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Chiropractic

Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).

Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.


Acupuncture for Reducing Joint Pain in Lupus: A Natural Approach

Acupuncture for Reducing Joint Pain in Lupus: A Natural Approach

Can individuals dealing with joint pain incorporate acupuncture therapy to manage lupus symptoms and restore body mobility?

Introduction

The immune system is highly important to the body as its main job is to protect vital structures from foreign invaders that can cause pain-like issues and discomfort. The immune system has a healthy relationship with the different body systems, including the musculoskeletal system, as the inflammatory cytokines help heal muscle and tissue damage when the body is injured. Over time, however, when normal environmental and genetic factors start to develop in the body, the immune system will begin to send out these cytokines to healthy, normal cells. To that point, the body starts at risk of developing autoimmune diseases. Now, autoimmune diseases in the body can cause havoc over time when they are not managed, leading to chronic disorders that can cause overlapping symptoms in the musculoskeletal system. One of the most common autoimmune diseases is systemic lupus erythematosus or lupus, and it can cause a person to be in consistent pain and discomfort while correlating with muscle and joint pain. Today’s article looks at the factors and effects of lupus, the burden of joint pain in lupus, and how holistic approaches like acupuncture can help manage lupus while restoring body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how to minimize the pain effects caused by lupus on the joints. We also inform and guide patients on how acupuncture can help manage lupus and combine other therapies to reduce its pain-like symptoms affecting the musculoskeletal system. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating acupuncture therapy to relieve the inflammatory effects of lupus while finding natural ways to restore mobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Factors & Effects Of Lupus

Have you been experiencing joint pain in your upper or lower extremities, making it difficult to function throughout the day? Have you been feeling the constant effects of fatigue? Many individuals experiencing these pain-like issues could risk developing systemic lupus erythematosus. In this autoimmune disease, the body’s own immune system mistakenly starts to attack its tissues, thus leading to inflammation and a range of pain-like symptoms. Lupis is tricky to diagnose because of its complex immune dysregulation that can lead to an overproduction of cytokines that can affect the body. (Lazar & Kahlenberg, 2023) At the same time, lupus can affect a diverse population, with symptoms and severity varying depending on how mild or severe the factors affect the body. Lupus can impact various body parts, including the joints, skin, kidneys, blood cells, and other vital body parts and organs, as environmental and hormonal factors can influence its development. (Tsang & Bultink, 2021) Additionally, lupus can be closely associated with other comorbidities that are causing overlapping risk profiles with inflammation that can affect the joints in the musculoskeletal system.

 

The Burden of Joint Pain In Lupus

 

Lupus is tricky to diagnose since it often mimics other ailments; the most common pain symptom that lupus affects is the joints. Individuals with lupus experience joint pain, which can cause inflammatory effects and structural damage to the joints, tendons, muscles, and bones, causing pathological abnormalities. (Di Matteo et al., 2021) Since lupus causes inflammatory effects in the joints, many individuals will think that they are experiencing inflammatory arthritis, and it can cause overlapping risk profiles as it is accompanied by lupus, thus causing localized pain in the joints regardless of its origin. (Senthelal et al., 2024) Joint pain in lupus individuals can significantly hinder daily activities, reducing mobility and overall quality of life as they are trying to find relief. 

 


Unlocking The Secrets of Inflammation-Video


 

A Holistic Approach to Managing Lupus

While standard treatments for lupus involve medication and immunosuppressants to reduce the inflammation caused by lupus, many people want to seek out holistic approaches to manage lupus and reduce the inflammatory effects from affecting their joints by making small changes in their lives. Many people incorporate anti-inflammatory foods rich in antioxidants to dampen the inflammatory effects. Various supplements, like vitamin D, calcium, zinc, etc., can help reduce inflammation caused by lupus and strengthen bone health. Additionally, non-surgical treatments can even improve cardiorespiratory capacity and decrease fatigue while improving psychological function, which can help improve a person’s quality of life by managing the symptoms caused by lupus. (Fangtham et al., 2019)

 

How Acupuncture Could Help Lupus & Restore Mobility

One of the oldest forms of non-surgical and holistic approaches to reducing inflammation and managing lupus is acupuncture. Acupuncture involves solid, thin needles used by highly trained professionals to be inserted into specific body points to balance the body’s qi (energy) by stimulating the nervous system and releasing beneficial chemicals into the affected muscles, spinal cord, and brain. Additionally, acupuncture, with its minimal side effects and holistic approach, can help manage lupus. This is because when acupuncture needles are placed at the acupoints of the body, it can disrupt the pain signals that are causing pain in the affected area and regulate the inflammatory cytokines from lupus to provide relief. (Wang et al., 2023) This is due to its philosophy of addressing not only the physical pain but also the emotional and psychological symptoms of living with a chronic condition like lupus.

 

 

Additionally, acupuncture can help restore joint mobility while managing lupus through consecutive treatments, as many people notice that their joint mobility is improved and their pain is diminished. This is because the insertion and manipulation of the needles in the body’s acupoints cause alterations in afferent sensory input to the central nervous system, which increases alpha motoneuron excitability and reduces inflammation. (Kim et al., 2020) When individuals are dealing with lupus and are trying to find alternative holistic methods to relieve inflammation and joint pain caused by lupus, acupuncture, and non-surgical treatments can offer a ray of hope in managing the daily challenges of lupus. 

 


References

Di Matteo, A., Smerilli, G., Cipolletta, E., Salaffi, F., De Angelis, R., Di Carlo, M., Filippucci, E., & Grassi, W. (2021). Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus. Curr Rheumatol Rep, 23(9), 73. doi.org/10.1007/s11926-021-01040-8

Fangtham, M., Kasturi, S., Bannuru, R. R., Nash, J. L., & Wang, C. (2019). Non-pharmacologic therapies for systemic lupus erythematosus. Lupus, 28(6), 703-712. doi.org/10.1177/0961203319841435

Kim, D., Jang, S., & Park, J. (2020). Electroacupuncture and Manual Acupuncture Increase Joint Flexibility but Reduce Muscle Strength. Healthcare (Basel), 8(4). doi.org/10.3390/healthcare8040414

Lazar, S., & Kahlenberg, J. M. (2023). Systemic Lupus Erythematosus: New Diagnostic and Therapeutic Approaches. Annu Rev Med, 74, 339-352. doi.org/10.1146/annurev-med-043021-032611

Senthelal, S., Li, J., Ardeshirzadeh, S., & Thomas, M. A. (2024). Arthritis. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30085534

Tsang, A. S. M. W. P., & Bultink, I. E. M. (2021). New developments in systemic lupus erythematosus. Rheumatology (Oxford), 60(Suppl 6), vi21-vi28. doi.org/10.1093/rheumatology/keab498

Wang, H., Wang, B., Huang, J., Yang, Z., Song, Z., Zhu, Q., Xie, Z., Sun, Q., & Zhao, T. (2023). Efficacy and safety of acupuncture therapy combined with conventional pharmacotherapy in the treatment of systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore), 102(40), e35418. doi.org/10.1097/MD.0000000000035418

Disclaimer

Managing Sciatica Pain with Acupuncture: What You Need to Know

Managing Sciatica Pain with Acupuncture: What You Need to Know

For individuals considering acupuncture for sciatica relief and management, can knowing how it works and what to expect during a session help in making the decision?

Managing Sciatica Pain with Acupuncture: What You Need to Know

Acupuncture Sciatica Treatment Session

Acupuncture for sciatica is a safe and effective medical treatment to relieve and manage pain symptoms. Studies suggest it is as effective as other treatment strategies and causes fewer side effects. (Zhihui Zhang et al., 2023) The frequency of acupuncture to relieve sciatica pain depends on the severity of the condition and injury, but many report improvement within two to three weeks. (Fang-Ting Yu et al., 2022)

Needle Placement

  • Circulation problems can cause the body’s energy to stagnate in one or more meridians/channels, leading to pain in and around the surrounding area. (Wei-Bo Zhang et al., 2018)
  • The objective of acupuncture is to restore optimal circulation by stimulating specific points in the body called acupoints.
  • Thin, sterile needles stimulate the acupoints to activate the body’s natural healing abilities and relieve pain. (Heming Zhu 2014)
  • Some practitioners use electroacupuncture – a gentle, mild electrical current is applied to the needles and passes through the tissues to activate the nervous system. (Ruixin Zhang et al., 2014)

Acupoints

Acupuncture sciatica treatment involves specific acupoints along the bladder and gallbladder meridians.

Bladder Meridian – BL

The bladder meridian/BL runs down the back along the spine, hips, and legs. The acupoints within the meridian for sciatica include: (Fang-Ting Yu et al., 2022)

  • BL 23  -Shenshu – Location on the lower back, near the kidney.
  • BL 25 – Dachangshu – Location on the lower back.
  • BL 36  – Chengfu – Location on the back of the thigh, just below the buttocks.
  • BL 40 – Weizhong – Location behind the knee.

Gallbladder Meridian – GB

The gallbladder meridian/GB runs along the sides from the corner of the eyes to the pinky toe. (Thomas Perreault et al., 2021) The acupoints for sciatica within this meridian include: (Zhihui Zhang et al., 2023)

  • GB 30 – Huantiao – Location on the back, where the buttocks meet the hips.
  • GB 34 – Yanglingquan – Location on the outside of the leg, below the knee.
  • GB 33 – Xiyangguan – Location lateral to the knee, on the side.

Stimulating acupoints in these meridians increases blood flow to the area, reduces inflammation, and releases endorphins and other pain-relieving neurochemicals to relieve symptoms. (Ningcen Li et al., 2021) The specific acupoints vary depending on symptoms and the root cause. (Tiaw-Kee Lim et al., 2018)

Example Patient

An example of acupuncture sciatica treatment session: A patient with persistent shooting pain extending down the back and side of the leg. A standard treatment consists of the following:

  • The acupuncturist thoroughly goes over the patient’s medical history and symptoms and has the patient point to where the pain is located.
  • Then, they palpate on and around the area to find where the pain worsens and lessens, communicating with the patient as they go along.
  • Depending on the site and severity, they may start placing needles at the lower back, focusing on the site of the injury.
  • Sometimes, the sacrum is involved, so the acupuncturist will place needles on those acupoints.
  • They then move to the back of the leg and insert needles.
  • The needles are retained for 20-30 minutes.
  • The acupuncturist leaves the room or treatment area but regularly checks in.
  • The patient may feel a warmth, tingling, or mild heaviness, which is a normal response. This is where patients report a calming effect. (Shilpadevi Patil et al., 2016)
  • The needles are carefully removed.
  • The patient may feel deeply relaxed and will be advised to get up slowly to avoid dizziness.
  • There may be soreness, redness, or bruising at the needle insertion site, which is normal and should resolve quickly.
  • The patient will be given recommendations as to avoiding strenuous activity, properly hydrating, and performing gentle stretches.

Acupuncture Benefits

Acupuncture has been shown to be a complementary therapy for pain relief and management. The benefits of acupuncture:

Improves Circulation

  • Acupuncture stimulates blood circulation, which nourishes damaged or irritated nerves and promotes healing.
  • This helps relieve sciatica symptoms, like numbness, tingling, and pain. (Song-Yi Kim et al., 2016)

Releases Endorphins

  • Acupuncture triggers the release of endorphins and other natural pain-relieving chemicals, which help relieve pain. (Shilpadevi Patil et al., 2016)

Regulates the Nervous System

  • Acupuncture rebalances the sympathetic and parasympathetic responses, which reduces stress, tension, and pain. (Xin Ma et al., 2022)

Relaxes the Muscles

  • Nerve pain often accompanies muscle tension and spasms.
  • Acupuncture relaxes tight muscles, reducing pressure and providing relief. (Zhihui Zhang et al., 2023)

From Symptoms to Solutions


References

Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Frontiers in neuroscience, 17, 1097830. doi.org/10.3389/fnins.2023.1097830

Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., Wan, W. J., … Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566

Zhang, W. B., Jia, D. X., Li, H. Y., Wei, Y. L., Yan, H., Zhao, P. N., Gu, F. F., Wang, G. J., & Wang, Y. P. (2018). Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance. Chinese journal of integrative medicine, 24(4), 304–307. doi.org/10.1007/s11655-017-2791-3

Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. doi.org/10.1089/acu.2014.1057

Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. doi.org/10.1097/ALN.0000000000000101

Perreault, T., Fernández-de-Las-Peñas, C., Cummings, M., & Gendron, B. C. (2021). Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms-A Scoping Review. Journal of clinical medicine, 10(10), 2189. doi.org/10.3390/jcm10102189

Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., Chen, Z., Dou, B., Lin, X., Chen, B., Chen, Z., Xu, Z., & Lyu, Z. (2021). The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of inflammation research, 14, 7191–7224. doi.org/10.2147/JIR.S341581

Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel, Switzerland), 5(3), 63. doi.org/10.3390/medicines5030063

Kim, S. Y., Min, S., Lee, H., Cheon, S., Zhang, X., Park, J. Y., Song, T. J., & Park, H. J. (2016). Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2016, 9874207. doi.org/10.1155/2016/9874207

Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1

Ma, X., Chen, W., Yang, N. N., Wang, L., Hao, X. W., Tan, C. X., Li, H. P., & Liu, C. Z. (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in neuroscience, 16, 940343. doi.org/10.3389/fnins.2022.940343

The Impact of Electroacupuncture on Thoracic Outlet Syndrome

The Impact of Electroacupuncture on Thoracic Outlet Syndrome

Can individuals with thoracic outlet syndrome incorporate electroacupuncture to reduce neck pain and restore proper posture?

Introduction

More times throughout the world, many individuals have experienced pain around their necks, which can lead to pain and discomfort. Many environmental factors, like being in a hunched position while looking at the computer or phone, traumatic injuries, poor posture, or spinal issues, can cause pain-like symptoms and complications to the body. Since neck pain is a common complaint many people suffer, symptoms like tingling, numbness, or muscle weakness in the upper extremities can lead to comorbidities. When this happens, it can lead to the development of a complex condition known as thoracic outlet syndrome or TOS. Today’s article looks at the link between thoracic outlet syndrome and neck pain, how to manage TOS while alleviating neck pain, and how electroacupuncture can help with TOS. We talk with certified medical providers who consolidate our patients’ information to assess how to minimize the effects of TOS while reducing neck pain. We also inform and guide patients on how electroacupuncture can help manage TOS. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating electroacupuncture to alleviate TOS associated with the neck. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Link Between Thoracic Outlet Syndrome & Neck Pain

Have you been noticing how you are hunched over more than usual? Do you experience symptoms of tingling or numbness down from your arms to your hands? Or do you feel muscle tension in your neck? Thoracic outlet syndrome, or TOS, is a challenging condition resulting in the compression of neurovascular structures between the clavicle and the first rib. (Masocatto et al., 2019) These neurovascular structures are near the neck and shoulders. When environmental structures affect the upper extremities, it can lead to referred neck pain, which can cause overlapping risk profiles. Some of the factors that TOS can contribute to neck pain include: 

  • Atomical variations
  • Poor posture
  • Repetitive motions
  • Traumatic injuries

 

 

At the same time, people with neck pain can develop TOS, as neck pain is a multifactorial musculoskeletal condition that can be associated with overlapping risk profiles that contribute to TOS. (Kazeminasab et al., 2022) As stated earlier, factors like poor posture can overstretch the neck muscles and the neurovascular structures, leading to neuropathic pain symptoms that can cause deep aching referred pain to the neck and muscle weakness. (Childress & Stuek, 2020) When this happens, many people will begin to feel miserable and start to seek treatment to not only reduce TOS but also alleviate neck pain.

 


What Is Thoracic Outlet Syndrome- Video


Managing TOS & Alleviating Neck Pain

When it comes to treating TOS, especially when neck pain is a significant component, many individuals will try to seek out non-surgical treatments to reduce the symptoms. Many individuals may try physical therapy to stretch and strengthen their shoulder, chest, and neck muscles to relieve compression. Others might try a manual treatment that is joint-oriented for the neck while neural-tissue-oriented for TOS to improve mobilization on the upper extremities and even improve poor posture. (Kuligowski et al., 2021) Additionally, non-surgical treatments can be combined with other therapies to reduce the chances of TOS from returning as they can further increase sensory-motor function back to the neck and upper extremities. (Borrella-Andres et al., 2021)

 

How Electroacupuncture Can Help With TOS

 

Electroacupuncture is a modern form of traditional acupuncture that is part of the non-surgical treatments that can help manage TOS while alleviating neck pain. Electroacupuncture is a modification of inserting needles into the body’s acupoints while incorporating electric stimulation to deliver a pulsed electrical current to the affected area gently. (Zhang et al., 2022) Some of the beneficial properties that electrostimulation can provide for TOS include:

  • Pain reduction by stimulating the release of endorphins to decrease inflammation.
  • Help relax the affected muscles in the chest and neck to alleviate the pressure on the nerves of the thoracic outlet.
  • Help enhance the blood flow to reduce vascular compression of TOS.
  • Help stimulate the nerve pathway to promote healthy nerve function and reduce pain-like symptoms. 

By incorporating electroacupuncture and non-surgical treatments to reduce TOS, many individuals can make modifications to their lifestyle habits and prevent issues from affecting their upper body extremities. By utilizing these treatments, many people can listen to their bodies and focus on their health and well-being by addressing the pain-like symptoms they are experiencing from TOS correlating with neck pain. At the same time, they have a positive relationship with their primary doctors to develop a personalized treatment plan that can manage their TOS symptoms to the best outcomes. 

 


References

Borrella-Andres, S., Marques-Garcia, I., Lucha-Lopez, M. O., Fanlo-Mazas, P., Hernandez-Secorun, M., Perez-Bellmunt, A., Tricas-Moreno, J. M., & Hidalgo-Garcia, C. (2021). Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review. Biomed Res Int, 2021, 9936981. doi.org/10.1155/2021/9936981

Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American Family Physician, 102(3), 150-156. www.ncbi.nlm.nih.gov/pubmed/32735440

www.aafp.org/dam/brand/aafp/pubs/afp/issues/2020/0801/p150.pdf

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4

Kuligowski, T., Skrzek, A., & Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. Int J Environ Res Public Health, 18(11). doi.org/10.3390/ijerph18116176

Masocatto, N. O., Da-Matta, T., Prozzo, T. G., Couto, W. J., & Porfirio, G. (2019). Thoracic outlet syndrome: a narrative review. Rev Col Bras Cir, 46(5), e20192243. doi.org/10.1590/0100-6991e-20192243 (Sindrome do desfiladeiro toracico: uma revisao narrativa.)

Zhang, B., Shi, H., Cao, S., Xie, L., Ren, P., Wang, J., & Shi, B. (2022). Revealing the magic of acupuncture based on biological mechanisms: A literature review. Biosci Trends, 16(1), 73-90. doi.org/10.5582/bst.2022.01039

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Discover Nonsurgical Solutions for Hip Pain and Plantar Fasciitis

Discover Nonsurgical Solutions for Hip Pain and Plantar Fasciitis

Can plantar fasciitis patients incorporate non-surgical treatments to reduce hip pain and restore mobility?

Introduction

Everyone is on their feet constantly as it helps people stay mobile and allows them to go from one location to another. Many people are constantly on their feet from childhood to adulthood. This is because the feet are part of the lower musculoskeletal extremities that stabilize the hips and allow sensory-motor function to the legs, thighs, and calves. The feet also have various muscles, tendons, and ligaments surrounding the skeletal structure to prevent pain and discomfort. However, when repetitive motions or injuries start to affect the feet, it can lead to plantar fasciitis and, over time, cause overlapping risk profiles that lead to hip pain. When people are experiencing these pain-like conditions, it can significantly affect their daily activities and overall quality of life. When this happens, many people seek various treatments to reduce the pain-like symptoms caused by plantar fasciitis and restore hip mobility. Today’s article looks at how plantar fasciitis correlates with hip pain, the connection between the feet and the hips, and how there are non-surgical solutions to reduce plantar fasciitis. We talk with certified medical providers who consolidate our patients’ information to assess how to mitigate plantar fasciitis and restore hip mobility. We also inform and guide patients on how numerous non-surgical treatments can help strengthen weak muscles associated with plantar fasciitis and help with restoring stabilization from hip pain. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating small changes to reduce the pain-like effects caused by plantar fasciitis. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

How Plantar Fasciitis Correlates With Hip Pain

Do you experience pain in your heels constantly after a long walk? Do you feel stiffness in your hips when stretching? Or do you feel your shoes are causing tension and pain in your feet and calves? Often, many of these pain-like scenarios are due to people dealing with plantar fasciitis, characterized by heel pain due to inflammation or degenerative irritation of the plantar fascia, a band of thick tissues is running across the bottom of the foot and connecting to the heel bone to the toes in the lower extremities. This band of tissues plays an essential role in the body, providing normal biomechanics to the foot while supporting the arch and helping with shock absorption. (Buchanan et al., 2024) Plantar fasciitis can affect the stability of the lower extremities since the pain affects the feet and causes hip pain.

 

 

So, how would plantar fasciitis correlate with hip pain? With plantar fasciitis, many people are experiencing pain in their feet. It can lead to abnormal foot posture, lower extremity muscle weakness, and muscle stress that can reduce the stability of the legs and hip muscles. (Lee et al., 2022) With hip pain, many people can experience a gait dysfunction that causes muscle weakness in the lower extremities and causes the accessory muscles to perform the primary muscles’ jobs. To that point, this forces people to scrap the ground when walking. (Ahuja et al., 2020) This is because normal conditions like natural aging, muscle overuse, or trauma can cause pain-like symptoms to the hips, including discomfort on the thighs, groin, and buttock region, joint stiffness, and reduced range of motion. Hip pain can cause overlapping risk profiles that may include repetitive strain on the feet, thus leading to symptoms of sharp to dull aches on the heel.

 

The Connection Between The Feet and The Hips

It is important to understand that foot problems like plantar fasciitis can affect the hips and vice versa, as both body regions have a beautiful relationship within the musculoskeletal system. Plantar fasciitis on their feet can alter their gait function, potentially leading to hip pain over time. This is due to many environmental factors that can affect the hips and feet over time, leading to plantar fasciitis correlating with hip pain. From excessive weight-bearing activities to microtrauma in the hips or the plantar fascia, many people will often seek treatment to reduce the effects of plantar fasciitis correlated with hip pain by addressing how their range of motion is affecting the plantarflexion and their load on the force-absorbing plantar surface structures could be good starting points in the prevention and treatment of plantar fasciitis correlated with hip pain. (Hamstra-Wright et al., 2021)

 


What Is Plantar Fasciitis?-Video


Non-Surgical Solutions To Reduce Plantar Fasciitis

When it comes to reducing plantar fasciitis in the body, many individuals will seek non-surgical treatments that can alleviate the pain from plantar fascia. Non-surgical treatments are cost-effective and can reduce the pain from plantar fasciitis and its associated symptoms, like hip pain. Some of the benefits of non-surgical treatments are promising, as they have a low risk of complications, good accessibility, and even a high capacity to relieve the mechanical load on the plantar fascia when doing regular activities. (Schuitema et al., 2020) Some of the non-surgical treatments that many people can incorporate include:

  • Stretching exercises
  • Orthotic devices
  • Chiropractic care
  • Massage therapy
  • Acupuncture/electroacupuncture
  • Spinal decompression

 

These non-surgical treatments not only help reduce plantar fasciitis but also help alleviate hip pain. For example, spinal decompression can help restore hip mobility by stretching the lumbar spine and relieving the lower extremities from numbness while strengthening tight muscles. (Takagi et al., 2023). Electroacupuncture can stimulate the body’s acupoints to release endorphins from the lower extremities to reduce inflammation of the plantar fascia. (Wang et al., 2019) When people begin to make small changes in their routine, like wearing proper footwear and not carrying or lifting heavy weighted objects, it can go a long way to prevent plantar fasciitis and hip pain from reoccurring can go a long way. Having a personalized treatment plan can ensure many individuals seeking non-surgical treatments have a better outcome on their health and mobility while preventing long-term complications. 

 


References

Ahuja, V., Thapa, D., Patial, S., Chander, A., & Ahuja, A. (2020). Chronic hip pain in adults: Current knowledge and future prospective. J Anaesthesiol Clin Pharmacol, 36(4), 450-457. doi.org/10.4103/joacp.JOACP_170_19

Buchanan, B. K., Sina, R. E., & Kushner, D. (2024). Plantar Fasciitis. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/28613727

Hamstra-Wright, K. L., Huxel Bliven, K. C., Bay, R. C., & Aydemir, B. (2021). Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis. Sports Health, 13(3), 296-303. doi.org/10.1177/1941738120970976

Lee, J. H., Shin, K. H., Jung, T. S., & Jang, W. Y. (2022). Lower Extremity Muscle Performance and Foot Pressure in Patients Who Have Plantar Fasciitis with and without Flat Foot Posture. Int J Environ Res Public Health, 20(1). doi.org/10.3390/ijerph20010087

Schuitema, D., Greve, C., Postema, K., Dekker, R., & Hijmans, J. M. (2020). Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review. J Sport Rehabil, 29(5), 657-674. doi.org/10.1123/jsr.2019-0036

Takagi, Y., Yamada, H., Ebara, H., Hayashi, H., Inatani, H., Toyooka, K., Mori, A., Kitano, Y., Nakanami, A., Kagechika, K., Yahata, T., & Tsuchiya, H. (2023). Decompression for lumbar spinal stenosis at the intrathecal catheter insertion site during intrathecal baclofen therapy: a case report. J Med Case Rep, 17(1), 239. doi.org/10.1186/s13256-023-03959-1

Wang, W., Liu, Y., Zhao, J., Jiao, R., & Liu, Z. (2019). Electroacupuncture versus manual acupuncture in the treatment of plantar heel pain syndrome: study protocol for an upcoming randomised controlled trial. BMJ Open, 9(4), e026147. doi.org/10.1136/bmjopen-2018-026147

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Intervertebral Foramen: The Gateway to Spine Health

Intervertebral Foramen: The Gateway to Spine Health

For individuals looking to improve their spinal health, can understanding the anatomy of the intervertebral foramen help in injury rehabilitation and prevention?

Intervertebral Foramen: The Gateway to Spine Health

Intervertebral Foramen

The intervertebral foramen, aka neural foramen, is the opening between the vertebrae through which spinal nerve roots connect and exit to other body areas. If the foramina narrows, it can place added pressure on the nerve roots near and around them, causing pain symptoms and sensations. This is known as neuroforaminal stenosis. (Sumihisa Orita et al., 2016)

Anatomy

  • The vertebrae comprise the spinal column.
  • They protect and support the spinal cord and most of the weight placed on the spine.
  • Foramen is the singular form, and foramina is the plural form.

Structure

  • The body is the large, round part of the bone that makes up each vertebra.
  • The body of each vertebra is attached to a bony ring.
  • As the vertebrae are stacked on each other, the ring creates a tube through which the spinal cord passes. (American Academy of Orthopaedic Surgeons 2020)
  1. The intervertebral foramen opening is between every two vertebrae, where the nerve roots exit the spine.
  2. Two neural foramina exist between each pair of vertebrae, with one on each side.
  3. The nerve roots move through the foramen to the rest of the body.

Function

  • The intervertebral foramina are exits from which the nerve roots leave the spine and branch out to the rest of the body.
  • Without the foramen, nerve signals cannot transmit to and from the brain to the body.
  • Without nerve signals, the body is unable to function correctly.

Conditions

A common condition that can affect the neuroforamina is spinal stenosis. Stenosis means narrowing.

  • Spinal stenosis is (not always) usually an age-related disorder associated with arthritis. (American Academy of Orthopaedic Surgeons, 2021)
  • Stenosis can occur in the spinal canal, known as central canal stenosis, and the foramina.
  • Pain brought on by neuroforaminal spinal stenosis and arthritis-related bone growth/bone spurs/osteophytes that are present in one or more foramen rub against the nerve root that passes through the space, causing radicular pain.
  • Pain accompanied by other sensations, like tingling or numbness, is known as radiculopathy. (Young Kook Choi, 2019)
  1. The main symptom is pain.
  2. Numbness and/or tingling can present depending on the injury.
  3. Neurogenic claudication occurs as a result of ischemia or a lack of blood circulation to the nerves and typically presents with a heaviness in the legs.
  4. It is typically associated with central stenosis rather than foraminal stenosis.
  5. Most individuals with spinal stenosis feel better when flexing or bending forward and worse when arching their backs.
  6. Other symptoms include weakness and/or difficulty walking. (Seung Yeop Lee et al., 2015)

Treatment

Stenosis treatment aims to relieve pain and prevent nerve symptoms from occurring or worsening. Conservative treatments are recommended and can be highly effective.
These include:

  • Physical therapy
  • Acupuncture and Electroacupuncture
  • Chiropractic
  • Non-surgical decompression
  • Therapeutic massage
  • Nonsteroidal anti-inflammatory drugs/NSAIDs
  • Targeted exercises and stretches
  • Cortisone injections. (American Academy of Orthopaedic Surgeons, 2021)
  • Surgery is usually not necessary.

However, a doctor may recommend surgery for an individual who is experiencing:

Different surgical techniques include:

  • Decompression laminectomy – entails removing the buildup of bone in the spinal canal.
  • Spinal fusion – when there is instability of the spine or severe foraminal stenosis.
  • However, most cases don’t require fusion. (American Academy of Orthopaedic Surgeons, 2021)

Root Causes Spinal Stenosis


References

Orita, S., Inage, K., Eguchi, Y., Kubota, G., Aoki, Y., Nakamura, J., Matsuura, Y., Furuya, T., Koda, M., & Ohtori, S. (2016). Lumbar foraminal stenosis, the hidden stenosis including at L5/S1. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 26(7), 685–693. doi.org/10.1007/s00590-016-1806-7

American Academy of Orthopaedic Surgeons. (2020). Spine Basics (OrthoInfo, Issue. orthoinfo.aaos.org/en/diseases–conditions/spine-basics/

American Academy of Orthopaedic Surgeons. (2021). Lumbar spinal stenosis (OrthoInfo, Issue. orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

Choi Y. K. (2019). Lumbar foraminal neuropathy: an update on non-surgical management. The Korean journal of pain, 32(3), 147–159. doi.org/10.3344/kjp.2019.32.3.147

Lee, S. Y., Kim, T. H., Oh, J. K., Lee, S. J., & Park, M. S. (2015). Lumbar Stenosis: A Recent Update by Review of Literature. Asian spine journal, 9(5), 818–828. doi.org/10.4184/asj.2015.9.5.818

Lurie, J., & Tomkins-Lane, C. (2016). Management of lumbar spinal stenosis. BMJ (Clinical research ed.), 352, h6234. doi.org/10.1136/bmj.h6234

Cleveland Clinic. (2021). Myelopathy (Health Library, Issue. my.clevelandclinic.org/health/diseases/21966-myelopathy

Achieve Relief: Spinal Decompression for Cervical Spinal Pain

Achieve Relief: Spinal Decompression for Cervical Spinal Pain

Can individuals with cervical spinal pain incorporate spinal decompression therapy to reduce neck pain and headaches?

Introduction

Many individuals deal with neck pain at some point, leading to many issues that can impact their daily lives. See, the neck is part of the cervical region of the musculoskeletal system. It is surrounded by muscles, soft tissues, and ligaments that protect the spinal cord while allowing the head to be mobile. Like back pain, neck pain is a common issue that causes pain and discomfort from associated environmental factors and traumatic injuries. When a person is dealing with neck pain, they are also coping with comorbidities that cause overlapping risk profiles like headaches and migraines. However, treatments like spinal decompression can help reduce cervical spinal pain affecting the neck and reduce the painful effects of headaches and migraines. Today’s article looks at the impact of cervical pain and headaches, how spinal decompression can reduce cervical spinal pain, and how it benefits from reducing headaches. We talk with certified medical providers who consolidate our patients’ information to assess how to mitigate cervical spinal pain from the neck. We also inform and guide patients on how spinal decompression can help reduce headaches caused by cervical spinal pain. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating spinal decompression therapy as part of their routine to reduce headaches and migraines associated with the neck. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Effects Of Cervical Pain & Headaches

Do you feel stiffness on both sides of your neck that causes you limited mobility when you turn your neck? Have you experienced constant throbbing pain in your temples? Or do you feel muscle aches on your neck and shoulders from being hunched on the computer for an extended period? Many individuals dealing with these pain-like issues could be coping with cervical spinal pain. Various causes that can lead to the development of cervical spinal pain include herniated discs, pinched nerves, spinal stenosis, and muscle strain that originates from the neck region. This is because cervical spinal pain can be associated with environmental factors that can cause pain and discomfort, disability, and impaired quality of life as the surrounding neck muscles are overstretched and tight. (Ben Ayed et al., 2019) When people are dealing with cervical spinal pain, one of the symptoms it is associated with is headaches. This is because the intricated nerve pathways are connected to the neck and head. When cervical spinal pain is causing these issues, it can significantly impact a person’s daily body function as the pain is traveling upwards. 

 

 

At the same time, neck pain is a multifactorial disease that can become a major issue worldwide. Like back pain, numerous risk factors can contribute to its development. (Kazeminasab et al., 2022) Some risk factors, like excessive phone usage, cause prolonged neck flexion to the neck and shoulders, causing static muscular loading with a lack of support to the upper extremities. (Al-Hadidi et al., 2019) To this point, environmental risk factors like excessive phone usage can make individuals develop a hunched position in their necks that can compress the spinal disc in the cervical region and aggravate the nerve roots to produce headaches and pain. However, many individuals have found ways to reduce cervical spinal pain and find pain relief from their headaches.

 


Home Exercises for Pain Relief-Video


How Spinal Decompression Reduces Cervical Spinal Pain

When it comes to reducing cervical spinal pain, many individuals have experienced that spinal decompression can help mitigate the effects of cervical pain. Spinal decompression has increasingly been recognized as an effective non-surgical treatment when it comes to alleviating cervical spinal pain. What spinal decompression does is that it allows negative pressure on the cervical spine to relieve any herniated disc of the aggravated nerve roots and help improve neurological symptoms. (Kang et al., 2016) This is due to a person being strapped comfortably on a traction machine that gently stretches and decompresses the spinal vertebrae. Additionally, some of the benefits of spinal decompression for cervical spinal pain include:

  • Improved spinal alignment to reduce muscle strain on the neck muscles and joints.
  • Enhanced the body’s natural healing by increasing blood flow and nutrient exchange.
  • Increased neck mobility by decreasing muscle stiffness.
  • Reducing pain levels that are causing intense headaches. 

 

The Benefits of Spinal Decompression For Headaches

Additionally, spinal decompression can help reduce headaches associated with cervical spinal pain as spinal decompression can be combined with other therapies like acupuncture and physical therapy to relieve the protruding spinal dice and stabilize within the annulus by spinal elongation. (Van Der Heijden et al., 1995) This is due to gentle traction on the neck that is causing the prolapsed disc to reposition itself while restoring disc height to minimize the pressure on the nerves. (Amjad et al., 2022) When a person is doing spinal decompression therapy consecutively, the pain-like effects of cervical spinal pain and the associated headaches begin to reduce over time, and many people will start to notice how their habits are in correlation with their pain. By incorporating spinal decompression therapy as part of their treatment, many people can make small changes in their routine and be more mindful of their bodies to prevent the progression of cervical spinal pain from returning. 

 


References

Al-Hadidi, F., Bsisu, I., AlRyalat, S. A., Al-Zu’bi, B., Bsisu, R., Hamdan, M., Kanaan, T., Yasin, M., & Samarah, O. (2019). Association between mobile phone use and neck pain in university students: A cross-sectional study using numeric rating scale for evaluation of neck pain. PLOS ONE, 14(5), e0217231. doi.org/10.1371/journal.pone.0217231

Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x

Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. www.ncbi.nlm.nih.gov/pubmed/31133629

www.ncbi.nlm.nih.gov/pmc/articles/PMC6941626/pdf/jrhs-19-e00440.pdf

Kang, J.-I., Jeong, D.-K., & Choi, H. (2016). Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. Journal of Physical Therapy Science, 28(11), 3125-3130. doi.org/10.1589/jpts.28.3125

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4

Van Der Heijden, G. J., Beurskens, A. J., Koes, B. W., Assendelft, W. J., De Vet, H. C., & Bouter, L. M. (1995). The Efficacy of Traction for Back and Neck Pain: A Systematic, Blinded Review of Randomized Clinical Trial Methods. Physical Therapy, 75(2), 93-104. doi.org/10.1093/ptj/75.2.93

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How Acupuncture-Electroacupuncture Can Improve Your Health

How Acupuncture-Electroacupuncture Can Improve Your Health

For individuals dealing with musculoskeletal pain, can incorporating acupuncture and electroacupuncture therapy provide beneficial results?

Introduction

The upper and lower body quadrants are surrounded by muscles, soft tissues, and ligaments that allow the body to be mobile with feelings of pain or discomfort. Each muscle group has an important job providing sensory-motor functions like grasping objects, moving extremities, supporting the body in a correct posture, and stabilizing vertical axial weight. However, many people have adopted various habits from environmental factors or have been through traumatic injuries that can cause referred muscle pain in the upper and lower body quadrants. When this happens, it can lead to a life of disability, pain, and discomfort over time if it is not treated right away. To that point, musculoskeletal pain can also cause overlapping risk profiles with other comorbidities that can be pre-existing in the body. Fortunately, numerous treatments can help reduce musculoskeletal pain and benefit the body. Today’s article looks at two different non-surgical therapies, how each is beneficial to reducing musculoskeletal pain, and how effective they can help many people with musculoskeletal pain. We talk with certified medical providers who consolidate our patients’ information to assess how to reduce the pain-like effects of musculoskeletal pain with non-surgical treatments. We also guide patients on how these non-surgical treatments can help lessen the referred pain caused by various environmental factors affecting their musculoskeletal system. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments into their health and wellness treatments. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

The Traditional Touch Of Acupuncture

After a long workday, do you feel soreness in your arms, legs, or feet? Have you experienced any symptoms of numbness or stiffness in the upper or lower portions of your body? Or do you feel muscle aches and pains after waking up in the morning? Around the world, many individuals have dealt with musculoskeletal pain at some point, which causes many people to miss out on numerous activities. Musculoskeletal pain is a multifactorial condition that any individual can develop over time. Some biological mechanisms contributing to the development of musculoskeletal pain can be heterogeneous, cardiometabolic, and systemic inflammation that can affect the body. (Dzakpasu et al., 2021) When many people are doing repetitive motions or have dealt with injuries, it can cause the various muscles to be overstretched, tightened, or weak, which can cause individuals to feel miserable and seek treatment. When people go to get treatment for their musculoskeletal pain, many people will tell their doctors about their pain experience and how it impacts their daily social well-being. By gaining information about how musculoskeletal pain negatively affects their lives, a multidisciplinary approach to pain management that emphasizes rehabilitation and non-surgical treatments can be the first step in effectively managing musculoskeletal pain. (Welsh et al., 2020)

 

 

Now, non-surgical treatments vary depending on the severity of musculoskeletal pain the person is experiencing. Since musculoskeletal pain is a multifactorial condition, many people could experience comorbidities that cause overlapping risk profiles that correlate with musculoskeletal pain, hence why many people incorporate non-surgical treatments since it is affordable and can be combined with other treatments. One of the oldest therapies that is still practiced today is acupuncture. Now, acupuncture involves the insertion of thin, solid needles into the body’s acupoints to restore the normal flow of energy through the body’s pathways. Highly trained professionals do acupuncture, and it is safe and effective for the person dealing with musculoskeletal pain. Additionally, acupuncture can positively affect the body as it can help change the pain perception of the affected muscle. (Kelly & Willis, 2019)

 

How Acupuncture Benefits Muscle Pain

Acupuncture can also provide beneficial results to individuals by emphasizing the mobilization of self-healing mechanisms to restore the body’s homeostasis to normal. (Wang et al., 2023) Some of the beneficial properties that people can experience with acupuncture include:

  • Provides natural pain relief by stimulating the release of endorphins in the affected muscle.
  • Reducing muscle inflammation in the affected muscle group area.
  • Improving blood flow circulation to decrease muscle stiffness and soreness.
  • Reducing stress and muscle tension in the affected area.

At the same time, acupuncture therapy for muscle pain can help reduce the inhibitory effects and modulate the feeling of pain, which then modifies central sensitization. (Zhu et al., 2021)

 

The Modern Twist Of Electroacupuncture

Now, electroacupuncture is a different form of acupuncture that uses the application of acupuncture needles and electric stimulation on the affected muscle. At the same time, when people are getting treated with electroacupuncture, their somatosensory afferent nerves provide pain relief. They are blocked to stop the pain signals from reaching the central nervous system. (Chen et al., 2021) This is because adding electric stimulation can enhance the therapeutic effects of the acupuncture points in the body. 

 

How Electroacupuncture Benefits Muscle Pain

Regarding reducing muscle pain, electroacupuncture is more effective as acupuncturists can help adjust the intensity of the electric currents on the affected muscle to ensure comfort. Some of the benefits that electroacupuncture provides include:

  • Enhanced pain relief as the electric current can stimulate endorphin release.
  • Muscle relaxation from spasms in the affected muscle group.
  • Increased the healing rate by stimulating deeper muscles.
  • Help enhance muscle strength and flexibility to improve functionality.

Electroacupuncture can relieve pain and even adjust the biomechanical properties of the extensor-flexor muscles to improve abnormal joint loading caused by musculoskeletal pain. (Shi et al., 2020)

 

How These Two Treatments Help With Musculoskeletal Pain?

When it comes to acupuncture and electroacupuncture, it all depends on the severity of musculoskeletal pain affecting the body. Many people prefer traditional acupuncture for acute musculoskeletal pain in a more holistic approach. In comparison, others might prefer electroacupuncture to reduce the chronic pain effects of musculoskeletal pain. However, both of these treatments are non-surgical. They can be combined with other therapies like physical therapy or chiropractic care to help stimulate the body’s natural healing factor and relieve musculoskeletal pain. When these two treatments are combined with other therapies, the affected muscles are strengthened and provide mobility function back into the extremities. When people start thinking about their well-being, they can utilize these treatments to reduce the comorbidities associated with musculoskeletal pain that is affecting them. Thus allowing them to make small, healthy changes to their routine and live pain-free lives.

 


Beyond Adjustments: Chiropractic and Integrative Healthcare- Video


References

Chen, L., Wang, X., Zhang, X., Wan, H., Su, Y., He, W., Xie, Y., & Jing, X. (2021). Electroacupuncture and Moxibustion-Like Stimulation Relieves Inflammatory Muscle Pain by Activating Local Distinct Layer Somatosensory Afferent Fibers. Front Neurosci, 15, 695152. doi.org/10.3389/fnins.2021.695152

Dzakpasu, F. Q. S., Carver, A., Brakenridge, C. J., Cicuttini, F., Urquhart, D. M., Owen, N., & Dunstan, D. W. (2021). Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis. Int J Behav Nutr Phys Act, 18(1), 159. doi.org/10.1186/s12966-021-01191-y

Kelly, R. B., & Willis, J. (2019). Acupuncture for Pain. American Family Physician, 100(2), 89-96. www.ncbi.nlm.nih.gov/pubmed/31305037

www.aafp.org/pubs/afp/issues/2019/0715/p89.pdf

Shi, X., Yu, W., Wang, T., Battulga, O., Wang, C., Shu, Q., Yang, X., Liu, C., & Guo, C. (2020). Electroacupuncture alleviates cartilage degradation: Improvement in cartilage biomechanics via pain relief and potentiation of muscle function in a rabbit model of knee osteoarthritis. Biomed Pharmacother, 123, 109724. doi.org/10.1016/j.biopha.2019.109724

Wang, M., Liu, W., Ge, J., & Liu, S. (2023). The immunomodulatory mechanisms for acupuncture practice. Front Immunol, 14, 1147718. doi.org/10.3389/fimmu.2023.1147718

Welsh, T. P., Yang, A. E., & Makris, U. E. (2020). Musculoskeletal Pain in Older Adults: A Clinical Review. Med Clin North Am, 104(5), 855-872. doi.org/10.1016/j.mcna.2020.05.002

Zhu, J., Li, J., Yang, L., & Liu, S. (2021). Acupuncture, from the ancient to the current. Anat Rec (Hoboken), 304(11), 2365-2371. doi.org/10.1002/ar.24625

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