Back Clinic Chronic Back Pain Team. Chronic back pain has a far-reaching effect on many physiological processes. Dr. Jimenez reveals topics and issues affecting his patients. Understanding the pain is critical to its treatment. So here we begin the process for our patients in the journey of recovery.
Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting.
Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.
Chronic back pain can have real effects on your day-to-day life and your mental health. But you and your doctor can work together to treat it.
Do call upon us to help you. We do understand the problem that should never be taken lightly.
Back pain usually comes from lifting an object the wrong way or awkwardly moving the body, injuring the spinal structures or muscles. However, sometimes it could be signs/symptoms of a more serious medical condition. The back pain could be caused by:
How to know when the root cause of back pain is from something else in the body? There are two types of pain that pain specialists look at. These are visceral pain and somatic pain. Visceral pain comes from damage or injury to the organs or organ tissues. This internal pain can radiate to the spine from conditions like:
Pancreatitis
Ulcerative colitis
Crohn’s disease
Gall stones
Cancers
Kidney pain
Urinary tract infections
Somatic pain is injury or damage to the muscles, skin, and soft tissues. It can be caused by:
Regular wear and tear
Aging
Injury
Sedentary lifestyle
However, visceral pain can cause somatic/bodily pain to flare up. The stress the body is going through because of the medical condition can cause inflammation.
Kidney Infections and Stones
The kidneys are located in the rear of the body toward the middle of the back. The kidneys:
Filter waste products from the body
Regulate bodily fluids
Perform other vital functions.
Kidney infections and kidney stones can easily mimic a sprain or strain in the back. Infections or stones can also present with other symptoms like:
Side and groin pain could accompany the back pain.
The pain does not go away after shifting positions or lying down.
Urinary Tract Infection UTI
Upper urinary tract infections in the kidneys or ureters can cause back pain. Upper UTIs happen when a lower UTI in the bladder or urethra goes unnoticed or does not respond to antibiotic treatment. Infections can occur at any age, with women and older men being more susceptible. The pain usually presents in the lower back and groin area. Other possible symptoms include:
Pain in the back, sides of the lower abdomen between the lower ribs and hips.
Fever
Vomiting
Frequent urination in small amounts
Burning during urination
Strong urge to urinate
Foul-smelling urine
Cloudy urine
Fatigue.
The pain can feel like:
Cramping pain
Pressure
Soreness
Pancreatitis
Pancreatitis is inflammation of the pancreas, the long flat organ located in the upper abdomen behind the stomach. It assists digestion and sugar management. The American Pancreatic Associationreports acute pancreatitis can make individuals feel sick with moderate to severe abdominal pain that can radiate to the back and often worsens after eating. The pain is felt in the upper to middle back. Other possible symptoms include:
Abdominal pain that radiates to the back
Abdominal pain after eating
Fever
Nausea
Vomiting
Tenderness in the abdomen
The pain can feel like a pulled muscle or joint pain that increases and decreases at first and then strengthens after eating or lying down.
Inflammatory Bowel Diseases IBD
Ulcerative colitis and Crohn’s disease are inflammatory bowel diseases not to be confused with irritable bowel syndrome.
Ulcerative colitis affects the colon.
Inflamed intestinal areas characterize Crohn’s disease.
Both can cause spreading back pain.
A study found 25% of individuals with IBD have chronic back pain. Other possible symptoms include:
The pain can feel mild or severe, like a cramp in the lower abdomen around the low back. It can present in cycles as a flare-up, then goes away. It’s essential to read the body’s warning signs and not push through the pain or ignore it. If any back pain goes on for more than a week, consult a doctor or chiropractor for a thorough examination. A pain specialist could be recommended if there is chronic back pain from a severe medical condition. A primary doctor or specialist helps keep the medical condition in check, while a pain specialist and/or chiropractor can alleviate chronic musculoskeletal pain from inflammation, irritation, and overstimulated nerves.
Body Composition
Personalized Lifestyle Medicine
Personalized lifestyle medicine develops customized treatment/health plans to fit the individual. It includes:
Research on how the body works as an integrated system.
Combines new technology approaches in medicine.
The relationship between nutrients and gene expression.
Life and behavioral sciences.
Nutrigenomics testing helps individuals understand the influence of dietary components on their genes, which can help prevent the development of certain chronic diseases.
It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.
Inflammatory vs. Mechanical Pain
Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.
Inflammatory
Pain caused by inflammation can be described as:
Not having a known definite cause.
Characterized by stiffness, especially after waking up.
Pain reduces with movement, activity, stretching, exercise.
Is worst during the early hours of the morning.
Is often accompanied by pain in the buttocks/sciatica symptoms.
Mechanical
Mechanical pain can be described as:
Pain that becomes worse with activity, stretching, or exercise.
Pain reduces with rest.
There is no stiffness after sleeping.
This pain is not constant but can become intense/severe for short periods.
Pain in the buttocks/sciatica symptoms do not present.
Inflammatory and Non-Inflammatory
Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:
Chiropractic adjusting
Physical therapy
Spinal decompression
Contributing Autoimmune Diseases
When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:
Rheumatoid Arthritis
Arthritis causes the immune system to attack the joints throughout the body.
Ankylosing Spondylitis
This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.
Multiple Sclerosis
This is a disease where the immune system attacks nerve fibers and can lead to back pain.
Psoriatic Arthritis
This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.
Inflammatory Pain Treatment
Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.
Chiropractic and Physical Therapy
These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:
Chiropractic adjustments
Flexion-distraction
Posture correction
Personalized exercises
Inflammation Night Pain
Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.
Stretch Before Bed and When Waking
Performing stretches before going to bed and after waking up helps keep the body limber.
Inspect Pillows and Mattress
Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.
Exercises
Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.
Cardio
These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:
Swimming
Walking
Cycling
Strength-Building
Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:
Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:
Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
Go vegetarian for one day a week.
Cut out processed meats with high levels of preservatives.
Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2
Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5
Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001
Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745
Individuals and doctors have praised the anti-inflammatory, pain-relieving properties of drinking tea. Inflammation is the body’s natural immune response when injury and infection present. This is good. However, it’s meant to be a temporary response that deactivates when there is no longer any danger. When the body is exposed to various irritants like industrial chemicals, inflammatory foods like sugar, refined carbohydrates, and autoimmune disorderscan cause the immune system to go into overdrive. Chronic inflammation can develop, circulating powerful hormones and chemicals through the body, causing damage to the cells. One consequence of chronic inflammation is back pain. Besides standard backaches, some chronic conditions are directly tied to inflammation. These include forms of arthritis:
Ankylosing spondylitis
Rheumatoid arthritis
Transverse myelitis
Multiple sclerosis
These conditions involve inflammation of the central nervous system.
Drinking tea can help with back pain and pain in general.
Teas With Anti-Inflammatory Properties
Certain teas contain anti-inflammatory compounds. These compounds are called polyphenols and work to decrease the chemicals in the body responsible for pain and inflammation. There are varieties of teas that contain anti-inflammatory properties.
Certain Teas Reduce Inflammation
Drinking specific teas with more polyphenols can better decrease inflammation. For example, green tea is higher in polyphenols than black tea. Recent studies centered on individuals with rheumatoid arthritis over six months found significant improvement in symptoms in those who drank green tea. Green tea works best when part of an anti-inflammatory and nutritional lifestyle adjustment. This supports combating inflammation. Other teas that are believed to reduce inflammation include:
Turmeric
Holy basil
Ginger
Three Cups a Day
The amount of tea depends on the quality of the tea and how it is prepared. Doctors recommend around three cups a day for individuals with rheumatoid arthritis. However, these could contain caffeine. If this is an issue, there are decaffeinated versions with the same anti-inflammatory properties.
Drinking Tea Works Best When Combined with Other Treatments
If experiencing back pain or looking to combat a specific condition, it’s recommended to utilize various treatment approaches combined with drinking tea. This includes:
Certain back conditions benefit from drinking tea regularly; however, spine structural issues or fractures will not benefit from tea’s mild anti-inflammatory properties. It is vital for individuals with back pain that a spine specialist or chiropractor perform a proper and thorough examination, especially for Individuals that take medication that could directly interact with anti-inflammatory teas.
Drinking Tea for Back Pain
For most individuals, drinking tea is safe to help treat back pain conditions and added health benefits. For example, studies have found that green tea has mild anti-cancer, anti-diabetic properties and can help in maintaining a healthy weight. If tea helps reduce pain, it’s worth trying. Remember, pain is the body’s way to alert the individual that something is wrong.
Body Composition
Alcohol and Heart Health
According to the Mayo Clinic, consuming more than three alcoholic drinks in one sitting causes a temporary blood pressure elevation. Foods often served with alcohol are usually high in salt, which can also raise blood pressure. A few alcoholic beverages on a night out is fine, but heavy or binge drinking can lead to short-term spikes in blood pressure that could cause cardiac health problems. These are the short-term effects of alcohol on blood pressure. Heavy alcohol consumption can lead to long term health risks like:
Hypertension
Heart disease
Digestive issues
Liver disease
Stroke
It’s recommended that individuals incorporate regular exercise/physical activity and healthy diet changes and watch alcohol intake to improve heart health.
References
The Clinical Journal of Pain. (October 2019) “Nonspecific Low Back Pain:
Certain Teas Bring Down Inflammation More Than Others: Journal of Physical Therapy Science. (October 2016) “Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis” www.ncbi.nlm.nih.gov/pmc/articles/PMC5088134/
The Bottom Line: Proceeding of the Japan Academy, Series B Physical and Biological Sciences. (March 2012) “Health-promoting effects of green tea” www.ncbi.nlm.nih.gov/pmc/articles/PMC3365247/
At home or a gym, working out with cardio exercise equipment can be a highly beneficial treatment for back discomfort, soreness, and pain. However, when checking out all the cardio machines it is recommended to use those that will help with back pain and not worsen or cause further injury. The same goes for purchasing cardio equipment to use at home. Research has found that exercise training could be highly effective in the treatment of back pain. A study on pain found that the endorphins generated from aerobic exercise help to lessen low back pain. The North American Spine Society announced evidence-based recommendations for the treatment of back pain, and one of the top recommendations was aerobic exercise. Individuals can always go outside to:
Walk
Hike
Run
Bike ride
But mixing it up with cardio equipment can have its own benefits for different reasons. It could be too hot, raining, sometimes individuals prefer a set workout program to reach calorie or distance goals, and it could be easier on the spine. Working out at home or at a gym, cardiovascular machines can help bring relief for back pain.
Cardiovascular Exercise Back Pain Treatment
Cardiovascular exercise is highly recommended for everyone. For individuals dealing with back pain, exercise combined with conservative therapy is usually part of a treatment plan. This includes:
Physical therapy
Chiropractic care
Health coaching
Diet
Aerobic exercise regimen
With an exercise program, experts recommend starting with moderate-intensity aerobic exercise. Moderate intensity workouts are meant to get an individual’s heart and blood pumping, sweating a little, and slightly deep breathing. These types of exercise include:
Power walking outside
Power walking on a treadmill
Stationary biking
As long as the physical activity gets the heart rate up, these exercises have been shown to decrease back pain, relieve stress, and elevate mood. 20 minutes of moderate-intensity exercise three to five times a week for six weeks is what is recommended. This will help the back become healthier, feel better, and is recommended by the American Heart Association.
Exercise Not For All Spine Conditions
However, not all spinal conditions benefit from regular exercising. Getting an evaluation from a doctor, spine specialist, or chiropractor is recommended for injuries, severe and/or persistent back pain before starting a cardiovascular exercise program. This could be a spinal fracture, or spinal condition that requires bracing, or intense physical therapy/rehabilitation. Individuals that do not exercise regularly or have a medical or heart condition/s definitely need to get a doctor’s clearance before beginning a cardiovascular workout regimen.
Top Cardiovascular Exercises and Equipment
Once a doctor clears the individual for aerobic exercise there is no cardio equipment that is off-limits. Elliptical machines and stationary bikes are the most well-tolerated by individuals with back problems/conditions. Because they are low impact. However, if it is tolerable using a jogging treadmill is beneficial as well. Listen to the body. If a workout on a treadmill causes back pain that is not just workout soreness, stop with that machine and try different cardiovascular equipment that is more low impact. Do not ignore back pain. If pain is continuous and exercising is not helping, stop and see a doctor, or chiropractor to evaluate and analyze the situation. Then they can adjust the exercise part of the treatment plan according to the presenting symptoms.
Body Composition
Concurrent Training
Concurrent training is the combination of aerobic and resistance exercises during the same workout session. Aerobic and resistance exercise impacts the body in different ways. The type of aerobic training determines how it interacts with resistance exercise. The order of the types of exercises like aerobic and resistance workouts can make a difference. Having an understanding of a few specifics about concurrent training will help to make decisions about an exercise program.
Aerobic/interval and resistance training does not seem to interfere with the others’ adaptations
However, gaining strength could be lowered by adding running to a resistance program
Whereas bicycling does not have the same effect.
Cycling and the ergonomics that go with it are similar to traditional lower-body resistance exercises. The muscle contractions that come with running result in muscle damage, while the contractions in cycling also cause muscle damage, it is not to the same extent. Pairing the exercise programs correctly is key, such as a running program in combination with an upper-body lifting exercise can be beneficial. While running and doing leg presses every day could interfere with each other and could cause injuries. Or if doing both aerobic and resistance exercises in the same session, or on the same day, consider the order of the exercises, depending on what the goal is.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
British Journal of Sports Medicine. (November 2020) “Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis” https://bjsm.bmj.com/content/54/21/1279
Pain. (December 2020) “Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial” https://journals.lww.com/pain/Citation/2020/12000/Are_endogenous_opioid_mechanisms_involved_in_the.23.aspx
North American Spine Society. (2020) “Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care” https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf
The diabetic disease processes can be a contributor to chronic back pain. Diabetes can damage the human body from the eyes to the feet if left untreated, and the spine/back is a prime target. Data from 11 studies consisted of individuals over 18 years of age diagnosed with type 1 or type 2 diabetes. The results showed individuals with diabetes had a 35% increased risk of experiencing lower back pain. According to the Centers for Disease Control and Prevention, around 34 million people were found to have diabetes in 2021. Diabetes primarily impacts blood sugar/glucose levels. However, the disease can affect several of the body’s systems. It is a state of chronic inflammation.
Diabetic Back Pain Connection
The connection between diabetes and back pain include:
Neuropathy
Diabetic neuropathy happens when constant high glucose levels damage/injure the nerves. The result is symptoms like pain, tingling, and numbness. It affects up to 50% of individuals with diabetes and can lead to severe chronic back pain. High sugar levels damage various organ systems including the nervous system that results in neuropathy that causes pain/discomfort.
Bone Health
A complication that diabetes can cause is compromised bone health.High glucose levels can damage the collagen that makes up bone. This creates an increased risk of vertebral and other types of fractures. The high-risk compounds fractures that do not heal properly or correctly. Diabetics have an increased risk of fracture because of the accumulation increase of advanced glycation products. This substance forms when proteins or lipids combine with sugar. With time these products can cause damage to various tissues that include bone.
Obesity
Obesity contributes to the development of type 2 diabetes and is also a complication that results from incorrect glucose level management. Regardless of which came first, the added weight is a major contributor to back pain because of the added pressure/load on the spine. Excess weight and physical inactivity can result in serious issues of the musculoskeletal system.
Additional Factors
Poorly controlled diabetes also reduces muscle blood flow and increases cartilage inflammation. Other types of tissue damage can occur like degeneration of intervertebral discs and spinal canal stenosis. Disc degeneration and spinal stenosis are common causes of back and neck pain. Diabetics are prone to infection/s. This can cause back pain if it is in the bone known as osteomyelitis.
Diabetic Back Pain Management
There are steps that can help ease pain and discomfort.
Getting Involved In Physical Activity
Exercising/physical activity is a must. The body needs to move to get all the systems flowing improving diabetes and back pain. A sedentary lifestyle can take back pain to new levels with time. Even though when pain presents the first instinct is to stop and rest. Simple ways to get moving include:
Walks
Stretches
Gentle laps in a pool
All can help with:
Improved blood flow
Aids in weight loss
Recommended for both conditions
Exercising releases endorphins, which are the pain relief chemicals that the body produces naturally.
Yoga can reduce physical pain and discomfort throughout the body
Quitting Bad Habits
Smokers have a significantly higher risk for low back pain compared to non-smokers. Nicotine can alleviate pain short term, but over time the nerves become more sensitive and can increase the pain. Alcohol use can help numb the pain short term, but it can cause muscle spasms and dehydration intensifying the pain. Complications can arise if taking pain medication. The most important thing is managing diabetes effectively.Injury Medical Chiropractic and Functional Medicine Clinic will help the individual feel better, move better, and keep back pain away.
Body Composition
Vitamin D and Healthy Blood Sugar Levels
Vitamin D benefits muscle health, muscle mass, and blood sugar. Insulin is the hormone that lets blood sugar into the muscles. Individuals with adequate blood vitamin D levels significantly lower the risk of hyperglycemia than those with below-recommended levels. Research shows daily vitamin D supplements used in combination with calcium decelerate the gradual rise in blood sugar in those with prediabetes. Adequate vitamin D levels can prevent the progression of hyperglycemia. Supplementation is beneficial for individuals going through a deficiency. Adults should aim for a dietary intake of 600 – 800 IU per day. However, supplements are never a substitute for a healthy and diverse diet.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
References
Pozzobon, Daniel, et al. “Is There an Association between Diabetes and Neck and Back Pain? A Systematic Review with Meta-Analyses.” PLOS ONE, vol. 14, no. 2, 2019, doi:10.1371/journal.pone .0212030.
Murray, Cliodhna E, and Cynthia M Coleman. “Impact of Diabetes Mellitus on Bone Health.” International Journal of Molecular Sciences, MDPI, 30 Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6801685/.
Groen BBL, Hamer HM, Snijders T, van Kranenburg J, Frijns D, Vink H, et al. Skeletal muscle capillary density and microvascular function are compromised with aging and type 2 diabetes. Journal of Applied Physiology. 2014;116(8):998–1005. pmid:24577061
Eivazi M, Abadi L. Low Back Pain in Diabetes Mellitus and Importance of Preventive Approach. Health Promotion Perspectives. 2012;2(1):80–8. pmid:24688921
Chiropractic manipulation under anesthesia, also known as M.U.A is a non-invasive stretching and musculoskeletal manipulation technique. This type of chiropractic treatment can offer relief from chronic and constant back pain and other types of pain that have not responded well or at all to conservative non-surgical care. Chiropractic manipulation under anesthesia breaks up adhesions/internal scar tissue that could result from an injury or previous surgery, helping restore the normal range of motion and reduce pain. This technique is utilized to treat:
Undergoing chiropractic manipulation under anesthesia while sedated means the body is in a highly relaxed state. This sedation allows the chiropractor to adjust the bones, joints into proper alignment and stretch the muscles without the individual�s voluntary/reflexive resistance. And the sedation allows the chiropractor to use less force, making the procedure painless.
Manipulation Under Anesthesia Specialists
This type of manipulation is a specialty procedure. Trained and certified physicians only perform it in the fields of:
Chiropractic medicine
Orthopedics
Physical therapy and rehabilitation
Osteopathy
Advantages to MUA treatment
There are individuals with pain that respond well to regular chiropractic manipulation, physical therapy, or exercise. However, depending on their condition, relief might only last for a few days or weeks. This is where manipulation under anesthesia could improve the range of motion and relieve pain. Manipulation under anesthesia has been performed for more than sixty years. It can be cost-effective and safer than invasive treatment like spine surgery. It is recognized and covered by most insurance and workers’� compensation plans.
Determining if MUA is right for the individual and their condition
Manipulation under anesthesia is not for all individuals with back pain. MUA is only recommended for patients that meet the procedure’s criteria. Like any other type of recommended treatment, a doctor will carefully consider the individual’s medical history, symptoms, previous treatments, and effectiveness. A doctor will also perform a physical and neurological examination with an individual’s complete medical history. Test results will confirm the patient�s diagnosis and determine if anesthetic manipulation can help relieve pain and other symptoms. Tests can include:
Not an appropriate treatment for individuals with:
Uncontrolled diabetic neuropathy
Spinal cord compression
Morbid obesity
Any cancer
Acute or healing bone fracture/s
Osteomyelitis vertebral bone infection
Acute inflammatory arthritis
Metastatic bone disease
Severe osteoporosis
Acute inflammatory gout
Tuberculosis of the bone
Co-existing medical problems could mean an individual may not be able to undergo any procedure that requires sedation.
Another reason why a patient’s complete medical history is vital
Procedure
This procedure is usually performed in an ambulatory surgery center that is a modern healthcare facility focused on providing same-day surgical care for diagnostic and preventive procedures or at a hospital. An anesthesiologist administers the medicine/s. The patient could be sedated but not unconscious or general anesthesia meaning complete unconsciousness. The choice of sedation depends on various factors, like the patient’s diagnosis and how severe the condition is. The anesthesiologist can recommend a specific type of medicine or a cocktail of medications for the patient’s comfort during and after.
Once sedated, the chiropractor utilizes specialized techniques to stretch, adjust and mobilize the affected areas of the spine and body. The manipulations free up fibrous adhesions or scar tissue in one or more areas of the spine and surrounding tissues. The procedure usually takes 15 to 30 minutes. The individual will be awakened and then is carefully monitored in a recovery area. Many report an immediate reduction in pain and a broader range of motion after the procedure. There is usually temporary muscle soreness, similar to the soreness after an intense workout.
Recommended aftercare
Before being discharged, the patient is provided instructions about aftercare therapy. Instructions may include:
At-home warm-up movements
Physical therapy rehabilitation
Passive stretching
Electrical stimulation
Cryotherapy or cold therapy to reduce inflammation and pain
Physical therapy, exercise, and stretching
Three to six weeks after the procedure, individuals continue with physical therapy to help prevent back pain from returning and any fibrous adhesions/scar tissue broken up from reforming. Exercise and stretching will help strengthen and stabilize the abdominal and spinal muscles and prevent pain from returning.
InBody
Malnutrition
Malnutrition is defined as a lack of uptake or intake of nutrition that can negatively affect body composition. An important nutrient that elderly individuals might not get enough of is protein. Trouble chewing, food cost, and trouble cooking are all factors that limit elderly individuals’ access to protein, which can lead to sarcopenia. These complications can affect how the body responds to diet and exercise.
That is because protein requirements for the elderly are usually higher than for younger individuals. This comes from age-related changes in the metabolism that includes a decreased response to protein intake. This means that an older individual needs to consume more protein to achieve the same anabolic effect. Micronutrient deficiency is a lack of nutrients like minerals and vitamins. These support important bodily processes like cell regeneration, immune system function, and vision. A common example is iron and calcium deficiencies. This type of deficiency has the greatest impact on normal physiological functions in conjunction with protein-energy deficiency, as most micronutrients are acquired from food.
Dr. Alex Jimenezs Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that directly or indirectly support our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
When spinal misalignments happen the body experiences soreness, inability to rotate the neck, or after sitting/standing in one position for too long hip and leg discomfort/pain. This is why spinal alignment is so crucial to healthy living. These examples help to illustrate the delicate balance required in the spine to maintain optimal health, stay pain-free, prevent injury, and the ability to conduct everyday chores/responsibilities without the fear and anxiety of setting off pain symptoms.
Understanding how pain is processed
Pain is a complex sensation. Neural pain receptors, also known as nociceptors detect harmful stimulation/s in the form of:
Body Temperature changes
Mechanical forces and pressure on the body
Chemical changes in the body brought on by inflammation or cell damage
How the signal transmits from the stimulated nerve and how it is perceived depends on the upper levels of neural activity in the body. Specifically, the spinal cord, brainstem, and the brain. Examples of pain perceptions:
Previous pain generating experiences – auto accident, work injury, etc.
Spinal Misalignments and Balance
Pain is essential for alerting the body when engaged in activities, and body positions that can cause damage to the tissues like poor postures, work/sports/personal injuries, inflammatory foods, etc. The nerves’ pain pathways can experience overstimulation when the system is overloaded.
Excessive stimulation can be brought on by chronic inflammation, mood disorders, and poor health. One overlooked issue with the perception of pain is the health/effectiveness of the actual neural pathways. The nerve’s energy is affected by spinal misalignments. Proper nerve health and circulation are crucial for the body to transmit proper pain signals. Spinal misalignments can be brought on by:
Can lead to major dysfunction of the nerves pathways
The longer the pain and discomfort go on the more intense/severe the issues can become. This is when pain and discomfort become chronic leaving individuals feeling hopeless, frustrated.
Symptoms
The spine does more than provide stability. Any type of spinal misalignments will affect the rest of the body as well. Possible symptoms that the spine is out of alignment includes:
Chronic headaches
Frequent illnesses
Fatigue
Lower back pain
Neck pain
Hip pain
Knee pain
Numbness/tingling in the hands or feet
Walking gait abnormalities causing one shoe to wear out quicker than the other
Chiropractic Management
Many treatments focus on masking the pain rather than addressing the underlying root cause. This can lead to a chronic pain cycle and dependence on pain medications and invasive treatment. Chiropractic is a science-based approach that focuses on getting to the root issue. Chiropractic utilizes gentle and effective techniques like:
Manipulation
Exercise regimen
Stretching regimen
Body mechanics training
Health nutritional education
When the body is aligned and the spinal nerves are healthy, an individual’s pain perception will be changed for optimal functionality.
The first step is to reduce caloric intake by changing/adjusting dietary nutritional habits. Individuals can experiment with various types of diets and regular exercise regimens, and getting into the habit of getting the proper amount of sleep. Depending on an individual’s existing muscle mass, gaining Lean Body Mass first could be an option. An individual may be able to lose fat and gain muscle because:
Increased muscle mass will increase the Basal Metabolic Rate/metabolism, and if no extra calories are added body fat can be shed while building muscle.
Lifting weights can increase Total Daily Energy Expenditure, causing the body to burn more calories.
Circuit training is one option for improving changes in body composition while not affecting changes in overall body weight. This means muscle gain and fat loss is happening at the same time.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Dubinsky RM, Miyasaki J.Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.�Neurology. 2010;74:173-176.
Shrier I. Does stretching help prevent injuries?�Evidence-based Sports Medicine. Williston, VT: BMJ Books; 2002.
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