Individuals dealing with aching knees is one of the most common health problems and affects people of all ages. The knee is the largest joint in the body, comprised of muscles, tendons, ligaments, cartilage, and bones. The knees support walking, standing, running, and even sitting. Constant use makes them highly susceptible to injuries and conditions. The knees are also surrounded by a complex network of nerves that transmit messages to and from the brain. Damage to the nerves from an injury or disease can create various symptoms of discomfort in and around the knee joint.
Contents
Knee Neuropathy
Causes
Knee discomfort symptoms can be brought on by injury, degenerative disorders, arthritis, infection, and other causes, including:
Rheumatoid arthritis
This is a chronic inflammatory disorder that causes the knees to swell and causes damage to the cartilage.
Osteoarthritis
This type of arthritis causes the cartilage to steadily wear away, causing damage to the joints and various symptoms.
Cartilage Issues
Overuse, muscle weakness, injury, and misalignments can cause compensating postures and movements that can wear down and soften the cartilage, generating symptoms.
Several factors can increase the risk of developing knee neuropathy, including:
Previous knee injury
Undiagnosed and untreated knee injury
Unhealthy Weight
Gout
Compromised leg muscle strength and/or flexibility
Symptoms
Symptoms associated with a knee injury or disorder can vary, depending on the severity and damage. Symptoms can include:
Joint stiffness
Swelling in the joint.
Reduced movement/flexibility in the joint.
Increased instability/feeling of weakness in the knee.
Changes in skin color around the knee joint, like increased redness or pale discoloration.
Numbness, coldness, or tingling in and/or around the joint.
Pain symptoms could be a dull ache or throbbing felt throughout the knee.
Sharp, stabbing discomfort in a specific area.
If left untreated, knee neuropathy could permanently affect the ability to walk and lead to partial or total loss of knee function and mobility. Doctors recommend taking note of the following:
What activity/s generates symptoms?
Where are the symptoms located?
What the pain feels like?
Treatments available for knee pain
Chiropractic treatment offers various approaches to addressing the pain caused by nerve damage. Standard treatment includes chiropractic adjustments, therapeutic massage, non-surgical decompression, stretching, posture and movement training, and nutritional anti-inflammatory plans. Our medical team specializes in non-surgical treatments that decrease symptoms and increase strength, flexibility, mobility, and restore function.
Knee Injuries Adjustment
References
Edmonds, Michael, et al. “The current burden of diabetic foot disease.” Journal of clinical orthopedics and trauma vol. 17 88-93. 8 Feb. 2021, doi:10.1016/j.jcot.2021.01.017
Hawk, Cheryl, et al. “Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline.” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181
Hunter, David J et al. “Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY.” BMC musculoskeletal disorders vol. 19,1 132. 30 Apr. 2018, doi:10.1186/s12891-018-2048-0
Kidd, Vasco Deon, et al. “Genicular Nerve Radiofrequency Ablation for Painful Knee Arthritis: The Why and the How.” JBJS essential surgical techniques vol. 9,1 e10. 13 Mar. 2019, doi:10.2106/JBJS.ST.18.00016
Krishnan, Yamini, and Alan J Grodzinsky. “Cartilage diseases.” Matrix biology: journal of the International Society for Matrix Biology vol. 71-72 (2018): 51-69. doi:10.1016/j.matbio.2018.05.005
Speelziek, Scott J A, et al. “Clinical spectrum of neuropathy after primary total knee arthroplasty: A series of 54 cases.” Muscle & nerve vol. 59,6 (2019): 679-682. doi:10.1002/mus.26473
Dr. Jimenez, D.C., presents how dyslipidemia can increase the chances of various issues associated with multiple risk factors that can cause muscle and joint pain. By understanding where these issues affect the body, many specialists associated with dyslipidemia can come up with a solution to reduce dyslipidemia symptoms and other pre-existing symptoms that correlate with high cholesterol. We acknowledge patients to certified providers that provide treatment options for dyslipidemia that can restore body functionality and improve a person’s health. We assess each individual and their symptoms by entrusting them to our associated medical providers based on their diagnosis results for a better understanding. We recognize that education is a tremendous way to ask our providers questions that apply to the patient’s knowledge and symptoms. Dr. Jimenez, D.C., implements this information as an educational service. Disclaimer
The Risk Factors Of Dyslipidemia
Dr. Alex Jimenez, D.C., presents: Today we will look at the guidelines and the risk factors of dyslipidemia. When specialists utilize these guidelines that involve lipid production in the patient’s body, they use these guidelines to emphasize lifestyle therapies that can encourage more patient involvement and decision-making regarding their health. When an issue involves an increase or decrease in lipid production in the body, it can be due to lifestyle choices that can affect anyone and correlate to metabolic syndrome. In functional medicine, it is important to look, follow, and know these guidelines to understand better what is going on with the patients and come up with a treatment plan that can help reduce the risk factors of dyslipidemia and treat the symptoms associated with these risk factors.
Regarding these guidelines, doctors work with associated medical specialists that look into lipid production and develop a personalized list for the patients that shows the risk-enhancing factors causing dyslipidemia associated with cardiovascular diseases causing metabolic syndrome. Dyslipidemia is when an imbalance of lipid production in the body causes an increase in high cholesterol due to various factors that can lead to cardiovascular diseases. To that point, when a patient is dealing with high cholesterol due to a sedentary lifestyle or being constantly stressed, it can lead to an imbalance of lipid production and cause doctors to not just look at the standard lipid panels but also figure out how to come up with a treatment plan for their patients to regulate their lipid production.
How To Look For The Risk Factors Of Dyslipidemia?
Dr. Alex Jimenez, D.C., presents: So when it comes to looking at the risk factors that are developing dyslipidemia, functional medicine allows doctors to look at advanced lipid tests and evaluate the risk factors causing dyslipidemia. The evaluations of these tests find various risk factors that conventional medicine would not see, and it shows patients the importance of these results and gets their attention. To that point, many risk factors can enhance the progress of dyslipidemia. Risk factors include:
Having a family history of premature atherosclerotic cardiovascular diseases (ASCVD).
High levels of lipoprotein and triglycerides.
Excessive sedentary lifestyle.
Lack of physical activity.
Having pre-existing chronic inflammatory disorders that can cause hypersensitivity to the body.
All these risk factors can cause dyslipidemia to develop and can even overlap risk factors related to metabolic syndrome that can cause muscle and joint pain. Now how is metabolic syndrome associated with dyslipidemia?
Metabolic Syndrome & Dyslipidemia
Dr. Alex Jimenez, D.C., presents: Metabolic syndrome is a cluster of disorders that could be associated with dyslipidemia, as it can cause a person to feel miserable and affect their quality of life. When individuals have high cholesterol due to physical inactivity, not consuming lots of healthy fruits, vegetables, protein, and whole grains, smoking, or being in constant stress, it can affect the body both inside and out as it can cause a person to have imbalances of lipid and hormone function. When these imbalances affect the body, they can affect the individual’s mentality, bring down their energy to feel sluggish, and cause inflammatory issues in their joints and muscles that can lead to various injuries and diseases.
An example would be an individual who comes in dealing with back pain associated with obesity and has been dealing with high blood pressure and high cholesterol. When that person is being examined by their doctor, their results show an imbalance of how much their body produces lipids. To that point, many individuals are unaware that they have dyslipidemia unless they have a routine blood test and if it has gone severe. Other symptoms that dyslipidemia can cause in the body include:
Leg pain
Chest pain and tightness
Pain in the neck, jaw, shoulders, and back
Heart palpitations
Sleep problems
Leg swelling
If it is not treated right away, it can lead to more issues that can cause pain to the body and leave them feeling hopeless. When these unwanted symptoms and pathogens start to affect the body, it can cause the vital organs that monitor lipid production to be dysfunctional and cause chronic symptoms to rise over time.
Treatments & Guidelines For Dyslipidemia
Dr. Alex Jimenez, D.C., presents: By looking at the guidelines, we can assess the situation that the patient is dealing with, come up with an evaluation of how to reduce these risk factors that are causing dysfunction in the patient’s body, and come up with a personalized treatment plan that encourages the patient to participate in and work with other associated medical providers to ensure health and wellness to the person. All is not lost, as there are ways to reduce dyslipidemia associated with metabolic syndrome.
Treatments like chiropractic care can help restore the body’s systems through spinal manipulation in the cervical, thoracic, and lumbar regions to reduce stiffness and restore mobility to the person. An anti-inflammatory diet and exercise can help lower inflammatory effects and lower the high cholesterol the person is dealing with. And finally, exercise can help reduce stress and improve the range of motion of the body’s joints and muscles. All these treatments work together regarding a person’s health and wellness, as the body is a complex machine. The combination of functional medicine and chiropractic care can allow individuals to start making small changes in their lives to restore their health and become pain-free from metabolic syndrome associated with dyslipidemia. Remembering that it takes time for these treatments to show results of feeling good can make the journey to a healthier version of yourself worth it.
Idiopathic scoliosis means that no cause congenital or neuromuscular that created the spinal deformation has been identified. However, idiopathic scoliosis is the most common type, affecting 2% to 3% of individuals. Individuals diagnosed with an idiopathic disease or condition can be frustrated with more questions than answers, but it can still be treated in adults and kids.
Contents
Idiopathic Scoliosis
Congenital Scoliosis
Congenital scoliosis is an abnormal curvature of the spine related to which the patient was born.
Usually, a failure of formation or segmentation during normal development leads to the spinal condition.
Neuromuscular Scoliosis
Individuals with neuromuscular scoliosis are usually born with neurological disorders that contribute to muscular unevenness, often resulting in the development of the condition.
For example, individuals with cerebral palsy are born with muscular unevenness that can contribute to scoliosis development.
Who Is Affected
Anyone can develop scoliosis, but children and adults are divided into separate categories.
Children
Children with this condition are divided into three subcategories:
Adolescents are from 11 onward or when starting puberty, to the point where the skeleton fully matures.
Adults
Idiopathic scoliosis in adults results from undiagnosed or untreated scoliosis in childhood that gradually progressed.
Causes
Research has found a genetic predisposition to developing scoliosis, as it has been found to run in families. Genetic testing has been designed to help determine the risk of developing progressive scoliosis. Theories have been presented about abnormalities that affect the nervous system. These include:
Dysfunctions of the brain stem or equilibrium have been frequently identified in individuals with idiopathic scoliosis.
Other theories suggest skeletal growth abnormalities or hormonal/metabolic dysfunction may contribute to the condition.
However, determining its exact cause remains unknown.
Signs and Symptoms
Here are some things to look out for.
The body leans to one side.
There is an unevenness of the ribcage or hips.
Uneven shoulders.
Shoulder blades may protrude or stick out.
The head is not positioned directly above the pelvis.
Diagnosis
Idiopathic scoliosis curves tend to follow predictable patterns.
Magnetic resonance images/MRIs of the spine can show evidence of any significant abnormalities. If no other related condition is present to suggest different causes, then the idiopathic scoliosis diagnosis can be made.
Treatment
Treatment depends on the individual’s age and the degree of curvature in the spine.
In many cases, adolescent or juvenile idiopathic scoliosis patients that have a mild curve can be treated with a brace.
Adults could need surgical intervention, such as a fusion surgery where rods and screws are added to realign the spine and relieve the pressure on the nerves.
Chiropractor
References
Burnei, G et al. “Congenital scoliosis: an up-to-date.” Journal of medicine and life vol. 8,3 (2015): 388-97.
Clément, Jean-Luc, et al. “Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis.” The 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 vol. 22,11 (2013): 2414-20. doi:10.1007/s00586-013-2852-z
Giampietro, Philip F et al. “Congenital and idiopathic scoliosis: clinical and genetic aspects.” Clinical medicine & research vol. 1,2 (2003): 125-36. doi:10.3121/cmr.1.2.125
Pinched Nerves and Muscle Spasms: A pinched or compressed nerve can occur in various body regions, from the wrist to the foot. When a nerve is compressed, a pins and needles feeling can present until the pressure is relieved, or there can be no sensation symptoms, but other symptoms like muscle spasms, especially in the arm or leg, can appear. Individuals will feel a repetitive fluttering or twitching when the arm or leg is not in motion. A pinched nerve could be the cause of spasms in the back or extremities. Injury Medical Chiropractic and Functional Medicine Clinic can help if symptoms are not stopping or worsening.
Contents
Pinched Nerves and Muscle Spasms
When multiple symptoms appear, individuals may not realize they are connected. Individuals may think aches, pains, and spasms are normal aging processes. Pinched nerves occur when there is an impingement on any one of the numerous nerves of the spine. Impingements can be caused by:
Repetitive motion injuries
Disc degeneration
Herniated/ruptured discs
Bone spurs
Arthritis
Trauma injury
The pain symptoms from the spasm can be quick, sharp, or pulsating and throbbing. The muscles respond by tightening or spasming as the nerve sends interrupted/incomplete signals. In addition to muscle spasms, a pinched nerve can contribute to other symptoms, including the following.
Tingling
Numbness
Pins and needles sensation
Reduced range of motion
Muscle weakness
Signs a Pinched Nerve Might Be Causing Spasms
Sudden shooting pain that radiates down the leg or arm.
Weak muscles
Muscle atrophy – shrinking or deteriorating.
Chronic tingling in the extremities.
A burning sensation in a specific area; this could but is not necessarily the source of the pinched nerve.
Electrical shock-type pain accompanies the spasms.
If a pinched nerve is left untreated and continues to generate symptoms, it can affect daily life and lead to uncomfortable long-term issues. Severe nerve compression combined with inflammation can cause damage to nearby soft tissues and muscles, leading to chronic conditions. When the nerves are damaged, it can be harder to control the muscles making certain motions uncomfortable or difficult to move certain body parts.
Chiropractic Care
Chiropractic care, massage, and decompression therapy will relieve pinched nerves and muscle spasms and restore neuromusculoskeletal system function. The body will be realigned, and patients will be trained on stretching exercises, muscle strengthening, posture training, and nutritional support to optimize the body’s natural healing abilities to repair the damaged nerves.
Low Back Pain
References
Bustamante, S, and P G Houlton. “Swelling of the leg, deep venous thrombosis, and the piriformis syndrome.” Pain research & management vol. 6,4 (2001): 200-3. doi:10.1155/2001/104091
Chu, Eric Chun-Pu, and Robert J Trager. “Thoracic Schwannoma as an Unusual Cause of Sciatic Pain in the Chiropractic Office: A Case Report.” The American journal of case reports vol. 23 e938448. 16 Nov. 2022, doi:10.12659/AJCR.938448
Coletti, Roger H. “The ischemic model of chronic muscle spasm and pain.” European journal of translational myology vol. 32,1 10323. 18 Jan. 2022, doi:10.4081/ejtm.2022.10323
Hirayama, Jiro, et al. “Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation.” The 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 vol. 15,1 (2006): 41-7. doi:10.1007/s00586-004-0813-2
Kennedy, John G, and Donald E Baxter. “Nerve disorders in dancers.” Clinics in sports medicine vol. 27,2 (2008): 329-34. doi:10.1016/j.csm.2008.01.001
Waddell, Roger K. “Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma.” Journal of chiropractic medicine vol. 4,1 (2005): 19-24. doi:10.1016/S0899-3467(07)60108-6
Dr. Alex Jimenez, D.C., presents how to look for signs of hormonal imbalances in men and how different treatment strategies, like chiropractic care, can help regulate hormonal functionality in the body. We direct patients to certified providers that provide functional hormonal replacement treatments that can restore body functionality. We acknowledge each patient and their symptoms by referring them to our associated medical providers based on their diagnosis to understand better what they are dealing with. We understand that education is a tremendous way to ask our providers various questions that apply to the patient’s knowledge. Dr. Jimenez, D.C., applies this information as an educational service. Disclaimer
Hormone Imbalances
Dr. Alex Jimenez, D.C., presents: Today, we will be looking at how to look for the signs of hormonal imbalances in men and how chiropractic care can help with the symptoms associated with hormonal imbalances. We need to understand the subtypes of hormonal deficiency to enable appropriate treatment strategies like chiropractic care. So when it comes to hormones in the body, it is important to know how hormones function in the body and what happens when comorbidities are associated with hormonal imbalances. The hormonal imbalances in the male body could cause physiologic effects of low testosterone correlating with disruptive factors.
Now hormones in both male and female bodies provide various actions that make the body functional. This includes:
Regulating body temperature
Sexual function
Work with other hormones (insulin, DHEA, cortisol)
Support the major body systems
When it comes to the male body, the two main hormones, androgen and testosterone, can help with cognitive function. However, when the body begins to age naturally, the hormonal process begins to decrease in the male body and causes chronic illnesses to start to cause problems in the body. When this happens, it can cause the individual to be in pain and disrupt daily activities.
Dr. Alex Jimenez, D.C., presents: Since many environmental disruptors can affect the body and cause hormonal imbalances, they can cause various symptoms in many test results when patients are being examined by their primary doctors. Signs of chronic fatigue, brain fog, depression, increased muscle mass, and low libido correlates with testosterone deficiency and can make the body dysfunctional. And if there is chronic hormonal dysfunction in the body, it can also lead to inflammation associated with hormonal deficiency. When inflammation starts to affect the muscles and joints of the male body, it can lead to issues affecting the back, hips, legs, shoulders, and neck that can cause limited mobility, muscle fatigue, increased body fat, and a decrease in bone mineral density.
Low testosterone levels in the body can overlap with pre-existing conditions that correlate with metabolic syndrome associated with hypogonadism. Hypogonadism is when the body’s reproductive organs produce little to no hormones for sexual function. Hypogonadism can affect about 30% of all males between the ages of 40-79. To that point, it causes the male body to produce more leptin hormones and can negatively affect the brain when it comes to releasing these hormones to the body. At the hypothalamic level of gonadotropin-releasing hormones, we have increased sensitivity at the hypothalamus to negative feedback from androgens. This can be many factors that can contribute to low male testosterone levels:
Diet
Stress
Toxin exposure
Osteoporosis
Decreased hair density
Erectile dysfunction
Andropause
When the reproductive organs produce little to no hormones, they can develop andropause and cause testosterone levels to diminish. Andropause is the male version of menopause for females, which can contribute to other conditions like dementia, Alzheimer’s, diabetes, and metabolic syndrome. How is metabolic syndrome associated with andropause when it comes to hormone imbalances? Well, low levels of testosterone in the body can increase insulin levels, causing insulin resistance, which then leads to an increase in BMI in the body. To that point, disorders like chronic stress can lower DHEA and testosterone hormone levels, which can then increase insulin levels and cause more pain-like issues in the body.
Chiropractic Care & Hormones
Dr. Alex Jimenez, D.C., presents: Now all is not lost, as there are ways to improve hormone production in the body. Many individuals can exercise regularly to lower cortisol and insulin levels while boosting testosterone levels. Another way to improve hormone dysfunction is by going to various therapies like chiropractic care to help reduce some of the symptoms associated with hormonal imbalances. Now how would chiropractic care be correlated with hormonal imbalances? Isn’t just manual manipulation to the back?
Surprisingly chiropractic care is more than just manipulating the spine when it is in subluxation. As stated earlier, hormonal imbalances can lead to chronic muscle and joint stress that can become inflamed and lead to chronic issues. When hormonal imbalances in the body cause low testosterone production, it can cause stress on the muscle groups and affect the joints. To that point, the body will be in constant pain or succumb to various injuries. So, incorporating chiropractic care as part of treatment can help improve the body’s musculoskeletal structure and how to deal with stress, allowing the nervous system, where hormones are being sent to different areas in the body, to function properly and operate normally. Chiropractic care enables the musculoskeletal structure to be pain-free from musculoskeletal dysfunction associated with hormone imbalances and can be combined with other treatments.
Conclusion
Utilizing and incorporating chiropractic care and hormone therapy can allow the body to function with normal hormone levels and reduce the pain-like symptoms that may affect the body’s muscles and joints. Chiropractic care combined with a nutritional diet that helps with hormone regulation and physical therapy can help the body’s hormone levels to be normal. To that point, this combination of treatments can improve muscle growth and reduce the symptoms associated with hormone imbalances that can cause muscle and joint pain associated with other pre-existing conditions related to hormone balance.
Healthy Posture Guidelines: Posture is how an individual holds their body. Healthy posture is when minimal stress is applied to the joints. Maintaining and holding your body correctly can prevent pain, injuries, and other health problems. Faulty postures and musculoskeletal imbalances often precipitate painful conditions in the spine and extremities. However, unhealthy postures do not always present with discomfort and pain symptoms that can go unnoticed for years. This leads to chronic stress and advanced wear of the joints. Injury Medical Chiropractic and Functional Medicine Clinic can realign the spine, relieve symptoms, and restore flexibility, mobility, and function.
Contents
Healthy Posture Guidelines
There are two types of posture:
Dynamic Posture
This posture is when the body moves, like walking, running, or bending to pick up something.
Static Posture
This posture is when the body is not moving, like sitting, standing, or sleeping.
Both are important, and the key is the spine’s position. The spine has three natural curves: neck, mid, and low back. Correct posture maintains the curves with the head above the shoulders, and the top of the shoulder should be over the hips.
Unhealthy Positioning
Postural faults include:
Forward head positioning
Rounded shoulders
Loss of the normal lordosis curve in the lower back.
Early warning signs of postural problems may include:
The inability to sit or stand for a prolonged period.
Stiffness when getting up from a chair after sitting.
Feeling of physical exhaustion at the end of the day.
Muscle imbalances.
Loss of normal flexibility.
Symptoms of discomfort.
Affected Health
Unhealthy posture can affect overall health and includes:
Misaligned musculoskeletal system.
Decreased flexibility.
Neck, shoulder, and back pain.
The advanced wearing down of the spine making it more fragile and susceptible to injury.
Affected joint movement.
Affected balance.
Increased risk of falling.
Digestion problems.
Potential breathing problems.
Improvements
Be mindful of your posture during everyday activities, like walking, watching tv, washing dishes, etc.
Maintain Physical Activity
Certain exercises like yoga, tai chi, and other classes focusing on body awareness can help develop healthy posture habits.
Exercises that strengthen the core muscles around the back, abdomen, and pelvis.
Maintain Healthy Weight
Extra weight can weaken the abdominal muscles, cause problems for the pelvis and spine, and contribute to back pain.
Wear Comfortable Shoes
High heels, for example, can throw off the body’s balance and force unhealthy walking movements.
This puts added stress on the muscles and affects posture.
Proper Height
Make sure workstations are at a comfortable height, whether sitting in front of a computer, making dinner, or eating.
Chiropractic Care
Chiropractors and physical massage therapists specialize in evaluating and treating musculoskeletal dysfunction and identifying and screening for postural dysfunction. Healthy posture can have an immediate effect on health that include:
Proper alignment of bones and joints.
Reduced wear on the muscles and joints.
Reduced stress on ligaments.
Decreased risk of back injury.
Increased energy.
Improved digestion.
A chiropractic team will massage and relax the muscles reducing tension, adjust and realign the spine, increase joint movement, and ease the individual into a healthy posture. The team will also provide careful rehabilitation exercises and nutritional recommendations to maintain a healthy posture.
Custom Foot Orthotics
References
Carini, Francesco, et al. “posture and posturology, anatomical and physiological profiles: overview and current state of the art.”Acta bio-medica : Atenei Parmensis vol. 88,1 11-16. 28 Apr. 2017, doi:10.23750/abm.v88i1.5309
Creze, Maud, et al. “posture-related stiffness mapping of paraspinal muscles.”Journal of anatomy vol. 234,6 (2019): 787-799. doi:10.1111/joa.12978
Korakakis, Vasileios, et al. “physiotherapist perceptions of optimal sitting and standing posture.”Musculoskeletal science & practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004
Dr. Alex Jimenez, D.C., presents the effects of metabolic syndrome that can disrupt the body’s functionality. Metabolic syndrome is a common disorder that can range from insulin resistance to inflammation and muscle pain. Considering how every person is different, we look at how metabolic syndrome is associated with insulin dysfunction and correlated with inflammation. We direct patients to certified providers that provide functional medicine treatments related to metabolic syndrome to restore body functionality. We acknowledge each patient and their symptoms by referring them to our associated medical providers based on their diagnosis for a better understanding of what they are dealing with. We understand that education is a tremendous way to ask our providers various questions that apply to the patient’s knowledge. Dr. Jimenez, D.C., applies this information as an educational service. Disclaimer
The Effects Of Metabolic Syndrome
Dr. Alex Jimenez, D.C., presents: Metabolic syndrome is a cluster of disorders that can affect the body and cause other issues to vital organs and muscle and joint functionality. Metabolic syndrome can also correlate with other conditions like diabetes and insulin resistance, which can cause referred pain in different body locations. For example, back pain associated with metabolic syndrome could overlap with obesity. So in the last article, we looked at how to recognize the causes of metabolic syndrome. In trying to understand how many people are prone to develop metabolic syndrome, we need to look at what they are eating, what kind of lifestyle they have, and if they have any pre-existing conditions. All these matters when they undergo an examination with their primary doctor.
Another thing to look into when diagnosing patients for metabolic syndrome is by looking at their genes. Whether it is a person’s lifestyle or environment, looking at a person’s genes, you will get a certain phenotype in the DNA sequence. To that point, if someone has an inflammatory lifestyle combined with a unique genetic code, functional medicine doctors can identify a bunch of comorbidities affecting the individual. With this information, doctors can inform their patients that if they don’t make small lifestyle changes, they could be at risk of developing overlapping conditions that can affect their bodies and invoke pain in the muscles, organs, and joints.
Functional Medicine & Metabolic Syndrome
Dr. Alex Jimenez, D.C., presents: That’s what the functional medicine conversation is about because we are trying to catch the issue before microvascular and macrovascular complications even set in the body. Since metabolic syndrome is a cluster of disorders, can it potentially correlate with other problems like insulin dysfunction?
Well, it can. When the body doesn’t produce enough insulin to provide energy to the body, it can lead to chronic inflammation. So whether it’s a poor lifestyle, microbiome dysfunction, visceral adiposity, or constant stress, inflammation associated with insulin dysfunction can drive the HPA axis into overdrive. Sometimes it could be not inflammation based. It could be related to mitochondrial dysfunction. So by looking at the analysis of the person dealing with metabolic syndrome, you look at their timeline, lifestyle, and the clinical imbalances driving the inflammatory markers to affect the body. The data can also look for signs of mitochondrial insults and comorbidities that could create insulin dysfunction that can lead to the development of the metabolic syndrome. This information will give functional medicine doctors a sense of what they are genetically predisposed to in their bodies.
Everyone is different, and catering to unique treatment plans for them can provide lasting results in the future. So when it comes to the functional and conventional approaches to metabolic syndrome associated with other various disorders, it is important to compare and contrast both methods to determine what the patient should consider doing to regain their health and wellness. This could be from the treatments that can work for the individual, what kind of foods can reduce the inflammatory markers and regulate hormone production, or their physical activity level. To that point, we will treat the cause through various techniques beyond pharmaceuticals and surgery as much as possible and, simultaneously, meet the patients where they are because sometimes people do well with lifestyle intervention. In contrast, others with more risks need more screening time and diagnostic tests.
Insulin Dysfunction Associated With Inflammation
Dr. Alex Jimenez, D.C., presents: Our main goal is to detect insulin dysfunction associated with inflammation that correlates with early metabolic syndrome. The lab results from our associated medical providers can tell us a story of what the patient is going through and determine whether we need to either put in nutrients that the body needs to correct or take out toxins, let’s say, that are interfering with the ability of the body to self-correct insulin dysfunction. Because preventing these comorbidities associated with metabolic syndrome can help many individuals regain their health and wellness.
Since we all have different microbiomes, the beautiful thing about functional medicine is that it brings awareness that needs to be addressed when our bodies are dealing with inflammation and insulin dysfunction that causes us to respond and use that response as an understanding of our microbiome. It allows us to reduce the effects of many issues and symptoms associated with metabolic syndrome that we may not even know about if we left it untreated. By being aware of what is causing problems in our bodies, we can make small changes in our daily life to better ourselves and our health.
Conclusion
Dr. Alex Jimenez, D.C., presents: With that being said, as stated earlier, metabolic syndrome can be a cluster of conditions that includes inflammation, insulin resistance, obesity, and hormonal dysfunction that can develop into somato-visceral or visceral-somatic issues that affect the organs and muscle groups. When all these issues begin to affect the body, they can lead to pre-existing conditions that can lead to joint and muscle pain. Regarding health and wellness, treating the effects of metabolic syndrome can do wonders for the body, mind, and soul. Making small changes to a lifestyle can provide numerous positive results and can restore functionality to the body.
The hip joint is a ball-and-socket joint composed of the femur head and a socket, which is part of the pelvis. The labrum is a cartilage ring on the socket part of the hip joint that helps keep joint fluid inside to ensure frictionless hip motion and alignment during movement. A labral tear of the hip is an injury to the labrum. The extent of the damage can vary. Sometimes, the hip labrum can have mini tears or fray at the edges, usually caused by gradual wear and tear. In other cases, a section of the labrum can separate or get torn away from the socket bone. These types of injuries are usually due to trauma. There are conservative hip labral tear tests to determine the type of injury. The Injury Medical Chiropractic and Functional Medicine Clinic team can help.
Contents
Symptoms
Symptoms are similar regardless of the type of tear, but where they are felt depends on whether the tear is in the front or the back. Common symptoms include:
Hip stiffness
Limited range of motion
A clicking or locking sensation in the hip joint when moving.
Pain in the hip, groin, or buttocks, especially when walking or running.
Night discomfort and pain symptoms when sleeping.
Some tears can cause no symptoms and can go unnoticed for years.
Hip Labral Tear Tests
A hip labral tear can occur anywhere along the labrum. They can be described as anterior or posterior, depending on which part of the joint is affected:
Anterior hip labral tears: The most common type of hip labral tear. These tears occur on the front of the hip joint.
Posterior hip labral tears: This type appears on the back of the hip joint.
Tests
The most common hip labral tear tests include:
The Hip Impingement Test
The Straight Leg Raise Test
The FABER Test – stands for Flexion, Abduction, and External Rotation.
The THIRD Test – stands for the Hip Internal Rotation with Distraction.
Hip Impingement Tests
There are two types of hip impingement tests.
Anterior Hip Impingement
This test involves the patient lying on their back with their knee bent at 90 degrees and then rotated inward towards the body.
If there is pain, the test is considered positive.
Posterior Hip Impingement
This test involves the patient lying on their back with their hip extended and their knee flexed and bent at 90 degrees.
The leg is then rotated outward away from the body.
If it results in pain or apprehension, it is considered positive.
Straight Leg Raise Test
This test is used on various medical conditions that involve back pain.
The test begins with the patient sitting or lying down.
On the unaffected side, the range of motion is examined.
Then the hip is flexed while the knee is straight on both legs.
The patient may be asked to flex the neck or extend the foot to stretch nerves.
The FABER Test
It stands for Flexion, Abduction, and External Rotation.
The test begins with the patient lying on their back with their legs straight.
The affected leg is placed in a figure four position.
The physician will then apply incremental downward pressure to the bent knee.
If there is hip or groin pain, the test is positive.
The THIRD Test
This stands for – the Hip Internal Rotation with Distraction
The test begins with the patient lying on their back.
The patient then flexes their knee to 90 degrees and turns it inward around 10 degrees.
The hip is then rotated inward with downward pressure on the hip joint.
The maneuver is repeated with the joint slightly distracted/pulled apart.
It is considered positive if the pain is present when the hip is rotated and diminished pain when distracted and rotated.
Chiropractic Treatment
Chiropractic treatment involves hip adjustments to realign the bones around the hip and up through the spine, soft tissue massage therapy to relax the muscles around the pelvis and thigh, targeted flexibility exercises to restore range of motion, motor control exercises, and strengthening exercises to correct muscular imbalances.
Treatment and Therapy
References
Chamberlain, Rachel. “Hip Pain in Adults: Evaluation and Differential Diagnosis.” American family physician vol. 103,2 (2021): 81-89.
Groh, M.M., Herrera, J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9
Dr. Alex Jimenez, D.C., presents how many people can recognize the cause of metabolic syndrome. Metabolic syndrome is a cluster of conditions ranging from insulin resistance to muscle and joint pain. Considering how every person is different, we look at how metabolic syndrome is associated with cardiovascular disorders. We refer patients to certified providers that provide cardiovascular treatments associated with metabolic syndrome to relieve issues affecting the body while ensuring optimal wellness for the patient through various treatments. We acknowledge each patient by referring them to our associated medical providers based on their diagnosis to understand better what they are dealing with appropriately. We understand that education is an excellent way to ask our providers various intricated questions to the patient’s knowledge. Dr. Jimenez, D.C., utilizes this information as an educational service. Disclaimer
What Is Metabolic Syndrome?
Dr. Alex Jimenez, D.C., presents: Today, we are going to start widening the lens on metabolic syndrome. From a functional medicine perspective, many didn’t always call it metabolic syndrome. Other terms used to describe the diagnosis were:
Dysmetabolic syndrome
Hypertriglyceridemic waist
Insulin resistance syndrome
Obesity syndrome
Syndrome X
Metabolic syndrome is a cluster of disorders that can affect an individual’s daily life and cause various issues that can cause the body to be dysfunctional. So in 2005, the ATP three guidelines told us that patients must meet three out of five criteria to get the diagnosis of metabolic syndrome. So these are around waist circumference, which is about visceral adiposity, blood pressure, blood glucose, triglycerides, and HDL. And then you see the cutoffs there. So in the International Diabetes Federation diagnosis criteria, notice that it’s required to have central obesity, but per ethnicity-specific cutoffs for waist circumference. So instead of three out of five, you have to have one, and then the other two out of four must be met. So you see the other ones the same as before, but they’re just compartmentalized differently in this diagnosis scheme. Now let’s talk about these ethnicity-specific cutoffs.
So if you are a standard corn-fed American, your waist circumference cutoff is 40 inches as a male and 35 inches as a female. Now, if you were from different parts of the world, the numbers for waist circumference are different whether the ethnicity is Asian, Hispanic, African, European, or Middle Eastern. By looking at the diagnosis of metabolic syndrome by looking more into the ethnicity-specific cutoffs, you can see that more people would start to meet the criteria for metabolic syndrome if doctors use the stringent ethnicity-specific standards to diagnose their patients for metabolic syndrome. Other diagnoses would also notice where the visceral adiposity is at during the cutoff and see additional hints of insulin resistance. Other factors besides insulin resistance can cause the body’s systems to be dysfunctional, which will drive the common risk factors to cause the pain associated with metabolic syndrome to affect the muscles and muscle groups. When the body becomes dysfunctional due to metabolic syndrome, it can also affect vital organ systems like the cardiovascular system. Now how does metabolic syndrome correlate with the cardiovascular system?
How Does Metabolic Syndrome Associated With Cardiovascular System?
Dr. Alex Jimenez, D.C., presents: If you look at how a person’s lifestyle habits affect their body, you can see that the data shows how metabolic factors contribute to total cardiometabolic risk. This information lets the doctors and patients know about their LDL cholesterol, BMIs, family history, and blood pressure. Suppose a person has pre-existing cardiovascular issues associated with metabolic syndrome. In that case, it is important to know if their glucose levels have elevated or dropped and to see how to control those risk factors associated with cardiometabolic syndrome. These are important risk factors that have to be brought up in a metabolic dysfunction conversation to have a better understanding.
Now there are ways to reduce the effects of metabolic syndrome associated with cardiovascular diseases. By expanding the data from the patient’s test results, we can look beyond the cardiometabolic risk; we can determine the causes that are the progression of these issues affecting the body. This can be numerous issues like how much exercise the person is doing, how they deal with stress and inflammation, and what foods they eat.
By recognizing these results, we can identify things beyond metabolic syndrome and figure out what other disorders are contributing to metabolic syndrome. Many doctors will inform their patients about how their insulin levels can become elevated, which can cause them to develop insulin resistance and lose their beta cells. When insulin resistance corresponds with metabolic syndrome, many people need to realize that their genes can also play into effect. Some people have genes that drive them with the same kind of lifestyle dysfunction, inflammation, dysfunction, and insulin resistance. Their genes will also equal blood pressure issues or crazy lipid disturbances. When cardiometabolic risk factors are contributing to underlying problems affecting the body, it is really important to have functional medicine be the main focus to figure out where the issues are causing dysfunction in the body.
Insulin Resistance & Metabolic Syndrome
Dr. Alex Jimenez, D.C., presents: So when it comes to insulin resistance, it is important to take note of the abnormal beta cell function in the body if the pancreas can’t produce enough insulin to be turned into glucose. When this happens, people will begin to have elevated glucose levels, and if it continues to rise at a certain point, they will already be prone to having type 2 diabetes. To that point, the body will have this relative insulin deficiency, causing the body’s receptors not to be as sticky and functional.
When enough insulin is circulating the body and doing its job, the blood glucose levels don’t hit the threshold to become diabetes. Now, suppose the body maintains normal beta cell function. In that case, however, the insulin receptors are not working, which allows the pancreas to start pumping out insulin to be able to keep up with this resistance, causing the individual to be at a compensatory high insulin state. By stabilizing insulin levels, many individuals can control how much glucose is in their bodies. However, suppose a person is prone to becoming diabetic. In that case, all that insulin is being pumped out is a massive system biology dysfunction signaling many other nondiabetic downstream diseases.
Conclusion
So insulin dysfunction can be associated with cardiovascular disease due to poor lifestyle choices, dietary habits, and physical activity. When dealing with metabolic syndrome associated with these risk factors, it can cause the body to be dysfunctional and cause pain in the organs, muscles, and joints. This can lead to obesity and diabetes if it is not handled properly. Getting a routine started can help lower insulin resistance by eating properly, getting adequate sleep, practicing mindfulness, and exercising can help improve the body and mind.
Non-radiographic axial spondyloarthritis or nr-axSpA and non-radiographic ankylosing spondylitis/AS are related. However, non-radiographic axial spondyloarthritis can present AS symptoms with active inflammation of the spine and sacroiliac/SI joints, causing back and hip pain but does not reveal joint damage on X-rays or MRIs. Injury Medical Chiropractic and Functional Medicine Clinic can explain what it means to have non-radiographic axial spondyloarthritis, how it can be managed, and what to do to prevent it from turning into ankylosing spondylitis.
Contents
Non-Radiographic Axial Spondyloarthritis
Non-radiographic axial spondyloarthritis means there are early AS symptoms but have not developed enough joint inflammation or damage to show up on an X-ray or other form of imaging. Early evidence of joint inflammation includes blurring of the joint edges and localized regions of joint erosion. It can be difficult for physicians to see these subtle changes on an x-ray.
Ankylosing Spondylitis
Ankylosing spondylitis, or AS, is a form of inflammatory arthritis that affects joints in the spine and elsewhere.
It is a chronic, inflammatory, autoimmune disease.
Medical research is still ongoing to determine the exact cause, but a genetic component is believed to be contributing factor.
Around 85% of individuals with ankylosing spondylitis have inherited the HLA-B27 gene, which is associated with multiple autoimmune conditions.
In the early stages, individuals will present lower back pain around the sacroiliac joints or the joints that connect the spine to the pelvis.
Later stages have more obvious X-ray findings, like the fusing of the sacroiliac joints and the lower spine that takes place over time.
Joint inflammation can progress, causing permanent joint damage and spine rigidity.
Most individuals with the condition can manage their symptoms with NSAIDs, chiropractic care, physical and massage therapy, and range of motion exercises.
Stage 1
There is no evidence of spinal inflammation on x-rays.
MRI provides more detailed images of bones and may reveal bone marrow edema or accumulation of fluid in the structures of the spinal bones and joints.
Individuals with non-radiographic axial spondyloarthritis, you are here.
Stage 2
There is visible inflammation of the spinal joints on the x-ray.
The sacroiliac joints between the spine and the pelvis are the most affected.
Stage 3
Chronic inflammation of the joints has caused bone loss and permanent joint damage, resulting in spine rigidity.
Symptoms of Non-Radiographic Axial Spondyloarthritis
There are differences between back pain associated with muscle strain and arthritis. Back pain symptoms include:
Starts to present before age 40.
It has a gradual onset and can go unnoticed for years.
Improves with movement or activity.
Eases up throughout the day.
Starts up in the evening when resting.
Other symptoms include:
Joint stiffness
Swollen fingers
Heel pain
Bilateral buttock discomfort and pain
Slowing Progression
Progression from non-radiographic axial spondyloarthritis to ankylosing spondylitis occurs in 10% – 20% of individuals over a two-year period. Progression factors include genetics, gender, degree of joint damage, and level of inflammatory markers at the time of diagnosis.
Early diagnosis and treatment can slow the progression before significant joint damage with anti-inflammatory therapy, rheumatological therapy, and targeted exercise.
Work with a specialist like an orthopedic spine specialist and rheumatologist that understands the disorder and is up to date on the most recent treatment modalities.
D. J. Pradeep, A. Keat, K. Gaffney, Predicting outcome in ankylosing spondylitis, Rheumatology, Volume 47, Issue 7, July 2008, Pages 942–945, doi.org/10.1093/rheumatology/ken195
Kucybała, Iwona, et al. “Radiologic approach to axial spondyloarthritis: where are we now and where are we heading?.” Rheumatology international vol. 38,10 (2018): 1753-1762. doi:10.1007/s00296-018-4130-1
Michelena, Xabier, López-Medina, Clementina, and Helena Marzo-Ortega. “Non-radiographic versus radiographic axSpA: what’s in a name?”.” National Center for Biotechnology Information. October 14, 2020. doi.org/10.1093/rheumatology/keaa422
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