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Gate Control Theory and Pain Management in El Paso, TX

Gate Control Theory and Pain Management in El Paso, TX

Pain perception varies across different people based on their mood, psychological condition and previous experience, even when pain is brought on by similar physical stimulation and ends in a similar level of damage. In 1965, Ronald Melzack and Patrick Wall summarized a scientific theory about the psychological influence on pain perception; known as the gate control theory.

 

If it wasn’t for this theory, pain perception would still be connected to the intensity of the pain stimulation and the degree of damage caused to the affected tissue. But Melzack and Wall made it clear that pain perception is far more complicated than we believe.

 

Based on the gate control theory, pain signals aren’t free to travel to the brain as soon as they’re generated in the region of the damaged or injured tissues. These first need to encounter specific neural gates found at the level of the spinal cord level, where these gates ascertain whether the pain signals should reach the brain or not. To put it differently, pain is perceived when the gate gives way to the pain signals and it is not as intense or it is not sensed at all when the gate closes for the signs to pass through.

 

This theory provides the explanation for why people find relief by massaging or rubbing a damage, injured or painful site. Although the gate control theory cannot demonstrate the whole picture of the fundamental system which underlies pain, it’s visualized the mechanism of pain perception and it has created a pathway to various pain management treatment approaches.

 

Nerve Fibers in Transmission of Sensory Signals

 

Every organ, or portion of the human body, has its own nerve supply which are in charge of carrying electric impulses generated in reaction to several senses, such as touch, temperature, pressure and pain. These nerves, which make up the peripheral nervous system, transmit these sensory signals, to the central nervous system, or the brain and the spinal cord. These impulses are then translated and perceived as senses. The peripheral nerves send signals to the dorsal horn of the spinal cord and from there, the sensory signals are transmitted into the brain through the spinothalamic tract. Pain is a sensation which alarms a person that a tissue or certain portion of the human body has been damaged or injured.

 

Due to their axonal diameter and their conduction speed, nerve fibers can be categorized into three different types, nerve fibers A, B and C. The C fibers are considered to be the smallest among the three different types. Moreover, there are four subtypes within the A fibers: A-alpha, A-beta, A-gamma and A-delta. From the A fiber subtypes, the A-alpha fibers are the largest and the A-delta fibers are the smallest.

 

Gate Control Theory Diagram 2 | El Paso, TX Chiropractor

 

The A fibers which are larger compared to the A-delta fibers, carry sensations, such as touch, pressure, etc., into the spinal cord. The A-delta fibers as well as the C fibers carry pain signals into the spinal cord. A-delta fibers are faster and carry sharp pain signals while the C fibers are slower and carry diffuse pain signals.

 

When thinking about that the conduction velocity of nerve fibers, the A-alpha fibers, which are the biggest A nerve fibers, have greater conduction speed compared to A-delta fibers and C fibers, which are considered to be the smallest nerve pathways. When a tissue is damaged or injured, the A-delta fibers are activated first, followed by the activation of the C fibers. These nerve fibers have a tendency to carry the pain signals to the spinal cord and then to the brain. However, the pain signals are transmitted through a much more complex process than what is simply explained above.

 

Ascending Tracts | Pain Modulation: Gate Control Theory

 

 

What is the Gate Control Theory of Pain?

 

The gate control theory implies that the sensory signals or impulses which are transmitted by the nerve fibers encounter neural gates at the level of the spinal cord and these will need to get cleared through those gates to reach the brain. Various factors determine how the pain signals ought to be treated in the neurological gates, including:

 

  • The intensity of the pain signals
  • The degree of another sensory signal, such as touch, temperature and pressure, if produced at the site of damage or injury
  • The message from the brain itself to deliver the pain signals or not

 

As previously mentioned, the nerve fibers, both large and small, carrying the sensory signals, end in the dorsal horn of the spinal cord from where the impulses are transmitted into the brain. According to the original postulate of Melzack and Wall, the nerve fibers project to the substantia gelatinosa, or SG, of the dorsal horn and the initial central transmission (T) cells of the spinal cord. The SG consists of inhibitory interneurons that behave as the gate and ascertain which sensory signals should get to the T cells then go further throughout the spinothalamic tract to finally reach the brain.

 

When the pain signals carried by the small nerve fibers, or the A-delta fibers and the C fibers, are somewhat less intense compared to another non-pain sensory signal like touch, temperature and pressure, the inhibitory neurons stop the transmission of the pain signals through the T cells. The non-pain signals override the pain signals and therefore the pain is not perceived by the brain. When the pain signals are somewhat more intense compared to the non-pain signals, the inhibitory neurons are inactivated and the gate is opened. The T cells transmit the pain signals into the spinothalamic tract which carries those impulses to the brain. As a result, the neurological gate is influenced by the relative amount of activity from the large and the small nerve fibers.

 

Gate Control Theory Diagram 1 | El Paso, TX Chiropractor

 

Gate Control Theory Diagram 3 | El Paso, TX Chiropractor

 

How Emotions and Thoughts Affect Pain

 

The gate control theory also suggests that the pain signal transmission could be affected by thoughts and emotions. It’s well known that people do not feel that a chronic pain or, more appropriately, the pain does not disturb them if they concentrate on other activities which interest them. Whereas, people who are depressed or anxious may often feel intense pain and can also find it challenging to cope with. This is due to the fact that the brain sends messages through descending nerve fibers which stop, reduce or enhance the transmission of pain signals through the gate, depending on the emotions and thoughts someone may be going through.

 

Gate Control Theory in Pain Management

 

The gate control theory has caused a radical revolution within the field of pain management. The theory suggested that pain management can be accomplished by influencing the larger nerve fibers that carry non-pain stimulation. The concept has also paved way for more research on cognitive and behavioral strategies to achieve pain relief.

 

Among the most tremendous advances in pain management research is the arrival of Transcutaneous Electrical Nerve Stimulation (TENS). The gate control theory forms the cornerstone of TENS. In this procedure, the selective stimulation of the large diameter nerve fibers taking non-pain sensory stimulation from a particular region nullifies or reduces the impact of pain signals from the region. TENS is a non-invasive and affordable pain control strategy that has been widely used for the treatment of chronic and intractable pain by various healthcare professionals, which may otherwise have been non-responsive to analgesics and surgical interventions. TENS is tremendously advantageous over pain drugs from the aspect that it does not have the problem of medication interactions and toxicity.

 

For instance, many doctors of chiropractic, or chiropractors, utilize TENS and other electrotherapeutic procedures in their practice. These are generally utilized along with spinal adjustments and manual manipulations to increase circulation as well as to aid in the support of chiropractic care. Several other invasive and noninvasive electrical stimulation techniques are discovered to be helpful in several chronic pain conditions such as arthritic pain, diabetic neuropathy, fibromyalgia, etc.. The theory has also been extensively studied in treating chronic back pain and cancer pain. However, favorable results are not attained in some conditions and the long term efficacy of these techniques based on the theory still remains under consideration.

 

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Dr. Alex Jimenez’s Insight

Chiropractic care is widely utilized to benefit patients with chronic pain. Symptoms of persistent pain and discomfort have become a big health issue in the United States where many years of research have found that drugs and/or medications are not necessarily a solution to the problem. The gate control theory, which was first proposed over half a century ago, has offered healthcare professionals new insights on the perception of pain, providing a variety of pain management treatment methods, such as the use of transcutaneous electrical nerve stimulation, or TENS, as well as other electrotherapeutic procedures. Chiropractors can help with pain management through spinal adjustments and manual manipulations, and through the use of TENS.

 

Nevertheless, the gate control theory has radically revolutionized the area of pain research and it has achieved to get numerous studies which aim at presenting a pain-free lifestyle into the patients who suffer from chronic pain. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

 

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Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

 

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EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

Infantile Colic And Chiropractic Treatment | El Paso, TX.

Infantile Colic And Chiropractic Treatment | El Paso, TX.

Infantile Colic: If you have ever cared for an infant with colic, you know how frustrating and helpless it can make you feel. It is so hard to see a little one in such obvious discomfort and you can�t help them no matter what you do. When you have a baby who experiences frequent colic it can be heartbreaking. An infant is so small and they can�t tell you where it hurts or what is wrong; all they can do is cry.

Chiropractic has been proven to help with infantile colic. It can soothe fussy babies and ease the nerves of frazzled parents. Some moms and dads may be a little ambivalent about the idea of having a chiropractor �work� on their baby, but the benefits are incredible � and baby�s comfort is definitely worth it.

What Is Colic?

Colic is a condition that has frustrated parents since the beginning of time. The most prevalent symptom is the severe distress that occurs over predictable periods of time. It is labeled colic when there is no obvious underlying condition that could cause the distress, and occurs in babies that are newborn to 3 months (sometimes up to 6 months), healthy and well fed.

The bouts of crying and distress can last hours, days, or even weeks. Often it seems that there is no way to comfort the baby or provide relief. Symptoms of colic include:

  • Crying that does not seem to have a reason
  • Crying that is intense and indicates obvious distress
  • Crying that occurs at predictable times
  • Changes in posture that include tense abdominal muscles, clenched fists, and curled legs.

What To Expect When You Take Your Infant To A Chiropractor

Some parents may balk at taking their infant to a chiropractor, their minds filled with images of the stereotypical snap, crackle, and pop that is so often associated with the practice. However, infant chiropractic is different and much milder. Chiropractic adjustments for infants are very gentle.

The chiropractor will use his fingers to gently apply pressure to areas on the back and neck. Most babies completely relax as the doctor corrects the misalignments � some even fall peacefully asleep. When you are choosing a chiropractor for your baby, ask if he or she is experienced in working with babies.

infantile colic el paso tx.

How Chiropractic To Treat Colic Works

Childbirth is not a gentle experience. As the baby�s tiny body is compressed and stretched as it is emerging into the world, it can cause the vertebrae of the neck and back to become misaligned. If the delivery included vacuum extraction, forceps, or prolonged pushing, or other things that doctors or midwives must do to assist in delivery, the chances that the baby will experience misalignment are very good.

When these misalignments, called vertebral subluxations, are significant enough, it can impede on how well other major systems in the body are able to function. Digestion is one area that can be greatly impacted and when digestion of formula or breastmilk is compromised it can be the cause of major distress and discomfort for the baby. This can lead to episodes of colic.

Studies That Support How Chiropractic Helps Infantile Colic

There have been several studies that explores the efficacy of chiropractic for colic. The majority of this research has shown that it is a very effective treatment.

A 1999 study published in the Journal of Manipulative and Physiological Therapeutics reported that spinal manipulation for colic is a very effective treatment for the condition. Babies treated using chiropractic experienced a decrease in crying by 67 percent. Babies who received medication experienced a decrease in crying by 38 percent. Another study showed similar results. Chiropractic improved crying behavior in babies that had colic.

Chiropractic is an effective, gentle, and drug free way to treat colic. Babies can thrive and be free of distress and discomfort while mom and dad can get some much needed sleep � and peace of mind.

Injury Medical Clinic: Migraine Treatment & Recovery

Cerebral Palsy And Chiropractic Treatment | El Paso, TX. | Video

Cerebral Palsy And Chiropractic Treatment | El Paso, TX. | Video

Robert “Bobby” Gomez was born with cerebral palsy. Bobby describes how he felt like an outcast, growing up with the disorder, but he explains how much he can accomplish when he’s not underestimated. While Robert Gomez describes experiencing no setbacks due to his cerebral palsy, he suffered from pain and limited mobility. That’s when he decided to seek chiropractic care with Dr. Alex Jimenez and found much more help than he expected. Through spinal adjustments, manual manipulations, and rehabilitation exercises, Robert “Bobby” Gomez has regained some mobility and has experienced decreased pain symptoms. Bobby recommends Dr. Jimenez as the non-surgical choice for back pain and encourages others to educate themselves on cerebral palsy.

Chiropractic Treatment For Cerebral Palsy

 

Cerebral palsy is a permanent movement disorder that appears in early youth. Signs and symptoms vary among people. Symptoms often include poor coordination, stiff muscles, weakness, and tremors. There may be problems with feeling, vision, hearing, swallowing, and talking. Usually, infants with cerebral palsy don’t roll over, sit, walk or crawl as early as other kids of their age. Other symptoms may include seizures and problems with reasoning or thinking, which happen in about one-third of individuals with cerebral palsy. While the symptoms may get more noticeable over the first few years of life, the underlying problems don’t worsen. Cerebral palsy is caused by abnormal development or damage to the areas of the brain that control movement, balance, and posture. Most often, the problems occur during pregnancy; however, they may also happen during childbirth or soon after birth.

cerebral palsy el paso tx.

We are blessed to present El Paso s Premier Wellness & Injury Care Clinic to you.

Our services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are passionately focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities.

Please feel free to subscribe and share if you have enjoyed this video and we have helped you.

Thank You & God Bless.

Dr. Alex Jimenez DC, C.C.S.T

Facebook Clinical Page: https://www.facebook.com/dralexjimenez/

Facebook Sports Page: https://www.facebook.com/pushasrx/

Facebook Injuries Page: https://www.facebook.com/elpasochiropractor/

Facebook Neuropathy Page: https://www.facebook.com/ElPasoNeuropathyCenter/

Facebook Fitness Center Page: https://www.facebook.com/PUSHftinessathletictraining/

Yelp: El Paso Rehabilitation Center: http://goo.gl/pwY2n2

Yelp: El Paso Clinical Center: Treatment: https://goo.gl/r2QPuZ

Clinical Testimonies: https://www.dralexjimenez.com/category/testimonies/

Information:

LinkedIn: https://www.linkedin.com/in/dralexjimenez

Clinical Site: https://www.dralexjimenez.com

Injury Site: https://personalinjurydoctorgroup.com

Sports Injury Site: https://chiropracticscientist.com

Back Injury Site: https://elpasobackclinic.com

Rehabilitation Center: https://www.pushasrx.com

Fitness & Nutrition: http://www.push4fitness.com/team/

Pinterest: https://www.pinterest.com/dralexjimenez/

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Injury Medical Clinic: Herniated Disc Treatment & Recovery

Chiropractic Rehabilitation | El Paso, TX. | Video

Chiropractic Rehabilitation | El Paso, TX. | Video

Malik Decquir is an athlete who has learned how to accomplish anything he sets his mind to through chiropractic rehabilitation. The trainer’s at Push have taught Malik never to give up, always being there to help him achieve his fitness goals and offering nutritional as well as fitness advice when he needs it. Malik Decquir has found tremendous mental and physical support with the trainers at Push.

Chiropractic Rehabilitation

Sports medicine, also referred to as sport and exercise medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to exercise and sports. Although most sports clubs have used team doctors for several years, it is only because the late 20th century that sports medicine has emerged as a distinct field of healthcare in order to help treat sports injuries.

chiropractic rehabilitation el paso tx.We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process.�Our areas of practice include:Wellness & Nutrition, Chronic Pain,�Personal Injury,�Auto Accident Care, Work Injuries, Back Injury, Low�Back Pain, Neck Pain, Migraine Headaches, Sport Injuries,�Severe Sciatica, Scoliosis, Complex Herniated Discs,�Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

If you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and share us.

Thank You & God Bless.

Dr. Alex Jimenez DC, C.C.S.T

Facebook Clinical Page: https://www.facebook.com/dralexjimenez/

Facebook Sports Page: https://www.facebook.com/pushasrx/

Facebook Injuries Page: https://www.facebook.com/elpasochiropractor/

Facebook Neuropathy Page: https://www.facebook.com/ElPasoNeuropathyCenter/

Facebook Fitness Center Page: https://www.facebook.com/PUSHftinessathletictraining/

Yelp: El Paso Rehabilitation Center: http://goo.gl/pwY2n2

Yelp: El Paso Clinical Center: Treatment: https://goo.gl/r2QPuZ

Clinical Testimonies: https://www.dralexjimenez.com/category/testimonies/

Information:

LinkedIn: https://www.linkedin.com/in/dralexjimenez

Clinical Site: https://www.dralexjimenez.com

Injury Site: https://personalinjurydoctorgroup.com

Sports Injury Site: https://chiropracticscientist.com

Back Injury Site: https://elpasobackclinic.com

Rehabilitation Center: https://www.pushasrx.com

Fitness & Nutrition: http://www.push4fitness.com/team/

Pinterest: https://www.pinterest.com/dralexjimenez/

Twitter: https://twitter.com/dralexjimenez

Twitter: https://twitter.com/crossfitdoctor

Injury Medical Clinic: Sport Injury Treatments

What is Central Sensitization? | El Paso, TX Chiropractor

What is Central Sensitization? | El Paso, TX Chiropractor

Central sensitization is a state of the nervous system that’s related to the development and maintenance of chronic pain. When central sensitization occurs, the nervous system goes through a procedure known as wind-up and gets regulated in a constant condition of increased reactivity. This persistent, or regulated, state of reactivity decreases the threshold for what causes pain and subsequently learns to keep pain after the initial injury has healed. Central sensitization has two major characteristics. Both have an increased sensitivity to pain and to the feeling of touch. These are referred to as allodynia and hyperalgesia.

 

Allodynia occurs when an individual experiences pain with circumstances that are normally not supposed to be painful. For instance, chronic pain patients often experience pain even with things as simple as touch or a massage. In these situations, nerves in the region which has been touched sends signals through the nervous system into the brain. Because the nervous system is in a constant condition of heightened reactivity, the brain doesn’t generate a mild feeling of touch as it should, given that the stimulus that initiated it was an easy touch or massage. Instead, the brain produces a feeling of pain and discomfort.

 

Hyperalgesia occurs when a stimulus that’s usually considered to be somewhat painful is perceived as a much more debilitating pain than it ought to be. For instance, chronic pain patients that experience a simple bump, which generally would be mildly painful, will often feel intense pain. Again, once the nervous system is in a constant condition of high reactivity, it amplifies pain.

 

Peripheral and Central Sensitization

 

 

Chronic pain patients sometimes believe they might be suffering from a mental health issue because they understand from common sense that touch or simple bumps produce tremendous amounts of pain or discomfort. Other times, it’s not the patients themselves who feel this way, but their friends and family members. Individuals who don’t suffer with chronic pain may witness others who have central sensitization experience pain at the slightest touch or cry out at the simplest bump. However, because they don’t have the condition, it may be difficult for them to understand what someone who does is going through.

 

In addition to allodynia and hyperalgesia, central sensitization has other well-known features, though they may occur less commonly. Central sensitization may lead to heightened sensitivities throughout all senses, not only the feeling of touch. Chronic pain patients can sometimes report sensitivities to light, smell and sound. As such, regular levels of light may seem overly bright or even the perfume aisle in the department shop can produce a headache. Central sensitization can also be associated with cognitive deficits, such as poor concentration and poor short-term memory. Central sensitization also interferes with increased levels of psychological distress, particularly fear and axiety. After all, the nervous system is responsible for not merely senses, like pain, but also emotions. If the nervous system is trapped in a constant condition of reactivity, patients are going to be nervous or anxious. Lastly, central sensitization is also correlated with sick role behaviors, such as resting and malaise, and pain behavior.

 

Central sensitization has long been known as a potential consequence of stroke and spinal cord injury. However, it is increasingly believed that it plays a part in several different chronic pain disorders. It may happen with chronic low back pain, chronic neck pain, whiplash injuries, chronic tension headaches, migraine headaches, rheumatoid arthritis, osteoarthritis of the knee, endometriosis, injuries sustained in an automobile accident, and even following surgeries. Fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, all appear to occur due to central sensitization as well.

 

Central Sensitization and C Fibers

 

 

What Causes Central Sensitization?

 

Central sensitization involves specific changes to the nervous system. Changes in the dorsal horn of the spinal cord and in the brain occur, particularly at the cellular level, such as at the receptor sites. As mentioned previously, it has long been proven that fractures and spinal cord injuries can cause central sensitization. It stands to reason. Strokes and spinal cord injuries cause harm to the central nervous system, including the brain, in the event of strokes, and the spinal cord, in the case of spinal cord injuries. These injuries change the sections of the nervous system which are involved in central sensitization.

 

However, what about the other, more prevalent, types of chronic pain disorders, recorded above, such as headaches, chronic back pain, or pain in the extremities? The accidents or conditions which lead to these kinds of chronic pain are not direct injuries to the brain or spinal cord. Rather, they include injuries or condition which affect the peripheral nervous system, particularly in that are of the nervous system which lies outside the spinal cord and brain. How can health issues associated with the peripheral nervous system contribute to modifications in the central nervous system and cause chronic pain in the isolated area of the initial injury? In summary, how can isolated migraine headaches eventually become chronic daily headaches? How can an acute low back lifting injury become chronic low back pain? How does an injury to the hand or foot turn into a complex regional pain syndrome?

 

There are probably multiple factors that cause the development of central sensitization in these ‘peripheral’ chronic pain disorders. These variables may be divided into two classes:

 

  • Factors that are associated with the state of the central nervous system before onset of the initial pain or injury condition
  • Factors that are associated with the central nervous system following onset of the initial pain or injury condition

 

The first group involves those factors that might predispose individuals to developing central sensitization once an accident occurs and the next group involves antecedent factors that boost central sensitization once pain begins.

 

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Dr. Alex Jimenez’s Insight

Chronic pain can often modify the way the central nervous system itself functions, so much so that a patient may become more sensitive to pain with less provocation. This is what’s referred to as central sensitization and it generally involves changes in the central nervous system, or CNS, more specifically, in the brain and the spinal cord. Central sensitization has been associated with several common diseases and it’s even been reported to develop with something as simple as a muscle ache. Central sensitization has also been documented to persist and worsen even in the absence of obvious provocation. Several factors have also been attributed with the development of central sensitization, although the true cause is still unknown.

 

Predisposing Factors for Central Sensitization

 

There are probably biological, emotional, and environmental predisposing factors for central sensitization. Low and higher sensitivity to pain, or pain thresholds, are perhaps in part due to numerous genetic factors. While there’s absolutely no research as of yet to support a causal link between pre-existing pain thresholds and following development of central sensitization after an incident, it’s largely assumed that it will be eventually found.

 

Psychophysiological factors, like the stress-response, are also apt to play a part in the development of central sensitization. Direct experimental evidence on animals and humans, as well as prospective studies on humans, have demonstrated a connection between stress and the decrease of pain thresholds. Similarly, different kinds of pre-existing anxiety about pain is consistently related to higher pain sensitivities. All these psychophysiological aspects suggest that the preexisting state of the nervous system is also an important determinant of creating central sensitization after the onset of pain. If the stress response has made the nervous system responsive prior to injury, then the nervous system might be more prone to become sensitized once onset of pain happens.

 

There is considerable indirect evidence for this theory as well. A prior history of anxiety, physical and psychological trauma, and depression are predictive of onset of chronic pain later in life. The most common denominator between chronic pain, anxiety, nervousness, injury, and depression, is the nervous system. They’re all states of the nervous system, especially a persistently changed, or dysregulated, nervous system.

 

It’s not that such pre-existing health issues make individuals more vulnerable to injury or the onset of illness, as injury or illness is apt to happen on a somewhat random basis across the populace. Instead, these pre-existing health issues are more inclined to make people prone to the development of chronic pain once an injury or disease occurs. The dysregulated nervous system, at the time of injury, for instance, may interfere with the normal trajectory of healing and thereby stop pain from subsiding once tissue damage is healed.

 

Factors Resulting in Central Sensitization After Onset of Pain

 

Predisposing factors may also be part of the development of central sensitization. The onset of pain is frequently associated with subsequent development of conditions, such as depression, fear-avoidance, nervousness or anxiety and other phobias. The stress of those responses can, in turn, further exacerbate the reactivity of the nervous system, leading to central sensitization.�Inadequate sleep is also a frequent effect of living with chronic pain. It’s associated with increased sensitivity to pain as well. In what’s technically known as operant learning, interpersonal and environmental reinforcements have long been proven to lead to pain behaviors, however, it is also evident that such reinforcements may lead to the development of central sensitization.

 

Mayo Clinic Discusses Central Sensitization

 

 

Treatments of Central Sensitization

 

Treatments for chronic pain syndromes that involve fundamental sensitization typically target the central nervous system or the inflammation which corresponds with central sensitization. All these often generally include antidepressants and anticonvulsant medications, and cognitive behavioral treatment. While usually not considered to target the central nervous system, regular mild aerobic exercise changes structures in the central nervous system and contributes to reductions in the pain of many ailments which are mediated by central sensitization. As such, moderate aerobic exercise is used to treat chronic pain syndromes marked by central sensitization. Non-steroidal anti-inflammatories are utilized for the inflammation associated with central sensitization.

 

Finally, chronic pain rehabilitation programs are a standard, interdisciplinary treatment that employs each of the above-noted therapy strategies in a coordinated manner. They also make the most of the research on the role of operant learning from central sensitization and also have developed behavioral interventions to reduce the pain and discomfort associated with the health issue. Such applications are typically considered the most effective treatment option for chronic pain syndromes.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

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Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

 

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EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

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References

1.�Phillips, K. & Clauw, D. J. (2011). Central pain mechanisms in chronic pain states � maybe it is all in their head.�Best Practice Research in Clinical Rheumatology, 25, 141-154.

2.�Yunus, M. B. (2007). The role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain.�Best Practice Research in Clinical Rheumatology, 21, 481-497.

3.�Curatolo, M., Arendt-Nielsen, L., & Petersen-Felix, S. (2006). Central hypersensitivity in chronic pain: Mechanisms and clinical implications.�Physical Medicine and Rehabilitation Clinics of North America, 17, 287-302.

4.�Wieseler-Frank, J., Maier, S. F., & Watkins, L. R. (2005). Immune-to-brain communication dynamically modulates pain: Physiological and pathological consequences.�Brain, Behavior, & Immunity, 19, 104-111.

5.�Meeus M., & Nijs, J. (2007). Central sensitization: A biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome.�Clinical Journal of Rheumatology, 26, 465-473.

6. Melzack, R., Coderre, T. J., Kat, J., & Vaccarino, A. L. (2001). Central neuroplasticity and pathological pain.�Annals of the New York Academy of Sciences, 933, 157-174.

7.�Flor, H., Braun, C., Elbert, T., & Birbaumer, N. (1997). Extensive reorganization of primary somatosensory cortex in chronic back pain patients.�Neuroscience Letters, 224, 5-8.

8. O�Neill, S., Manniche, C., Graven-Nielsen, T., Arendt-Nielsen, L. (2007). Generalized deep-tissue hyperalgesia in patients with chronic low-back pain.�European Journal of Pain, 11, 415-420.

9.�Chua, N. H., Van Suijlekom, H. A., Vissers, K. C., Arendt-Nielsen, L., & Wilder-Smith, O. H. (2011). Differences in sensory processing between chronic cervical zygapophysial joint pain patients with and without cervicogenic headache.�Cephalalgia, 31, 953-963.

10.�Banic, B, Petersen-Felix, S., Andersen O. K., Radanov, B. P., Villiger, P. M., Arendt-Nielsen, L., & Curatolo, M. (2004). Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and fibromyalgia.�Pain, 107, 7-15.

11.�Bendtsen, L. (2000). Central sensitization in tension-type headaches � possible pathophysiological mechanisms.�Cephalalgia, 20, 486-508.

12. Coppola, G., DiLorenzo, C., Schoenen, J. & Peirelli, F. (2013). Habituation and sensitization in primary headaches. Journal of Headache and Pain, 14, 65.

13.�Stankewitz, A., & May, A. (2009). The phenomenon of changes in cortical excitability in migraine is not migraine-specific � A unifying thesis.�Pain, 145, 14-17.

14.�Meeus M., Vervisch, S., De Clerck, L. S., Moorkens, G., Hans, G., & Nijs, J. (2012). Central sensitization in patients with rheumatoid arthritis: A systematic literature review.�Seminars in Arthritis & Rheumatism, 41, 556-567.

15.�Arendt-Nielsen, L., Nie, H., Laursen M. B., Laursen, B. S., Madeleine P., Simonson O. H., & Graven-Nielsen, T. (2010). Sensitization in patients with painful knee osteoarthritis.�Pain, 149, 573-581.

16.�Bajaj, P., Bajaj, P., Madsen, H., & Arendt-Nielsen, L. (2003). Endometriosis is associated with central sensitization: A psychophysical controlled study.�The Journal of Pain, 4, 372-380.

17.�McLean, S., Clauw, D. J., Abelson, J. L., & Liberzon, I. (2005). The development of persistent pain and psychological morbidity after motor vehicle collision: Integrating the potential role of stress response systems into a biopsychosocial model.�Psychosomatic Medicine, 67, 783-790.

18.�Fernandez-Lao, Cantarero-Villanueva, I., Fernandez-de-Las-Penas, C, Del-Moral-Avila, R., Arendt-Nielsen, L., Arroyo-Morales, M. (2010). Myofascial trigger points in neck and shoulder muscles and widespread pressure pain hypersensitivity in patients with post-mastectomy pain: Evidence of peripheral and central sensitization.�Clinical Journal of Pain, 26, 798-806.

19.�Staud, R. (2006). Biology and therapy of fibromyalgia: Pain in fibromyalgia syndrome.�Arthritis Research and Therapy, 8, 208.

20. Verne, V. N., & Price, D. D. (2002). Irritable bowel syndrome as a common precipitant of central sensitization.�Current Rheumatology Reports, 4, 322-328.

21.�Meeus M., & Nijs, J. (2007). Central sensitization: A biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome.�Clinical Journal of Rheumatology, 26, 465-473.

22.�Schwartzman, R. J., Grothusen, R. J., Kiefer, T. R., & Rohr, P. (2001). Neuropathic central pain: Epidemiology, etiology, and treatment options.�Archives of Neurology, 58, 1547-1550.

23.�Alexander, J., DeVries, A., Kigerl, K., Dahlman, J., & Popovich, P. (2009). Stress exacerbates neuropathic pain via glucocorticoid and NMDA receptor activation.�Brain, Behavior and Immunity, 23, 851-860.

24. Imbe, H., Iwai-Liao, Y., & Senba, E. (2006). Stress-induced hyperalgesia: Animal models and putative mechanisms.�Frontiers in Bioscience, 11, 2179-2192.

25. Kuehl, L. �K., Michaux, G. �P., Richter, S., Schachinger, H., & Anton F. (2010). Increased basal mechanical sensitivity but decreased perceptual wind-up in a human model of relative hypocortisolism.�Pain, 194, 539-546.

26. Rivat, C., Becker, C., Blugeot, A., Zeau, B., Mauborgne, A., Pohl, M., & Benoliel, J. (2010). Chronic stress induces transient spinal neuroinflammation, triggering sensory hypersensitivity and long-lasting anxiety-induced hyperalgesia.�Pain, 150, 358-368.

27.�Slade, G. D., Diatchenko, L., Bhalang, K., Sigurdsson, A., Fillingim, R. B., Belfer, I., Max, M. B., Goldman, D., & Maixner, W. (2007). Influence of psychological factors on risk of temporomandibular disorders.�Journal of Dental Research, 86, 1120-1125.

28.�Hirsh, A. T., George, S. Z., Bialosky, J. E., & Robinson, M. E. (2008). Fear of pain, pain catastrophizing, and acute pain perception: Relative prediction and timing of assessment.�Journal of Pain, 9, 806-812.

29. Sullivan, M. J. Thorn, B., Rodgers, W., & Ward, L. C. (2004). Path model of psychological antecedents to pain experience: Experimental and clinical findings.�Clinical Journal of Pain, 20, 164-173.

30.�Nahit, E. S., Hunt, I. M., Lunt, M., Dunn, G., Silman, A. J., & Macfarlane, G. J. (2003). Effects of psychosocial and individual psychological factors on the onset of musculoskeletal pain: Common and site-specific effects.�Annals of Rheumatic Disease, 62, 755-760.

31. Talbot, N. L., Chapman, B., Conwell, Y., McCollumn, K., Franus, N., Cotescu, S., & Duberstein, P. R. (2009). Childhood sexual abuse is associated with physical illness burden and functioning in psychiatric patients 50 years of age or older.�Psychosomatic Medicine, 71, 417-422.

32. McLean, S. A., Clauw, D. J., Abelson, J. L., & Liberzon, I. (2005). The development of persistent pain and psychological morbidity after motor vehicle collision: Integrating the potential role of stress response systems into a biopsychosocial model.�Psychosomatic Medicine, 67, 783-790.

33. Hauser, W., Galek, A., Erbsloh-Moller, B., Kollner, V., Kuhn-Becker, H., Langhorst, J… & Glaesmer, H. (2013). Posttraumatic stress disorder in fibromyalgia syndrome: Prevalence, temporal relationship between posttraumatic stress and fibromyalgia symptoms and impact on clinical outcome.�Pain, 154, 1216-1223.

34.�Diatchenko, L., Nackley, A. G., Slade, G. D., Fillingim, R. B., & Maixner, W. (2006). Idiopathic pain disorders � Pathways of vulnerability.�Pain, 123, 226-230.

35.�Azevedo, E., Manzano, G. M., Silva, A., Martins, R., Andersen, M. L., & Tufik, S. (2011). The effects of total and REM sleep deprivation on laser-invoked potential threshold and pain perception.�Pain, 152, 2052-2058.

36. Chiu, Y. H., Silman, A. J., Macfarlane, G. J., Ray, D., Gupta, A., Dickens, C., Morris, R., & McBeth, J. (2005). Poor sleep and depression are independently associated with a reduced pain threshold: Results of a population based study.�Pain, 115, 316-321.

37.�Holzl, R., Kleinbohl, D. & Huse, E. (2005). Implicit operant learning of pain sensitization.�Pain, 115, 12-20.

38. Baumbauer, K. M., Young, E. E., & Joynes, R. L. (2009). Pain and learning in spinal system: Contradictory outcomes from common origins.�Brain Research Reviews, 61, 124-143.

39. Becker, S., Kleinbohl, D., Baus, D., & Holzl, R. (2011). Operant learning of perceptual sensitization and habituation is impaired in fibromyalgia patients with and without irritable bowel syndrome.�Pain, 152, 1408-1417.

40.�Hauser, W., Wolfe, F., Tolle, T., Uceyler, N. & Sommer, C. (2012). The role of antidepressants in the management of fibromyalgia: A systematic review and meta-analysis.�CNS Drugs, 26, 297-307.

41.�Hauser, W., Bernardy, K., Uceyler, N., & Sommer, C. (2009). Treatment of fibromyalgia syndrome with gabapentin and pregabalin � A meta-analysis of randomized controlled trials.�Pain, 145, 169-181.

42. Straube, S., Derry, S., Moore, R. A., & McQuay, H. J. (2010). Pregabalin in fibromyalgia: Meta-analysis of efficacy and safety from company clinical trial reports.�Rheumatology, 49, 706-715.

43. Tzellos, T. G., Toulis, K. A., Goulis, D. G., Papazisis, G., Zampellis, Z. A., Vakfari, A., & Kouvelas, D. (2010). Gabapentin and pregabalin in the treatment of fibromyalgia: A systematic review and meta-analysis.�Journal of Clinical Pharmacy and Therapeutics, 35, 639-656.

44.�Thieme, K. Flor, H., & Turk, D. C. (2006). Psychological pain treatment in fibromyalgia syndrome: Efficacy of operant behavioral and cognitive behavioral treatments.�Arthritis Research & Therapy, 8, R121.

45. Lackner, J. M., Mesmer, C., Morley, S., Dowzer, C., & Hamilton, S. (2004). Psychological treatments for irritable bowel syndrome: A systematic review and meta-analysis.�Journal of Clinical and Consulting Psychology, 72, 1100-1113.

46. Salomons, T. V., Moayedi, M. Erpelding, N., & Davis, K. D. (2014). A brief cognitive-behavioral intervention for pain reduces secondary hyperalgesia. Pain, 155, 1446-1452. doi: 10.1016/j.pain.2014,02.012

47.�Erickson, K. I., Voss., M. W., Prakesh, R. S., et al. (2011). Exercise training increases size of hippocampus and improves memory.�Proceedings of the National Academy of Sciences, 108, 3017-3022.

48. Hilman, C. H., Erickson, K. I., & Kramer, A. F. (2008). Be smart, exercise your heart: Exercise effects on brain and cognition.�Nature Reviews Neuroscience, 9, 58-65.

49.�Busch, A. J., Barber, K. A., Overend, T. J., Peloso, P. M., & Schachter, C. L. (Updated August 17, 2007). Exercise for treating fibromyalgia. In Cochrane Database Reviews, 2007, (4). Retrieved May 16, 2011, from The Cochrane Library, Wiley Interscience.

50.�Fordyce, W. E., Fowler, R. S., Lehmann, J. F., Delateur, B. J., Sand, P. L., & Trieschmann, R. B. (1973). Operant conditioning in the treatment of chronic pain.�Archives of Physical Medicine and Rehabilitation, 54, 399-408.

51. Gatzounis, R., Schrooten, M. G., Crombez, G., & Vlaeyen, J. W. (2012). Operant learning theory in pain and chronic pain rehabilitation.�Current Pain and Headache Reports, 16, 117-126.

52.�Hauser, W., Bernardy, K., Arnold, B., Offenbacher, M., & Schiltenwolf, M. (2009). Efficacy of multicomponent treatment in fibromyalgia syndrome: A meta-analysis of randomized controlled clinical trials.�Arthritis & Rheumatism, 61, 216-224.

53. Flor, H., Fydrich, T. & Turk, D. C. (1992). Efficacy of multidisciplinary pain treatment centers: A meta-analytic review.�Pain, 49, 221-230.

54. Gatchel, R., J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic non-malignant pain.�Journal of Pain, 7, 779-793.

55. Turk, D. C. (2002). Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain.�The Clinical Journal of Pain, 18, 355-365.

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Is It Really Autoimmunity? | El Paso, TX. | Part II

Is It Really Autoimmunity? | El Paso, TX. | Part II

Autoimmunity:�One of the most common things is to leave the doctor�s office with a diagnosis of an autoimmune disease and no nutritional or lifestyle changing insight. Autoimmune diseases are related to inflammation. Keeping� the inflammation down is the goal with autoimmune attacks. The foods you eat make a huge difference in the frequency and severity of flare-ups. Steady dietary changes can help you reach your optimal self.

Is Autoimmune Disease A Result Of The Collective Perturbations Of The Exposome & Its Impact On The Immunometabolic System?

 

autoimmunity el paso tx.

http://science.sciencemag.org/content/330/6003/460.summary?sid=1ab5a992-4406-499c-b24f-6e7a46c1dc95

autoimmunity el paso tx.

The Exposome

autoimmunity el paso tx.

autoimmunity el paso tx.Semin Arthritis Rheum. 2018; 47(5): 710?717.

Exposome Influence On SLE

autoimmunity el paso tx.The Ecology Of The Exposome

autoimmunity el paso tx.Exposome & The Alteration Of �Self�

autoimmunity el paso tx.The Exposome Connections To Autoimmune Diseases Converting Self Into Non?Self

  • Immunometabolic dysfunctions through diet and lifestyle imbalances
  • Gut Ecology and the Microbiome
  • ViralorBacterialInfections
  • Hormones
  • Drugs
  • Chemicals
  • IonizingRadiation
  • PsychologicalStress

autoimmunity el paso tx.FEBS Lett. 2017 Oct;591(19):3119?3134.

autoimmunity el paso tx.Cell. 2018 Jan 11;172(1?2):22?40.

Cross?Talk Among The Endocrine, Immune & Metabolic Systems

autoimmunity el paso tx.Multi?Organ Network Biology

autoimmunity el paso tx.In Autoimmunity, Warburg Metabolism Is Increased Through Increased Activity Of GAPDH

autoimmunity el paso tx.Science. 2018; 360: 377?78. Dietary Influence?

Blocking Immune Cell Glycolysis & �Starving� Its Function

autoimmunity el paso tx.Science. 2018; 360: 449?54.

Ketogenic Diet�s Potential Impact On GAPDH Immunometabolic Regulation

autoimmunity el paso tx.

autoimmunity el paso tx.Cell. 2018 Jan 11;172(1?2):162?175.

autoimmunity el paso tx.Gut Microbes. 2016;7(1):82?9.

autoimmunity el paso tx.

autoimmunity el paso tx.Front Immunol. 2017 Mar 21;8:311.

autoimmunity el paso tx.Origin Of IL?17 Producing Th17 Cells

autoimmunity el paso tx.What Is The Relationship Of The Gut Microbiome To Autoimmune Disease?

autoimmunity el paso tx.

https://www.cell.com/cell/issue?pii=S0092-8674(17)X0006-8

autoimmunity el paso tx.Science. 2018 Mar 9;359(6380):1097?98.

autoimmunity el paso tx.

autoimmunity el paso tx.Science. 2018 Mar 9;359(6380):1156?61.

autoimmunity el paso tx.Allergol Int. 2018 Jan 6;67(1):32?42.

autoimmunity el paso tx.Int J Mol Sci. 2015 Sep 1;16(9):20841?58.

autoimmunity el paso tx.Science. 2018 Mar 9;359(6380):1151?56.

High Fiber Influences On Diabetes In Animal Model

autoimmunity el paso tx.80% Of Patients With Autoimmune Disease Are Female

Why?

Estrogen & Autoimmunity

autoimmunity el paso tx.

  • The greatest association with autoimmune diseases is the female gender
  • 17?beta estradiol seems to play a role in activating T cells in autoimmune disease
  • T cells have ER?alpha receptors that are activated by 17?beta estradiol resulting in the production of inflammatory cytokines
  • Blocking ER?alpha receptors may have a beneficial effect on autoimmune activation

Sci Signal. 2018 Apr 17;11(526). piieaap 9415

Eleanor Rogan, PhD IFM Linus Pauling Award Winner

autoimmunity el paso tx.www.JeffreyBland.com

Estrogen & Androgen Metabolism

autoimmunity el paso tx.4?Hydroxyestrogens & DNA reactivity

autoimmunity el paso tx.

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/22155198

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/21432907

Indole?3?Carbinol (I3C) Inhibition Of ER?Alpha

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/27312859

autoimmunity el paso tx.Relationship Of Hepatic Drug Detoxification To Anti?Nuclear Antibody Development

autoimmunity el paso tx.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.1780240805

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/24763537

autoimmunity el paso tx.Biomed Res Int. 2015;2015:194031.

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365752/

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/18995849

autoimmunity el paso tx.

https://www.ncbi.nlm.nih.gov/pubmed/24530186

Making Friends With Ourselves: Clinical Implications

  • Reduce exposure to agents that activate immunometabolic dysfunction through the exposome
  • � Dietary
  • � Infection
  • � Parasites
  • � Xenobiotics
  • � Hormone
  • � Allergy
  • � Specific medications
  • � Dysbiosis
  • Reduce exposure to DNA damage (radiation, chemicals)
  • Support hepatic detoxification
  • Implement gastrointestinal restoration program
  • Reduce metabolic inflammation and endotoxin
  • Reduce psychological stress factors that activate HPA axis

 

Jeffrey Bland, PhD

Chairman Emeritus & Member, Board of Directors The Institute for Functional Medicine

Integrated Chiro and Rehab El Paso, TX CHiropractor | Video

Integrated Chiro and Rehab El Paso, TX CHiropractor | Video

Integrated: Brian Filidor is an aspiring wrestler who’s had a life-changing experience through chiropractic and agility training with Dr. Alex Jimenez. Over a variety of lifestyle modifications, Brian Filidor has achieved a higher conditioning, including improved performance in his strength, reaction time and overall health. Brian Filidor appreciates the help of all the trainers towards helping him become a better athlete.

Integrated Chiro & Rehab

Physical fitness is a state of health and well-being and, more specifically, the capacity to perform aspects of sports, jobs and daily activities. Physical fitness is usually accomplished through proper nourishment, moderate-vigorous physical exercise, and adequate rest. Fitness is defined as the quality or state of being healthy.

We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process.�Our areas of practice include:Wellness & Nutrition, Chronic Pain,�Personal Injury,�Auto Accident Care, Work Injuries, Back Injury, Low�Back Pain, Neck Pain, Migraine Headaches, Sport Injuries,�Severe Sciatica, Scoliosis, Complex Herniated Discs,�Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

If you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and share us.

Thank You & God Bless.

Dr. Alex Jimenez DC, C.C.S.T

Facebook Clinical Page: https://www.facebook.com/dralexjimenez/

Facebook Sports Page: https://www.facebook.com/pushasrx/

Facebook Injuries Page: https://www.facebook.com/elpasochiropractor/

Facebook Neuropathy Page: https://www.facebook.com/ElPasoNeuropathyCenter/

Facebook Fitness Center Page: https://www.facebook.com/PUSHftinessathletictraining/

Yelp: El Paso Rehabilitation Center: http://goo.gl/pwY2n2

Yelp: El Paso Clinical Center: Treatment: https://goo.gl/r2QPuZ

Clinical Testimonies: https://www.dralexjimenez.com/category/testimonies/

Information:

LinkedIn: https://www.linkedin.com/in/dralexjimenez

Clinical Site: https://www.dralexjimenez.com

Injury Site: https://personalinjurydoctorgroup.com

Sports Injury Site: https://chiropracticscientist.com

Back Injury Site: https://elpasobackclinic.com

Rehabilitation Center: https://www.pushasrx.com

Fitness & Nutrition: http://www.push4fitness.com/team/

Pinterest: https://www.pinterest.com/dralexjimenez/

Twitter: https://twitter.com/dralexjimenez

Twitter: https://twitter.com/crossfitdoctor

Injury Medical Clinic: Sciatica Treatment & Recovery

Is It Really Autoimmunity? | El Paso, TX. | Part I

Is It Really Autoimmunity? | El Paso, TX. | Part I

The western diet is associated with inflammation, and inflammation is central to autoimmunity and autoimmune diseases. Keeping the inflammation down can help in lengthening time between attacks. What to eat and what not to eat are the common questions. In order to quiet� inflammation triggers, educate ourselves and live a normal life is the focus.

Contents

My 2006 Seminar Series

�Understanding the Origins of Autoimmune Disease�

autoimmunity el paso tx.

Autoimmunity:

The Central Question I Asked In This series,

Are We Allergic to Ourselves?

� Autoantibodies

� Are they really �autoantibodies�?

� Self or Non?self?

I would like to re?explore this question using what we have learned in 2018.

autoimmunity el paso tx.www.aarda.org

Endocrine

autoimmunity el paso tx.Endocrine Thyroid

autoimmunity el paso tx.Endocrine?Thyroid

autoimmunity el paso tx.Musculoskeletal

autoimmunity el paso tx.Musculoskeletal & Kidney

autoimmunity el paso tx.Neurological

autoimmunity el paso tx.Autoimmunity

Our Immune system in battle with our self?

autoimmunity el paso tx.Presence of Anti?Chromatin, DNA and RNA Antibodies

autoimmunity el paso tx.

autoimmunity el paso tx.What Biological Processes May Make Self Into Non?Self?

  • Post?translationalmodificationofProtein
    � Glycation of protein
    � Protein Oxidation
    � Amino Acid Conjugation of Protein (Citrullinated Protein/AntiCCP and RA)
  • ProteinSynthesisErrors
  • DNA and RNA Changes
    � Radiation Induced Crosslinking of DNA
    � Oxidation of DNA
    � Copy Errors not corrected by DNA repair process � Epigenetic Changes (the methylome)

Where Do Anti?Cyclic Citrullinated Peptides (AntiCCPs) Come From?

  • Activation of the immune system resulting in increased iNOS production of nitric oxide
  • Arginine residues in proteins can be converted in situ into citrulline with the release of nitric oxide by iNOS
  • The citrulline produced in the protein is now �foreign� and can be recognized by the immune system as such
  • Antibodies can then be produced against this �foreign protein�

Disease Modifying Anti?Rheumatic Drugs (DMARDs)

autoimmunity el paso tx.The Facts on Methotrexate For Rheumatoid Arthritis Treatment

Methotrexate is the most commonly prescribed drug to treat rheumatoid arthritis, yet it only helps about half of those who try it. Find out how it works and how to lessen its side effects.

Folate Inhibition To Block Immune Cell Proliferation

TNF Alpha Blocking Biologicals

autoimmunity el paso tx.

UNASSISTED COST APPROXIMATELY $6000 PER MONTH

autoimmunity el paso tx.

Targeting The Autoimmune Inflammatory Signaling Process With Phytochemicals

autoimmunity el paso tx.Autoantibodies Are Increasing At Least Five Years Before Diagnosis Of SLE

autoimmunity el paso tx.NEJM 2003; 349: 1526?33.

autoimmunity el paso tx.The Argument For Preventing Self From Becoming Non?Self

A Systems Biology Approach To Prevention

autoimmunity el paso tx.NEJM. 2018; 378: 1761?64.
autoimmunity el paso tx.NEJM. 2017; 377: 465?74.
autoimmunity el paso tx.J Autoimmun. 2012; 39(3): 154?60.

Mechanisms By Which Hypomethylated Immune Cells Can Induce Antibodies Associated With SLE

autoimmunity el paso tx.

autoimmunity el paso tx.NEJM. 2018; 378: 1323?34.

Transmitting SNPs Through Behavioral Epigenomics

autoimmunity el paso tx.Science. 2018; 359: 424?28.
autoimmunity el paso tx.The Atlantic March 3, 2017
autoimmunity el paso tx.Frage MF et al. PNAS 2005; July 26: 10604?09.
autoimmunity el paso tx.Environ Health Perspect. 2008; 116(11): 1547?1552.

High Correlation Of POPs With DNA Hypomethylation

autoimmunity el paso tx.Environ Health Perspect. 2008; 116(11): 1547?1552.

 

Jeffrey Bland, PhD

Chairman Emeritus & Member, Board of Directors The Institute for Functional Medicine

Active Release Technique (A.R.T.) for Chronic Neck Pain in El Paso, TX

Active Release Technique (A.R.T.) for Chronic Neck Pain in El Paso, TX

Active Release Technique (A.R.T) is a hands on soft tissue treatment for ligaments, tendons muscles and nerves. It is the leading soft tissue treatment utilized widely in the treatment of soft tissue injuries and conditions among professional athletes and the general population alike. In the instance of chronic neck pain, along with shoulder and subscapularis pain, ART involves guided pressure being applied to a shortened muscle in the top region of the neck or cervical spine. Most commonly, a healthcare professional will move the patient’s head in a direction that lengthens the muscle. During the motion the doctor maintains a strain on the muscle, as it slides out from beneath the doctor’s fingers.

 

The active release technique hurts a bit (many patients describe it as a”good hurt”), and it feels like a stretch that you need but can’t do yourself. When a muscle is tight the procedure operates by increasing the nervous system’s tolerance to extend the muscle. ART is utilized to take care of repetitive strain injuries, and it is often used in a variety of other medical practices. This is because it can offer quick results in treating ailments like: tennis elbow, frozen shoulder, shoulder rotator cuff injuries and plantar fasciitis. ART permits the physician to isolate treatment to each individual small muscle of the neck, and treat it through its full selection of movement. The neck muscles are layered, and also to isolate them during therapy demands careful attention.

 

Effects of the Active Release Technique on Pain and Range of Motion in Patients with Chronic Neck Pain

 

Abstract

 

  • Purpose: To compare the influences of the active release technique (ART) and joint mobilization (JM) on the visual analog scale (VAS) pain score, pressure pain threshold (PPT), and neck range of motion (ROM) of patients with chronic neck pain.
  • Subjects: Twenty-four individuals with chronic neck pain were randomly and equally assigned to 3 groups: an ART group, a joint mobilization (JM) group, and a control group. Before and after the intervention, the degree of pain, PPT, and ROM of the neck were measured using a VAS, algometer, and goniometer, respectively.
  • Results: The ART group and JM group demonstrated significant changes in VAS and ROM between pre and post-intervention, while no significant change was observed in the control group. Significant differences in the PPT of all muscles were found in the ART group, while significant differences in all muscles other than the trapezius were found in the JM group. No significant difference in PPT was observed in any muscle of the control group. The posthoc test indicated no statistically significant difference between the ART and JM group, but the differences of variation in VAS, PPT, and ROM were greater in the ART group than in the JM and control groups.
  • Conclusion: ART for the treatment of chronic neck pain may be beneficial for neck pain and movement.
  • Key words: Active release technique, Soft tissue, Chronic neck pain

 

Introduction

 

People have a 70% likelihood of developing neck pain during their lives; thus, neck pain is an important issue affecting economic productivity in modern society[1]. Neck pain is a work-related musculoskeletal disorder that can occur when a person works for a long time or at a high intensity. An increasing number of patients also visit hospitals complaining of pain occurring not only in the neck but also in the upper extremities and head as a result of sustained excessive tension[2]. Although the issue of neck pain is becoming increasingly common and important, research into optimal treatmentslacking[3].

 

A common cause of neck pain is mechanical dysfunction, which causes abnormal joint movement, as abnormal cervical joint mobility inside the joint capsule can limit neck movement[4, 5]. Additionally, unbalanced soft tissue around the head and neck structure can place limits on the range of motion (ROM) of the head and cause neck pain[6]. Therefore, many treatments are performed with the aim of restoring soft tissue function or mobility to the joints in patients with chronic neck pain. Joint mobilization (JM) and joint manipulation are the most widely used methods to increase mobility inside the joint capsule. These methods have been reported to increase the ROM and relieve pain[7, 8]. However, JM and joint manipulation performed at the end range of the ROM directly on the joints of the cervical vertebrae can cause tension in the patient�s neck muscles, because the cervical vertebrae are the most sensitive part of the spine and this tension protects the nerves and blood vessels[9].

 

The active release technique (ART) is a manual therapy for the recovery of soft tissue function that involves the removal of scar tissue, which can cause pain, stiffness, muscle weakness, and abnormal sensations including mechanical dysfunction in the muscles, myofascia, and soft tissue[10]. The effectiveness of ART has been reported for carpal tunnel syndrome, Achilles tendonitis, and tennis elbow, all of which involve soft tissue near joints in the distal parts of the body[11]. ART is also effective at reducing pain and increasing ROM in patients with a partial tear of the supraspinatus tendon[12]. Most patients with chronic neck pain experience pain and movement limitation as a result of soft tissue impairment in the neck[13]. Accordingly, more research on ART for the treatment of the soft tissues of the neck is warranted. However, no previous studies have assessed how ART can improve ROM in patients with neck pain.

 

Therefore, the purpose of this study was to compare the influence of ART and JM on the visual analog scale (VAS) score, pressure pain threshold (PPT), and neck ROM of patients with chronic neck pain, with the aim of elucidating additional information on their effects and identifying more efficient treatments that can be used in clinical settings.

 

Subjects and Methods

 

The study subjects were 24 patients admitted to Hospital A in Gangnamgu who had a 3-month or longer history of neck pain and had mild disability based on the Neck Disability Index (NDI; 5�14 points). The sample size of this study was based on that of Hyun[14], while considering the subject dropout rate, and accounting for significance level (5%), power of the test (0.8), and the effect size (f=0.7). Patients with structural abnormalities involving bone fracture or nerves those who had undergone surgery for hernia or had high blood pressure, spondyloarthritis, lumbar spinal stenosis, or scoliosis were excluded from the study. The participating patients understood the study purpose and associated information and provided their written consent to participation. This study was conducted using a procedure ethically suitable for human research in accordance with the Declaration of Helsinki.

 

We used the VAS to evaluate the degree of neck pain. The VAS is a subjective scoring method for recording the degree of present pain from 0 (no pain) to 10 (the most severe pain ever experienced) on a 10-cm scale. The VAS is difficult to compare among patients because of the subjective nature of the pain, but its reproducibility has been recognized in individual patients (ICC=0.97)[15].

 

The PPT measurement was performed by one investigator using an algometer. The right and left upper trapezius and sternocleidomastoideus (SCM) were pressed at a constant speed. The subject was asked to respond immediately when the pressure changed to pain, and the mechanical pressure was recorded. The mean value of two measurements was used; increasing PPT values indicate a higher-pressure pain threshold. An algometer is particularly useful for measuring the trigger point in myofacial pain syndrome, because it can determine the precise location of the source pain and quantify the pressure sensitivity of muscles (ICC=0.78�0.93)[16, 17].

 

Passive ROM was measured by fixing the subject�s shoulder so that it was not affected by the other parts of the trunk. Then, neck flexion, extension, right side bending, left side bending, right rotation, and left rotation were measured. The range of the angle was measured with a therapist passively assessing the patient�s pain-free neck-joint ROM[18].

 

The 24 subjects with chronic neck pain included in the study were randomly assigned to one of three groups following an equivalent control group pre-test/post-test design. For 3 weeks, the ART and JM groups received treatment twice per week for 20 minutes. After all the interventions were completed, the VAS score, PPT, and ROM were measured again. In the ART group, ART was used to treat the muscles demonstrating scar tissue, among the muscles involved in neck movement. After shortening based on fiber texture in the longitudinal direction, soft tissue mobilization was performed with active or passive stretching to lengthen the tissue that had been shortened[12].

 

JM was performed using Kaltenborn�s techniques of traction and gliding. In order to relieve pain with physiological movements including flexion, extension, side bending, and rotation, traction at Grade I or II was performed for 10 seconds. Additionally, in order to recover hypomobility, traction and gliding were performed at level 3 and maintained for 7 seconds. Both treatments included 2�3 seconds of rest and were repeated 10 times[19]. Subjects in the control group did not receive any treatment for chronic neck pain.

 

SPSS 18.0 for Windows was used to analyze the results. In order to confirm the homogeneity of subjects� general characteristics and dependent variables, descriptive statistics and the Kruskal-Wallis test were used. The Wilcoxon rank test was performed to assess the difference between pre- and post-treatment values in each group, and the Mann-Whitney U test was used to identify significant differences among the groups. The threshold for statistical significance was chosen as 0.05.

 

Results

 

The extent of change in VAS score, PPT, and ROM was compared between patients with chronic neck pain who underwent ART or JM. Twenty-four patients with a 3-month or longer history of chronic neck pain participated in this study. The three groups demonstrated no significant differences in NDI scores, ages, heights, or weights (p>0.05) (Table 1).

 

ART Table 1 | El Paso, TX Chiropractor

 

The ART and JM groups both demonstrated significant improvements in VAS pain scores (p<0.05), but no significant change was observed in the control group (p>0.05). The PPT significantly increased (p<0.05), in every muscle measured in the ART group, and in all muscles other than the right upper trapezius in the JM group. Muscle PPT demonstrated no significant change in the control group (p>0.05) (Table 2).

 

ART Table 2 | El Paso, TX Chiropractor

 

After treatment, the ART and JM groups both demonstrated significant increases (p<0.05) in every neck joint ROM parameter, while no significant changes were observed in the control group (p>0.05) (Table 2).

 

The extent of change in the VAS pain score and PPT between pre- and post-treatment significantly differed across the three groups (p<0.05). The posthoc test indicated that changes in the VAS scores significantly differed between the ART and control groups, and between the JM and control groups (p<0.05), but not between the ART and JM groups (p>0.05). The changes in PPTs of the right upper trapezius and left SCM significantly differed to between the ART and JM groups (p<0.05); however no significant differences were observed in the other muscles (p>0.05). Between the JM and control groups, the change in right SCM PPT demonstrated a significant difference (p<0.05); however, no difference was observed in other muscles (p>0.05). Between the ART and control group, the change in PPT significantly differed for all the measured muscles (p<0.05). The changes in VAS score and PPT were greater in the ART group than in the JM group, but these differences were not statistically significant (Table 3).

 

ART Table 3 | El Paso, TX Chiropractor

 

The extent of change in ROM after the treatments significantly differed across the three groups (p<0.05). The posthoc test indicated that the change in ROM significantly differed between the ART and JM groups only in neck flexion (p<0.05), but not in other ROM measurements (p>0.05). There was no significant difference in neck flexion ROM between the JM and control groups (p>0.05), but all other ROM parameters significantly differed between these groups (p<0.05). The ART and control groups significantly differed in terms of the change in ROM for all the parameters measured (p<0.05). The change in ROM was greater in the ART group than in the JM group, but this difference was not reach statistically significant (Table 3).

 

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Dr. Alex Jimenez’s Insight

The following study compared the use of the active release technique (A.R.T.) to the use of joint mobilization to determine the best method for treating chronic neck pain symptoms. As it will be properly described below, the research study concluded that ART and joint mobilizations are both effective as treatment for patients with chronic neck pain, however, the active release technique demonstrated a greater effectiveness for neck pain associated with soft tissue injury. A.R.T. is believed to be a better treatment option for chronic neck pain mainly because soft tissue injuries are believed to be the cause of painful symptoms in 87.5 percent of cases, where ART is performed directly on the area of damage.

 

Discussion

 

Repetitive motions and the use of smart phones and tablets in abnormal head postures can stress the head, neck, and shoulder areas. Additionally, abnormal head posture can cause mechanical dysfunction of the cervical joint, which can lead to pain, fibrosis of soft tissue, adaptive shortening, loss of flexibility, and mechanical deformation reflecting the condition of hypomobility, where there is no movement inside the normal joint capsule[20, 21]. When mechanical dysfunction is present in a vertebra, manual therapy is typically performed, and it can be an effective method of relieving neck pain related to such dysfunction[22]. JM is used to treat joints with hypomobility or progressive limitation of mobility, by identifying a cervical segment with abnormal mobility and irritating the sensory receptors that sense pain, thus eliciting effects on the muscle, which in turn stimulate the muscles to apply force in the appropriate direction[8].

 

After 3 weeks of JM, the VAS, ROM, and PPT values of muscles other than the right upper trapezius demonstrated significant improvements compared to their pre-test values. The PPT also increased in the right upper trapezius, but the difference was not statistically significant. The trapezius is particularly susceptible to damage by repetitive movements of the hand and arm while performing work such as using a computer[23]. Most of the study participants were right-handed and thus performed more movement of the right upper extremity than the left, which may explain why the improvement of the right upper trapezius PPT was not reach statistically significant.

 

ART is a method for treating the soft tissues such as the tendon, nerve, and myofascia, and is performed for repetitive strain injury, acute injury, and functional fixation damage due to abnormal posture maintained over the long term. Furthermore, ART is an effective at resolving adhesion of scar tissue and the soft tissue that causes pain, spasm, muscle weakness, tingling, and other symptoms[11].

 

Robb et al.[24] demonstrated immediate improvement of muscle PPT when ART was used to treat patients with adductor strain. Additionally, in a study by Tak et al.[10], ART treatment for 3 weeks on the gluteus medius of a patient with low back pain for 3 weeks resulted in improvement of the patient�s VAS score and PPT. Although our target area differed from the studies of Tak et al.[10] and Robb et al.[24], significant improvement was observed in the VAS score, PPT, and ROM after using ART to treat the neck muscles in the present study. It is our opinion that these improvements in VAS score and PPT after treatment is the result of decreases in muscle tone after removing scar tissue adherent to soft tissue.

 

In a study by James[25] involving 20 young men with no injury of the lower extremity, hamstring flexibility increased immediately after ART was applied. Similarly, in the present study, ROM significantly increased after ART was applied on the neck for 3 weeks. This finding indicates that scar tissue, which can limit the mobility of soft tissue, can be removed by ART and thus relieve limitations of movement[12].

 

Although no statistically significant difference was detected in many cases, the change in the VAS score, PPT, and ROM demonstrated a consistent trend toward being greater in the ART group than in the JM group. This greater effect may be related to the observation that soft tissue injury is the cause of pain in 87.5% of neck pain cases, and ART is performed directly on the injured soft tissue[13], whereas JM treats the limited area of the joint. This study compared the effect of treatment over a short period of 3 weeks, and thus, it remains unclear how long its effectiveness is maintained. Longerterm follow-up surveys are needed after the cessation of treatment. Additionally, it is difficult to generalize our findings, as the sample sizes were small. In order to reinforce these findings, more research is needed.

 

In conclusion, this study compared the VAS score, PPT, and ROM across 24 subjects with chronic neck pain receiving ART, JM, or no treatment. It revealed that ART and JM both positively affected the VAS score, PPT, and ROM, and that the two methods demonstrated few significant differences in their effects. Thus, ART and JM are both effective for the treatment of patients with chronic neck pain, but ART demonstrated a trend toward greater effectiveness for patients with neck pain involving soft tissue injury. Therefore, ART appears to be a better option for treating patients with chronic neck pain in the clinical setting. Follow-up research involving greater numbers and diversity of subjects with longer terms are needed to expand upon these findings.

 

The purpose of the article above is to present the effectiveness of the active release technique, or ART, towards the management and improvement of chronic neck pain in a clinical setting. Information referenced from the National Center for Biotechnology Information (NCBI). The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

 

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Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

 

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EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

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References
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2.�Hwangbo G:�Analysis of the change of the neck pressure pain threshold in long term computer users.�Int J Contents, 2008,�8: 151�158.
3.�Sarig-Bahat H:�Evidence for exercise therapy in mechanical neck disorders.�Man Ther, 2003,�8: 10�20.[PubMed]
4.�Hyung IH, Kim SS, Lee SY:�The effect of immediate pain and cervical ROM of cervical pain patients on stretching and manipulation.�J Korean Soc Phys Ther, 2009,�21: 1�7.
5.�Oh SG, Yu SH:�Biomechanical changes in lower quadrant after manipulation of low back pain patients with sacroiliac joint dysfunction.�J Korean Soc Phys Ther, 2001,�8: 167�180.
6.�Jull GA, Falla D, Vicenzino B, et al. :�The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain.�Man Ther, 2009,�14: 696�701.�[PubMed]
7.�Ko TS, Jeong UC, Lee KW:�Effects of the inclusion thoracic mobilization into cranio-cervical flexor exercise in patients with chronic neck pain.�J Phys Ther Sci, 2010,�22: 87�91.
8.�Kim DD:�The effects of manipulation and mobilization on NDI and CROM in young adults with mild neck disability.�J Korean Acad Orthop Man Phys Ther, 2010,�16: 53�60.
9.�Jun YW: The effects of upper thoracic joint mobilization technique using Kaltenborn-Evjenth concept on cervicothoracic ROM and pain in patients with chronic neck pain. Graduate school Korea University Master�s Degree, 2012.
10.�Tak SJ, Lee YW, Choi W, et al. :�The effects of active release technique on the gluteus mediusfor pain relief in persons with chronic low back pain.�Physical Therapy Rehabilitation Science, 2013,�2: 27�30.
11.�Brian A, Kamali A, Michael Leahy P: Release Your Pain: Resolving Repetitive Strain Injuries with Active Release Techniques. Pub Group West, 2005, 15�29.
12.�Lee SJ, Park JH, Nam SH, et al. :�Two clinical cases of active release technique with Korean medicine treatment for supraspinatus tendon partial tear.�J CHUNA Man Med Spine Nerves, 2014,�9: 89�101.
13.�Dvord J, Valach L, Schmdt S:�Cervical spine injuries in Swizerland.�Man Med, 1989,�4: 7�16.
14.�Hyun SW: The effects of joint mobilization and conservative physical therapy on the range of motion and pain in patients with cervical pain. Graduate school Kookmin University Master�s Degree, 2003.
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16.�Kim SH, Kwon BA, Lee WH:�Effects of cervical spinal stabilization training in private security on chronic neck pain and cervical function, neck pain, ROM.�Korean Secur Sci Rev, 2010,�25: 89�107.
17.�Cho SH: The effect of myofascial release technique and forward head posture correction exercise on chronic tension-type headache. Graduate school Catholic University of Pusan Doctor�s Degree, 2014.
18.�Jang HJ: Effects of combined exercise program on pain and function and range of motion and fatigability in chronic neck pain. Graduate school University Sahmyook Master�s Degree, 2011.
19.�Kim HJ, Bae SS, Jang C:�The effects of joint mobilization on neck pain.�J Korean Soc Phys Ther, 2003,15: 65�90.
20.�C�t� P, Cassidy JD, Carroll LJ, et al. :�The annual incidence and course of neck pain in the general population: a population-based cohort study.�Pain, 2004,�112: 267�273.�[PubMed]
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24.�Robb A, Pajaczkowski J:�Immediate effect on pain thresholds using active release technique on adductor strains: pilot study.�J Bodyw Mov Ther, 2011,�15: 57�62.�[PubMed]
25.�George JW, Tunstall AC, Tepe RE, et al. :�The effects of active release technique on hamstring flexibility: a pilot study.�J Manipulative Physiol Ther, 2006,�29: 224�227.�[PubMed]
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What is P.N.F. Proprioceptive Neuromuscular Facilitation?

What is P.N.F. Proprioceptive Neuromuscular Facilitation?

Flexibility is critical for athletes and non-athletes alike. It allows people to move freely and easily in their everyday life and can also help prevent injury or aggravated conditions during physical activities. One of the best methods to maximize flexibility is through stretching. However, research suggests that not all stretching techniques are created equal. Proprioceptive neuromuscular facilitation, or P.N.F., stretching is depends on reflexes to produce deeper stretches which increase flexibility.

 

What is P.N.F. stretching?

 

Proprioceptive neuromuscular facilitation (PNF) is a more complex form of endurance training which involves both the stretching and contraction of the muscle group being targeted. PNF stretching was initially developed as a form of rehabilitation, and to that effect, it’s very effective. It’s also great for targeting specific muscle groups, and also, while it helps increase flexibility, it also enhances muscle power.

 

As stated by the International PNF Association, P.N.F. stretching was developed by Dr. Herman Kabat in the 1940’s as a means to take care of neuromuscular ailments, including polio and multiple sclerosis. Proprioceptive neuromuscular facilitation techniques have since gained recognition with healthcare professionals, such as chiropractors, physical therapists and other fitness professionals. Based on research from the University of Queensland, PNF stretching may be the best stretching procedure for increasing range of motion.

 

How Does Proprioceptive Neuromuscular Facilitation Function?

 

While there are multiple PNF stretching techniques, all of these rely on extending a muscle to its own limitation. Doing so causes the inverse myotatic reflex, a protective reflex that calms the muscle to prevent injury. P.N.F. induces the brain to think “I do not need that muscle to rip” and sends a message to let the muscle relax a bit more than it would normally.

 

You know the feeling when you stretch a muscle? It feels great when you stretch it until you move nearer to the end of its range of movement and it starts to feel extremely tight and even painful. It’s similar to a flexible band that does not want to stretch any farther.This is known as the myotatic reflex, which is the human body’s natural method of protecting your muscles from stretching too far. It is possible to conquer this to an extent by gradually extending and exhaling to decrease tension in the muscle.

 

However, proprioceptive neuromuscular facilitation, or PNF, stretching tricks your nervous system into relaxing the myotatic reflex, enabling your muscles to extend further than what’s attainable using a conventional style of stretching. All PNF stretching requires is that you stretch a muscle and then forcefully contract that muscle before stretching it again. As you proceed into the stretch after the contraction, you will be able to stretch farther that you did earlier. This permits you to create more length in the muscle and receives a much greater flexibility benefit from the stretch. P.N.F. stretching consists of several techniques which can help achieve the same effect as described above.

 

PNF Diagram 1 | El Paso, TX Chiropractor

 

Mechanics of Stretching Diagram 1 | El Paso, TX Chiropractor

 

Hold-Relax Stretch

 

This type of PNF stretch relies on the concept of autogenic inhibition. By stretching the muscle and after using an isometric contraction of the muscle, it’s possible to decrease the activity (or tone) of the muscle and deceive the myotatic reflex to permit for a more significant stretch. To perform this technique, stretch a muscle as far as you can, remember, it shouldn’t be painful, and then hold the stretch for 10 seconds. Next, contract that muscle as forcefully as possible against an immovable object. Hold this for 5 minutes. Now move into a stretch, using a partner’s assistance if needed, which ought to be deeper than what you attained before. Repeat the stretch-contraction order three times for each muscle.

 

Contract-Relax, Antagonist-Contract Stretch

 

Your system is wired so that two muscles cannot shorten at precisely the exact same time, otherwise they’d fight against one another, and you would not be able to move. So when you consciously contract a muscle, your nervous system automatically sends an indication to the opposing muscle, or antagonist, that it ought to relax so that your joint can proceed. This is called reciprocal inhibition. This variant of PNF benefits from reciprocal inhibition. It resembles the hold-relax stretch but entails a forceful contraction of the opposing muscle to the one being extended in order to move deeper into the stretch.

 

To perform this technique, stretch a muscle as far as you can, again, remember it shouldn’t be painful, and hold the stretch for 10 seconds. Next, contract that muscle as aggressively as you can against an immovable object, such as your partner’s chest. Hold this for 5 seconds. Now use the opposing muscle to pull yourself back to the stretch. Again for the hamstring stretch, this would be your hip flexors. Your partner won’t have to supply as much assistance as the hold-relax stretch technique, but can give an excess drive and will help you maintain the stretch if needed. Repeat the sequence three times for each muscle.

 

Contract-Relax Stretch

 

Finally, the third type of PNF stretch closely resembles the hold-relax stretch but rather entails contracting the muscle through an active assortment of motion. To perform this technique for a hamstring stretch, for instance, you’d extend the muscle for 10 seconds and slowly lower your leg into a table. Now increase your leg back around 90 degrees and also have a partner move you into the next stretch.

 

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Dr. Alex Jimenez’s Insight

Proprioceptive Neuromuscular Facilitation, or PNF, is a rehabilitation stretching technique used to help increase flexibility as well as improve muscle elasticity. P.N.F. has been demonstrated to have a positive effect on active and passive range of motion because it can increase the length of the muscle and neuromuscular efficiency. Stretching has long been seen as beneficial to enhance performance and decrease risk of injury during physical activities. Proprioceptive neuromuscular facilitation stretching can also improve function and range of motion following an injury. Proper protocol should be followed when performing PNF stretching to attain and maintain the benefits of these techniques.

 

A Word of Caution Regarding PNF Stretching

 

Certain precautions need to be taken when performing proprioceptive neuromuscular facilitation, or PNF, stretches because they can place additional amounts of stress, pressure and/or tension on the targeted muscle group, which can boost the risk of soft tissue injury. To help reduce this risk, it’s important to incorporate a conditioning stage before a maximum, or extreme effort is utilized.

 

Additionally, before undertaking any form of stretching it is extremely important that a comprehensive warm up is completed. Warming up prior to stretching does a variety of valuable things, but mainly its objective is to prepare the body and mind for more strenuous physical activities. Among the ways it accomplishes this is by helping to increase the body’s core temperature whilst also increasing the body’s muscle dimensions. This is imperative to ensure the maximum benefit is obtained from your stretching. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

 

blog picture of cartoon paperboy big news

 

EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

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