Sciatica pain can radiate to the knee. Individuals with sciatica do report unique/unusual knee pain that was never there and no past or recent physical injuries. Sciatica is the culprit, as the knee muscles are powered and controlled by nerves in the lower spine. Irritation or compression of these nerves can cause symptoms that can include: random back pain, hamstring tightness, weakness in the hips or quadriceps, the development of bunions, and knee pain and/or weakness. Chiropractic treatment can release the compression, heal the sciatic nerve, and alleviate knee problems.
Contents
Sciatica Pain Can Radiate To The Knee
Spine conditions that can cause sciatica include:
Disc herniation – Where the inside of the discs leak out and compress and/or irritate surrounding nerves.
Spinal stenosis – The spinal canal begins to narrow, not allowing enough space for the nerves to rest comfortably, resulting in compressed nerves.
Spondylolisthesis – A condition that occurs when a vertebrae slips forward onto the vertebrae below it.
Any can cause irritation, inflammation, or compression of the sciatic nerve leading to painful sensations that extends from the lower back down through the leg.
Symptoms
Common knee symptoms that may be experienced with sciatica include:
A dull ache, warm sensation, or sharp pain around the knee.
Bunions form from weakened stabilizing muscles that affect walking, running, and standing posture.
As sciatica pain can radiate to the knee, individuals will usually also experience pain in their buttocks, thigh, calf, and/or foot. The nerve sensations and other symptoms in the knee can be felt through a branch of the sciatic nerve known as the peroneal nerve.
Duration
The knee pain will last as long as sciatica does, depending on the type of sciatica, whether it is acute or chronic.
An acute sciatic episode usually resolves after a few weeks, with possible future flare-ups.
Chronic sciatica is a long-term condition that does not resolve independently and necessitates intervention by a specialist.
Chiropractic Treatment Plan
Depending on the diagnosis, a chiropractor will develop a personalized treatment plan to address the root cause and heal the injury. The treatment plan will include therapeutic massage, posture training, and at-home self-care to help heal and prevent future sciatica.
Massage Rehabilitation
Physical therapy and therapeutic massage will loosen and relax the muscles, nerves, tendons, and ligaments.
Heat and ice, exercises, and stretches will prepare the muscles and nerves for chiropractic decompression adjustments.
Posture Training
Training will be provided to maintain the back, hips, knees, and feet in proper alignment.
Training on removing pressure from the lower back and restabilizing the rest of the body.
Training on proper body mechanics, safe lifting techniques, and injury prevention.
Self-Pain Management
Training on self-care habits that include healthy weight, core strengthening exercises and stretches for the back muscles, and proper rest for a full recovery.
An anti-inflammatory diet to reduce/eliminate inflammation and achieve a healthy weight and a nutrition plan to maintain overall health.
Surgery
Surgery is the final option when conservative treatments are not working.
Treating Severe & Complex Sciatica Syndromes
References
Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK546593/
Hirabayashi, Hiroki, et al. “Characteristics of L3 nerve root radiculopathy.” Surgical neurology vol. 72,1 (2009): 36-40; discussion 40. doi:10.1016/j.surneu.2008.08.073
Jandre Reis, Felipe Jose, and Adriana Ribeiro Macedo. “Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during forwarding Bending.” Asian spine journal vol. 9,4 (2015): 535-40. doi:10.4184/asj.2015.9.4.535
Jeong, Ui-Cheol, et al. “The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.” Journal of physical therapy science vol. 28,1 (2016): 46-50. doi:10.1589/jpts.28.46
The body incorporates different muscles that have specific jobs to help mobilize the skeletal joints while providing function to the arms, neck, legs, and back. Many individuals use their muscles for everyday uses like lifting and carrying objects, moving from one place to another, and protecting vital organs from damage. To that point, issues like traumatic events, injuries, and environmental factors can affect the body and cause damage to the muscles. When the muscles are affected by these factors, tiny knots can form along the taut muscle band that can cause painful symptoms that affect specific areas in the body. One of the muscles affected by pain is the trapezius muscle, known as the “coat hanger” muscle, which can be associated with chronic symptoms of myofascial pain syndrome. Today’s article examines the trapezius muscle, how myofascial pain affects the trapezius muscle, and how to manage myofascial trapezius pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from trapezius muscle pain associated with myofascial pain. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC provides this information as an educational service only. Disclaimer
What Is The Trapezius Muscle?
Have you experienced pain in your neck, shoulders, or mid-upper back? Do you feel headaches occurring near your temples? What about tenderness in certain areas of your body? Some of these symptoms may appear in your trapezius muscles. The trapezius muscle is located across the back that looks like a simple trapezoid with upper, middle, and lower muscle fibers that have different functions for the upper-middle back, shoulders, and neck. While the entire trapezius muscle helps rotates, elevate, and retract the scapula while extending the head and neck, and turning the chin by itself. At the same time, the entire muscle can help with assisting the extension of the cervical and thoracic spine.
Upper Trapezius muscles: allow the shoulders to rise, bend the head and neck, and help support the weight of the upper extremities of the body, including the arms.
Middle Trapezius muscles: assist with flexion and abduction of the arms around the shoulders at a nearly full range.
Lower Trapezius muscles: Helps retract the scapula while rotating the glenoid fossa upwards by decompressing the vertebral borders of the scapula. These fibers help assist the flexion and abduction of the arms.
When traumatic forces or injuries affect the trapezius muscles, painful symptoms begin to affect the muscles, causing them to be tender to the touch and affecting different areas in the body.
How Does Myofascial Pain Affect The Trapezius Muscle?
When traumatic forces or injuries affect the trapezius muscles, certain parts of the shoulders, neck, and upper-mid back will experience pain-related symptoms. When people experience headaches and shoulder and neck pain in their bodies while feeling tenderness in their trapezius muscles, this is known as referred pain associated with myofascial pain. Myofascial pain is when tiny knots along the taut muscle bands begin to make the muscle area tender to the touch. Individuals who suffer from myofascial pain in their trapezius muscles might experience hyperirritable spots that inflict pain and motor dysfunction. Studies reveal that individuals who work in food services may have symptoms of shoulder pain associated with myofascial pain due to repetitive motions on the upper trapezius muscles affecting their upper bodies. Myofascial trigger pain is a bit challenging to diagnose since the pain can be in different locations and mimic various ailments in the body. To that point, when the trapezius muscles are affected by trigger pain may potentially be involved with cervical myofascial pain. Cervical myofascial pain is a disorder that causes pain from muscle overuse or trauma in the neck. When the pain affects the neck muscles, it can travel down to the trapezius muscles causing tenderness and sensitivity in the affected muscle area. Stress, postural mechanics, or repetitive movements can develop myofascial pain syndrome and affect the surrounding muscles.
Trapezius Trigger Points- Video
Have you felt sore around your shoulders, neck, and upper-mid back? What about muscle tenderness in certain areas of your body? Do you feel tension along your neck or near the temples of your head? If you have been dealing with any of these symptoms, then you might be experiencing myofascial trapezius pain. The video above explains how trigger points from traumatic events can affect the trapezius muscle and cause referred pain that overlaps other conditions that may affect the body. Studies reveal that trigger points in the head and neck muscles of many suffering individuals have tension-type headaches. Tension-type headaches are one of the symptoms associated with myofascial trapezius pain. Some of the other symptoms related to myofascial pain affecting the trapezius muscle include:
Deep aching pain
Stiffness
Muscle spasms
Tightness around the shoulder and neck
Tenderness along the shoulders, neck, and upper back
Occipital headaches
How To Manage Myofascial Trapezius Pain
When many individuals suffer from myofascial trapezius pain, many would go to their primary doctor and explain to them that they are experiencing tension headaches constantly. Since myofascial pain is associated with the trapezius muscle is a bit complex and challenging for doctors to diagnose since every person’s pain is different. Many doctors will refer their patients to associated specialists like physical therapists, massage therapists, or chiropractors to determine where the pain is located along the trapezius muscle. Different treatments can help alleviate stiff muscles, and studies reveal that spinal manipulative therapy can help manage chronic pain from myofascial origins. Spinal subluxations or misalignment could potentially involve the corresponding spinal nerve root causing antinociceptive effects to the tender muscle, thus causing pain to the trapezius muscle. Utilizing various treatments to treat myofascial trapezius pain can provide individuals with beneficial relief from their pain along with managing their associated symptoms.
Conclusion
The trapezius muscle is a large superficial trapezoid-shaped muscle located in the back. The upper, middle, and lower muscle fibers have different functions in the head, neck, shoulders, and arms. The trapezius muscle also helps with assisting the extension of the cervical and thoracic spine. When traumatic events or injuries affect the trapezius muscle, it can be developed over time to create trigger points along the taut muscle band of the trapezius muscle and cause referred pain to the upper extremities of the body. Luckily various treatments can help manage the associated pain symptoms from myofascial trapezius pain and can help many individuals get back on their health and wellness journey.
References
Fernández-de-Las-Peñas, César, et al. “Myofascial Trigger Points and Their Relationship to Headache Clinical Parameters in Chronic Tension-Type Headache.” Headache, U.S. National Library of Medicine, Sept. 2006, pubmed.ncbi.nlm.nih.gov/16942471/.
Hwang, Ui-Jae, et al. “Predictors of Upper Trapezius Pain with Myofascial Trigger Points in Food Service Workers: The Strobe Study.” Medicine, Wolters Kluwer Health, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5500039.
Laframboise, Michelle A, et al. “Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity: A Randomized Controlled Trial.” The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4915475/.
Ourieff, Jared, et al. “Anatomy, Back, Trapezius – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 26 July 2021, www.ncbi.nlm.nih.gov/books/NBK518994/.
Touma, Jeffrey, et al. “Cervical Myofascial Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK507825/.
Kombucha is a fermented tea that has been around for nearly 2,000 years. It became popular in Europe in the early 20th century. It has the same health benefits as tea, is rich in probiotics, contains antioxidants, and can destroy harmful bacteria. Kombucha sales are growing at stores because of its health and energy benefits.
Contents
Kombucha
It is typically made with black or green tea, sugar, healthy bacteria, and yeast. It is flavored by adding spices or fruits into the tea while it ferments. It is fermented for about a week, when gases, 0.5 percent of alcohol, beneficial bacteria, and acetic acid are produced. The fermentation process makes the tea slightly effervescent. It contains B vitamins, antioxidants, and probiotics, but the nutritional content will vary depending on the brand and its preparation.
Benefits
The benefits include:
Improved digestion from the fact that fermentation makes probiotics.
Helps with diarrhea and irritable bowel syndrome/IBS.
Toxin removal
Increased energy
Improved immune system health
Weight loss
Helps with high blood pressure
Heart disease
Kombucha, made from green tea, includes the benefits of:
Beneficial bacteria are known as probiotics. These same probiotics are found in other fermented foods, like yogurt and sauerkraut. Probiotics help populate the gut with healthy bacteria that aid digestion, reduce inflammation, and produce essential vitamins B and K. The probiotics improve bowel movements and alleviate nausea, bloating, and indigestion.
Antioxidants
The antioxidants and polyphenols benefits include:
Increased metabolic rate
Reduced blood pressure
Lowered cholesterol
Improved cognitive function
Decreased risk of chronic diseases – cardiovascular disease, type 2 diabetes, and certain cancers.
Anti-Bacterial Properties
The fermentation process produces acetic acid that destroys harmful pathogens like invasive bacteria and yeasts, preventing infection.
The anti-bacterial effect also preserves the beneficial bacteria.
Liver Detoxification
It can help detoxify the liver, which:
Improves overall skin health
Improves liver function
Decreases abdominal bloating and pain
Improves digestion and bladder function
Pancreatic Support
It can improve pancreatic function, which can help protect the body from diseases and illnesses like:
Acid reflux
Abdominal spasms
Numbness
Pancreatic cancer
Joint Support
The tea contains compounds like glucosamines that have been shown to improve joint health and relieve joint pain.
Glucosamines increase hyaluronic acid, lubricating the joints, which helps protect and strengthen them.
Satisfy Soda Craving
The variety of flavors and natural carbonation can satisfy the craving for a soda or other unhealthy beverages.
Injury Medical Chiropractic and Functional Medicine Clinic includes elements of integrative medicine and takes a different approach to health and wellness. Specialists take a comprehensive view of an individual’s health, recognizing the need for a personalized treatment plan to help identify what is needed to get healthy. The team will create a customized plan that fits an individual’s schedule and needs.
Dietitian Explains Kombucha
References
Cortesia, Claudia et al. “Acetic Acid, the active component of vinegar, is an effective tuberculocidal disinfectant.” mBio vol. 5,2 e00013-14. 25 Feb. 2014, doi:10.1128/mBio.00013-14
Costa, Mirian Aparecida de Campos et al. “Effect of kombucha intake on the gut microbiota and obesity-related comorbidities: A systematic review.” Critical reviews in food science and nutrition, 1-16. 26 Oct. 2021, doi:10.1080/10408398.2021.1995321
Gaggìa, Francesca, et al. “Kombucha Beverage from Green, Black and Rooibos Teas: A Comparative Study Looking at Microbiology, Chemistry and Antioxidant Activity.” Nutrients vol. 11,1 1. 20 Dec. 2018, doi:10.3390/nu11010001
Kapp, Julie M, and Walton Sumner. “Kombucha: a systematic review of the empirical evidence of human health benefit.” Annals of epidemiology vol. 30 (2019): 66-70. doi:10.1016/j.annepidem.2018.11.001
Villarreal-Soto, Silvia Alejandra, et al. “Understanding Kombucha Tea Fermentation: A Review.” Journal of food science vol. 83,3 (2018): 580-588. doi:10.1111/1750-3841.14068
Herniated, slipped, or ruptured discs affect 80% or more of the population. Most individuals don’t even realize they suffered a vertebral subluxation, as it shifted slightly but returned on its own and healed itself. Herniated disc/s symptoms can subside over time and can heal on their own. However, there are times when chiropractic is necessary to help the slipped or ruptured disc back into correct alignment and to help prevent re-injury or the development of new ones.
Contents
When Chiropractic Is Necessary
When an individual’s ability to move is limited is definitely when chiropractic is necessary. Individuals twist and turn their bodies, and the rotational force that comes from lifting and moving objects at home, work, school, sports, or lifting weights increases the risk of disc injury.
The lumbar spine or lower back is the most common location for a herniated disc injury.
The pain can spread to the glutes and legs, causing sciatica or sciatica-like symptoms.
When back pain spreads to the shoulder through the arm, it s caused by a herniated neck/cervical disc.
When the cushioning material from the disc/nucleus pulposus presses on surrounding nerves, it causes inflammation, pain, and numbness.
Individuals can suffer a herniated disc after changing a flat tire, stepping/slipping out of the bath/shower, or coughing and sneezing.
Healing
Herniated discs can be treated with ice packs and heat, over-the-counter medications, and anti-inflammatories. However, if these approaches are not producing results, chiropractic and physical therapy could be necessary to address the pain, reactivate the body’s healing system, and get the body’s circulation energy flowing. Exercises/movements are recommended depending on the injury to allow the musculoskeletal system to realign and circulate the nutrient-rich blood.
Evaluation
The chiropractic team must check if the individual is cleared for chiropractic care. Some individuals cannot undergo chiropractic adjustments because of the following:
The chiropractor will assess the injury and damage by evaluating the spine’s overall health, not just the painful areas.
They will inquire about medical history and conduct a physical examination.
Diagnostic tests could be necessary depending on the condition.
The team will evaluate the following criteria:
If reflexes are normal.
If there is muscle loss or decreased muscle strength.
If there is numbness or loss of sensation.
Loss of reflexes, muscle strength, and sensation could indicate the need for more aggressive treatment.
Depending on what is found, they may refer the individual to a spinal surgeon or specialist.
Techniques
Chiropractic focuses on restoring structural integrity to the body, reducing pressure on neurological tissue, and re-establishing a normal range of motion. With this treatment, pain and inflammation will be reduced or eliminated, and regular movement and reflexes will return. The body is realigned, stress is reduced, and the body’s natural energy can repair the damage. Adjustments involve:
HVLA is a high velocity, low amplitude short thrust to vertebrae that are out of position.
Mobilization involves low-velocity manipulation, stretching, and moving affected muscles and joints.
Joint cavitation expels oxygen, nitrogen, and carbon dioxide from the vertebrae and releases pressure on the affected area.
This technique uses a drop table while the chiropractor uses quick thrust and release manipulation.
Logan Basic Technique
This technique uses a light touch to level the sacrum.
Thompson Terminal Point Technique or Thompson Drop
This table technique adjusts with a weight mechanism to keep the patient in the correct position before the thrust is applied.
DOC Decompression Table
References
Danazumi, Musa S et al. “Two manual therapy techniques for management of lumbar radiculopathy: a randomized clinical trial.” Journal of osteopathic medicine vol. 121,4 391-400. 26 Feb. 2021, doi:10.1515/jom-2020-0261
Kerr, Dana, et al. “What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study.” Clinical orthopedics and related research vol. 473,6 (2015): 1920-30. doi:10.1007/s11999-014-3803-7
Lurie, Jon D et al. “Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial.” Spine vol. 39,1 (2014): 3-16. doi:10.1097/BRS.0000000000000088
Wang, Jeffrey C et al. “Epidural injections for the treatment of symptomatic lumbar herniated discs.” Journal of spinal disorders & techniques vol. 15,4 (2002): 269-72. doi:10.1097/00024720-200208000-00001
Yussen, P S, and J D Swartz. “The acute lumbar disc herniation: imaging diagnosis.” Seminars in ultrasound, CT, and MR vol. 14,6 (1993): 389-98. doi:10.1016/s0887-2171(05)80032-0
The neck ensures that the head is upright in the body while providing mobility to rotate, bend, and tilt in various directions. The neck is part of the cervical spine and provides sensory-motor functions from the nerve pathways spread out along the shoulders and upper back. When traumatic events or injuries affect the cervical spine and cause pain to the neck over time, however, if not treated, it can lead to problematic symptoms associated with muscle pain. Neck pain can lead to muscle stiffness and cause myofascial trigger pain associated with referred pain along the rest of the upper body. Today’s article looks at the effects of neck pain, how it is associated with myofascial trigger pain, and ways to manage neck pain associated with myofascial trigger pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from neck pain associated with myofascial trigger pain. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC provides this information as an educational service only. Disclaimer
The Effects Of Neck Pain
Have you been feeling muscle stiffness around your neck and shoulders? Do you experience random headaches that affect your day? What about feeling tingling sensations along your arms and hands? These symptoms are associated with neck pain and can affect many individuals if not treated over time. Many people who suffer from neck pain will feel muscle stiffness that affects not only the sides of the neck but around the shoulders and their upper back. Studies reveal that neck pain is a multifactorial musculoskeletal disorder that affects the worldwide population and can become a chronic problem. Risk factors associated with the contributing development of neck pain include:
Stress
Poor posture
Anxiety
Sleep position
Neuromusculoskeletal disorders
Auto accidents
Traumatic events
Many of these risk factors associated with neck pain can cause pain symptoms and cause pain in different locations of the body, making diagnosing the pain source problematic for doctors.
Neck Pain Associated With Myofascial Trigger Pain
Since neck pain is common for many individuals, one of the symptoms associated with muscle stiffness and tenderness is myofascial trigger pain overlapping neck pain. Studies reveal that the formation of trigger points is caused when various physical activities begin to yield repetitive stress or cause micro-tears in the definite muscle groups that can cause tension within the muscle fibers. To that point, knots in the taut band of the muscles become hypersensitive and produce referred pain, tenderness, motor dysfunction, and autonomic phenomena. When the neck suffers from a traumatic event that affects the spine, over time can create trigger points or myofascial pain. It is difficult to diagnose where the pain is located in the body because myofascial trigger pain often mimics other pain conditions. It can confuse many individuals as they think they are suffering from one pain, but it’s a different pain that affects their body. Other studies reveal that individuals with myofascial pain syndrome associated with neck pain have a tender point within the tight muscular band, causing local discomfort. To that point, myofascial pain can cause referral pain in remote areas like cervical spine disorders like herniation can often be confused with myofascial pain when there is referral pain in the upper extremities of the body. Some of the symptoms associated with myofascial trigger pain that affects the neck include:
Deep, aching pain
Headaches
Muscle tenderness in the neck or shoulders
Tingling sensation or numbness down the arms and hands
Muscle stiffness
Neck Pain & Trigger Points- Video
Are you experiencing numbness that is running down your shoulders to your hands? What about muscle stiffness along the sides of the neck or shoulders? Or do headaches seem to pop out of nowhere and affect your day? You could risk suffering from neck pain associated with myofascial trigger pain. The video above explains how neck pain is associated with trigger points and how to trigger pain can be primary or secondary to neck pain. Studies reveal that myofascial pain syndrome is a common muscular pain disorder that is misunderstood and involves referred pain to form minor, tender trigger points within the muscles. To that point, myofascial pain associated with neck pain may be consistent with specific patterns of pain associated with each trigger point, contributing factors like emotional, postural, and behavioral factors that cause tension in the neck and frequently related symptoms from various conditions make diagnosing difficult. Since myofascial trigger points are complex and mimic other conditions that affect a different body part, many believe that different ailments affect their body than the actual ailment itself. Thankfully there are ways to manage neck pain associated with myofascial trigger pain and relieve muscle pain.
Ways To Manage Neck Pain Associated With Myofascial Trigger Pain
Since myofascial trigger pain associated with the neck can be a bit complex and challenging to diagnose, many doctors will refer patients to a physical therapist, a chiropractor, or another spine specialist to examine the trigger points causing neck pain. Various treatments can range from home remedies to severe muscle injections, depending on how severe the injuries are since everyone’s pain is different. Some of the available treatments that can reduce and manage myofascial neck pain include:
Exercising (helps stretch and strengthen neck and upper back muscles)
Massage (helps loosen stiff muscles in the neck and shoulders)
Heat therapy (helps relax and increase blood flow to the affected area)
Chiropractic care (uses spinal manipulation to prevent further pain issues from happening)
Acupuncture (helps to relax the trigger point and relieve pain)
Incorporating these various treatments can provide beneficial relief to those suffering from myofascial neck pain and help manage the symptoms associated with the body.
Conclusion
The neck provides mobility to the head as it can rotate, bend, and tilt in various directions while providing sensory-motor functions to the shoulders and upper back from the nerve roots in the cervical spine. When traumatic forces impact the neck, myofascial trigger pain can lead to neck pain. Myofascial trigger pain associated with neck pain is where tiny knots in the affected neck muscles become tender and stiff, which causes referred pain to different locations in the body. Myofascial neck pain is challenging to diagnose but manageable to treat with various treatments and techniques that can release the knots from the affected muscle and prevent future symptoms from happening. This allows many individuals to feel relief from their neck pain and continue their wellness journey.
References
Alghadir, Ahmad H, et al. “Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points.” BioMed Research International, Hindawi, 10 Mar. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7085833/.
Ezzati, Kamran, et al. “Prevalence of Cervical Myofascial Pain Syndrome and Its Correlation with the Severity of Pain and Disability in Patients with Chronic Non-Specific Neck Pain.” The Archives of Bone and Joint Surgery, Mashhad University of Medical Sciences, Mar. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8121028/.
Fricton, J R, et al. “Myofascial Pain Syndrome of the Head and Neck: A Review of Clinical Characteristics of 164 Patients.” Oral Surgery, Oral Medicine, and Oral Pathology, U.S. National Library of Medicine, Dec. 1985, pubmed.ncbi.nlm.nih.gov/3865133/.
Kazeminasab, Somaye, et al. “Neck Pain: Global Epidemiology, Trends and Risk Factors.” BMC Musculoskeletal Disorders, BioMed Central, 3 Jan. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC8725362/.
Toxin overload is the condition of having an excessive amount of toxins in the body. Harmful substances can come from water, food, cleaning products, and environmental sources that individuals are exposed to regularly. Toxins are also produced in the body by poor gut health through autointoxication. Considering the number of toxins from food additives, preservatives, and perfumes to cleaning products, cosmetic products, and plastic water bottles, much of everyday life include exposure to chemicals that are not healthy. That’s why it’s recommended to undergo regular detoxes to ensure optimal body function and disease prevention.
Contents
Toxin Overload
One of the main ways toxins damage the body is they poison the enzymes, which prevents the body from functioning correctly. The body relies on enzymes for every physiological function. When toxins damage the enzymes, the production of hemoglobin in the blood is prevented, which can accelerate aging and lead to the failure of energy production and lower protection against oxidated stress. The failure of normal body functions increases the risk of diseases that include:
Proper waste elimination is essential to optimal health.
80% of the immune system is in the gut, and with a compromised digestive system, toxins can begin to accumulate.
Fatigue
When the body efficiently delivers nutrients to the cells and eliminates waste, there should be balanced energy throughout the day.
Toxin overload can cause individuals to experience fatigue, even in individuals that eat healthily and exercise, which could be an indicator of accumulation.
Chronic fatigue and viral infections could present from a weakened immune system.
Muscle Joint Aches and Pains
When gut health is compromised, undigested food particles can cause tears in the lining of the intestinal wall leading to a leaky gut.
The food particles enter the bloodstream and can cause an inflammatory response.
They can lodge themselves in weak areas of the joints, causing pain and increased muscle soreness.
Proper digestion and detoxification help eliminate toxins from the joints and muscles and heal the damaged lining.
Insomnia
Sleep is when the body detoxes, repairs, and rejuvenates itself.
Sleep problems could be a sign that the body is struggling to detoxify.
Chronic Headaches
Chronic headaches often result from imbalances in the body resulting from toxin overload and obstructed/blocked detoxification pathways.
Fluid Retention and Congestion
The lymphatic system is part of the circulatory system. The primary function is to transport lymph, a clear fluid that contains white blood cells essential for regulating inflammation.
Diet, hormone imbalances, sedentary lifestyle, medications, and genetics can contribute to fluid retention and congestion, causing stagnation of the lymphatic system.
If the system becomes congested, it can cause pain and swelling.
Unusual Weight Loss or Gain
Increased belly/visceral fat is the fat stored within the abdominal cavity. This is the most dangerous fat because of its proximity to vital organs like the liver, pancreas, and stomach.
Visceral fat or active fat influences how hormones function in the body. Stress, lack of exercise, and an unhealthy diet contribute to excess visceral fat.
Individuals trying to lose weight unsuccessfully could be a sign of having excessive toxins in the body.
Skin Problems
The skin reveals what’s happening inside the body.
Acne, rosacea, eczema, or other chronic skin issues, could indicate toxins are traveling through the skin.
When waste is not eliminated thoroughly through sweat, urine, and feces, the body could try to expel it through the skin.
Improving the body’s digestive and detoxification processes can help heal the root problem.
Giannini, Edoardo G et al. “Liver enzyme alteration: a guide for clinicians.” CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne vol. 172,3 (2005): 367-79. doi:10.1503/cmaj.1040752
Grant, D M. “Detoxification pathways in the liver.” Journal of inherited metabolic disease vol. 14,4 (1991): 421-30. doi:10.1007/BF01797915
Lala V, Goyal A, Minter DA. Liver Function Tests. [Updated 2022 Mar 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482489/
Mattick, R P, and W Hall. “Are detoxification programmes effective?.” Lancet (London, England) vol. 347,8994 (1996): 97-100. doi:10.1016/s0140-6736(96)90215-9
Seaman, David R. “Toxins, Toxicity, and Endotoxemia: A Historical and Clinical Perspective for Chiropractors.” Journal of chiropractic humanities vol. 23,1 68-76. 3 Sep. 2016, doi:10.1016/j.echu.2016.07.003
The body is a functional machine that consists of muscles, organs, and skeletal joints that play different parts in making the body healthy as possible. Each section has a casual relationship as they work together and do their jobs separately. The muscles provide protection and movement from daily activities. The organs supply hormones, oxygen, and nutrients, so the body’s internal functions work correctly. And finally, the skeletal joints help with mobility and stabilization for the body to stay upright. When environmental factors or traumatic injuries affect the body, many issues over time may cause damage, and the body may develop pain-related symptoms. Today’s article examines how the musculoskeletal system works in the body, how trigger points affect the musculoskeletal system, and how chiropractic care can help alleviate trigger point pain. We refer patients to certified providers specializing in musculoskeletal treatments to aid individuals suffering from muscle pain associated with trigger points. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
How Does The Musculoskeletal System Works?
Have you been experiencing muscle stiffness in specific areas located in your body? Do you feel tenderness in your neck, shoulders, or back? Or do you feel knots along your muscles that are causing you pain? Some of these symptoms are associated with muscle pain in the musculoskeletal system. The musculoskeletal system in the body has muscles, ligaments, and connective tissues surrounding the skeletal joints. Studies reveal that the structure of the musculoskeletal system shows how the surrounding muscles protect the joints and help provide the body functionality. The various muscles in the body offer a range of motion, sensory-motor functions, reflexes, and strength when functioning normally. However, when environmental factors begin to affect the body over time, it can lead to musculoskeletal disorders associated with pain. Studies reveal that when the body succumbs to pain related to musculoskeletal disorders. Musculoskeletal disorders are a common issue that has affected many individuals worldwide and causes various disabilities and symptoms that affect the body. Some of the musculoskeletal disorder symptoms that affect the body include:
Burning sensations
Muscle twitches
Fatigue
Stiffness and aching
Myofascial trigger pain
How Do Trigger Points Affect The Body?
One of the musculoskeletal symptoms associated with muscle pain is trigger points or myofascial pain. Myofascial pain is a common condition involving the muscles and surrounding connective tissues that may be acute or chronic depending on where the pain is located. While trigger points refer to hard palpable nodules in the taut bands of the skeletal muscle that can be active (causes spontaneous pain or abnormal sensory symptoms) or latent (causes no spontaneous pain but shows operational myofascial trigger points characteristics). Studies reveal that myofascial pain can be associated with muscle dysfunction, weakness, and limited range of motion that affects the body. A knot in the muscle in certain body areas can make the muscle hyperirritable, causing painful compression while invoking characteristic referred pain and autonomic phenomena in the body. To that point, it can be difficult for doctors to diagnose since trigger points are caused by traumatic events in the body and can occur in different spots in different people. Trigger points can form all over the body, including:
Neck
Mid-back
Low back
One common characteristic when trigger points affect the body is that they can travel or even spread to the surrounding muscles.
Myofascial Pain Syndrome & Trigger Points- Video
Have you been feeling pain located in your neck, back, or particular areas in your body? What about feeling pain in a different location of your body? Or have you experienced muscle stiffness or tenderness in certain areas of your body? If you have been experiencing these symptoms associated with muscle pain, you could be dealing with trigger point pain or myofascial pain in your musculoskeletal system. The video above explains myofascial pain and trigger points and how they affect the body. Studies reveal that myofascial pain is caused by myofascial trigger points that produce exquisitely tender spots in the taut bands of hardened muscles. To that point, it stimulates local and referred pain amongst other sensory, motor, and autonomic symptoms. Myofascial trigger points can cause stiffness and weakness in the involved muscle, making it difficult to diagnose since it can cause pain in different body areas. Fortunately, there are ways to alleviate trigger point pain associated with myofascial pain syndrome from the body.
How Chiropractic Care Alleviates Trigger Point Pain
Since myofascial trigger point pain can be challenging to diagnose, it can range from neck to low back pain in different locations and mimic other pain conditions that affect the body. It can affect the body to become hypersensitive and hyperirritable while decreasing a person’s overall sense of well-being. Luckily, treatments like chiropractic care can help alleviate trigger point pain and help manage myofascial pain syndrome. Chiropractic care is not just for the skeletal system but can help relieve muscle pain associated with myofascial pain. Since the muscles are layered and interwoven around the joints, they play an integral part in supporting the body. Studies reveal that chiropractors are great at finding trigger points and utilize specific exercises and physical modalities to treat myofascial pain syndrome symptoms. Some of the benefits chiropractic care use include:
Breaking up scar tissue
Applying pressure on the trigger point
Aligning the spine to reduce the spinal subluxation
Ease muscle pain
Conclusion
The body consists of muscles, organs, and joints in a casual relationship that helps function and stabilizes the host. The musculoskeletal system has muscles, tissues, and ligaments that are interwoven and layered, surrounding the skeletal joints to prevent injuries or traumatic events from affecting the body. When the body does suffer from damages caused by traumatic events, it can lead to a musculoskeletal disorder known as myofascial pain or trigger pain. Trigger pain is when the muscles have knots along taut bands of the muscle that can cause muscle stiffness and pain. Trigger point pain can be challenging to diagnose since the pain can travel from one location to another section of the body. This is referred pain, and myofascial trigger pain can mimic other chronic musculoskeletal symptoms. Treatments like chiropractic care can help alleviate myofascial trigger pain through spinal manipulation and trigger point therapy, thus relieving the stiff muscle causing pain. Incorporating treatments like chiropractic care can help loosen stiff muscles, increase joint range of motion and bring a person’s wellness back.
References
Bron, Carel, and Jan D Dommerholt. “Etiology of Myofascial Trigger Points.” Current Pain and Headache Reports, Current Science Inc., Oct. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3440564/.
Murphy, Andrew C, et al. “Structure, Function, and Control of the Human Musculoskeletal Network.” PLoS Biology, Public Library of Science, 18 Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5773011/.
Shah, Jay P, et al. “Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.” PM & R : the Journal of Injury, Function, and Rehabilitation, U.S. National Library of Medicine, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/.
Functional fitness conditioning exercises train the muscles for everyday activities safely and efficiently. It refers to exercises that simulate daily movements like standing, bending, reaching, jumping, twisting, pushing, pulling, squatting, lunging, turning, walking, and running. These exercises improve functional body strength to train the muscles to work together and prepare for daily tasks and chores that individuals do at home, at work, or in sports activities. Strengthening the muscles the same way they are needed for everyday tasks reduces the risk of injury, allowing individuals to go through the day without worrying about straining or pulling something.
Contents
Functional Fitness Conditioning
Functional fitness conditioning exercises can be done at home, park, or gym and is an excellent way to combat restlessness and keep the body moving. Training the muscles to work the way they do daily prepares the body to move optimally and efficiently in various situations. Functional fitness exercises simultaneously utilize upper and lower body muscles to increase core stability and train the whole body. Examples include:
Combining strength training with exercises that mirror the movements of daily life increase overall strength and improves:
Balance
Endurance
Flexibility
Mobility
Various gyms or fitness centers may offer functional fitness conditioning classes or incorporate functional fitness into their exercise courses. Exercise equipment can include:
Primarily using body weight makes this strength training simple and safe for almost anybody. Functional fitness conditioning is laidback, requiring less equipment and intensity. The objective is to develop and strengthen the entire body to handle daily life while minimizing the risk of injury, making it suitable for individuals of all ages and fitness levels.
Benefits
These include benefits for overall health and physical performance.
Everyday life
Quality of life improves because of the stress relief factor.
This type of training has been reported to be more enjoyable because the training is for everyday life.
Increased muscle memory
Builds muscle and core strength and exercises the brain to increase memory.
Increased mobility
Improves balance
Coordination
Flexibility
Muscle strength
Agility
Improves balance and posture
Training and strengthening the muscles to manage/balance weight correctly reduces stress on the body.
Faster injury recovery
A strengthened body operates at optimal levels that improve repairing and healing capabilities.
It is recommended to check with your doctor before starting any new exercise program, and pregnant women should check with their doctors. A personal trainer, functional medicine, or sports chiropractor can discuss available conditioning options specific to the individual.
Functional Fitness
References
Fahlman, Mariane M et al. “Effects of resistance training on functional ability in elderly individuals.” American Journal of health promotion: AJHP vol. 25,4 (2011): 237-43. doi:10.4278/ajhp.081125-QUAN-292
Gerards, Marissa H G, et al. “Perturbation-based balance training to improve balance control and reduce falls in older adults – study protocol for a randomized controlled trial.” BMC geriatrics vol. 21,1 9. 6 Jan. 2021, doi:10.1186/s12877-020-01944-7
Pacheco, Matheus Maia, et al. “Functional vs. Strength training in adults: specific needs define the best intervention.” International Journal of sports physical therapy vol. 8,1 (2013): 34-43.
Pullyblank, Kristin, et al. “Effects of the Strong Hearts, Healthy Communities Intervention on Functional Fitness of Rural Women.” The Journal of rural health: official Journal of the American Rural Health Association and the National Rural Health Care Association vol. 36,1 (2020): 104-110. doi:10.1111/jrh.12361
The body’s nerves are the communication system that carries messages between the brain and the rest of the body. Some nerves transmit messages from the brain to muscles to make the body move, while others relay pain, pressure, or temperature signals. Tiny fibers bundled inside each nerve carry the messages with an outer layer/sheathing that insulates and protects the nerves. The brachial plexus is a network of nerves that send signals from the spinal cord to the shoulders, arms, and hands. A brachial plexus nerve injury occurs when the nerves are over-stretched, compressed, torn, cut, or ripped from the spinal cord.
Contents
Brachial Plexus Nerve Injury
The injury involves the head or neck hitting or getting hit and shifting to one side while the shoulder is stretched/pulled in the opposite direction.
Minor brachial plexus injuries are commonly known as stingers or burners and are common in sports like football, wrestling, hockey, soccer, and basketball.
Severe brachial plexus injuries can cause arm paralysis and usually result from vehicle or motorcycle accidents.
Other conditions like inflammation or tumors can affect the brachial plexus.
Sometimes babies can sustain brachial plexus injuries during birth.
Pressure and stretching injuries do not physically sever the nerve but can disrupt communication.
Cutting injuries vary depending on the severity of the cut and because the nerves are in a protective canal that can also be fractured or broken. If the canal remains intact, the nerve fibers could grow back with time.
However, surgery is necessary to repair the damage if the canal is broken.
Signs and symptoms of a brachial plexus nerve injury can vary, depending on the severity and location of the injury. Usually, only one arm is affected.
Minor Injuries
Minor damage comes from over-stretching or mild compression.
An electric or burning sensation shoots down the arm.
Numbness and weakness in the arm.
Neck pain.
These symptoms usually last for a few seconds or minutes but can linger for days or longer.
Severe Injuries
More-severe symptoms result from injuries that impact, tear, or rupture the nerves.
The most severe injury occurs when the nerve root is torn from the spinal cord.
Symptoms include:
Intense pain.
Writhing neck pain.
Weakness or inability to use specific shoulder, arm, and/or hand muscles.
Complete lack of movement and feeling in the shoulder, arm, and/or hand.
Symptoms in both arms.
Complications
With time, most brachial plexus injuries in children and adults heal with minimal long-term damage. But some injuries can cause long-lasting problems that include:
Joint Stiffness
The joints can stiffen, making movement difficult.
Healthcare providers often recommend ongoing chiropractic and physical rehabilitation during recovery.
Atrophy
Nerves regrow slowly and can take some time to completely heal after the injury.
During that time, lack of use can cause the muscles to break down.
Chronic Pain
Nerve damage can cause pain signals to be constantly firing.
Numbness
It can occur in the arm or hand, increasing the risk of worsening the injury or causing new injuries.
Disability
Recovery from a severe brachial plexus injury depends on age, damage, location, and severity.
Even with surgery, individuals can experience long-term muscle weakness or paralysis.
Chiropractic Treatment and Rehabilitation
Treatment depends on the severity of the damage. Chiropractic can help realign, rehabilitate, stretch, and strengthen the muscles, nerves, tendons, joints, and ligaments to expedite recovery. For less severe injuries:
Muscle strengthening and posture exercises help maintain motion.
Therapeutic massage will stimulate circulation and keep the muscles loose.
For severe injuries:
Surgery
Continued chiropractic and physical rehabilitation to maintain thorough circulation, range of motion, and relaxed muscles.
The Brachial Plexus
References
Brucker, J et al. “Brachial plexus birth injury.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 23,6 (1991): 374-80. doi:10.1097/01376517-199112000-00006
Gutkowska, Olga, et al. “Brachial plexus injury after shoulder dislocation: a literature review.” Neurosurgical review vol. 43,2 (2020): 407-423. doi:10.1007/s10143-018-1001-x
Joyner, Benny, et al. “Brachial plexus injury.” Pediatrics in review vol. 27,6 (2006): 238-9. doi:10.1542/pir.27-6-238
Noland, Shelley S et al. “Adult Traumatic Brachial Plexus Injuries.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,19 (2019): 705-716. doi:10.5435/JAAOS-D-18-00433
In many situations, stress or cortisol in the body allows the host to go into a “fight or flight” response that works together with the sympathetic nervous system. In its acute form, stress enables the individual to experience various symptoms quickly and doesn’t last very long. However, when there is residual stress still in the body over an extended period can cause havoc to the body and affect a person’s well-being is known as chronic stress. To that point, when the body is dealing with chronic stress, over time can become at risk of developing chronic disorders associated with chronic issues affecting the endocrine system. One of the endocrine disorders that correlate with chronic stress is Cushing syndrome. Today’s article examines Cushing syndrome, its symptoms, and ways to manage Cushing syndrome in the body. We refer patients to certified providers specializing in endocrinology treatments to aid individuals suffering from Cushing syndrome. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
What Is Cushing Syndrome?
Have you been experiencing abnormal weight gain around your midsection? What about feeling tired throughout the entire day? Or has your mood been changing all day? Many of these symptoms that you are experiencing could potentially make you at risk of developing Cushing syndrome. Cushing syndrome is an endocrine disorder that causes the brain’s anterior pituitary to produce excessive ACTH (adrenocorticotropic hormone), leading to excess cortisol release from the adrenal glands. In the endocrine system, cortisol is a hormone produced in the adrenal glands above the kidneys. These hormones help the body by:
Maintaining blood pressure
Regulates glucose levels
Reduces inflammation in the body
Converts food into energy
Manages respiration
When the adrenal glands overproduce cortisol, it causes the body to be on high alert and can become a risk of developing chronic symptoms associated with Cushing syndrome. Studies reveal that Cushing’s disease (a condition where the pituitary glands overproduce ACTH and turn into cortisol) becomes associated with an increased risk of cardiovascular and metabolic disorders that overlaps chronic symptoms, thus affecting the body.
The Symptoms
When the body is dealing with Cushing syndrome, studies reveal that chronic exposure to excess cortisol could potentially be involved with its associated comorbidities that contribute to decreasing a person’s quality of life. When a person has the signs of Cushing syndrome, the symptoms are unmistakable as the symptoms vary in different people. One of the prominent symptoms of Cushing’s syndrome is rapid weight gain along the face, abdomen, back of the neck, and chest. Some other symptoms associated with Cushing’s syndrome include:
High blood pressure
Purple/red stretch marks along the abdomen
Fatigue
Weak, thin muscles along the arms and legs
Excessive hair growth in some regions of the body
Cognitive difficulties
An Overview Of Cushing Syndrome-Video
Have you been experiencing rapid weight gain along your face, neck, and abdomen? What about feeling stressed constantly? Or have you noticed that your memory is declining? Many of these symptoms are associated with an endocrine disorder called Cushing syndrome. The video above explains what Cushing’s syndrome is, its causes and symptoms, and how to treat Cushing’s syndrome. Cushing syndrome is developed when the adrenal glands produce an excessive amount of cortisol in the body. When the body is suffering from too much cortisol caused by Cushing syndrome, one of the symptoms is bone fractures associated with Cushing syndrome. Studies reveal that the skeletal system is one of the common targets that cause glucocorticoids to attach themselves to the skeletal joints. To that point, Cushing syndrome causes structural and functional impairment to the skeletal system associated with morbidity and disability to many individuals. Fortunately, there are many ways to manage Cushing syndrome and lower cortisol levels in the body.
How To Manage Cushing Syndrome
Since stress/cortisol is beneficial and harmful to the body, it has a causal relationship with the organs and tissues in the body. The body needs cortisol to regulate the metabolism and functionality of the endocrine organs. Too much cortisol causes the development of Cushing syndrome, and fortunately, there are ways many individuals can manage this endocrine disorder while keeping an eye on their cortisol levels. Many individuals suffering from weight gain from Cushing syndrome should try to find an exercise regime that their primary physician recommends to lose weight and improve their muscle strength little by a little. Other ways that individuals can manage Cushing syndrome are by:
Eating nutritious foods that are anti-inflammatory and taking supplements that have calcium and vitamin D.
Meditation or yoga can help calm the mind, and taking deep breaths can help relax the body while lowering cortisol levels.
Incorporating massages and chiropractic care to alleviate muscle and joint pain caused by Cushing syndrome. Chiropractic care and massages can help loosen stiff muscles and support the joints to regain their range of motion in the body.
Slowly incorporating these lifestyle changes can lower cortisol levels and help prevent Cushing’s syndrome from progressing further in the body while helping the individual get back on their health journey.
Conclusion
The body needs cortisol or stress to get through stressful situations that a person is going through. Cortisol is a hormone formed from the adrenal glands that help regulate the body’s metabolism and provide the functionality to the organs and tissues. In its acute and chronic form, cortisol can range from mild to severe depending on the body’s situation. The body risks developing Cushing’s syndrome when the adrenal glands overproduce cortisol. Cushing syndrome is an endocrine disorder that causes an increased risk of metabolic disorders associated with chronic symptoms like weight gain around the face, neck, and abdomen. Luckily, there are ways to manage Cushing’s syndrome and lower cortisol levels by incorporating an exercise regime, eating anti-inflammatory foods filled with calcium and vitamin D, meditation to calm the mind, and incorporating deep breaths to lower cortisol levels. Utilizing these small changes can significantly impact the body while helping the individual better manage their cortisol levels.
References
Buliman, A, et al. “Cushing’s Disease: A Multidisciplinary Overview of the Clinical Features, Diagnosis, and Treatment.” Journal of Medicine and Life, Carol Davila University Press, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5152600/.
Faggiano, A, et al. “Spine Abnormalities and Damage in Patients Cured from Cushing’s Disease.” Pituitary, U.S. National Library of Medicine, Aug. 2001, pubmed.ncbi.nlm.nih.gov/12138988/.
Kairys, Norah, and Ari Schwell. “Cushing Disease.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 2 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK448184/.
Nieman, Lynnette K. “Cushing’s Syndrome: Update on Signs, Symptoms and Biochemical Screening.” European Journal of Endocrinology, U.S. National Library of Medicine, Oct. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4553096/.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
