root Of Pain And Discomfort

Chiropractic Management

Many treatments focus on masking the pain rather than addressing the underlying root cause. This can lead to a chronic pain cycle and dependence on pain medications and invasive treatment. Chiropractic is a science-based approach that focuses on getting to the root issue. Chiropractic utilizes gentle and effective techniques like:
  • Manipulation
  • Exercise regimen
  • Stretching regimen
  • Body mechanics training
  • Health nutritional education
When the body is aligned and the spinal nerves are healthy, an individual’s pain perception will be changed for optimal functionality.

InBody Composition


Body composition goals

The first step is to reduce caloric intake by changing/adjusting dietary nutritional habits. Individuals can experiment with various types of diets and regular exercise regimens, and getting into the habit of getting the proper amount of sleep. Depending on an individual’s existing muscle mass, gaining Lean Body Mass first could be an option. An individual may be able to lose fat and gain muscle because:
  • Increased muscle mass will increase the Basal Metabolic Rate/metabolism, and if no extra calories are added body fat can be shed while building muscle.
  • Lifting weights can increase Total Daily Energy Expenditure, causing the body to burn more calories.
Circuit training is one option for improving changes in body composition while not affecting changes in overall body weight. This means muscle gain and fat loss is happening at the same time.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Dubinsky RM, Miyasaki J.Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.�Neurology. 2010;74:173-176. Shrier I. Does stretching help prevent injuries?�Evidence-based Sports Medicine. Williston, VT: BMJ Books; 2002.
Best Mattress Toppers for Back Pain Chiropractic Review

Best Mattress Toppers for Back Pain Chiropractic Review

A mattress topper for back pain can help by conforming closely to the body, correctly aligning the spine, and providing relief to the pressure points. The right quality mattress topper can provide relief when sleeping and can help keep the spine in proper alignment. Chiropractor Dr. Jimenez shares some top mattress toppers for back pain including:
  • Pros
  • What to consider when buying
  • Determine if a mattress topper is the best solution
11860 Vista Del Sol, Ste. 128 Best Mattress Toppers for Back Pain Chiropractic Review
 

Layla Memory Foam

Best Temperature Neutral

The Layla Memory Foam Topper is 2-inches thick and made from memory foam infused with copper. It’s enclosed in a polyester cover and becomes denser under deep compression points, like the hips and shoulders. The Layla brand is known for coming with cooling copper-infusion technology improving airflow and blood circulation. The copper helps an individual sleep cooler than most memory foam and is available at a reasonable price. All sizes cost less than $400 and come with free shipping and returns, a 120-night trial, and a 5-year warranty.  
 

Snuggle-Pedic Memory Foam

Best Memory Foam

The Snuggle-Pedic is a two-layer structure, with softer memory foam on the outer layer and a firm channeled base layer for spinal support. It is a versatile design that makes it appropriate for back, side, and stomach sleepers. Memory foam mattress toppers can be too soft, providing no support, or too firm. This topper finds the balance. One side is soft-to-the-touch, with the other providing twice the support. This double layer system is soft but supportive. It is available in all sizes for less than $300 and comes with free shipping, returns, and customizations.  
 

Saatva Latex Mattress Topper

Best Latex

The Saatva is 1.5 inches of latex and is covered in organic cotton. The latex has ventilation to aid in breathability and the cotton cover adds to the overall temperature neutrality. For individuals that prefer all-natural materials, this latex topper is recommended. The latex used is Talalay latex and is natural and breathable. It also has ventilation spots and is hypoallergenic. For individuals that sleep hot, want a natural option, or have allergies, this could be an option. It comes with a 120-night trial period, free shipping and costs less than $350 in all sizes.  
 

Zinus Memory Foam

Best For Side Sleepers

The Zinus topper measures four inches thick. It is a simple design with 2 inches of gel memory foam that is highly durable. Under the gel foam is a 2-inch-thick layer of support foam for added durability and support. This is an affordable option. The dual-layer provides cooling comfort, durable support and is designed to fit under any deep-pocket sheets. Side sleepers with hip and shoulder pain can appreciate the top layer�s softness and benefit from the durability of the bottom layer, preventing cradling and sinking.  
11860 Vista Del Sol, Ste. 128 Best Mattress Toppers for Back Pain Chiropractic Review
 

Linenspa

Fastest Relief

The Linenspa is made with three inches of memory foam that conforms to the body’s curves while sleeping. This mattress topper is infused with temperature-regulating gel beads that evaporates any heat. It is available in two-inch, three-inch profiles and the foam is made to distribute weight evenly. With every size available for less than $105, this is a comfortable and affordable way to rejuvenate a worn mattress or soften a mattress that is too hard.  
 

What to Look For

Mattress toppers can be beneficial for providing relief for aches and pains, but the best topper for back pain requires knowledge about materials, styles, and features that will provide relief. An overview of what to look for:  

Materials

  • Memory foam and latex are ideal for pressure relief because they conform to the body�s curves without sagging. Look for high-quality materials, like American Talalay latex and open-cell foam.

Body Conformity Amount

  • The ideal amount of conformity provides pressure relief for painful areas. An ideal level depends on weight and sleeping positions. Look for details about the mattress weight, type, and sleeping style.

Sleeping Position

  • Sleeping on the back is a way to naturally align the spine, but a firm topper that does not sag is needed to provide the proper support.
  • Stomach sleepers need a topper that does not sag in the midsection, which can lead to neck pain.
  • Side sleepers need a topper that conforms to the contoured areas, like the shoulders and hips.

Price

  • Prices for mattress toppers vary. There are high-quality mattress toppers available for $150. For luxury, prices will be in the $300s and above.

Durability

  • Sagging is the main issue to avoid. Optimal spinal support is the objective. Do the research, read reviews, consult a chiropractor, and take plenty of time before investing.

Thickness

  • Toppers differ in thickness and can measure from one to seven inches thick. Thicker does not mean more comfortable and thicker toppers tend to be softer. Thinner toppers are usually firmer, which is better for back and stomach sleepers. What feels right depends on an individual’s sleeping position, weight, and size, however, most toppers fall in the two to three-inch thickness range.

Back Pain Causes

Back pain can range from a dull ache to sharp sensations and can be the result of an auto accident, work injury, or personal injury that has developed over time. A sedentary lifestyle also contributes to low back pain. The following conditions are common sources of back pain:
  • Strains
  • Sprains
  • Disc degeneration
  • Herniated discs
  • Sciatica
  • Traumatic injury
  • Radiculopathy
Lifestyle-related risk factors:
  • Aging
  • Fitness level
  • Pregnancy
  • Weight gain
  • Occupation
  • Mental health
  • Genetics
Regardless of the cause or source, a mattress topper, which is more supportive than a mattress pad, can help alleviate back pain when sleeping, leading to a minimization of symptoms and improved quality of life.  

Possible Option

Aching muscles, shooting/stabbing pain, reduced range of motion, and flexibility are detrimental to work, and home life. Whatever the case, there�s an option out there. An overview of mattress topper benefits:
  • The current mattress is old or not supportive enough, but don�t want to invest in a new mattress.
  • The current mattress is too firm, but a partner is comfortable on it. Mattress toppers are available in split sizes to soften/firm up one side.
  • A sedentary lifestyle has increased the frequency of dull low-back pain. A topper can help with back pain prevention.
  • Improve the comfort of a guest bed without spending too much. Similar to the first scenario, a mattress topper can be an upgrade for just several hundred dollars.
One of the most affordable sleep innovations today, but remember that durability, materials, and sleep factors, like weight, position, and height, should all be considered.

Composition of The Body

 
 

Sleep Stages

Sleep researchers are divided into two types of sleep: REM sleep is when dreams occur and NREM sleep which is non-REM sleep. NREM sleep is divided into stages:

Stage 1

  • Stage 1 makes up just 5-10% of a sleep cycle and is known as light sleeping. In this stage, the brain remains semi-conscious and is in between wakefulness and sleep. The brain waves start to elongate from alpha to theta waves.

Stage 2

  • Stage 2 is the bulk of the sleep cycle and makes up around 55%. In this stage, the body/brain is fully asleep and brain waves slow down even more.

Stage 3

  • Stage 3 is the deepest sleep state and is marked by elongated brain waves and slowed brain activity. It is also called short wave sleep. Slow-wave sleep makes up 15-25% of sleep but is the most important sleep state for body composition because most of the body’s restoration happens during this cycle.

REM/Rapid Eye Movement

  • This is the stage where dreams occur. It�s very distinct from the other three in that brain activity becomes more active. An individual passes through these sleep stages every 90 minutes. Getting 7-8 hours of sleep every night means going through 4-5 cycles. Going through a complete sleep cycle ensures an individual will go through Stage 3, which has a significant effect on body composition.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Bolash R, Drerup M. How to Beat Insomnia When You Have Chronic Pain. Cleveland Clinic Web site. health.clevelandclinic.org/2015/12/managing-insomnia-for-those-with-chronic-pain/. Published December 18, 2015. Accessed April 18, 2017. Improving Sleep: Special Health Report. Boston, MA: Harvard Medical School; 2015. What is Sleep? American Sleep Association Web site. www.sleepassociation.org/patients-general-public/what-is-sleep/. Accessed April 18, 2017.
Cauda Equina Syndrome Nerve Compression

Cauda Equina Syndrome Nerve Compression

Cauda equina syndrome is an emergency that needs to be treated as soon as possible. It is a form of spinal nerve compression, but if left untreated, it can lead to permanent paralysis of one or both legs and permanent loss of bowel/bladder control. Lower back pain after sitting for too long or improperly lifting something heavy happens to most if not all of us.
However, sometimes pain in the lower back can be an indicator of something more serious. Especially, for individuals that are dealing with or managing back pain. One condition is cauda equina syndrome. It�s not like sciatica or arthritis, but it does have specific symptoms that individuals should be aware of.

Cauda Equina Syndrome

The term comes from Latin that means horse�s tail. The cauda equina forms the group of nerves that run through the lumbar spinal canal. Generally, the condition means two things:
  • There is nerve compression of most of the lumbar spinal canal
  • Compression symptoms like numbness or weakness in the leg/s
How cauda equina syndrome differs from typical compression of the lumbar spinal canal is that it can be caused by different issues, from fractures, tumors, and infections. More commonly, it is disc herniations that cause the problems. The key difference is the degree of nerve compression, and the number of nerves compressed. For example, compression of a single nerve will not cause loss of bladder function. But compression of multiple nerves, especially the sacral nerves can cause loss of function. Nerve compression that leads to pain or numbness can be treated differently. Surgery is reserved for severe cases and for individuals that are not improving with non-invasive treatment.
11860 Vista Del Sol, Ste. 128 Cauda Equina Syndrome Nerve Compression Chiropractic Diagnosis

Sneaky Presentation

One of the major factors is long-term compression that individuals do not realize they have. Individuals are more likely to be aware of symptoms from another spinal condition before cauda equina syndrome presents. However, the condition presents quickly but often other overlapping back problems mask cauda equina syndrome.

Causes

The syndrome can be brought on from anything that compresses the nerves. Most commonly, it is a root compression from degenerative processes, specifically lumbar disc herniations. Other causes include:
  • Bleeding like an epidural hematoma
  • Trauma like fractures or penetrating trauma
  • Tumors growing in the canal or the collapse of a tumor-affected bone
  • Disc herniations can progressively grow in size, which leads to a slowly-evolving cauda equina syndrome.
  • An enlarging disc herniation or synovial cyst can further compromise the already compressed nerves.
  • Overgrowth of arthritic joints or bone spurs into the spinal canal can lead to long-term compression.

Symptoms

The symptoms vary based on the degree that the spinal canal has been affected:
  • Back pain
  • Leg pain
  • Sciatica
  • Saddle numbness that extends into other areas of the legs
  • Neurogenic bladder dysfunction. This can range from difficulty starting to urinate or limited and/or non-voluntary control urinating.
  • Bowel dysfunction
  • Sexual dysfunction

Diagnosis

A doctor will examine any significant changes in bladder, bowel, or leg function that are considered red flags prompting an early and complete assessment. A physician will ask for a complete/detailed history of the onset and progression of symptoms. The second is a close physical examination which includes testing sensation and strength along with a rectal exam to assess voluntary contraction. Also checking the body’s reflexes, assess walking gait and alignment. If most or all of the symptoms are presenting this will set in motion spinal imaging or an MRI. If the symptoms, exam, and imaging match, it will lead to an emergency admission to the hospital.
11860 Vista Del Sol, Ste. 128 Cauda Equina Syndrome Nerve Compression Chiropractic Diagnosis

Body Composition Spotlight


 

Obesity and Osteoarthritis Connection

A variety of factors contribute to the development of osteoarthritis, including genetic factors and lifestyle choices. Research supports obesity is a significant risk factor in the development of osteoarthritis. It is pretty straightforward as body weight increases this equals increased load on the spine, and joints, especially the weight-bearing ones like the hips and knees. Increased pressure leads to early wearing, tearing, and eventual development of osteoarthritis. Added weight affects the body’s biomechanics and gait patterns. However, obesity has also been shown to be a risk factor even on the non-weight-bearing joints. This is based on adipose tissue, which is more than just insulation. Adipose tissue is metabolically active and is involved in the secreting adipokines and cytokines which promote an inflammatory response. Pro-inflammatory adipokines and cytokines can have detrimental effects on joint tissue including damage to cartilage, synovial joints, and subchondral bone. The effect of inflammation on the joints in the body can contribute to the development of osteoarthritis.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Causes of Cauda Equina:�Neurosurgical Focus.�(June 2004) �Spinal epidural hematoma causing acute cauda equina syndrome��pubmed.ncbi.nlm.nih.gov/15202871/ Arriving at a Diagnosis:�British Journal of Neurosurgery. (August 2010) �Reliability of clinical assessment in diagnosing cauda equina syndrome��www.tandfonline.com/doi/abs/10.3109/02688697.2010.505987
Sleeping With Sciatica and A Better Night’s Rest

Sleeping With Sciatica and A Better Night’s Rest

Trying to get a proper night’s rest and healthy sleep with sciatica can be difficult. Here we discuss how to combat sciatica discomfort for a better night�s rest. The sciatic nerves are the two largest nerves in the body. They run from the low back through the:
  • Hips
  • Buttocks
  • Down each leg into the feet
 
When the nerve gets:
  • Irritated
  • Inflamed
  • Pinched
  • Compressed
Sciatica can cause pain, tingling, numbness in the butt, lower back, leg, calf, and foot. It is a common condition that affects many individuals.

Is It Sciatica

Sciatica happens when the nerve becomes pinched from a bulging or herniated disc. In rare cases, the pain can result from a tumor putting pressure on the nerve or damage to the nerve caused by disease. The location and intensity of the pain depend on where the injury or damage occurred and how bad it is. Sciatica pain can be described as:
  • Dull
  • Sore
  • Numbing
  • Jolting
  • Throbbing
  • Hot
  • Stabbing
  • Radiating
11860 Vista Del Sol, Ste. 128 Sleeping With Sciatica and A Better Night's Rest
 
For many sciatica usually resolves within a matter of weeks. However, once sciatica has presented future episodes are almost guaranteed to resurface and if not treated properly can lead to more serious problems.

Symptoms

The sciatic nerve/s can affect several areas of the body, making symptoms vary. The most common include:
  • Lower back pain starts at the low back, runs along the hips and buttocks down each leg.
  • Pain radiates/spreads down the butt/leg area sometimes described as a shooting pain and usually occurs on just one side.
  • Pain while sitting for long periods of time places pressure on the gluteal muscles, lower back, and nerves. This can cause or worsen the condition. When having to sit for a while, it is recommended to get up every hour or so and walk/move around. This gets the blood flowing and stretches out the tightened muscles.
  • Hip pain, as the sciatic nerves run through the hip joint and in some cases can cause pain to settle in the hip. Injuries in the hip can mimic the symptoms of sciatica. If there is hip pain that does not improve with time get checked by a doctor to rule out other causes like osteoarthritis, bursitis.
  • Numbness, some experience weakness in the legs and an altered sensation of numbness. This is caused by a herniated disc in the lower lumbar region.
  • Burning/tingling like a pins and needles sensation, especially in the feet and toes.
 

Conditions/Causes

There are several conditions that can cause sciatica:
  • Degenerative Disc Disease is where the discs of the spine deteriorate and become susceptible to painful herniation.
  • Spondylolisthesis is a painful condition where the lower vertebrae slip forward onto the bone directly below impinging the sciatic nerve.
  • Muscle Spasms and involuntary contractions of the muscles can cause sciatica if they compress the nerve.
  • Pregnancy sciatica is not uncommon. As the baby grows it places pressure on the nerve causing aches and pains.
  • Lumbar spinal stenosis is when the spaces in the low back begin to narrow compressing and irritating the nerve.
  Risk factors include:
  • Age, as the spine gets older it becomes more susceptible to herniated discs and bone spurs, which are leading causes of sciatica.
  • Obesity and excess weight create added stress on the spine, which can inflame the nerves.
  • Occupation/work that requires standing/sitting for long periods or if a lot of heavy lifting is involved there is added pressure on the back increasing the risk for back problems.
  • Individuals with diabetes have an increased risk for nerve damage. When nerves are damaged, they can cause radiating pain.

Night Time

Sleeping at night can be a challenge, especially not being able to get into a comfortable position. Sleep deficits and insufficient sleep can reduce the body�s tolerance to pain and worsen inflammation. Many wake up with increased symptoms. This is likely due to the fact that when the body is laying down the discs draw in and absorb fluid, which results in increased pressure within the disc, creating more pressure on the nerve. But there are some things to do to lessen pain and get a good night�s sleep. This includes changing sleep position, stretching, and practicing healthy sleep hygiene.  
11860 Vista Del Sol, Ste. 128 Sleeping With Sciatica and A Better Night's Rest
 

Sleeping Positions

  • Sleeping on the back is considered the best sleeping position for sciatica because it eases pressure on the low back and discs where the nerves are located.
  • Sleeping on the side can be more comfortable and is a good position because it doesn�t place direct pressure on the muscles, discs, or sciatic nerve. But, it is important that the mattress is supportive enough to keep the spine aligned. If more support is needed place a pillow between the legs.
  • Sleeping with the knees elevated can help take the pressure off the low back. To achieve this place a pillow under the knees or, with an adjustable bed, use it to elevate the foot of the bed.
  • Sleeping with a body pillow provides extra comfort and helps the body remain in a certain position throughout the night. These pillows come in a variety of shapes, sizes.
 

Stretches

Stretching can provide relief. It�s important to stretch to keep the body flexible and to prevent pain. Gentle stretches before bed, and after waking up will loosen the muscles and ligaments surrounding the spine and joints.
  • Reclining pigeon pose is a yoga pose that opens the hips and eases lower back pain.
  • Lying on the back with both knees bent.
  • Lift the right leg and place the ankle on the top of the left knee. Hold the stretch for 15 to 30 seconds.
  • Repeat with the other leg.
  • Sitting pigeon pose stretch is similar to the reclining pigeon but is done while sitting.
  • Sitting on the floor with knees bent. Keep balance by placing the hands on the floor.
  • While seated, place the right ankle on the top of the left knee.
  • Lean forward and move the upper body forward. Hold for 15 to 30 seconds.
  • Repeat with the other leg.
  • Forward pigeon pose is a more advanced version of the pigeon stretch.
  • Start in a plank or push-up position.
  • Move the right leg in front so that the right knee is toward the right wrist and the right foot toward the left wrist.
  • Stretch the left leg out behind. The top of the foot should be on the ground and toes flat against the floor.
  • Shift the weight forward onto the hands or elbows. Feel the stretch in the right glute.
  • Repeat steps with other leg.
  • The knee�to the opposite shoulder is a simple stretch that is easy and pain-relieving.
  • Lie on back with legs extended.
  • Bend the right leg, grasp the knee and pull it toward the abdomen.
  • Straighten the leg and then repeat these steps with the left leg.
  • Do three times on each side.
  • Sitting spinal stretch can help open the vertebrae to relieve sciatica pain.
  • Sit on the floor with the legs extended.
  • Bend the right knee so that the foot is next to the inside of the left knee. Keep the right foot flat on the ground.
  • Move the left arm around so that the elbow is on the outside of the right knee. Place right hand behind for balance.
  • Gently turn toward the right, looking behind. Hold the position for 15 to 30 seconds.
  • Repeat with the other leg.
  • Standing hamstring stretch can ease pain in the hamstrings.
  • Stand and place one heel on an elevated surface, like a chair.
  • Fully extend the knee and flex the ankle by pointing the toes toward the ceiling.
  • Bend forward at the hips keeping the spine in a neutral position. Hold for 15 to 30 seconds.
  • Repeat with the other leg.
11860 Vista Del Sol, Ste. 128 Sleeping With Sciatica and A Better Night's Rest
 

Sleep Hygiene

Proper sleep hygiene helps prepare for a good night�s sleep. Here are some tips to help improve sleep hygiene.
  • A nighttime routine will help unwind the body before bedtime. Start the routine 30 minutes before planning to go to sleep. Some things to do to help unwind:
  • Take a warm bath
  • Listen to relaxing/soothing music
  • Meditation
  • Reading
  • Get a new mattress. An old, sagging mattress can worsen sciatica and strain the back. The best mattresses for sciatica pain combines contour comfort to ease pressure points at the hips and shoulders with the proper support to keep the spine aligned.
  • Eye masks can help with artificial light which can fool the mind along with the circadian clock into thinking it�s daylight. Keeping out unwanted light all night can help.
  • Avoid blue light too close to bedtime like lamps and device screens. These are great for the day, as they help boost attention, reaction time, and mood. But at night it can be disruptive. Turn off electronics at least 30 minutes before bed to help the body adjust.
  • Room temperature control has found that most sleep better in a cool room. The optimal temperature is between 60 and 67 degrees.
  • Avoid exercise close to bedtime. Working out before bed can interfere with sleep. This is because exercise releases adrenaline keeping the mind and body alert.
  • Avoid stimulants before bedtime like caffeine, sugar, etc. which will keep the body up.
 
 

Medical Intervention

Sciatica pain can be mild or severe. Stretching or changing up sleeping position can help ease discomfort. But if the pain is severe or chronic, and if it prevents getting a good night�s sleep, consult a chiropractic professional.

InBody Spotlight


 

Sleep And Body Composition

A lack of sleep makes it harder to gain muscle and harder to lose fat.
  • Sleeping less means fewer opportunities to secrete growth hormone and develop muscle
  • Testosterone is negatively affected by lack of sleep
  • Sleeping less can increase cortisol levels, impairing muscle development
  • Irregular sleep throws off the body’s cycles, making the body feel hungrier
  • Sleeping less is linked to eating more snacks, increasing energy levels
  • Lack of sleep can cause reductions in Basal Metabolic Rate by 20%, reducing total energy output
  • Being tired reduces spontaneous movements, reducing total energy output
If trying to get into shape and change body composition, sufficient sleep is vital. Any positive changes to get more sleep are going to have positive changes in efforts to change body composition.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Siengsukon, Catherine F et al. �Sleep Health Promotion: Practical Information for Physical Therapists.��Physical therapy�vol. 97,8 (2017): 826-836. doi:10.1093/ptj/pzx057