Learn about kyphosis, its causes and symptoms, and treatment approaches to alleviate discomfort and improve posture.
Contents
What Is Kyphosis?
How frequently have you seen that after spending too much time sitting down, your posture has become more hunched? Do you have neck and shoulder strains that are momentarily relieved by stretching? Or do you experience shoulder and back discomfort and tension as a result of bad posture? Frequently, people have experienced musculoskeletal problems that may impact the neck, shoulders, and back—the three most frequent parts of the body. A spinal disorder called kyphosis may result from prolonged hunching. An increase in the forward curve of the spine that affects the thoracic location is known as kyphosis, and it may be brought on by degenerative alterations in the intervertebral discs. (Lam & Mukhdomi, 2025) The development of a hunchback or rounded upper back is a symptom of kyphosis that may impact posture and general musculoskeletal health. Depending on how severe the kyphosis is, the symptoms might vary from severe stiffness and pain to trouble breathing. Finding different treatment choices for this spinal ailment may also be made easier for many people by having a better grasp of the environmental variables that contribute to its development and the symptoms that are connected with it.
Environmental Factors Contributing to Kyphosis
Kyphosis may occur as a result of many environmental factors. This is because a lot of individuals engage in physically demanding activities that put a lot of strain on the spine. On the other hand, kyphosis may occur as a result of the spine’s gradual aging process. Among the environmental elements that cause kyphosis are:
Bad Posture
Living a Sedentary Lifestyle
Overweight Items & Inappropriate Lifting
Osteoporosis
Conditions & Injuries of the Spine
Kyphosis Symptoms & Its Effects on the Musculoskeletal System
Because it may impact both the cervical and thoracic regions of the spine, kyphosis can result in a number of musculoskeletal issues.When kyphosis begins to damage the cervical region, it may result in referred neck pain, which puts more pressure on the soft tissues in the back. This forces the head to cope with a mechanical imbalance, which puts strain on the muscles and creates weariness. (Ogura and others, 2021) At the same time, when kyphosis begins to impact the thoracic spine, other risk factors include poor bone density and dysfunction in the lower extremities in older persons, which may restrict movement. (Lorbergs and others, 2017). Other musculoskeletal problems linked to kyphosis include:
Stiffness & Pain in the Upper Back
Minimal Flexibility & Mobility
Referred pain
Weakness and Muscle Fatigue
Digestive & Breathing Problems
Understanding Long-Lasting Injuries- Video
Treatment Approaches For Kyphosis
If the spinal curvature has become much worse, many people have chosen to undergo surgery to manage the symptoms of kyphosis. Nonetheless, a lot of individuals have chosen nonsurgical treatments since they are less expensive and noninvasive. In order to improve a person’s posture and lessen the difficulties associated with kyphosis, nonsurgical therapies may take many different forms. (Jenkins et al., 2021) When individuals begin using nonsurgical methods to lessen cervical kyphosis, their mobility and postural control will significantly improve. (Oakley and others, 2024)
Chiropractic Care & More
For those with kyphosis, chiropractic adjustments are a non-invasive treatment option that may help reduce pain and realign the spine. The goal of chiropractic therapy is to stretch and strengthen weak, tense muscles while realigning the spine to its natural position. By increasing the range of motion in the neck, chiropractic therapy may alleviate overlapping risk profiles, such as headaches and kyphotic neck discomfort. (Norton and others, 2022) Additionally, in order to avoid a slouched posture, chiropractors may create a personalized treatment plan for those with kyphosis that offers substantial relief from the neck to the back. (Fortner and others, 2017). For those with kyphosis, chiropractic adjustments may provide the following advantages:
Adjustments to the spine may help realign the vertebrae, improve posture, and lessen excessive curvature.
Postural Training: To improve support, chiropractors may provide workouts that build stronger core and back muscles.
Pain management: Spinal decompression methods and manual treatment may ease tense muscles and lessen transferred pain.
Increased Flexibility and Mobility: Mobility exercises and stretching help increase range of motion and avoid stiffness.
Additional Treatments For Kyphosis
In addition to chiropractic treatment, alternative kyphosis management techniques may enhance spinal stability and stop the progression of spine curvature. Among these extra treatments are;
Physical Therapy.
Supporting Postural Ergonomics
Final Thoughts
Although kyphosis may cause pain and suffering, quality of life can be greatly improved with early diagnosis and appropriate therapy. Proactively treating kyphosis may result in improved posture, less discomfort, and more mobility, whether via physical therapy, chiropractic adjustments, or lifestyle changes.
Injury Medical Chiropractic & Functional Medicine Clinic
We associate with certified medical providers who implement the importance of the causes and symptoms of kyphosis. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to reduce the effects of kyphosis from affecting the cervical and thoracic areas. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
References
Fortner, M. O., Oakley, P. A., & Harrison, D. E. (2017). Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics((R)): a case report utilizing a multimodal mirror image((R)) rehabilitation program. Journal of Physical Therapy Science, 29(8), 1475-1480. doi.org/10.1589/jpts.29.1475
Jenkins, H. J., Downie, A. S., Fernandez, M., & Hancock, M. J. (2021). Decreasing thoracic hyperkyphosis – Which treatments are most effective? A systematic literature review and meta-analysis. Musculoskelet Sci Pract, 56, 102438. doi.org/10.1016/j.msksp.2021.102438
Lorbergs, A. L., Murabito, J. M., Jarraya, M., Guermazi, A., Allaire, B. T., Yang, L., Kiel, D. P., Cupples, L. A., Bouxsein, M. L., Travison, T. G., & Samelson, E. J. (2017). Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc, 65(10), 2257-2264. doi.org/10.1111/jgs.15038
Norton, T. C., Oakley, P. A., & Harrison, D. E. (2022). Improving the cervical lordosis relieves neck pain and chronic headaches in a pediatric: a Chiropractic Biophysics((R)) (CBP((R))) case report with a 17-month follow-up. Journal of Physical Therapy Science, 34(1), 71-75. doi.org/10.1589/jpts.34.71
Oakley, P. A., Gage, W. H., Harrison, D. E., & Mochizuki, G. (2024). Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics((R)) case report. Journal of Physical Therapy Science, 36(11), 756-764. doi.org/10.1589/jpts.36.756
Ogura, Y., Dimar, J. R., Djurasovic, M., & Carreon, L. Y. (2021). Etiology and treatment of cervical kyphosis: state of the art review-a narrative review. J Spine Surg, 7(3), 422-433. doi.org/10.21037/jss-21-54
In females, hernia symptoms are often smaller and deeper without a noticeable lump and can mimic gynecological issues, with misdiagnoses being common. Can knowing the risk factors and how female hernias are treated help women get relief?
Contents
Female Hernia
A hernia occurs when an internal structure pushes through a weak spot in the abdominal wall, the muscles, and the tissue covering the front of the torso. The more common include:
Groin hernia, known as an inguinal hernia.
Upper thigh or femoral hernia.
However, a hernia can develop anywhere from the ribcage to the upper thigh. Hernias are less common in women, have different symptoms than in men, and are often misdiagnosed. Lower abdominal and pelvic hernias present differently in women than men, who typically have a visible bulge. Instead, female hernias tend to be smaller, deeper, and less noticeable. They can also cause chronic pelvic pressure or pain that can be mistaken for gynecological problems.
Hernia Symptoms For a Woman
Hernias in women tend to be smaller and deeper than male hernias, with no lump showing. Instead, female hernias can cause chronic, deep pelvic pain and occasional sharp, stabbing pain that comes on fast and lingers. (Köckerling F., Koch A., & Lorenz R. 2019) Hernia pain worsens with exercise, laughing, coughing, or straining to evacuate the bowels. The pain is often described as:
Dull
Aching
Pinching
Sharp
Shooting
Burning
Inguinal hernia pain is usually felt at or above the groin and may radiate to the hip, lower back, vulva, or thigh. Many women find the pain increases during their menstrual cycle. The pain can also be exacerbated by any activity that generates extra pressure on the pelvic floor, including:
Prolonged sitting or standing.
Bending
Getting in or out of bed.
Getting in or out of a car.
Sexual intercourse
Emergency
Hernias in the pelvic area are at risk of becoming incarcerated hernias. An incarcerated hernia occurs when a portion of the intestine or other abdominal tissue becomes trapped in the hernial sac, making it impossible to push it back into place. If this gets trapped or strangulated, it can cause tissue death. Strangulated hernias are a medical emergency. Symptoms include:
Deep red or purple tissues.
The hernia bulge does not shrink when you lie down.
Contact a healthcare provider or the emergency room if experiencing any of the above symptoms.
Types
Hernias can occur anywhere on the abdominal wall. They may be caused by:
Internal pressure, such as during pregnancy.
A sports injury
Tissue weakness
Hernias in the lower abdomen or groin are typically indirect inguinal hernias. The inguinal canal comprises multiple layers of muscles and fascia that the thin round ligament threads through. Other groin and pelvic hernias include:
A direct inguinal hernia
A femoral hernia at the top of the inner thigh.
An obturator hernia in the front upper thigh, although this type is rare.
Other common hernias in women are:
Incisional hernia – at the site of a surgical incision
Pregnancy and repeated pregnancies are linked to an increased risk of hernia. Types that are more common in pregnancy include:
Umbilical hernia
Ventral hernia
Inguinal hernia
Umbilical hernias are the most common. However, only a small percentage of pregnant individuals get them. (Kulacoglu H. 2018)
Diagnosis
A hernia diagnosis is made with a physical examination and, if needed, imaging studies. Patients are asked to describe their symptoms precisely, where the pain is located, and any activities that exacerbate it. To check for a hernia, the healthcare provider will palpate for a hernia while the patient sits, stands, or coughs. Imaging tests can include:
Ultrasound
CT scan
Endoscopy – a camera is used to see inside the esophagus and stomach.
Misdiagnoses
Female hernia symptoms can be vague, which often points healthcare providers in the wrong direction. Female hernias are commonly misdiagnosed as: (Köckerling F., Koch A., & Lorenz R. 2019)
Cysts in the reproductive organs
Endometriosis
Fibroid tumors
Treatment
A small hernia that does not cause problems or pain may be treated with a wait-and-evaluate protocol. A hernia often worsens over time and could eventually require surgery. (University of Michigan Health, 2024) Self-care treatments include:
Medical treatments usually start with conservative measures, including physical therapy, stretching, exercise, and rest. Physical therapists often use myofascial release techniques to relieve muscle spasms. Surgery may be needed to repair the weak area of the abdominal wall to relieve symptoms. (University of Michigan Health, 2024) Hernia repair surgery is typically performed as a laparoscopic surgery. (Köckerling F., Koch A., & Lorenz R. 2019) Most patients heal quickly from the surgery and can return to regular activities in a week or two.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Lumbar Spine Injuries in Sports: Chiropractic Healing
References
Köckerling, F., Koch, A., & Lorenz, R. (2019). Groin Hernias in Women-A Review of the Literature. Frontiers in surgery, 6, 4. doi.org/10.3389/fsurg.2019.00004
Northeast Georgia Health System. (2022). Living with a hernia. Northeast Georgia Health System Improving the health of our community in all we do. www.nghs.com/2022/02/15/living-with-a-hernia
Gain insights with this overview of Maslow’s hierarchy of needs from a clinical approach, enriching psychological perspectives.
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The Humanistic Perspective
Because of behaviorism and psychoanalytic theory, the humanistic viewpoint gained popularity in the middle of the 20th century. Humanism is the term used to describe those who stress human potential and the capacity for change. The notion of biological determinism, which holds that the majority of human traits, both mental and physical, are predetermined from conception, is simultaneously rejected by humanism. The humanistic viewpoint stresses a person’s innate desire for creativity and self-actualization and focuses on how individuals grow. The idea that development is seen as an ongoing process that is influenced more by an individual’s social and environmental conditions than by genetics or other natural causes is also fundamental to the humanistic viewpoint. The use of the human viewpoint in a therapeutic setting was examined by several prominent humanistic thinkers, including Abraham Maslow and Carl Rogers. In addition to enabling a better understanding of pain, suffering, and emotions, this guarantees a more optimistic approach to enhance patient and nurse practitioner results. (Boston-Leary et al., 2024)
The development potential of healthy people was the subject of research by American humanistic psychologist Abraham Maslow (1908–1970). According to him, individuals aspire to self-actualization and begin accepting both themselves and other people for who they are. He saw that a lot of individuals were able to enjoy themselves and live comparatively guilt-free while also losing inhibitions.
Maslow’s hierarchy of needs is a psychological theory that explains a pattern by which human motivations often emerge at the following level by enabling the person to be fully satisfied with the previous level. As a result, many individuals start using it to encourage action. Several distinct underlying systems constitute the basis of motivation in Maslow’s hierarchy of wants; certain motivations are generated and given precedence over others. (Kenrick et al., 2010) Our knowledge of the self has also been substantially enhanced by Maslow’s ideas. The five levels of Maslow’s hierarchy of needs—physiological necessities, safety, love and belonging, esteem, and self-actualization—allow people to evolve. These five phases show how a person develops in order to meet their most basic requirements.
Physiological Needs
The primary physical need for human life, according to Maslow, are physiological needs, which include food, water, sleep, shelter, sex, and maintaining bodily homeostasis. In order to be motivated by the next level of demands, many individuals must have their physiological needs—such as breathing, eating, drinking, or sleeping—met. As they exhibit stability and endurance and adjust to the changing demands of the healthcare system, many nurses in a healthcare context move away from physiological needs and safety. (Hayre-Kwan et al., 2021)
Safety
Safety, the second stage, takes over and becomes a dominating behavior if a person’s physiological demands are addressed and mostly satisfied. This may be achieved via working, saving money, and looking for safe havens. That individual has time to consider their desires once they are content and feel secure. However, many people may experience or re-experience post-traumatic stress disorder (PTSD) or transgenerational trauma when physical safety is lacking due to environmental factors like war, natural disasters, family violence, childhood abuse, or institutional racism. For this reason, safety needs must include mental, emotional, financial, and physical security.
Another example of how environmental variables impact safety is economic safety, which may be impacted by a financial crisis and a lack of employment prospects. In the absence of economic safety, it must show itself in things like a need for work stability, grievance processes to shield individuals from unjustified power, insurance plans, savings accounts, etc. Since children typically need to feel protected, this level of Maslow’s hierarchy of needs tends to prevail in their lives.
Love & Belonging
Maslow’s hierarchy of wants places love and belonging at stage three. Intimacy, companionship, and a sense of belonging are all necessary for love and belonging. Many individuals want to join a club or be a part of a society where they may be near their friends and relatives. Maintaining a positive nurse-patient connection in a healthcare context requires professionals to provide affection and belonging to people who are experiencing pain-like sensations. In addition to giving the person a good outlook to lessen their suffering, this will guarantee that their needs and desires are acknowledged. (Xu et al., 2021) During childhood, the desire for love and belonging is very strong and might take precedence over the need for protection. Children who attach to abusive parents exhibit this as a bad problem. Hospitalization, neglect, shunning, or ostracism are examples of deficiencies in this level of Maslow’s hierarchy that may negatively impact a person’s capacity to establish and sustain emotionally meaningful connections. Furthermore, a person’s growth may be greatly impacted by these adverse events.
Esteem
The fourth level of Maslow’s hierarchy is esteem, which is the universal human need to be respected and accepted by others. Since everyone wants to be someone at this point, a lot of individuals search for peer regard, self-confidence, and esteem. For instance, someone with money would purchase a high-end watch, while someone with a brain would be able to write, ponder, or even work a lot. The drive to compete and achieve at the top level is the cause of this. At the same time, a lot of individuals will often pursue a career or pastime because ego demands like status or respect are met by these pursuits. Since most individuals desire to feel valued, many will worry about receiving respect, prestige, significance, and acknowledgment from others. The desire for self-respect and self-esteem follows from this. Lack of positive reinforcement, however, may have an impact on a person’s self-esteem and their ability to improve. therefore taking care of the fundamental problems that are hurting and upsetting them in 2025. (Carroll et al., 2025)
Self-Actualization
Maslow’s hierarchy of needs places self-actualization at the top. Reaching the lowest levels of needs—such as having the ability to eat, sleep, feel secure, fit in with a group, and yet feel unique—is necessary for individuals to reach the greatest level of their existence. At the greatest level, we are able to relax, be creative, and accept things as they are. Even when there is no longer any pressure on particular requirements, it is still possible for any of the needs at lower levels to stay low. Self-actualization is the drive to become the best version of oneself by completing the tasks at hand. Humanistic theory defines self-actualization as a condition of self-fulfillment when individuals are able to reach their full potential in a way that is unique to them. Many people may have a highly distinct perception of or concentrate on this desire. There are several instances, such as:
Someone who is driven to become the perfect parent
Someone who wants to express themselves via sports
Someone who used their skills and abilities to create art as a means of self-expression.
Questions of the Hierarchal Status
When talking about human behavior, Maslow’s hierarchy of needs serves as a crucial basis for comprehending the relationship between drive and motivation. As one moves up the ladder, each requirement is shown in the levels that call for motivation. Numerous significant problems begin to surface while examining the hierarchical structure.
The first concern is the path of advancement when a person advances both within and between levels. Maslow first highlighted the need of attending to lower-level needs before moving on to higher-level requirements. This original idea gave rise to an understanding of how different people are in how they see and value each fundamental need. For instance, females may prioritize their reproductive requirements above those of other people. According to Maslow, satisfying every need is not a prerequisite for fulfilling needs at a higher level. The next level of demands takes precedence after a person’s fundamental, lower-level wants have been mostly met. Higher-level wants, like self-actualization, might be satisfied before certain lower-level needs are completely satisfied.
Whether a person climbs unidirectionally from the base of the pyramid to the summit is a second, related topic. Multidirectional mobility throughout the phases is conceivable because a person’s requirements at a given period of life may be influenced by a variety of variables. In light of being laid off, an employee who is considering raising a family—the third stage of Maslow’s hierarchy—may need to concentrate on the second level, safety. The second and third levels of Maslow’s hierarchy of needs would take unemployment into account, even if this worker had created a feeling of safety and security. Because human existence and progress are dynamic rather than static, the hierarchy must allow for this fluctuation, which is why it is significant. The main idea behind Maslow’s theory is that because self-actualization is the aim, fundamental needs must be satisfied before one is inspired to pursue higher-level wants. This encourages the person to evaluate every need that must be met in order to achieve self-actualization with a positive connection. (Taormina & Gao, 2013) People will see improvements in their bodies and mentalities as well as better lifestyles as they begin to incorporate Maslow’s hierarchy of needs into their daily routines.
Injury Medical Chiropractic & Functional Medicine Clinic
We collaborate with licensed healthcare professionals who apply Maslow’s hierarchy of needs to our patients’ pain and suffering in a clinical setting. In addition to posing crucial queries to our affiliated healthcare professionals, we counsel individuals to incorporate minor adjustments into their everyday schedules and provide them a secure environment.This material is envisioned as an academic service by Dr. Alex Jimenez, D.C. Disclaimer.
References
Boston-Leary, K., Alexander, G. R., & Davis, S. (2024). Leveraging Maslow’s Hierarchy of Needs to Build Nursing’s More Inclusive Future. Nurs Adm Q, 48(1), 55-64. doi.org/10.1097/NAQ.0000000000000613
Carroll, A., Collins, C., & McKenzie, J. (2025). Physician wellbeing in a national rehabilitation hospital, a qualitative study utilizing Maslow’s hierarchy of needs as a framework for analysis. BMC Health Serv Res, 25(1), 175. doi.org/10.1186/s12913-025-12310-x
Hayre-Kwan, S., Quinn, B., Chu, T., Orr, P., & Snoke, J. (2021). Nursing and Maslow’s Hierarchy: A Health Care Pyramid Approach to Safety and Security During a Global Pandemic. Nurse Lead, 19(6), 590-595. doi.org/10.1016/j.mnl.2021.08.013
Kenrick, D. T., Griskevicius, V., Neuberg, S. L., & Schaller, M. (2010). Renovating the Pyramid of Needs: Contemporary Extensions Built Upon Ancient Foundations. Perspect Psychol Sci, 5(3), 292-314. doi.org/10.1177/1745691610369469
Taormina, R. J., & Gao, J. H. (2013). Maslow and the motivation hierarchy: measuring satisfaction of the needs. Am J Psychol, 126(2), 155-177. doi.org/10.5406/amerjpsyc.126.2.0155
Xu, J. X., Wu, L. X., Jiang, W., & Fan, G. H. (2021). Effect of nursing intervention based on Maslow’s hierarchy of needs in patients with coronary heart disease interventional surgery. World J Clin Cases, 9(33), 10189-10197. doi.org/10.12998/wjcc.v9.i33.10189
Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?
Contents
Straight Leg Test
The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what’s causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they’ll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.
Some studies suggest the straight leg test helps diagnose sciatica and other causes. (Pesonen J. et al., 2021)
Purpose
The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what’s happening. It is a manual exam, and the healthcare provider will:
Position the patient
Moves the patient
Create pressure to see how well the patient can resist it
This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)
During the Test
Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:
Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:
The patient lies on their back with their legs straight.
The provider will ask the patient to turn one of the legs in.
This tells them what hip position affects the lower back symptoms.
They’ll then ask you to bring the leg toward the body’s center.
Then, they’ll lift the straight leg until the patient experiences symptoms.
Pain suggests a herniated disc.
If there is no pain, this also provides valuable information.
The procedure is repeated with the other leg.
Modifications
It’s important to let the examiner know about any limitations. The straight leg raise test has modifications if the patient cannot lift their leg while it’s straight or if they have difficulty lying on their back, which can also help avoid an injury during the test.
Variations
The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they’ll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. doi.org/10.1186/s12891-021-04649-z
Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. doi.org/10.12688/f1000research.8105.2
Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. doi.org/10.1016/j.apmr.2016.06.019
Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. doi.org/10.5704/MOJ.1511.012
Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. doi.org/10.1186/1757-1146-6-46
Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. doi.org/10.1097/BRS.0000000000001867
For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?
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Weight Resistance Training
Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.
Resistance Training and Improved Sleep
Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:
Your body weight
Resistance bands
Free weights
Weight-lifting machines
The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.
Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)
How Much Resistance Training Is Needed?
Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.
The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
They added that higher intensity and frequency of training could have a greater effect on sleep.
In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)
Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.
Strength Workouts
Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including:
Leg presses
Chest presses
Lat pulldowns
Bicep curls
Abdominal crunches
Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)
However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.
Other Ways to Improve Sleep Without Meds
Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Weight Loss Techniques
References
Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. doi.org/10.1371/journal.pone.0301616
Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. doi.org/10.1016/j.jpsychores.2017.12.012
Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. doi.org/10.3390/ijerph20054431
Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. doi.org/10.1519/JSC.0000000000000750
Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. doi.org/10.1249/JES.0000000000000273
Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. doi.org/10.1016/j.smrv.2017.07.002
Can physical therapy help individuals with a pinched nerve in the neck?
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Pinched Nerve In The Neck
A pinched nerve in the neck can cause pain, numbness, and weakness that extends through the neck, shoulder, and arm. (American Academy of Orthopaedic Surgeons, 2024) Over-the-counter pain medications, resting the muscles, and gentle stretching can help. However, if you’re still in pain after a few days, see a healthcare provider. Common treatments include:
Rest
Over-the-counter (OTC) pain meds
Physical therapy
Steroid injections
Wearing a neck collar
Surgery is rarely needed, but it can provide relief if other treatments don’t help. Most of the time, a pinched nerve resolves within days or weeks.
Sharp pain that extends into the shoulder and arm.
The pain worsens, or there is a shooting sensation when turning the head.
Tingling or feeling of pins-and-needles in the fingers or hand.
Weakness in the arm, shoulder, or hand.
Numbness or loss of feeling.
Often, these symptoms occur only on one side. Some find their pain less when they lift their hand onto their head, which can relieve pressure on the nerve.
Causes
The cervical spine is the spinal cord area around the neck. It’s made up of seven vertebrae. Nerves branch off the spinal cords in the spaces between the vertebrae. Nerve compression occurs when the space between two vertebrae is reduced, putting pressure on the nerve, pinching it, and causing pain. Pinched nerves develop from age because the spinal discs between the vertebrae become compressed over time. Age causes about 70% to 80% of nerve compression. Other factors that cause pinched nerves include: (Harvard Health Publishing, 2021)
Degenerative disc disease
A herniated disc
Injuries like car accidents falls, or other trauma to the spine
Find a comfortable position and try to allow the muscles in your neck to relax and rest.
Heat or Ice
Warmth and coolness can relieve pain and inflammation.
Use a warm or cool compress for 15 minutes at a time.
Over-The-Counter Pain Medications
Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can help bring relief.
Treatment for Severe Symptoms
If pain doesn’t resolve within a few days, or if it is so bad that you can’t go about daily activities, it’s recommended to see a healthcare provider. They can diagnose a pinched nerve after a physical exam and may also recommend imaging, including an X-ray, CT scan, MRI, or EMG, to reveal what’s causing the symptoms. After diagnosing the condition, the healthcare provider will develop a personalized treatment plan, which may include the following (Harvard Health Publishing, 2021)
Physical Therapy
Physical therapy can help build strength and flexibility in the neck.
This is especially important if there is frequent nerve pain in the same spot.
Cervical Collar
A soft cervical collar is a brace that fits around the neck.
It supports your head so the neck muscles can relax, facilitating healing.
The collar can also keep the head from turning in painful ways.
Oral Corticosteroids
Oral steroids like prednisone can help reduce inflammation.
If inflammation or swelling in the neck puts more pressure on the nerve, they can help.
Steroid Injections
Steroid shots right into the painful tissue reduce inflammation right away.
Muscle Relaxers
These medications keep the muscles in the neck from seizing up.
As the muscles relax, this brings pain relief.
Narcotic Pain Medications
Narcotic pain medications can be used short-term by individuals who have severe pain.
A healthcare provider will inform the patient of the benefits and drawbacks of these medications, which include opiates.
Hold for 20 seconds, then return to a neutral position.
Do this five times.
Eyes to Sky
Lean your head back and look toward the sky.
Hold for 20 seconds, then return to your starting position.
Do this five times.
Side to Side
Turn your head to the right as far as possible, bringing your chin in line with your shoulder.
Hold for 20 seconds, then turn as far as possible toward the left.
Repeat four times.
Ear to Shoulder
Bring your ear down toward your shoulder.
Hold for 20 seconds, then repeat the exercise on the other side.
Alternate between the right and left, stretching each side five times.
While it’s normal for exercises to hurt from stretching the muscles, they should never hurt more than a five on a pain scale of 1 to 10. If they do, stop exercising (National Health Service, 2025)
Healing Time
Healing and recovery depend on the severity of the injury. Some individuals find that the pain from a pinched nerve goes away in days, while for others, it can last for weeks. The pain goes away and then returns. If pain doesn’t go away with the conservative treatments or lasts more than a few days, talk with a healthcare provider or return for a second visit. Rarely do individuals need surgery to bring pain relief. The healthcare provider will discuss whether surgery is the best option and what to expect regarding pain relief. (American Academy of Orthopaedic Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
While cheddar cheese’s high-calorie count and saturated fat content have nutritional drawbacks, can a moderate amount be an enjoyable part of a healthy diet?
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Cheddar Cheese
Cheddar is a hard, cow’s milk cheese known for its dense, layered texture and nutty flavor. It is a favorite cheese served in quesadillas, mac and cheese, or on burgers. However, cheddar cheese nutrition isn’t considered ideal.
Protein performs a variety of functions in the body.
Protein helps build muscle; it’s necessary to produce enzymes, give structure to cells, maintain fluid balance, and more. (Carbone J. W., & Pasiakos S. M. 2019)
Calorie-Dense
Cheddar is calorie-dense, which increases its satisfaction factor.
May Help Weight Loss
There is the belief that cheese causes weight gain; however, the full-fat dairy paradox, which goes against dietary guidelines, is the idea that full-fat dairy products may be healthier than low-fat or fat-free dairy,
Research now suggests removing fat from dairy products may make them more likely to cause weight gain, making full-fat the better choice for weight management. (Soltani S., & Vafa M. 2017)
Compatible With Keto and Low-Carb Diets
Because of cheddar’s high fat percentage, it’s compatible with high-fat nutrition plans.
With zero carbohydrates, cheddar also fits well in low-carb diets.
Low Lactose
Cheddar is one of the harder, aged cheeses that’s quite low in lactose.
This means lactose-intolerant individuals can often eat it without unpleasant symptoms like bloating, stomach upset, and gas.
Allergies
Although it is low in lactose, cheddar still contains casein and whey, two components that can trigger an immune response in individuals with a dairy allergy. (He, M. et al., 2017)
Storage and Safety
Cheddar does not technically require refrigeration. However, storing it in the fridge will help it last longer. According to the USDA, unopened cheddar can last up to six months in the refrigerator, and opened packages can last three to four weeks. Because it’s a hard cheese, cheddar even takes well to freezing, but this will not extend its life more than refrigeration. The USDA estimates cheddar can be frozen for about six months.
Preparation
Cheddar can be added to any number of cheesy dishes or, of course, served alone with crackers. It doesn’t require high heat to become nice and melty. Try adding a whole-grain base and veggies to increase the nutrients in dishes like cheesy casseroles, Mexican dishes, sandwiches, or pasta.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Lordan, R., Tsoupras, A., Mitra, B., & Zabetakis, I. (2018). Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned?. Foods (Basel, Switzerland), 7(3), 29. doi.org/10.3390/foods7030029
Astrup, A., Geiker, N. R. W., & Magkos, F. (2019). Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts. Advances in nutrition (Bethesda, Md.), 10(5), 924S–930S. doi.org/10.1093/advances/nmz069
Hirahatake, K. M., Astrup, A., Hill, J. O., Slavin, J. L., Allison, D. B., & Maki, K. C. (2020). Potential Cardiometabolic Health Benefits of Full-Fat Dairy: The Evidence Base. Advances in nutrition (Bethesda, Md.), 11(3), 533–547. doi.org/10.1093/advances/nmz132
Malmir, H., Larijani, B., & Esmaillzadeh, A. (2020). Consumption of milk and dairy products and risk of osteoporosis and hip fracture: a systematic review and Meta-analysis. Critical reviews in food science and nutrition, 60(10), 1722–1737. doi.org/10.1080/10408398.2019.1590800
Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. doi.org/10.3390/nu11051136
Soltani, S., & Vafa, M. (2017). The dairy fat paradox: Whole dairy products may be healthier than we thought. Medical journal of the Islamic Republic of Iran, 31, 110. doi.org/10.14196/mjiri.31.110
He, M., Sun, J., Jiang, Z. Q., & Yang, Y. X. (2017). Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study. Nutrition journal, 16(1), 72. doi.org/10.1186/s12937-017-0275-0
Individuals who have fractured their scaphoid bone may experience pain and swelling in the wrist just below the thumb. Can immobilization with a cast and physical therapy help?
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Scaphoid Fracture
A scaphoid fracture is a break in one of the wrist’s small or carpal bones. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include swelling and pain in the wrist just below the base of the thumb. These fractures can be difficult to diagnose since they don’t always appear on an X-ray. If the X-ray is negative and the healthcare provider suspects a scaphoid fracture, an MRI may be necessary. Surgery may be required in more severe cases or when the injury is not healing correctly. (American Academy of Orthopaedic Surgeons, 2023)
A Break In The – Navicular Bone
The scaphoid is one of eight carpal bones in the wrist. It is located just below the thumb’s base and is shaped like a kidney bean. This bone can be identified by holding a thumbs-up position and feeling for the hollow between the two tendons below your thumb. The scaphoid is located at the base of the hollow. A break in the scaphoid bone most commonly occurs in the middle of the bone but can also happen at either end. A scaphoid fracture can be displaced or non-displaced (American Academy of Orthopaedic Surgeons, 2023)
Displaced Fracture
It is when the bone fragments have moved out of alignment.
Non-displaced Fracture
It is when the fragments are still in their normal location in the hand.
The scaphoid’s blood supply comes from a small vessel that enters the most distant part of the bone and flows back through the bone. Because of this one small blood supply, a fracture in the center can stop the circulation to the proximal portion of the bone. Because of this, scaphoid fractures need immediate diagnosis and treatment.
Symptoms
Pain or deep aching on the thumb-side of the wrist, typically after a fall on an outstretched arm, could be a scaphoid fracture. Other symptoms experienced include: (American Academy of Orthopaedic Surgeons, 2023)
A healthcare provider will evaluate the hand for tenderness and pain in the hollow and/or the bone. If a break is suspected, they will order an X-ray. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) Many patients are diagnosed with a wrist sprain when they have a fracture. Diagnosis can be difficult because the fracture often doesn’t appear on X-rays until weeks after the healing process starts. Physicians commonly treat a wrist injury as a scaphoid fracture initially and then repeat X-rays within two weeks. (American Academy of Orthopaedic Surgeons, 2023) If the injury doesn’t show on an X-ray, the provider may order an MRI, as these fractures can be easier to see on an MRI. An MRI can help ensure appropriate treatment immediately. (Wong S. B. S., & Peh W. C. G. 2019)
Treatment
If a wrist fracture is diagnosed, the wrist will be immobilized in a cast. However, a healthcare provider may also put the wrist in a cast if the X-ray is negative but they suspect a fracture. This will stabilize the injury until an MRI can be performed. With immobilization and follow-up treatment, scaphoid fractures often heal without surgery. Repeat X-rays are taken over several weeks or months so the provider can make sure the injury is healing correctly. If it is not healing correctly, surgery may be recommended. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) If the fracture is displaced, healing correctly may be a challenge. In this case, a physician may recommend initial surgery to reposition the bones. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) This type of surgery involves pinning the bone in place with screws.
Rehabilitation is an important part of healing because immobilization takes a long time. Wrist range-of-motion exercises can be started, followed by strengthening exercises for the wrist flexors and extensors. Supination, pronation, and grip exercises are also part of physical therapy.
This condition causes degeneration of the cartilage in the joint.
Avascular Necrosis
This is when the blood supply to the bone is reduced or cut off, causing the bone to die.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Clementson, M., Björkman, A., & Thomsen, N. O. B. (2020). Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT open reviews, 5(2), 96–103. doi.org/10.1302/2058-5241.5.190025
Wong, S. B. S., & Peh, W. C. G. (2019). The role of magnetic resonance imaging in the evaluation of scaphoid fractures. Journal of Medical Radiation Sciences, 66(1), 3–4. doi.org/10.1002/jmrs.316
Almigdad, A., Al-Zoubi, A., Mustafa, A., Al-Qasaimeh, M., Azzam, E., Mestarihi, S., Khair, Y., & Almanasier, G. (2024). A review of scaphoid fracture, treatment outcomes, and consequences. International orthopaedics, 48(2), 529–536. doi.org/10.1007/s00264-023-06014-2
Cauda equina syndrome/CES is a rare condition in which the nerves in the lower back are compressed. It can include sciatica as one of its symptoms. Individuals presenting with symptoms that could be CES are advised to see a healthcare provider as soon as possible, as delaying treatment can lead to permanent damage.
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Cauda Equina Syndrome
A cluster of nerve roots called the cauda equina, Latin for horse’s tail, sends and receives messages to the legs, bladder, and other body parts. Cauda equina syndrome is a rare condition in which nerve roots in the lower spinal cord are compressed. This compresses the nerves and disrupts motor and sensory function in the bladder and lower extremities. The most common cause is a ruptured or herniated disc in the lumbar area. This usually occurs when a severe disc herniation compresses the nerve bundle at the base of the spinal cord, causing significant neurological dysfunction like bladder/bowel issues and numbness in the saddle area. If found early, it is treated with surgery within 24 to 48 hours of symptom onset.
This is characterized by symptoms that include unusual urinary sensation, loss of desire to urinate, poor urinary stream, and having to strain to urinate. (Gardner A., Gardner E., & Morley T. 2011)
Pott’s paralysis is a neurological complication of tuberculosis (TB) of the spine.
TB is a bacterial infection that usually affects the lungs but can spread to the spine.
Iatrogenic Side Effects
Injuries or illnesses that result from medical or surgical treatment
Spinal Lesions or Malignant Tumors
A spinal lesion refers to any abnormal growth or damage within the spine.
It can include benign (noncancerous) and malignant (cancerous) tumors.
A malignant tumor is a cancerous growth within the spine; essentially, a malignant tumor is a type of spinal lesion with the potential to spread to other parts of the body.
Spinal Infection, Inflammation, Hemorrhage, or Fracture
A spinal infection refers to a bacterial, fungal, or viral infection that occurs within the bones of the spine (vertebrae) or the surrounding tissues, potentially causing pain, inflammation, and, in severe cases, neurological complications like weakness or paralysis;
Spinal inflammation is a general term for swelling or irritation within the spinal column.
Spinal hemorrhage” indicates bleeding within the spinal canal.
A spinal fracture refers to a break in one or more of the vertebrae in the spine.
Spinal Arteriovenous Malformations (AVMs)
A spinal arteriovenous malformation (AVM) is a rare condition in which the arteries and veins in the spinal cord tangle abnormally.
This can damage the spinal cord over time.
Complications from Lumbar Surgery
Lumbar surgery can have several complications, including infections, blood clots, nerve damage, and spinal fluid leaks.
Spinal Anesthesia
Spinal anesthesia is a regional anesthesia that blocks pain and sensation in the lower body.
It involves injecting a local anesthetic medication into the subarachnoid space surrounding the spinal cord.
The exact cause is not fully understood, but it can involve direct nerve root injury from the needle, inflammation caused by the anesthetic, or a spinal hematoma compressing the nerve roots.
Infection of the tissues (meninges) that cover the cauda equina and spinal cord.
An abscess pressing on the cauda equina.
Diagnosis
Diagnosis requires a medical history of symptoms, general health, activity level, and a physical exam to assess strength, reflexes, sensation, stability, alignment, and motion. (American Association of Neurological Surgeons, 2024) Testing includes:
X-ray or computerized tomography (CT) imaging is enhanced by the injection of contrast material into the cerebrospinal fluid spaces, which can show displacement of the spinal cord or spinal nerves.
Specialized Nerve Testing
This could be nerve conduction velocity tests and testing electrical activity in muscles or electromyography.
Treatment
The extent of urinary problems can determine treatment protocols. A CES diagnosis is usually followed by emergency surgery within 24 to 48 hours to relieve compression of the nerves. Moving quickly is essential to prevent permanent complications such as nerve damage, incontinence, or leg paralysis. (American Association of Neurological Surgeons, 2024)
Depending on the cause, corticosteroids also may be prescribed to reduce swelling.
Antibiotics may be needed if an infection is responsible for CES.
For situations in which a tumor is the cause, surgery to remove it may be necessary, followed by chemotherapy and/or radiation.
The outcome with CES-I during surgery is generally favorable.
Those whose CES has deteriorated to CES-R tend to have a less favorable prognosis.
Post Surgery Therapy
After surgery, CES can be challenging to deal with. If bladder function has been impaired, recovery of control can take time.
Frequent urinary infections are also a potential complication.
Loss of bladder or bowel control can be psychologically distressing, impacting social life, work, and relationships.
Sexual dysfunction can also occur, contributing to relationship difficulties or depression.
Therapy with a mental health professional may be recommended. When damage is permanent, it will be important to include family and friends in the adjustment to living with a chronic condition. Psychological counseling and/or a support group can be helpful. Other specialists who can help include: (American Academy of Orthopaedic Surgeons, 2024)
Occupational therapist
Physical therapist
Physiotherapist
Sex therapist
Social worker
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Gardner, A., Gardner, E., & Morley, T. (2011). Cauda equina syndrome: a review of the current clinical and medico-legal position. European Spine Journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20(5), 690–697. doi.org/10.1007/s00586-010-1668-3
Fairbank, J., & Mallen, C. (2014). Cauda equina syndrome: implications for primary care. The British journal of general practice: the journal of the Royal College of General Practitioners, 64(619), 67–68. doi.org/10.3399/bjgp14X676988
Should individuals experiencing lower left back pain see a healthcare provider if it lasts more than a few weeks?
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Left Side Lower Back Pain
Lower left back pain can impact your ability to go about your day. If left-side lower back pain lasts longer than a week, it is considered chronic back pain, which can severely impact one’s quality of life. This type of pain has various causes. Muscle or spine and nerve damage, including sciatica, can cause pain. Organs in the lower back, including the kidneys, can cause pain. Pregnancy-related changes, fibromyalgia, and other conditions can cause lower left-side back pain in females.
Causes
Back pain is common and affects almost everyone. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023) Lower left back pain can have many causes, ranging from muscle and spine issues to organ infections. One way to help tell what’s causing the symptoms is to determine whether there is also sciatica, sharp or burning pain that radiates down one side of the body. It happens when the sciatic nerve gets compressed or irritated. Possible causes include (Penn Medicine, 2020)
Muscle Injury
A muscle injury from an accident or injury can be a cause that can appear with or without sciatica.
If this is the cause, you’ll notice that the pain improves with rest but worsens after you’ve sat for a long time or after getting up from sleep.
There may also be a limited range of motion, tenderness, or swelling.
Arthritis or Bone Conditions
Arthritis and bone issues, like osteoporosis, can also be a cause.
This can happen if the arthritis is in the left hip or the root cause is on the right side, but the body compensates by overusing muscles on the left side of the back.
Unhealthy Posture and Body Positioning
Unhealthy postures and body positioning can contribute to back pain and musculoskeletal problems.
To avoid straining the muscles, try sitting and standing straight and keeping all the joints at a 90-degree angle.
Move around every 20-30 minutes and stretch out.
Kidneys
The kidneys are located in the middle back.
Kidney infections or kidney stones could cause pain on the left side.
Other symptoms include pain when urinating, fever, and nausea.
Ulcerative Colitis
Ulcerative colitis, inflammation of the large intestine, can also cause lower left back pain in some cases.
If this is the cause, there may also be abdominal pain, cramping, nausea, and fatigue.
Uterine-Related Pain
Several conditions related to the uterus can cause back pain symptoms, including PMS, period cramps, endometriosis, and more.
Sometimes, these conditions cause pain on both sides, but some individuals may experience pain just on the left side.
Pregnancy
The weight gain, hormonal changes, and limited movement can also contribute to lower left back pain. (Cedars Sinai, 2024)
Spinal Disease
If one of the discs or vertebrae in the spine slips out of place or becomes damaged, this can cause upper, middle, or lower back pain.
In many cases, over-the-counter anti-inflammatory medications can help with sciatica. If it persists, it is recommended to see your healthcare provider to find the root cause. The causes include: (Aguilar-Shea, A. L. et al., 2022)
Herniated disc
A disc that pops out of place can add pressure to the sciatic nerve.
Spinal Stenosis
Spinal stenosis, or spine narrowing, can also cause sciatic symptoms.
Spondylolisthesis
Occurs when vertebrae are out of alignment, leading to sciatic symptoms.
Pregnancy
Pregnancy-related growth and bodily changes oftentimes lead to sciatic nerve symptoms and sensations.
Muscle Spasms
Spasms like piriformis syndrome, a spasm of the muscle in the buttocks, can cause back pain.
Surgery
It’s normal to have back pain for up to six weeks after a back procedure.
However, if there is new or worsening lower left back pain after surgery, consult the healthcare provider. (Penn Medicine, 2017)
Your healthcare provider may recommend massage, chiropractic care, and acupuncture treatments.
If pain can’t be managed at home, your healthcare provider may suggest prescription medications, including muscle relaxers.
These can allow the tissue to heal and reduce your pain as well.
If you have severe sciatica or vertebrae that have slipped out of place, the healthcare team might recommend a steroid injection into the lower left back to reduce pain by reducing inflammation.
In addition to prescription treatments, your healthcare provider might recommend physical therapy to retrain movements, build strength, and help prevent back pain.
Sleep on a firm mattress that will support your back.
Get a comfortable, ergonomic chair for your job.
If you work on your feet, learn to practice healthy posture and use shoes and insoles to facilitate and maintain correct posture.
Once you’ve healed, building your core strength may help avoid lower back pain in the future.
Injury Medical Chiropractic and Functional Medicine Clinic
Talk with a healthcare provider and request a referral to a specialist who can help with long-term management. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-González, R., & Paredes, I. (2022). Sciatica. Management for family physicians. Journal of family medicine and primary care, 11(8), 4174–4179. doi.org/10.4103/jfmpc.jfmpc_1061_21
See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. doi.org/10.11622/smedj.2021086
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