For individuals suffering from neck pain and headaches, can craniosacral head massage therapy help provide relief?
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Craniosacral Therapy
Craniosacral therapy is a gentle massage to release fascia or connective tissue network tension. The therapy is not new but has gained new attention because of the public interest in natural pain treatments and therapies. Studies are limited, but clinical research is ongoing to see if the therapy can become a mainstream treatment option. The therapy aims to alleviate the symptoms of various health ailments and conditions, including:
By relieving compression in the lower back, head, and spinal column, cerebrospinal fluid circulation is restored, and the body rhythms within the nervous system are reset. This provides pain relief, lowers stress, and improves overall well-being.
The focus areas are those along the fascia, the connective tissue that holds organs, blood vessels, bones, nerve fibers, and muscles in place. By working this tissue through gentle-pressure massage, practitioners help to calm the fight-or-flight response by relaxing the sympathetic nervous system. The symptoms will determine what areas of the body necessitate craniosacral therapy. Individuals with headaches will be given a head or neck massage. Other areas involved in craniosacral therapy include: (Heidemarie Haller, Gustav Dobos, and Holger Cramer, 2021)
Back
Around the spinal column.
Other areas like the joints or muscles.
The pressure applied during craniosacral therapy is light and not the same as a deep tissue massage.
The parasympathetic and sympathetic nervous systems control various body responses.
The parasympathetic nervous system supports proper rest and digestive functions, and the sympathetic nervous system regulates the body’s fight-or-flight response. (Cleveland Clinic. 2022)
Therapy Techniques
The massage techniques used in craniosacral therapy rely on low pressure intended to be as gentle as possible. The fingertips are often used to avoid applying too much pressure. Healthcare providers work the areas between the skull and the bottom of the spine to identify and reset imbalances within the body and the cerebrospinal fluid. If there is an imbalance in cerebrospinal fluid, the massage therapist will reposition the individual or press on the area to release and/or increase circulation. The techniques work to improve the body’s ability to regulate physiological responses. (Heidemarie Haller et al., 2019) During and after the session, individuals may experience different sensations, including: (Biodynamic Craniosacral Therapy Association of North America, 2024)
Relaxation.
Feeling like being in a meditative state.
Sleepiness.
Energized.
Feeling a sense of warmth.
Deeper breathing.
Feeling the body is straighter and taller.
Individuals Who Should Not Receive Craniosacral Therapy
Craniosacral therapy is considered safe; however, some individuals should avoid it or consult a healthcare provider before trying it. Those recommended not to receive the treatment include individuals with the following ailments or disorders:
Concussion or other traumatic brain injuries.
Blood clots.
Brain swelling.
Brain aneurysm – a blood-filled bulge in a blood vessel in or around the brain.
Conditions that cause cerebrospinal fluid buildup.
Treatment
Craniosacral therapy is offered by several healthcare providers, including:
Craniosacral therapy licensed massage therapists
Physical therapists
Occupational therapists
Osteopaths
Chiropractors
These professionals know how to perform the massage technique correctly.
Tension Headaches
References
Haller, H., Lauche, R., Sundberg, T., Dobos, G., & Cramer, H. (2019). Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC musculoskeletal disorders, 21(1), 1. doi.org/10.1186/s12891-019-3017-y
Haller, H., Dobos, G., & Cramer, H. (2021). The use and benefits of Craniosacral Therapy in primary health care: A prospective cohort study. Complementary therapies in medicine, 58, 102702. doi.org/10.1016/j.ctim.2021.102702
For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?
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Almond Flour
Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.
Almond Flour and Almond Meal
The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.
Carbohydrates and Calories
A half cup of commercially prepared flour contains about:
The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
The high glycemic index of whole wheat flour is 71, and rice flour is 98.
Using Almond Flour
It is recommended for making gluten-free quick bread recipes, such as gluten-free:
Muffins
Pumpkin bread
Pancakes
Some cake recipes
Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.
Almond Meal
Almond meal can be cooked as polenta or grits such as shrimp and grits.
Cookies can be made gluten-free with almond meal.
Almond meal biscuits can be made, but pay attention to the recipe.
Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.
Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.
Sensitivities
Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.
Making Your Own
It can be made in a blender or food processor.
Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
Add a little at a time and pulse until it is ground into meal.
Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.
Store Bought
Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.
Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. www.anaphylaxis.org.uk/factsheets/
Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. doi.org/10.1093/ajcn/nqab233
“For individuals who want to exercise but have fears or concerns, can understanding what they are scared of help ease their minds?”
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Overcoming Exercise Fears
One reason for the ongoing weight problem is that individuals don’t move around enough, and one reason individuals don’t exercise is fear (Craig M. Hales et al., 2020). For individuals, physical exertion and moving the body to the point of increased heart rate, heavy breathing, and excessive sweating can cause anxiety and be scary when they haven’t done it in a while or have never worked out. Some anxieties and fears individuals may experience include the following:
Looking Foolish
Anything can happen when exercising. When individuals can’t figure out how a machine works or aren’t sure if they’re doing an exercise correctly, falling off a machine or dropping a weight can cause a feeling of foolishness. Knowing how to use machines and weights takes practice. Ask a gym employee or personal trainer for guidance, as educating individuals on doing exercises correctly and safely is their job. And most individuals working out are happy to help as well.
Experiencing Pain
Some avoid exercise, fearing intense pain. Exercise is not supposed to be painful, but it will cause soreness because individuals use muscles that they haven’t used for a while or at all. For instance, the muscles will experience a slight burning sensation when lifting weights. The body reacts to the workout and adapts to exercise. As the body gets stronger, individuals recognize their body’s response and are able to challenge themselves with heavier weights, longer runs, walks, and workouts. When beginning an exercise program, start slow. Some trainers recommend doing slightly less than an individual thinks they can for the first weeks. This helps to build a habit without the risk of burnout.
Injuries
When starting an exercise program, individuals can feel changes all over their bodies, like everything is pulling and tearing apart. Individuals who haven’t exercised much may be unable to distinguish between the normal discomfort from exercising for the first time and pain from an injury. Shin splints, side stitches, or other common side effects may develop from beginning an exercise program. Individuals may need to stop exercising, treat the injury, and start again.
If there are sharp pains in the joints, tearing in the muscles or ligaments, or anything else that doesn’t feel normal, stop and seek medical attention.
Exercise Mindfulness
The body will feel something while exercising, but separating real injury pain from normal sensations is important.
Be aware of how the body feels throughout the workout.
Follow instructions and pay attention to proper form to minimize the risk of injury.
Proper Footwear
Wearing the right workout shoes is a good idea to avoid and prevent injuries.
Invest in a quality pair of shoes to give the body the support it needs.
Proper Form
If lifting weights, one way to sustain an injury is using incorrect form or posture.
If you are unsure how to do the exercises, consult a trainer or gym employee to explain how the machine works.
Warm Up
Jumping into a workout without warming up can lead to injuries that can lead to chronic pain conditions.
If lifting weights, do a little cardiovascular exercise first or a warm-up set with lighter weights.
Workout Within Fitness Levels
Injuries happen when trying to do too much too soon.
Start with a light program.
Work up to more intense and frequent workouts.
For example, if only able to walk for 10 minutes, start there and increase gradually.
Failure
When it comes to exercise, failure can be experienced in different ways, like losing weight, failing to make it through a workout, being unable to stick to an exercise program, etc. This is part of the process, but individuals can overcome exercise fears through perseverance.
Setting the bar too high can become an excuse to quit.
A simple way to deal with this is to set a reachable goal.
Long-term goals can be set to work toward.
Do what you can handle now.
Individuals take risks whenever they do something out of their comfort zone. However, taking risks may be necessary to overcome exercise fears, keep going, and achieve success.
Weight Loss Techniques
References
Hales CM, C. M., Fryar CD, Ogden CL. (2020). Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. Retrieved from www.cdc.gov/nchs/products/databriefs/db360.htm#Suggested_citation
For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?
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Sleep With A Pillow Between The Legs
Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.
The Benefits
Some potential benefits of sleeping with a pillow between the knees.
Reduce Back and Hip Pain
When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.
Reduce Sciatica Symptoms
Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.
Reduce Herniated Disc Symptoms
A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)
Improve Posture
Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)
Increased weight leads to increased pressure on joints.
Significant change in the center of gravity.
Hormonal changes make connective tissues more lax.
Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.
Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.
What Causes Disc Herniation?
References
Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777
Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248
O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4
For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?
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Peppermint
First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.
How It Is Used
Peppermint oil can be taken as a tea or in capsule form.
Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.
For Irritable Bowel Syndrome
Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)
Peppermint extract may increase serum levels of these medications.
It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.
Pregnancy
Peppermint is not recommended for use during pregnancy or by nursing individuals.
It is unknown if it could affect a developing fetus.
It is unknown if it can affect a nursing baby.
How To Use The Herb
It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.
Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
Supplements may contain harmful ingredients or not contain the active ingredient at all.
This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.
It has the potential to worsen certain conditions and should not be used by:
Peppermint was used to treat colic in infants but is not recommended today.
The menthol in the tea may cause infants and small children to choke.
Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. doi.org/10.1186/s12906-018-2409-0
Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. doi.org/10.3399/bjgp18X699101
Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. doi.org/10.1007/s10620-015-3858-7
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. doi.org/10.1097/MCG.0b013e3182a88357
For individuals dealing with eczema, can incorporating acupuncture into a treatment plan help manage and reduce symptoms?
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Acupuncture for Eczema
Eczema is a chronic skin disorder that causes intense itching, dry skin, and rashes. Common treatment options for eczema include:
Moisturizers
Topical steroids
Prescription medications
Some research suggests that acupuncture may also help individuals with eczema. In recent years, researchers have looked at acupuncture as a possible treatment option and found that it can reduce symptoms.
Acupuncture
Acupuncture involves inserting thin metallic needles in specific acupoints in the body. It is believed that by stimulating specific points, the body’s central nervous system activates and releases certain chemicals designed to enable healing. Ailments that are treated using acupuncture include: (Johns Hopkins Medicine. 2024)
Headaches
Back pain
Nausea
Asthma
Osteoarthritis
Fibromyalgia
Treatment
Studies have found that acupuncture could be a treatment option depending on the severity of the condition and the intensity of the itching sensations. (Ruimin Jiao et al., 2020) The needles are placed at various points associated with relieving the condition. These points include: (Zhiwen Zeng et al., 2021)
LI4
Located at the base of the thumb and index finger.
It has been shown to help reduce inflammation and irritation.
LI11
This point is located within the elbow to reduce itchiness and dryness.
LV3
Located on the top of the foot, this point reduces stress on the nervous system.
SP6
The SP6 is on the lower calf above the ankle and can help reduce inflammation, redness, and skin irritation.
SP10
This point is located adjacent to the knee and reduces itchiness and inflammation.
ST36
This point is located below the knee on the back of the leg and is used to improve overall well-being.
Eczema flare-ups are also linked to stress and anxiety. Acupuncture has been shown to reduce anxiety and stress, which can also help relieve eczema symptoms (Beate Wild et al., 2020).
Acupuncture helps repair skin barrier damage or the outer part of the skin designed to protect the body. (Rezan Akpinar, Saliha Karatay, 2018)
Individuals with eczema tend to have a weakened skin barrier; this benefit can also improve symptoms. (National Eczema Association. 2023)
Individuals with eczema often have an overactive immune system contributing to the disorder.
According to research, acupuncture can also help in regulating the immune system. (Zhiwen Zeng et al., 2021)
Risks
Acupuncture is generally considered safe, but there are some risks to be aware of. These risks include: (Ruimin Jiao et al., 2020)
Swelling where the needles are inserted.
Red spots on the skin.
Increased itchiness.
A rash known as erythema – occurs when small blood vessels are injured.
Most studies on acupuncture for eczema show positive results that prove it can aid in relieving symptoms. (SeHyun Kang et al., 2018) (Ruimin Jiao et al., 2020) However, individuals should talk to their healthcare provider to see if it’s a safe option.
Jiao, R., Yang, Z., Wang, Y., Zhou, J., Zeng, Y., & Liu, Z. (2020). The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 38(1), 3–14. doi.org/10.1177/0964528419871058
Zeng, Z., Li, M., Zeng, Y., Zhang, J., Zhao, Y., Lin, Y., Qiu, R., Zhang, D. S., & Shang, H. C. (2021). Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review. Evidence-based complementary and alternative medicine : eCAM, 2021, 9994824. doi.org/10.1155/2021/9994824
Wild, B., Brenner, J., Joos, S., Samstag, Y., Buckert, M., & Valentini, J. (2020). Acupuncture in persons with an increased stress level-Results from a randomized-controlled pilot trial. PloS one, 15(7), e0236004. doi.org/10.1371/journal.pone.0236004
Akpinar R, Karatay S. (2018). Positive Effects of Acupuncture on Atopic Dermatitis. International Journal of Allergy Medications 4:030. doi.org/10.23937/2572-3308.1510030
Kang, S., Kim, Y. K., Yeom, M., Lee, H., Jang, H., Park, H. J., & Kim, K. (2018). Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: A randomized, sham-controlled preliminary trial. Complementary therapies in medicine, 41, 90–98. doi.org/10.1016/j.ctim.2018.08.013
Those experiencing neck pain, stiffness, headache, shoulder and back pain may suffer from a whiplash injury. Can knowing whiplash signs and symptoms help individuals recognize the injury and help healthcare providers develop an effective treatment plan?
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Whiplash Signs and Symptoms
Whiplash is a neck injury that typically occurs after a motor vehicle collision or accident but can happen with any injury that rapidly whips the neck forward and backward. It is a mild to moderate injury of the neck muscles. Common whiplash signs and symptoms include:
Some individuals can develop chronic pain and headaches.
The symptoms and treatment depend on the severity of the injury. Treatment can include over-the-counter pain medicines, ice and heat therapy, chiropractic, physical therapy, and stretching exercises.
Frequent Signs and Symptoms
The sudden whipping movement of the head can affect several structures within the neck. These structures include:
Muscles
Bones
Joints
Tendons
Ligaments
Intervertebral discs
Blood vessels
Nerves.
Any or all of these can be affected by a whiplash injury. (MedlinePlus, 2017)
Statistics
Whiplash is a neck sprain that occurs from a fast neck-jerking motion. Whiplash injuries account for more than half of vehicle traffic collision injuries. (Michele Sterling, 2014) Even with a minor injury, the most frequent symptoms include: (Nobuhiro Tanaka et al., 2018)
Neck pain
Next stiffness
Neck tenderness
Limited range of motion of the neck
Individuals can develop neck discomfort and pain shortly after an injury; however, the more intense pain and stiffness typically do not occur right after the injury. Symptoms tend to worsen the next day or 24 hours later. (Nobuhiro Tanaka et al., 2018)
Beginning Symptoms
Researchers have found that approximately more than half of individuals with whiplash develop symptoms within six hours of the injury. Around 90% develop symptoms within 24 hours, and 100% develop symptoms within 72 hours. (Nobuhiro Tanaka et al., 2018)
Whiplash vs. Traumatic Cervical Spine Injury
Whiplash describes a mild to moderate neck injury without significant skeletal or neurological symptoms. Significant neck injuries can lead to fractures and dislocations of the spine that can affect the nerves and spinal cord. Once an individual develops neurological problems associated with a neck injury, the diagnosis changes from whiplash to traumatic cervical spine injury. These differences can be confusing as they are on the same spectrum. To better understand the severity of a neck sprain, the Quebec classification system divides neck injury into the following grades (Nobuhiro Tanaka et al., 2018)
Grade 0
This means there are no neck symptoms or physical examination signs.
Grade 1
There is neck pain and stiffness.
Very few findings from the physical examination.
Grade 2
Indicates neck pain and stiffness
Neck tenderness
Decreased mobility or neck range of motion on physical examination.
Grade 3
Involves muscle pain and stiffness.
Neurologic symptoms include:
Numbness
Tingling
Weakness in the arms
Decreased reflexes
Grade 4
Involves a fracture or dislocation of the bones of the spinal column.
Other Symptoms
Other whiplash signs and symptoms that can be associated with the injury but are less common or only occur with a severe injury include (Nobuhiro Tanaka et al., 2018)
Tension headache
Jaw pain
Sleep problems
Migraine headache
Difficulty concentrating
Reading difficulties
Blurred vision
Dizziness
Driving difficulties
Rare Symptoms
Individuals with severe injuries can develop rare symptoms that often indicate traumatic cervical spine injury and include: (Nobuhiro Tanaka et al., 2018)
Amnesia
Tremor
Voice changes
Torticollis – painful muscle spasms that keep the head turned to one side.
Bleeding in the brain
Complications
Most individual generally recover from their symptoms within a few weeks to a few months. (Michele Sterling, 2014) However, whiplash complications can occur, especially with severe grade 3 or grade 4 injuries. The most common complications of a whiplash injury include chronic/long-term pain and headaches. (Michele Sterling, 2014) Traumatic cervical spine injury can affect the spinal cord and be associated with chronic neurological problems, including numbness, weakness, and difficulty walking. (Luc van Den Hauwe et al., 2020)
Treatment
The pain is typically more severe the next day than after the injury. Whiplash musculoskeletal injury treatment depends on whether it is an acute injury or the individual has developed chronic neck pain and stiffness.
Acute pain can be treated with over-the-counter medicines like Tylenol and Advil, which effectively treat the pain.
Advil is a nonsteroidal anti-inflammatory that can be taken with the pain reliever Tylenol, which works in different ways.
The mainstay of treatment is encouraging regular activity with stretching and exercise. (Michele Sterling, 2014)
Physical therapy uses various range of motion exercises to strengthen the neck muscles and relieve the pain.
Chiropractic adjustments and non-surgical decompression can help realign and nourish the spine.
Acupuncture can cause the body to release natural hormones that provide pain relief, help relax the soft tissues, increase circulation, and reduce inflammation. The cervical spine can return to alignment when the soft tissues are no longer inflamed and spasming. (Tae-Woong Moon et al., 2014)
Sterling M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of physiotherapy, 60(1), 5–12. doi.org/10.1016/j.jphys.2013.12.004
Tanaka, N., Atesok, K., Nakanishi, K., Kamei, N., Nakamae, T., Kotaka, S., & Adachi, N. (2018). Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury. Advances in orthopedics, 2018, 4765050. doi.org/10.1155/2018/4765050
van Den Hauwe L, Sundgren PC, Flanders AE. (2020). Spinal Trauma and Spinal Cord Injury (SCI). In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 19. Available from: www.ncbi.nlm.nih.gov/books/NBK554330/ doi: 10.1007/978-3-030-38490-6_19
Moon, T. W., Posadzki, P., Choi, T. Y., Park, T. Y., Kim, H. J., Lee, M. S., & Ernst, E. (2014). Acupuncture for treating whiplash associated disorder: a systematic review of randomised clinical trials. Evidence-based complementary and alternative medicine : eCAM, 2014, 870271. doi.org/10.1155/2014/870271
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
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Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. doi.org/10.2337/dc06-2506
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. doi.org/10.1111/nmo.13986
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Can improving breathing patterns help further fitness and optimize overall health for individuals who walk for exercise?
Contents
Improve Breathing and Walking
Exercising is a moment in which breathing can quicken and become labored if not done correctly. There is a proper way to breathe when exercising, especially when walking or speed walking. Breathing incorrectly causes rapid fatigue and exhaustion. Controlling the flow of one’s breath improves endurance and cardiovascular health, and it can also amplify metabolism, mood, and energy levels. (Hsiu-Chin Teng et al., 2018) Known as diaphragmatic breathing, it is used for those with reduced lung capacity, like individuals with chronic obstructive pulmonary disease/COPD. The practice improves lung capacity and is a recommended way to help relieve stress.
Physiology
During exercise, the oxygen inhaled converts the calories consumed into energy that fuels the body. This process is referred to as metabolism.
When the oxygen supply exceeds the body’s oxygen needs, the body is in an aerobic state. This means there is plenty of oxygen to fuel physical activity/exercise as there are calories to burn.
If the oxygen supply falls short of the body’s oxygen needs, the body falls into an anaerobic state.
Deprived of oxygen, the body turns to stored fuel in the muscles, known as glycogen.
This delivers a powerful burst of energy, but the fuel is quickly spent and fatigue and exhaustion soon follow.
Increasing airflow in and out of the lungs can prevent early exhaustion and help the body burn calories more effectively. (Your lungs and exercise. Breathe 2016)
Improved Breathing Benefits
Optimal breathing starts in infancy. When a baby breathes, their belly rises and falls. This facilitates respiration by pushing and pulling the diaphragm – the muscle that separates the lungs and abdominal cavity. When the baby inhales, the belly extends, pulling the diaphragm downward and allowing the lungs to fill with air. When the baby exhales, the belly draws in, pressing the diaphragm upward and forcing air out. As the body ages and the capacity of the lungs increases, individuals shift from belly-breathing to chest-breathing. Chest breathing involves the chest wall muscles with little use of the diaphragm. Chest breathing usually provides enough air for everyday activity but does not fill the lungs.
This is why individuals resort to mouth-breathing or gasping when the oxygen supply is limited. Even those in decent physical shape may be inadvertently undermining efforts by sucking in their stomach to look thinner, depriving themselves of complete inhalations and exhalations. To overcome this, individuals need to re-train their bodies to activate the abdominal muscles when walking. Belly or diaphragmatic breathing can extend the duration of exercise while strengthening the core muscles. (Nelson, Nicole 2012) By increasing core stability, individuals can better support the spine and maintain a healthy posture when walking. This stabilizes the hips, knees, upper back, and shoulders, making the body less prone to strain, instability, and fatigue from unhealthy posture. (Tomas K. Tong et al., 2014)
Breathing Correctly
The inhalation draws the belly out, pulls the diaphragm down, and inflates the lungs. Simultaneously, it extends the ribcage and lengthens the lower spine. This forces the shoulders and collarbone backward, further opening the chest. Exhaling does the reverse.
Walking
Start by inhaling and exhaling through the nose, ensuring that the inhalation duration matches the exhalation duration. When picking up the pace, individuals can resort to mouth-breathing, maintaining the same inhalation/exhalation rhythm. At no time should breathing be held in. Learning diaphragmatic breathing takes time, but the following steps can be a starting point:
Inhale by inflating the belly fully on a count of five.
Allow the lungs to fill, drawing the shoulders back as this happens.
Exhale by pulling the belly button toward the spine on a count of five.
Use the diaphragm to press the air out of the lungs, keeping the spine erect.
Repeat.
If unable to maintain a count of five, individuals can shorten the count or slow the pace of the walk. Individuals in good shape may be able to extend the count. Initially, diaphragmatic breathing may not come naturally, but it will become automatic with practice. Stop and place the hands over the head if short of breath when walking. Breathe in and out deeply and evenly until breathing returns to normal.
Unlocking Wellness
References
Teng, H. C., Yeh, M. L., & Wang, M. H. (2018). Walking with controlled breathing improves exercise tolerance, anxiety, and quality of life in heart failure patients: A randomized controlled trial. European journal of cardiovascular nursing, 17(8), 717–727. doi.org/10.1177/1474515118778453
Tong, T. K., Wu, S., Nie, J., Baker, J. S., & Lin, H. (2014). The occurrence of core muscle fatigue during high-intensity running exercise and its limitation to performance: the role of respiratory work. Journal of sports science & medicine, 13(2), 244–251.
Nelson, Nicole MS, LMT. (2012). Diaphragmatic Breathing: The Foundation of Core Stability. Strength and Conditioning Journal 34(5):p 34-40, October 2012. | DOI: 10.1519/SSC.0b013e31826ddc07
Can individuals with joint hypermobility find relief through nonsurgical treatments in reducing pain and restoring body mobility?
Contents
Introduction
When a person moves their body, the surrounding muscles, joints, and ligaments are incorporated into various tasks that allow them to stretch and be flexible without pain or discomfort. Many repetitive motions enable the individual to continue their routine. However, when the joints, muscles, and ligaments are stretched farther than normal in the upper and lower extremities without pain, it is known as joint hypermobility. This connective tissue disorder can correlate with other symptoms that affect the body and cause many people to seek treatment to manage joint hypermobility symptoms. In today’s article, we will look at joint hypermobility and how various non-surgical treatments can help reduce pain caused by joint hypermobility and restore body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how their pain may be associated with joint hypermobility. We also inform and guide patients on how integrating various non-surgical treatments can help improve joint function while managing the associated symptoms. We encourage our patients to ask their associated medical providers intricate and insightful questions about incorporating non-surgical therapies as part of their routine to reduce pain and discomfort from joint hypermobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Joint Hypermobility?
Do you often feel your joints locked up in your hands, wrists, knees, and elbows? Do you experience pain and fatigue in your joints when your body feels constantly tired? Or when you stretch your extremities, do they extend farther than usual to feel the relief? Many of these various scenarios are often correlated with individuals experiencing joint hypermobility. Joint hypermobility is an inherited disorder with autosomal dominant patterns that characterize joint hyperlaxity and musculoskeletal pain within the body extremities. (Carbonell-Bobadilla et al., 2020) This connective tissue condition is often related to the flexibility of the connected tissues like ligaments and tendons in the body. An example would be if a person’s thumb is touching their inner forearm without feeling pain or discomfort, they have joint hypermobility. Additionally, many individuals dealing with joint hypermobility will often have a difficult diagnosis as they will develop skin and tissue fragility over time, causing musculoskeletal complications. (Tofts et al., 2023)
When individuals deal with joint hypermobility over time, many often have symptomatic joint hypermobility. They will present with musculoskeletal and systemic symptoms that lead to displaying skeletal deformities, tissue and skin fragility, and structural differences in the body’s system. (Nicholson et al., 2022) Some of the symptoms that joint hypermobility are shown in a diagnosis include:
Muscle pain and joint stiffness
Clicking joints
Fatigue
Digestive issues
Balance issues
Luckily, there are various treatments that many people can use to help restrengthen the surrounding muscles around the joints and reduce the correlating symptoms caused by joint hypermobility.
Movement As Medicine-Video
Nonsurgical Treatments For Joint Hypermobility
When dealing with joint hypermobility, many individuals need to seek treatments to reduce the correlating pain-like symptoms of joint hypermobility and help relieve the body’s extremities while restoring mobility. Some excellent treatments for joint hypermobility are non-surgical therapies that are non-invasive, gentle on the joints and muscles, and cost-effective. Various non-surgical treatments can be customized for the individual depending on how severe their joint hypermobility and comorbidities affect the person’s body. Non-surgical treatments can relieve the body from joint hypermobility by treating the causes of the pain through reduction and maximizing functional capacity and restoring a person’s quality of life. (Atwell et al., 2021) The three non-surgical treatments that are excellent for reducing pain from joint hypermobility and helping strengthen the surrounding muscles are below.
Chiropractic Care
Chiropractic care utilizes spinal manipulation and helps restore joint mobility in the body to reduce the effects of joint hypermobility by stabilizing the affected joints from the hypermobile extremities. (Boudreau et al., 2020) Chiropractors incorporate mechanical and manual manipulation and various techniques to help many individuals improve their posture by being more mindful of their bodies and work with multiple other therapies to emphasize controlled movements. With other comorbidities associated with joint hypermobility, like back and neck pain, chiropractic care can reduce these comorbidity symptoms and allow the individual to regain their quality of life.
Acupuncture
Another non-surgical treatment that many individuals can incorporate to reduce joint hypermobility and its comorbidities is acupuncture. Acupuncture utilizes small, thin, solid needles that acupuncturists use to block pain receptors and restore the body’s energy flow. When many individuals are dealing with joint hypermobility, their extremities in the legs, hands, and feet are in pain over time, which can cause the body to be unstable. What acupuncture does is help reduce the pain caused by joint hypermobility associated with the extremities and restore balance and functionality to the body (Luan et al., 2023). This means that if a person is dealing with stiffness and muscle pain from joint hypermobility, acupuncture can help rewire the pain by placing the needles in the body’s acupoints to provide relief.
Physical Therapy
Physical therapy is the last non-surgical treatment many people can incorporate into their daily routine. Physical therapy can help manage joint hypermobility that are tailored to help strengthen weak muscles that are surrounding the affected joints, improving a person’s stability and helping reduce the risk of dislocation. Additionally, many individuals can use low-impact exercise to ensure optimal motor control when doing regular exercises without putting excessive strain on the joints. (Russek et al., 2022)
By incorporating these three non-surgical treatments as part of a customized treatment for joint hypermobility, many individuals will begin to feel a difference in their balance. They will not experience joint pain by being more mindful of the body and incorporating small changes in their routine. Even though living with joint hypermobility can be a challenge for many individuals, by integrating and utilizing the right combination of non-surgical treatments, many can begin to lead active and fulfilling lives.
References
Atwell, K., Michael, W., Dubey, J., James, S., Martonffy, A., Anderson, S., Rudin, N., & Schrager, S. (2021). Diagnosis and Management of Hypermobility Spectrum Disorders in Primary Care. J Am Board Fam Med, 34(4), 838-848. doi.org/10.3122/jabfm.2021.04.200374
Boudreau, P. A., Steiman, I., & Mior, S. (2020). Clinical management of benign joint hypermobility syndrome: a case series. J Can Chiropr Assoc, 64(1), 43-54. www.ncbi.nlm.nih.gov/pubmed/32476667
Carbonell-Bobadilla, N., Rodriguez-Alvarez, A. A., Rojas-Garcia, G., Barragan-Garfias, J. A., Orrantia-Vertiz, M., & Rodriguez-Romo, R. (2020). [Joint hypermobility syndrome]. Acta Ortop Mex, 34(6), 441-449. www.ncbi.nlm.nih.gov/pubmed/34020527 (Sindrome de hipermovilidad articular.)
Luan, L., Zhu, M., Adams, R., Witchalls, J., Pranata, A., & Han, J. (2023). Effects of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with chronic ankle instability: A systematic review and meta-analysis. Complement Ther Med, 77, 102983. doi.org/10.1016/j.ctim.2023.102983
Nicholson, L. L., Simmonds, J., Pacey, V., De Wandele, I., Rombaut, L., Williams, C. M., & Chan, C. (2022). International Perspectives on Joint Hypermobility: A Synthesis of Current Science to Guide Clinical and Research Directions. J Clin Rheumatol, 28(6), 314-320. doi.org/10.1097/RHU.0000000000001864
Russek, L. N., Block, N. P., Byrne, E., Chalela, S., Chan, C., Comerford, M., Frost, N., Hennessey, S., McCarthy, A., Nicholson, L. L., Parry, J., Simmonds, J., Stott, P. J., Thomas, L., Treleaven, J., Wagner, W., & Hakim, A. (2022). Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations. Front Med (Lausanne), 9, 1072764. doi.org/10.3389/fmed.2022.1072764
Tofts, L. J., Simmonds, J., Schwartz, S. B., Richheimer, R. M., O’Connor, C., Elias, E., Engelbert, R., Cleary, K., Tinkle, B. T., Kline, A. D., Hakim, A. J., van Rossum, M. A. J., & Pacey, V. (2023). Pediatric joint hypermobility: a diagnostic framework and narrative review. Orphanet J Rare Dis, 18(1), 104. doi.org/10.1186/s13023-023-02717-2
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