Back Clinic Chiropractic Examination. An initial chiropractic examination for musculoskeletal disorders will typically have four parts: a consultation, case history, and physical examination. Laboratory analysis and X-ray examination may be performed. Our office provides additional Functional and Integrative Wellness Assessments in order to bring greater insight into a patient’s physiological presentations.
Consultation:
The patient will meet the chiropractor which will assess and question a brief synopsis of his or her lower back pain, such as:
Duration and frequency of symptoms
Description of the symptoms (e.g. burning, throbbing)
Areas of pain
What makes the pain feel better (e.g. sitting, stretching)
What makes the pain feel worse (e.g. standing, lifting).
Case history. The chiropractor identifies the area(s) of complaint and the nature of the back pain by asking questions and learning more about different areas of the patient’s history, including:
Family history
Dietary habits
Past history of other treatments (chiropractic, osteopathic, medical and other)
Occupational history
Psychosocial history
Other areas to probe, often based on responses to the above questions.
Physical examination: We will utilize a variety of methods to determine the spinal segments that require chiropractic treatments, including but not limited to static and motion palpation techniques determining spinal segments that are hypo mobile (restricted in their movement) or fixated. Depending on the results of the above examination, a chiropractor may use additional diagnostic tests, such as:
X-ray to locate subluxations (the altered position of the vertebra)
A device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.
Laboratory Diagnostics: If needed we also use a variety of lab diagnostic protocols in order to determine a complete clinical picture of the patient. We have teamed up with the top labs in the city in order to give our patients the optimal clinical picture and appropriate treatments.
Discover how a clinical approach to opioid therapy can transform pain management strategies for patients in a healthcare setting.
Key Points on Safe Pain Management with Opioids
Pain Affects Many People: Research suggests that about 100 million adults in the U.S. deal with pain, and this number might grow due to aging, more health issues like diabetes, and better survival from injuries. It’s important to address pain early to prevent it from becoming long-term (Institute of Medicine, 2011).
Non-Opioid Options First: Evidence leans toward starting with treatments like exercise, therapy, or over-the-counter meds before opioids, as they can be just as effective for common pains like backaches or headaches, with fewer risks (National Academies of Sciences, Engineering, and Medicine, 2019).
Team-Based Care Works Best: Studies show teams of doctors, nurses, and therapists can improve pain relief and daily life, though results vary. This approach seems likely to help more than solo care, especially for ongoing pain (Gauthier et al., 2019).
Opioids When Needed, But Carefully: Guidelines recommend low doses, short times, and regular check-ins to balance relief with risks like addiction. It’s complex, so talk openly with your doctor (Centers for Disease Control and Prevention, 2022).
Alternatives Like Chiropractic and NP Support: Integrative methods, such as chiropractic adjustments for spine alignment and ergonomic tips from nurse practitioners, can reduce reliance on meds. Clinical observations from experts like Dr. Alexander Jimenez highlight non-invasive approaches to managing pain effectively.
Understanding Pain Types
Pain can be short-term (acute), medium-term (subacute), or long-lasting (chronic). Acute pain often lasts less than three months and comes from injuries. If not treated well, it might turn chronic, affecting daily activities. Always respect someone’s pain experience—it’s personal and influenced by life factors (Raja et al., 2020).
Assessing Pain Simply
Doctors use tools like questions about when pain started, what makes it worse, and how it feels. Scales help rate it, from numbers (0-10) to faces showing discomfort. For kids or elders, special tools watch for signs like faster heartbeats (Wong-Baker FACES Foundation, 2022).
Treatment Basics
Start with non-drug options like rest, ice, or physical therapy. For chronic pain, meds like acetaminophen or therapies like yoga help. Opioids are for severe cases but come with risks—use them wisely (Agency for Healthcare Research and Quality, n.d.).
Role of Experts
According to clinical observations by Dr. Alexander Jimenez, DC, APRN, FNP-BC, who runs a multidisciplinary practice in El Paso, Texas (https://dralexjimenez.com/), combining chiropractic care with exercises targets root causes, such as misaligned spines, reducing opioid needs. As a nurse practitioner, he coordinates care and offers ergonomic advice to prevent pain from daily habits (LinkedIn Profile).
Comprehensive Guide to Safe and Effective Pain Management Using Opioid Therapy
Millions of people struggle with pain, which affects everything from hobbies to employment. Finding safe strategies to deal with pain is crucial, whether it’s a recent injury or persistent discomfort. This comprehensive handbook examines how to measure pain, available treatments, and responsible opioid use recommendations. We’ll discuss team-based treatment, non-opioid alternatives, and perspectives from professionals like Dr. Alexander Jimenez, who prioritizes holistic approaches. To help you locate trustworthy information online, keywords like “pain management strategies,” “opioid therapy guidelines,” and “non-opioid pain relief” are interwoven.
Introduction to Pain in America
The Institute of Medicine estimates that around 100 million American adults face acute or chronic pain daily. This number is expected to climb due to an aging population, rising rates of conditions like diabetes, heart disease, arthritis, and cancer, plus better survival from serious injuries and more surgeries that can lead to post-op pain (Institute of Medicine, 2011).
As people learn more about pain relief options and gain better access through laws like the Affordable Care Act (ACA), more folks—especially older ones—seek help. Passed in 2010, the ACA requires insurers to cover essential pain management benefits, including prescription drugs, chronic disease care, mental health support, and emergency services (111th Congress, 2009-2010). To use these effectively, healthcare providers need a solid grasp of pain assessment, classification, and treatment.
What Is Pain?
The International Association for the Study of Pain defines it as an unpleasant feeling associated with real or potential tissue damage. It’s subjective, shaped by biology, emotions, and social life. People learn about pain through experiences—some seek help right away, others try home remedies first. Respect their stories (Raja et al., 2020).
Pain falls into three main types, though definitions overlap:
Acute Pain: Lasts less than 3 months, or 1 day to 12 weeks; often limits daily activities for a month or less.
Subacute Pain: Sometimes seen as part of acute, or separate; lasts 1-3 months, or 6-12 weeks.
Chronic Pain: Persists over 3 months, or limits activities for more than 12 weeks (Banerjee & Argáez, 2019).
Poorly managed short-term pain can become chronic, so early action is important (Marin et al., 2017).
Assessing Pain Thoroughly
Pain is complex, influenced by body, mind, and environment. A full check includes history, physical exam, pain details, other health issues, and mental states like anxiety.
Basic pain evaluation covers:
When it started (date/time).
What caused it (injury?).
How does it feel (sharp, dull?)?
How bad it is.
Where is it?
How long does it last?
What worsens it (moving?).
What helps it?
Related signs (swelling?).
Impact on daily life.
Mnemonics help remember these. Here’s a table comparing common ones:
Pain scales provide information but aren’t diagnoses because they’re subjective. Single-dimensional ones focus on intensity:
Verbal: Mild, moderate, severe.
Numeric: 0 (none) to 10 (worst).
Visual: Like Wong-Baker FACES®, using faces for kids, adults, or those with barriers (Wong-Baker FACES Foundation, 2022). An emoji version works for surgery patients (Li et al., 2023).
Multi-dimensional scales check intensity plus life impact. The McGill Pain Questionnaire uses words like “dull” to rate sensory, emotional, and overall effects; shorter versions exist (Melzack, 1975; Main, 2016). For nerve pain, PainDETECT helps (König et al., 2021). Brief Pain Inventory scores severity and interference with mood/life (Poquet & Lin, 2016).
For babies, watch heart rate, oxygen, and breathing. Tools like CRIES rate crying, oxygen need, vitals, expression, sleep (Castagno et al., 2022). FLACC for ages 2 months-7 years checks face, legs, activity, cry, consolability (Crellin et al., 2015). Older kids use Varni-Thompson or draw pain maps (Sawyer et al., 2004; Jacob et al., 2014).
Elders face barriers like hearing loss or dementia. PAINAD assesses breathing, sounds, face, body, and consolability on a 0-10 scale (Malara et al., 2016).
The Joint Commission sets standards across various settings, which affect tool choice (The Joint Commission, n.d.).
Building Treatment Plans
Plans depend on pain type, cause, severity, and patient traits. For acute: meds, distraction, psych therapies, rest, heat/ice, massage, activity, meditation, stimulation, blocks, injections (National Academies of Sciences, Engineering, and Medicine, 2019).
Re-check ongoing acute pain to avoid chronic shift. Goals: control pain, prevent long-term opioids. Barriers: access to docs/pharmacies, costs, follow-ups.
For chronic: meds, anesthesia, surgery, psych, rehab, CAM. Non-opioids include:
Oral Meds:
Acetaminophen.
NSAIDs (celecoxib, etc.).
Antidepressants (SNRIs like duloxetine; TCAs like amitriptyline).
Anticonvulsants (gabapentin, etc.).
Muscle relaxers (cyclobenzaprine).
Memantine.
Topical: Diclofenac, capsaicin, lidocaine.
Cannabis: Medical (inhaled/oral/topical); phytocannabinoids (THC/CBD); synthetics (dronabinol) (Agency for Healthcare Research and Quality, n.d.).
Opioid use has risen, raising concerns (National Academies of Sciences, Engineering, and Medicine, 2019).
Key plan elements:
Quick recognition/treatment.
Address barriers.
Involve patients/families.
Reassess/adjust.
Coordinate transitions.
Monitor processes/outcomes.
Assess outpatient failure risk.
Check opioid misuse (Wells et al., 2008; Society of Hospital Medicine, n.d.).
Team Approach to Pain
Studies support the use of interprofessional teams for better results (Gauthier et al., 2019). Teams include docs, nurses, NPs, pharmacists, PAs, social workers, PTs, behavioral therapists, and abuse experts.
A 2017 report showed that teams improved pain/function from baseline, though not always compared with controls (Banerjee & Argáez, 2017). A meta-analysis found that teams were better at reducing pain after 1 month and sustained benefits at 12 months (Liossi et al., 2019).
Integrative chiropractic care fits here. It involves spinal adjustments—gentle manipulations to correct misalignments—and targeted exercises, such as core strengthening, to maintain alignment and reduce pressure on nerves/muscles. Dr. Alexander Jimenez observes that this helps sciatica/back pain without opioids, using tools like decompression (dralexjimenez.com).
Nurse Practitioners (NPs) provide comprehensive management, including ergonomic advice (e.g., better sitting postures) to prevent strain. They coordinate by reviewing options, referring to specialists, and overseeing plans, as seen in Dr. Jimenez’s practice, where his FNP-BC role includes telemedicine for holistic care (LinkedIn, n.d.).
Beyond Adjustments: Chiropractic and Integrative Healthcare- Video
Managing Opioids Safely
CDC’s 2022 guidelines cover starting opioids, dosing, duration, and risks (Centers for Disease Control and Prevention, 2022).
1. Starting Opioids:
Maximize non-opioids first—they match opioids for many acute pains (back, neck, etc.). Discuss benefits/risks (Recommendation 1, Category B, Type 3).
Review labels, use the lowest dose/shortest time. Set goals, exit strategy. For ongoing, optimize non-opioids (Recommendation 2, A, 2).
2. Choosing/Dosing Opioids:
Immediate-release (hydromorphone, etc.) over ER/LA (methadone, etc.). Studies show no edge for ER/LA; avoid for acute/intermittent (Recommendation 3, A, 4).
No rigid thresholds—guideposts. Risks rise with dose; avoid high if benefits dim (Recommendation 4, A, 3).
Taper slowly to avoid withdrawal (anxiety, etc.). Collaborate on plans; use Teams. If there is disagreement, empathize and avoid abandonment (Recommendation 5, B, 4).
3. Duration/Follow-Up:
For acute, prescribe just enough—often 3 days or less. Evaluate every 2 weeks. Taper if used for days. Avoid unintended long-term (Recommendation 6, A, 4).
Follow-up 1-4 weeks after start/escalation; closer for high-risk (Recommendation 7, A, 4).
4. Risks/Harms:
Screen for SUD/OUD. Offer naloxone for overdose risk (Recommendation 8, A, 4).
Check PDMPs for scripts/combos (Recommendation 9, B, 4).
Toxicology tests are performed annually to assess interactions (Recommendation 10, B, 4).
Caution with benzodiazepines (Recommendation 11, B, 3).
For OUD, use DSM-5 (2+ criteria/year); offer meds like buprenorphine (Recommendation 12, A, 1) (Hasin et al., 2013; American Psychiatric Association, 2013).
OUD signs: Larger amounts, failed cuts, time spent, cravings, role failures, social issues, activity loss, hazardous use, continued despite problems, tolerance, withdrawal.
Treatment: Meds, counseling, groups. Coordinate with specialists.
Conclusion
Finally, relying only on opioids is not necessary for efficient pain management. We can improve the lives of millions of people by giving priority to non-opioid alternatives like acetaminophen, physical therapy, or mindfulness and by taking opioids only when necessary under strict supervision. Teams of professionals, such as physicians, nurses, pharmacists, and specialists like chiropractors, collaborate to develop individualized strategies that lower dangers like addiction. By emphasizing spinal adjustments and targeted exercises, integrative chiropractic therapy may help restore normal alignment and reduce pain naturally, often eliminating the need for medication. Complete management, ergonomic guidance to prevent problems, and treatment coordination for optimal outcomes are all ways nurse practitioners provide value.
According to experts like Dr. Alexander Jimenez, these approaches target underlying issues using non-invasive treatments and functional medicine, promoting long-term well-being. Future developments in pain management seem promising, including FDA-approved non-opioid medications and distraction technologies such as virtual reality. In the end, everyone is empowered to address pain head-on, enhancing everyday activities and general health, when patients are included in decision-making and kept informed. Early evaluation and balanced treatment are crucial; discuss your options with your healthcare professional to determine what is best for you.
Banerjee, S., & Argáez, C. (2017). Multidisciplinary treatment programs for patients with chronic non-malignant pain: A review of clinical effectiveness, cost-effectiveness, and guidelines. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK545496/
Banerjee, S., & Argáez, C. (2019). Multidisciplinary treatment programs for patients with acute or subacute pain: A review of clinical effectiveness, cost-effectiveness, and guidelines. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK546002/
Castagno, E., Fabiano, G., Carmellino, V., et al. (2022). Neonatal pain assessment scales: Review of the literature. Prof Inferm, 75(1), 17-28. https://pubmed.ncbi.nlm.nih.gov/35837859/
Centers for Disease Control and Prevention. (2022). CDC clinical practice guideline for prescribing opioids for pain — United States, 2022. MMWR Recommendations and Reports, 71(3), 1-95. https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
Crellin, D. J., Harrison, D., Santamaria, N., et al. (2015). Systematic review of the Face, Legs, Activity, Cry, and Consolability scale for assessing pain in infants and children: Is it reliable, valid, and feasible for use? Pain, 156(11), 2132-2151. https://pubmed.ncbi.nlm.nih.gov/26218755/
Gauthier, K., Dulong, C., & Argáez, C. (2019). Multidisciplinary treatment programs for patients with chronic non-malignant pain: A review of clinical effectiveness, cost-effectiveness, and guidelines – an update. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK545496/
Hasin, D. S., O’Brien, C. P., Auriacombe, M., et al. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry, 170(8), 834-851. https://pubmed.ncbi.nlm.nih.gov/23903334/
Jacob, E., Luck, A. K., Savedra, M., et al. (2014). Adolescent pediatric pain tool for multidimensional pain measurement in children and adolescents. Pain Management Nursing, 15(3), 694-706. https://pubmed.ncbi.nlm.nih.gov/24360399/
König, S. L., Prusak, M., Pramhas, S., et al. (2021). Correlation between the neuropathic PainDETECT screening questionnaire and pain intensity in chronic pain patients. Medicina (Kaunas), 57(4), 353. https://pubmed.ncbi.nlm.nih.gov/33918596/
Li, L., Wu, S., Wang, J., et al. (2023). Development of the Emoji Faces Pain Scale and its validation on mobile devices in adult surgical patients: a longitudinal observational study. Journal of Medical Internet Research, 25, e41189. https://pubmed.ncbi.nlm.nih.gov/37052994/
Liossi, C., Johnstone, L., Lilley, S., et al. (2019). Effectiveness of interdisciplinary interventions in paediatric chronic pain management: A systematic review and subset meta-analysis. British Journal of Anaesthesia, 123(2), e359-e371. https://pubmed.ncbi.nlm.nih.gov/30954242/
Main, C. J. (2016). Pain assessment in context: A state of the science review of the McGill pain questionnaire 40 years on. Pain, 157(7), 1387-1399. https://pubmed.ncbi.nlm.nih.gov/26901072/
Malara, A., De Biase, G. A., Bettarini, F., et al. (2016). Pain assessment in the elderly with behavioral and psychological symptoms of dementia. Journal of Alzheimer’s Disease, 50(4), 1217-225. https://pubmed.ncbi.nlm.nih.gov/26836181/
Marin, T. J., Van Eerd, D., Irvin, E., et al. (2017). Multidisciplinary biopsychosocial rehabilitation for subacute low back pain. Cochrane Database of Systematic Reviews, 6(6), CD002193. https://pubmed.ncbi.nlm.nih.gov/28664541/
National Academies of Sciences, Engineering, and Medicine. (2019). Framing opioid prescribing guidelines for acute pain: Developing the evidence. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK554977/
Raja, S. N., Carr, D. B., Cohen, M., et al. (2020). The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain, 161(9), 1976-1982. https://pubmed.ncbi.nlm.nih.gov/32694387/
Sawyer, M. G., Whitham, J. F., Roberton, D. M., et al. (2004). The relationship between health-related quality of life, pain, and coping strategies in juvenile idiopathic arthritis. Rheumatology (Oxford), 43(3), 325-330. https://pubmed.ncbi.nlm.nih.gov/14623990/
Wells, N., Pasero, C., & McCaffery, M. (2008). Improving the quality of care through pain assessment and management. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality. https://www.ncbi.nlm.nih.gov/books/NBK2658/
Discover the clinical approach for substance use disorder, a vital method in addressing challenges related to addiction treatment.
Integrative Management of Substance Use Disorder (SUD) and Musculoskeletal Health: A Collaborative Model for Chiropractors and Nurse Practitioners
Substance use disorder (SUD) is a chronic, treatable medical condition that affects the brain, behavior, and the entire body, including the musculoskeletal system. For many patients, SUD overlaps with chronic pain, injury, emotional distress, and functional limitations. An integrative care model that combines evidence‑based SUD screening and treatment with chiropractic care and nurse practitioner (NP)–led primary care can reduce risk, improve function, and support long‑term recovery (American Medical Association [AMA], n.d.; National Institute on Drug Abuse [NIDA], n.d.; National Institute of Mental Health [NIMH], 2025).
This article explains what SUD is, how it is identified and categorized, how clinicians can manage it using practical workflows, and how integrative chiropractic and NP care can address overlapping risk profiles and musculoskeletal consequences.
What Is Substance Use Disorder (SUD)?
SUD is a medical condition in which the use of alcohol, medications, or other substances leads to significant impairment or distress in daily life. It is not a moral failing or a lack of willpower; it is a chronic, brain‑ and body‑based disease that is treatable (NIDA, n.d.; NIMH, 2025).
SUD exists on a spectrum from mild to severe. People with SUD may:
Use more of the substance than they planned
Try and fail to cut down or stop
Spend a lot of time obtaining, using, or recovering from the substance
Continue to use even though it harms health, work, relationships, or safety (American Psychiatric Association, 2022; NIMH, 2025)
Person‑first, non‑stigmatizing language
Stigma can keep people from seeking care. Using respectful, person‑first language reduces shame and supports engagement. NIDA and the AMA recommend (NIDA, n.d.; AMA, n.d.):
Say “person with a substance use disorder,” not “addict” or “drug abuser.”
Say “substance use” or “misuse,” not “abuse.”
Focus on SUD as a chronic, treatable condition.
Categories and Diagnostic Features of SUD
DSM‑5‑TR framework: Mild, moderate, severe
Diagnostic criteria for SUD come from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM‑5‑TR) (American Psychiatric Association, 2022; NIAAA, 2025). A diagnosis is based on the number of symptoms present over 12 months.
Typical criteria include (paraphrased):
Using more or for longer than intended
Unsuccessful efforts to cut down
Spending a lot of time obtaining, using, or recovering
Cravings or strong urges
Role failures at work, school, or home
Social or interpersonal problems caused or worsened by use
Giving up important activities
Using in physically hazardous situations
Continued use despite physical or psychological problems
Tolerance
Withdrawal
Severity is determined by symptom count (American Psychiatric Association, 2022; NIAAA, 2025):
Mild: 2–3 symptoms
Moderate: 4–5 symptoms
Severe: 6 or more symptoms
Substance‑specific categories
Clinically, SUD is further categorized by substance type (NIDA, n.d.; NIMH, 2025):
Alcohol use disorder (AUD)
Opioid use disorder (e.g., heroin, oxycodone, hydrocodone)
Stimulant use disorder (e.g., cocaine, methamphetamine)
Sedative, hypnotic, or anxiolytic use disorder (e.g., benzodiazepines)
Cannabis, tobacco, hallucinogen, or inhalant use disorders
Each category has similar behavioral criteria but unique medical risks, withdrawal profiles, and treatment options (NIDA, n.d.; NIAAA, 2025).
Risk and severity categories for clinical workflows
For practical care, validated screening tools classify risk that guide next steps (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):
Low/no risk: Negative screen or very low scores
Moderate risk: At‑risk use with potential consequences (e.g., falls, crashes, future disease)
Substantial/severe risk: High scores suggest likely SUD and active harm
For example, adult risk zones using tools like AUDIT and DAST (AMA, n.d.):
Low risk/abstain: AUDIT 0–7; DAST 0–2
Moderate risk: AUDIT 8–15; DAST 3–5
Substantial/severe risk: AUDIT ≥16; DAST ≥6
These categories help teams decide when to give brief interventions, when to intensify care, and when to refer to specialty treatment.
Epidemiology and Public Health Impact
National surveys show that millions of people in the United States live with SUD, yet only a fraction receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). The 2022 National Survey on Drug Use and Health reported high rates of both substance use and serious mental illness, often co‑occurring (SAMHSA, 2023).
Key points from recent federal data (SAMHSA, 2023; NIMH, 2025):
SUD commonly co‑occurs with depression, anxiety, and other mental disorders.
Co‑occurring conditions worsen medical outcomes and increase healthcare use.
Early identification and integrated treatment can improve function, reduce complications, and lower long‑term costs.
Identifying Patients With SUD: Screening and Assessment
Early, routine identification is critical. Primary care teams, NPs, and chiropractic clinics that integrate behavioral health can all play a role (AMA, n.d.; NIDA, n.d.; NIAAA, 2025).
Building a safe, trauma‑informed environment
Before asking about substance use, the team should (AMA, n.d.; NIDA, n.d.):
Explain that “we screen everyone” as part of whole‑person care.
Emphasize confidentiality within legal limits.
Use a calm, nonjudgmental tone and body language.
Offer patients the option not to answer any question.
Acknowledge that stress, trauma, pain, and life pressures often contribute to substance use.
This aligns with trauma‑informed care principles promoted by SAMHSA and helps patients feel safe enough to share (AMA, n.d.).
Validated screening tools
Evidence‑based tools are preferred over informal questioning. Common options include (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):
For adults:
AUDIT or AUDIT‑C (Alcohol Use Disorders Identification Test) – screens for unhealthy alcohol use and risk of AUD.
DAST‑10 (Drug Abuse Screening Test) – screens for non‑alcohol drug use problems.
TAPS Tool (Tobacco, Alcohol, Prescription medication, and other Substances) – combined screen and brief assessment.
For adolescents:
CRAFFT 2.1+N – widely used for youth; captures risk behaviors and problems.
S2BI (Screening to Brief Intervention) and BSTAD – brief tools validated for ages 12–17 (NIDA, n.d.; AMA, n.d.).
For alcohol‑specific quick screens:
AUDIT‑C (3 questions) or full AUDIT
NIAAA Single Alcohol Screening Question (SASQ):
“How many times in the past year have you had 4 (for women) or 5 (for men) or more drinks in a day?” (NIAAA, 2025)
Results guide risk categorization and next steps.
Role of the care team
In integrated practices, roles can be divided (AMA, n.d.):
Medical assistants or nurses
Administer pre‑screens and full questionnaires.
Flag positive or concerning responses.
Nurse practitioners / primary care clinicians
Review screening results.
Deliver brief interventions using motivational interviewing.
Conduct or oversee further assessment.
Prescribe and manage pharmacotherapy for SUD when indicated.
Coordinate referrals and follow‑up.
Behavioral health clinicians (on‑site or virtual)
Perform biopsychosocial in-depth evaluations.
Provide psychotherapy and relapse‑prevention skills.
Support motivational enhancement and family engagement.
Chiropractors and physical‑medicine providers
Screen for substance misuse related to pain, function, and injury patterns.
Observe red flags (frequent lost prescriptions, inconsistent pain reports, sedation, falls).
Communicate concerns to the NP or primary medical provider.
Dr. Alexander Jimenez, DC, APRN, FNP‑BC, exemplifies this dual role. As both a chiropractor and a family practice NP, he combines neuromusculoskeletal assessment with medical screening and functional medicine evaluation to identify root causes of chronic pain and unhealthy substance use patterns (Jimenez, n.d.).
Clinical clues that may suggest SUD
Beyond formal tools, clinicians should stay alert for patterns such as (AMA, n.d.; NIMH, 2025):
Frequent injuries, falls, or motor vehicle accidents
Repeated missed appointments or poor adherence to treatment
Drowsiness, agitation, slurred speech, or odor of alcohol
Unexplained weight loss, infections, or liver abnormalities
Social and financial instability, job loss, or legal problems
In chiropractic and musculoskeletal settings, repeated injuries, delayed healing, inconsistent exam findings, or “pain behaviors” that do not match imaging or biomechanics may prompt gentle, supportive screening and medical referral.
Understanding Long Lasting Injuries- Video
Comprehensive Assessment and Risk Stratification
Once a screen is positive, the next level is a more detailed assessment. This should examine substance type, frequency, amount, impact, withdrawal, mental health, physical comorbidities, and function (AMA, n.d.; NIMH, 2025).
Structured assessment tools
Clinicians may use (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):
Full AUDIT for alcohol
DAST‑10 for general drugs
CRAFFT or GAIN for adolescents
Checklists based directly on DSM‑5‑TR criteria to rate symptom count and severity (NIAAA, 2025).
These tools allow classification into mild, moderate, or severe SUD and support shared decision‑making regarding level of care.
Co‑occurring mental health conditions
SUD frequently co‑occurs with (NIMH, 2025):
Major depressive disorder
Anxiety disorders
Posttraumatic stress disorder (PTSD)
Bipolar disorder
Attention‑deficit/hyperactivity disorder
Co‑occurring disorders can:
Increased risk for self‑medication with substances
Worsen treatment outcomes if not recognized
Require integrated treatment plans (NIMH, 2025)
NPs, behavioral health clinicians, and chiropractors with integrative training should maintain a low threshold for mental health screening and referral.
Managing Patients With SUD: A Practical Clinical Process
Effective SUD care is chronic‑disease care: ongoing, team‑based, and tailored to readiness to change (AMA, n.d.; SAMHSA, 2023).
Core elements of management
Key components include (AMA, n.d.; NIDA, n.d.; NIMH, 2025):
Routine screening and re‑screening
Brief interventions and motivational interviewing
Harm‑reduction strategies
Medications for certain SUDs (when appropriate)
Evidence‑based behavioral therapies
Peer and family support
Long‑term follow‑up and relapse‑prevention planning
Brief intervention and motivational interviewing
For patients with low to moderate risk, brief intervention can be delivered in 5–15 minutes and often by NPs or primary care clinicians (AMA, n.d.; NIAAA, 2025). Using motivational interviewing, clinicians:
Ask open‑ended questions (“What do you enjoy about drinking? What concerns you about it?”)
Reflect and summarize the patient’s own statements
Ask permission before giving advice
Help patients set realistic, patient‑chosen goals (cutting down, abstaining, or seeking treatment)
This approach respects autonomy and builds internal motivation for change.
Determining level of care
The American Society of Addiction Medicine (ASAM) describes a continuum of care (AMA, n.d.; SAMHSA, 2023):
Prevention/early intervention
Brief interventions in primary care
Self‑management support and education
Outpatient services
Office‑based counseling and medications for AUD or opioid use disorder (OUD)
Integrated behavioral health visits
Intensive outpatient / partial hospitalization
Several therapy sessions per week, day or evening programs
Residential/inpatient services
24‑hour structured care for severe or complex cases
Medically managed intensive inpatient services
Medically supervised detoxification and stabilization
NPs and primary care teams decide the appropriate level based on risk severity, co‑occurring medical and psychiatric conditions, social supports, and patient preference (AMA, n.d.; NIMH, 2025).
Medications for SUD
For some patients, medications support recovery by reducing cravings, blocking rewarding effects, or stabilizing brain function (SAMHSA, 2020; AMA, n.d.; NIAAA, 2025). Examples include:
Alcohol use disorder
Acamprosate – supports abstinence after detox
Disulfiram – creates an unpleasant reaction to alcohol, discouraging use
Naltrexone blocks the rewarding effects of alcohol
Opioid use disorder
Buprenorphine – a partial opioid agonist that reduces cravings and overdose risk; often prescribed in primary care with appropriate DEA registration
Methadone – full agonist, dispensed in specialized opioid treatment programs
Naltrexone (extended‑release) – opioid antagonist that prevents relapse after detox
Overdose prevention
Naloxone – rapid opioid‑overdose reversal, recommended for anyone at risk (AMA, n.d.).
NPs managing patients with SUD work within state scope‑of‑practice rules and in collaboration with addiction specialists where needed.
Behavioral therapies and peer support
Evidence‑based therapies include (AMA, n.d.; NIDA, n.d.):
Cognitive behavioral therapy (CBT)
Dialectical behavior therapy (DBT)
Motivational enhancement therapy
The Matrix Model (especially for stimulants)
Family‑based therapy for adolescents
Peer support groups (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery) can reinforce coping skills, hope, and accountability.
Long‑term follow‑up
SUD is chronic; relapse risk can persist for years. Best practice includes (AMA, n.d.; NIMH, 2025):
Follow‑up within 2 weeks after treatment initiation
Monthly to quarterly visits as patients stabilize
Peer support and care management between visits
Rapid re‑engagement after any relapse or lapse
NASW, NIDA, and NIMH stress that relapse should be treated as a signal to adjust care—not as failure (NIDA, n.d.; NIMH, 2025).
How SUD Affects the Body and the Musculoskeletal System
SUD impacts nearly every organ system. Many effects directly or indirectly worsen neuromusculoskeletal health and pain.
General systemic effects
Common systemic consequences include (NIDA, n.d.; NIMH, 2025; SAMHSA, 2023):
Cardiovascular disease and hypertension
Liver disease and pancreatitis (especially with alcohol)
Respiratory disease (especially with tobacco and some drugs)
Endocrine and hormonal disruption
Immune dysfunction and higher infection risk
Sleep disturbances and fatigue
Worsening of mood, anxiety, and cognitive function
These changes affect healing capacity, resilience, and the way patients perceive pain.
Musculoskeletal and pain‑related effects
Substance use and SUD can influence the musculoskeletal system through several pathways:
Increased injury risk
Impaired judgment, coordination, and reaction time increase the risk of falls, motor vehicle accidents, and sports injuries.
Heavy alcohol use is associated with fractures, soft tissue injuries, and delayed healing (AMA, n.d.; SAMHSA, 2023).
Bone, joint, and muscle changes
Alcohol and some drugs can impair bone density and quality, increasing osteoporosis and fracture risk.
Nutritional deficiencies associated with SUDs weaken connective tissue and muscle function.
Sedentary behavior and deconditioning are common in people with long‑standing SUD.
Chronic pain and central sensitization
Chronic alcohol or opioid use can alter pain pathways in the central nervous system, raising pain sensitivity.
Opioid‑induced hyperalgesia can make pain seem worse even at stable or increasing doses.
Functional and ergonomic stress
Disrupted sleep, poor posture, and prolonged sitting or immobility (for example, in recovery environments or during unemployment) can lead to spinal stress, neck and low back pain, and muscle imbalance.
Clinically, Dr. Jimenez and similar integrative providers often see patients with combined profiles: chronic low back or neck pain, sedentary work, ergonomic strain, poor sleep, high stress, and escalating reliance on medications, including opioids or sedatives. Addressing both the mechanical and behavioral contributors can change the trajectory of pain and SUD risk (Jimenez, n.d.).
Integrative Chiropractic Care in the Context of SUD
Philosophy of integrative chiropractic care
Integrative chiropractic care focuses on restoring alignment, mobility, and neuromuscular control while considering lifestyle, nutrition, sleep, and emotional stress. In the model used by Dr. Jimenez, chiropractic adjustments are combined with functional medicine strategies, targeted exercise, and collaborative medical care (Jimenez, n.d.).
For patients with or at risk of SUD, this approach offers:
Non‑pharmacologic pain management
Improved movement, posture, and ergonomics
Education that empowers patients to self‑manage pain
Reduced reliance on habit‑forming medications
Spinal adjustments and targeted exercises
Spinal and extremity adjustments aim to:
Restore joint mobility
Reduce mechanical irritation of nerves and soft tissues
Improve segmental alignment and overall posture
Targeted exercises are prescribed to:
Strengthen deep stabilizing muscles (core, gluteal, cervical stabilizers)
Correct muscle imbalances and faulty patterns
Increase flexibility and joint range of motion
Enhance proprioception, balance, and movement control
Examples of targeted exercise strategies often used in integrative chiropractic and rehab clinics include (Jimenez, n.d.):
Lumbar stabilization and core‑strengthening sequences
Hip mobility and glute activation drills for low back and sciatica‑like pain
Cervical and scapular stabilization for neck and shoulder pain
Postural retraining, including ergonomic break routines for prolonged sitting
By reducing biomechanical stress and enhancing functional capacity, these interventions may decrease pain intensity, frequency, and flare‑ups, which in turn can lower the drive to self‑medicate with substances.
Reducing overlapping risk profiles
Many risk factors for SUD and for chronic musculoskeletal pain overlap, including (NIMH, 2025; NIDA, n.d.; Jimenez, n.d.):
Chronic stress and trauma
Poor sleep and circadian disruption
Sedentary lifestyle and obesity
Repetitive strain and poor ergonomics
Social isolation and low self‑efficacy
Integrative chiropractic care can help shift these shared risk profiles by:
Encouraging regular physical activity and graded movement
Coaching ergonomic and postural strategies at work and home
Teaching breathing, stretching, and relaxation routines that reduce muscle tension and sympathetic overdrive
Collaborating with NPs and behavioral health clinicians to align interventions with mental health and SUD treatment plans
In Dr. Jimenez’s practice, this often includes structured flexibility, mobility, and agility programs that are adapted to age and functional status, with close monitoring to avoid over‑reliance on medications, including opioids and sedatives (Jimenez, n.d.).
The Nurse Practitioner’s Role in Comprehensive SUD and Musculoskeletal Care
NPs are well-positioned to coordinate SUD care and integrate it with musculoskeletal and chiropractic treatment.
Comprehensive medical management
NP responsibilities typically include (AMA, n.d.; NIMH, 2025; NIAAA, 2025):
Conducting and interpreting SUD screening and risk stratification
Performing physical exams and ordering labs or imaging
Diagnosing SUD and co‑occurring conditions
Prescribing non‑addictive pain strategies and medications where indicated
Managing or co‑managing medications for AUD or OUD (per training and regulations)
Monitoring for drug–drug and drug–disease interactions
Coordinating with behavioral health and community resources
In integrative settings like Dr. Jimenez’s clinic, the NP role is blended with functional medicine principles, looking at nutrition, metabolic health, hormonal balance, and inflammation that influence both pain and SUD risk (Jimenez, n.d.).
Activity pacing and graded return to work or sport
Sleep hygiene and circadian rhythm support
Nutrition strategies that support musculoskeletal healing and brain health
These interventions lower the mechanical load on the spine and joints, reduce fatigue, and increase a patient’s sense of control—all of which help reduce triggers for substance use and relapse.
Care coordination and team communication
NPs often serve as the central coordinator who (AMA, n.d.; NIMH, 2025):
Ensures all team members (chiropractor, physical therapist, behavioral health, addiction medicine, primary care, or specialty providers) share a coherent plan
Tracks progress on pain, function, substance use, mood, and quality of life
Adjusts the plan as conditions change
Supports families and caregivers in understanding both SUD and musculoskeletal needs
In a model like Dr. Jimenez’s, this may involve regular case conferences, shared EHR notes, and integrated treatment plans that align spinal rehabilitation with SUD recovery goals (Jimenez, n.d.).
Practical Clinical Pathway: From First Contact to Long‑Term Recovery
For clinics that combine chiropractic and NP services, a practical, stepwise pathway for patients with possible SUD and musculoskeletal complaints can look like this (AMA, n.d.; NIDA, n.d.; NIAAA, 2025; NIMH, 2025; Jimenez, n.d.):
Step 1: Initial visit and global screening
Intake includes questions on pain, function, injuries, sleep, mood, and substance use.
Staff administer brief tools (for example, AUDIT‑C and DAST‑10 for adults, CRAFFT for adolescents).
The chiropractor documents neuromusculoskeletal findings; the NP reviews medical and behavioral health risks.
Step 2: Identification of SUD risk
Negative or low‑risk screens → brief positive health message and reinforcement of low‑risk behavior.
Moderate risk → NP provides brief intervention, motivational interviewing, and a follow‑up plan.
Substantial or severe risk → NP initiates comprehensive assessment, safety planning, and possible referral to specialized services.
Step 3: Integrated treatment planning
The team crafts a unified plan that may include:
Spinal adjustments and targeted exercises to correct alignment and biomechanics
Gradual increase in physical activity with pain‑sensitive pacing
Behavioral health referral for CBT, trauma‑informed treatment, or other modalities
Consideration of medications for AUD or OUD, if indicated
Harm‑reduction measures (for example, naloxone prescription for those at overdose risk)
Step 4: Ergonomics and lifestyle
NP and chiropractor jointly review workplace and home ergonomics, posture, and activity patterns.
Patients learn micro‑break routines, stretching, and strengthening sequences for high‑risk tasks (for example, lifting or prolonged sitting).
Nutrition, stress‑management, and sleep interventions are introduced or refined.
Step 5: Monitoring and long‑term follow‑up
Regular follow‑up visits evaluate:
Pain levels and functional capacity
Substance use patterns and cravings
Mood, sleep, and quality of life
Adherence to exercise and ergonomic plans
The team updates the treatment plan to respond to progress, setbacks, or new diagnoses.
Patients are coached to view flare-ups or lapses as opportunities to learn and adjust, not as failures.
This kind of coordinated, integrative approach can reduce repeated injuries, unnecessary imaging or surgeries, and long‑term dependence on medications, including opioids.
Clinical Insights from an Integrative Practice Model
Although each practice is unique, Dr. Alexander Jimenez’s clinic illustrates several principles that can guide others (Jimenez, n.d.):
Whole‑person assessment: History taking includes injuries, lifestyle, trauma, nutrition, environment, and psychosocial stressors.
Functional movement focus: Care plans emphasize flexibility, mobility, agility, and strength to restore capacity rather than just relieve symptoms.
Non‑invasive first: Chiropractic adjustments, functional exercise, and lifestyle interventions are prioritized before invasive procedures or long‑term controlled substances.
Integrated roles: As both DC and FNP‑BC, Dr. Jimenez unifies neuromusculoskeletal, primary care, and functional medicine perspectives in a single, coordinated plan.
Patient empowerment: Education, coaching, and accessible care options help patients take a proactive role in maintaining spinal health and reducing SUD risk.
This model aligns with national guidance on behavioral health integration and SUD management in medical settings while adding the musculoskeletal and ergonomic expertise of chiropractic care (AMA, n.d.; NIDA, n.d.; NIMH, 2025).
Key Takeaways
SUD is a chronic, treatable medical condition that often co‑occurs with mental disorders and chronic pain.
Validated screening tools and non‑stigmatizing, trauma‑informed communication are core to early identification.
Risk and severity categories (mild, moderate, severe) guide brief intervention, level of care, and referral decisions.
SUD significantly affects the body, including bone health, soft tissue integrity, injury risk, and chronic pain pathways.
Integrative chiropractic care—with spinal adjustments, targeted exercises, and ergonomic guidance—can reduce pain, improve function, and lower overlapping risk factors for SUD.
Nurse practitioners provide comprehensive SUD management, coordinate care, and deliver ergonomic and lifestyle counseling that complements chiropractic treatment.
A collaborative, long‑term, patient‑centered model—such as the one exemplified by Dr. Alexander Jimenez—offers a promising pathway to healthier spines, healthier brains, and healthier lives.
Conclusion
Substance use disorder is a complex medical condition that requires compassion, evidence‑based screening, and coordinated care across multiple disciplines. For healthcare professionals—whether chiropractors, nurse practitioners, primary care physicians, or behavioral health specialists—the opportunity to identify and support patients with SUD begins with understanding what it is, how to recognize it, and how to respond with respect and proven interventions.
The integration of chiropractic care and nurse practitioner-led primary care offers a distinctive advantage for patients struggling with both chronic pain and substance use. When a patient presents with a work injury, auto accident, or years of poor ergonomics, they may not volunteer that they are also wrestling with alcohol dependence, prescription opioid misuse, or stimulant use. Yet these challenges often coexist. The musculoskeletal system bears the weight of increased fracture risk, muscle wasting, poor healing, and heightened pain sensitivity. The mind and nervous system are equally affected, with sleep disruption, mood changes, and reduced resilience to stress all fueling the cycle of pain and substance use.
Clinics and practices that integrate screening, brief intervention, and coordinated treatment have a powerful tool to interrupt this cycle. Spinal adjustments restore mechanical function. Targeted exercises rebuild strength and proprioception. Ergonomic guidance prevents re‑injury. Nurse practitioners coordinate medications, monitor for drug interactions, and counsel on lifestyle factors that support both spine health and recovery from SUD. Behavioral health clinicians provide therapy, peer support, and relapse prevention. Together, this team addresses root causes, not just symptoms.
The clinical model exemplified by providers like Dr. Alexander Jimenez demonstrates that a single clinician with dual expertise—chiropractic and family practice nurse practitioner credentials—can seamlessly weave these threads into a coherent, patient‑centered plan. Patients benefit from continuity, alignment of goals, and a provider who understands both the biomechanics of a herniated disc and the neurobiology of addiction. Larger practices can achieve similar results through deliberate team communication, shared decision‑making, and a commitment to non‑stigmatizing, trauma‑informed care.
The evidence is clear: early identification saves lives and improves outcomes. Validated screening tools are quick and accurate. Motivational interviewing and brief interventions work. Medications for alcohol and opioid use disorders are safe and effective when used thoughtfully. Non‑pharmacologic approaches—exercise, manual therapy, stress management, social support—are powerful and underutilized. And when musculoskeletal and behavioral health care are woven together, patients heal faster, return to function sooner, and are far less likely to relapse into substance misuse.
For healthcare teams willing to expand their lens beyond isolated complaints—beyond “just” back pain or “just” anxiety—the reward is profound: patients who reclaim their health, their relationships, and their sense of purpose. This is the promise of integrative, collaborative, evidence‑based care for substance use disorder and musculoskeletal health.
References
American Medical Association. (n.d.). Substance use disorder treatment: How‑to guide for primary care integration [PDF]. American Medical Association.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
Jimenez, A. D. (n.d.). Injury specialists: El Paso family practice nurse practitioner and chiropractor. Dr. Alex Jimenez. https://dralexjimenez.com/
Substance Abuse and Mental Health Services Administration. (2023). 2022 national survey on drug use and health: Annual national report (HHS Publication No. PEP23‑07‑01‑006). U.S. Department of Health and Human Services. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report
Real-Life Posture Rehab: How El Paso Back Clinic Helps You Move Better Every Day
Move around and change posture positions throughout the day.
Improving posture is one of the fastest ways to feel stronger, breathe easier, and protect your spine—especially if you live with long commutes, heavy work, or hours at a desk, like many people in El Paso. At El Paso Back Clinic, Dr. Alexander Jimenez, DC, APRN, FNP-BC, and his team see every day how targeted physical activity, along with integrative chiropractic and nurse practitioner (NP) care, can turn slouching and stiffness into confident, upright movement. El Paso, TX Doctor Of Chiropractic+1
This article explains, in simple language:
What good posture really is
Recommended physical activities and exercises to enhance posture
How yoga, Pilates, and mind-body practices improve alignment
Easy desk and “tech neck” fixes
How integrative chiropractic care supports posture
How nurse practitioners help with medical, ergonomic, and lifestyle support
How the El Paso Back Clinic combines all of this in real-world care
What “Good Posture” Means (and Why It Matters in Daily Life)
Good posture means your body is stacked in a natural, balanced way:
Ears over shoulders
Shoulders over hips
Hips over knees and ankles
Spine holding its natural curves (neck, mid-back, low back)
When posture is poor—like slouching over a phone or leaning forward at a desk—stress builds up in your neck, shoulders, and back. Over time, this can lead to:
Chronic neck and back pain
Tension headaches
Fatigue and shallow breathing
Tight hip flexors and weak glutes
Early joint wear and tear
Research and clinical guides show that specific exercises and posture-friendly habits can reduce pain and improve alignment by strengthening postural muscles and keeping you moving throughout the day. Healthline+2Harvard Health+2
At El Paso Back Clinic, Dr. Jimenez often reminds patients that posture is not about “standing stiff.” It is about a strong, relaxed, and mobile spine that can handle work, sports, and life in the desert heat. El Paso, TX Doctor Of Chiropractic+1
Core Principles of Posture-Focused Exercise
Most effective posture plans share the same core goals:
Strengthen the core and back—so your spine has solid support
Activate glutes and shoulders—to counter slumping and hip stress
Improve flexibility—especially in chest, hip flexors, and hamstrings
Train body awareness—so you notice and correct slouching
Add low-impact cardio—to boost circulation and recovery
Think of Your Program in Simple Pieces
Try to include each week:
2–3 days of core and back strengthening
2–3 days of mobility and stretching
2–4 days of low-impact cardio like walking or swimming
Daily micro-breaks from sitting or driving
That may sound like a lot, but many of these can be done in 10–20 minute blocks and woven into your normal day.
Foundational Strength Exercises for Better Posture
Many posture programs start with bodyweight moves you can do at home—no machines, no fancy equipment. Sources on physical therapy and spine health support these exercises. Healthline+2Primal Physical Therapy+2
Planks (Front and Side Planks)
Why they help: Planks strengthen your deep core, shoulders, and glutes. A strong core keeps your spine from sagging or arching too much.
Basic front plank:
Start on your forearms and toes
Keep your body in a straight line from head to heels
Gently pull your belly toward your spine
Hold 20–30 seconds, rest, repeat 2–3 times
Side planks add extra stability for your sides and hips, which support upright posture. Woodlands Sports Medicine
Bird-Dog
Why it helps: Bird-dog builds core and back strength while training balance and control.
How to do it:
Start on hands and knees
Extend your right arm forward and left leg back
Keep your hips level; don’t twist
Hold 3–5 seconds, then switch sides
Do 8–10 reps per side
Physical therapists often use this exercise to improve posture and relieve back pain. Primal Physical Therapy+1
Glute Bridges
Why they help: Bridges work the glutes and hamstrings and relieve stress on the lower back.
Lie on your back, knees bent, feet flat
Press through your heels and lift your hips
Squeeze your glutes at the top
Hold 3–5 seconds, then lower
Repeat 10–15 times
Strong glutes help balance tight hip flexors from long periods of sitting, which is very common among drivers and office workers in El Paso. Primal Physical Therapy+1
Superman Exercise
Why it helps: The Superman move targets the “posterior chain,” the muscles along the back of your body that help prevent slouching. Woman & Home
Lie face down
Lift your chest, arms, and legs slightly off the floor
Hold briefly and lower with control
Start with 5–8 reps
This move is especially useful if you sit a lot or look down at screens, as it helps your back muscles stay active.
Rowing Movements (Bands or Dumbbells)
Why they help: Rowing exercises strengthen the upper back and shoulder stabilizers that pull your shoulders back.
Use a resistance band or light dumbbells
Pull your elbows back and squeeze your shoulder blades together
Mobility and Stretching: Releasing the “Posture Brakes”
If strength is the “engine,” tight muscles are the “brakes.” You need both to work well. Stretching and mobility exercises help open areas that tend to tighten up, such as the chest, neck, hips, and upper back. Illinois Back Institute+1
Key Posture Stretches
Chest Opens / Doorway Stretch
Stand in a doorway with your forearms on the frame
Gently lean forward until you feel a stretch across your chest
Gently slide your chin straight back (like a mini “double chin”)
Hold 3–5 seconds
Repeat 10 times
Cat-Cow
On hands and knees
Slowly round your back toward the ceiling, then gently arch it
Move with your breath for 8–10 cycles
Hip Flexor Stretch
In a half-kneeling position, gently shift your hips forward
Keep your torso upright; avoid over-arching your back
Hold 20–30 seconds on each side
These stretches are simple but powerful when done daily—especially if you spend long hours driving I-10 or sitting at a workstation in El Paso. Illinois Back Institute+1
Mind-Body Practices: Yoga, Pilates, and Tai Chi
Mind-body exercises are excellent for posture because they combine strength, flexibility, and body awareness.
Yoga for Alignment and Awareness
Yoga routines often include:
Mountain Pose (Tadasana)—teaches what upright alignment feels like
Child’s Pose and Cat-Cow – gently move and decompress the spine
Bridge Pose – strengthens glutes and back
Chest opener poses—counter phone and computer hunching
Research-based guides show yoga can improve postural muscle endurance and help people become more aware of how they carry themselves. Healthline+1
Pilates for Core Control
Pilates focuses on:
Deep core strength
Controlled breathing
Smooth, precise movements
Many physical therapy and rehab programs use Pilates-style exercises to support spinal alignment and postural stability. Primal Physical Therapy+1
Tai Chi for Balance and Relaxed Upright Posture
Tai chi uses slow, flowing movements with calm breathing. It helps:
Improve balance and coordination
Encourage relaxed, upright posture
Reduce stress and muscle guarding
Chiropractic resources often recommend swimming, walking, yoga, and tai chi as ideal companions to chiropractic care. Muscle and Joint Chiropractic+1
Everyday Physical Activities That Support Posture
You don’t have to become a gym athlete to help your posture. Many everyday activities, done with good form, support a healthier spine.
Helpful posture-friendly options include:
Walking:
Encourages natural spinal motion
Easy to fit into breaks or evenings
Swimming:
Full-body, low-impact workout
Strengthens back and shoulder muscles with less joint stress
Dancing:
Builds coordination and body awareness
Helps you practice an upright chest and an active core
Cycling (with proper bike fit):
Strengthens hips and legs
Supports overall fitness and endurance
Clinics that treat back pain often highlight walking and swimming as key activities for long-term spinal health. Illinois Pain & Spine Institute+1
Desk, Phone, and “Tech Neck”: Quick Fixes You Can Actually Use
Long hours on a computer or phone are a major reason posture has become such a problem. Harvard Health and orthopedic clinics stress the importance of frequent movement breaks and simple desk exercises. Harvard Health+2barringtonortho.com+2
Desk-Friendly Posture Break Routine
Try this mini-routine a few times each day:
Chin tucks – 10 reps
Shoulder blade squeezes – hold 5 seconds × 10 reps
Seated Cat-Cow – 5–10 slow breaths
Forward fold stretch next to your desk—hold 20–30 seconds
Simple Ergonomic Tips
Keep feet flat on the floor
Hips and knees are near 90 degrees
Screen at or just below eye level
Use a small lumbar support or rolled towel behind your low back
Stand and walk at least every 30–60 minutes
Recent expert tips also support using standing desks, wireless headphones for “walking meetings,” and light resistance bands at your station to keep postural muscles awake. Harvard Health+1
How Integrative Chiropractic Care at El Paso Back Clinic Supports Posture
Chiropractic care focuses on the spine, joints, and nervous system. Integrative chiropractic care goes further, combining adjustments with corrective exercises, lifestyle coaching, and medical input from NPs. Advanced Spine & Posture+1
What a Posture-Focused Chiropractic Visit Often Includes
The Nurse Practitioner’s Role in Supporting Posture
At El Paso Back Clinic, Dr. Jimenez works not only as a chiropractor but also as a board-certified family nurse practitioner, which provides a broader, medically informed perspective on posture-related problems. El Paso, TX Doctor Of Chiropractic+1
A nurse practitioner can:
Review your full medical history
Identify arthritis, osteoporosis, nerve issues, or autoimmune conditions that affect posture.
Order and interpret imaging and labs
X-rays, MRIs, and blood work when appropriate
Prescribe or adjust medications
Short-term pain or muscle-relaxant use when necessary
Coordinate referrals
Physical therapy, pain management, and surgical consults if needed
Give lifestyle and ergonomic counseling
Weight management, sleep, stress, and work setup
Use telemedicine for follow-up
To keep you on track with your exercise and pain management plan
This integrative model makes it easier to catch red flags early, adjust plans safely, and provide each patient with a personalized path rather than a one-size-fits-all list of exercises.
How Dr. Alexander Jimenez Combines Physical Activity, Chiropractic Care, and NP Expertise
With decades of experience in personal injury, sports, and functional medicine, Dr. Jimenez has seen the same pattern again and again: posture improves the most when hands-on care, smart exercise, and patient education are combined. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2
In his clinical observations at El Paso Back Clinic:
Agility and functional training (such as controlled squats, lunges, and balance drills) help patients return to sports, warehouse work, or family life with greater resilience.
Posture work is often integrated with nutrition, sleep, and stress management, because tired, inflamed bodies struggle to maintain good alignment. El Paso, TX Doctor Of Chiropractic+1
This dual license (DC + APRN, FNP-BC) allows Dr. Jimenez to move comfortably between spine mechanics and whole-person health, which is ideal for complex posture and pain cases.
Sample Weekly Posture-Boosting Plan (General Example)
This is a general example for educational purposes, not a personal prescription. Always consult your provider—especially if you have pain, injuries, or medical conditions.
Posture check around your home and car: adjust chairs, pillows, and monitor height
Patients at El Paso Back Clinic often have a plan customized to their injury type (auto accident, work injury, or sports strain) and their job or sport. El Paso Back Clinic® • 915-850-0900+1
Safety Tips: When to Get Help
Stop and get professional care if posture exercises cause:
Sharp or stabbing pain
Numbness or tingling in arms or legs
New weakness or loss of coordination
Trouble walking or standing
Loss of bladder or bowel control (emergency—seek urgent care)
A chiropractor can evaluate your spine and joints; a nurse practitioner can check for underlying medical causes. At El Paso Back Clinic, the team works together to decide whether you need imaging, medication, rehab, or a referral to another specialist. El Paso, TX Doctor Of Chiropractic+1
Bringing It All Together
To enhance posture and protect your spine:
Strengthen your core, back, and glutes with planks, bridges, bird-dogs, rows, and Supermans
Stretch your chest, neck, and hips to release tight, “slouching” muscles
Use mind-body practices like yoga, Pilates, and tai chi to build body awareness
Add low-impact activities like walking and swimming to support overall spine health
Fix your desk and phone habits with regular movement breaks and better ergonomics
At El Paso Back Clinic, integrative chiropractic care and nurse practitioner support bring all of these pieces together. With Dr. Alexander Jimenez’s dual training, patients receive:
Spinal and joint adjustments
Corrective exercise and posture coaching
Medical evaluation, imaging, and medication management when needed
Telemedicine and follow-up plans that fit real life in El Paso
The goal is simple: help you stand taller, move with less pain, and feel stronger in everything you do—from lifting kids or boxes at work to walking the trails of the Franklin Mountains.
Faster Recovery After Spine Surgery: Enhanced Surgical Recovery (ESR) Programs at El Paso Back Clinic® in El Paso, TX
The doctor administers a local anesthetic into the patient’s affected area, using ultrasound to visualize the spine’s anatomical components.
Spine surgery can help treat serious back problems, such as pain from injuries, disc issues, or aging. At El Paso Back Clinic® in El Paso, TX, we focus on helping patients recover faster and more safely through modern methods. Enhanced Surgical Recovery (ESR), also called Enhanced Recovery After Surgery (ERAS), is a team-based plan that reduces the need for strong pain medications, shortens hospital stays, and lowers the risk of readmission. Led by Dr. Alexander Jimenez, DC, APRN, FNP-BC, our clinic combines chiropractic care, nurse practitioner expertise, and new tools to support healing. This article explains the main parts of ESR for spine surgery, how it cuts opioid use, shortens hospital stays, and reduces readmissions. We also cover the big roles of integrative chiropractic care and nurse practitioners, plus exciting new tech like virtual reality (VR) for building strength after surgery.
Many people in El Paso face back pain from work, accidents, or daily life. Surgery may be necessary, but traditional methods can make recovery challenging. ESR improves this process by planning care before, during, and after the operation. It uses simple steps, such as teaching patients, eating better, and moving early. Studies show these measures can cut opioid use a lot and help people go home sooner (Dagal et al., 2023). At El Paso Back Clinic®, we work with surgeons to add non-drug options for even better results.
What Is Enhanced Surgical Recovery (ESR)?
ESR is a proven plan to make surgery recovery easier and quicker. It started in other surgeries, but now helps a lot with spine operations, such as fusions or disc repairs. The idea is to lower body stress and speed natural healing. Instead of staying in bed and taking many pain pills, patients move soon and use gentler pain control.
Key parts of ESR include:
Team Approach — Doctors, nurses, chiropractors, and therapists all work together.
Step-by-Step Care — Planning starts before surgery and continues at home.
Personal Plans — Care fits each person’s health needs.
Research shows ESR helps with many spine issues, from small fixes to big ones (Zaed et al., 2023). Reviews find that most programs use around 12 key steps, such as better pain management and early walking (Berk et al., 2025).
Main Components of ESR for Spine Surgery
ESR has steps before, during, and after surgery to make things smoother.
Before Surgery (Pre-Op)
Getting ready early helps avoid problems.
Teaching Patients: Learn what to expect, how to manage pain, and why moving matters. This lowers worry and helps follow the plan (Zaed et al., 2023).
Better Nutrition: Check for low energy or anemia. Eat protein and carbs to build strength. Nutritious food helps healing (Soffin et al., 2022).
Pain Prep: Start gentle meds like acetaminophen. Quit smoking to lower risks (American Association of Nurse Anesthesiology, n.d.).
Prehab Exercises: Build strength with walks or stretches.
These make surgery safer.
During Surgery (Intra-Op)
The team uses ways to protect the body.
Better Anesthesia: Short drugs to wake up fast. Add non-opioid options (Dagal et al., 2023).
Careful Fluids: Just the right amount to avoid issues.
Small Cuts: Less muscle damage for quicker recovery (Dietz et al., 2019).
Pain Blocks: Numb the area for hours after.
Patients feel better right away.
After Surgery (Post-Op)
Focus on rapid healing.
Early Walking: Get up soon and walk daily (Zaed et al., 2023).
Mixed Pain Control: Use non-opioids, ice, and movement.
Quick Eating: Start foods and drinks early.
Checks for Safety: Watch for clots or other issues.
These steps lower risks.
How ESR Reduces Opioid Use
Strong pain drugs like opioids help, but can lead to problems like addiction. ESR cuts its use by at least half (Dagal et al., 2023). At El Paso Back Clinic®, we add chiropractic methods for even less need.
Mixed Pain Options: Non-opioids first, like NSAIDs and nerve meds. Some programs use almost no IV opioids (HCA Healthcare, n.d.).
Teaching Non-Drug Ways: Ice, breathing, and adjustments.
Blocks and Early Move: Numb areas and walk to ease pain.
In fusions, opioids dropped considerably without worse pain (Dagal et al., 2023). This helps avoid side effects and promotes natural healing.
Shortening Hospital Stays with ESR
Long hospital time raises costs and risks. ESR cuts stay by 1-2 days (HCA Healthcare Today, 2022).
Early Movement: Prevents issues and builds strength.
Fast Nutrition: Energy for recovery.
Good Pain Control: Less bedtime.
Team Reviews: Go home when ready.
One example shows noticeable shortened stays (Dagal et al., 2023). Patients heal better at home.
Lowering Readmission Rates
Going back to the hospital is tough. ESR lowers this risk (HCA Healthcare Today, 2022).
Home Care Teaching: Know warning signs.
Follow-Ups: Calls from our team at El Paso Back Clinic®.
Fewer Problems: Better prep means fewer infections.
Full Care: Controls swelling early.
Fewer complications overall (Berk et al., 2025).
Integrative Chiropractic Care at El Paso Back Clinic®
Chiropractic care fits perfectly with ESR. At our clinic, Dr. Jimenez uses hands-on adjustments to align and relieve symptoms.
Before Surgery: Improve posture and movement.
Pain Without Drugs: Soft tissue work eases tension.
After Surgery: Reduce scar tissue and build mobility (New York City Spine, n.d.).
Nerve Help: Better signals for less pain.
We complement therapy for smoother recovery (Active Health Center, n.d.).
Role of Nurse Practitioners
Nurse practitioners (NPs) like Dr. Jimenez coordinate care.
Team Links: Connect everyone.
Teaching and Meds: Focus on safe, non-opioid options.
Tracking Progress: Adjust plans.
NPs help stick to ESR paths (American Association of Nurse Anesthesiology, n.d.).
New Tech: Virtual Reality (VR) for Recovery
VR uses games and guides to make rehab more enjoyable. It helps spine patients build strength.
Fun Exercises: Improves engagement and movement.
Less Pain Feel: Distraction helps.
Strength Gains: Tailored for muscles and focus.
Home Options: Practice alone.
Recent studies show VR speeds recovery after spine issues, like in cervical cases or general neurorehab (Bolton et al., 2025; various 2025 trials).
Insights from Dr. Alexander Jimenez at El Paso Back Clinic®
Dr. Alexander Jimenez, DC, APRN, FNP-BC, leads El Paso Back Clinic® with dual expertise in chiropractic and nursing. He uses team care for pain management and rehab after injuries or surgery. His plans include adjustments, nutrition, and integrative methods for better mobility without heavy drugs. He stresses whole-body healing for lasting results (Dr. Alex Jimenez, n.d.; LinkedIn, n.d.).
Conclusion
ESR programs accelerate spine surgery recovery and make it safer. With education, nutrition, movement, and team support, they reduce opioids, shorten stays, and lower readmissions. At El Paso Back Clinic® in El Paso, TX, we add chiropractic care and NP guidance for full support. New VR tech adds exciting ways to build strength. If facing spine surgery, ask about ESR and our integrative options. Contact us at 915-850-0900 for help.
Understand the importance of pain management in a clinical setting in fostering recovery and improving patients’ overall health.
Understanding Pain: Causes, Categories, and Effective Management Strategies
Pain is a universal experience that can range from mild discomfort to debilitating agony, affecting millions worldwide. Environmental factors often play a key role in how pain develops, particularly in muscles and joints, where things like weather changes or stress can trigger or worsen symptoms. This comprehensive guide explores the origins of pain, its various categories with real-life examples, and how healthcare professionals manage it in clinical settings through both surgical and non-surgical therapies. Drawing from expert insights, including those from Dr. Alexander Jimenez, DC, APRN, FNP-BC, we delve into integrative approaches that promote natural healing and prevent long-term issues.
Research indicates that pain isn’t solely from physical trauma; external influences like humidity or pollution can heighten sensitivity in the body. It appears that addressing these factors through lifestyle adjustments and targeted therapies can significantly improve outcomes. The evidence points toward a balanced approach that combines medical interventions with natural methods to help individuals regain control over their health.
Key Insights on Pain and Its Management
Environmental Triggers Are Common: Factors such as cold temperatures or air pollution can trigger inflammation in muscles and joints, increasing the risk of pain.
Pain Comes in Many Forms: From acute, sharp stabs to chronic, dull aches, understanding the categories helps choose the right treatment.
Clinical Care Varies: Specialists use non-surgical options such as exercise and acupuncture for many cases, reserving surgery for severe cases.
Integrative Methods Work Well: Experts like Dr. Jimenez show how chiropractic care and massage can address root causes, fostering natural recovery.
Pain management in clinics follows guidelines that prioritize patient safety and effectiveness, as outlined in resources on defining and managing pain (U.S. Department of Justice, Drug Enforcement Administration, 2023).
—
Pain affects everyone differently, but understanding its roots can empower better handling. This article expands on the biology of pain, environmental influences, categories, and management techniques, incorporating clinical observations from professionals like Dr. Alexander Jimenez. We’ll cover detailed examples, case studies, and tables to make the information accessible and actionable.
The Biology of Pain: How It Develops in the Body
Pain starts as a protective mechanism. When the body detects harm, nerves send signals to the brain, which processes them as pain to prompt action, like pulling away from heat. However, this system can go awry, especially with environmental factors involved.
Nociceptors, the body’s pain sensors, are found in skin, muscles, joints, and organs. They respond to stimuli such as temperature and pressure. When activated, they trigger inflammation, which can swell tissues and press on nerves, amplifying discomfort (International Association for the Study of Pain, 2022). In muscles, this might cause tightness or spasms; in joints, it leads to stiffness or swelling.
Chronic pain, lasting over three months, often persists beyond the initial injury due to sensitized nerves. This sensitization lowers the pain threshold, making everyday activities hurtful (International Association for the Study of Pain, 2022). For instance, a minor joint strain can progress to ongoing arthritis if environmental stressors, such as humidity, exacerbate inflammation.
How Pain Affects Muscles and Joints Specifically
Muscles, made of fibers that contract for movement, can develop pain from overuse or tension. Environmental factors cause micro-tears or inflammation, leading to conditions like myalgia. Joints, cushioned by cartilage and synovial fluid, suffer when pressure changes cause fluid shifts, resulting in arthritis-like pain (Arthritis Foundation, 2024).
Case Study: A 45-year-old office worker experiences shoulder pain from poor ergonomics (static posture) combined with stress, leading to muscle knots and joint misalignment. Over time, this evolves into chronic upper back pain, affecting daily life.
Environmental Factors Contributing to Pain Development
Environmental factors are crucial in the onset and progression of pain, especially in muscles and joints. These factors interact with biology, making some people more susceptible.
Weather and Climate Influences
Weather changes significantly impact pain. Low temperatures constrict blood vessels, reducing flow to muscles and causing stiffness. High humidity increases joint fluid pressure, leading to swelling and ache (Arthritis Foundation, 2024). Barometric pressure drops before storms can trigger migraines or joint pain by altering tissue expansion.
Examples:
In osteoarthritis, patients report worse knee pain during cold, damp weather due to increased joint rigidity (PMC, 2025a).
Fibromyalgia sufferers experience muscle flares from temperature swings, with cold lowering pain thresholds by 11.3°C compared to healthy individuals (PMC, 2025a).
Studies show modest correlations between pain and humidity, pressure, and wind speed (Arthritis Foundation, 2024). For muscles, cold induces spasms; for joints, humidity exacerbates inflammation.
Stress and Psychosocial Elements
Stress releases cortisol, promoting inflammation that affects muscles and joints. Chronic stress from work or life events heightens pain perception, leading to tension headaches or back pain (MDPI, 2022). Low social support or discrimination correlates with thicker brain structures involved in pain processing, such as the insula, making discomfort more intense (Nature, 2024).
Examples:
Job insecurity causes muscle tension in the neck and shoulders, evolving into chronic pain.
Discrimination experiences are associated with greater hippocampal volume and greater pain in patients with knee osteoarthritis (Nature, 2024).
Pollution and Toxins
Air pollution, including particulates and toxins such as acrolein, increases inflammation, worsening joint pain in rheumatic diseases (ScienceDirect, 2024a). Smoking aggravates arthritis by activating immune cells, predicting higher pain in spinal injuries (ScienceDirect, 2024a).
Examples:
Urban dwellers exposed to pollution have more emergency visits for joint pain.
Vitamin D deficiency due to reduced sunlight exposure is associated with muscle hypersensitivity (ScienceDirect, 2024a).
Work and Lifestyle Environments
Poor ergonomics, such as prolonged sitting, strains muscles and joints, leading to musculoskeletal pain (MDPI, 2022). Repetitive tasks lead to back pain by reducing movement variability (IASP, n.d.a).
Examples:
Factory workers develop joint pain from repetitive lifting.
Sedentary lifestyles in air-conditioned offices can cause dry-air-related stiffness.
Sociocultural Factors
Lower income and education are associated with higher pain levels due to limited access to healthy environments (Nature, 2024). Household size and employment status explain variance in pain-related brain structures.
To mitigate, strategies include weather-appropriate clothing, stress management, and pollution avoidance. Tables below summarize factors.
Environmental Factor
Description
Impact on Muscles
Impact on Joints
Examples
Weather (Temperature)
Changes in ambient heat/cold
Constriction, spasms
Stiffness, reduced mobility
OA knee pain in cold
Humidity
High moisture levels
Swelling, tension
Fluid pressure increase
Arthritis flares in damp weather
Stress
Psychosocial pressures
Tension, knots
Inflammation from cortisol
Neck pain from job stress
Pollution
Air toxins
Inflammation, hypersensitivity
Rheumatic exacerbations
Joint pain in urban areas
Work Conditions
Ergonomic issues
Strain, fatigue
Misalignment
Back pain from sitting
Deeper Dive into Physicochemical Factors
Physicochemical factors, such as pollution and toxins, directly alter pain pathways. Air pollution exacerbates neuropathic pain by sensitizing nerves (ScienceDirect, 2024a). Toxic compounds such as 4-HNE activate receptors, triggering neurogenic inflammation in joints.
Biological factors, such as viral infections, lead to arthritis-like joint pain (ScienceDirect, 2024a). Smoking induces hyperalgesia through serotonergic changes.
Psychosocial factors, such as stress, promote chronicity, while environmental enrichment reduces pain by lowering stress (ScienceDirect, 2024a).
Case Study: A patient with rheumatoid arthritis experiences worse joint pain during pollution spikes, managed by indoor air filters and an anti-inflammatory diet.
Categories of Pain: Descriptions and Examples
Pain is classified by duration, cause, and location to guide treatment (Healthline, 2018).
Acute Pain
Short-term, lasting days to weeks, from injury. Sharp or intense, it alerts the body (Healthline, 2018).
Examples:
Muscle strain from lifting heavy objects.
Joint pain from a sprained ankle.
Chronic Pain
Lasts months or years, often without a clear cause. Mild to severe, impacting life (Healthline, 2018).
Examples:
Low back pain from poor posture.
Arthritis causes ongoing joint pain.
Nociceptive Pain
From tissue damage, activating nociceptors. Acute or chronic (WebMD, 2025).
Subtypes:
Somatic: Skin, muscles, bones. Aching or throbbing.
Examples: Muscle pull, joint fracture.
Visceral: Organs. Dull, cramping.
Examples: Appendicitis, but it can also refer to muscle pain.
Neuropathic Pain
From nerve damage. Burning, tingling (WebMD, 2025).
Examples:
Diabetic neuropathy in the feet (joint-related).
Sciatica from spinal nerve compression (muscle/joint).
Other Categories (IASP Definitions)
Allodynia: Pain from non-painful stimuli, e.g., light touch on sunburned muscle (IASP, 2022).
Hyperalgesia: Amplified pain from normal stimuli, e.g., pinprick on an inflamed joint.
Nociplastic Pain: Altered nociception without damage, e.g., fibromyalgia muscle pain.
Category
Duration
Cause
Sensation
Muscle/Joint Example
Acute
Short
Injury
Sharp
Strained hamstring
Chronic
Long
Ongoing
Dull
Chronic knee arthritis
Nociceptive Somatic
Varies
Tissue
Aching
Bone fracture joint pain
Neuropathic
Varies
Nerve
Burning
Sciatica leg muscle
Nociplastic
Chronic
Altered processing
Widespread
Fibromyalgia joint tenderness
Case Study: An athlete with acute nociceptive pain from a joint sprain transitions to chronic pain if left untreated, demonstrating category evolution.
Exploring Integrative Medicine- Video
Pain Management in Clinical Settings
Healthcare specialists follow evidence-based rationale for pain management, emphasizing multimodal approaches to minimize risks like addiction (SAMHSA, 2024). The MATE Act requires training on safe prescribing, focusing on opioid use disorders and pain treatment (DEA, 2023).
Non-Surgical Therapies
These are first-line for many, using meds, therapy, and complementary methods.
Medications: NSAIDs for inflammation, acetaminophen for mild pain (NEJM, 2019).
Physical Therapy: Exercises strengthen muscles and improve joint mobility.
Complementary: Acupuncture and massage reduce tension (PMC, 2024).
Examples: Massage post-injury eases muscle tension; breathing techniques lower anxiety in the clinic.
Surgical Therapies
For severe cases, such as joint replacement. Post-op management includes multimodal analgesia (JAMA, 2021).
Opioids: Short-term for breakthrough pain.
Non-Drug: Music therapy reduces opioid needs by 31% (PMC, 2024).
Rationale: Balances relief with safety, per guidelines (DEA, 2023).
Therapy Type
Examples
Benefits
Clinical Rationale
Non-Surgical Meds
NSAIDs
Reduce inflammation
Low risk for chronic pain
Physical Therapy
Exercises
Strengthen muscles
Prevents long-term weakness
Surgical Post-Op
Opioids + Music
Pain relief
Minimizes addiction risk
Case Study: Patient with joint pain undergoes non-surgical acupuncture, avoiding surgery.
Insights from Dr. Alexander Jimenez
Dr. Jimenez, with 30+ years in chiropractic and functional medicine, observes correlations such as perimenopausal estrogen drops causing joint pain or TBI leading to posture issues and muscle aches (LinkedIn, n.d.; DrAlexJimenez.com, n.d.).
His integrative approach addresses causes:
Targeted Exercise: Rehab programs build strength and prevent recurrence.
Massage Therapy: Relieves soft tissue tension.
Acupuncture: Promotes healing in sciatica.
Prevents long-term problems through nutrition and monitoring (DrAlexJimenez.com, n.d.).
Case Study: TBI patient regains mobility via chiropractic adjustments and exercises.
Prevention and Future Trends
Prevention involves environmental awareness, regular physical activity, and a healthy diet. Future trends include wearables for trigger monitoring.
This guide, drawing from diverse sources, shows pain as manageable with informed care.
Conclusion: Embracing a Future Free from Chronic Pain
Pain is a complex signal influenced by biology, environment, and lifestyle, as we have covered in this lengthy piece. It is not only a transient discomfort. Understanding these things, such as the distinctions between nociplastic, neuropathic, and nociceptive pain, and how pollution and barometric pressure may cause muscles and joints to expand, empowers us to take control. The 2024 recommendations (American College of Surgeons et al., 2024) stress that proactive, multimodal approaches in both surgical and non-surgical settings are highly valued for treating pain to reduce symptoms, prevent worsening, and avoid the onset of chronic illnesses.
Health care providers are crucial in this situation. They use ERAS protocols to support rehabilitation after surgery and integrative therapies to help individuals feel better every day. El Paso chiropractor Dr. Alexander Jimenez, DC, APRN, FNP-BC, has shown that addressing the root causes with acupuncture, massage therapy, chiropractic adjustments, and targeted workouts promotes the body’s natural healing process and prevents long-term issues. His case correlations demonstrate that while environmental stresses, including metabolic imbalances or repetitive work strains, often cause chronic pain, these effects may be reduced with evidence-based, individualized therapies.
Restoring equilibrium and enhancing general health, rather than masking the issue, are the ultimate objectives of effective pain management. You may end the cycle of suffering by recognizing the environmental sources of your pain, appropriately categorizing it, and looking for all-encompassing answers. You may still have a more mobile, healthy, and contented life if you make the proper decisions and seek professional help, regardless of how long you’ve experienced joint pain or how recently you were injured. Speak with a professional as soon as possible, implement your own strategy, and begin a better, less painful future.
How Telemedicine Can Assist in the Management of Sciatica (with Integrative Chiropractic Care)
A man at home consults a chiropractor via telemedicine for back pain and sciatica.
Sciatica can make even simple tasks—like getting out of bed, sitting at a desk, or driving—feel almost impossible. When pain shoots down your leg or feels like burning, stabbing, or tingling, the idea of driving across town to sit in a waiting room can be overwhelming.
Telemedicine offers a way to get expert help for sciatica without leaving home. Telemedicine can significantly improve the quality of life for many individuals experiencing limited mobility or frequent flare-ups of pain. Spine specialists and integrative chiropractic teams now use secure video visits to evaluate symptoms, design treatment plans, and follow patients through recovery. UT Southwestern Medical Center+1
Dr. Alexander Jimenez, DC, APRN, FNP-BC, is a dual-licensed chiropractor and nurse practitioner in El Paso, Texas. His integrative model combines medical decision-making (such as imaging and prescriptions) with chiropractic and functional medicine. This blended approach fits perfectly with telemedicine because it allows him to assess nerve pain, guide movement, and adjust treatment plans over time—even when the patient is at home. El Paso, TX Doctor Of Chiropractic
What Is Sciatica?
Sciatica is not a disease by itself. It is a pattern of symptoms caused by irritation or compression of the sciatic nerve. This nerve starts in the lower back, runs through the hips and buttocks, and travels down each leg.
Common symptoms include:
Sharp or burning pain in the lower back, buttocks, and legs
Numbness, tingling, or “pins and needles” in the leg or foot
Weakness when trying to stand, walk, or lift the leg
Pain that worsens with sitting, coughing, or bending
Sciatica is usually caused by:
Herniated or bulging discs pressing on a nerve root
Spinal stenosis (narrowing of the spinal canal)
Degenerative disc disease
Muscle or joint dysfunction in the pelvis and lower back
Less commonly, tumors, infections, or serious conditions
Because sciatica can have many causes, proper evaluation and treatment planning are very important—this is where telemedicine can help you start sooner and stay on track.
What Is Telemedicine and How Does It Work for Back and Nerve Pain?
Telemedicine (also called telehealth) is health care delivered via secure video or phone rather than an in-person visit. You use a smartphone, tablet, or computer to speak with your provider, similar to a video call with family or friends.
Clinics that treat spine and nerve problems have made telemedicine a core part of their care model. They use it for first visits, follow-ups, second opinions, and surgical planning, especially for conditions like back pain, neck pain, and sciatica. UT Southwestern Medical Center+1
During a typical telemedicine visit for sciatica, your provider can:
Ask detailed questions about your pain pattern
Watch how you move on camera
Guide simple movement and strength tests
Review MRI, X-ray, or CT results
Explain treatment options, including chiropractic, physical therapy, injections, or surgery if needed
Many clinics report that they can accurately diagnose spine issues through video visits and that most telemedicine-based surgical plans do not require major changes after in-person exams. UT Southwestern Medical Center
Why Telemedicine Is Especially Helpful for Sciatica
People with sciatica often have trouble sitting, driving, or walking long distances. Telemedicine meets them where they are—literally.
Key benefits for sciatica patients
Less travel and less pain getting to care
No long car rides or sitting in waiting rooms
Easier for patients who have mobility issues or rely on others for transportation Southeast Texas Spine+1
Faster access to evaluation and treatment
Many clinics can schedule telemedicine visits sooner than in-person visits
You can start treatment earlier instead of waiting weeks to be seen
Better continuity of care
Telemedicine makes it easier to attend follow-ups, especially during long recovery plans
Providers can adjust medications, exercises, and activity limits in real time Southeast Texas Spine+1
Home-based evaluation of your real environment
Your provider can see your work setup, couch, bed, or home office
Straight-leg raise or seated leg raise while on camera
Heel and toe walking to assess nerve strength
Balance and gait observation
Imaging and tests
Your nurse practitioner or physician can order MRI, X-rays, or CT scans when needed
They may also recommend nerve tests (EMG/NCS) through in-person referrals
Spine centers and orthopedic clinics report that telemedicine visits can help determine when conservative care is sufficient and when urgent in-person care or surgery is needed. UT Southwestern Medical Center+1
Integrative Chiropractic Telemedicine for Sciatica
Integrative chiropractic telemedicine combines:
Medical care—history, diagnosis, imaging orders, prescriptions, and referrals
Chiropractic care—movement analysis, spinal and pelvic mechanics, and guided home-based therapies
Dr. Jimenez’s dual-scope role as a chiropractor and nurse practitioner is a strong example of this model. In his practice, he uses telemedicine to:
Review MRI and other imaging results with patients
Coordinate conservative care (chiropractic, physical therapy, massage, acupuncture, and functional medicine)
Monitor nerve symptoms and red flags that require fast in-person intervention
Looks for patterns of dysfunction in the lower back, pelvis, and hips
Guides you through gentle tests and movements
Designs a home exercise and stretching plan
Educates you about ergonomics, sleep positions, and movement habits
Even without hands-on adjustments, chiropractic expertise is used to understand mechanics and guide safe self-care at home. Evolve Chiropractic+2HealthCentral+2
Telemedicine and Medication Management for Sciatica
Telemedicine is also useful for medication oversight and pain management. Virtual pain management services can:
Review current medications and supplements
Start or adjust anti-inflammatory drugs, muscle relaxers, or nerve pain medications when appropriate
Help taper short-term medications to avoid long-term dependence
Coordinate with other therapies like physical therapy and chiropractic care Everlywell+1
This is important because the goal is not just to reduce pain for a few days but to manage it safely while addressing the underlying cause.
Guided Home Exercises and Self-Care for Sciatica via Telemedicine
A large part of sciatica management involves what you do every day at home. Telemedicine allows your integrative provider to coach you in real time.
Types of exercises a provider may guide over video
Always follow your own provider’s instructions. The list below is for education, not a personal prescription.
An integrative chiropractor, such as Dr. Jimenez, will often blend chiropractic reasoning (how joints and muscles are moving) with physical therapy-style exercise progressions to build strength and reduce nerve irritation over time. Integrative Medical of DFW+1
Telemedicine and Physical Therapy for Sciatica
Physical therapy is a key part of long-term sciatica care. Telemedicine makes it easier for your team to coordinate and supervise this care.
An NP–chiropractor team can:
Refer you to in-person physical therapy when you need hands-on manual work
Work with therapists to align goals: pain reduction, nerve mobility, strength, and posture
Review PT progress notes with you by video
Add or modify home exercises between in-person therapy visits
Modern integrative clinics describe physical therapy as treatment focused on your goals, your function, and your time—whether you are recovering from an acute episode of sciatica or managing long-term spine issues. Integrative Medical of DFW+1
Telemedicine for Office Workers and Remote Workers with Sciatica
Many people with sciatica sit for long periods at desks or work remotely at kitchen tables, couches, or beds. Poor ergonomics can worsen nerve pain.
Telemedicine allows providers to see your real work setup and give specific advice.
They may help you:
Adjust chair height, screen level, and keyboard position
Chiropractic-based telemedicine visits for office workers often focus on spinal alignment, hip position, and load sharing between joints — even if the provider cannot physically adjust the spine during the visit, they can teach you how to move better and reduce pressure on the sciatic nerve. tigardchiropracticautoinjury.com+1
How to Prepare for a Telemedicine Visit for Sciatica
Preparing well can make your telemedicine visit smoother and more helpful.
Before your appointment
Check your technology
Test your camera, microphone, and internet connection
Charge your device and have a backup (like a phone) ready
Choose your space
Find a quiet, private room
Make sure you have enough room to stand, walk, and lie down if needed
Gather information
List your current medications and supplements
Have your medical history and imaging reports handy
Dr. Jimenez’s clinical experience shows that when patients feel seen and supported—through regular check-ins, education, and coordinated care—they are more likely to stay consistent with their home program and achieve better long-term outcomes. El Paso, TX Doctor Of Chiropractic+1
Practical Tips for Getting the Most from Telemedicine for Sciatica
Here are some simple strategies to make telemedicine work for you:
Treat the visit like an in-person appointment
Show up on time and minimize distractions
Have a notebook handy for instructions
Be specific about your goals
“I want to sit for 30 minutes without pain”
“I want to walk around the block again”
Clear goals help your provider design better plans
Use photos or videos
Take a short video of how you walk or how you get out of a chair during painful times
Share this with your provider if their platform allows
Stay consistent with home exercises
Put reminders in your phone
Tie exercises to habits (after brushing teeth, after lunch, etc.)
Ask for a written or emailed summary
Many clinics send a visit summary through the patient portal
This can include your diagnosis, exercise plan, and red-flag symptoms
The Future: Telemedicine, Sciatica, and Integrative Care
Telemedicine is no longer just an emergency backup plan—it is a core part of modern spine and pain care. Spine centers, pain clinics, and integrative practices across the country use telemedicine to: UT Southwestern Medical Center+2NJ Spine & Orthopedic+2
Speed up diagnosis and treatment
Improve convenience for patients in pain
Coordinate care between specialists, therapists, and primary providers
Support long-term recovery with flexible follow-ups
For people with sciatica, this means you can:
Get expert guidance without leaving your home
Partner with an integrative chiropractor and nurse practitioner who can see both the nerve problem and the whole person
Combine remote consultations, at-home exercises, and lifestyle changes into a comprehensive plan
Under the care of a dual-licensed provider like Dr. Alexander Jimenez, telemedicine becomes more than a video call. It becomes a bridge between medical science, chiropractic biomechanics, and day-to-day life—helping you move from intense nerve pain toward safer movement, better function, and long-term relief. El Paso, TX Doctor Of Chiropractic+2Evolve Chiropractic+2
Fast Sports Injury Help Online: How Telemedicine Guides Diagnosis, Rehab, and Return to Play
A massage therapist treats the injury of a professional athlete at El Paso Back Clinic
Telemedicine is changing how athletes get help after an injury. When a chiropractor and a nurse practitioner (NP) work together online, they can guide recovery from many sports injuries without the need for an in-office visit. This is especially helpful for athletes who travel, live far from clinics, or are balancing school, work, family, and training.
In this article, we’ll break down how an integrated chiropractor–NP telemedicine team can:
Do virtual exams from a distance
Share treatment plans and coordinate care
Support at-home rehab, nutrition, and mental health
Help with urgent issues like a possible concussion during games
Reduce unnecessary ER visits while still protecting your safety
1. Why telemedicine matters for sports injuries
Telemedicine is more than a video call. It is a structured way to deliver health care at a distance using secure video, phone, apps, and online tools. Johns Hopkins Medicine notes that telemedicine improves comfort, convenience, and access, especially for people who would otherwise struggle to travel or fit visits into a busy schedule. Hopkins Medicine
For athletes, that matters because:
Practices and games already take up time.
Travel teams may compete hours away from home.
Injuries often happen suddenly—during a weekend tournament, camp, or late-night match.
Telehealth physical therapy and sports services now let athletes receive full evaluations and guided rehab sessions from home, with real-time video coaching. SportsMD+1 Research shows telehealth physical therapy is effective for many orthopedic and sports-related conditions, including non-surgical and post-surgical rehab. PMC
At the same time, sports medicine researchers have shown that telehealth can support concussion care, including baseline testing, diagnosis, and follow-up—especially in rural or resource-limited settings. PMC+1
2. What is an integrated chiropractor + NP telemedicine team?
An integrated team means the chiropractor and nurse practitioner work together instead of in separate silos.
The nurse practitioner (NP) focuses on your overall health, medical history, medications, imaging, and underlying conditions (like asthma, diabetes, or heart issues).
The chiropractor focuses on your spine, joints, muscles, and movement patterns, using guided tests, posture checks, and therapeutic exercises delivered remotely.
In Dr. Alexander Jimenez’s clinical model in El Paso, Texas, the same provider is both a board-certified family nurse practitioner and a chiropractor, which allows one clinician to blend medical and musculoskeletal care through telemedicine for neck pain, low back pain, headaches, and sports injuries. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2
When the chiropractor and NP are separate providers, they can still share:
Notes and findings in the same electronic health record
Imaging reports and lab results
Exercise programs and rehab goals
Messages with athletic trainers, physical therapists, and coaches
This two-pronged approach helps create one unified plan that covers:
Functional goals (return to sport, position-specific demands)
3. How a virtual sports injury exam works
A telemedicine visit is structured and systematic, not just a quick chat.
3.1 Before the visit
You’ll usually:
Complete an online intake form about symptoms, past injuries, and sport.
Upload any previous X-rays, MRIs, or reports, if available.
Test your camera, microphone, and Wi-Fi connection. SportsMD+1
3.2 During the visit: what the NP does
The nurse practitioner can:
Take a detailed medical history:
How the injury happened
Any prior concussions, surgeries, or chronic conditions
Current medications and allergies
Screen for red flags like chest pain, severe shortness of breath, uncontrolled bleeding, or signs of serious head injury. telehealth.hhs.gov+1
Order diagnostic imaging (X-ray, MRI, CT) if needed.
Write or adjust prescriptions, such as:
Pain medications (when appropriate)
Muscle relaxants
Anti-inflammatory medications
Coordinate referrals to orthopedics, neurology, or emergency care if telemedicine alone is unsafe. OrthoLive+1
3.3 During the visit: what the chiropractor does
Over secure video, the chiropractor can:
Observe posture and alignment (standing, sitting, walking).
Guide you through movement tests, for example:
Bending, rotating, or side-bending the spine
Squats, lunges, or single-leg balance
Shoulder or hip range of motion
Identify pain patterns that suggest sprain, strain, tendinopathy, or joint irritation. sportsandexercise.physio+1
Teach safe at-home movements, such as:
Gentle mobility drills
Core stability exercises
Isometrics to protect healing tissue
In his telemedicine work, Dr. Jimenez describes using these virtual exams to track changes in pain, strength, and mobility from week to week, adjusting exercise progressions and ensuring athletes are not overloading injured tissue. El Paso, TX Doctor Of Chiropractic+1
3.4 Typical flow of a telemedicine sports injury visit
NP and chiropractor (or dual-licensed provider) review your history and goals.
Guided movement and functional tests help narrow down the likely diagnosis.
The NP decides whether imaging or labs are needed.
The chiropractor designs initial movement and pain-reduction strategies.
You leave with a clear home plan and follow-up schedule.
4. Building a shared treatment plan online
After the virtual exam, the team builds a plan that blends medical and musculoskeletal care. Telehealth orthopedic and sports practices report four consistent benefits from this style of care: improved access, reduced costs, better quality and safety, and higher patient satisfaction. OrthoLive
Clear guidelines for when to go to urgent care or ER
Chiropractic and movement actions
Joint and spinal stabilization work
Mobility and flexibility progression
Posture and movement training specific to your sport position
Rehab schedule
How often you meet on video
How many daily or weekly exercises
When to retest speed, strength, or sport-specific skills
Telehealth sports physiotherapy services emphasize that virtual care works best when the athlete receives personalized exercise programs, regular online check-ins, and careful progression from injury to return to play. sportsandexercise.physio+1
5. Conditions that respond well to integrated telemedicine care
Research and real-world practice show that many sports injuries can be evaluated and managed, at least partly, through telemedicine. SportsMD+1
5.1 Common injuries suited for telemedicine
Mild to moderate ankle sprains
Knee pain related to overuse (patellofemoral pain, mild tendinopathy)
Back and neck pain from training load, lifting, or collisions
Mild muscle contusions without signs of fracture
Telehealth physical therapy has shown promise in non-operative and post-operative sports rehab, especially when therapists guide exercise, monitor progress, and adjust programs in real time. PMC+1
5.2 How the NP and chiropractor divide roles
The NP can:
Confirm whether the injury is stable enough for home care.
Check for other health issues (asthma, heart conditions, bleeding disorders).
Manage medications and monitor side effects.
The chiropractor can:
Analyze movement patterns that caused or worsened the injury.
Dr. Jimenez’s clinical work often combines telemedicine visits with in-clinic follow-ups, advanced imaging review, and collaboration with physical therapy and sports training teams to keep athletes progressing without re-injury. El Paso, TX Doctor Of Chiropractic+1
6. Telemedicine and concussion: quick decisions from a distance
Concussions and suspected head injuries are a special case. A missed or delayed diagnosis can put an athlete at serious risk.
A systematic review found that telehealth has been used successfully for concussion baseline testing, diagnosis, and management, especially in military and rural settings. PMC+1 Another review focused on sideline telehealth, where sports medicine physicians assist trainers in real time through video connections during games. PMC+1
SportsMD describes “teleconcussion,” where athletes can quickly access concussion specialists via telehealth instead of waiting days or weeks for in-person care. SportsMD
6.1 How telemedicine helps when you suspect a concussion
During or shortly after a game, a telemedicine visit can help:
Review how the head impact occurred (direct hit, whiplash, fall).
Check acute symptoms, such as:
Headache
Dizziness
Nausea or vomiting
Vision changes
Confusion or memory loss
Guide a brief neurological exam and balance checks via video. PMC+1
Decide whether the athlete must leave the game immediately and seek emergency care.
Telemedicine programs in school sports have also been used to minimize risk by providing teams with rapid access to sports medicine expertise, rather than relying solely on coaches to decide whether a player is safe to continue. NFHS+1
6.2 Role of the integrated team
The NP can determine whether emergency imaging or ER evaluation is needed, arrange teleconcussion follow-ups, and manage symptom-relief medications when appropriate.
The chiropractor can later help with neck pain, posture, and vestibular-related issues—such as balance and coordination problems—once the acute phase is stable and medical clearance is given.
7. At-home rehab and return-to-play through telemedicine
Telehealth lets rehab follow you to your home, hotel room, or training camp.
Telehealth physical therapy programs show several key benefits: increased accessibility, reduced travel burden, and the ability to continue personalized plans even when athletes are on the road. SportsMD+2SportsMD+2
7.1 Common tele-rehab tools
An integrated chiropractor–NP team may use:
Video exercise sessions where the provider:
Demonstrates exercises
Watches your form from different angles
Makes real-time corrections
Secure messaging for quick questions about pain flare-ups or modifications. ATI+1
Remote monitoring apps, where you log:
Pain levels
Step counts or training minutes
Completion of home exercises
Progress checks every 1–2 weeks to advance the plan or adjust if pain increases.
7.2 Examples of tele-rehab goals
Acute phase (first days)
Protect the injured area
Control swelling and pain
Maintain gentle mobility where safe
Subacute phase (1–4 weeks)
Restore the normal range of motion
Begin light strengthening and balance work
Fix faulty movement patterns
Return-to-play phase
Add power, agility, and sport-specific drills
Monitor for any return of pain or instability
Clear the athlete for full competition once the criteria are met
Telehealth sports physio services emphasize a “injury to return-to-play” continuum, where the same remote team oversees each phase to avoid gaps in care. sportsandexercise.physio+1
8. Lifestyle, nutrition, and mental health support from afar
Sports injuries are never just physical. Pain, sudden time off from sport, and stress about losing a starting spot can weigh heavily on athletes.
Telemedicine makes it easier to address the whole person, not just the injured body part:
Nutrition – Remote visits can cover:
Protein and calorie needs during healing
Anti-inflammatory food choices
Hydration strategies for training and games SportsMD+1
Sleep and recovery habits – Online coaching about sleep routines, stretching, and scheduling lighter days can support healing. SportsMD
Mental health – some telemedicine platforms connect athletes with sports psychologists or counselors for stress, anxiety, or mood changes after injury. Programs that highlight telemedicine for athlete health care note that virtual visits help athletes stay engaged in care without derailing their training or school schedules. Nully Medical LLC+2Nully Medical LLC+2
In Dr. Jimenez’s integrative model, telemedicine visits often combine pain management, mobility training, nutritional guidance, and coaching on long-term wellness so that athletes return to sport stronger and healthier, not just “cleared.” El Paso, TX Doctor Of Chiropractic+2LinkedIn+2
9. Benefits for remote and traveling athletes
Telemedicine is especially valuable if you:
Live in a rural area with limited access to sports medicine. Hopkins Medicine+1
Travel often for tournaments, camps, or professional seasons. Nully Medical LLC+1
Have trouble arranging rides, time off work, or childcare. Hopkins Medicine+1
Telehealth platforms built for sports and orthopedic care highlight these advantages:
Faster access to specialists who may be in another city or state. OrthoLive+1
Fewer missed practices or school days.
Less time sitting in traffic or waiting rooms.
Continuous oversight of rehab, even during road trips. SportsMD+1
In school and youth sports, telemedicine programs have also been used to minimize risk by providing real-time medical input during events and improving response to injuries. NFHS+1
10. When telemedicine is not enough: red flags
Telemedicine is powerful, but it is not a replacement for emergency or in-person care when certain warning signs are present. National telehealth guidance stresses that some situations require hands-on exams or urgent evaluation. telehealth.hhs.gov+1
If you experience any of the following, seek in-person or emergency care immediately:
Loss of consciousness, seizure, or severe confusion after a hit to the head
Repeated vomiting, severe headache, or worsening neurologic symptoms
Clear deformity of a bone or joint, or inability to bear weight at all
Suspected fracture with severe swelling or visible misalignment
Chest pain, shortness of breath, or signs of allergic reaction
Suspected spinal injury with numbness, weakness, or loss of bowel/bladder control
In these cases, telemedicine can still play a role after emergency care—for follow-up visits, rehab planning, and coordination between specialists, the NP, and the chiropractor. PMC+1
11. Clinical observations from Dr. Alexander Jimenez, DC, APRN, FNP-BC
1. Telemedicine speeds up early decisions. Athletes can be evaluated within hours of an injury—sometimes the same day—without waiting for an in-person slot. This helps determine quickly whether an athlete can manage at home, needs imaging, or must seek urgent or emergency care.
2. Dual-scope evaluation reduces gaps. Because Dr. Jimenez is both a chiropractor and an NP, he can:
Interpret imaging and lab results
Address inflammation, pain, and sleep issues medically
Analyze biomechanics, joint function, and movement patterns
Coordinate with attorneys and athletic organizations when injuries occur in organized sports or school settings El Paso, TX Doctor Of Chiropractic+1
3. Telemedicine helps keep athletes compliant. Through secure messaging and remote check-ins, many athletes are more likely to complete their exercises and follow nutrition or recovery plans. This lines up with broader telehealth research showing high patient satisfaction and good adherence when care is accessible and flexible. OrthoLive+1
4. Hybrid care works best. Dr. Jimenez often uses a hybrid model: telemedicine for triage, education, home-based rehab progressions, and imaging review, plus targeted in-clinic visits for hands-on care when necessary. This mirrors national trends where telemedicine is integrated into, not replacing, in-person sports and orthopedic care. El Paso, TX Doctor Of Chiropractic+1
12. Practical tips for athletes using telemedicine for sports injuries
To get the most out of a telemedicine visit with an NP and chiropractor, prepare like you would for a big game.
Before your visit
Write down:
When and how the injury happened
What makes it better or worse
Medications and supplements you take
Set up your space:
Good lighting
Enough room to walk, squat, or lie down
A stable surface for your phone or laptop
Have gear ready:
Resistance bands or light weights (if you have them)
A chair, wall, or countertop for balance work
During your visit
Be honest about your pain level and limitations.
If you are worried about a concussion, clearly describe all symptoms, even if they seem minor. SportsMD+1
Ask about clear return-to-play criteria:
Pain goals
Strength targets
Functional tests (jumping, sprinting, cutting)
After your visit
Follow the home exercise program and track your progress.
Use the patient portal or app to ask questions if pain changes or if you have trouble with a movement. ATI+1
Schedule regular follow-up telehealth visits so your plan can be adjusted as you improve.
13. Putting it all together
An integrated chiropractor and nurse practitioner telemedicine team gives athletes a powerful, flexible way to:
Get fast evaluations after a sports injury
Receive coordinated medical and musculoskeletal care
Follow individualized rehab plans at home
Access nutrition and mental health support
Lower the chance of unnecessary ER visits, while still protecting safety
From major health systems like Johns Hopkins to specialized sports platforms, and from youth leagues to professional levels, the evidence continues to grow that telemedicine—when used wisely—can make sports medicine more accessible, more coordinated, and more athlete-friendly. InjureFree+3Hopkins Medicine+3OrthoLive+3
In real-world practice, clinicians like Dr. Alexander Jimenez show how blending chiropractic care, nurse practitioner expertise, and telemedicine can keep athletes moving forward—even when they are injured, on the road, or far from a clinic. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2
Kim, B. I., et al. (2022). Telehealth physical therapy for sports medicine and orthopedic care. Journal of Telemedicine and Telecare. (Summary from PMC article). PMC
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