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.
Accident/Collisions are seeing a rise and along with those crashes are spinal injuries. What you need to know about:
Accident-related injuries
Treatment
Recovery
Legal issues
We take a risk, however small, every time we get in the car/truck, of being involved in a car wreck that results in injuries and specifically a spinal injury/s. The National Spinal Cord Injury Statistical Center has seen that motor vehicle accidents/collisions with the majority being car/truck accidents. �
�
However, with all the construction taking place nowadays, excavators, bulldozers, steamrollers, forklifts, and other vehicles are also seeing a rise in accidents. This is also generating a rise in spinal cord injury/s. Auto accidents are now ranked as the number one cause of spinal injury. The risk of an accident is small and the risk of a resulting serious spine injury is smaller still, it�s not anything. What you need to know about a motor vehicle accident/collision includes:
Injuries
Treatment
Recovery
Insurance
Legal issues
Common Motor Vehicle Accidents/Collisions
�
Whiplash
Whiplash is one of the most typical injuries following an accident, especially when rear-ended or a rear-end collision. Its a neck injury that happens when the neck snaps suddenly back and forth causing trauma to the tissues in the neck. Symptoms often develop a few days after the accident including:
Limited neck movement
Stiffness and pain in the neck
Pain or tenderness in the upper back, shoulders, and arms
Numbness or tingling in the arms
Dizzyness
Headaches starting at the base of the skull
Problems with concentration or memory
Ringing in the ears
Sleep issues
Depression
Herniated Disc
�
The discs in the spine cushion the vertebrae by absorbing the weight, force, and overall impact of a regular day. They are made of a soft, gel-like substance in the center that behaves like the gel in foot orthotics, shoes, mattresses, etc made to feel soft and comfortable. It has a tough outer membrane.
A herniated disc happens when that soft gel springs a leak/s out from a tear, meaning the shock-absorbing cushion has been compromised and is not delivering the absorption it’s supposed to and places added pressure on the surrounding nerve/s and roots. Herniations can happen naturally from age and from jobs that involve consistent and constant repetitive:
Pushing
Pulling
Bending
Twisting
Herniations also happen after going through some type of physical trauma like a motor vehicle accident/collision. Symptoms depend on where the herniation occurs and include:
Muscle weakness around the affected nerve/s
Sharp shooting pain that can spread out from the shoulders to the arms, legs and low back
Tingling in arms or legs
Numbness
There could also be no symptoms and no discovery of a herniated disc until tested for something else.
�
Vertebral Fractures
�
The vertebrae are highly susceptible to fractures of all types and can appear at any spot along the spine. For many, the injuries are mild and heal with non-surgical treatment and time. Major trauma to the spine can cause severe injuries/conditions which include:
Burst fractures
�
This is where the vertebra fractures in multiple places into bony fragments that fall into the spinal cord getting lodged inside with the jagged edges of the bones creating tears, cuts, etc that can result in paralysis and even death.
Flexion fracture
�
This is an injury seen in head-on collisions where the upper part of the body gets thrown forward and the bottom part stays in place likely from the seatbelt. This tears the vertebra apart resulting in a flexion teardrop fracture.
Vertebral compression
�
These types cause the front of the vertebra to collapse while the back keeps its position that forms a wedge-like shape. However, more often it is associated with osteoporosis, healthy individuals can experience a vertebral compression fracture from a serious traumatic event like an auto accident. Fractures can cause mild to severe pain that is exacerbated with movement. If the spinal cord is injured the individual could experience:
Tingling
Numbness
Weakness in the limbs
Loss of bladder/bowel function
Because of the increased safety features in today’s vehicles, fractures of the spine are rare except for severe motor vehicle accidents/collisions.
�
Diagnosis and treatment
A doctor will review medical history along with the accident information. Imaging tests will follow like:
X-ray
CT or computed tomography scan
MRI or magnetic resonance imaging
�
The way these techniques of imaging are done depends on the accident and the state of the spine. Being brought into the hospital from a motor vehicle accident/collision with a suspected spinal injury means the imaging will be done first to rule out or not potentially life-threatening injury/s to the spine. Treatment for spinal injuries can range from:
Soft collar
Chiropractic
Over-the-counter anti-inflammatory medications
Corticosteroid injection/s
Nerve blocks
Physical therapy
Surgery to correct certain injuries when all other forms of treatment are not working
�
Recovery
Every case, accident, and injury is different�and depends on several factors, like age, health, and how severe the accident/collision was. Severe and extreme injures like a burst fracture can take a long time to heal. �
�
Legal Issues
Individuals with a spinal injury can face thousands in medical bills. If there is medical equipment involved along with therapeutic services for long-term care, like physical therapy then bills will accumulate.
Also, a personal injury claim could be necessary to pay for everything, especially, if the accident/collision is no fault of your own. Compensation could help with:
Loss of employment
Employment benefits
Wages lost
Ability to work/earn income
Medical expenses
Pain
Suffering
Consult with a specialist when considering filing a personal injury claim
�
Work Compensation
If a spinal injury accident happens at work there could be worker’s compensation. Workers� compensation is insurance that replaces wages and medical benefits to workers that have been injured while doing their job. These are injuries that happened during the operation of a motor vehicle, like a truck, or forklift. The worker must file an injury report immediately so there is documentation supporting the injury claim. Waiting to file can make the employer question if there even was an injury. A workers� compensation claim works differently than a personal injury claim, based primarily on what is covered under the job’s insurance policies.
An example is the legal term pain and suffering. This is not covered by workers� compensation. However, a work training accident would be covered by work comp in the event that the individual cannot return to their job/occupation after the injury. However, any injury/s after a motor vehicle accident/collision should never be taken lightly or ignored. Individuals must be proactive in their treatment after an accident/collision. This is to prevent and avoid further injury.
�
Auto Accident Doctors & Chiropractor Treatments
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*
Part 2 delayed braking reaction time caused by sciatica, we continue with the spinal cord, nerves, and how they communicate with the brain. A herniated disc can cause sciatica, which is a compressing of the nerve/s in and around the spinal cord. This compression causes a pinching of the nerve/s like bending a water hose cuts off the flow and damages the hose, is what happens to the spinal nerve/s cutting proper blood flow, and proper synapse/signal flow.
This occurs from the damage to the nerve/s and could delay braking signals for a split second. But that is all that is needed for an auto accident to happen. A delay in braking time has been found in individuals with herniated/bulging/ruptured/slipped discs. Fortunately, through chiropractic and physical therapy, the nerves can be re-stimulated and brought back to optimal function.
�
�
Communication
The spinal cord is about one inch across at its widest and around eighteen inches long. The spinal cord is a type of tube that is filled with nerves and cerebrospinal fluid. This protects and nourishes the cord. Spinal cord added protection includes:
There are three types of membranes surrounding the spinal cord referred to as meninges. The outer membrane is known as the dura mater, the middle membrane is the arachnoid mater and the innermost membrane is the pia mater. �
� These membranes can become inflamed and damaged by disease or trauma. Arachnoiditis is caused by inflammation of the arachnoid lining that results in intense stinging and burning pain. This can happen post-surgery and can cause the scarring of nerve/s.
The nerves exit the spinal column and branch out to the rest of the body. All parts of the body are controlled by specific spinal nerves. The nerves are placed in and around the area they control. Like the nerves in the neck area branch out into the arms. This is why a neck ache/pain issue can lead to pain spreading into the arms and hands.
Thoracic spine controls the middle of the body,
The lumbar spine extends into the outer legs controlling that area
Sacral nerves control the middle of the legs and organ functions of the pelvis
�
The brain
Two major types of nerves: sensory and motor. Sensory nerves send information like:
Touch
Temperature
Pain
These get sent to the brain via the spinal cord. Motor nerves relay signals from the brain back to the muscles making them contract voluntarily or reflexively. Peripheral nervous system – the PNS has nerves that extend down the spinal canal and branch out at openings in the vertebrae called foramina. �
�
�
Signals/messages get sent to and from the brain aka the central nervous system. It sends all types of signals including pain and initiates movement. For example, the nerves reflexively make the spine twist and turn when driving to keep balance when turning and braking. The peripheral nervous system is a collection of millions of nerves throughout the torso and limbs. This system conveys messages to the central nervous system.
�
Referred pain
When a health problem/issue/condition takes place in one part of the body with pain being felt in another or several areas, pain specialists call it referred pain.
�
Nerves
Nerves exiting the spinal cord is done in pairs with one being a sensory nerve, and the other a motor nerve. Motor nerves initiate movement and bodily function. Damage to a motor nerve could cause a weakness in a muscle or loss of function. For example, a prick in the foot that is not felt could mean there is some sensational loss, indicating a problem with the sensory nerves and or possible nerve damage. These are the nerves that control pain, temperature, etc. Sensory nerve issues can feel like shooting electrical pain Continuing with activities could exacerbate the nerve damage.
�
Cauda Equina
� The spinal cord ends at the lumbar low back, where the nerves extend in a bundle of strands called cauda equina, called this because it looks like a horsetail. These nerves provide motor and sensory function to the:
Legs
Intestines
Genitals
Bladder
Therefore, based on this knowledge there is adequate information displaying how sciatica could cause a delayed braking reaction time based on the nerves’ dysfunctional signal firing. Chiropractic treatment could be an option to help an individual realign their spine, work out tight muscles, nerves, ligaments preventing any further damage, and getting the individual back in top form.
�
Chiropractors & Sciatica Syndrome Expose
NCBI Resources
�
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*
Research has found that individuals with disc herniation/s can have a delayed braking time when driving. After undergoing surgery these individuals showed significant improvement in braking time.
Based on this information Dr. Jimenez looks at how individuals with functional sciatica, (often caused by a herniated disc) meaning they can move and operate a vehicle to a certain point without generating pain, however they often put themselves in extreme/awkward positions just to operate, could also have a delay in brake reaction time. �
�
Sciatic Nerve
The sciatic nerve is a large nerve that travels from the lower back down both of the legs and into the feet.�Sciatica begins in the low back. The nerve roots in the lower spine come together and turn into the sciatic nerve. Sciatica happens when these nerves get pinched/compressed. This usually occurs from a herniated disc or when the spinal canal narrows called stenosis.
�
Symptoms
Typically, sciatica causes:
Pain in the leg/s
Shooting pain that goes down from the low back, through the leg, calf and sometimes into the foot
Electrical pain running/shooting down the leg
Burning pain
Pain from slight movement
Numbness
Weakness
�
A car accident can cause sciatica, but now it seems that sciatica can cause an automobile accident because of delayed braking reaction time. People with sciatica that is present without pain often say there is a constant non-painful tingling, numbness, or numbing sensation along the leg that lets them know the sciatica is still there.
This could be insufficient blood flow from wherever the impingement is happening. Keep in mind that there could be multiple areas of impingement. Just like the slow blood flow, they may find when they drive the impingement slows the motor-sensory signal and braking time to depress the brake pedal fast enough to avoid a collision.
�
Nerve Treatment
Sciatica can be treated non-surgically with:
Chiropractic
Physical therapy
24 to 48 hours of rest
Over the counter pain relievers like ibuprofen or acetaminophen
Muscle spasms can be treated with heat or ice
� Patients with sciatica feel better with time, usually a few weeks. However, if pain continues, other forms of treatment can be discussed.�A doctor or chiropractor may advise�light exercise and therapeutic stretching. As recovery progresses they may give you exercises to strengthen the back and core.
With new automobiles implementing automatic braking systems has helped significantly reduce accidents, however, there are still bugs to sort out. This is normal with these computerized systems. Reliance upon these systems, especially those with sciatica, herniated, or bulging disc/s, could be a dangerous combination, specifically when it comes to braking reaction time.
Sciatica Pain* Treatment Relief
�
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 make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require added 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. Alexander Jimenez of Injury Medical and Chiropractic Clinic focuses on long-haul truck driversand non-invasive spinal treatments. Truck drivers are at a much higher risk of developing degenerative spinal disorders from the stress that constant driving and repetitive lifting can place on the spinal muscles of the lower back.
Driving a huge truck for eight to ten hours every day/night means the person sits in a stationary position for a long time. The muscles, joints, and ligaments tend to become stiff, and proper blood circulation is affected over time. Ailments can last for weeks, even up to several years if drivers don’t take time to focus on their health and find the right treatment.
Teams are in a truck that never stops. Even sleeping in the bunk, these drivers are subject to constant vibration and bouncing as the truck moves. Roads that are poorly maintained can cause impact trauma to both the driver and the person in the bunk. Various factors can cause musculoskeletal pain like:
Having limited mobility can lead to structural problems like pain in the back, hip, knee, shoulder, arms, and legs. This is compounded by the fact that prescription medications are the norm for these issues and can be dangerous.
Long Haul
These individuals are taught proper lifting techniques but with time forget to follow them during the rush to make the delivery/s on time. Driving for extended periods regularly places added strain on the back. This is due in part because these individuals can’t use their feet to support the lower part of their bodies while working the pedals of the truck.
The continuous instability, vibrations, and positional changes that come with long-haul driving can cause tension in the spine and surrounding muscles in the area. Research has shown that vibration of the body while driving increases the load on the lower back and driving on roads that are not maintained can exacerbate the condition.
The continuous bouncing can lead to spinal disc compression, which in turn causes degeneration of pain in the spine and nerves. This continuous strenuous routine can lead to herniated/bulging discs, which can cause pain and lead to the development of other spinal conditions like sciatica. Improper alignment of the spine can lead to dysfunction and pain in one or several areas of the body. Other conditions that could develop include:
Facet joint syndrome – the cartilage wears away making the spinal joints stiff and swollen. This syndrome can lead to reduced mobility.
Spinal compression from sitting in a single position for a long time places pressure on the spinal column. As the spinal column compresses, it causes tightness in the lower and upper back muscles.
Sciatica is a combination of symptoms and pain that travel from the lower back to the knee and even into the foot. Usually, caused by a herniated disc that compresses the sciatic nerve, it can cause shooting electrical pain down the leg. Drivers with sciatica can also have tight gluteal muscles that place pressure on the nerve.
Neck pain from tight and tender muscles can affect the middle back and cervical/neck area of the spine causing soreness.
Tension headaches begin with the muscles at the base of the skull. When these muscles are tight, they can pinch the nerves, beginning a headache.
Shoulder pain can be caused by overuse when loading, along with rotator cuff injuries and bicep tendonitis. An inflamed bicep can cause inflammation and pain in the shoulder.
Preventable and Treatable
Prevention and proper treatment are key. Here are a few simple ways to improve the drive:
Better seating to reduce vibration
Correct sitting posture
Chiropractic/physical therapy
Exercise
Proper diet
Ice therapy
Proper sleep support
Proper Seat
The seats that are standard in a truck do not offer proper support for a driver’s back, shoulders, neck, and legs. A seat pad for extra comfort or a memory foam seat with a massage base can relax the muscles. For quick lumbar supportroll up a pillow, towel, or t-shirt and place it behind the lower back.
An ergonomic truck seat helps fight the discomfort and awkward positions, that result in positive posture. A proper seat will force the back into its healthy arch. Driving with less strain helps:
Boost circulation
Distribute the body weight evenly
Helps drivers operate longer
Reduces the vibrations running through the body
These long-haul drivers can choose to bypass invasive procedures that can take months to heal. This is because the inability to drive means they don’t earn a check. And being taken out of a driving job for any period can cause financial difficulties.
Chiropractic provides long-haul truck drivers with a non-invasive, drug-free way to treat injuries, manage conditions, and relieve pain. Regular chiropractic can help correct postural habits that expose the body to injury or move the body and the spine out of alignment. It can identify emerging issues before they become a severe condition.
Larger truck stops offer drivers access to medical and chiropractic services allowing them to get treatment when they need it. Long haul drivers can be out for weeks and may not be able to get their regular adjustments. But it is still a good idea to have a regular chiropractor at home so you can stay healthy and on the road.
Chiropractic works great for neck and back problems, but it is highly effective for the entire body. Carpal tunnel syndrome or CTS is becoming a widespread health issue with so many working on computers, devices, phones, etc. Chiropractic is perfect for treating CTS. It relieves pain, loosens/stretches the ligaments, and promotes healing without meds. �
�
�
Carpal Tunnel
Carpal tunnel is diagnosed as a repetitive stress injury. This is a condition that affects the hands and wrists. The most common symptoms include:
Tingling
Numbness
Weakness in the middle, index, and thumb
Pain in the wrist/hand
Gets worse at night
It is found in:
Hairdressers
Office workers – typing, writing, filing, etc.
Mechanics
Cashiers
Those who perform repetitive hand motions throughout the day
It is estimated that around 3% of adults will deal with CTS at some time in their lives. Around 50 percent of workplace injuries are attributed to CTS. Research has shown that job occupation plays a large role in how it develops. �
�
The carpal tunnel lies on the front side of the wrist. Here is where the blood vessels, nerves, and tendons necessary for the hand to move and work reside. The carpal tunnel can become inflamed, damaged, or strained with added pressure on the area compressing the arteries and nerves. This is when CTS develops. It starts slowly with symptoms gradually worsening as the condition progresses.
�
How chiropractic helps
There are 3 primary ways that chiropractors treat carpal tunnel syndrome. Manual Adjustment of the:
Upper spine
Arm
Wrist
If the spine is out of alignment it could contribute and exacerbate the carpal tunnel. Chiropractic utilizes spinal manipulation to realign the spine to its correct position. These adjustments are performed by hand, but special devices, instruments, tools, rollers, etc, could be used during the treatments. A chiropractor will make adjustments to the arm and wrist, as well. �
� Ultrasound
Ultrasound uses low energy sound or high energy sound. The sound waves are highly focused and penetrate the body�s tissue at a very deep level. These waves are quite effective in reducing inflammation, alleviating pain, and relaxing the muscles. It could be used as a stand-alone treatment or along with chiropractic treatment. �
�
Wrist Supports
Wrist supports are used to keep the wrist properly aligned with the rest of the arm to reduce pressure and compression. It can be used as a preventative measure against carpal tunnel. A chiropractor could go with this option if the individual does repetitive work that could contribute to the condition. �
�
This is usually done in conjunction with regular chiropractic care. When treating carpal tunnel, a chiropractor could suggest certain therapeutic exercises and a dietary change to help promote optimal wellness. This is to help the individual get the most benefits from the treatment and to help prevent the condition from worsening, as well as, other conditions. �
�
Posture
Proper posture is essential for optimal health, well being, can help avoid age-related conditions and allows the organs room to operate properly and efficiently. Posture can be affected in different ways. Sustaining an injury is one in which the body compensates by listing to one side or hunching over to relieve the pain.
Another reason is slouching. Those of us that just don�t stand and sit up straight through bad habits, lack of exercise, improper diet, medication, and the list goes on and on. Whatever the reason, poor posture will gradually lead to:
Back pain
Headaches
Increased risk of injury
Decreased flexibility
Decreased mobility
It can cause the body to age quicker. However, in most cases, even those with extremely poor posture can find help and return to a high quality of life. Chiropractic has shown to help many regain a straight, healthy posture.
�
Postural Conditions
There are postural conditions that chiropractic is very helpful in alleviating, include:
Forward head posture – usually associated with mobile devices
Kyphosis
Scoliosis
�
Treatment
A chiropractor will:
Discuss the problem/s you are experiencing
Listen to the complaints
Find out when the problem started
Go through events or work that could have contributed to the problem
Thoroughly evaluate the medical history
Observe the way you sit, walk, bend, and movearound
A chiropractor will request x-rays and assess the alignment of the spine. If necessary a neurological or orthopedic test could be done to ensure that there is no underlying condition or injury that is causing the problem.
They will ask you to stand straight and possibly take measurements to determine if there is any visible deviation from the optimum posture. They will then ask you to move and bend while they test the range of motion, mobility, flexibility along with muscle strength and length. �
�
Posture Plan
Once the assessments are complete the chiropractor will discuss the best treatment option available. They will walk you through the adjustments that will be performed along with other therapies they might recommend. The best course of action to relieve any pain will be discussed, as well as get your spine into proper alignment improving posture. They will also talk to you about stretching exercises and things to do at home. They could also discuss:
Sleep positions
Diet
Work area adjustments
Exercise
Weight loss
Chiropractic focuses on whole-body treatment. This means addressing lifestyle changes and getting the individual into optimal shape. Basic chiropractic adjustments can help improve posture within a few sessions.
After the body is in alignment you will feel more energetic, healthier, and happier. The body is an intricate machine and when one part is out of order it begins to affect all the other parts. Chiropractic can improve overall health and wellness. We want to get your body functioning more effectively and efficiently and feeling better.
�
Chiropractic Podcasting: Why Chiropractic Works
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*
Spinal injections are exactly what the name says. They are administered direct injections of medicine/s in a specific location of the spine. These are used to treat various conditions affecting the spine when non-invasive treatment/s are not working.
This could be an area along the upper cervical/neck spine all the way down to the sacrum. Injections are also utilized in helping to diagnose neck or back pain that radiates or spreads into an individual�s arms and legs. These are known as:
Cervical radiculopathy
Lumbar radiculopathy
Spinal injection/s for diagnostic or treatment purposes could be a part of an overall treatment plan along with chiropractic/physical therapy and possible medication.
�
�
The medicine in the injection
The medicine could be comprised of a local anesthetic on its own, steroid on its own, or a combination of the two. Steroids are short for corticosteroid, which is a strong anti-inflammatory medication. A contrast dye like an x-ray dye could be added to the injection mix. This dye acts as a guide for precise placement of the needle using image guidance.
�
Spinal disorders that could benefit
Proceeding with an injection treatment plan is based on an individual’s unique factors that apply to their condition/state. This decision will be made after consultation, and diagnosis with your doctor, spine specialist, or chiropractor.
Healthcare providers recommend conservative treatment first. A treatment plan typically runs around 4-6 weeks. If there is no change or improvement in the individual’s condition from the conservative therapy then injection treatment/s could be recommended. Conditions, where injection/s are used, include:
Disc herniation
Facet joint pain
Failed back syndrome
Sacroiliac joint pain
Sciatica
Spinal stenosis
�
Spinal injection and nerve block difference
Spinal injections are a general term that could mean any type of injection involving the spine. Nerve blocks are a precise type of injection that targets a specific nerve. As the medicine is injected into the target nerve/s, it blocks or creates a blockade of the pain signals being sent from the area (ex. neck, low back, etc.) that is generating the pain.
�
Injection types
Epidural
An epidural means an injection on the dura. The dura is the outermost layer that encloses the spinal cord. �
�
3 types of epidurals. They are named according to the direction and angle the needle takes to get to the dura.
Caudal epidural:
The spinal canal ends at an opening at the end of the sacrum called the spinal hiatus. The medicine is injected into the epidural space through the sacral hiatus. This is the method that is used to provide anesthesia to pregnant women when they’re in labor. �
�
Transforaminal epidural:
There are nerve roots that come out of the spinal canal at each level through a bony opening called the intervertebral foramen or neuroforamen. The medicine is injected into the epidural space in these areas.
Interlaminar epidural:
The lamina is a section that forms the arch of each level and forms the spinal canal. The lamina at each level lays on top of the lamina right below. The needle is inserted between the lamina for delivery of the medicine into the epidural space. �
�
Selective Nerve Root Block – SNRB
These involve the injection of a local anesthetic onto a targeted nerve. They are typically used for diagnostic purposes. For individuals with multi-spinal compression/s, these combined with:
Medical history
Physical exam
MRI
These can help identify the pain generator such as spinal stenosis.
�
Medial Branch Block – MBB
The facet joints are bony projections that connect a vertebral level to the levels above and below. These can become arthritic and is responsible for different forms of back pain.
This type of spinal injection is local anesthetic injected on the medial branch nerves. These are the nerves that send pain signals from the facet joint/s. They are useful in determining if the facet joint is the pain generator. �
�
Facet Joint
These are injections directly into the facet joint itself. Much like injecting anti-inflammatory and pain meds into a knee with arthritis.
�
Sacroiliac Joint
The two sacroiliac joints help connect either side of the sacrum to the hip joint. Like other joints, these can get inflamed and cause painful symptoms. This is an injection directly into one or both of the sacroiliac joints.
�
Administration of the spinal injection or nerve block
Injections are only to be performed by doctors trained specifically in spinal injections. Injections are usually performed by an:
Anesthesiologist
Neurologist
Neurosurgeon
Orthopedic surgeon
Physiatrist
Radiologist
�
Role of these procedures
Reasons why an injection could be used:
Help as a diagnostic to identify the pain generator
Therapeutically to provide pain relief
As a prognostic pain predictor of the relief, an individual could expect from a more invasive procedure like nerve ablation.
�
How often
A maximum of 6 injections for one year is the recommended treatment protocol. Each injection should be based on the effect/s of the previous injection.
�
Potential benefits
The main benefit is to bring pain relief and the ability to function.
Major complications happen in less than one percent of those undergoing the treatment. Individuals with diabetes could see a temporary elevation of their blood sugar.
�
Lasting effects
How long the medicine lasts is different for everyone and comes with variables like:
Type of injection
Type of pathology
Diagnosis
Cause
How long the symptoms last
Most can expect to have one and a half to three months of relief. However, with some, they may only provide minimal relief, while others may see improvements for up to a year.
�
Treating Severe & Complex Sciatica Syndromes
�
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*
Discitis affects around 1 out of every 100,000 people. This means that it is not a common spinal disease. Discitis can occur in adults and children, however, it is more common in children. �
�
Discitis mostly occurs in the low back region of the spine
Followed by the neck region
Finally the middle-back region
It accompanies vertebral osteomyelitis. Both types of infections share many of the same symptoms/characteristics. Although these are uncommon conditions, they can produce severe symptoms affecting an individual’s quality of life. This is why early diagnosis and treatment are essential.
�
Discitis Causes
There are two recognized causes of discitis. The rarest form comes from a prior surgical or diagnostic procedure. This usually happens when a needle or other tool/device transfers the infection. The other is the more common, and it is known as spontaneous discitis. Here the infection develops from a bacterial or viral organism that travels to the disc/s via the blood supply from another part of the body.
When an infection starts somewhere else and then travels to the disc, it is called transient bacteremia, which is bacteria in the bloodstream that has a short life. Ear infections along with skin infections are perfect examples of infections that can lead to transient bacteremia and discitis. �
After a disc becomes infected, it can be quite difficult for the body to fight the infection. The disc/s are the largest avascular organs in the body, which means they do not have their own blood supply. The discs get their nutrition and blood supply, which includes the white blood cells for fighting infections, from the vertebral endplates. Because the discs lack the resources to fight infections on their own, there is a struggle when trying to protect against infection.
Because discitis is usually caused by an infection that developed in another area of the body, individuals with medical conditions are at a higher risk for developing discitis. These conditions include:
Diabetes
A.I.D.S
Cancer
Chronic kidney disease
�
Symptoms
Intense back pain that starts gradually is the distinctive characteristic symptom of discitis. The pain is usually localized to the area where the infection is located. This means that the pain doesn’t radiate or spread out like other types of back pain conditions. �
�
Diagnosis
A doctor, spine specialist, or chiropractor will review medical history and symptoms with the individual. A fever is normally not present once the infection is inside the disc, along with the white blood cell count being normal.
However, the erythrocyte sedimentation rate increases. This is a blood test that examines how fast red blood cells fall to the bottom of a tube. The faster that they fall to the bottom, the more likely there is inflammation somewhere in the body.
Blood tests can be utilized during diagnosis, however, the most accurate diagnostic tool to confirm discitis is magnetic resonance imaging or MRI that shows if an infection is present. �
�
Treatment
Treatment can be challenging. This is because of the fact that the discs do not have a blood supply, and medications/antibiotics travel through the blood. It is treatable and is usually done within a six to eight-week course of antibiotics intravenously or through an IV.
IV administered antibiotics could require treatment on an outpatient basis. The entire course of antibiotics must be completed in its entirety in order to manage the discitis. A doctor could also prescribe a spinal brace to help stabilize the spine and reduce pain. A brace can limit movement, however, it will help ensure proper healing.
�
Spinal Infections
Spinal infections can present spontaneously or as secondary conditions, e.g. after a surgical procedure. Spinal infections can affect different structures, like the:
Vertebral column or the bones of the spine
Intervertebral disc space, which is the cushion-gel structures between the vertebrae
� Here are some facts about the occurrence and prevalence of different infections of the spine:
Vertebral osteomyelitis is the most common type of infection. It affects an estimated 27,000 to 66,000 people a year.
Epidural abscess is an infection inside the spinal canal that affects up to two cases per 10,000 in hospital admissions around the U.S. It is pretty common in individuals with vertebral osteomyelitis or discitis. Eighteen percent of those individuals can develop this infection. However, it is more common in people fifty and older.
Discitis, as aforementioned is a pretty uncommon condition. Although, treatment has advanced, around twenty percent of individuals with this infection do not survive.
�
Infection Risk Factors
There are certain factors that increase the risk of developing an infection. These factors include:
Symptoms from a spinal infection can vary. However, continuous back pain with no history of trauma or injury. Usually, there is a delay in the diagnosis for an infection of the spine because of the:
Subtle nature of the symptoms
Individual’s belief that the pain is not serious
Absence of body-wide symptoms like a fever
Lab results can also complicate the diagnostic process, as they can be misleading. There could be normal white blood cell counts, x-rays that show no abnormalities, and a sensitive diagnostic test like a bone scan might not show that an individual is positive until a week later.
An erythrocyte sedimentation rate is a valuable screening test when it comes to spinal infections. The test can measure inflammation and infection in the body. If a spinal infection is suspected, an MRI could be the most reliable tool to confirm early diagnosis.
Health & Immunity Series
�
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
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
�
