Back Clinic Chiropractic News. El Paso, TX. Chiropractor, Dr. Alex Jimenez brings various chiropractic news articles dealing with the latest in adjustment techniques, technology, and medical discoveries. It is the third-largest area of medicine today. The word chiropractic comes from Greek meaning treatment by hand, which is exactly what chiropractors do they use their hands to manipulate the body and promote healing and wellness. A doctor of chiropractic (DC), chiropractor or chiropractic physician, is a health professional who is trained to diagnose and treat disorders of the musculoskeletal and nervous systems. Chiropractors treat patients of all ages, infants, children, and adults. They believe in a traditional (non-surgical) hands-on method of treating these disorders.
The chiropractic philosophy is dependent on the following belief statements: All bodily functions are connected as well as the healing process requires the entire body. A healthy nervous system, especially the spine, is an important factor in a healthy body. The spinal cord carries advice throughout the body and is accountable for many bodily functions including voluntary movements (such as walking) and involuntary functions (like respiration). When the systems of the body are in equilibrium, it is called homeostasis. Disorders of the bones, muscles, and nerves increase the risk of disorder along with other health problems and can disrupt homeostasis. When body systems are in harmony, the human anatomy gets the extraordinary ability to keep well-being and heal itself. For answers to any questions you may have please call Dr. Alexander Jimenez at 915-850-0900
The importance of Magnetic Resonance Imaging to evaluate the integrity of the lumbar posterior ligament complex post trauma.
Abstract: Posterior ligamentous complex(PLC), consisting of the supraspinous ligament, interspinous ligament, ligamentum flavum, and the facet joint capsules is thought to contribute significantly to the stability of the lumbar spine. There has been much debate on whether Magnetic Resonance Imaging(MRI) is specific and sensitive in diagnosing pathology to the PLC. The objective is to determine the necessity of MRI imaging for evaluating the integrity of the lumbar posterior ligament complex post trauma.
Key Words: Magnetic Resonance Imaging(MRI), interspinous ligament, posterior ligament complex, low back pain, ligament laxity, electromyography, impairment rating
A 41-year-old male, presented to my office for an examination with complaints of low back pain with numbness, tingling and weakness into the left lower extremity after he was the restraint driver in a motor vehicle collision approximately three and a half months� post trauma.�He�rated the pain as a�3/10 on a visual analog scale with 10/10 being the worst and the pain and noted the pain as being�present most of the time.� He stated that he was on pain killers daily and this helped manage his daily activities. Without pain killers his pain levels are rated 8/10 being present most of the time. The pain killers stated by the patient are Oxycodone and Naproxen. He�reported that the pain would be aggravated by activities which required excessive standing, repetitive bending, and lifting. He further noted that in the morning the pain was increased and his left leg would be numb and weak for about the first hour.
The patient stated that his care to date had been managed by a pain management clinic and that he had minimal improvement with treatment which has included physical therapy and massage therapy. He reported the pain clinic next recommended steroid injections which he refused. He states there has been was no imaging ordered and that an Electromyography(EMG) had been performed. He was told the test was negative for pathology.
Prior History: No significant medical history was reported. Clinical Findings:�The patient is 6�0� and weighs 210 lbs.
Physical Exam Findings:
Cervical Spine:
Cervical spine range of motion is full and unrestricted. Maximum cervical compression is negative. Motor and other regional sensory exam are unremarkable at this time.
Thoracic Spine:
Palpation of the thoracic spine region reveals taught and tender fibers in the area of the bilateral upper and mid thoracic musculature. Thoracic spine range of motion is restricted in flexion, extension, bilateral lateral flexion, and bilateral rotation. Regional motor and sensory exam are unremarkable at this time.
Lumbar Spine:
Palpation of the lumbosacral spine region reveals taught and tender fibers in the area of the lumbar paraspinal musculature. Lumbar spine range of motion is limited in flexion, extension, bilateral lateral flexion and bilateral rotation. Extension restriction is due to pain and spasm. Straight leg raise causes pain at approximately 50 degrees when testing either side in the left low back. There is no radicular symptomatology down the leg. Kemp�s maneuver recreates pain in the L4 region on the left. No radicular symptoms are noted. The patient is able to heel and toe walk. Regional motor and sensory exam is unremarkable at this time other than L4, L5 and S1 dermatomes having decreased sensation with light touch.
Muscle testing of the upper and lower extremities was tested at a 5/5 with the exception of the left quadricep tested at a 4/5.� The patient�s deep tendon reflexes of the upper and lower extremities were tested including triceps, biceps, brachioradialis, patella, and Achilles and all were tested at 2+ bilaterally except the left patellar reflex was 1+.
RANGES OF MOTION EVALUATION
All range of motions are based on the�American Medical Association�s Guides to the Evaluation of Permanent Impairment, 5th�Edition1�and performed by a dual inclinometer for the lumbar spine.
�� Range of Motion������Normal�������� Examination�������� % Deficit
Flexion
60
48
20
Extension
25
12
52
Left Lateral Flexion
25
16
36
Right Lateral Flexion
25
18
28
An MRI was ordered to rule out gross pathology.
Imaging:
�
A lumbar MRI reveals;
1)��� Mild disc bulges at T11-T12, T12-L1, L1-L2 and L5-S1
2)��� Low disc signals indicative of disc desiccation at T11-T12, T12-L1, L1-L2, L2-L3, L3-L4 and L4-L5
3)��� Retrolisthesis of 2mm at L3-L4
4)��� Mild ligamentous hypertrophy at L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1
5)��� L4-L5 has a Grade 1-2 tear of the interspinous ligament with mild inflammation
6)��� L5-S1 has a Grade 1 interspinous ligament tear with mild inflammation
After reviewing the MRI I ordered lumbar x-rays to rule out ligament laxity.
X-RAY STUDIES
Lumbar x-rays reveal the following:
1)��� Left lateral tilt
2)��� Retrolisthesis at L1 of 3mm
3)��� Retrolisthesis at L2 of 3mm
4)��� Combined excessive translation of 4mm of L1 during flexion-extension
5)��� Combined excessive translation of 4mm of L2 during flexion-extension
6)��� Excessive translation of L3 in extension posteriorly of 2.5mm
7)��� Decreased disc space at L5-S1
Chiropractic care was initiated. The patient was placed on an initial care plan of 2-3x/week for 3 months and then a recommended break in care for one month so the patient could be evaluated for permanency while he was not care dependent.
At maximum medical improvement, he had continued low back pain rated 4/10, continued numbness and tingling into his left leg and left quadricep weakness rated 4/5. He does not need pain killers for pain management anymore. He continues chiropractic care every two weeks to manage his symptoms.
Conclusion:
In this specific case, pathology to the posterior ligament complex diagnosed on MRI lead to the x-ray finding of excessive translation at L1-L2 and L2-L3. The patient was given a permanent impairment rating of 22% based on my interpretation of the American Medical Association�s Guides to the Evaluation of Permanent Impairment, 5th�Edition1. The interspinous ligament tears at the L4-L5 and L5-S1 level would not have been diagnosed without the MRI.
There has been much debate on whether MRI imaging has a role in evaluating lumbar PLC. MRI is a powerful diagnostic tool that can provide important clinical information regarding the condition of the PLC. Useful sequences for spinal MRI in trauma include sagittal and axial T1-weighted images, T2-weighted FSE, fat-saturated T2-weighted FSE, and STIR sequences to highlight bone edema.2�Ligamentous injuries are best identified on T2-weighted images with fat saturation because the ligaments are thin and bonded on either side by fat, which can appear as hyperintense on both T1 and T2 images.3�T1-weighted images are inadequate in isolation for identifying ligamentous injuries.4�
The diagnostic accuracy for MRI was reported for both supraspinous ligament and interspinous ligament injury with a sensitivity of 89.4% and 98.5%, respectively, and a specificity of 92.3% and 87.2% in 35 patients.5
For patients with persistent symptoms after trauma an MRI may be indicated to evaluate posterior ligamentous complex integrity.
Competing Interests:� There are no competing interests in the writing of this case report.
De-Identification: All of the patient�s data has been removed from this case.
References:
1. Cocchiarella L., Anderson G. Guides to the Evaluation of Permanent Impairment, 5th Edition, Chicago IL, 2001 AMA Press.
2. Cohen, W.A., Giauque, A.P., Hallam, D.K., Linnau, K.F. and Mann, F.A., 2003. Evidence-based approach to use of MR imaging in acute spinal trauma.�European journal of radiology,�48(1), pp.49-60.
3. Terk, M.R., Hume-Neal, M., Fraipont, M., Ahmadi, J. and Colletti, P.M., 1997. Injury of the posterior ligament complex in patients with acute spinal trauma: evaluation by MR imaging.�AJR. American journal of roentgenology,�168(6), pp.1481-1486.
4. Saifuddin, A., Green, R. and White, J., 2003. Magnetic resonance imaging of the cervical ligaments in the absence of trauma.�Spine,�28(15), pp.1686-1691.
5. Haba H, Taneichi H, Kotani Y, et al. Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures.�J Neurosurg. 2003; 99(1 Suppl):20-26.
Chiropractic treatment has been associated with pain relief ever since it became part of the public consciousness. If you have a sore back, shoulder, or neck you head to the chiropractor for an adjustment and all-natural pain relief. But is pain the only reason to see a El Paso chiropractor? �New studies from the Journal of the American Medical Association JAMA, have shed new light on why Chiropractic is a great first choice with back pain.
Drawn In By Pain
The main reason people make that first visit to see a El Paso chiropractor is because they are in pain. They may have a persistent headache, lower back pain, radiating pain from the neck, sore shoulders, knees, or some other type of pain. The common denominator is pain and the need for relief. Some patients will be trying out a chiropractor as a last resort after exhausting all conventional options, and others will be looking for chiropractic treatment right from the start.
Chiropractors are experts at adjusting spinal misalignments, which is a major cause of pain throughout the body. And while many patients are drawn in to see chiropractors in El Paso because of pain, they quickly discover there is a lot more to it than just pain relief.
A Host of Other Benefits
Chiropractic treatment has the potential to improve and eliminate scores of different health issues and related problems. Some health problems and other factors that you probably haven�t associated with chiropractic treatment before, include:
Ear Infections
Increased Range of Motion
Colic
PMS Symptoms
High Blood Pressure
Various Behavioral Issues
Improved Productivity
Improved Immunity
Stress Reduction
Decreased Need for Pain Medication
Improved Sleep Quality
More Comfortable Pregnancy
Allergy Relief
When you visit an El Paso chiropractor it is important to clearly detail why you are there and explain every health issue that has been plaguing you. Many patients don�t bother telling the chiropractor about certain health conditions because they feel chiropractic treatment is only effective for pain. Much of the time whatever you are experiencing is just a symptom of a more complex issue. Chiropractors are trained to treat causes, not just symptoms, so you may notice improvements in several different areas after treatment.
The goal of a chiropractic office is to create a comprehensive treatment plan that will restore your body back to its original balance. It might take only a few sessions, or it may take longer, but in the end you�ll be free of pain and you�ll feel like your old self. We are happy to help answer any questions that you might have.
Scope: In Texas, the scope of practice is limited to the treatment and diagnosis of musculo-skeletal system. �Texas statute and TBCE board rules define and interpret what a licensed chiropractor is allowed to do in Texas. Many chiropractors are trained to provide far more services to patients than a Texas license actually permits, but training does not drive scope. Each state has its specified scope. Specialty board training does not change Texas chiropractic�scope. Scope of Practice can only be changed by legislative action. For example, Texas Chiropractors cannot treat diseases or disorders, such as: diabetes, hypothyroidism, infertility, schizophrenia, Parkinson�s, colic, diarrhea, asthma or constipation.
Chiropractic received a boost from some major national sources in recent months. Here�s a recap.
1. American College of Physicians issues new guideline for low-back pain treatment
The American College of Physicians (ACP) published a new low-back pain treatment guideline recommending first using non-invasive, non-drug treatments, including spinal manipulation, before resorting to drug therapies. The guideline was published Feb. 14, 2017 in the Annals of Internal Medicine. For more information, see the American Chiropractic Association news release on the guideline.
On May 1, 2017, the New York Times published an editorial by Aaron E. Carroll, M.D., that mentions the new guideline in a generally positive light. The article appeared in a major, mainstream publication read by millions of people. �Spinal manipulation�along with other less traditional therapies like heat, meditation and acupuncture�seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer,� he wrote.
Talking points on new ACP guideline:
The chiropractic profession has advocated for decades that conservative care choices such as chiropractic be the first line of treatment for low-back pain. Now, with this new guideline, the medical profession is recognizing the benefits of conservative care for this common problem.
Thanks to this guideline, it�s possible more medical doctors will choose to refer their patients with low-back pain to chiropractors.
The ACP guideline was adopted by the American Chiropractic Association, which also adopted the Clinical Compass guidelines on chiropractic for LBP at its HOD meeting in March.
2. Article�and editorial on spinal manipulation published in JAMA
The April 11, 2017, issue of the Journal of the American Medical Association(JAMA) featured the article �Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain.� This systematic review and meta-analysis found that of the 26 eligible RCTs identified, 15 RCTS (1,711 patients) provided moderate-quality evidence that SMT has a statistically significant association with improvements in pain. Twelve RCTs (1,381 patients) produced moderate-quality evidence that SMT has a statistically significant association with improvements in function. One of the RCTs included in this analysis, �Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study,� was led by investigators at the Palmer Center for Chiropractic Research.
Additionally, an editorial by Richard A. Deyo, M.D., M.P.H., titled �The Role of Spinal Manipulation in the Treatment of Low Back Pain,� was published in the April 11 issue of JAMA. �If manipulation is at least as effective and as safe as conventional care, it may be an appropriate choice for some patients with uncomplicated acute low back pain,� Dr. Deyo wrote. �This is an area in which a well-informed patient�s decisions should count as much as a practitioner�s preference.�
A National Public Radio story on April 11 quoted Dr. Paul Shekelle, an internist with the West Los Angeles Veterans Affairs Medical Center and one of the study authors, as saying the JAMA study found patients undergoing spinal manipulation experienced a decline of one point in their pain rating. He added that the study also found spinal manipulation modestly improved function.
3. Article�and editorial on spinal manipulation published in JAMA
An article published April 4 in STAT News, a medical journal, discussed the ACP guideline and how it�s bolstering the cause of non-pharmaceutical pain control methods like chiropractic and acupuncture. Another article published May 10 in STAT News covered proposed FDA recommendations that physicians learn more about chiropractic, acupuncture and other drug-free pain treatments as therapies to help patients avoid prescription opioids.
4.�Article posted May 19 on Psychology Today website about new research on chiropractors helping people with low-back pain
This article, �The Evolving Evidence on Chiropractors for Low Back Pain,� covered the ACP guideline and its recommendation for conservative care first, as well as the Annals of Internal Medicine systematic review that found evidence spinal manipulation helps to reduce pain for people with chronic low-back pain. It concluded by saying, �On the whole, the evidence suggests that seeing a chiropractor can reduce pain levels and increase function for people with chronic low back pain.�
The Journal of Clinical Chiropractic Pediatrics (JCCP) is the official peer-reviewed journal of the ICA Council on Chiropractic Pediatrics. It is committed to publishing research, scientific and professional papers, literature reviews, case reports and clinical commentaries for chiropractors and other health care professionals interested in the treatment of the pregnant, postpartum and pediatric patient. Through the publication of these papers and the dissemination of this information, the JCCP seeks to encourage professional dialogue and awareness about chiropractic pediatric care to help enhance patient care and improve patient outcomes.
Editors: Sharon A. Vallone, DC., DICCP., Cheryl Hawk, DC, PhD.
We are hopeful that this venue will provide field clinicians interested in maternal health and pediatric chiropractic with current research, case reports and clinical commentary that they will find both useful and informative. �We invite you to submit your own research or scientific writing for consideration for publication in this journal.
Though the most visible kinesiology tape users might be professional athletes, Olympians, or weekend warriors � a much smaller clientele is also proving the advantages of this unique treatment. With a special line designed for sensitive skin and playful prints and colors that will speak to the sticker and Band-Aid loving child, it�s not surprising that kinesiology tape is quickly becoming more than an athlete�s aid.
While the uses and applications of kinesiology tape for pediatric treatment are growing daily, here is a quick run down of how kinesiology tape is being used in pediatric care today:
Pain and Swelling Relief
� When kinesiology tape is applied to an injured or inflamed area, children can enjoy some relief without having to take pain medication or sit through icing and therapy treatments.
Orthopedic Treatment
� Children often don�t understand the purpose behind rehabilitation exercises, so kinesiology tape provides an additional or alternative treatment for children with orthopedic injuries, weak or underdeveloped muscles, gait abnormalities, paralysis � even poor posture.
Neuromuscular Disorders
� Kinesiology tape has proven effective to activate weak muscles and inhibit overactive muscles.� With a simple and safe taping application, children suffering from neuromuscular conditions like cerebral palsy, or muscular dystrophy could see improvements in symptoms and movement ability. It has also been shown to improve muscle tone in genetic disorders like Downs Syndrome and other conditions causing either spasticity, atrophy or poor muscle tone.
For children dealing with serious medical conditions, a colorful and painless treatment that can be worn for several days, even while playing and bathing, can make a big difference in their comfort level.
Interested in learning more about pediatric kinesiology taping? Dr. Kenzo Kaze, the creator of Kinesio Tape, provides step by step guidelines for taping infants and children in his manual, Kinesio Taping in Pediatrics available at Theratape.com.
For a list of successful case studies where kinesiology tape has provided improvement for children, check out Theratape�s research compilation as well as this case report (pdf) from Novel Physiotherapies. Hopefully, as more and more case studies document positive results, the use of kinesiology tape in pediatric care will continue to expand and increase.
It is with utmost respect and great humility for our community that we received this amazing chiropractic award. I thank God, our patients, staff, family, friends, colleagues and many others for this. We feel very bless in being considered. It is an award that we did not expect to receive, nevertheless humbly appreciate and accept. All of us at the office and rehab center share in this commendation. Being considered with these fine peer doctors gives all of us here a great sense of highly respected accomplishment. We will alway remain steadfast and ready to take care of all our patients no matter the complexity of their musculoskeletal issues. For over 25 years we have devoted ourselves to improve the lives of every loving soul walking through our doors. Thank you from the bottom of our hearts. God Bless… Dr. Alexander D. Jimenez D.C.,C.C.S.T
The following was published on Public Register. Congratulations! You are now listed as one of the Top 3 Chiropractors in El Paso, TX. We want to Thank You for providing consistent high quality in your area of business. Our review team either approved or updated your business listing after checking customer reviews, history, complaints, ratings, satisfaction, trust, cost, and general excellence.
Dr. Alexander Jimenez DC
11860 Vista Del Sol, Suite 128
El Paso, TX 79936
Dr. Alexander Jimenez, DC
6440 Gateway East Building B,
El Paso, TX 79905
Businesses DO NOT pay us to list them ever. You DO NOT pay us for the listing any time. We believe that local businesses provide better and personal services locally. Local businesses know your city better since they live there too. Our policy is free to list because if you can pay to list, is it really the best business?
It has been an honor and a pleasure to work with you.
Super Bowl LI kicks-off with a team of doctors of chiropractic (DC)�to help these professional athletes prevent, manage and care for injuries, as well as, achieve peak performance. The Foundation for Chiropractic Progress� (F4CP), the leading voice of the chiropractic profession, points to the role of DCs with all four play-off teams,and cites data from the Professional Football Chiropractic Society (PFCS) showing on average, a professional football DC performs between 30 to 50 weekly treatments during the regular season � not including training camp or the playoffs.
F4CP� celebrates Super Bowl LI with NFL doctors of chiropractic
New England Patriots Team Chiropractor of 35+ years and proud to attend his ninth Super Bowl, Dr. Michael Miller, states, �During the NFL season, I regularly visit the stadium on my afternoon off from my office, as well as on game days both at home and away. Chiropractic care is emphasized by the head coach, trainers and medical staff as a proactive regimen to prevent injuries, with most of the players receiving adjustments roughly 1-2 times per week.�
He adds that chiropractic care has proven itself over the years in the sports injury arena to be well-accepted as the choice of champions and an integral part of any injury prevention program. �We�ve also earned the respect of other team physicians as a necessary protocol, and are all committed to one goal: keeping the athletes performing at their maximum potential and preventing and managing injuries as they occur.�
He says that chiropractic care provides the athletes with the confidence they need to play without the distraction of pain. �The players are educated about the principles of chiropractic and that it is designed to eliminate the cause of their problem rather than just masking their symptoms.�
Joseph Krzemien, DC, team chiropractor, Atlanta Falcons, says that there is growing evidence and a correlation between football players who receive consistent chiropractic care and a decline in injuries during practice or play:
�During the six seasons I�ve spent with the Atlanta Falcons, my goal has always been to prepare each player�s body to better resist trauma and to speed its natural recovery time,� he says. �This season, the Falcons have been successful for a lot of reasons, but I firmly believe that regular chiropractic care has played an important role in helping us stay healthy and get to Super Bowl LI � I am proud of the role I�ve played in their success.�
For Michael Zoelle, DC, team chiropractor, Green Bay Packers, the trauma experienced by the athletes� bodies during a game is very similar to that of a car accident.
�Ensuring that the joints are functioning properly is critical in the healing process, as well as for injury prevention and optimal performance,� says Dr. Zoelle. �The players recognize that chiropractic care helps them to perform better and heal faster, ultimately leading to better team success.�
DCs receive a minimum of seven years of higher level education, and are qualified to diagnose, treat and manage a broad spectrum of health conditions. They are the primary care professionals for spinal health and well-being. For athletes, chiropractic care helps to reduce the risk of injuries and improve health and performance through enhancements in range of motion, flexibility, balance, muscle strength and other key factors.
On every sideline all over the NFL and NCAA game you will now see chiropractors fixing and maintaining their local teams. In our very own back yard, you will see chiropractors treating El Paso’s finest at most high school games. �UTEP now has Dr. Paul Munoz standing tall ready to help our kids perform better. �The story is getting better each and every year how the public understands joint health as to how it applies to peak performance. �This last Olympics we saw Usain Bolt getting tuned just before his record breaking run. �The day of ushering in alternative care for high performance has for sure landed. �The spine was created to propel the creature faster and to transmit power. �No surprise that most sports have embraced the science and art. �Proud to be a part of the movement…..
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Joseph Krzemien, DC, team chiropractor, Atlanta Falcons, says that there is growing evidence and a correlation between football players who receive consistent chiropractic care and a decline in injuries during practice or play:
