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.
Many individuals will be looking up at the fireworks this 4th of July weekend. A word of caution when keeping the neck in one position for too long can cause neck discomfort and/or pain. Neck discomfort and pain can cause significant disruption with everyday activities. The neck is an area that is constantly in motion. Keeping it in one position for an extended period can cause damage/injury and spinal misalignment. Although neck pain often resolves on its own in a few days. However, it can lead to headaches or an inability to concentrate, affecting an individual’s quality of life. Here are some potential causes and remedies for decreasing neck discomfort and pain.
Keeping The Neck In One Position For Too Long Can Cause
Mechanical issues and imbalances in the upper spine, known as the cervical spine
Muscle tension
Muscle strain
Spinal misalignment
Poor posture
Sleeping problems
Injury or trauma to the neck from the force and weight
Chronic neck misalignment
If symptoms come on suddenly, are severe, or result in neurological issues like severe shooting pain, tingling, numbness, or sudden loss of arm strength, seek medical attention immediately.
Treatment
When the neck is strained or out of alignment, it disrupts nerve circulation integrity. Spinal misalignment is subtle in nature and can be difficult to detect without a professional examination. A chiropractor is trained to recognize any underlying issues to reset/realign the entire spine to optimal form. They will assess, guide, and treat the issue/s specific to the individual’s needs. Once the nerves are working uninhibited, a chiropractor can recommend neck exercises, stretches, and more to strengthen and prevent neck problems. When spinal alignment is restored, the body will begin to operate at full potential.
Healthy Body Composition
Meal Prep to Success
For individuals that want to eat less and change eating habits, change up the approach.
Meal prepping is a healthy habit that many have had success with because it helps achieve sustainable outcomes in weight loss. Every meal plan will vary for everyone.
First, individuals have different health goals.
Second, everyone has a different approach to their diet choices. For example, an individual might want to go low-carb and goes with the ketogenic diet. In comparison, some individuals are comfortable planning a week in advance and freezing labeled plastic containers.
Regardless of goals, dietary, or fitness preferences, a workable meal plan is recommended. The ultimate goal is to prevent feeling overwhelmed about planning the next healthy meal and resort to a junk food meal. To steer clear of unhealthy food choices and achieve a healthy body composition, here is a real-world tip to create and stick to a healthy meal plan.
Have a well-stocked fridge and pantry
Keeping to a meal plan is easier with a well-stocked fridge and pantry. Ensure to keep a list of essential groceries whenever going to the store to ensure plenty. This list of staples includes:
Having these ingredients ready to go means a healthy meal can be quickly put together when short on time.
Be realistic and make room for crazy days
You don’t have to come up with a seven-day weekly meal plan. It is important to change up the routine, so boredom doesn’t set in. Before planning and prepping several meals, double-check the calendar. Allow yourself some slack. This could be one or two lunches or dinners in a week just in case something comes up. If batch cooking, even schedule days for leftovers for that extra flexibility.
References
BMJ. 2017 Advances in the diagnosis and management of neck pain. Available at: https://pubmed.ncbi.nlm.nih.gov/28807894/
Mayo Clin Proc. 2015. Epidemiology, diagnosis, and treatment of neck pain. Available at: https://pubmed.ncbi.nlm.nih.gov/25659245/
Open Orthop J. 2016. A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301418/
Phys Ther. 2018. A Mechanism-Based Approach to Physical Therapist Management of Pain. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256939/
Maintaining the body’s musculoskeletal system and keeping it strong can be done through chiropractic and by managing general overall health. This system includes the:
Bones
Muscles
Tendons
Ligaments
Soft tissues
These all work together to support the body’s weight and allow for movement.Injuries, disease, and aging can cause stiffness, pain, and other issues with mobility, function that can lead to various conditions and/or disease.
The musculoskeletal system
The skeleton provides the framework for the muscles and other soft tissues. Working together, they support the body’s weight, help to maintain proper posture and the ability for movement. Various disorders and conditions can lead to problems with the musculoskeletal system. This includes:
Focusing on overall health and maintaining it will keep the system in top form. This is done by:
Eating a healthy balanced diet
Maintaining a healthy weight
Regular physical activity/exercise
Chiropractic support will take the body to optimal health levels.
How does the system work?
The nervous system is the body’s central command center. It controls voluntary muscle movements. Voluntary muscles are controlled intentionally. Large muscle groups are utilized to do activities like lifting a large object. Smaller groups are used for movements, like pressing a button. Movement/motion occurs when:
The nervous system which includes the brain and nerves, transmits a signal to activate the skeletal/voluntary muscles.
The muscle fibers contract/tense in response to the signal.
When the muscle activates, it pulls on the tendon.
Tendons attach muscles to bones.
The tendon pulls the bone, generating movement.
For the muscle to relax, the nervous system sends another signal.
This signal triggers the muscle/s to relax/deactivate.
The relaxed muscle releases tension
The bone is moved to a resting position.
System Parts
The musculoskeletal system functions to help stand, sit, walk, run and move in general. The adult body has 206 bones and more than 600 muscles. These are connected by ligaments, tendons, and soft tissues. The parts of the system are:
Bones
Bones support the body, protect organs and tissues, store calcium, fat and produce blood cells.
A bone’s outside shell encapsulates a spongy center.
Bones provide structure and form to the body.
They work with the muscles, tendons, ligaments, and other connective tissues to help with movement.
Cartilage
This is a type of connective tissue.
Cartilage provides cushion to the bones inside the joints, along the spine, and ribcage.
It is firm and rubbery.
It protects bones from rubbing against each other.
It is also found in the nose, ears, pelvis, and lungs.
Joints
Bones come together and form joints.
Some have a large range of motion, for example, the ball-and-socket shoulder joint.
Others, like the knee, allow bones to move back and forth but do not rotate.
Muscles
Every muscle is made of thousands of fibers.
The muscles allow the body to move, sit upright, and remain still.
Some muscles help with running, dancing, and lifting.
Others are for writing, fastening something, talking, and swallowing.
Ligaments
Ligaments are made of tough collagen fibers
They connect the bones and provide stability to the joints.
Tendons
Tendons connect the muscles to the bones.
They are made of fibrous tissue and collagen
They are tough but not as stretchable.
Conditions and disorders
Various conditions can cause problems with the musculoskeletal system. They can affect the way an individual moves. The most common causes of inflammation, pain, and mobility issues are:
Aging
With the natural aging process, bones lose density.
Less-dense bones can lead to osteoporosis and bone fractures/broken bones.
As the body ages, muscles lose their mass, and cartilage starts to wear down.
This can lead to pain, stiffness, and decreased range of motion.
After an injury, an individual might not heal as quickly.
Arthritis
Pain, inflammation, and joint stiffness are the result of arthritis.
Older individuals are more likely to develop osteoarthritis. This is from the cartilage inside the joints breaking down. However, the condition can affect individuals of all ages.
Other types of arthritis also cause pain and inflammation. This includes:
Rheumatoid arthritis
Ankylosing spondylitis
Gout
Back problems
Back pain and muscle spasms can result from muscle strains or injuries, for example, a herniated disc.
Some conditions like spinal stenosis and scoliosis can cause structural problems in the back.
This can lead to pain and limited mobility.
Cancer
Different types of cancer affect the musculoskeletal system, for example, bone cancer.
Congenital abnormalities can affect the body’s structure, function, and appearance. For example, clubfoot is a common musculoskeletal condition that babies can be born with. It causes stiffness and reduces the range of motion.
Disease
A wide range of diseases can affect bones, muscles, and connective tissues functionality.
For example, osteonecrosiscauses the bones to deteriorate and the cells to die.
Other disorders, like fibrous dysplasia and brittle bone disease, cause the bones to fracture/break easily.
All types of injuries can affect bones, muscles, cartilage, and connective tissues.
Injuries can occur from repetitive overuse. Examples include:
Carpal tunnel syndrome, Bursitis, and Tendinitis
Sprains
Muscle tears
Broken bones
Injuries to the tendons, ligaments and other soft tissues can lead to chronic conditions.
Maintaining musculoskeletal health
Recommended ways of maintaining a healthy musculoskeletal system are to keep the bones and muscles healthy by getting:
Regular physical activity and exercise
This includes weight-bearing exercises combined with cardiovascular activities. Strengthening the muscles will support the joints and protect/prevent damage.
Proper sleep
This is so the bones and muscles can recover and rebuild.
Maintain a healthy weight
Added weight places pressure on the bones and joints.
This causes various health problems.
If there is added weight, it is recommended to consult a health coach and nutritionist about a personalized weight-loss plan.
They can help make healthy food choices that will make for strong bones and include anti-inflammation foods.
Quit tobacco use
Smoking decreases blood flow in the body.
The bones, muscles, and soft tissues need proper blood circulation to maintain health.
Regular chiropractic adjustments
Adjustments will help maintain the body’s balance and alignment.
This, along with recommended stretches and exercises, will take the body to optimal health.
Healthy Body Composition
Bodyweight Squat
This is one of the best strength exercises for building general functional low body strength. The muscle groups that get worked include the:
Quadriceps
Hamstrings
Glutes
Deep abdominals
Hip abductors
Hip rotators
Squats work almost every muscle in the legs. This also builds core strength to help with everyday movements like pushing, pulling, and lifting. There is no need to load added weight on the back to benefit from this exercise. Using the body’s weight is a perfect workout. This can be done with several variations once strength is built up. The objective is to focus on strict form for maximum effectiveness.
The feet should be shoulder-width apart.
Bend at the hips
Don’t let the knees go past the toes.
Lower the body until the thighs are parallel to the floor
References
American Chiropractic Association. Back Pain Facts and Statistics. Accessed 1/5/2021.
Centers for Disease Control and Prevention. Arthritis. Accessed 1/5/2021.
Centers for Disease Control and Prevention. Arthritis-Related Statistics. Accessed 1/5/2021.
Centers for Disease Control and Prevention. Work-Related Musculoskeletal Disorders & Ergonomics. Accessed 1/5/2021.
Merck Manuals. Effects of Aging on the Musculoskeletal System. Accessed 1/5/2021.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Healthy Muscles Matter. Accessed 1/5/2021.
APT is short for anterior pelvic tilt. APT is when the pelvis tilts more down than forward, which can cause strain on the surrounding muscles and the spine to hold the torso up. The body’s own anatomical structure causing the condition and/or part of a bad habit that an individual has grown accustomed to. This can be from injury/s, back, and/or hip pain causing an individual to take on awkward postures to compensate for the discomfort and try and avoid it. However, these unhealthy postures cause their own set of musculoskeletal problems. Addressing this form of poor posture can help reduce and alleviate low back and hip pain and prevent further injuries. Chiropractic can pinpoint an anterior pelvic tilt and fix it.
Anterior Pelvic Tilt
What happens is the pelvis becomes tilted or rotated forward. Place the hands, specifically the fingertips, on the hips. There are bone ridges. These are the iliac crests. If they’re facing more toward the ground than directly forward, this could be an anterior pelvic tilt. It usually happens when the hip flexors become tight and pull the pelvis down. Another contributor is the glute and hamstring muscles have weakened and are not strong enough to counteract the forward pulling. This can be caused by sitting for long periods, poor posture, and for women who wear high heels regularly. These contribute to tightening the hip flexors and the glutes, hamstrings, and core muscles.
An anterior pelvic tilt causes an increase in the curve of the lower back. It can feel like the hip flexors are tightening up. It typically affects the lower back at the lowest two levels, which are L4-5 and L5-S1. There can be long-term issues if an anterior pelvic tilt is left untreated. The spine becomes more vulnerable to disc issues that can include:
An anterior pelvic tilt is a repairable condition. Several exercises can help loosen/relax the hip flexors and strengthen the core and posterior muscle chain. This in addition to walking and reducing wearing high heels regularly. A few exercises for anterior pelvic tilt.
The Tail Tuck
This is literally trying to tilt the tailbone forward, like tucking in an imaginary tail. This can be done for 10-12 reps and up to 3 times.
Plank
Core-strengthening exercises can help with all types of back and hip problems. If possible, do the exercises in front of a mirror to ensure no arching of the back or the butt sticking out. If it is too difficult on the hands, go to the elbows. If there are wrist or shoulder issues, planks can be done on a raised surface, like a table or couch. Hold as long as possible, maintaining proper form. Start with 10-30 seconds and build up to minutes.
Strengthening the Glutes
It is recommended to strengthen the glute muscles. This can be done with exercises like clams or side-stepping with resistance bands. For clams, lie on the side and raise each leg up and down 10-12 times, up to 3 sets. For side-stepping, place resistance bands around the ankle/shin area and step to the side for 8-10 steps. Then go the other direction for the same number of steps. Repeat up to 3 sets.
Hip Flexor Stretch
Lunge forward while standing or lunge and kneel with the other leg on the ground. Then move the torso back a little and engage the core to stretch the hip flexors in the front of the thigh/pelvis area. Hold for 30 seconds, then release. Repeat 3-5 times per leg.
Lifestyle
These exercises can help, but if there is no progress around a month, contact a qualified chiropractor or physical therapist for further instruction and supervision. Also, if any neurological symptoms present like:
Sciatica
Shooting pain
Numbness
Tingling
Weakness
See a doctor as soon as possible.
Fixing posture-related problems require individuals to learn to be posture aware along with making some lifestyle adjustments. One way to do these exercises is to tack them onto a workout. Also, set reminders on a calendar to get up, stretch, and move around if sitting most of the day.
Body Composition Health
Difference between Processed sugar and Natural sugar
There are different types of sugar. There are natural sugars that are found in:
Fruits
Vegetables
Nuts
Whole grains
Beans
All sugar is broken down into glucose. However, foods that contain natural sugar are also rich in nutrients, including:
Vitamins
Minerals
Fiber
Protein
All which the body requires for optimal health.
Natural sugar does not lead to excess sugar intake; it happens with processed sugar. Processed sugar is extracted from sugarcane or sugar beet and is normally found as sucrose. This is present in cakes, cookies, cereal, and beverages. Processed sugar is also hidden in foods that are not sweet, like:
Microwave meals
Spaghetti sauce
Low-fat yogurt
Ketchup
Sports drinks
Foods that contain processed sugar are an energy source, but they contain little or no nutrients and can cause blood sugar levels to spike. In addition, consuming too much sugar is linked to an increased risk of:
Diabetes
Accelerated aging
Weight gain
Research has found that added sugar contributes to around 17% of the total calorie intake for adults. The recommended daily amount of calories from added sugar is 10%.
References
Azaïs-Braesco, Véronique et al. “A review of total & added sugar intakes and dietary sources in Europe.” Nutrition journal vol. 16,1 6. 21 Jan. 2017, doi:10.1186/s12937-016-0225-2
Centers for Disease Control and Prevention (CDC). (May 2020) “Acute Low Back Pain” https://www.cdc.gov/acute-pain/low-back-pain/index.html
National Institute of Neurological Disorders and Stroke. (March 2020) “Low Back Pain Fact Sheet” https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
Orlando Health. (2019) “Bad Posture Often to Blame for Chronic Pain and Health Issues, But Survey Finds Too Few Americans Are Concerned” https://www.orlandohealth.com/content-hub/bad-posture-often-to-blame-for-chronic-pain-and-health-issues
Re-energize from a lack of energy and fatigue with Bio-chiropractic. Millions of individuals struggle to get through the day or night depending on work/school schedules because of deficient energy levels that result in fatigue. Unfortunately, many begin taking over the counter or prescription medication, drinking coffee or highly caffeinated/energy beverages, or taking days off to catch up on rest. There is a wide range of high-sugar and caffeine energy products to help with fatigue. But, research has shown how overconsumption of these products can contribute and/or cause:
High blood pressure
Cardiovascular disease
Diabetes
When a tired body takes in caffeinated energy, it is only for a temporary energy boost.
Energy products can mask the fatigue causation. This could be a disease, a type of condition, or an overlapping of causes.
Nervous System
The nervous system is the body’s life energy source. It is responsible for facilitating millions of functions that occur throughout the body every day. These include:
Shifts the spine out of alignment, placing added pressure on the delicate nerves in the neck and back.
The compression causes nerve interference that disrupts optimal nerve energy flow from reaching the organs. This leads to:
Fatigue
Pain
Organ dysfunction
Eventually disease
Bio-Chiropractic
Bio-Chiropractic is a scientific and researched based form of musculoskeletal corrective care. It aims to unblock nerve interference through the proper realignment of the spine, returning it to its proper curvature. As a result, many individuals under chiropractic care report immediate relief from neck or back pain, along with a vibrant, energized feeling, and with time their overall health improves.
Body Composition Feedback
Malnutrition
Malnutrition can be defined as a deficiency, excess, or imbalance in an individual’s intake of energy and nutrients. Protein-energy deficiency is a common form of malnutrition. It is a health condition that can have immediate/negative effects on body composition. This deficiency causes damage to skeletal muscle mass as the body progresses into starvation mode, breaking down its own protein stored in the muscles for fuel.
Micronutrient deficiency is a lack of nutrients like minerals and vitamins. These support important functions like cell regeneration, the immune system, and eyesight. Common examples are iron and/or calcium deficiencies. Micronutrient deficiency has the greatest impact on the body’s physiological functions/processes. They can occur at the same time that protein-energy deficiency is happening overlapping each other. Nutritional deficiencies can impact processes like:
Building and repairing muscle
Protein-energy deficiency has a more pronounced effect on body composition, as lowered protein intake can lead to increased losses in muscle mass.
Berkson, D L. “Osteoarthritis, chiropractic, and nutrition: osteoarthritis considered as a natural part of a three-stage subluxation complex: its reversibility: its relevance and treatability by chiropractic and nutritional correlates.” Medical hypotheses vol. 36,4 (1991): 356-67. doi:10.1016/0306-9877(91)90010-v
Jensen, Gordon L et al. “Recognizing malnutrition in adults: definitions and characteristics, screening, assessment, and team approach.” JPEN. Journal of parenteral and enteral nutrition vol. 37,6 (2013): 802-7. doi:10.1177/0148607113492338
Oakley, Paul A et al. “Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics® (CBP®) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders.” Journal of physical therapy science vol. 32,9 (2020): 601-610. doi:10.1589/jpts.32.601
Living with sciatica can be debilitating and exhausting. Find out how different individuals reduced their pain from this condition. Sciatica has different treatment options. It is often a matter of trial and error to find a treatment/therapy that works for the individual. These include:
Different individuals with sciatica share what works for them. Here are their stories.
Rudy Found Relief With Self Care
A bad fall left Rudy, a graphic designer, with a broken pelvis and broken foot. I was in the hospital for a few days, and when I came home, I noticed I was hobbling. I had developed sciatica. I was in a lot of pain but decided to try the treatment that had helped me manage chronic migraines. This was yoga. Specifically, it was hot yoga sessions that, despite the pain, worked. However, for others, he recommends not staying still. The body can’t stay stagnant with no movement.
Rudy follows a plant-based diet. Eating right has helped significantly. He starts the day with a green smoothie and sips one throughout the day. This reduces inflammation and pain. His stress would also contribute to the pain. Anything felt from a pain perspective becomes amplified when in a sad, frustrated, confused mood. Rudy’s advice is to get the body moving. And follow a plant-based anti-inflammation diet.
Medication and a Topical Pain Balm Work For Jose
Jose, 66, figured how his sciatica developed was when he decided to insulate the garage. I was bending, twisting, turning, and contouring my body every which way. A week after the job, I developed excruciating pain that got worse over the following weeks. I would jolt out of bed at 2-3 in the morning with severe pain. My doctor gave me steroids that didn’t do anything. I could barely sit down and had to go through a careful method of getting into a chair. I was prescribed Vicodin – hydrocodone/acetaminophen. I took them for a week and a half.
The pain went away, but it came right back as soon as I stopped taking the meds. The meds were only masking the pain. I decided only to use it when the pain was excruciating. This was because I was worried about addiction. I tried chiropractic, massage, acupuncture, cupping, and physical therapy. Unfortunately, I was not feeling any real relief. Then I went to a pain management doctor, who ordered an X-ray and an MRI.
The doctor informed me that my spine was in great shape. The pain management doctor gave me a piriformis injection and, later, an epidural steroid injection. There were still no positive results. My primary care doctor prescribed gabapentin. This is an anti-epilepsy medication that has been shown to help some cases of back pain. Most of the major pain is gone, and I’m pretty sure it’s from the gabapentin along with weekly deep massage sessions. I also use CBD cream with arnica. Movement is important; during the day, I make sure to stand up and walk around.
Epidural Injections Work For Isabel
Isabel has chronic pain. This comes from arthritis, migraines, and fibromyalgia. Sciatica developed as a result of these conditions. Soon she couldn’t get into the car or even empty the dishwasher without going through excruciating pain. Nerve ablation or physical therapy was ineffective at relieving the pain. Then my doctor suggested getting an epidural injection. This is not the same type of injection as when having a baby. It is not the same at all. The injection includes a steroid medication called a corticosteroid that is an anti-inflammatory, along with an anesthetic. I tried it and got some relief, but the pain came back. However, after a month and a half, I began to feel more relief. The pain is not completely gone. I do feel better, but there is still some pain. My doctor told me that patients are all different and require different amounts of medication and time to work.
Surgery Gave Pablo His Life Back
Pablo, 50, is no stranger to back pain or back surgery. After living with chronic back pain from a roll-over auto accident, Pablo underwent a laminectomy. A doctor removed a portion of the vertebra in 1998 and spinal fusion in 2004 that fused the discs from L5 to S1. Life was going well until I was laid off from my desk job. I started working at a warehouse doing light work, but I would still help lift moderate/heavy bags, boxes, etc. I just pushed through the pain, thinking it was a strain that would go away.
However, during the last six months, the pain was so bad I had to stop working. I needed a cane to get out of a chair. Friends and family told me I was walking like a 90-year-old. I also lost feeling in a couple of my toes. In 2021 I had another fusion and had a broken screw from my earlier fusion repaired. The surgery went well, and they said as long as I don’t do any heavy lifting, I should be alright. Although there is still pain, it is much less than it was before the surgery. My doctor recommended a new desk job and a physical therapy rehabilitation, stretching, and strengthening program.
Body Composition
Calories burned from 10,000 steps
Estimations of how many calories are burned from exercises like walking or running depends on how heavy an individual is. Heavier people use more energy to move than lighter people. Estimates revolve around 100 calories burned per mile for a 180-pound person. 10,000 steps comes to around roughly 5 miles. Assuming an individual weighs 180 pounds means 100 calories x 5 miles equals 500 calories. Over a week, it becomes 3,500 calories. However, lighter or heavier individuals will burn less or more calories while walking the same number of steps or distance.
Individuals that go through severe low back pain caused by degeneration, herniated discs, vehicle, personal, work, and sports injuries, surgery, or spinal fusion is usually a last resort if non-invasive treatments fail to provide relief or not enough relief. Patients try to avoid spinal fusion because it can be an intense experience and requires a year-long recovery period. Unfortunately, individuals still experience discomfort and pain after surgery. Do individuals want to know what other treatment options are available, including chiropractic care?
Doctors will inform post-op patients of the risks involved with chiropractic therapy. However, chiropractic medicine can bring natural pain relief after surgery. Chiropractic treatment requires that an individual be adequately or fully healed before beginning a personalized treatment plan. At Injury Medical Chiropractic and Functional Medicine Clinic, we consult patients post-surgery about the effectiveness of rehabilitation spinal adjustments and physical therapy massage.
Wait Time After Surgery
Spinal fusion surgery involves removing the discs between two or more vertebrae and fusing the bones with metal screws and plates. The objective is to correct conditions like herniated discs and degenerative diseases by immobilizing the spine in that area. It can take at least three months for the vertebrae to fuse for a fully immobilized graft. Once the graft is complete, a few months of physical therapy are recommended to loosen/stretch and strengthen the muscles around the graft. Initial recovery combined with physical therapy typically takes a full year for a complete recovery.
It is during recovery where it can be difficult and for discomfort and pain to present. The reason is patients are recommended to avoid any twisting, bending, over-reaching motions, or the graft could break. This can make an individual take on awkward poses/postures, flexing and contracting muscles incorrectly, causing strain. The result is added discomfort and/or pain.
How Chiropractic Helps
Spinal fusion is not guaranteed to alleviate an individual’s back pain completely. But many do experience discomfort or pain post-surgery. This could be for a little while or longer, depending on their condition or injuries. Fortunately, chiropractic treatment can help bring pain relief through mobilization, manipulation, and massage techniques. Manipulations’ objective is to adjust and/or realign the bones of the spine and other areas of the body. Because of the intricacy of spinal manipulations, many who have undergone back or spinal fusion surgery are hesitant to seek chiropractic treatment. Discuss possible chiropractic care with your physician to determine if the surgical graft is strong enough to withstand spinal manipulations. If the graft is adequately/fully healed and your physician believes it can endure mild adjustments, reach out to a chiropractor to discuss a customized treatment plan.
Body Composition Testing
Poor Leg Skeletal Muscle Mass
The gluteal muscles or buttock muscles are the largest muscle group in the body. Individuals can start losing bone density by their 30s. This increases the risk of injury and further bone density loss. Bone density loss is a natural process, but the process can be accelerated for individuals with under-developed skeletal muscle mass. The health of muscles and bones are closely linked. Researchers found that individuals with less muscle mass than average for their height tended to have narrower and thinner bones. This resulted in limited lower bending strength.
Decreased muscle mass was shown to be linked to balance problems and increased risk of falls. There is a higher prevalence of sarcopenia or muscle wasting for patients with hip fractures and a reduction of leg muscle mass. The combination of:
Low muscle mass
Low bone density
Hip fractures
It can have lifelong consequences
References
Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” The 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 vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y
Keller, Glenda. “The effects of massage therapy after decompression and fusion surgery of the lumbar spine: a case study.” International journal of therapeutic massage & bodywork vol. 5,4 (2012): 3-8. doi:10.3822/ijtmb.v5i4.189
O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7
Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post-spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0
Szulc, Pawel et al. “Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study.” Journal of bone and mineral research: The American Society for Bone and Mineral Research vol. 20,5 (2005): 721-9. doi:10.1359/JBMR.041230
Many doctors/surgeons rely on the widely adopted lumbar spinal fusion. However, experts have asserted that lumbar total disc replacement or TDR should be made available and increased for treating degenerative disc disease and other spinal conditions. Individuals interested in total disc replacement, the ability to have it done, and if insurance will pay? What to know about TDR and fusion before deciding and moving forward.
Total Disc Replacement
Spinal fusion has been the traditional approach for relieving lower back pain. In this procedure, a bone graft is inserted between two or more vertebrae. This eliminates movement that causes pain or could be dangerous to the individual. Total disc replacement demands more on a technical level than spinal fusion. However, the worn-out, injured, or damaged disc is fully replaced, even a completely degenerated disc, with a metal and/or plastic one. Benefits from lumbar TDR surgery include:
Shown to be a safe procedure with minimal complications
Significant improvement in health and quality of life
High rates of successful outcomes
Mobility is preserved
Who Needs Disc Replacement?
Low back problems affect more than a third of the population. This can come from:
Personal
Work
Sports
Automobile injuries
Aging
All are risk factors
Fusion or Total disc replacement
Fusion reduces and eliminates motion around the affected area which also changes with the spine’s mechanics. It can also place increased stress on the surrounding segments. However, the lack of motion is to eliminate the pain. Total disc replacement does increase mobility, but it can’t fully relieve the pain. It can relieve pain generated from the disc but not from other causes. TDR has been shown to:
Provides motion preservation
Reduces staying at the hospital
Provides long-term durability
Lower reoperation rates compared to fusion
Total disc replacement issues:
The procedure is more time-consuming
A lot of time making decisions
A lot of time preparing
An example could be the patient has a narrow disc space. Looking at the X-rays of the discs above and below, the surgeon has to make sure they choose the right size. Next, the narrow space needs to be mobilized back to a normal height that cannot be too high or too short. Finally, the surgeon has to make sure that the disc is anchored and fits properly.
Why Surgeons Still Choose Fusion?
Despite the benefits, there are reasons why surgeons still choose fusion.
There are strict rules as to when TDR can be used. This means insurers are prone only to approve fusion procedures.
The surgical technique is challenging. TDR surgery is a highly demanding procedure. As a result, many doctors specializing in fusion for 20 years or more can be reluctant to perform the procedure.
Complications and revision surgeries. Reoperations are sometimes necessary, but this happens in both fusion and TDR.
Individual Needs
Fortunately, most individuals with lower back problems never need total disc replacement. And those that do have severe pain/conditions are recommended to try non-invasive/surgical treatment. This ranges from:
Chiropractic
Physical therapy
Massage
Imaging and lab tests will be required. However, if an operation is necessary, ask questions about both procedures. For example, if a surgeon insists that fusion is the only option, ask why total disc replacement is not an option?
Body Composition Testing
Protein and Weight Loss
Protein is one of three basic macronutrients found in food. Proteins are made up of smaller units called amino acids. There are 22 amino acids, with 9 of these being essential. This means the body needs them, as the body cannot produce them. These essential amino acids can be obtained by eating protein-rich foods like:
Eggs
Meat
Fish
Vegetarian/vegan options include:
Nuts
Seeds
Beans
Tofu
Generally, all the essential amino acids cannot be obtained from just one food. Therefore it is recommended to eat a variety of animal and plant-based proteins. Protein is in almost every structure and function of the body.
Antibodies
These proteins fight off any infections, bacteria, etc.
Repair, maintenance, and structural
Proteins are the building blocks of the body’s muscles, bones, skin, and hair.
Hormones
Chemical messenger proteins are how cells and organs communicate. For example, Growth Hormone affects muscle gain and fat loss.
Enzymes
Not all proteins are enzymes; however, all enzymes are proteins. These proteins are catalysts or starters for chemical reactions in the body.
Transportation and storage
Some proteins carry molecules where they are needed. For example, hemoglobin or the red blood cells carry oxygen to cells, then transport carbon dioxide away.
Not getting enough protein in one’s diet can have serious consequences on the body’s health. Without enough protein, the muscles can begin to atrophy or waste away, taking Lean Body Mass, strength, and energy away as well.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or 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 injuries or disorders of the musculoskeletal system. 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. In addition, 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.
Salzmann, Stephan N et al. “Lumbar disc replacement surgery-successes and obstacles to widespread adoption.” Current reviews in musculoskeletal medicine vol. 10,2 (2017): 153-159. doi:10.1007/s12178-017-9397-4
Hopkins overview of Lumbar TDR (for consumers) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement
“Comparison of Lumbar Total Disc Replacement With Surgical Spinal Fusion for the Treatment of Single-Level Degenerative Disc Disease: A Meta-Analysis of 5-Year Outcomes From Randomized Controlled Trials”, Zigler J, et al., Global Spine Journal, June 2018, PMC602295 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022955/
“Overview of Lumbar TDR” (for consumers); Johns Hopkins Medical Center https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement
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