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Chiropractic

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.


Personal TENS: Your Solution to Chronic Pain

Personal TENS: Your Solution to Chronic Pain

For individuals managing chronic pain conditions, can incorporating a personal TENS device help?

Personal TENS: Your Solution to Chronic Pain

Personal TENS Device

Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.

How It Works

TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.

Uses

TENS units are used to treat a variety of conditions, including:

  • Arthritis
  • Muscle cramps
  • Neck pain
  • Back pain
  • Pelvic pain
  • Knee pain
  • Osteoarthritis
  • Fibromyalgia
  • Tendinitis
  • Bursitis
  • Diabetes-related neuropathy
  • Pelvic pain from periods or endometriosis

Features

Portability

  • TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)

Electrodes

  • The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.

Adjustable Settings

  • Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.

Benefits

Non-Invasive

  • TENS therapy is a non-invasive method for relieving pain.

Drug-Free

  • It can provide pain relief without the need for medication.

Convenient

  • TENS units are small, portable, and relatively discrete.

Precautions

Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)

  • Head
  • Eyes
  • Mouth
  • Front of the Neck
  • Chest and upper back at the same time
  • Numb areas
  • Broken skin
  • Tumors

There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.

Effectiveness

Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)

Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Don’t Ignore Post-Accident Pain


References

National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/

Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30725873

Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. doi.org/10.1016/j.pain.2013.07.043

Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. doi.org/10.2217/pmt.14.13

Cupping Benefits for Musculoskeletal Health

Cupping Benefits for Musculoskeletal Health

For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?

Cupping Benefits for Musculoskeletal Health

Cupping Therapy

This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)

Increasing Blood Circulation

  • The suction draws blood to the area, which can help reduce inflammation and promote healing.

Releasing Muscle Tension

  • The suction can stretch and pull on muscles, which can help relieve pain and tightness.

Breaking Up Adhesions

  • The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.

Detoxifying the Body

  • Some practitioners believe that cupping can help remove toxins from the body.

It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)

Benefits

  • Pain relief, especially for muscle and joint pain
  • Reduced inflammation
  • Improved circulation
  • Increased range of motion
  • Detoxification

Procedure

The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:

Preparation

  • The practitioner cleans the area where the cups will be placed.
  • They may apply oil or massage cream to the skin for easier movement of the cups.

Techniques

Dry

  • The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
  • The cup is then placed on the skin, which adheres due to the negative pressure.
  • The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.

Wet

  • Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
  • This allows blood to flow into the cup, creating a more intense suction.

Aftercare

  • The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
  • The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.

The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)

It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)

Risks

The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:

Bruising

  • It can cause temporary bruising at the site of the cups.

Skin Irritation

  • Some people may experience skin irritation or burns from the suction.

Infection

  • There is a small risk of infection if the cups are not properly sterilized.

Who should avoid the therapy?

Those with skin conditions like eczema and psoriasis should avoid cupping, as it may worsen them. (National Center for Complementary and Integrative Health, 2018)

Injury Medical Chiropractic & Functional Medicine Clinic

It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Beyond Medicine: The Power of Chiropractic Care


References

Cleveland Clinic. (2023). Cupping Therapy. my.clevelandclinic.org/health/treatments/16554-cupping

Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. doi.org/10.1016/j.jams.2018.02.001

National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from www.nccih.nih.gov/health/cupping

Sleep Cervical Neck Roll: Say Goodbye to Pain

Sleep Cervical Neck Roll: Say Goodbye to Pain

Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?

Sleep Cervical Neck Roll: Say Goodbye to Pain

Sleep Cervical Neck Roll

Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.

For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.

Neck Support During Sleep

The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)

  • Individuals can purchase a cervical roll online or at a store or pharmacy.
  • Individuals can also contact a physical therapist to help them obtain a cervical roll.

Making Your Own

Making a cervical roll is simple to do. Here’s how:

  • Using a hand towel.
  • Fold it in half.
  • Slide the towel into the pillowcase along the lower edge.
  • Be sure the towel is tucked in so it doesn’t slip out.
  • Individuals can place tape around it so it stays in the rolled shape.

The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)

If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.

Injury Medical Chiropractic & Functional Medicine Clinic

A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


The Road To Recovery: Chiropractic Care


References

Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. doi.org/10.1186/s13063-015-0770-6

Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. doi.org/10.1186/s13643-019-1125-2

Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. doi.org/10.2174/1874325001307010530

Harvard Health Publishing. (2022). Say “good night” to neck pain. www.health.harvard.edu/pain/say-good-night-to-neck-pain

Lidocaine Patch: Effective Pain Relief Options

Lidocaine Patch: Effective Pain Relief Options

For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?

Lidocaine Patch: Effective Pain Relief Options

Lidocaine Patch

Lidocaine patches are in a drug class called local anesthetics (MedlinePlus, 2025) (Food and Drug Administration, 2022). They relieve pain in small body areas by blocking the nerves from sending pain signals. The Food and Drug Administration approved lidocaine 5% or 1.8% patches for relieving postherpetic neuralgia (PHN) pain. These lidocaine patches are prescription-only (Food and Drug Administration, 2022). They are available either by prescription or over the counter and are commonly used for back pain and other areas. Over-the-counter lidocaine, 4% patches, can be used to relieve minor aches and pains, including back pain. However, further research is needed to recommend the use of lidocaine patches as an effective method of pain relief. (Department of Veterans Affairs/Department of Defense, 2022) (North American Spine Society, 2020)

The Patch

They are available in prescription and over-the-counter forms. Over-the-counter forms come as a 4% patch in various brands, such as (MedlinePlus, 2025)

  • Aspercreme
  • Lidocare
  • Salonpas

Prescription-only patches come in 5% or 1.8% patches and are approved to relieve long-term nerve pain from shingles in adults. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically. (DailyMed, 2018) (Food and Drug Administration, 2021) The safety and effectiveness in children are unknown. (Food and Drug Administration, 2022)

Other Lidocaine Forms

As a local anesthetic, it is available in several other forms, including:

  • Spray
  • Topical cream
  • Lotion
  • Liquid
  • Ear drops
  • Eye gel
  • Injection
  • It is also available as a short-term intravenous infusion for abnormal heart rhythm. (DailyMed, 2025)

Effectiveness

Clinical trials have shown that the patches effectively relieve chronic low back pain. However, these studies were nonrandomized and did not include a control group to compare against the treatment group. (Santana J. A., Klass S., & Felix E. R. 2020) The results may be subject to potential biases. For this reason, further evidence is needed to support lidocaine patches’ effectiveness in reducing low back pain. (North American Spine Society, 2020) High-quality randomized and controlled clinical trials are necessary to study the effectiveness. (North American Spine Society, 2020) (Santana J. A., Klass S., & Felix E. R. 2020)

How to Use Safely

In general, keep the following in mind (MedlinePlus, 2025)

  • Use according to the directions on the box and the healthcare provider’s recommendations.
  • Do not use on broken or inflamed, swollen skin.
  • Do not apply heat like heating pads or electric blankets over patches.
  • Avoid getting water on or around the patch.
  • Avoid letting a patch near your eyes to limit eye irritation.
  • Fold the sticky sides of the used lidocaine patches together and safely throw them away, keeping them away from children and pets.

How to use (MedlinePlus, 2025)

  • Clean and dry the affected area before placing the patch.
  • Apply to the affected body area as directed.
  • Wash your hands after touching the patch.
  • Remove the patch after what is usually recommended after eight hours.

How Quickly Does It Work?

The amount of medication absorbed into the blood depends on how long the patch is placed on the body and how much is covered with the patch. In a study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during 24 hours. Lidocaine levels were highest at 11 hours. At the end of the 24 hours, there was still some lidocaine left in the bloodstream. (Food and Drug Administration, 2022)

Individuals with PHN may notice a difference in pain intensity after four hours of using the patch. (Rowbotham, M. C. et al., 1996) (Food and Drug Administration, 2022) Experts may suggest using patches for four weeks for those who experience pain after their shingles rash disappears. However, if there is still pain after these four weeks, it is recommended to see a pain specialist. (Gross, G. E. et al., 2020)

Side Effects

Common side effects are typically mild skin reactions where the patch is. These reactions are usually temporary and will disappear within a few minutes or hours. Examples include: (Food and Drug Administration, 2022)

  • Irritation
  • Itchiness
  • Abnormal or burning sensation
  • Redness
  • Swelling
  • Blisters
  • Bruises
  • Skin bumps
  • Skin color changes
  • Skin peeling

Potentially serious side effects include: (Food and Drug Administration, 2022)

Serious Allergic Reaction

  • Severe allergic reactions are rare, but it is possible.
  • Symptoms include breathing problems, itchiness, and rash.

Methemoglobinemia

  • Methemoglobinemia is a condition that makes it hard for red blood cells to carry oxygen.
  • Individuals may experience symptoms of blue-looking skin, headache, lightheadedness, shortness of breath, abnormal heart rhythm, or seizures.

Using too many lidocaine patches to cover large parts of the body or using the patches longer than 12 hours within 24 hours may cause side effects that may include heart-related effects, such as a slow heart rate and low blood pressure. Individuals may also experience the following side effects (Food and Drug Administration, 2022)

  • Hot or cold sensation
  • Numbness
  • Dizziness
  • Ringing ears
  • Lightheadedness
  • Mood changes
  • Drowsiness to unconsciousness
  • Vision changes
  • Seizures
  • Tremors
  • Vomiting

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Sciatica Causes and Treatments


References

National Library of Medicine. MedlinePlus. (2025). Lidocaine transdermal patch. Retrieved from medlineplus.gov/druginfo/meds/a603026.html

Food and Drug Administration. (2022). Lidoderm label. Retrieved from www.accessdata.fda.gov/spl/data/eedfe43b-1019-19a0-e053-2995a90a7696/eedfe43b-1019-19a0-e053-2995a90a7696.xml

Department of Veterans Affairs/Department of Defense. (2022). VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain. Retrieved from www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGFinal508.pdf

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain. www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

National Library of Medicine. DailyMed. (2018). Label: lidocaine patch. Retrieved from dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c66f3b9-6e04-47ab-8d94-21e89ceec154

Food and Drug Administration. (2021). Ztlido label. Retrieved from www.ztlido.com/wp-content/uploads/2022/12/ZTlido-LABEL.pdf

National Library of Medicine. DailyMed. (2025). Lidocaine-lidocaine hydrochloride injection, solution. Retrieved from dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f1b26274-a55e-4321-b96c-ce0df830f205

Santana, J. A., Klass, S., & Felix, E. R. (2020). The Efficacy, Effectiveness and Safety of 5% Transdermal Lidocaine Patch for Chronic Low Back Pain: A Narrative Review. PM & R: the journal of injury, function, and rehabilitation, 12(12), 1260–1267. doi.org/10.1002/pmrj.12366

Rowbotham, M. C., Davies, P. S., Verkempinck, C., & Galer, B. S. (1996). Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain, 65(1), 39–44. doi.org/10.1016/0304-3959(95)00146-8

Gross, G. E., Eisert, L., Doerr, H. W., Fickenscher, H., Knuf, M., Maier, P., Maschke, M., Müller, R., Pleyer, U., Schäfer, M., Sunderkötter, C., Werner, R. N., Wutzler, P., & Nast, A. (2020). S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG, 18(1), 55–78. doi.org/10.1111/ddg.14013

What to Wear to Physical Therapy for Your Appointment

What to Wear to Physical Therapy for Your Appointment

Individuals with difficulty with normal functional mobility after surgery, injury, or illness may be referred to physical therapy during recovery. A common question patients have before treatment is: What should they wear to the physical therapy appointment?

What to Wear to Physical Therapy for Your Appointment

What To Wear To Physical Therapy?

Individuals referred to physical therapy usually have questions about what to expect and how to prepare. What to wear is a common question and is important because patients want to wear the right physical therapy outfit for their specific condition and feel comfortable and safe at their physical therapy appointments. A treatment plan may include exercise and stretching. Clothing recommendations may vary slightly depending on the type of physical therapy the patient is receiving; it is recommended to wear:

  • Athletic wear like t-shirts, shorts, yoga pants, and comfortable shoes like sneakers.
  • Sometimes, exercises are performed, and modalities such as heat, cold, or electrical stimulation are applied.
  • Comfortable, loose-fitting clothing allows for a full range of motion and easy access to the affected area.

Physical Therapy

  • The therapist will examine the patient’s mobility and flexibility.
  • Exercises may be prescribed, and therapeutic modalities, like ice or heat, may be applied.
  • Wearing the right clothing can make the therapy experience highly effective and productive.

This way, therapy sessions go smoothly, and there is a level of comfort and confidence to reach goals quickly.

Upper Body Neck, Shoulders, Arms, Back

For upper body injuries, wear clothing that provides access and mobility to the areas affected, such as the neck, shoulders, arms, or back.

  • For neck pain, wear a shirt that allows the therapist to see the neck, shoulders, and upper back, such as a loose, open T-shirt with a scoop neck, V-neck, or tank top.
  • For long hair, bring a hair tie.
  • Women are recommended to wear a sports bra.
  • For an arm, wrist, or hand injury, wear a loose-fitting shirt with the arms exposed.
  • Tight shirts like those made from Lycra are not advisable because the therapist cannot effectively evaluate and treat the injury if the patient wears something tight.

Lower Body, Hips, Legs, Knees

For lower extremity problems and injuries, wear clothing that allows free movement to exercise while allowing the therapist to visualize and examine the back, hips, knees, and legs.

  • Wear a T-shirt, sports bra, and shorts or pants with an elastic waistband for back, lower spine, or pelvis injuries.
  • For hip pain, the therapist should be able to see and adjust the spine and hips.
  • Avoid wearing tight-fitting pants that don’t allow for full movement.
  • Shorts with an elastic waistband are recommended.
  • Leggings may not roll up easily.

Feet and Ankles

For a foot or ankle injury, the therapist will want to observe the patient walk in shoes and bare feet for conditions like plantar fasciitis or ankle sprains. For any lower extremity condition, expect some light or heavy exercise. Wear socks to absorb sweat and odor and sneakers or athletic shoes. Avoid open-toed sandals, high heels, or casual lightweight footwear like Crocs.

Other Considerations

Avoid

  • Bracelets and necklaces
  • Turtleneck shirts
  • Tight-fitting long-sleeved shirts
  • Leggings
  • Sandals

When preparing for appointments, consider your specific condition. Remember that you will likely be exercising, so wear loose, comfortable clothing that allows you to move around freely. If you are coming directly from work or a formal event, ask the office staff if there is a changing room that you can use. It may also be a good idea to avoid wearing dangling jewelry. A necklace or bracelet may get in the way, so be prepared to remove it for your appointments. Therapists can also use draping with towels or pillowcases/sheets to help you feel comfortable when certain body areas are exposed. That way, you can be relaxed and more able to focus on recovery and rehabilitation to return to normal activities.

Injury Medical Chiropractic & Functional Medicine Clinic

If you are unsure if what you plan to wear is appropriate, call the office and ask. If you’re leaving work and need to change, make sure your therapist’s office has a place for you to do that. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Unlocking Pain Relief: How We Assess Motion To Alleviate Pain


 

Cobb Angle: Understanding Spinal Curvature Measurement

Cobb Angle: Understanding Spinal Curvature Measurement

The Cobb angle is a mathematical measurement tool for assessing the curvature of the spine. Along with physical exams and other tests, how is it used to evaluate scoliosis and kyphosis of the spine?

Cobb Angle: Understanding Spinal Curvature Measurement

Cobb Angle

The Cobb angle is used to quantify the curvature of the spine, particularly in conditions like scoliosis. It measures the degree of side-to-side spinal curvature, a deformity called scoliosis. The angle’s size helps determine what kind of treatment is needed. Monitoring may be all that’s necessary for mild curvature. With severe scoliosis, treatment may require spinal fusion surgery. Named for orthopedic surgery pioneer John Robert Cobb, it describes the distance a scoliotic curve may deviate from being straight. (Botterbush K. S. et al., 2023) Generally, it takes at least 10 degrees of deviation from straight before scoliosis is confirmed.

X-Ray and Interpretation

An X-ray is taken to measure the Cobb angle. Side and back views are taken. The healthcare provider or examiner then views the X-rays and locates the most affected vertebra in the curve, the apical vertebra. In a scoliotic curve, the apical vertebra is the spinal bone with the greatest degree of rotation that takes the biggest curve away from the center of a normal spine column.

Visualizing the Angle

The apical vertebra is where two lines drawn from the X-rays meet. Two lines are drawn along the edge of the top and bottom bones of the curve. The lines extend out as follows:

  • On the top bone, the line starts on the high side, continues along the top edge, and then slopes down according to the angle of the vertebra. (Jin, C. et al., 2022)
  • On the bottom vertebra, the line starts on the low side, continues along the bottom edge, and slopes upward.
  • The Cobb angle is found by measuring the angle of the two intersecting lines where they meet.

Then, the top and bottom vertebrae of the side-to-side curve are identified to create a number for the Cobb angle. These bones have the most tilt but the least rotation and displacement and are located above and below the apical vertebra. Computer software is commonly used to calculate the Cobb angle. (Jin, C. et al., 2022) Treatment is based on the:

10 Degrees Cobb Angle 

Scoliosis is diagnosed when the Cobb angle reaches 10 degrees or more. However, this is not generally considered a significant curvature (American Association of Neurological Surgeons, 2024). In around 80% of cases, the scoliosis is considered idiopathic or without congenital or other underlying causes.

Less Than 25 Degrees Cobb Angle

If a scoliotic curve is less than 25 degrees, individuals may only need to visit their healthcare provider periodically so long as the scoliosis is monitored. These are mild cases, often without symptoms, but there is a chance that the curvature can progress. This usually means reassessing the Cobb angle every four to six months in a growing child or adolescent. (National Scoliosis Foundation, 2015) A 5-degree or more progression can change the diagnosis and treatment. (Jin, C. et al., 2022)

Between 25 and 40 Degrees Cobb Angle

A Cobb angle of 25 to 40 degrees usually requires wearing a back brace and intensive physical therapy. The goal of these treatments is to help halt the curve’s progression. Braces are generally worn 16 to 23 hours every day. (National Scoliosis Foundation, 2015) The healthcare provider will provide a referral for physical therapy. Many report excellent results with the Schroth or other scoliosis-specific exercise methods. A study found that core stabilization exercise programs can decrease Cobb angles in adolescents with idiopathic scoliosis. (Ko K. J. & Kang S. J. 2017)

Scoliosis in Adults

Scoliosis is diagnosed in adults, usually in those who have had the condition, treated or not, that was identified in their youth. A study that followed various cases for 20 years found disease progression occurred in 40% of adults but was usually less than one degree per year. However, degenerative scoliosis can also occur in individuals aged 65 and older. (American Association of Neurological Surgeons, 2024)

40 Degrees or More Cobb Angle

Surgery may be recommended once the Cobb angle reaches 40 to 50 degrees. A spinal fusion is often used to force the curve to stop developing. In adults, surgery may be needed if the angle reaches 50 degrees and they experience complications, such as nerve damage or bowel/bladder dysfunction. Risk factors in adults include older age, a history of smoking, and a diagnosis of other conditions, including being overweight. (American Association of Neurological Surgeons, 2024)

Variations

Variations occur in measuring scoliosis, and it is important to understand the difference between a change in scoliosis and a change in the tools or measurement. Equipment errors, imaging errors, and the subjective reading of the healthcare provider can change the values. (Jin, C. et al., 2022) Scoliosis measurement software and intelligent medical devices continue to improve how scoliosis is evaluated and treated. Physical exams, symptoms, and careful monitoring of changes in posture or function are still critical to an accurate diagnosis. The healthcare provider will explain the Cobb angle and other test results.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Academic Low Back Pain: Impact and Chiropractic Solutions


References

Botterbush, K. S., Zhang, J. K., Chimakurty, P. S., Mercier, P., & Mattei, T. A. (2023). The life and legacy of John Robert Cobb: the man behind the angle. Journal of neurosurgery. Spine, 39(6), 839–846. doi.org/10.3171/2023.7.SPINE23146

Jin, C., Wang, S., Yang, G., Li, E., & Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel, Switzerland), 22(9), 3258. doi.org/10.3390/s22093258

National Scoliosis Foundation. (2015). Scoliosis Media & Community Guide. www.scoliosis.org/nsf2/wp-content/uploads/2015/06/ScoliMediaGuide_9June3.pdf

American Association of Neurological Surgeons. (2024). Scoliosis. www.aans.org/patients/conditions-treatments/scoliosis/

Ko, K. J., & Kang, S. J. (2017). Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. Journal of Exercise Rehabilitation, 13(2), 244–249. doi.org/10.12965/jer.1734952.476

Moringa: Nature’s Nutritional Powerhouse

Moringa: Nature’s Nutritional Powerhouse

Experience the powerful properties of moringa. Understand its health benefits and how it can support a healthier lifestyle.

Introduction

How often do you experience joint pain after doing daily tasks? Do you find that the upper and lower body extremities are hot and sensitive to the touch? Or do you wake up with widespread joint and muscle discomfort that goes away over the day? Inflammatory effects might result from overlapping pain feelings that are caused by inflammation in certain bodily joints. When this occurs, a lot of folks start searching for strategies to lessen joint inflammation. To lessen joint inflammation, many patients choose holistic therapies that include vitamins, herbal supplements, and nutraceuticals. Moringa is one of the supplements we will examine.

 

Moringa: The Nutritional Powerhouse

The “Miracle Tree,” or moringa, is a plant that is indigenous to many regions of Africa and Asia and has strong nutritional and therapeutic qualities. This nutrient-dense superfood is a multifunctional plant with a wide range of nutritional and medicinal benefits. (Arora and Arora, 2021) Numerous vital vitamins, minerals, antioxidants, and bioactive substances found in moringa plants support general health. To demonstrate the nutritional value of moringa oleifera, one gram of dried moringa leaves contains:

  • 9 grams of protein.
  • Vitamin C: 51.7 milligrams
  • 378 mcg of Vitamin
  • 185 mg of calcium; 337 mg of potassium; 4 mg of iron; and 147 mg of magnesium
  • Two grams of fiber

Additionally, moringa’s inherent capacity to reduce inflammation and ease joint pain brought on by arthritis and other joint disorders is among its most advantageous qualities for a large number of people.

 

A Natural Remedy For Inflammation

The body’s normal reaction to diseases, traumas, and long-term joint disorders like arthritis is inflammation. Depending on how severe the damaged region is, a person may have either acute or chronic inflammation. In contrast to chronic inflammation, which may result in overlapping risk profiles and cause tissue damage and long-term discomfort, acute inflammation causes redness and heat to radiate from the afflicted location. When this occurs, moringa’s anti-inflammatory properties may aid in the natural reduction of joint inflammation.

 

How Moringa Helps Fight Inflammation

Moringa has numerous beneficial properties to reduce the impact of inflammation; it includes:

 

Antioxidant Riched

Strong antioxidants found in moringa neutralize dangerous oxidants brought on by inflammation and oxidative stress while also inhibiting the pro-inflammatory enzymes quercetin and kaempferol. (Chis and others, 2023) By neutralizing free radicals, moringa’s antioxidant properties help reduce the harm they cause. (Jimenez-Vergara et al., 2017)

 

Contains Natural Anti-Inflammatory Compounds

Moringa has strong antioxidants that neutralize dangerous oxidants brought on by inflammation and oxidative stress while blocking the pro-inflammatory enzymes quercetin and kaempferol. (Chis and others, 2023) Moringa’s antioxidant properties may neutralize free radicals and reduce their harmful effects. In 2017, Vergara-Jimenez et al.

 

Supports Immune Function

Many individuals are unaware that immune system failure is often associated with chronic inflammation, and that moringa may enhance immunological function. By causing a mild inflammatory phase to aid in healing, moringa consumption may reduce chemical and physical irritants as well as immunological problems. (Xiao and others, 2020) Moringa also contains significant levels of beta-carotene, vitamin A, and vitamin C, which enhance the immune system and support and control a healthy inflammatory response.

 


Unlocking The Secrets Of Inflammation-Video


Moringa for Joint Pain & Arthritis

Moringa may be a natural remedy for joint pain, whether from rheumatoid arthritis or osteoarthritis, without the typical negative effects of prescription drugs. This is because as the body ages, the joints may get smaller, resulting in inflammation-related pain that eventually leads to malalignment. (Gessl and others, 2021)

 

Reduces Joint Swelling

The anti-inflammatory properties that moringa has can help decrease joint swelling and reduce stiffness and pain. At the same time, the anti-inflammatory properties of moringa can help improve skeletal muscle dysfunction associated with joint swelling by reducing the pro-inflammatory cytokines. (Sailaja et al., 2022)

 

Prevents Cartilage Breakdown

The antioxidants in moringa help protect against cartilage degradation, which is a major cause of joint pain.

 

Improves Joint Mobility & Flexibility

Many people found that incorporating and regularly consuming moringa can help reduce joint pain and stiffness while improving mobility and flexibility in the upper and lower extremities.

 

Incorporating Moringa Into Your Diet

Many people who are thinking about their health and wellness can make small changes to their daily routine, especially regarding their eating habits. Since food and nutrition are crucial to developing and maintaining a healthy lifestyle, adding moringa into a person’s daily routine can do that. (Bibi et al., 2024) There are several ways to enjoy moringa’s benefits:  

 

1. Moringa Powder

– Adding 1-2 teaspoons of moringa powder to smoothies, soups, or teas can provide an extra nutritional boost to the body. 

2. Moringa Capsules

– For individuals with a busy, hectic lifestyle, consuming moringa capsules daily can help many people incorporate taking supplements as a daily habit.  

3. Moringa Tea

– For those individuals who enjoy a warm cup of tea, seeping moringa leaves for three to five minutes in hot water can create a soothing anti-inflammatory tea.  

4. Moringa Oil (Ben Oil)  

– Individuals dealing with joint pain can apply moringa oil to their joints for additional pain relief. 

Final Thoughts

Moringa is a powerful superfood with anti-inflammatory and joint pain-relieving properties that can be incorporated into a healthy diet. Due to its essential nutrients, antioxidants, and bioactive compounds can be a natural alternative for individuals seeking relief from arthritis and chronic inflammation. Incorporating moringa as part of a healthy dietary habit can improve individuals’ health and joint mobility.

 


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the various effects of incorporating moringa to reduce the inflammatory effects that are causing joint pain. When asking important questions to our associated medical providers, we advise patients to implement small changes to their daily routine, like incorporating anti-inflammatory foods into their diets to reduce the effects of joint inflammation and restore mobility. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.


References

Arora, S., & Arora, S. (2021). Nutritional significance and therapeutic potential of Moringa oleifera: The wonder plant. J Food Biochem, 45(10), e13933. doi.org/10.1111/jfbc.13933

Bibi, N., Rahman, N., Ali, M. Q., Ahmad, N., & Sarwar, F. (2024). Nutritional value and therapeutic potential of Moringa oleifera: a short overview of current research. Nat Prod Res, 38(23), 4261-4279. doi.org/10.1080/14786419.2023.2284862

Chis, A., Noubissi, P. A., Pop, O. L., Muresan, C. I., Fokam Tagne, M. A., Kamgang, R., Fodor, A., Sitar-Taut, A. V., Cozma, A., Orasan, O. H., Heghes, S. C., Vulturar, R., & Suharoschi, R. (2023). Bioactive Compounds in Moringa oleifera: Mechanisms of Action, Focus on Their Anti-Inflammatory Properties. Plants (Basel), 13(1). doi.org/10.3390/plants13010020

Cuellar-Nunez, M. L., Gonzalez de Mejia, E., & Loarca-Pina, G. (2021). Moringa oleifera leaves alleviated inflammation through downregulation of IL-2, IL-6, and TNF-alpha in a colitis-associated colorectal cancer model. Food Res Int, 144, 110318. doi.org/10.1016/j.foodres.2021.110318

Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Ann Rheum Dis, 80(7), 884-890. doi.org/10.1136/annrheumdis-2020-218744

Sailaja, B. S., Hassan, S., Cohen, E., Tmenova, I., Farias-Pereira, R., Verzi, M. P., & Raskin, I. (2022). Moringa isothiocyanate-1 inhibits LPS-induced inflammation in mouse myoblasts and skeletal muscle. PLOS ONE, 17(12), e0279370. doi.org/10.1371/journal.pone.0279370

Vergara-Jimenez, M., Almatrafi, M. M., & Fernandez, M. L. (2017). Bioactive Components in Moringa Oleifera Leaves Protect against Chronic Disease. Antioxidants (Basel), 6(4). doi.org/10.3390/antiox6040091

Xiao, X., Wang, J., Meng, C., Liang, W., Wang, T., Zhou, B., Wang, Y., Luo, X., Gao, L., & Zhang, L. (2020). Moringa oleifera Lam and its Therapeutic Effects in Immune Disorders. Front Pharmacol, 11, 566783. doi.org/10.3389/fphar.2020.566783

 

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