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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.


Perimenopause: Managing Changes and Challenges

Perimenopause: Managing Changes and Challenges

Find useful information on perimenopause, including potential symptoms and expert tips to cope effectively.

Introduction

Regarding one’s health and well-being, many people often become aware of how their bodies are naturally changing. This may include both male and female hormonal changes as well as the normal skeletal deterioration that occurs inside the joints. Andropause is the period of time when male testosterone levels begin to diminish. Menopause is the natural aging process that begins for women when their levels of the hormones progesterone and estrogen start to decline. Nevertheless, women experience perimenopause prior to menopause taking place. This article will discuss the definition and symptoms of perimenopause, its effects on the musculoskeletal system, and strategies for managing these problems.

 

What Is Perimenopause?

Do you experience mental fogginess, where you can’t remember what you were doing? How often do your joints ache after doing a simple errand? Or how frequently does your bladder feel full that you constantly need to go to the bathroom? Many of these issues are associated with hormonal changes within the body. For women, perimenopause is a transformative menopausal stage that usually occurs in women in their 40s and early 50s, which is widely recognized for hormonal shifts and reproductive changes in the body.

Functional Medicine Doctor for Women's Hormones | El Paso, TX Chiropractor

Additionally, perimenopause usually starts when a woman is dealing with a persistent difference in their menstrual cycle length after 12 months. (Lega & Jacobson, 2024) This is due to the ovarian hormone production of estrogen and progesterone fluctuating unpredictably.

 

Common Symptoms Of Perimenopause

When it comes to perimenopause, it can affect women differently with its symptoms. Since hormones during perimenopause fluctuate unpredictably. This is because for women, ovarian hormones like estrogen play an important role in maintaining health and homeostasis by modulating the body’s nervous, endocrine, and immune function. (Priyanka & Nair, 2020) Some of the other symptoms that are included with perimenopause are:

  • Vasomotor symptoms: Hot flashes, night sweats
  • Sleep disturbances: Insomnia, early waking
  • Mood changes: Irritability, anxiety, depression
  • Cognitive difficulties: Brain fog, memory lapses
  • Urogenital symptoms: Vaginal dryness, urinary urgency
  • Menstrual irregularities: Skipped, prolonged, or heavy periods

Additionally, since perimenopausal symptoms vary from woman to woman, perimenopause can also affect the musculoskeletal system in the body.

 


Assessing Hormone Therapy- Video


How Perimenopause Affects The Musculoskeletal System

The musculoskeletal system’s various muscles, tissues, and ligaments allow the body to be mobile and flexible without pain. However, environmental factors like physical inactivity, poor dietary habits, and chronic issues affect the musculoskeletal system, leading to overlapping risk profiles affecting the body. For perimenopausal women, their musculoskeletal system is affected by fluctuating estrogen hormone levels. When it comes to perimenopause, the musculoskeletal system will begin to develop various issues that can affect the body over time. When a woman is going through perimenopause, their bone mineral density is reduced as well as their muscle mass due to the decline of estradiol. (Wright et al., 2024) This causes the musculoskeletal system to develop:

  • Increased joint stiffness (especially in the morning) and muscle pain
  • Osteopenia and osteoporosis
  • Sarcopenia (loss of muscle mass)

This is due to hormones being associated with inflammation. When a woman has low or fluctuating estrogen hormone levels, it can lead to developmental changes in their pain perception in their muscles. The hormone estrogen is responsible for inhibiting the actions of inflammatory mediators in osteoblasts and stromal cells to ensure that bone mass is reabsorbed into the skeletal system. When perimenopause naturally occurs in the body, estrogen levels decline, and the development of musculoskeletal issues starts to appear.

 

Managing Perimenopausal Symptoms

Now, when it comes to managing perimenopausal symptoms, many women can start researching non-surgical treatments and incorporating various techniques to help manage the symptoms and reduce any pain from musculoskeletal issues associated with perimenopause. Below are some therapeutic options for perimenopausal women to manage their symptoms and restore their musculoskeletal system.

 

Hormone Therapy

For many women, hormone replacement therapy remains the gold standard for treating moderate to severe vasomotor and musculoskeletal symptoms. Hormone therapy for perimenopausal women can help restore estrogen production to the body and accelerate skeletal growth. (Moustakli & Tsonis, 2023) Estrogen therapy can:

  • Reduce joint and muscle pain
  • Slow bone density loss
  • Improve overall well-being

Note: HRT is not suitable for everyone, particularly those with a history of breast cancer, thromboembolic disease, or certain cardiovascular conditions. Always conduct a thorough risk-benefit analysis.

 

Exercise & Nutrition

For perimenopausal women, proper nutrition and exercise can help manage the perimenopausal symptoms and maintain muscle tone. Incorporating nutritional foods with high protein, calcium, and vitamin D can help maintain skeletal muscle mass and regulate proper hormone functioning. (Erdélyi et al., 2023) Combined with exercises, it can help strengthen weak muscles, improve bone density, and promote flexibility while retaining the joint’s range of motion. Exercises like tai chi are excellent for perimenopausal women as they combine meditation through slow and gentle movements that can lower fracture risk, improve muscle strength, and restore balance functionality. (Li et al., 2023)

 

Manual Therapies

Many women find relief with:

  • Acupuncture: Shown to help reduce chronic pain affecting the joints and provide anti-inflammatory effects to the musculoskeletal system. (Zhao et al., 2023)
  • Mind-body therapies: Meditation, cognitive-behavioral therapy (CBT) to address mood swings and insomnia
  • Chiropractic and physical therapy: Effective in managing musculoskeletal discomfort

 

Final Thoughts

For many women, the perimenopause is a normal time of life, and it significantly affects musculoskeletal health. Women may handle this shift with fortitude and resiliency if they remain proactive with lifestyle changes, medical treatments, and routine monitoring. In order to help women feel strong and supported throughout their perimenopausal journey, a customized treatment plan that honors their individual needs might be helpful.


Injury Medical & Functional Wellness Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal issues related to perimenopause. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce pain-like symptoms related to the musculoskeletal system. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.


References

Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S. (2023). The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, 16(1), 27. doi.org/10.3390/nu16010027

Lega, I. C., & Jacobson, M. (2024). Perimenopause. CMAJ, 196(34), E1169. doi.org/10.1503/cmaj.240337

Li, J., Guo, J., Wang, X., Zhang, X., Zhang, Y., Bu, M., Yao, X., & She, Y. (2023). Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int, 34(11), 1853-1866. doi.org/10.1007/s00198-023-06830-7

Moustakli, E., & Tsonis, O. (2023). Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals. Medicina (Kaunas, Lithuania), 59(12). doi.org/10.3390/medicina59122094

Priyanka, H. P., & Nair, R. S. (2020). Neuroimmunomodulation by estrogen in health and disease. AIMS Neurosci, 7(4), 401-417. doi.org/10.3934/Neuroscience.2020025

Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. doi.org/10.1080/13697137.2024.2380363

Zhao, F.-Y., Zheng, Z., Fu, Q.-Q., Conduit, R., Xu, H., Wang, H.-R., Huang, Y.-L., Jiang, T., Zhang, W.-J., & Kennedy, G. A. (2023). Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Frontiers in Public Health, 11. doi.org/10.3389/fpubh.2023.1120567

Disclaimer

Muscles Retighten: The Importance of Ongoing Care

Muscles Retighten: The Importance of Ongoing Care

Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?

Muscles Retighten: The Importance of Ongoing Care

Muscles Retighten

Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.

  • Muscle memory: The body’s natural tendency to return to its previous state of tension.
  • This includes all the unhealthy postures/positioning
  • Delayed inflammatory response.
  • The body’s natural healing process
  • How muscles respond to manipulation
  • The need for ongoing maintenance of muscle health

After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)

Causes

Causes for muscles to retighten.

Underlying Issues

  • If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
  • In that case, the muscles may return to their original state after a few days or weeks.

Delayed Onset Muscle Soreness (DOMS)

  • For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)

Delayed Inflammatory Response

  • Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
  • This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)

Muscle Memory

  • The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
  • Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.

Muscle Guarding

  • The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage.
  • This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)

Muscle Health Maintenance

  • Regular Maintenance
  • Muscles need consistent care to maintain their optimal state of health and function.
  • Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.

Individual Variation

  • Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)

Massage Treatment

Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.

Type of Massage

  • Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
  • Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)

Muscle Fiber Manipulation

  • Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
  • This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.

Dehydration

  • Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)

Lactic Acid Buildup

  • During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness.
  • (Healthline, 2020)

Muscle Tensions

  • If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Secrets of Optimal Wellness


References

Cleveland Clinic. (2024). How to Relieve Muscle Soreness After a Massage. health.clevelandclinic.org/why-does-my-body-feel-worse-after-a-massage

Healthline. (2020). How to Relieve Sore Muscles After a Massage. www.healthline.com/health/sore-after-massage#causes-of-soreness

Essential Chiropractic and Physiotherapy. (2025). Muscle Ache After Massage: Common Causes and Relief. essentialchiropractic.co.uk/muscle-ache-after-massage-common-causes-and-relief/#:~:text=Post%2Dmassage%20soreness%20is%20a,hours%20as%20the%20muscles%20recover.

Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. doi.org/10.1097/rnj.0000000000000151

Center of Gravity: Understanding Body Balance

Center of Gravity: Understanding Body Balance

What is the body’s center of gravity to understand and maintain a healthy posture and balance?

Center of Gravity: Understanding Body Balance

Center of Gravity

The human center of gravity, or COG, also known as the center of mass, with the two terms being interchangeable, is where the body’s weight appears to be concentrated. It’s a point in space where the entire body’s mass can be concentrated. When standing upright, the COG is generally located behind the navel and in front of the sacrum, around the level of the second vertebra. (Le Huec, J. 2011) The center of gravity is related to posture, including issues such as swayback, the design of posture exercise programs, and much more.

  • Gravity is a downward pull or force the Earth exerts on the body, creating weight. (NASA, 2013)
  • The center of gravity (COG) is where a body’s weight is equally balanced in all directions. (Physiopedia, 2025)
  • When the COG is defined, it is done from the reference of a static, standing position.
  • Because the body is in motion when we change positions, the COG is located in a new position with each new position.
  • The center of gravity is the point around which all the parts balance, which may be inside or outside the body.
  • Even slight changes in position can change where the COG is. (Physiopedia, 2025)

Key aspects of the COG

Location

  • When standing upright, the COG is typically found at the second vertebral level, behind the navel and in front of the sacrum. (Le Huec, J. 2011)

Shifting COG

  • The COG can shift depending on body position, posture, and movements like bending forward or backward. (Physiopedia, 2025)

Balance Impact

  • The relationship between the COG and the base of support (the area of the body in contact with the ground) is fundamental to maintaining balance.

Variations

  • There can be variations in the COG location based on factors like gender (men tend to have a slightly higher COG), body shape, and even conditions like obesity or chronic low back pain. (Physiopedia, 2025)

Biomechanics

  • Understanding the COG is crucial in biomechanics and movement analysis, as it’s an index of total body motion and how the body responds to external forces.

The Human Center

The center of gravity is the point at which the body’s mass is equally balanced. This point changes depending on one’s position:

  • Arms up/down
  • Leaning
  • Turning

With strength and flexibility training, the human body can change its center of gravity, as gymnasts and dancers do.

  • When standing, the center of gravity is normally located behind the navel and in front of the sacrum bone (made up of five vertebrae fused vertically) at about the second vertebra level. (Hasegawa K. et al., 2022)
  • Because the body has moving parts, its overall shape changes every time it moves. Carrying something like a suitcase or grocery bag or wearing a backpack adds weight to some areas but not others, changing the center of gravity as it does.
  • The center of gravity is a continually changing point inside or outside the body that represents where the weight or mass of the rest of the body is equally balanced in every direction.
  • This point can and does change based on what is being carried and how it is carried, as well as body position and movements.

Chronic Lower Back Pain

  • A study in the Journal of Back and Musculoskeletal Rehabilitation found that individuals with chronic lower back pain tend to have their center of gravity located excessively towards the back. (Kim D. H., Park J. K., & Jeong M. K. 2014)
  • In the study, the individuals had decreased low back strength upon extension and a reduced normal low back curve.
  • The researchers found that those with chronic lower back pain whose center of gravity was too far back may need physical therapy to retrain the body to overcome strength and balance challenges to re-establish and maintain a healthy posture.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Enhance Your Lifestyle Today with Chiropractic Care


References

Le Huec, J. C., Saddiki, R., Franke, J., Rigal, J., & Aunoble, S. (2011). Equilibrium of the human body and the gravity line: the basics. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20 Suppl 5(Suppl 5), 558–563. doi.org/10.1007/s00586-011-1939-7

NASA. Jet Propulsion Laboratory, California Institute of Technology. (2013). What is gravity? Retrieved from gracefo.jpl.nasa.gov/news/5/what-is-gravity/

Physiopedia. (2025). Centre of gravity. www.physio-pedia.com/Centre_of_Gravity

Hasegawa, K., Amabile, C., Nesme, M., & Dubousset, J. (2022). Gravity center estimation for evaluation of standing whole body compensation using virtual barycentremetry based on biplanar slot-scanning stereoradiography – validation by simultaneous force plate measurement. BMC musculoskeletal disorders, 23(1), 22. doi.org/10.1186/s12891-021-04948-5

Kim, D. H., Park, J. K., & Jeong, M. K. (2014). Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 27(2), 231–237. doi.org/10.3233/BMR-130442

Paraspinal Effects on Lower Back Pain Explained

Paraspinal Effects on Lower Back Pain Explained

Can a paraspinal muscle spasm in the lower back create a chain reaction leading to hamstring spasms and potential sciatic nerve entrapment?

Paraspinal Effects on Lower Back Pain Explained

Paraspinal Muscle Spasm Chain Reaction

A paraspinal muscle spasm in the lower back can cause a cascade of events, including: (Cedars-Sinai, 2025)

  • Spasms in other lower back muscles
  • Hamstring spasms
  • Potential entrapment of the sciatic nerve

Leading to symptoms similar to sciatica:

  • Pain
  • Sore, achy muscles
  • Weak muscles
  • Numbness
  • Tingling along the back of the leg

Possible Mechanisms

Triggering Muscle Spasms in the Lower Back

  • Paraspinal muscles are located along the spine and help to stabilize and support the lower back.
  • When these muscles spasm, they can become tense and painful, causing a chain reaction.
  • This tension can radiate down and affect other muscles in the lower back. (Noonan A. M., & Brown S. H. M., 2021)

Can Affect Lower Back Muscles and Cause Hamstring Spasms

  • Lower back muscles, including those like the quadratus lumborum, can be affected by paraspinal spasms. (Hospital for Special Surgery, 2024)
  • The spasms can cause these muscles to tighten or spasm, potentially pulling on the hamstring muscles.
  • This can lead to hamstring spasms and tightness, further contributing to pain and potential nerve irritation.

Entrapment of the Sciatic Nerve

  • Piriformis syndrome is a common condition where the piriformis muscle (located in the buttock) spasms and compresses the sciatic nerve. (Cedars-Sinai, 2025)
  • The sciatic nerve runs from the lower back down the back of the thigh and into the leg, making it vulnerable to compression by surrounding muscles.
  • If the paraspinal and hamstring spasms create enough tension on the piriformis muscle or surrounding tissues, it can lead to sciatic nerve entrapment. (Hospital for Special Surgery, 2024)

How acupuncture helps relieve sciatica

Acupuncture can help relieve sciatica pain by stimulating specific points on the body, which can trigger the release of endorphins, reduce inflammation, improve blood flow, and relax tight muscles that could be compressing the sciatic nerve. By modulating the nervous system and promoting the body’s natural healing processes, acupuncture can help alleviate pain and improve overall function. (Qin, Z. et al., 2015)

Releases endorphins

  • Acupuncture stimulates the nervous system, triggering the release of endorphins, the body’s natural painkillers.

Reduces inflammation

  • Acupuncture can help reduce inflammation in the area surrounding the sciatic nerve, which can contribute to pain and nerve irritation. (Natural Care Chiropractic, 2022)

Improves circulation

  • By increasing blood flow to the affected area, acupuncture can help deliver nutrients and oxygen to the sciatic nerve and surrounding tissues, promoting faster healing.

Relaxes tight muscles

  • Sciatica pain can be exacerbated by tight muscles compressing the nerve. Acupuncture can help relax these muscles, reducing pressure on the sciatic nerve and alleviating pain.

Regulates the nervous system

  • Acupuncture can help regulate the nervous system, positively impacting pain perception and overall well-being. (Qin, Z. et al., 2015)

Promotes regeneration

  • Some evidence suggests that acupuncture can promote sciatic nerve regeneration, potentially leading to long-term pain relief. (Natural Care Chiropractic, 2022)

Needling Types

Distal needling

  • Acupuncture can also involve using points that are further away from the site of pain, which can also help to reduce pain and inflammation.

Local needling

  • Points are also selected on or near the sciatic nerve’s path, which can help directly address the source of pain and inflammation. (Qin, Z. et al., 2015)

Holistic approach

  • Acupuncture is often viewed as a holistic approach to pain management, addressing the symptoms of sciatica and the underlying causes and imbalances in the body.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Chiropractic and Integrative Healthcare


References

Cedars Sinai. (2025). Piriformis Syndrome. www.cedars-sinai.org/health-library/diseases-and-conditions/p/piriformis-syndrome.html#:~:text=Overview,can%20run%20through%20the%20muscle)

Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR spine, 4(3), e1171. doi.org/10.1002/jsp2.1171

Hospital for Special Surgery. (2024). Sciatica. www.hss.edu/condition-list_sciatica.asp

Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine: eCAM, 2015, 425108. doi.org/10.1155/2015/425108

Natural Care Chiropractic, D. M. F. (2022). Acupuncture for Sciatica Pain Relief. www.naturalcarechiropractic.com/post/acupuncture-for-sciatica-pain-relief

Pseudoarthrosis After Spinal Fusion Explained

Pseudoarthrosis After Spinal Fusion Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis After Spinal Fusion Explained

Pseudoarthrosis of the cervical and lumbar spine

Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:

  • Issues with the instruments used to stabilize the bone
  • Lack of bone growth
  • The number of vertebrae being fused.

The patient’s health and lifestyle play a role in failed fusions, which can include

  • Diabetes
  • Inflammatory health conditions increase the risk
  • Smoking
  • Long-term steroid use

In many cases, revision surgery is needed.

Surgery-Related

During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:

  • Plates
  • Rods
  • Screws
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. A rigid frame secured outside the body helps to stabilize the bones.

If the fusion fails, it could be caused by one or more of the following surgical issues:

Number of Vertebrae Being Fused

Hardware

  • The surgeon must carefully plan and use the right hardware.
  • The type of hardware used during a spinal fusion may influence bone healing.
  • The instruments can come loose or break, interfering with the fusion process.
  • Spinal osteoporosis, having thin, weak bones, can affect fixation.
  • Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.

Bone Graft

  • The type of bone graft used may affect the fusion.
  • For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
  • Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
  • The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.

Risk Factors

  • The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
  • Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)

The risk of pseudoarthrosis increases if the individual has any of the following: (Scoliosis Research Society, 2023)

  • Previous pseudoarthrosis
  • Obesity
  • Chronic steroid use
  • Malnutrition
  • Inflammatory diseases

Inflammatory conditions that can lead to bone loss and non-optimal bone healing include: (Torres H. M. et al., 2023)

  • Diabetes (Jiao H, Xiao E, & Graves DT, 2015)
  • Inflammatory bowel disease
  • Psoriasis
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease/COPD
  • Periodontitis
  • Systemic lupus erythematosus/SLE

Symptoms

  • The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
  • If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
  • Rarely does a pinched nerve affect both arms.
  • The pain may return shortly after the procedure.
  • The pain may develop gradually or not appear for many months.
  • However, it’s more likely to appear after several months when the individual returns to their usual activities.

Diagnosis

  • The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
  • They’ll assess mobility and the type of movement that causes pain.
  • Then, they order diagnostic imaging to see the spine and identify the cause of pain.
  • Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.

Treatment

Treatment for pseudoarthrosis will likely start with:

  • Physical therapy
  • Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
  • Medication
  • Injections
  • If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
  • Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Enhancing Health Together


References

Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. doi.org/10.1186/s12891-024-07531-w

Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. doi.org/10.1055/s-0041-1722853

Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. doi.org/10.14444/4029

Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1

Scoliosis Research Society. (2023). Pseudoarthrosis. www.srs.org/Patients/Conditions/Pseudoarthrosis

Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. doi.org/10.1007/s11914-023-00824-4

Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. doi.org/10.1007/s11914-015-0286-8

Length of Time to Alleviate Muscle Tightness

Length of Time to Alleviate Muscle Tightness

For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?

Length of Time to Alleviate Muscle Tightness

Length Of Time to Loosen Tight Muscles

Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.

Factors Influencing Timeline

Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)

Severity of Tightness

  • Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.

Underlying Causes

  • If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)

Individual Factors

  • Genetics, age, and overall health can influence how quickly muscles adapt to stretching.

Consistency

  • Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)

Stretching Routine

The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.

Consistency

Hold Time

  • Hold static stretches for at least 30 seconds.
  • Longer holds (1-2 minutes) can provide deeper benefits.

Long-term Gains

  • For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)

Initial Changes

  • Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.

Influencing Factors and Results

  • Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)

What To Expect

Improvements

  • Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)

Longer-Term Changes

  • Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.

Maintenance

Treatment Options

  • Stretching, physical therapy, massage, and other therapies can help alleviate tight muscles and promote recovery. (Spine Medicine and Surgery of Long Island, 2024)
  • Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.

The length of time to see results means consistency and patience are important.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Understanding Long-Lasting Injuries


References

Spine Medicine and Surgery of Long Island. (2024). How Long Do Muscle Knots Last? Spine Medicine and Surgery of Long Island. www.spinemedli.com/how-long-do-muscle-knots-last/#:~:text=The%20duration%20of%20a%20muscle,chronic%20pain%20if%20left%20untreated.

Peterson Physical Therapy. (2024). How Long Does It Take to Improve Flexibility? petersenpt.com/how-long-does-it-take-to-improve-flexibility#:~:text=Over%20the%20years%2C%20I've,takes%20to%20become%20more%20flexible.

Healthline. (2023). Everything You Need to Know About Muscle Stiffness. www.healthline.com/health/muscle-stiffness

Mayo Clinic. (2023). Stretching: Focus On Flexibility. www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931#:~:text=Stretch%20in%20a%20smooth%20movement,hold%20for%20around%2060%20seconds.

Harvard Health Publishing. (2022). Everyday Stretching. www.health.harvard.edu/everyday-stretching#:~:text=A%20daily%20regimen%20will%20deliver,or%20three%20times%20a%20week.

Migraines and Neck Pain: Symptoms and Treatment Insights

Migraines and Neck Pain: Symptoms and Treatment Insights

Learn about the relationship between migraines associated with neck pain and how to alleviate discomfort through various techniques.

Introduction

Having a busy day with routine may lead to a number of problems, including headaches, stress, and physical exhaustion in the many parts of the body, including the skeletal system, muscles, and organs. The combination of pain and discomfort may result in overlapping risk profiles linked to long-term problems. Do you, for instance, get headaches that throb in different parts of your brain all the time, making it hard to focus on your task? Does moving your shoulders or neck provide momentary relief from stiffness? Or do you need a dark, quiet environment to feel better because you have sensitive light or sound issues? Many people who have neck discomfort and headaches may also be suffering from migraines that affect their lifestyles. In this post, we’ll examine the relationship between migraines and neck pain, the relationship between migraines and fibromyalgia, and holistic approaches to migraine symptom management.

 

The Migraine & Neck Connection

When it comes to headaches and migraines, many people will begin to feel tension in their heads from various areas and notice that their neck is stiff. This unilateral pain usually starts in the neck and then is accompanied by a reduced range of motion called a cervicogenic headache that can be confused with a migraine. (Al Khalili et al., 2025) Migraines are often a full-body experience with numerous symptoms that can make anybody’s daily life feel unmanageable. This is because the extra-cranial autonomic nervous system activates the trigeminal autonomic reflex, which is a physiological response that follows harmful stimuli that cause migraines to develop. (Vicente et al., 2023) Additionally, migraines can cause the individual to develop increased pain sensitivity and cervical musculoskeletal impairments like neck pain correlating with environmental factors that lead to its development. (Di Antonio et al., 2023) Many environmental factors can trigger migraines associated with neck pain, including:

  • Poor posture
  • Cervical spine misalignment
  • Muscle tension from stress or overuse
  • TMJ dysfunction
  • Inadequate sleep

 

How Fibromyalgia Connects With Migraines

Now, how would fibromyalgia be correlated with migraines for individuals? Since this link is a bit complex, both fibromyalgia and migraines are due to mitochondrial dysfunction that causes the body not to function properly. Fibromyalgia is a condition that causes the central nervous system to be affected chronically and is frequently present with other chronic pain syndromes like migraines. (Janssen et al., 2021) Fibromyalgia is often characterized by widespread pain and heightened pain sensitivity from central sensitization, causing the central nervous system to become hyperresponsive. Migraines are familial, episodic, and complex sensory processing disturbances associated with various symptoms mimicking fibromyalgia. (Aguilar-Shea et al., 2022) However, many individuals with fibromyalgia can experience the following symptoms:

  • Intense and frequent migraines
  • Musculoskeletal tenderness in the neck and upper back
  • Amplified severity and frequency of migraine attacks

When this happens, many people who are dealing with migraines associated with fibromyalgia will seek essential integrative treatments to manage the symptoms and find relief.

 


Tension Headaches Explained- Video


Holistic & Functional To Reduce Migraine Symptoms

When it comes to looking for treatments that can help reduce migraine symptoms, a holistic functional treatment approach is often the best approach. By incorporating this approach, many healthcare professionals can look beyond and understand the root causes of migraines. Many migraine treatments are cost-effective and non-surgical and can help reduce the pain-like symptoms associated with migraines and help restore neck functionality.

 

Chiropractic Care & Manual Therapies

When the body is dealing with misalignment from the cervical area of the spine, neck pain and migraines can develop. Many individuals take chiropractic care to help with cervical mobilization and suboccipital release, which reduces tension in the muscles while increasing the range of motion in the neck. Chiropractors utilize manual and mechanical manipulation to help realign the spine and help stretch and strengthen weak muscles. Chiropractors also incorporate myofascial release and MET maneuvers to help release tension and reduce inflammation affecting the body’s soft tissue, especially within the muscles and fasciae, by allowing contraction and relaxation methods to improve somatic dysfunction within the cervical spinal area. (Jara Silva et al., 2022) Additionally, cervical spinal manipulation can be effective by reducing the pain intensity of migraines and improving the symptomatic days when individuals are experiencing migraine associated with neck pain. (Mayo & Keating, 2023)

 

Postural & Ergonomic Interventions

Many individuals don’t realize that some of the sources that cause their neck pain could be due to everyday motions that can lead to poor posture. Being hunched from looking down at their phones or leaning forward to look at the computer can strain the neck muscles, thus compressing the cervical nerves, leading to migraines and headaches. Incorporating craniocervical exercises can provide beneficial results for individuals with migraines correlated with neck pain, therefore reducing the frequency and improving disability that is affecting the body. (de Almeida Tolentino et al., 2021) When people start doing postural retraining and neck mobility exercises as part of their daily routine, they reduce the chances of migraines returning.

 

Anti-Inflammatory & Nutritional Support

Migraines can be triggered or worsened by inflammation and blood sugar instability through improper dieting. When it comes to dieting, many individuals can often see that certain foods can trigger different reactions in the body. Certain foods can trigger migraines to develop; however, by figuring out which food causes the triggers that lead to the migraine to establish, many individuals can make various changes in what they eat. Many people are encouraged to try the elimination diet to identify the food trigger causing the migraines and avoid it. (Gazerani, 2020) Hence why, incorporating foods rich in omega-3s can help not only reduce migraine headaches but also reduce chronic inflammation that is affecting the body.

 

Additionally, many individuals can incorporate magnesium supplements, which can help decrease migraine attacks by altering the neurotransmitter secretion in the central nervous system (Shin et al., 2020). This can help many individuals feel better over time.

 

Final Thoughts

There is a common route between migraines and neck pain when determining the relationship between the two conditions. Many people might have a personalized treatment strategy to control migraine symptoms and regain neck mobility by comprehending this overlapping link. The objective is to provide patients with resources that will lessen the frequency and intensity of migraines, increase energy, and enhance their quality of life, whether this is accomplished by physical treatments, dietary assistance, or lifestyle modifications.

 


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with neck pain associated with migraines. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce migraines from reappearing and causing neck pain. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.


References

Aguilar-Shea, A. L., Membrilla Md, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Aten Primaria, 54(2), 102208. doi.org/10.1016/j.aprim.2021.102208

Al Khalili, Y., Ly, N., & Murphy, P. B. (2025). Cervicogenic Headache. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29939639

de Almeida Tolentino, G., Lima Florencio, L., Ferreira Pinheiro, C., Dach, F., Fernandez-de-Las-Penas, C., & Bevilaqua-Grossi, D. (2021). Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol, 21(1), 249. doi.org/10.1186/s12883-021-02290-w

Di Antonio, S., Arendt-Nielsen, L., & Castaldo, M. (2023). Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract, 66, 102817. doi.org/10.1016/j.msksp.2023.102817

Gazerani, P. (2020). Migraine and Diet. Nutrients, 12(6). doi.org/10.3390/nu12061658

Janssen, L. P., Medeiros, L. F., Souza, A., & Silva, J. D. (2021). Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance. An Acad Bras Cienc, 93(suppl 4), e20210618. doi.org/10.1590/0001-3765202120210618

Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022). Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus, 14(8), e27830. doi.org/10.7759/cureus.27830

Mayo, Z., & Keating, C. (2023). Manual Therapy and Exercise for the Management of Chronic Neck Pain With Multiple Neurovascular Comorbidities: A Case Report. Cureus, 15(3), e36961. doi.org/10.7759/cureus.36961

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8). doi.org/10.3390/nu12082184

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). doi.org/10.3390/diagnostics13040590

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