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.
The Gluteus Maximus Muscle is the largest and the outermost of the gluteal muscles. It stretches from the sacrum and coccyx, parts of the spinal column, down to the femur. The other gluteal muscles include the gluteus minimus and medius. They each have a role in the normal function of the hips and legs. They are prone to tightness resulting in soreness, aches, and pain around the hips and in and around the buttocks.
The Gluteal/Rear End Muscles
There are three rear-end muscles:
The Gluteus Maximus extends the hip and rotates the thigh outwards, straightens the legs when moving, and provides strength.
Gluteus Minimus
Gluteus Medius
The minimus and medius are underneath the Maximus and stabilize the hip when:
Walking
Jumping
Other physical activities
There is another group of diagonal muscles under the gluteus minimus that attaches to the femur. The uppermost is the piriformis that is attached to the sacrum. The sciatic nerve and major arteries run below it.
Tightness and Irritation
The primary function of the muscles is to open the hips and push the legs out. Sitting for long periods shortens the gluteal muscles causing them to become tight, limiting normal hip function. The gluteal muscles are susceptible to tightness brought on from overuse and lack of development/strength. This can develop into tender/tight muscle bands that interfere with the normal function of the muscles. To get an example of what is happening imagine flexing and contracting one of the bicep muscles 6-10 hours a day. It would be extremely sore, tight, and tender.
Sports and Physically Active
Athletes and individuals that are physically active can also have tight gluteal muscles. This can cause post-game/exercise muscle soreness. Intense activities force the gluteal muscles to work overtime to support the back and knees. Sports that require a lot of leg muscle activation include:
Running
Soccer
Football
Crossfit
Dancing
Weight training
Awkward Walking Gait
Individuals that move with an unusual gait are vulnerable to straining the muscles. What happens is the muscles become stiff from the awkward positions/postures. This places additional strain on the back and hip muscles and worsens their overall posture. The hip muscles are also attached to the pelvis, and when the muscles begin to tighten they can pull on the gluteal muscles. Irritation of the sacroiliac joint can also place pressure on the piriformis, causing spasms that affect the gluteal muscles. Piriformis muscle spasms can also place pressure on the sciatic nerve, causing sciatica.
Diagnosis and Treatment
An examination will be necessary to diagnose whether the soreness or pain is due to muscle inflammation or other cause. Sciatica symptoms and problems at the hip level that involves the gluteus minimus and medius can be felt in the leg. The examination includes seeing and feeling muscle reactions, responses, contractions through a series of motion exercises and movements that involve different muscles. Common treatment includes:
Range of motion exercises
Strengthening exercises like bridging and resistance bands
Deep tissue massages
Heat and cold packs
Physical therapy
Electric muscle stimulation
Tightness in the glutes can be managed with chiropractic treatment. This includes:
Soft tissue work
Spinal joint manipulation
Lifestyle adjustments
Stretching
Diet
Health coaching
Simple exercises can help engage and strengthen the muscles. These include:
Individuals that sit for long periods of time, don’t get enough physical activity, and have an unhealthy diet can experience insulin resistance. This happens when insulin is not able to transport excess blood sugar out of the blood and into the muscles. A study found that women who sat for eight hours a day had an increased chance of developing diabetes. Diabetics can be inclined to have more fat within the body, specifically visceral fat. This further encourages insulin resistance. Diabetics also experience rapid loss of muscle mass as they age, intensifying symptoms and further affecting body composition.
References
Cochrane, Darryl J et al. “Does short-term gluteal activation enhance muscle performance?.” Research in sports medicine (Print) vol. 25,2 (2017): 156-165. doi:10.1080/15438627.2017.1282358
Coratella, Giuseppe et al. “The Activation of Gluteal, Thigh, and Lower Back Muscles in Different Squat Variations Performed by Competitive Bodybuilders: Implications for Resistance Training.” International journal of environmental research and public health vol. 18,2 772. 18 Jan. 2021, doi:10.3390/ijerph18020772
Distefano, Lindsay J et al. “Gluteal muscle activation during common therapeutic exercises.” The Journal of orthopedic and sports physical therapy vol. 39,7 (2009): 532-40. doi:10.2519/jospt.2009.2796
Kalyani, Rita Rastogi et al. “Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases.” The lancet. Diabetes & endocrinology vol. 2,10 (2014): 819-29. doi:10.1016/S2213-8587(14)70034-8
Selkowitz, David M et al. “Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes.” The Journal of orthopedic and sports physical therapy vol. 43,2 (2013): 54-64. doi:10.2519/jospt.2013.4116
Recent studies have begun to show that back pain apps can enhance the body’s recovery when combined with conservative treatments and physical activity/exercise. Low back pain – LBP can interfere with everyday activities, work, school, and sleep making life miserable. All around the world low back pain is one of the leading causes of disability. Studies have shown how physical activity/exercise, mindfulness, and spinal manipulation can reduce symptoms more effectively. Exercise has been shown to reduce anxiety and increase positive outlook/mood. However, the biggest problem for individuals is finding activities/exercises that they can enjoy and sticking with them. Individuals that use back pain apps have reported the benefits of being guided through the exercises and meditation that help decrease their pain.
Back Pain Apps
Several back pain apps utilize the brain and body connection. They provide exercises for the body and meditation to help the mind relax and work out and through the pain. The brain is the computer, the software is the mind and the hardware is the body. The brain is linked to the nervous system. Apps that help with psychosocial and behavioral issues have shown the ability to reverse the negative thinking of individuals with chronic pain. For individuals that don’t like exercising, there are apps to help address various barriers and obstacles.
They’re ready when and where you are
They track progress
They match guidance messages based on responses
They provide positive reinforcement
Before starting, if the answer is yes to any of the following questions consult with a physician first:
Is leg pain presenting?
Is there constant pain at night?
Is there a history of a recent accident or injury?
Effectiveness of Apps
A 12-week controlled trial in 2019, of individuals with low back pain, found that those who used an app did statistically better, in reducing their pain compared to the control group. The trial consisted of:
Those in the treatment group that completed the program found their pain level (based on a 100-point scale) had reduced 62% from a level of 44 to 14. Compared to an 8% reduction in the control group. However, scientific evidence on specific apps is limited and requires further research. However, the apps that scientists studied include:
A review of 25 apps for low back pain found the higher the price, the higher the app scored in the scientific study. The apps with the top scores included:
Strengthening exercises
Stretching
Core stability exercises
They were:
Interesting
Entertaining
Interactive
Customizable
The Lower Back Pain App, developed by a physiotherapist, scored the highest. It is a 10-week program where users are directed each week to perform three exercises twice daily. The exercises focus on:
Spinal mobility
Stability
Muscle strengthening
Instructions are given through videos and writing.
Back Pain Specific Apps
A variety of back pain-specific applications are available. Try them out and see which fits your style. They are there to guide, strengthen the body, help relax, and lessen the pain.
Body Composition
Chronic Stress
Chronic stress is like poison to the body. It negatively impacts every aspect of the body’s health and is more dangerous because of its ability to present without realizing it. One of the body’s systems responsible for handling difficult situations is the immune system. Specifically, cells of the immune systems have receptors that recognize stress hormones like cortisol. Acute stress can cause immune system problems by increasing the release of inflammatory cytokines that are a special type of immune cell. Stress, immunity, and disease can affect each other. But these relationships can be moderated by:
What is important is to develop a healthy strategy to relieve the symptoms of stress like meditating, exercising, and spending time with friends/family.
References
Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679058/
Current Directions in Stress and Human Immune Function. Current opinion in psychology vol. 5 (2015): 13-17. doi:10.1016/j.copsyc.2015.03.007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/
The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain https://pubmed.ncbi.nlm.nih.gov/27586832/#affiliation-1
Assessment of the Quality of Mobile Applications (Apps) for Management of Low Back Pain Using the Mobile App Rating Scale (MARS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763508/#B12-ijerph-17-09209
Surgical versus nonsurgical treatment of chronic low back pain: A meta-analysis based on current evidence https://pubmed.ncbi.nlm.nih.gov/26406211/
Randomized controlled trial of a 12-week digital care program in improving low back pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550254/#CR8
Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review https://mhealth.jmir.org/2019/2/e13080/
App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education: a randomized controlled trial https://www.nature.com/articles/s41746-019-0109-x
After a chiropractic adjustment, the body can feel weird or out of sorts. This is completely normal and can be attributed to toxin release. This release flushes out the toxic particles in the body. The adjustments get the blood and nerve energy circulating properly. As the toxins travel through and out of the bloodstream, they can make the individual body feel strange, even a little sick. This could lead to side effects that last around 1-2 days.
Toxin Release
It is a normal sign and starts during or slightly after the adjustment. This often occurs with subluxation treatment. Subluxations can block/interfere with proper blood flow around the spine. This leads to pain and inflammation. As the chiropractor treats and releases, the subluxations, proper blood flow is restored. This can overwhelm the body, which can lead to release symptoms.
Duration Side Effects
The unwellness goes away within a few hours or days, depending on the individual and their condition. However, if the symptoms do not go away after a week, contact the chiropractor to let them know what is happening. Going through a few episodes of release is expected, especially during the first chiropractic sessions. It also depends on where the individual is healthwise. Usually, the first session is the most intense. As all the toxins are being removed from around the:
Spine
Joints
Muscles
Symptoms
Symptoms vary, but the most common include:
Cold or flu-like symptoms
Fever
Sweating
Night sweats
Fatigue
Headaches
Dizziness
Nausea
Diarrhea
Muscle tension
The intensity of these symptoms depends on the number of toxins being released. The symptoms improve but don’t hesitate to contact the chiropractic clinic with any questions or concerns.
Benefits
Individuals that have to go through release symptoms for a few days will find that their body feels cleaner and highly energetic. Brain functions increase because of optimal communication through circulation. Individuals with anxiety find that their body feels more relaxed. This is because the toxins that were irritating the nervous system have been flushed out.
Treating Toxin Release
There are a few ways to calm the body if symptoms present.
Drink Water
Water will expel the toxins out of the body quicker. It will flush through the bloodstream and then through the bladder where they are discarded. This will help the body recover faster. Eight glasses a day is the recommendation. This will keep the body hydrated and enhance the toxin release. Add some lemon juice to maintain mineral levels during the recovery. Lemon juice contains:
Electrolytes can help reduce toxin release pain and help prevent symptoms.
Calcium
Magnesium
Potassium
This will maintain muscle health and function.
Added Rest
Make sure to rest the body after a chiropractic adjustment. It is not recommended to not try to fight through the symptoms. This could be dangerous as the body is in recovery mode. If overwhelmed the symptoms could worsen. This does not mean staying in bed and sleeping, just not overexerting the body. Engage in calm relaxing activities.
Fruits and Vegetables
These will nourish the recovering body with vitamins and minerals. They also aid in reducing pain and increases energy. Plus fruits and vegetables are filled with antioxidants that can keep the muscles and bones strong. These include:
Cranberries
Raspberries
Cherries
Tomatoes
Spinach
Kale
It is recommended to get at least one serving of fruits and vegetables per meal. Avoid processed or sugary foods, as they can cause inflammatory responses to present. This could make the toxin release symptoms worse.
Yoga Poses
The body will more than likely feel sore and weak from the adjustments and the toxin release. Yoga can alleviate the symptoms. Poses can seem difficult because of the side effects, but the movement and stretching will make the body feel better. Here are a few that many chiropractors recommend.
Detoxification diets are tools that are used by medical professionals and are not intended for quick or healthy weight loss. Naturopathic Practitioners have been shown to use a wide range of detox methods and products that include:
Vitamins
Minerals
Diet
Lifestyle adjustments
Health coaching
Physiological changes during detox diets
Metabolism is the rate at which the body burns energy. This rate can change from different factors that include a temporary increase when excessive calories are taken in. There is no difference in weight loss from diets that focus on reduced-fat vs. reduced carbohydrates. Individuals should consult with their physician before starting any body detox cleanse, especially if there are underlying medical conditions like diabetes or kidney disease. If struggling with obesity, then a physician can provide recommendations on a traditional diet, exercise, and other medically approved approaches.
References
Gardner, Christopher D et al. “Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial.” JAMA vol. 319,7 (2018): 667-679. doi:10.1001/jama.2018.0245
Seaman, David R. “Toxins, Toxicity, and Endotoxemia: A Historical and Clinical Perspective for Chiropractors.” Journal of chiropractic humanities vol. 23,1 68-76. 3 Sep. 2016, doi:10.1016/j.echu.2016.07.003
Valdivieso, Paola, et al. “Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?.” Frontiers in medicine vol. 5 77. 20 Mar. 2018, doi:10.3389/fmed.2018.00077
Pregnancy can take a toll on a woman’s body. New aches and pains start to present as the pregnancy progresses. Hormonal changes can affect the state of mind, making trying to relax or relieve stress extremely difficult to impossible, causing more frustration and tensed muscles. It’s absolutely safe and beneficial to get a professional therapeutic massage while pregnant. Most pregnant women are cleared to get massages after their first trimester. However, if it is a high-risk pregnancy, talk to your doctor before scheduling a massage.
Benefits of Therapeutic Massage
A therapeutic massage while pregnant, known as prenatal massage, generates a peaceful and serene mindset. Studies show prenatal massage is beneficial for the mother and baby. Pregnant women that are unable to find discomfort/pain relief benefit from prenatal massage. Benefits include:
Swelling is reduced
Improved hormone regulation helps reduce instances of low birth weight
Joint, back, and nerve pain/sciatica is reduced, and function improved
Headaches lessen in severity and frequency
Blood and nerve circulation improves
Sleep cycles improve
Anxiety, depression, and stress improves
Types of Massage
Safe massages when pregnant. The most common prenatal massage is a Swedish Massage. This type of massage is gentle but forceful enough to provide the aforementioned benefits. Swedish Massage focuses on the topmost layer of muscle with long strokes that incorporate movement of the joints. Avoid deep-tissue massage when pregnant, as this is a more aggressive style of massage.
Back Massage
During pregnancy, posture changes from the added weight. The center of gravity shifts making the spine and back muscles work harder. This regularly makes the muscles achy, sore, and stiff. Prenatal back massage is done while sitting or lying on the side. Long strokes are performed on the muscles, along with gentle kneading. The focus is on the muscles along the spine and the low back. This type of massage is highly beneficial if sciatica is presenting.
Neck Massage
Massaging the neck loosens tight muscles, improves awkward neck posture, alleviates nerve pain preventing tension headaches, and promotes flexibility. Most therapists will start with the neck and arms while the individual sits up, then lie down to work on the rest of the body.
Chiropractic Massage
This type of massage is performed by a licensed chiropractor and/or a physical massage therapist at the direction of a chiropractor. Chiropractic massage therapists have undergone thorough training and always take care to avoid any pressure points or areas that could cause discomfort.
Areas that Are Avoided During Massage
Professional massage therapists know what areas to avoid during the therapeutic massage, but it’s also important for the patient. The areas that will be avoided include:
The pressure points in the wrist and around the ankles. These areas have points that could cause uterine contractions and cervical ripening.
Around the belly. However, it is recommended to perform gentle, low-pressure massaging at home.
Around open wounds, rashes, or skin conditions.
Safety Tips
Other precautions to take when receiving a massage during pregnancy. The massage therapist should look out for blood clot symptoms or varicose veins. Other precautions to follow:
Make sure the massage therapist knows you are pregnant before beginning.
If the massage triggers nausea, discomfort, or is not enjoyable, ask to stop.
Avoid massage tables that have a hole cut out for the belly.
The recommended method is on the side, supported with proper padding to ensure stability and comfort.
The massage should be no more than an hour.
A massage in the first trimester is not recommended.
A trained massage therapist should perform a prenatal therapeutic massage. However, a partner can perform an easy, safe massage at home following a few guidelines.
Avoid the ankles and the areas around the wrists.
Avoid the belly and the area around it.
Back, neck, scalp, and foot rubs are recommended.
Utilize long gentle strokes with all-natural and safe massage oils or lotions.
Talk to your physician if you have an increased risk for blood clots.
Get a Massage
A prenatal therapeutic massage can improve hormone regulation, help sleep, reduce stress and anxiety, and promote a healthy and optimal delivery.
Body Composition
Diastasis Recti Post-Baby Weight
Pregnancy can cause abdominal muscle separation or diastasis recti.
This happens when the outermost abdominal muscles/rectus abdominis, which are the muscles from the breastbone to the pubic bone pull apart from the fibrous attachment point/linea alba. Muscle separation is common after pregnancy, but the degree and location of the separation are what vary from one woman to another. As the pregnancy progresses, the uterus makes room for the growing baby. This can cause the abdominal – recti muscles to stretch and become flabby. This muscle separation is not linked with complications for the mother or the baby and it is not a sign of muscle loss.
References
Hall, Helen et al. “The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis.” Medicine vol. 95,38 (2016): e4723. doi:10.1097/MD.0000000000004723
“Perineal Massage in Pregnancy.” Journal of midwifery & women’s health vol. 61,1 (2016): 143-4. doi:10.1111/jmwh.12427
Schreiner, Lucas et al. “Systematic review of pelvic floor interventions during pregnancy.” International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics vol. 143,1 (2018): 10-18. doi:10.1002/ijgo.12513
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
Rain generally comes with a drop in barometric pressure. A low-pressure system you may have heard from the local weather forecast. Lower pressure outside can cause tissues inside the body to swell and irritate sensitive nerves. For those who have sciatic nerve pain, rainy, hot, humid weather can cause the nerve tissues to expand causing increased compression, inflammation, and pain.
Rainy Weather
For anyone who is prone to inflammation, there are ways to cope with rainy weather-related symptoms, including:
Stay inside air-conditioned areas where the humidity level is lower.
Use a dehumidifier to keep the indoor air at 40-60% relative humidity for comfort.
Utilize vent fans in the kitchen and in laundry areas and after baths/showers in bathrooms.
Easy Physical Activity
Easing the pain can also be done through:
At work, school, home adjust the seat to work for you. Individuals with sciatic nerve pain already know how to make adjustments to chairs and other places for sitting.
If you’re heading out to a baseball or soccer game, you may want to use a comfortable sideline seat that provides cushion and support. If attending a pro game, check online or call to see if you can bring a therapeutic seat cushion.
Going on a trip whether road or flight, seats might not be comfortable or supportive. Tips that can help maintain comfort to mitigate the pain, include:
Adjust the seat for proper posture to maintain spinal curvature
Use lumbar support
Maintaining a workout routine is key leading up to your trip. If the body is inactive for a period of time, the back muscles are more likely to spasm when having to sit in tight quarters.
Don’t overpack. Carrying around heavy luggage increases the risk of straining the muscles.
Pack pain medication or anti-inflammatories on hand in case of a flare-up.
Inflammation
Target inflammation with ice therapy
Using topical heat or a heating pad can get the blood circulation flowing through the area
Wear compression garments over the affected areas to bring down swelling and promote blood and nerve circulation.
Chiropractic Rainy Day Relief
Chiropractors know the whole musculoskeletal system. Chiropractic massage therapy induces deep muscles relaxation and the release of endorphins/natural painkillers. A regular spa massage can release sore muscles and tension, chiropractic massage focuses on soothing and healing sciatica. Adjustments or spinal manipulations allow the disc/s rest back into position and relieve the pressure on the sciatic nerve. This will lessen the pain and generate nerve signal flow and mobility.
Spinal decompression relieves the compression of the nerves that are causing sciatica pain. This includes techniques to lengthen the spine and enhance the space between the vertebrae.
A chiropractor will recommend exercises to prevent nerve aggravation and help release the pressure that comes from the inflamed and tight muscles.
Exercises include stretching programs that can be done at home to release pressure on the nerve and ease irritations.
Body Composition
About Fat
Fat, also known as adipose tissue, contributes to overall body weight. This is also the type that individuals want to get rid of when talking about weight loss. Two different kinds of fat:
Subcutaneous fat is the fat that is beneath the skin.
Visceral fat lies deep in the abdominal cavity and surrounds the organs.
Having a certain amount of fat tissue is necessary for a healthy body.
The body stores unused energy from food as fat. This is to provide a reliable source of fuel when the body needs it.
Fat tissue acts as insulation to keep the body warm and as a cushion to protect the vital organs.
The problem/issue is excess body fat. This is what leads to higher body weight and altered hormone release that can make the excess weight condition worse.
References
National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.
Zwart, J A et al. “Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers.” Acta neurologica Scandinavica vol. 97,1 (1998): 41-5. doi:10.1111/j.1600-0404.1998.tb00607.x
Zwart, John-Anker, and Trond Sand. “Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica.” 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. 11,5 (2002): 441-6. doi:10.1007/s005860100333
Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:
In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining
These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.
Spinal Infection Types
They are classified according to the type of tissue they infect. The most common include:
Vertebral Osteomyelitis
This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:
Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site
Treatment includes:
Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.
Discitis
This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.
Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:
Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving
Treatment options include:
Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility
Epidural Abscess
This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:
Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems
Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.
Risk Factors
Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:
Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery
Risk factors include:
Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.
Surgical risk factors:
Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area
Diagnosis
Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:
Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI
Outcome
These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.
Body Composition
Practice Mindfulness
Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.
Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.
References
American Association of Neurological Surgeons. Spinal Infections. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.
Stat Pearls. (2021). Diskitis. https://www.ncbi.nlm.nih.gov/books/NBK541047/
Stat Pearls. (2021). Spinal Epidural Abscess. https://www.ncbi.nlm.nih.gov/books/NBK441890/
Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. https://www.frontiersin.org/articles/10.3389/fmed.2014.00007/full
Microorganisms. (2020). Spinal Infections: An Update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/
The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” https://www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext
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
