There are other causes of sciatica that are not spine-related. It is sometimes called non-spinal pathology, which means not related to the spine. The most common cause of sciatic pain is a herniated disc. Non-spine-related causes of sciatica can imitate/copy the symptoms of a herniated disc in the low back. When a lumbar herniated disc causes sciatica, people typically report a sudden onset of pain with leg pain worse than any back pain that might be present. In addition to pain in the leg, there are also reports of leg weakness, numbness, and tingling. Leg pain becomes worse after:
Long periods of sitting/standing
Forward bending
Body maneuvers that increase pressure in intervertebral discs
Coughing
Sneezing
Individuals also report when lying down and the spine is extended the back pain reduces and alleviates the pain. Determining the source of sciatica pain correctly means that it is important to:
Characterize the activities leading up to when the symptoms first presented
Location of the pain
Associated factors that reduce and worsen the pain
Medical history
Because there are quite a few non-spine-related causes, it can be helpful to keep in mind:
The way the sciatic nerve runs through the lower body. It starts in the lower lumbar and upper sacral nerve roots. It exits through the pelvis and runs down the back of the thigh to the knee where it branches out into nerves that provide the motor and sensory functions to the legs and feet.
Non-spinal sciatica causes. Non-spinal causes usually are the result of irritation of the nerve itself. The most common ways to irritate the nerve is compression, traction, or injury.
Symptoms perceived as sciatica may not be related to the nerve at all. Injury/s to structures close to the nerve, like the hip, can copy symptoms caused by irritation of the nerve.
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Hip joint disorders can emulate sciatica symptoms
Because the sciatic nerve is close to the hip joint, an injury to the hip could resemble symptoms of sciatica. Whatever the cause of the hip injury, those with hip pathology often report pain in the groin, upper thigh, and buttocks. The pain gets worse with activity, specifically bending, and rotation of the hip.
Leg pain that turns into a limp when walking means that more likely the hip, and not the lower back, is the cause of the leg pain. X-rays and if necessary MRIs of the hip can help in determining if the hip is the cause of leg pain. An example of hip pathology that mimics spine-related sciatica:
Hip Osteoarthritis
This is characterized by the loss of cartilage. This results in the narrowing of the ball and socket joint. Individuals with arthritis of the spine and hip, a doctor could use a steroid injection as a therapeutic providing pain relief and a diagnostic to help identify the root cause/pain generator.
Osteonecrosis
The femoral head can collapse from a lack of blood flow. Risk factors include:
Alcohol abuse
Sickle cell disease
Chronic steroid use
Femoral neck fracture
Hip dislocation
Femoroacetabular Impingement
This can stem from constant abnormal rubbing between the femoral neck and acetabulum from a bone deformity of the femur, or the acetabulum. Hip impingement at the joint can start the onset of arthritis along with tears of the labrum. This is cartilage that surrounds the hip joint and provides stability.
Trochanteric Bursitis
There are fluid-filled sacs called bursas/bursae that help decrease friction between the bones, surrounding tendons, and muscles. They are at multiple locations on the body. Bursitis means that the bursa is inflamed and can be quite painful. The greater trochanter is a bony outward bump that extends from the femur. Trochanteric bursitis refers to inflammation of the bursa that separates the greater trochanter with the muscles and tendons of the thigh. Common symptoms are pain on the outside of the thigh that worsens by pressing on the area and can interfere with proper sleep when lying on the affected side.
Femoral Neck Stress Fracture
Incomplete fracture/s of the femoral neck typically occur in individuals that walk or run long distances regularly like runners and soldiers. The pain is usually focused around the groin and can be subtle when it presents. Walking or running makes the pain worse.
Sacroiliac joints and fractures
The sacroiliac joints connect the spine to the pelvis. There are two joints, one on either side of the sacrum. While they are relatively immobile, they go through tremendous force doing routine daily activities. Sacroiliac joint pathology that can mimic spine-related sciatica include:
Sacroiliitis
This is inflammation of the sacroiliac joints. The pain presents in a slow fashion with no obvious injury or cause. The pain is usually localized to the buttocks and can radiate down the back of the thigh. It is believed to be caused by irritation of the sciatic nerve by the inflammatory molecules in the sacroiliac joint or could present as referred pain from the joint. This is pain that is detected in a location other than the area of the pain generator. The pain reduces with light walking.
Sacral Fracture
A fracture of the sacrum can occur in those with a weakened bone after a minor injury and without trauma. Risk factors include:
Advanced age
Osteoporosis
Chronic steroid use
Rheumatoid arthritis
Vitamin D deficiency.
The pain usually localizes in the low back that radiates to the buttocks, or groin, and worsens with activity.
Trauma-related
Trauma to the pelvis or thigh can definitely cause sciatica pain and symptoms. With high-energy injuries, it is possible for the nerve roots of the sciatic nerve to get pulled or torn. More common causes include:
Posterior hip dislocation
Pelvic fracture
The hamstring muscles are in close proximity to the sciatic nerve. A torn hamstring can irritate the sciatic nerve either through direct compression from the localized bleeding known as a hematoma or from an inflammatory response triggered when the injury happened.
Penetrating trauma
If some sharp object like a tool or shrapnel penetrates any area where the sciatic nerve is, it could cause sciatica by cutting the nerve. Or the object tears the nerve, known as a laceration. Most cases of trauma-induced sciatica result from a mild form of nerve injury known as neuropraxia. This is an injury that temporarily blocks nerve function. Neuropraxia can develop from the shock waves that surround the object as it travels through the tissue.
Benign tumors and metastatic cancer
Discovering cancer during diagnosis for sciatica is rare. Symptoms that increase the possibility of cancer being the cause include:
Cancer in medical history
50 years and older
Leg pain that goes on through the night
No relief from lying on the back
Night sweats
Unexplained weight loss
When back pain presents in a subtle fashion without a history of trauma or injury and is not affected by activity or changes in position can also suggest cancer as the cause. Tumors usually cause sciatica by applying direct compression on the nerve. They can be benign or malignant. Tumor/s can arise from the sciatic nerve itself:
Shingles is a painful rash that occurs on one side of the body. It is caused by the varicella-zoster virus, which is the virus that causes chickenpox. The virus can lie dormant in nerve cells for years without causing any symptoms. Older individuals and individuals with underlying conditions in an immunocompromised state can cause the virus to activate. If the virus reactivates around the buttock and thigh, it can feel like sciatica. The presence of a red rash with blisters around the painful area is consistent with shingles.
Childbirth and endometriosis
During pregnancy, the pelvis can become compressed between the growing baby and the bones in the pelvis. Also, having the hips and knees flexed and supported in stirrups too long can also cause sciatica. However, pregnancy-related sciatica is often temporary.
A less common cause that occurs in women is endometriosis. Endometriosis is the growth of tissue somewhere other than the uterus, usually the ovaries and fallopian tubes. In some cases, this tissue can accumulate around the sciatic nerve or the nerve itself. As the tissue responds to the changes taking place during a normal menstrual cycle, recurrent sciatica pain can present.
Vascular diagnoses
Arteries and veins in the pelvis and lower extremities that have become abnormal can cause sciatica. Either through compression or lack of oxygen from poor blood flow. An aneurysm can happen when the wall of the artery weakens and cannot withstand the pressure of the blood flowing through. This enlarges the artery and in some cases, the artery grows large enough to compress the nerve.
Peripheral artery disease can cause sciatica when not enough blood is circulated from the heart to the muscles in the legs. If not enough oxygen is delivered to the muscles, leg pain and numbness can occur. It’s called claudication and is characterized by pain that is aggravated when walking and relieved when standing still. Risk factors for peripheral artery disease include:
Smokers both current and those who have quit
High blood pressure
High cholesterol
Diabetic
Diabetes/high blood sugar
Diabetic peripheral neuropathy happens from nerve damage caused by high blood sugar. Nerves that are exposed to chronic high blood sugar can get damaged from the disruption of proper blood flow or from an alteration of the cellular structure of the nerve.
Prescription meds
Nerve and muscle damage can happen as a side effect from prescription meds. Neuropathy and myopathy can cause symptoms that mimic sciatica brought on by disc herniation. Sometimes, if the medication is no longer taken the symptoms go away. The list of medications include:
Chemotherapy agents
Antibiotics
Statins medication to help lower cholesterol
Piriformis syndrome and back pocket wallets
The piriformis muscle originates on the sacrum, runs through the sciatic notch, shown above, and attaches the top of the femur. The sciatic notch also includes the sciatic nerve. Piriformis syndrome is caused when the piriformis muscle compresses the sciatic nerve. Individuals typically report pain in the buttocks that shoots down the same leg and is made worse when sitting. Piriformis syndrome can be difficult to diagnose, but physical exam maneuvers have been developed in aiding the diagnosis of the syndrome. They involve some form of hip abduction resistance and external rotation to cause a contraction of the piriformis muscle.
Back pocket wallet
Also known as wallet neuritis, and wallet sciatica are terms that have been used to describe compression of the sciatic nerve by a heavy/bulky wallet in a back pocket. It is similar to symptoms of piriformis syndrome and presents in the buttocks and the same leg that can get aggravated from sitting. Usually, if the wallet is the sole cause, taking the wallet from the back pocket to another pocket or other storage option often brings pain relief.
Conclusion non-spine related causes
While the majority of sciatica cases are caused by a back problem, injury, etc. There are various causes outside of the spinal column. Being able to describe the:
Location
Pain severity
Associated symptoms
Factors that aggravate and alleviate the pain
These can absolutely help your doctor, chiropractor, specialist accurately diagnose and generate an optimal customized treatment plan for spine-related or non-spine-related sciatica.
Chiropractors & Sciatica Syndrome Expose
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*
Individuals dealing with back pain or spinal condition that negatively impacts their general health want to know about what they can do to make the pain go away. Back pain and spinal issues that individuals experience can be reduced and alleviated with proper nourishment, exercise, and if necessary chiropractic or physical therapy to keep the body aligned. Fortunately, the majority of these individuals will not need surgery.
In addition to the back pain, they want to know what they can do to prevent the pain from radiating to other areas and becoming chronic. This is where proper nourishment for bone health comes into play. It is now becoming a part of the mainstream media as science and technology are finding the links surrounding body/bone health and how nutrition fits into it all.
We’ve seen and heard about Omega-3 fatty acids for heart health or the importance of fruits and vegetables to help prevent cancer. There is also the nutritional health of the bones and the spine is the largest, not to mention the spinal cord housing all the nerves that establish communication with the body.
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Vitamins
Continual optimal health is based on the body’s vitamin and mineral composition. Many of the beneficial vitamins that keep the bones strong can be found in supplements. However, it is recommended to get into the habit of getting nourishment from real food in combination with supplements. This is because a person can follow a vitamin supplement regimen with no benefits. This is because their diet consists of heavily processed, unhealthy foods. Therefore eating highly nourishing foods is the best way to begin. Here are a few to consider:
Dairy
Dairy can be difficult for individuals with intestinal issues and other autoimmune conditions. It can seem daunting trying to figure out what to get and what to avoid. For those with lactose intolerance avoid dairy products altogether and look to calcium and vitamin D supplements. The quality of the dairy product/s also makes a difference. Therefore make sure it doesn’t have artificial ingredients or sugars. This is essential to keeping dairy as part of a healthy diet.
Offal
Offal is the term for internal organs of animals that are used as food. It offers a massive dose of bone-healthy vitamins. Before saying absolutely not, there are plenty of recipes to consider, remember this is about spinal bone health. Beef, calf, and chicken liver, are examples of high sources of:
Vitamin A, which repairs tissue and contributes to the formation of bone
Vitamin B12 which is important for healthy bone marrow
Vitamin K is necessary for proper absorption of calcium into the bones
Iron is a necessity for healthy cells and muscles that support the spine
Greens
Spinach packs vitamin A and B12. Kale and broccoli are great sources of Vitamin K and Iron. Nutritionists have a saying that goes “the greener the vegetable, the better.” Eating these vegetables in raw form is not for everybody, so find recipes that incorporate them into favorite dishes while adjusting to the flavors.
Oranges
Orange fruits are all great sources of vitamin A essential for repairing damaged tissue and in the formation of strong healthy bones and include:
Nectarines
Cantaloupe
Apricots
Carrots
Sweet potatoes
It does not matter if it is the brain, heart, digestive system, or the spine the body is as healthy as what it consumes. Small dietary changes can generate intense bone protection, especially when it comes to a healthy weight. Obesity and back pain are becoming too common. The condition has been studied extensively and the proof is overwhelming. The body was not designed to carry around this extra weight. Remember the spine is the central support structure and needs to be maintained with proper posture, exercise, and nourishment.
Improve Whole Body Wellness with Functional Foot Orthotics
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*
Essential oils for back pain could be a treatment option as long as they are used correctly. Although their popularity has grown, people are still divided when it comes to their effectiveness. The common questions that arise are, do these plant-based oils have the power to alleviate pain, or are they just a placebo?
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Oils
They are essentially chemicals extracted from various plants. They are aromatic, and as far as chemical compounds go they can easily enter the air allowing for inhalation. Doctors have been asked for their opinions on essential oils. And they agree that they can be effective. However, it is something that is difficult to prove scientifically. Currently, there is not a great deal of research to turn to prove that they work. One reason is that it�s difficult to do this type of study.
But there are some reliable studies. An example is a study found that using essential oils as aromatherapy can significantly reduce pain. Another study found orange oilspecifically to relieve pain. There is more developing research that suggests certain oils applied as a topical agent to the low back, like wintergreen or peppermint, they act as an alternativepain reducer to traditional meds that cause side effects.
Definitely more research needs to be done to become a standard form of care. And they can be it just depends on what it’s for. For example, can they cure cancer? No. Can they help with the symptoms? Yes. Certain oils have anti-inflammatory and muscle-relaxing properties. Patients have reported aromatherapy and oils applied topically has helped them with their pain. But, just like anything, it is different for everybody.
When to use
Back pain/conditions that are appropriate for essential oils would be chronic, low-level pain. With any type of numbness, weakness, bowel/bladder dysfunction, or severe, incapacitating pain, go to the hospital, emergency clinic, etc. If pain symptoms do not improve within three to five days, make an appointment with a doctor, chiropractor, or spine specialist.
Always check with a healthcare physician before starting an essential oil regimen. This is to make sure there are no adverse effects or complications. It is essential to see a doctor or spine specialist making sure a serious condition is not the cause of the back pain. Severe conditions should not be treated with only essential oils. Oils are considered to be a small part of a larger integrative treatment plan. This includes:
Allopathic therapies
Physical therapy
Mind-body
Exercises
Sleep
Anti-inflammatory diet
Use for back pain
Once a doctor clears an individual to use essential oils, adding them to a back-care treatment plan can be done in two ways.
Aromatherapy, with the use of a diffuser to release into the air, allowing for inhalation.
Topical agent in the form of a salve, lotion, or cream, and massaged into the pain area
There are combined aromatic salves and lotions that appeal to patients. An example is an aromatherapy combined with calming lavender oil. Oils that are used to alleviate back pain:
Lavender is an excellent choice as an aromatherapy
Orange
For a topical agent:
Ginger
Camphor
Menthol
Rosemary
Wintergreen
Mint
What to Know
Choosing the topical option means the oil needs to be diluted as undiluted oil can cause a rash or other reaction. They can be diluted with a carrier. This can be almond, avocado, or coconut. Never ingest essential oil. They can be extremely toxic if ingested and should not be used for small children. Used correctly they could help out with back pain issues, ask your doctor or chiropractor if they could be an option.
Lower Back Pain Treatment
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*
A doctor, chiropractor, or physical therapist could recommend therapeutic stretches along with exercises as part of a sacroiliitis or sacroiliac joint pain treatment plan. Sacroiliitis refers to inflammation in one or both of the sacroiliac joints. This could be caused by:
Pregnancy
Injury
Infection
Arthritis
Ankylosing spondylitis
Sacroiliac joint pain is a symptom related to sacroiliac joint dysfunction. The symptoms of sacroiliitis and sacroiliac joint pain can be felt in the lower back, buttocks, hips, and legs. These symptoms can be similar to sciatica and can mimic other lower back disorders.
Some of the stretches and exercises included are common for treatment plans for various low back conditions/problems. Talk with a chiropractor or doctor to get their recommendation prior to starting any exercise or stretching program.
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Stretches
Piriformis stretch
The piriformis muscle extends over the hip and can aggravate the sacroiliac joint when it becomes tight. To help stretch the muscle:
Lie on back with knees bent
Feet flat on the floor
Slowly raise the right leg
Bring the right knee toward chest
Gently pull the leg in until there is a comfortable stretch in the buttock
Exhale during the stretch movement
Hold the stretch for 30 seconds
Lower leg
Repeat on the left leg
Repeat each side 3 times daily, as needed
The stretch helps the muscle fibers to lengthen/elongate and relax.
Trunk rotation
Trunk rotation increases flexibility in the low back and hips. This can help relieve pressure on the sacroiliac joints. To do this stretch:
Lie on back with knees bent
Feet flat on the floor
With knees together
Slowly rotate to one side
Feet, hips, and back should stay on the floor
Hold 3-5 seconds
Move knees to the opposite side
Repeat 5-10 times on each side
Bridge
This is a stretch that strengthens the muscles in the lower back, buttocks, and hips.
Lie on back with arms at side
Knees should be bent, and feet flat on the floor
Slowly raise hips while squeezing buttocks and hamstrings
Hold raised position for 5 seconds
Repeat 10 times
Water Therapy and Yoga Exercises
Aquatics and yoga are a gentle and natural form of exercise that is recommended for staying active. Talk to a doctor before starting any exercise program. Aquatic therapy, known now as hydrotherapy/water therapy, is one of the gentlest forms of exercise and is highly effective.
Exercising in water creates an almost weightless environment without gravity. Hydrotherapy uses the resistance from the water to improve strength and flexibility without straining the muscles. Regular exercise can cause pain by placing added pressure on the sacroiliac joints. Water therapy conditions the spine and hip muscles without generating muscle stress. Another option for individuals with back pain is yoga. The following poses are recommended and beneficial for the sacroiliac joints:
Child�s pose
This pose stretches the hips and thighs and is a great yoga pose for beginners.
Cobra
Cobra pose can help strengthen and stabilize the sacroiliac joints.
Lie flat on the stomach
Hands beneath the shoulders
Slowly push up as far as the arms extend
Bring upper body off the ground
Keep the pelvis and legs on the floor
When extended, be sure low back and buttocks are relaxed
Hold for 15 to 30 seconds
Gently lower to the floor
Triangle pose
Triangle pose helps to strengthen the sacroiliac joints and makes them less susceptible to pain. However, this pose involves twisting, so make sure to do this pose only when the joints are stable and pain-free.
Before stretching and exercise
Before starting any stretching or exercise program, check with a doctor or chiropractor, if the joints are able then the stretching/exercise could begin right away. However, in most cases, a doctor will refer the patient to a physical therapist or chiropractor to create a customized exercise and stretching plan. The therapist will show exactly what activities will strengthen the joints and how to do them properly and safely. These movements can help condition the spinal and abdominal muscles. This can help prevent future episodes of back pain.
If an individual just had surgery for sacroiliac joint pain, the surgeon more than likely prescribed a customized rehabilitation stretching/exercise program. Follow instructions, and get the surgeon�s approval before engaging in anything outside of the plan.
Staying fit safely
When dealing with sacroiliac joint dysfunction or sacroiliitis, physical activity may need to be redefined after treatment. As regular exercise could mean strenuous activity and could do more damage. Exercises like heavy weightlifting, contact sports, and intense biking could place excessive pressure on the joints. A doctor or chiropractor will offer the best stretching and exercises for every individual.
Physical activity combined with gentle stretching and conditioning exercises can effectively reduce low back and hip pain. Talk to a doctor, chiropractor, or physical therapist about incorporating healthy exercise into a daily regimen. For some, the workout might not feel like there’s anything going on, but the effects on the pain will be.
Chiropractic Hip Pain Treatment
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*
Understanding the cause of spinal stenosis is important for accurate diagnosis and in creating a customized optimal treatment plan. The cause of spinal stenosis is categorized as either primary or acquired.
Primary means the stenosis could be congenital or since birth. Some individuals are born with a spinal canal that is narrower than normal. This is a rare occurrence. Signs or symptoms of primary spinal stenosis do not present until adulthood usually around mid-life.
Acquired spinal stenosis can develop as a result of:
Bone overgrowth brought on from wear and tear from osteoarthritis on the spinal bones can form bone spurs, that can grow into the spinal canal.
Paget’s disease is a bone disease that affects adults, and can also cause bone overgrowth in the spine.
Herniated discs – The discs can begin to dry out with age and form cracks or tears letting out the soft inner material creating pressure on the spinal cord or nerves.
The ligaments are tough cords that hold the bones of the spine together. They can become stiff and thickened with age and time. The thick ligaments can then bulge into the spinal canal.
Tumors or abnormal growths can develop inside the spinal cord, in the membranes that cover the spinal cord or inside the space between the cord and vertebrae.
Spinal trauma/injury like automobile accidents, sports, and other trauma can cause dislocations or fractures of the vertebrae. Pieces of bone from a spinal fracture can fall into and damage the spinal canal.
Back surgeryswelling of tissue immediately after can put pressure on the spinal cord or nerves.
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Acquired Spinal Stenosis
The leading cause is wear and tear on the spine due to aging. The most common direct cause is osteoarthritis, where the cartilage that cushions the joints begins to degenerate with age. The cartilage is smooth when brand new. As the body ages, the cartilage can become rough and can wear through completely. This allows the bones to rub against each other. The rubbing produces small bone growths called bone spurs.
Individuals with these symptoms try to limit movement and limit pain from the bones rubbing together. However, individuals can’t stop moving entirely, and less movement reduces the quality of life. The bone spurs can create other types of pain. Inside the spine, the spurs can narrow the spinal canal, which can compress the spinal cord or nerve roots.
Risk factors for osteoarthritis and disc problems include:
Lifting heavy objects without using proper lifting techniques.
This can damage a disc or move the vertebrae out of proper alignment.
Prevention
Spinal stenosis prevention is about practicing lifestyle habits to improve and maintain spinal health. For those with stenosis, regular exercise combined with proper body mechanics will help reduce the risk of the spinal stenosis becoming worse.
Exercise
Exercise, done properly, strengthens and protects the spine from the everyday wear and tear and helps maintain body weight. Being at the proper weight puts less pressure on the spine. Gradually build up the workout sessions until comfortable. General exercise guidelines are to go for 30 minutes a day. This in combination with aerobic activities like walking or swimming and resistance training like yoga or weight lifting. Stretching out regularly is highly recommended as an effective way to lengthen, loosen, and warm up the spinal muscles. Here are some basic back stretches and exercises for spinal stenosis.
Body Mechanics
Proper posture along with proper body mechanics are some of the best ways to prevent stenosis from developing/progressing and ensures the health of the spine. They should be practiced all the time:
Sitting
Standing
Lifting heavy objects
Sleeping
Proper mechanics and posture keep the spine operating at the top level even when doing regular/normal activities. Even though aging is the primary cause of spinal stenosis, does not mean to not be proactive about spinal and general health. Exercise and proper mechanics give the back and neck a strong defense system against cervical or lumbar stenosis that will serve for years.
Chiropractic Care For Auto Accident Injuries
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*
Whiplash injuries very rarely call for surgery. But with those rare occurrences, that are severe cases, surgery is considered appropriate when neck or shoulder pain worsens. Doctors recommend patients go through 4 to 6 weeks of non-surgical treatment. If there is no improvement or the condition is worsening then a doctor could recommend whiplash surgery as the best option.
A spine surgeon will recommend the best procedure for the specific injury. Ask all the questions you have to fully understand the exact process, the outcome, and the recovery time. Surgery is an individual’s decision. The surgeon can recommend it, but the patient has the final say. The procedure depends on what area/s the cervical spine is injured/damaged.
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Disc Herniation
Depending on the type of trauma individuals can rupture or herniate the intervertebral disc/s, located between the vertebrae. This can generate constant pain, numbness, and weakness. With cases like this sometimes removal of the disc is necessary.
A surgeon will remove all or portion of the damaged disc through a process called a discectomy. After the discectomy, a doctor may have to permanently stabilize the area. This is because the spine becomes unstable and can move in abnormal ways. This increases the risk of a serious neurological injury. Therefore a discectomy is usually followed with a re-stabilization of the spine. Spinal stabilization techniques used:
Artificial Disc Replacement
Cervical artificial disc replacement also known as ADR could be performed instead of standard discectomy combined with spinal fusion. An artificial disc is implanted into the empty space following the procedure. Artificial disc replacement preserves or restores movement of the neck.
Fusion and Spinal Instrumentation
This form of spine stabilization can be done on its own or in combination with decompression surgery. The bones in the spine fuse together over time usually several months or longer depending on how the surgeon set up the fusion process. The surgeon will use a bone graft or a biological chemical that stimulates bone growth. A surgeon could use spinal instrumentation. These are:
Interbody device/s
Screws
Rods
Plates
These all are used to increase stability and help fuse the bones properly. The fusion prohibits movement between the vertebrae for long-term stability.
Stenosis
Whiplash surgery could also be necessary if the injury caused the spinal canal in the neck to narrow. Here a cervical corpectomy could be performed to remove part of the vertebra and intervertebral disc/s. This reduces the added pressure on the spinal cord and nerves.
A surgeon could also do a laminectomy or a laminoplasty. Both focus on the lamina, which is the bony plate at the back of each vertebra. The lamina protects the spinal cord and canal. The lamina could also present added pressure on the spinal cord. This is where the surgeon will create extra space for the cord by removing all or part of the lamina. This is a laminectomy.
A laminoplasty re-shapes the lamina to create more room for the spinal cord. If there is a narrowing of the space where the nerve exits the canal, a cervical foraminotomy could be utilized. The foramen is the area where the nerve roots exit the spinal canal. This is removed to allow for more space for the nerves to move through. A larger pathway is less likely to pinch/compress the nerve.
Complications
A doctor will discuss all the potential risks before being asked to sign a surgical consent form. Complications can include:
Injury to the spinal cord, nerves, esophagus, carotid artery, vocal cords
Pain and swelling in the leg veins known as phlebitis
Blood clots in the lung
Urination problems
Complications could lead to more surgery, so make sure there is a complete understanding of the surgery and the risks before proceeding. The final decision is up to the individual.
Whiplash Surgery Recovery
After surgery, things might not be great right away. More than likely individuals are out of bed within 24 hours, and on pain meds for 2 to 4 weeks. Individuals will receive instructions on how to sitting down, and standing up. The body needs time to heal, so the doctor will recommend restricting certain activities that involve moving the neck too much. Avoid sports, twisting, or heavy lifting during recovery. And report any problems like fever increased pain, or infection right away.
Whiplash Massage Therapy
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*
Moderate physical activity for most expectant moms is encouraged for a healthy pregnancy. The CDC warns that bending too much while pregnant could lead to complications. However, moving boxes is not all there is to do. There are plenty of things like cleaning, organizing, packing, showing where to put the boxes, getting food and refreshments, etc.
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Moving during pregnancy
Moving is exciting and stressful at the same time. Questions start to come up like bending, lifting, and wearing a back brace. Here are some tips during your move.
Talk to a doctor
Your doctor or chiropractor should know about the upcoming move giving them an opportunity to help and provide safety tips. If it is during the first trimester it could be stressful for the pregnancy if not careful. Moving during the first three months could cause preterm labor with other possible complications. This does not mean to not move just to make a plan with your doctor for keeping the stress low and avoiding the risk for potential issues.
Questions to ask:
What can I lift while pregnant?
Is there a specific bending technique?
Is lifting during the first trimester safe?
How long should I be on my feet during the move?
Is it safe to go up and down stairs consistently?
Brain fog and planning ahead
This is also known as baby brain or pregnancy brain and is the cognitive slowdown and memory issues that many pregnant women report. If there are issues with general cognitive functioning, fatigue, or other brain fog symptoms, careful planning can help.
Help for pregnancy brain fog:
Create detailed lists and save them to your phone or location where they won�t get lost.
Sleep a lot more as being tired will worsen symptoms.
During the move take frequent breaks.
Eat foods with Omega-3, these benefit brain function, and the baby�s development.
Packing fun
Packing the right way can mean all the difference between a smooth move and a chaotic one. It is recommended to allow for a week longer than anticipated for packing. Declutter a month before packing. Then donate, sell, and give away whatever is not needed to lighten the load. Create a moving day kit with a change of clothes, snacks, water, vitamins, a cooling pack, and anything else that a pregnant woman will need.
Having fun during the packing process can be accomplished by turning the tasks into a game or some type of fun activity. Working/dancing with fun music can ease the monotony, keeps the joints loose, proper blood circulation is achieved and the stress is worked out. Light aerobic dancing has shown to decrease the risk of disorders while pregnant, and the recovery time after giving birth.
Get plenty of help
Nobody wants to help family, friends move. Therefore throw a party or some event where everyone will be of the mindset that it was worth helping out. More help is needed during pregnancy because of the added rest times and minimal heavy lifting. If there is not enough help, an investment in professional movers could be necessary. Prices vary depending on where someone lives and the companies available. However, with some research, it can be money well spent while pregnant.
Safety checklist
Create a safety checklist that includes:
Regular water breaks – hydration is extremely important while pregnant, especially if prone to morning sickness.Dehydration symptoms can include:
Doctors generally recommend twenty-five pounds as the threshold during pregnancy. However, it depends on the trimester and what the individual is already used to lifting. An example is a woman lifting something heavy in the third trimester is different than when they were only five weeks. Proper lifting techniques need to be implemented like bending the knees not the back, keep the back straight while doing so, and avoid quick jerking movements.
Proper moving attire
On moving day, wear lightweight, breathable, stretchy clothing, so discomfort and malfunction won’t pop up. Cotton stays cool and free of sweat or itchiness. When pregnant the center of balance shifts, therefore, the right shoes are a must. Here are some shoes that can help during pregnancy.
Don’t rush the nursery
Getting the nursery finished for the baby, creates added pressure. Pretty much all newborns sleep in the same room with their parents, and the American Academy of Pediatrics recommends this for the first months. So cut yourself some slack when it comes to the perfect baby nursery. The baby is not going to hold it against you and there is time after the move to settle in.
Proper rest
This is a stressful time that requires a lot of energy. But just like proper hydration is important, so is plenty of sleep and embrace the positive aspects rather than focus on the complications. Talk to your doctor, enlist plenty of help, drink lots of water, and leave the heavy lifting to those that are not pregnant. At the end of the day, it will all be worth it.
Back Pain During Pregnancy Treatment
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*
Indoors or out, bicycling can be great for an individual’s back with proper preparation. With everything that is going on, many individuals are getting creative with their workouts. Many are turning to home or outdoor exercise. Bicycling is considered a safe activity. According to the NPD Group, bicycle sales have tripled in sales since March.
However, back pain could be affected by a biking routine. Whether a newfound hobby or regular activity, individuals need to prepare and plan ahead before getting out on the trails or on a stationary exercise bike and avoid developing or aggravating back pain. Here are a few essential tips to create a safe and back-healthy bicycling experience.
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Understanding back pain
Bicycling is a type of aerobic exercise that can help with overall health. Done regularly it can improve the heart and lungs’ performance. Other areas of the body like the spine along with the musculoskeletal system, also benefit. For some, it is an even better form of exercise than jogging or aerobics, as it can be less jolting on the body and spine.
Back pain during cycling is rare except when individuals try to push the intensity level beyond their normal workout. If there is back pain from an unknown cause it should be looked into by a doctor, physical therapist, or chiropractor before beginning a regular bicycling regimen.
There are certain spinal conditions where bicycling can benefit. Individuals that bike ride with conditions like degenerative disc disease and lumbar spinal stenosis can experience relief in the back and legs, as it�s an exercise in which flexes the back. But there are spinal instability conditions like spondylolisthesis, that create forward flexion and can worsen back and leg pain. Therefore it is essential to attain a diagnosis before committing to regular bicycling.
Talk to a Doctor
Before starting any exercise program, talk with your doctor to find out if you are healthy enough for this type of therapeutic workout. Those with present back pain issues also need to be cleared by their doctors. But more than likely if they are already following a treatment plan, their doctor would have them doing some form of stretching/exercise as part of their plan, and they just need to find out if riding a bicycle is OK. Once cleared, even with chronic mild back pain an individual can initiate bicycling into their regimen.
Reasonable workout
In addition to safety basics individuals need to:
Wear a helmet
Wear highly-visible clothing
Get their bike serviced for optimal performance
Add reflectors
Add lighting
Have a workout/training plan
As with any exercise, there should be a training plan that will be sustainable and help to avoid injury. Set small goals, especially when beginning. Go for an achievable distance or workout time. Then gradually build up and don’t rush. Allow yourself to go through the experience, learning as much as you can.
Both indoor and outdoor biking require a thorough warm-up and stretching of the body. This definitely includes the spine, that needs some time to loosen up, properly. A healthy comfortable bike seat or saddle with the proper height for body type and inseam is vital. Being uncomfortable while trying to perform therapeutic exercises plus the added possibility of worsening the injury or creating a new one from a stock seat is not worth the risk. At the end of the ride, cooling down is strongly advised.
Pay attention to form/mechanics
When it comes to biking technique, there is no particular form that is ideal or the best.� Always try to be in a position where the spine is comfortable. This type of bicycling is low-impact and should be fluid in motion. Poor posture, jerking motions of the spine, neck, or not using the proper equipment can cause poor mechanics and increase the risk of injury.
Indoor bicycling
Cycling indoors could be safer for individuals that do not have access to safe bicycling areas or are older. Options include spin class or stationary bike. Both are set in a controlled environment with accidents being a rare occurrence. Outdoor biking happens on the road, bike path, sidewalk, or terrain where there is potential for an accident. With the machine or class, individuals can:
Choose the workout type
Fitness level
Intensity
Workout duration
Heart rate
Resistance
Spin classes also follow the pattern with a warmup, a specific workout, and a cool down. However, there are the mental health benefits of being outdoors. Whatever is best for the individual, it is up to them to ride the bike outdoors, indoors, or a combination of both. It is an excellent form of exercise, as it:
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*
Getting workers� compensation for a back/spinal injury can be a daunting and overwhelming task. There are plenty of questions, and we have answers from both medical and legal professionals. Anyone can be affected by back pain at work.
Work-related back injuries can be prevented by paying attention to posture, taking standing/moving breaks, stretching out, and lifting properly. However, if back pain at work stems from a work injury individuals could be entitled to workers� compensation benefits.
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Workers� Compensation
Workers’ compensation is an insurance program that helps with and provides benefits and medical care for workers that have been injured or fallen ill resulting directly from their job. This means if an individual is injured at work, employers have negotiated to free themselves of a majority of the liability by paying for the treatment and recovery.
Companies that employ five-hundred or more are able to manage their own workers� compensation program. However, most workers� compensation programs are managed by state governments. Every state has its own workers� compensation program that employers pay into. The federal government handles the federal workers� compensation program for federal employees. The program is funded by the employer with the cost not affecting an individual’s paycheck.
Workers� Compensation Coverage
Compensation programs are different throughout the country. Typically workers� compensation pays for:
Initial emergency department
Urgent care visit
Diagnostic testing recommended by the emergency department
Follow-up physician
Surgical intervention
Rehabilitation
Under workers� comp back injury treatment/s are completely covered, meaning an individual does not have to meet a deductible or pay premiums, copayments, or coinsurance. Individuals continue to receive regular health insurance benefits from the employer. This could require a deductible, premiums, copays, and coinsurance. This is for the treatment of other health issues while receiving workers� compensation care.
If an individual is unable to work because of a workers’ comp back injury, a worker can expect to be paid a base salary after taxes while being treated. Those whose salary is dependent on overtime creates a disadvantage. Workers� compensation can mean a pay cut for these individuals. Workers� comp pay depends on the state. Usually, there is a wage rate set by the state.
High Risk for Back Injury on the Job
Employees that are involved in physical labor like construction, factory work, and healthcare work have a higher risk of getting a back injury on the job. These injuries are often the result of:
Improper lifting techniques
Repetitively turning
Twisting while lifting
Holding something heavy
Lifting heavy objects above the head
Using the back muscles instead of the hips and legs when lifting bending of the knees and bringing heavy objects close to the core
Truck drivers also have a higher risk of back injuries. Sitting for long periods and reduced physical activity contributes to the back muscles losing their strength, endurance, and cardiovascular ability. Then when unloading the cargo the stress on the spine is doubled.
Injury Report
A back injury should be reported to the supervisor or the company�s human resources department. Depending on the state, there is a statute of limitations to file an injury claim. For example, an individual has one year from the date of injury to file a workers� compensation claim with the supervisor or human resources department. However, it is best to report the injury and seek medical attention as soon as possible after being injured at work. The longer the wait, the more the employer could dispute the legal validity of a workers� compensation claim.
Injury Qualification
If injured at work, assume the injury will be covered by workers� compensation. However, it is not always completely clear. An individual could be injured at a work-related cookout or working from home and trip down the stairs. These are gray areas and are very new as more people working from home. These kinds of workers� comp claims are now starting to be seen. Whatever the event, report injury/s to the employer. If the situation is untraditional, there could be some back and forth with the employer.
Spine Specialist Referal
To receive work comp treatment patients with back injuries will be referred to an occupational therapy clinic. An occupational therapist or clinic will set up the treatment. This could include:
For many that could be enough to get them back to work. If the initial treatments fail an individual could be referred to a spine specialist to set up an optimal treatment plan. A spine specialist could recommend additional therapy, medication, diagnostic imaging, spinal injections, or surgery.
Occupational therapy usually goes on for four to six weeks before the individual is referred to a spine specialist. This all depends on the situation. Individuals can be referred immediately for specific spinal treatment or be told to wait for a specific time. It all depends on the medical situation.
Employer and the Spine Specialist
In most states, employers will request a copy of the treatment plan and spine surgeon�s clinical notes written about the case during office or telemedicine appointments. Doctors have to provide clinic notes and treatment plans to the human resources departments along with the workers� compensation insurance carrier.
Consistent, active communication goes on between the primary doctor, the company�s human resources department, and the insurance carrier. Note that workers� compensation is exempt from HIPAA privacy regulations. Employers and the workers� compensation insurance carrier have access to medical records related to the back injury. But medical information unrelated to the injury is restricted.
Obtaining Workers� Compensation From a Doctor
Generally, no. Obtaining Workers� comp is between the individual and their employer, not the doctor. Sometimes doctors are asked to determine if an individual’s injury/s are work-related. This involves going through medical records but these requests are rare.
Benefits Duration
It depends on the case and where an individual lives. Every state is its own system. In some states, treatment can be ongoing for as long as treatment is needed and is consistent. What is highly recommended is meeting with a workers� compensation attorney in your state when beginning the process to learn your rights and the process. This can help in preventing issues from popping up like an employer pressuring a worker to come back before a doctor has cleared them to return.
Making Most of Workers� Comp
Keep appointments and be compliant with the doctor’s treatment plan and recommendations. Be transparent with the doctor. Not telling them exactly what is happening will not help in their recovery. If there is an improvement from the treatment/s fantastic, but if there are minimal to no improvements be as descriptive as possible about what is happening and what does work. The goal is to work with a clinical team that can get an individual better back to work and normal activities.
Lower Back Bain Pain Chiropractic Relief
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*
There are certain foods that although healthy, for individuals trying to prevent osteoporosis, they could stunt healthy bone growth. There are ways to prevent osteoporosis, and eating a diet rich in calcium and vitamin D is one of them. However, not all foods are beneficial for bone health.
Some nutrients can actually damage bones when consumed in high doses. These foods do not have to be completely removed from an individual’s diet. These foods and nutrients are still important so it would not be healthy to just stop. Individuals with or trying to prevent osteoporosis just need to make adjustments and consume them in moderation.
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Caffeine
Too much caffeine more than four cups of coffee a day decreases calcium absorption, that increases risk for fractures. Coffee and tea contain caffeine naturally, but sodas create even larger concerns. Experts believe that the caffeine content in sodas is not the only danger. It is the substitution of milk and other calcium-based drinks.
Protein
Protein is essential for a balanced diet. This is because it helps build healthy muscle mass. A diet too high in animal protein (beef/pork) as opposed to protein from nuts and grains could contribute to calcium loss. Animal protein/s contain sulfur, that forms acid in the body. Acidic balance is necessary and so the body will release calcium from the bones to neutralize the acid and achieve balance.
What is considered too much protein?
No general amount has been determined. Therefore just an individual’s daily requirement, determined by body weight is what is recommended. Finding out how much protein is needed, take your weight in pounds, and multiply by .37. (Weight/lbs x .37 =) This will tell an individual how many grams they should be consuming every day. There are more specific techniques to get an exact number if need be.
Spinach
Green vegetables are considered some of the best foods to eat when the aim is to strengthen the bones. But spinach can prevent the body from absorbing calcium properly. This is because it contains oxalate. Oxalate interferes with the body’s ability to absorb calcium. Fortunately, spinach can still be included but may need to be adjusted/altered as to how it is prepared. In this case, spinach is best eaten cooked, as the chemical is destroyed through the process.
Salt
Too much salt makes it difficult for the body to keep the calcium, which can cause bone loss. Many processed foods are extremely high in sodium. Therefore, try to eat fresh foods and try sea, Himalayan, or healthy form of salt when seasoning meals.
Pure Wheat Bran
Pure wheat bran is the only food that can lower the absorption of calcium in other foods when eaten together. If taking a calcium supplement the effects of this process can be lessened by taking the supplement a few hours before or after eating foods with pure wheat bran.
These foods don’t have to be eliminated from your diet but should be consumed in moderation. The focus should be on a balanced diet. Building strong bones and maintaining them can be a delicious endeavor. Osteoporosis prevention is not the only benefit of healthy eating habits. A proper diet will promote and generate the optimal function of the body.
Learning About Food Substitutions
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*
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