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.
Spinal stimulation is a treatment option that could help bring relief from pain and improve the quality of life for individuals dealing with chronic pain, like low back, and leg pain. Spinal stimulation can help reduce and manage chronic pain that does not alleviate or reduce with physical therapy, pain medications, injections, and other non-surgical treatments/therapies. �
It is a form of neuromodulation that works by blocking pain signals that the nerves send out from reaching the brain. A spinal stimulator is a tiny device that is implanted underneath the skin. The device delivers a very low electrical impulse that masks/changes pain signals before they reach the brain.
�
A Spinal Stimulation System
�
Neurostimulator:
This is the entire device that is implanted and sends out electrical impulses through a lead wire to the nerves in the spine.
Lead:
The thin wire that delivers the electrical impulses from the neurostimulator.
Remote control:
This turns on/off the stimulator and increases or decreases the amount of stimulation.
Charger:
Stimulators are rechargeable and normally require recharging about one hour every two weeks.
�
Spinal Stimulator Types:
�
Traditional stimulators
These produce a gentle ringing/tingling sensation that masks the pain.
Burst stimulators
These send out random interval bursts of electrical impulses designed to copy the way the body sends out nerve impulses.
High-frequency stimulators
These reduce pain without generating tingling sensations. �
�
Types of Pain Spinal Stimulation Treats
Spinal stimulation is approved by the U.S. FDA to treat chronic back and leg pain, including pain that doesn’t go away after back surgery known as failed back surgery syndrome. Chronic neuropathic back and leg pain are the most common types that stimulation treats. This means back or leg pain caused by nerve damage from:
Auto accident
Injury – personal, sports, work
Disease
Acute pain is like stepping on a sharp piece of glass, where the pain serves as protection letting you know something is wrong and not to continue. Whereas chronic neuropathic pain lasts for 3 months or more and does not help protect the body. �
�
Spinal stimulation is also used to treat complex regional pain syndrome or CRPS. This is a rare condition that affects the arms/hands or legs/feet and is believed to be caused by damage or malfunction of the nervous system. It is also used in treating peripheral neuropathic pain. This is damage to the nerves outside of the spinal cord often in the hands/feet that is caused by an:
Infection
Trauma
Surgery
Diabetes
Other unknown causes
�
Appropriate Treatment
Spinal cord stimulation should not be used in patients that are pregnant, unable to operate the stimulation system, went through a failed trial of spinal stimulation, and are at risk for surgical complications. The decision to use spinal stimulation is based on an individual’s needs and risks. Talk to a doctor, spine specialist, chiropractor to see if spinal stimulation could be an option.
�
Benefits and Risks
The effects of stimulation are different for everyone. Therefore, it is important to understand that spinal stimulation can help reduce pain, but not completely eliminate it. �
�
The Benefits of Spinal Cord Stimulation
In addition to reducing pain, other benefits of spinal stimulation include:
Better sleep
Improved body function
Increased activity
Improved mobility
Reduced opioid medication/s use
Less need for other types of pain meds
Reduced dependence on braces/bracing
�
Risks
During the implantation, there is a risk for:
Bleeding
Infection
Pain at the site of incision
Nerve damage
Rarely paralysis
� For some individuals, scar tissue can build up over the electrode, which can block the stimulator’s electrical impulse. The lead wire could move or shift out of position. This could lead to impulses being sent to the wrong location. The device itself could shift under the skin causing pain, making it hard to re-charge or communicate with the remote.
There is a risk that the lead wire could detach or break off causing a malfunction and require a replacement. Also, individuals could respond well to the stimulation at first, but later on, they develop a tolerance, and so the therapy no longer has the same impact and the pain could get worse because the nerves stop responding.
�
Take Precautions
Discuss with a doctor, spine specialist, or chiropractor what you can and can’t do after the stimulator is implanted and activated. Here are a few precautions:
Do not drive or operate heavy equipment when the stimulator is active.
Stimulation systems could set off metal detectors, which could require manual screening.
MRIs, electrocautery, diathermy, defibrillators, and cardiac pacemakers could have a negative interaction with certain types of stimulators. This could result in injury or damage to the spinal stimulator. Talk to your doctor to determine if a spinal stimulator is a treatment option that will work for you.
�
Weight Loss Techniques – Push Fitness Center
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
Chiropractor, Dr. Alex Jimenez shares some how-to advice on taking hot baths for back tension and pain. A bath can be a wonderful and fulfilling experience in self-care for back pain. There are medical benefits from taking a hot bath, as well. A hot bath can be extremely helpful when it comes to back pain.
Dr. Jimenez helps his patients with spinal ailments and conditions that range from arthritis, degenerative disc disease to nerve compression, sciatica, auto accident injuries, sports injuries, etc. In addition to chiropractic, physical therapy, diet, and exercise, he has also seen the power of home remedies, like a hot bath.
There are scientific studies that have shown how hydrotherapy can relieve back pain. Dr. Jimenez describes a hot bath as a muscle-relaxing stimulus. It opens up the muscles, which allows more blood to flow through, which in turn helps to heal injury/s, tightness, and soreness. It helps to clean out lactic acid, which is known to cause muscle pain, fatigue, and muscle cramps.
Here is what usually happens to the spine when soreness, tightness, aching, and pain present. A spinal structure like a nerve, disc, vertebral bone, or other tissue is injured or on the verge of injury, and the muscles around it contract closely in to prevent more damage.
This is called muscle spasm. Don’t worry the body is supposed to respond this way, as it means the damaged tissue is less likely to sustain further injury. However, muscle spasms can be painful. Much like a Charley horse, a back spasm can have the same effect.
For example, someone standing or working for an extended period places the muscle/s under constant tension, which means they have a higher chance of having a spasm and developing painful symptoms. A hot bath relaxes the muscle/s and reduces/removes the aching soreness and pain. Here are some tips to help relax the back muscles. �
Try Epsom Salt
Taking a bath with Epsom salt or minerals that dissolve in water can be helpful, but are not necessary. Many are fantastic skin relaxants, but if you have a hot bath with or without the salt, it�s not going to make a huge difference. What makes the bath work is the heat and the floatation. This what creates the benefits.
Soak 15-20 Minutes
It is really up to the individual, as to how long they want to stay in the tub. One question to ask is how long can you take sitting in hot water? Hot tubs are normally heated to about 102 to 103 degrees. With these types of tubs, individuals can sit for a half-hour or more. However, most of us do not have a jacuzzi, so remember that a regular bath will be warmer possibly 105 or 106 degrees. It all depends on how long you can take the heat. �
� Remember not to scald yourself with a bath that is way too hot to soak in, please. It�s ok to get the water running hot, but as it fills turn the heat down and let it cool slightly before stepping in. Most individuals don�t need more than 15 to 20 minutes of soaking time maximum.
As for how often one should take a hot bath, Dr. Jimenez explains that it depends on the severity of the back pain and what type of work and activities the individual does. For most three times a week offers a balanced therapy. If an individual has a strenuous physical job like construction work, manual lifting, standing work, or doing highly repetitive work then they�ll need to do more than 3 times a week.
Strengthen the Body’s Core
A strong core can support and protect the spine, along with the rest of the body. Squeezing and contracting the back, side, and front muscles make the core strong and robust. It behaves like a steel beam supporting the spine when added protection is needed.
Stretch Out
After a hot bath is a perfect time to stretch. Toe touches can loosen tight hamstrings that can strain the lower back. Also, try out yoga’s upward-facing dog pose. Sun salutationscan help the spine go through a wide range of motion. Therefore do them slowly and hold each pose for a few breaths. A long salutation or two can feel tremendous when the spine is nice and relaxed.
Take Care When Getting Out
Hot baths might not be a good idea or the right option for certain people. If there is instability in your spine and the vertebra move around more than they are supposed to then a hot bath might not be the best option. Instead, a hot shower with a massage setting could be equivalent to taking a hot bath.
However, if a hot bath is not helping with back pain it could be a sign of something more than muscle tightness or a muscle spasm. A spine specialist or chiropractor can give you a proper diagnosis.
PODCAST: Ryan Welage and Alexander Jimenez, both medical students at the National University of Health Sciences, discuss the several new approaches that they developed in order to help people continue to engage and participate in exercise from the comfort of their own homes. Using their advanced understanding of functional medicine, biomechanics, and nutrition, they undertake explaining simple methods and techniques for complex movement protocols. Moreover, Alexander Jimenez and Ryan Welage discuss how diet can be an essential element in overall health and wellness. Dr. Alex Jimenez offers additional guidelines with the Functional Fitness Fellas, among further advice. – Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
PODCAST: Dr. Alex Jimenez, chiropractor in El Paso, TX, and Victoria Hahn discuss the fasting-mimicking diet and the ProLon Fasting Mimicking Diet program developed by Dr. Valter D. Longo. The ProLon Fasting Mimicking Diet is a high-fat, low-calorie intermittent fasting diet that may promote fat loss and reduce blood sugar, inflammation, and cholesterol, similar to other fasting methods. Valter D. Longo is an Italian-American biogerontologist and cell biologist known for his research studies on the role of fasting and nutrient response genes on cellular protection aging and diseases as well as for proposing that longevity is regulated by similar genes and mechanisms in many eukaryotes. Only a few research studies have been carried out to date regarding the fasting-mimicking diet and more research is needed to validate its benefits. �- Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
Research has found that vertebrogenic chronic low back pain could be caused by a lumbar vertebral endplatechange that involves the basivertebral nerveand is not disc-related. The underlying cause of chronic low back pain can be very difficult to diagnose. The intervertebral discs are a common suspect, but when disc-related treatments don�t ease the pain, the root problem could be something else. Researchers are exploring an overlooked area with the vertebral endplates being the cause of vertebrogenic low back pain.
Research has found that there are more nerves in the vertebral endplates than in the spinal discs. More nerves can mean higher potential/increase in pain. And like the other areas of the spine such as the discs and joints, vertebral endplates can also degenerate, also increasing the risk for pain.
Vertebral Endplates and Basivertebral Nerve
The vertebral endplates line the top and bottom of each vertebral body. These are the round, thick, weight-bearing bones in the spine. The vertebral endplates are made of cancellous or spongy bone and function as the barrier between each disc and the vertebrae.
The low back/lumbar spine takes the most weight. That can be a significant amount of pressure on the structures in the low back. The endplates are situated between a cushioned disc/s and the hard, bony vertebral body making them vulnerable to degeneration and nerve damage contributing to chronic low back pain. The endplates and vertebral bodies consist of a network of intraosseous nerves.
Intraosseous nerves live within the bone.
The basivertebral nerve� BVN is an intraosseous nerve that winds through the vertebral bodies. This nerve feeds into each spinal bone through the back of the vertebral body and then branches out with nerves going towards the top and bottom vertebral endplates. Research has shown that although these nerves are inside the bone they can send pain signals from a damaged vertebral endplate that could result in vertebrogenic low back pain. This is why it has been�recently linked it as a possible cause of chronic low back pain.
Nerve pain in the spine has been linked with discs that have degenerated. A doctor, chiropractor/spine specialist refers to this as discogenic pain. But with new research, an understanding of the function the vertebral endplates and BVN play in the sensation of pain has been realized and this is where the term vertebrogenic pain comes from. If a doctor discovers that the endplates could be the source of your chronic low back pain, they might use this term.
Vertebral Endplate Pain Diagnosis
Like most back pain conditions diagnosing vertebral endplate pain can be just as challenging. This is because diagnostic imaging scans typically don�t pick up mild to moderate endplate damage. A classification scale known as Modic changes helps doctors identify vertebrogenic pain.
Modic changes or MC are areas that show up on an MRI showing bone marrow damage that has been linked to low back pain. The name comes from the doctor that classified them in 1988, Dr. Michael Modic. Modic changes help doctors and spine specialists see and understand the connection between endplate damage and chronic low back pain.
2 types were identified that show a connection between vertebral endplate damage and chronic low back pain:
Type 1
This type shows a�development� in the vessels of the vertebral body, that includes:
Inflammation
Edema, which is a collection of excess fluid
Endplate changes like a split or crack/s in the endplate
Type 2
This type reveals changes in the bone marrow like fatty deposits that have taken the place of bone marrow.
If the lumbar MRI shows Type 1 or Type 2 MC, a doctor could recommend a conservative treatment plan that could include:
These could be utilized in conjunction with spine specialist care in addressing symptoms and pain. However, if the pain does not ease or reduce with conservative treatment, a doctor could suggest an outpatient procedure.
Candidates for this procedure usually qualify meeting the following:
The individual has struggled with chronic low back pain for at least 6 months
The pain has not reduced/eased up with at least 6 months of conservative care
MRI shows Type 1 or Type 2 Modic changes�that correlate symptoms of vertebrogenic low back pain
The procedure uses fluoroscopy or an x-ray video. A thin tube called a cannula is inserted into a vertebral pedicle. A pedicle is a structure that sticks out from the back of the vertebra. The cannula tunnels its way to the basivertebral nerve. The doctor then runs the Intracept Radiofrequency generator into the path of the nerve and ablates destroys/removes any obstructions in the nerve with the help of the frequency generator. Since it�s a minimally invasive procedure, it can be performed in an outpatient clinic, allowing the patient to go home the same day.
The device/tool used in the procedure is not implanted in the spine. It is removed once the procedure is done.
Expectations as to how long the pain relief will last depends on:
The severity of the condition
Post-physical therapy
Type of work
Diet
Exercise
One study showed the benefits to last up to two years.
If�nonsurgical treatment has not worked for at least six months talk to your doctor about basivertebral nerve ablation for vertebrogenic chronic low back pain. There are risks and benefits both of which should be discussed in depth.
Endplate or Disc and the Root Cause
The intervertebral discs are often the more common cause of low back pain. But they might not be the root cause of spine pain. More research is going on with the role the vertebral endplates play in spine health. As more patients are being diagnosed earlier then better long-term outcomes will follow.
Methods in treating inflammation are the focus of this video. Dr. Alex Jimenez presents a discussion of natural ways to treat inflammatory cascades. Knowing what are the best supplements are presented. This is a safe alternative that is well researched.
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
