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.
It is one thing to wake up with back pain, but another when the pain is combined with a fever, body aches, and chills. It could be the flu or another infection. However, after checking the body’s temperature and fever is present with no other symptoms than back pain unless it is the flu; the fever could be another issue that may or may not be related as there are a variety of causes for back pain like:
Muscle or ligament strain – If in poor physical condition, repeated and constant tension on the back can cause muscle spasms. Repeated heavy lifting or a sudden awkward movement can strain the back muscles and spinal ligaments.
Bulging or ruptured discs – Discs act as cushions between the bones/vertebrae in the spine. The soft material inside a disc can bulge or rupture and press on a nerve. However, a bulging or ruptured disc can present without back pain. Disc disease is often found by accident when spine X-rays are performed for another reason.
Arthritis – Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can narrow the space around the spinal cord, a condition called spinal stenosis.
Osteoporosis – The spine’s vertebrae can develop painful fractures if the bones become porous and brittle.
Back pain without a fever is usually an indication of a misaligned spine.
Fever A Sign of Something Else
A fever is the body’s way of trying to raise its core temperature in an attempt to kill off a virus or a bacterial infection. Possible causes of back pain with fever include:
Kidney Infection
This type of infection often presents with low back pain and fever.
Spinal Epidural Abscess
This is an infection of the lower region of the spine, causing fever and lower back pain.
Vertebral Osteomyelitis
This is an infection of the lower spine that causes pain in the arms, lower back, and legs, along with a fever.
Meningitis
This causes swelling and inflammation of the brain and spine and needs to be addressed immediately.
Spinal Cord Abscess
This is an infection of the internal part of the spine. It is rare but can happen, causing low back pain and fever.
Symptoms
This is when seeing a chiropractor can help. A few signs that should not be ignored include:
Recently involved in an automobile accident.
Suffered a serious fall.
Feeling a tingling in the legs.
Having balance issues.
Having abdominal pain.
Pain is not going away, or it goes away for a while, then comes back.
Have weakness in the arms or legs.
Having bowel or urinary problems that were not present previously.
The pain is worse when sitting or standing up after sitting.
Have upper back pain after alcohol consumption.
A chiropractor will take a complete medical history, X-rays, an MRI if necessary, and a thorough physical examination will be performed to determine the cause. After a diagnosis is reached, the chiropractor will perform adjustments to relieve the pain and open the nerve pathways to increase circulation to the area. A chiropractic massage will help reduce stress, relieve back pain, and reduce depression, which can also help reduce the fever unless it is from another issue.
Body Composition
Influenza
Influenza or the flu is a contagious respiratory illness caused by viruses that infect the nose, throat, and lungs. It can cause mild to severe illness and, in extreme cases, can lead to death. Like a common cold, the flu is spread primarily through tiny droplets that get expelled from an infected person when they sneeze, cough, or talk. Approximately 8% of the population gets the flu each season. Flu symptoms are sudden, causing the following:
Fever
Chills
Muscle or body aches
Headaches
Sore throat
Runny or stuffy nose
Cough
Fatigue
Vomiting and diarrhea which is more common in children.
Most individuals with healthy immune systems will recover around seven days. However, the elderly, pregnant women, individuals of any age with certain chronic medical conditions like asthma, diabetes, or heart disease, and children under the age of five have an increased risk of developing complications. Flu vaccination is currently recommended for anyone older than six months in the U.S. and effectively prevents infection in 50 – 80% of the population. The primary treatment method for the flu is to support the immune system with plenty of rest, proper nutrition, and hydration.
References
Ameer MA, Knorr TL, Mesfin FB. Spinal Epidural Abscess. [Updated 2021 Feb 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441890/
Kehrer, Michala et al. “Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population.” The spine journal: official journal of the North American Spine Society vol. 15,6 (2015): 1233-40. doi:10.1016/j.spinee.2015.02.021
Rubin, Devon I. “Epidemiology and risk factors for spine pain.” Neurologic clinics vol. 25,2 (2007): 353-71. doi:10.1016/j.ncl.2007.01.004
Tsantes, Andreas G et al. “Spinal Infections: An Update.” Microorganisms vol. 8,4 476. 27 Mar. 2020, doi:10.3390/microorganisms8040476
There are various causes for achiness or soreness under the shoulder blades. The shoulder blade is the triangular bone that forms the back of the shoulder. This pain can range from dull, sharp, burning, or a combination between the spine and shoulder blade to tender or achy across the shoulder or upper back. Pain can spread from another body part or structure, like the neck or spine. Inflammation from injury or overuse is noticeable at onset or gradually after engaging in physical activity and can limit arm movements and interfere with regular activities.
Improper Posture
Improper poster combined with prolonged sitting can cause the spine to develop structural changes that cause pain under the shoulder blade. Habits that lead to poor posture include:
Hunching the back.
Tilting the head down – looking at the phone.
Leaning to one side while sitting, working.
Poor posture habits cause the muscles to weaken, placing added pressure on the spinal discs, muscles, and ligaments. This body imbalance can contribute to upper back and shoulder pain.
Lifting Improperly
Lifting weight above the head and not using the proper technique can leave the upper back and shoulders vulnerable to injury. Lifting an object that is too heavy or is held in an awkward way causing the spine to be misaligned creates added pressure in the upper back. This can strain the muscles, sprain ligaments, injure the shoulder joint, or spine, which can cause spreading pain under and/or near the shoulder blade.
Repetitive Overuse Injury
Painting, moving furniture, or participating in sports are activities that can overwork the upper back muscles and shoulders. Overuse can lead to muscle strains and ligament sprains. This can cause pain in the upper back between the shoulder blade and the spine. Scapulothoracic bursitis, also known as snapping scapula syndrome, is when the bursa between the shoulder blade/scapula and the thoracic spine becomes inflamed, causing pain.
Cervical Herniated Disc
A herniated disc in the cervical spine/neck happens when a disc’s outer layer/annulus fibrosus tears and the inner layer/nucleus pulposus starts to leak outward. This can cause pain and cause the nearby nerve roots to become inflamed, causing pain to run down into the shoulder, arm, and/or hand. A disc herniation in the lower part of the neck usually radiates pain into or near the shoulder blade area. Although less common, a herniation in the upper back can cause pain around or near the shoulder blade.
Dislocated Rib
An accident or fall could cause a rib to become dislocated or misaligned after repetitive/overuse strain or reaching too far overhead. Sharp pain near the shoulder blade can result from this activity and can sometimes make it challenging to take a deep breath.
Compression Fracture
A compression fracture occurs when a vertebral bone in the upper back weakens and compresses. This can lead to back pain with a heightened sensitivity across the shoulder area. The pain usually decreases with rest. Compression fractures are commonly caused by osteoporosis in older individuals. Any back or shoulder pain that persists for weeks or interferes with regular activities should be evaluated by a doctor or chiropractor. If the pain is severe or accompanied by symptoms like headache, tingling, weakness, or nausea, individuals are recommended to seek medical attention.
Body Composition
Carbohydrate/Carb Loading
Carbohydrates are macronutrients that serve a critical function in the body, as they are the body’s primary energy source. The body breaks down carbohydrates into sugar that enters the bloodstream and is stored for energy use in the muscles and liver as glycogen. The muscles only store small quantities of glycogen. And when engaging in physical activity or exercise, the energy stores get used up.
Carbohydrate loading can raise glycogen stores in the muscles from 25 to 100 percent of their average amount in men. Women have shown mixed results in studies on carbohydrate loading. Women need to take in more calories than men when carb-loading to experience the same gains in glycogen. Reasons to carb load are either to:
Build-up stores of glycogen so an individual can use the extra energy storage to help improve endurance.
Fill the muscles with glycogen to bring water into the muscles to help gain mass and tone.
References
Hanchard, Nigel C A et al. “Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement.” The Cochrane database of systematic reviews vol. 2013,4 CD007427. 30 Apr. 2013, doi:10.1002/14651858.CD007427.pub2
Mizutamari M. et al. Corresponding scapular pain with the nerve root involved in cervical radiculopathy. J Orthop Surg. 2010; 18(3): 356–60.
Sergienko, Stanislav, and Leonid Kalichman. “Myofascial origin of shoulder pain: a literature review.” Journal of bodywork and movement therapies vol. 19,1 (2015): 91-101. doi:10.1016/j.jbmt.2014.05.004
Chiropractic treatment/care is a recommended pain relief option for musculoskeletal automobile, sports, personal – injuries, strains, sprains, pain, and rehabilitation. An initial chiropractic examination is similar to a standard examination administered by health care providers. What an individual can expect at their first consultation includes:
Some chiropractors offer individuals an initial interview over a video conference and/or phone call. It is focused on discussion with topics like the chiropractors:
The initial in-office clinical exam generally includes:
Patient History and Symptoms
The patient will be asked to fill out forms that can also be filled out online before the visit, saving a patient time if they so choose. This provides background information about symptoms and conditions in preparation for the in-person chiropractic consultation. Questions include:
Did the pain start as a result of an auto, sports, personal, work injury?
How did the pain start – activities, sports, work, etc.?
When did the pain start – a few days, weeks, months, years?
Where is the pain located?
Does the pain spread out to other areas?
Is the pain dull, sharp, burning, or throbbing?
Does the pain come and go, or is it constant?
What activities or body positions make it better and/or worse?
Patients are also asked to provide information on pre-existing medical conditions, family medical history if necessary, prior injuries, and previous and current treatments provided by other medical professionals.
Physical Examination
A chiropractic examination includes:
Reflexes
Respiration
Blood pressure
Pulse
Certain orthopedic and neurological tests can also be used. These include:
Range of motion
Neurological integrity
Muscle strength
Muscle tone
Walking gait
Posture analysis
Diagnostic Studies
Based on the medical history and physical exam results, diagnostic studies could help reveal pathologies and identify structural abnormalities to diagnose more accurately. X-rays are the most commonly used during an initial chiropractic exam and are used to:
Diagnose recent trauma
Diagnose bone fractures
Study spinal deformities
An MRI scan is recommended for soft tissue damage like a herniated disc, torn muscle/s, or nerve compression.
Patient Diagnosis after the Chiropractic Exam
All the findings from the medical history, physical exam, and diagnostic tests help the chiropractor form a diagnosis. Once the diagnosis is established, the chiropractor will discuss personalized treatment options.
Body Composition
Heart Disease
Many factors can contribute to heart disease, and research has pointed to inflammation caused by obesity as one of the most significant factors to its development. The main contributor is cytokines produced by excess body fat. Cytokinescause inflammation in the walls of the arteries causing damage and increasing pressure. Blood pressure is the force of blood pushing against the walls of the vessels. High blood pressure means that the heart is not pumping blood effectively, and the heart begins to enlarge. An enlarged heart is a significant risk factor that can lead to heart failure if interventions are not taken to repair the damage.
References
Jenkins HJ, Downie AS, French SD. Current evidence for spinal x-ray use in the chiropractic profession. Chiropr Man Therap. 2018; 26:48.
Wang, Zhaoxia, and Tomohiro Nakayama. “Inflammation, a link between obesity and cardiovascular disease.” Mediators of inflammation vol. 2010 (2010): 535918. doi:10.1155/2010/535918
Weeks, William B et al. “Public Perceptions of Doctors of Chiropractic: Results of a National Survey and Examination of Variation According to Respondents’ Likelihood to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply in Local Health Care Markets.” Journal of manipulative and physiological therapeutics vol. 38,8 (2015): 533-44. doi:10.1016/j.jmpt.2015.08.001
According to chiropractic physiological concepts, the body is in a state of relaxation when the body’s natural intelligence can properly function. With regular movement, work, school, chores, tasks, the body takes a beating getting pushed, pulled, and twisted. This results in loss of function, disharmony, chronic conditions, and disease. Chiropractic assistance restores the communication flow with various types of adjustments.
Like a vehicle that has something loose or is out of place, but can still move, so do individuals continue to work despite their body telling them that something is wrong or out of place. As they continue the body can start to break down. Even with a minor vertebral subluxation. A subluxation is when a vertebra/spine’s bones interfere with the transmission of information along the spine and throughout the central nervous system. The messages/transmissions to and from the brain disrupt the body’s ability to function properly resulting in health issues. A chiropractor adjusts the body to correct the subluxation. This facilitates the body’s natural ability to:
Adapt
Regulate
Heal itself through its own natural intelligence.
Chiropractic is based on principles of physiology. These principles have a significant impact on individuals:
Overall health
Vitality
Well-being
Self-healing and Regulating
When individuals cut themselves, or when a bone gets broken, the body will heal itself. No thought or practice is needed. The body breathes, digests food, the heart continues to beat and the kidneys filter out waste products.
Brain, Nervous System, and Body Health
The brain and nervous system are what controls and coordinate the body’s ability to heal and self-regulate. The brain sends out information through the nervous system to the organs of the body. The information tells the organs what to do and when to do it. The organs reply to the brain through the nervous system letting the brain know everything is operating correctly.
To function properly and maintain optimal function, the body depends on the proper circulation of nerve transmissions/information traveling through the nervous system.
Spinal State
The condition or state of the spine if out of place even just a little could interfere with the transmission of information via the nerve pathways. Misalignments and subluxations don’t always hurt so individuals don’t know this is happening. The nervous system is protected by the skull and spinal bones, known as the vertebrae. The spinal bones allow for free movement. Subluxations and misalignments:
Stretch
Pinch
Irritate
Choke
Rub the nerve fibers.
This alters the information/messages traveling and interferes with the body’s ability to function as it should.
Chiropractic Assistance
Chiropractic assistance will diagnose and correct misalignments and subluxations, restoring proper nerve circulation. These spinal adjustments unlock and realign the bones allowing for optimal movement and the communication pathways are fixed. A healthy spine and nervous system are vital to healthy body function. This is the body’s natural state. How to know if you have a subluxation, have your spine checked by a chiropractor.
Body Health Assistance
Body Composition Goals
For individuals that fall within the extremely overweight and obese body fat percentage category, an effective strategy is to lose fat while preserving the existing Lean Body Mass. Individuals with high body fat percentages often have existing muscle developed from carrying the added weight when moving. Preserving this muscle is important. Having more muscle means increased metabolism and more strength.
To start losing body fat it is recommended to cut down/cut out processed foods and reduce caloric intake.
Consult with a health coach and nutritionist to find out about different types of diets and types of physical activity.
One study showed that obese individuals could quickly improve body composition by:
Maltese, Paolo Enrico et al. “Molecular foundations of chiropractic therapy.” Acta bio-medica : Atenei Parmensis vol. 90,10-S 93-102. 30 Sep. 2019, doi:10.23750/abm.v90i10-S.8768
Pickar, Joel G. “Neurophysiological effects of spinal manipulation.” The spine journal: official journal of the North American Spine Society vol. 2,5 (2002): 357-71. doi:10.1016/s1529-9430(02)00400-x
Rosner, Anthony L. “Chiropractic Identity: A Neurological, Professional, and Political Assessment.” Journal of chiropractic humanities vol. 23,1 35-45. 20 Jul. 2016, doi:10.1016/j.echu.2016.05.001
Vining, Robert et al. “Assessment of chiropractic care on strength, balance, and endurance in active-duty U.S. military personnel with low back pain: a protocol for a randomized controlled trial.” Trials vol. 19,1 671. 5 Dec. 2018, doi:10.1186/s13063-018-3041-5
A proper diagnosis goes a long way. Treatment and recovery can happen relatively quickly or broken up into parts, phases, and sessions, as part of a treatment and rehabilitation plan. This depends on the individual, their age, underlying conditions, and the severity of their injury/s. It is not uncommon to have a treatment schedule that could be weeks/months long. This can be tough on individuals with limited abilities and/or a slow progressive rehab to get back to normal. It is arduous, but to achieve optimal healing and health, it is expected.
Chiropractic medicine is no different. It’s non-invasive compared to surgery but not as immediate as medication/s. This places it in between. Recovery timelines can vary significantly based on the nature of the condition, the patient, their injury/s, and everything attached. Most chiropractic treatment and adjustment plans are scheduled according to the individual’s injury and/or condition. Every case is different, meaning that treatment could be a couple of sessions for an individual with mild sciatica to a few weeks or months for more severe injuries/conditions. Most want to know why chiropractors execute these plans over weeks and months.
The Body Needs To Get Used To The Adjustments
One reason for an extended adjustment schedule is to prevent adjustment shock. Adjustment shock often presents through soreness and tenderness, and there could be a feeling of soreness when sitting or standing or difficulty when trying to move with a normal range of motion. This happens when trying to heal the body too much and too fast. Trying to perform massive chiropractic adjustments without preparing the body could worsen and/or create further injury/s.
For example, correcting severe lordosis requires repositioning the spine’s curvature through properly planned out adjustment sessions. If a chiropractor tries to adjust/align the spine into place over a few days, this would be extremely uncomfortable and more than likely painful for the individual. Plus, there is a lack of musculoskeletal support from the rest of the body that is needed to make sure that the adjustments/changes take hold and are maintained. A chiropractor wants to avoid these issues to focus on getting the individual back to proper health.
Preparing The Body With A Solid Foundation
Chiropractic manipulations and adjustments need time to settle in, ensuring that they take hold and not shift back to the incorrect position. Spinal problems are not solved overnight. This means that the causes of misalignment will remain for a period as the treatment/adjustment process begins. A spaced-out schedule ensures that the adjustments are made accordingly to strengthen the spine through the process. This enables adjustments and the body to develop the necessary support system and prevent any negative re-shifting. As time goes on, the adjustments achieve total realignment, restoring the positive curvature that can be maintained.
Schedule Benefits
Finally, the step-by-step nature of a chiropractic adjustment schedule enables the treatment team to check the status of an adjustment plan. If radiological imaging shows changes, setbacks, or new issues arise, the treatment plan and schedule can be changed and adapted accordingly.
Body Composition Testing
Too Much Alcohol Can Slow Recovery From Tissue Injuries
Alcohol is often associated with celebrations, anniversaries, etc. But drinking too much can damage the immune system. Too much alcohol contributes to organ damage, specifically the liver. However, it is known to slow down recovery from tissue injuries, as well. Moderate drinking is defined as drinking up to 1 drink a day for women and up to 2 a day. Exceeding the recommended intake disrupts the immune pathways and impairs the body’s ability to fight off infections. Alcohol-related immune system damage has been associated with the development of certain types of cancer, including head and neck cancers among alcohol users. Before thinking that this is a problem that only affects chronic alcohol users, acute binge drinking can also severely impair the body’s immune system.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Holt, Kelly, et al. “The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients.” Scientific Reports vol. 9,1 2673. 25 Feb. 2019, doi:10.1038/s41598-019-39577-5
Iben, Axén, et al. “Chiropractic maintenance care – what’s new? A systematic review of the literature.” Chiropractic & manual therapies vol. 27 63. 21 Nov. 2019, doi:10.1186/s12998-019-0283-6
Mior, Silvano et al. “Chiropractic services in the active-duty military setting: a scoping review.” Chiropractic & manual therapies vol. 27 45. 15 Jul. 2019, doi:10.1186/s12998-019-0259-6
Pasala, Sumana et al. “Impact of Alcohol Abuse on the Adaptive Immune System.” Alcohol research: current reviews vol. 37,2 (2015): 185-97.
Individuals are realizing the enhancements that chiropractic produces along with lifestyle adjustments. Chiropractic is about total body health. This includes:
Alleviating pain from injuries and musculoskeletal conditions
Reversing low energy levels
Healthy lifestyle adjustment support
Neck Pain
Back Pain
Chronic Pain
Herniated Disc/s
Headaches
Migraines
Sciatica
Sports Injuries
Healthy living and regular chiropractic adjustments will elevate the body’s health to new levels.
Chiropractic unlocks the body’s potential
Getting to the root cause of any symptoms that are presenting and addressing themis essential before the body can be at its optimum. A common root cause of pain, low energy, and various general health complaints is spinal misalignment. Poor spinal alignment leads to poor nerve energy flow and poor blood circulation. When the body and nervous system function incorrectly, there is interference with the body’s ability to process normal functions that leads to various forms of dysfunction. A chiropractor can recognize the smallest of changes in the spine that could be affecting the body’s health.
Good Health to Optimal Health
Restoring spinal alignment is the first step in improving body health. If condition/s are present, first the pain will need to be reduced and under management, then the energy can be increased. A chiropractor will recommend lifestyle adjustments to start building a routine to take good health to optimal health. Recommendations include:
Physical Activity/Exercise
Regular physical activity/exercise for weight management, building muscle and maintaining balance. Specific exercises could be recommended for spinal alignment and core strength reinforcement.
Health Coaching/Diet
The nutrients consumed can have positive and negative effects on the body’s ability to function and heal. A health coach and nutritionist can recommend a nutrition plan that will elevate the body’s health to new levels, increasing energy and helping with weight loss if it is necessary.
Stress management techniques
Stress is a major player when it comes to poor health. Chiropractic can help develop techniques and strategies to manage stress and reduce the strain on the body’s systems. This could include sleep hygiene, mindfulness, and more.
Neutral spine training
Healthy posture is highly neglected during daily activities, especially when sitting or lying down. A chiropractor will educate the individual on how to hold the spine and posture optimally to reduce awkward positions and unnecessary strain.
Consult a Chiropractic Provider
When making lifestyle changes, a vital component is learning how to incorporate the new adjustments consistently. This encourages the adjustment into becoming a healthy habit that can maintain optimal body health.
Body Composition
Reducing stress levels
There are various techniques that support relaxation, and help turn off the stress response. Here are a few science-backed options:
Stress-related eating is associated with an increased craving for calorie-dense and highly palatable/tasty usually unhealthy foods. When stress rises, food cravings rise triggering fat gain.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
References
Hawk, Cheryl et al. “Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline.” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181
Walsh, Roger. “Lifestyle and mental health.” The American psychologist vol. 66,7 (2011): 579-92. doi:10.1037/a0021769
Stonerock, Gregory L, and James A Blumenthal. “Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity.” Progress in cardiovascular diseases vol. 59,5 (2017): 455-462. doi:10.1016/j.pcad.2016.09.003
A fibromyalgia diagnosis involves the process of eliminating other disorders and conditions with similar symptoms. It can be difficult to diagnose fibromyalgia. There is no common exam or test that a doctor can use to definitively diagnose fibromyalgia. The elimination process is utilized because of several other conditions with similar symptoms. These include:
Rheumatoid arthritis
Chronic fatigue syndrome
Lupus
It can take some time when an individual first notices symptoms and actually being diagnosed with fibromyalgia, which can be frustrating. Doctors have to become detectives, working hard to find the right cause of pain and other symptoms. Developing the right diagnosis is necessary to create an optimal treatment plan.
Fibromyalgia Diagnosis Criteria
Pain and symptoms based on the total number of painful areas
Fatigue
Poor sleep
Thinking problems
Memory problems
In 2010, a study was published that updated fibromyalgia diagnosis criteria for fibromyalgia. The new criteria remove the emphasis on tender point examination.The 2010 criteria’s focus is more on the widespread pain index or WPI. There is an item checklist about where and when an individual experiences pain. This index is combined with a symptom severity scale, and the end result is a new way to classify and develop a fibromyalgia diagnosis.
Diagnostic Process
Medical History
A doctor will look at an individual’s complete medical history, asking about any other conditions present and family condition/disease history.
Symptoms Discussion
The most common questions asked by a doctor are where it hurts, how it hurts, how long it hurts, etc. However, an individual should offer as much or added details of their symptoms. Diagnosing fibromyalgia is very dependent on the report of the symptoms, so it is important to be as specific and accurate as possible. A pain diary, which is a record of all symptoms that present will make it easier to remember and share information with the doctor. An example is giving information on trouble sleeping, with a feeling of tiredness a majority of the time, and headache presentation.
Physical Examination
A doctor will palpate or apply light pressure with the hands around the tender points.
Other Tests
As previously stated symptoms can be very similar to other conditions like:
A doctor wants to rule out any other conditions, so they will order various tests. These tests are not to diagnose fibromyalgia but to eliminate other possible conditions. A doctor could order:
Anti-nuclear antibody – ANA test
Anti-nuclear antibodies are abnormal proteins that can present in the blood if an individual has lupus. The doctor will want to see if the blood has these proteins to rule out lupus.
Blood count
By looking at an individual’s blood count, a doctor will be able to develop other possible causes for extreme fatigue like anemia.
Erythrocyte sedimentation rate – ESR
An erythrocyte sedimentation rate test measures how quickly red blood cells fall to the bottom of a test tube. In individuals with a rheumatic disease like rheumatoid arthritis, the sedimentation rate is higher. The red blood cells fall quickly to the bottom. This suggests that there is inflammation in the body.
Rheumatoid factor – RF test
For individuals with an inflammatory condition like rheumatoid arthritis, a higher level of the rheumatoid factor can be identified in the blood. A higher level of RF does not guarantee that the pain is caused by rheumatoid arthritis, but doing an RF test will help the doctor explore a possible RA diagnosis.
Thyroid tests
Thyroid tests will help a doctor rule out thyroid problems.
Final Note Fibromyalgia Diagnosis
Again, diagnosing fibromyalgia can take awhile. A patient’s job is to be proactive in the diagnostic process. Be sure you understand what the results will tell and how that specific test will help figure out the cause of the pain. If you don’t understand the results, keep asking questions until it makes sense.
InBody
Body composition and Diabetes Connection
The body needs a balance of lean body mass and fat mass to function properly/optimally and maintain overall health. The balance can be disrupted in overweight and obese individuals because of excess fat. Individuals that are overweight should focus on improving body composition by reducing fat mass while maintaining or increasing lean body mass. Balanced body composition can reduce the risk of diabetes, other obesity-related disorders, and a positive effect on metabolism. Metabolism is the breaking down of foods for energy, the maintenance, and repair of body structures.
The body breaks down the food nutrients/minerals into elemental components and directs them to where they need to go. Diabetes is a metabolic disorder meaning it changes the way the body makes use of the nutrients, in such a way that the cells are unable to utilize digested glucose for energy. Without insulin, the glucose cannot get into the cells, so it ends up lingering in the blood. When the glucose can�t make its way out of the blood, it builds up. All the excess blood sugar can potentially be converted to triglycerides and stored as fat. With an increase in fat mass, hormone imbalances or systemic inflammation can happen or progress. This increases the risk for other diseases or conditions. A buildup of fat and diabetes are associated with increased risk for:
Heart attacks
Nerve damage
Eye problems
Kidney disease
Skin infections
Stroke
Diabetes can even cause the immune system to become impaired. When combined with poor circulation to the extremities, the risk of wounds, infections, can lead to amputation of the toes, foot/feet, or leg/s.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
American College of Rheumatology. Fibromyalgia. 2013.�http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Fibromyalgia/. Accessed December 5, 2014.
Living with Fibromyalgia:�Mayo Clinic Proceedings.�(June 2006) �Improvement in Fibromyalgia Symptoms With Acupuncture: Results of a Randomized Controlled Trial��www.sciencedirect.com/science/article/abs/pii/S0025619611617291What Are Common Fibromyalgia Symptoms and How Does It Cause Back Pain?:�Clinical Biomechanics.�(July 2012) �Functional capacity, muscle strength and falls in women with fibromyalgia��www.sciencedirect.com/science/article/abs/pii/S0268003311003226
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