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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.


Regain Your Strength: Rehabilitation Exercise Program Guide

Regain Your Strength: Rehabilitation Exercise Program Guide

Individuals who have gone through recent low back surgery, like a lumbar laminectomy and discectomy, could they benefit from physical therapy for full recovery? (Johns Hopkins Medicine. 2008)

Regain Your Strength: Rehabilitation Exercise Program Guide

Rehabilitation Exercise Program

A lumbar laminectomy and discectomy is a surgical procedure performed by an orthopedic or neurologic surgeon to help decrease pain, relieve associated symptoms and sensations, and improve flexibility and mobility. The procedure involves cutting away disc and bone material that presses against, irritates, and damages the spinal nerves. (Johns Hopkins Medicine. 2023)

Post-Surgery

The therapist will work with the individual to develop a rehabilitation exercise program. The objective of a rehabilitation exercise program is to help the individual:

  • Relax their muscles to prevent muscle tensing and becoming over-cautious
  • Regain full range of motion
  • Strengthen their spine
  • Prevent injuries

A guide on what to expect in physical therapy.

Postural Retraining

  • After back surgery, individuals have to work to maintain proper posture when sitting and standing. (Johns Hopkins Medicine. 2008)
  • Postural control is important to learn as it maintains the lower back in the optimal position to protect and expedite the healing of lumbar discs and muscles.
  • A physical therapist will teach the individual how to sit with proper posture and use lumbar support.
  • Attaining and maintaining proper posture is one of the most important things to help protect the back and prevent future back problems.

Walking Exercise

Walking is one of the best exercises after lumbar surgery. (Johns Hopkins Medicine. 2008)

  • Walking helps to improve cardiovascular health and blood circulation throughout the body.
  • This helps to provide added oxygen and nutrients to the spinal muscles and tissues as they heal.
  • It is an upright exercise that puts the spine in a natural position, which helps to protect the discs.
  • The therapist will help set up a program tailored to the individual’s condition.

Prone Press Up

One of the exercises to protect the back and lumbar discs is prone press-ups. (Johns Hopkins Medicine. 2008) This exercise helps keep the spinal discs situated in the proper position. It also helps to improve the ability to bend back into lumbar extension.

To perform the exercise:

  1. Lie facing down on a yoga/exercise mat and place both hands flat on the floor under the shoulders.
  2. Keep the back and hips relaxed.
  3. Use the arms to press the upper part of the body up while allowing the lower back to remain against the floor.
  4. There should be a slight pressure in the lower back while pressing up.
  5. Hold the press-up position for 2 seconds.
  6. Slowly lower back down to the starting position.
  7. Repeat for 10 to 15 repetitions.

Sciatic Nerve Gliding

Individuals who had leg pain coming from the back prior to surgery may have been diagnosed with sciatica or an irritation of the sciatic nerve. Post-surgery, individuals may notice their leg feels tight whenever straightening it out all the way. This could be a sign of an adhered/trapped sciatic nerve root, a common problem with sciatica.

  • After lumbar laminectomy and discectomy surgery, a physical therapist will prescribe targeted exercises called sciatic nerve glides to stretch and improve how the nerve moves. (Richard F. Ellis, Wayne A. Hing, Peter J. McNair. 2012)
  • Nerve glides can help free the stuck nerve root and allow for normal motion.

To perform the exercise:

  1. Lie on the back and bend one knee up.
  2. Grab underneath the knee with the hands.
  3. Straighten the knee while supporting it with the hands.
  4. Once the knee is fully straightened, flex and extend the ankle about 5 times.
  5. Return to the starting position.
  6. Repeat the sciatic nerve glide 10 times.
  7. The exercise can be performed several times to help improve how the nerve moves and glides in the lower back and leg.

Supine Lumbar Flexion

After surgery, gentle back flexion exercises can help safely stretch the low-back muscles and gently stretch the scar tissue from the surgical incision. Supine lumbar flexion is one of the simplest exercises to improve lumbar flexion range of motion.

To perform the exercise:

  1. Lie on the back with the knees bent.
  2. Slowly lift the bent knees towards the chest and grasp the knees with both hands.
  3. Gently pull the knees toward the chest.
  4. Hold the position for 1 or 2 seconds.
  5. Slowly lower the knees back to the starting position.
  6. Perform for 10 repetitions.
  7. Stop the exercise if experiencing an increase in pain in the lower back, buttocks, or legs.

Hip and Core Strengthening

Once cleared, individuals can progress to an abdominal and core strengthening program. This involves performing specific motions for the hips and legs while maintaining a pelvic neutral position. Advanced hip strengthening exercises help generate strength and stability in the muscles that surround the pelvic area and lower back. A physical therapist can help decide which exercises are recommended for the specific condition.

Return-to-Work and Physical Activities

Once individuals have gained an improved lumbar range of motion, hip, and core strength, their doctor and therapist may recommend working on specific activities to help them return to their previous level of work and recreation. Depending on job occupation, individuals may need to:

  • Work on proper lifting techniques.
  • Require an ergonomic evaluation if they spend time sitting at a desk or workstation.
  • Some surgeons may have restrictions on how much an individual can bend, lift, and twist from two to six weeks after surgery.

Low-back surgery can be difficult to rehab properly. Working with a healthcare provider and physical therapist, individuals can be sure to improve their range of motion, strength, and functional mobility to return to their previous level of function quickly and safely.


Sciatica, Causes, Symptoms and Tips


References

Johns Hopkins Medicine. (2008). The road to recovery after lumbar spine surgery.

Johns Hopkins Medicine. (2023). Minimally Invasive Lumbar Discectomy.

Ellis, R. F., Hing, W. A., & McNair, P. J. (2012). Comparison of longitudinal sciatic nerve movement with different mobilization exercises: an in vivo study utilizing ultrasound imaging. The Journal of orthopaedic and sports physical therapy, 42(8), 667–675. doi.org/10.2519/jospt.2012.3854

Headache On Top Of The Head: Causes, Symptoms And Relief

Headache On Top Of The Head: Causes, Symptoms And Relief

Individuals experiencing headaches on top of the head could be caused by different factors. Can recognizing what triggers pain or pressure help prevent this type of headache, and healthcare providers develop effective treatment plans?

Headache On Top Of The Head: Causes, Symptoms And Relief

Headache On Top of The Head

Various factors could cause a headache on top of the head; common causes include:

  • Stress
  • Sleep problems
  • Eye strain
  • Caffeine withdrawal
  • Dental problems
  • Hormonal changes
  • Alcohol consumption

Causes

Many causes have to do with underlying issues happening in other parts of the body.

Stress

  • Stress is a common cause of headaches, including one on top of the head.
  • Researchers don’t know exactly how stress causes headaches, but they think it causes tightening of the muscles in the back of the head or neck, which
  • pulls the tissues down, resulting in pain or pressure in the scalp and/or forehead area.
  • These are also called tension headaches.
  • Headaches caused by stress generally feel like dull pressure rather than throbbing pain.

Sleep Problems

  • Not getting enough sleep can induce a headache on top of the head.
  • When the mind and body do not get proper sleep, it can interfere with body functions like temperature, hunger, and sleep-wake cycles, which can lead to headaches.
  • It is common to feel more stressed when sleep-deprived, which can cause or compound a headache and other symptoms.

Eye Strain

  • You may develop a headache on the top of your head after you’ve been reading, watching, or otherwise focusing on something for a while.
  • Over time, your eye muscles tire and have to work harder, causing them to contract.
  • These spasms can lead to headaches. Squinting can make the muscle contractions even worse.

Caffeine Withdrawl

  • Individuals may feel pain on the top of their heads if they skip their regular coffee.
  • Regular caffeine consumption can lead to dependency and withdrawal symptoms, which include headaches when intake is reduced or stopped.
  • This type of headache can be moderate to severe and can feel worse with activity.
  • Most individuals start to feel better from caffeine withdrawal after a week. (World Health Organization. 2016)

Dental Problems

  • Teeth issues like cracks, cavities, or impaction can irritate the trigeminal nerve, setting off head pain.
  • Teeth grinding can also lead to headaches.

Hormonal Changes

  • Individuals who have a low level of thyroid hormone may experience headaches.
  • This could be from having too little thyroid or a symptom of the condition.
  • Like stress-induced headaches, this type is generally dull and not throbbing.
  • Some women may feel pain on the top of their heads before menstruation triggered by estrogen levels dropping.

Alcohol

  • Some individuals develop a headache on the top of their head or elsewhere within a few hours after drinking alcohol.
  • This is known as a cocktail headache.
  • Alcohol-induced headaches usually resolve within 72 hours.
  • The mechanism behind this headache is not fully researched, but it’s been thought that the widening of blood vessels in the brain/vasodilation when consuming alcohol may trigger head pain.
  • This type of headache is different than a hangover headache that comes from overconsumption and is based on dehydration and the toxic effects of alcohol. (J G Wiese, M. G. Shlipak, W. S. Browner. 2000)

Rare Causes

Top-of-the-head pain can also result from more serious and rare causes:

Brain Tumor

  • Headaches are one of the most common symptoms of brain tumors.
  • A headache on the top of the head depends on the location and size of the tumor. (MedlinePlus. 2021)

Brain Aneurysm

  • This is a weak or thin area in a brain artery that bulges and fills with blood, which can cause a life-threatening rupture.
  • Headaches are the most common symptom. (Brigham and Women’s Hospital. 2023)

Brain Bleed

  • Also known as a brain hemorrhage, this condition can cause intensely painful and quick headaches.
  • Brain bleeds can be caused by head trauma, high blood pressure, an aneurysm, a bleeding disorder, or liver disease. (New York-Presbyterian. 2023)

Treatment

Treatment for reducing a headache on top of the head includes:

  • Putting an ice bag over the area to reduce inflammation.
  • Getting an eye examination.
  • Making healthy lifestyle adjustments like drinking more water throughout the day.
  • Less caffeine intake.
  • Changing sleep patterns for a healthier, rested mind and body.
  • Taking a therapeutic bath to relax the body.
  • Gentle exercises like walking, pilates, or yoga.
  • Practicing deep breathing.
  • Mindfulness exercises like meditation.
  • Taking non-steroidal anti-inflammatory medication or NSAIDs like aspirin, Advil/ibuprofen), or Aleve/naproxen.

Depending on the cause and symptoms, a doctor may suggest specialist treatment options like:

  • Physical therapy
  • Cognitive behavioral therapy
  • Chiropractic therapy
  • Acupuncture
  • Prescription medication

A medical professional will be able to help identify the type of headache being experienced, offer treatment options, and advise on how to manage triggers.


Neck Injuries, El Paso, Texas


References

World Health Organization. (2016) Headache disorders.

Wiese, J. G., Shlipak, M. G., & Browner, W. S. (2000). The alcohol hangover. Annals of internal medicine, 132(11), 897–902. doi.org/10.7326/0003-4819-132-11-200006060-00008

MedlinePlus. (2021) Brain tumor.

Brigham and Women’s Hospital. (2023) Brain aneurysm.

New York-Presbyterian. (2023) Brain hemorrhage.

Dormant Butt Syndrome: What Causes it and How to Treat it

Dormant Butt Syndrome: What Causes it and How to Treat it

Individuals dealing with chronic knee discomfort, hip tightness, and lower back pain could be experiencing dormant gluteal-butt syndrome. Can recognizing the symptoms and signs and incorporating lower body and core fitness help prevent and treat the condition?

Dormant Butt Syndrome: What Causes it and How to Treat it

Dormant Gluteal Butt Syndrome

Knee, hip, and lower back problems could be traced back to weakened buttocks. Some scientists call the condition “dormant butt syndrome” (Ohio State University, .2023). However, researchers are learning about the important role the gluteal muscles provide in maintaining the lower body strong and healthy. (Hal David Martin, Manoj Reddy, Juan Gómez-Hoyos. 2015)

What Is It?

The syndrome is defined as weak buttock muscles and tight hip flexors. Experts from the Ohio State Wexner Medical Center have worked with individuals dealing with knee, hip, or back injuries and believe many of these issues are linked to weakened gluteal muscles. (Ohio State University.2023) The glutes are the muscles of the hips and buttocks. Weakened muscles fail to absorb the shock they’re supposed to during activities, which results in overloading the surrounding muscles and joints and increases the risk of injury. (Ohio State University, .2023)

  • Dormant gluteal-butt syndrome can result from a sedentary lifestyle and prolonged inactivity, like sitting for long periods.
  • The condition also occurs in runners and other physically active individuals who forget about these muscles with targeted exercises.

Exercises

Exercises to target the gluteals and prevent dormant gluteal-butt syndrome include activities/exercises that work the hips and core.

  • When walking properly, the gluteals should execute hip extension naturally.
  • Unhealthy postures, excessive sitting, and continued dysfunctional biomechanics mean walking without achieving optimal hip extension. (Hadi Daneshmandi. 2017)
  • When this happens, the gluteal muscles never get to fully function work, ending up with a series of aches and pains.
  • Pilates exercises can be adjusted to address order, repetition, and variation to strengthen the gluteals. (Laís Campos de Oliveira, 2015)

Hamstring Curls

  • Lie face down on an exercise mat.
  • Use your hands to create a cushion for the forehead.
  • Bend both knees so the feet point up towards the ceiling.
  • Let the knees be slightly apart, but keep the heels together.
  • Squeeze the heels together and tighten the gluteal muscles.
  • Hold for 3 seconds, then release the buttocks.
  • Repeat 10 times and then rest.
  • Hamstring curls can also be done using a weight machine.

Leg Pull Ups

  • Sit on a mat with your legs together in front.
  • Place the hands just behind the backside with the fingers pointing forward if possible.
  • Raise the body up.
  • Keep your head up and look straight ahead.
  • Raise one leg as high as possible.
  • Hold for as long as possible.
  • Lower and raise the other leg.
  • Repeat for a total of 3 reps.

Lining Up With A Wall Posture Helper

Standing posture is important to proper buttock function. Lining the body up with a wall can help train the body to maintain proper posture.

  • Find a wall and stand against it from the heels to the back of the head.
  • Work the backs of the legs and spine as firmly as possible into the wall.
  • Work to get the back of the skull into the wall as well.
  • Add some abdominal work by working the waistline inward and upward.
  • Hold for up to one minute.
  • The alignment is how you want to hold your body.
  • As you move off the wall, learn to maintain that posture throughout the day and night.
  • Repeat the wall exercise several times for reinforcement.

If aching of the hip, back, or knee is part of daily struggles, working out the gluteal muscles may be the solution. Contact the Injury Medical Chiropractic and Functional Medicine Clinic for a full consultation.


Easiest Weight Loss Hack


References

The Ohio State University Wexner Medical Center. (2023) Dormant butt syndrome may be to blame for knee, hip and back pain.

Martin, H. D., Reddy, M., & Gómez-Hoyos, J. (2015). Deep gluteal syndrome. Journal of hip preservation surgery, 2(2), 99–107. doi.org/10.1093/jhps/hnv029

Daneshmandi, H., Choobineh, A., Ghaem, H., & Karimi, M. (2017). Adverse Effects of Prolonged Sitting Behavior on the General Health of Office Workers. Journal of lifestyle medicine, 7(2), 69–75. doi.org/10.15280/jlm.2017.7.2.69

Campos de Oliveira, L., Gonçalves de Oliveira, R., & Pires-Oliveira, D. A. (2015). Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial. Journal of physical therapy science, 27(3), 871–876. doi.org/10.1589/jpts.27.871

Understanding the Sacrum: Shape, Structure, and Fusion

Understanding the Sacrum: Shape, Structure, and Fusion

“Various problems with the sacrum make up or contribute to a significant portion of lower back problems. Can understanding the anatomy and function help prevent and treat back injuries?”

Understanding the Sacrum: Shape, Structure and Fusion

The Sacrum

The sacrum is a bone shaped like an upside-down triangle located at the base of the spine that helps support the upper body when sitting or standing and provides pelvic girdle flexibility during childbirth. It comprises five vertebrae that fuse during adulthood and connect to the pelvis. This bone takes and endures all of the body’s pressure and stress from everyday activities and movements.

Formation

Humans are born with four to six sacral vertebrae. However, fusion does not take place in all sacral vertebrae simultaneously:

  • Fusion starts with the S1 and S2.
  • As the individual gets older, the overall shape of the sacrum begins to solidify, and the vertebrae fuse into a single structure.
  • The process usually starts in the mid-teens and finishes in the early to mid-twenties.
  • It is believed to start earlier in females than males.

The timing of the fusion can be used for estimating the age and sex of skeletal remains. (Laura Tobias Gruss, Daniel Schmitt. et al., 2015)

  1. The sacrum in a female is wider and shorter and has a more curved top or the pelvic inlet.
  2. The male sacrum is longer, narrower, and flatter.

Structure

The sacrum is an irregular bone that makes up the back/posterior third of the pelvic girdle.  There is a ridge across the front/anterior portion of the S1 vertebra known as the sacral promontory. Small holes/foramen on both sides of the sacrum are left over after the vertebrae fuse together. Depending on the number of vertebrae, there can be three to five foramen on each side, though there are usually four. (E. Nastoulis, et al., 2019)

  1. Each anterior foramen is typically wider than the posterior or dorsal/backside foramen.
  2. Each sacral foramina/plural of foramen provides a channel for the sacral nerves and blood vessels.
  • Small ridges develop between each of the fused vertebrae, known as transverse ridges or lines.
  • The top of the sacrum is called the base and is connected to the largest and lowest of the lumbar vertebrae – L5.
  • The bottom is connected to the tailbone/coccyx, known as the apex.
  • The sacral canal is hollow, runs from the base to the apex, and serves as a channel at the end of the spinal cord.
  • The sides of the sacrum connect to the right and left hip/iliac bones. The attachment point is the auricular surface.
  • Right behind the auricular surface is the sacral tuberosity, which serves as an attachment area for the ligaments that hold the pelvic girdle together.

Location

The sacrum is at the level of the lower back, just above the intergluteal cleft or where the buttocks split. The cleft starts at around the level of the tailbone or coccyx. The sacrum is curved forward and ends at the coccyx, with the curvature being more pronounced in females than males. It connects to the L5 lumbar vertebra by way of the lumbosacral joint. The disc between these two vertebrae is a common source of low back pain.

  1. On either side of the lumbosacral joint are wing-like structures known as the sacral ala, which connect to the iliac bones and form the top of the sacroiliac joint.
  2. These wings provide stability and strength for walking and standing.

Anatomical Variations

The most common anatomical variation applies to the number of vertebrae. The most common is five, but anomalies have been documented, including individuals with four or six sacral vertebrae. (E. Nastoulis, et al., 2019)

  • Other variations involve the sacrum’s surface and curvature, where the curvature differs widely between individuals.
  • In some cases, the first and second vertebrae do not fuse and remain separately articulated.
  • Failure of the canal to completely close during formation is a condition known as spina bifida.

Function

Studies on the sacrum are ongoing, but some proven functions include:

  • It serves as an anchor point for the spinal column to attach to the pelvis.
  • It provides stability for the body’s core.
  • It acts as a platform for the spinal column to rest on when sitting.
  • It facilitates childbirth, providing pelvic girdle flexibility.
  • It supports upper body weight when sitting or standing.
  • It provides extra stability for walking, balance, and mobility.

Conditions

The sacrum can be a main source or focal point for lower back pain. It is estimated that 28% of men and 31.6% of women aged 18 years or older have experienced low back pain in the past three months. (Centers for Disease Control and Prevention. 2020) Conditions that can cause sacrum pain symptoms include.

Sacroiliitis

  • This is a common condition of sacroiliac/SI joint inflammation.
  • A doctor only makes the diagnosis when all other possible causes of pain have been ruled out, known as a diagnosis of exclusion.
  • Sacroiliac joint dysfunction is thought to account for between 15% and 30% of low back pain cases. (Guilherme Barros, Lynn McGrath, Mikhail Gelfenbeyn. 2019)

Chordoma

  • This is a type of primary bone cancer.
  • About half of all chordomas form in the sacrum, but the tumors can also develop elsewhere in the vertebral column or at the base of the skull. (National Library of Medicine. 2015)

Spina Bifida

  • Individuals can be born with conditions that affect the sacrum.
  • Spina bifida is a congenital condition that can arise from the malformation of the sacral canal.

Unlocking the Secrets of Inflammation


References

Gruss, L. T., & Schmitt, D. (2015). The evolution of the human pelvis: changing adaptations to bipedalism, obstetrics and thermoregulation. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 370(1663), 20140063. doi.org/10.1098/rstb.2014.0063

Nastoulis, E., Karakasi, M. V., Pavlidis, P., Thomaidis, V., & Fiska, A. (2019). Anatomy and clinical significance of sacral variations: a systematic review. Folia morphologica, 78(4), 651–667. doi.org/10.5603/FM.a2019.0040

Centers for Disease Control and Prevention. QuickStats: Percentage of adults aged 18 years or older who had lower back pain in the past 3 months, by sex and age group.

Barros, G., McGrath, L., & Gelfenbeyn, M. (2019). Sacroiliac Joint Dysfunction in Patients With Low Back Pain. Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 36(8), 370–375.

National Library of Medicine, Chordoma.

Understanding Iliopsoas Syndrome: Symptoms & Causes

Understanding Iliopsoas Syndrome: Symptoms & Causes

Individuals suffering from hip, thigh, and/or groin pain could be experiencing iliopsoas syndrome. Could knowing the symptoms and causes help in diagnosis and treatment?

Understanding Iliopsoas Syndrome: Symptoms & Causes

Iliopsoas Syndrome

Iliopsoas syndrome encompasses several conditions that affect the inner hip muscle and can cause hip and thigh pain. The muscle helps to bend the leg toward the body.

  • The condition is usually caused by overuse injuries and commonly affects individuals who perform repeated hip flexion movements, like cyclists, gymnasts, dancers, runners, and soccer players. (Liran Lifshitz, et al., 2020)
  • The term is often used interchangeably with psoas syndrome, iliopsoas tendonitis, snapping hip syndrome, and iliopsoas bursitis. However, there are clinical differences.

Symptoms

Symptoms include: (American Association of Hip and Knee Surgeons. 2020)

  • Tenderness in the hip and groin area.
  • Hip or groin clicking or snapping that can be heard and/or felt during movement.
  • Pain and/or stiffness in the hip and thigh area.
  • Pain that worsens when bending the hip – walking, climbing stairs, squatting, sitting.
  • Movements that involve bringing the knee toward the chest can worsen the pain.

Causes

The iliopsoas muscles are hip muscles on the front of the hip. They are made up of the psoas major, the psoas minor, and the iliacus. Small, fluid-filled sacs/bursae are within the hip joint between bones and soft tissues. The bursae reduce friction and provide cushioning to help the tendons, muscles, and other structures move smoothly over the bony prominences.

  1. Iliopsoas bursitis happens when the bursa, which is located between the iliopsoas tendon and the inside of the hip joint, becomes inflamed and irritated.
  2. Iliopsoas tendonitis/hip tendonitis happens when the tendon that attaches the thigh bone to the iliopsoas muscle becomes inflamed and irritated.
  3. Iliopsoas bursitis and tendonitis are commonly caused by overuse injuries and intense activities like cycling, running, rowing, or strength training.

Diagnosis

  • Healthcare providers can diagnose iliopsoas syndrome based on symptom history and a hip examination.
  • Imaging tests – MRI and X-rays may be used to rule out other injuries or conditions like muscle tears. (Paul Walker, et al., 2021)

Treatment

Most mild cases of hip bursitis and hip tendonitis can be managed using the RICE method (American Association of Orthopedic Surgeons. 2020)

Rest

  • Avoid putting weight on the hip for a few days after the injury.

Ice

  • Apply ice immediately after the injury to bring the swelling down.
  • Use a cold pack for 20 minutes at a time, several times a day.
  • Do not apply ice directly on the skin.

Compression

  • Wrap the area in a soft bandage or use compression shorts to prevent further swelling.

Elevation

  • Rest as often as possible with the leg raised higher than the heart.

Medical Treatment

  • Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can alleviate pain and reduce inflammation. (Paul Walker, et al., 2021)
  • Steroid injections can be used if symptoms continue or come back with additional injections administered as necessary. (Paul Walker, et al., 2021)
  • After pain and swelling subside, physical therapy may be recommended, as well as mild exercises to gradually improve hip strength and flexibility. (Paul Walker, et al., 2021)
  • A healthcare provider may recommend surgery in severe cases where pain persists, and conservative treatments don’t provide enough relief.
  • However, this is rare due to muscle weakness and nerve damage risks. (Paul Walker, et al., 2021)

Hip Labral Tear – Chiropractic Treatment


References

Lifshitz, L., Bar Sela, S., Gal, N., Martin, R., & Fleitman Klar, M. (2020). Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current sports medicine reports, 19(6), 235–243. doi.org/10.1249/JSR.0000000000000723

American Association of Hip and Knee Surgeons. Iliopsoas tendonitis/bursitis.

Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, W. F., & Kaye, A. D. (2021). Snapping Hip Syndrome: A Comprehensive Update. Orthopedic reviews, 13(2), 25088. doi.org/10.52965/001c.25088

American Association of Orthopedic Surgeons. OrthoInfo. Hip strains.

Relieve Osteoarthritis Joint Pain: Massage Therapy Benefits

Relieve Osteoarthritis Joint Pain: Massage Therapy Benefits

For individuals managing osteoarthritis, could massage therapy provide added treatment benefits?

Relieve Osteoarthritis Joint Pain: Massage Therapy Benefits

Osteoarthritis Massage Therapy

Osteoarthritis happens when the cartilage between the joints wears away, causing stiffness and pain. Massage therapy is a treatment used to relieve various types of pain symptoms.

  • There are many types of massage therapy, that healthcare providers utilize to manipulate the muscles and other soft tissues to relieve symptoms, relax muscles, increase circulation, reduce inflammation, release trigger points, and restore mobility, flexibility, and function. (Ergonomic Trends. 2023)
  • Professional therapists can help relieve osteoarthritis joint pain by relaxing the surrounding muscles and other soft tissues to release stiffness. (Adam Perlman, et al., 2019)

Massage Objectives and Types

Massage therapists use their hands and fingers, forearms, elbows, and/or instruments to manipulate the body’s soft tissues. Soft tissues support and surround body structures and include muscle, fat, tendons, and ligaments.

  • The goal of osteoarthritis massage therapy is to relax muscles and soft tissues, increase blood and oxygen circulation, warm the affected area/s, relieve pain, and restore mobility and function.
  • Depending on the location of the muscles being massaged, individuals may be seated or lie down on a specialized table.
  • The amount of pressure and direction of movement depend on the body area.
  • Therapeutic oils and/or massage creams may be used to increase the therapy.

Types include:

Swedish

  • The therapist uses long strokes, kneading, and friction on the muscles.
  • Joints are moved to increase flexibility.

Deep Tissue

  • The therapist uses deep finger or instrument pressure, focusing on muscles that are tight or knotted.

Trigger Point

  • Trigger points represent a source of radiating pain symptoms.
  • The therapist focuses pressure on these myofascial tissue points using various strokes to release them.

Shiatsu

  • The therapist applies rhythmic pressure with their thumbs, fingers, and palms to redirect and increase energy or chi/qi.

A massage session lasts around 30–60 minutes depending on the severity of the condition and the number of sessions the patient has undergone. Chronic pain patients usually go through a series of specialized sessions that focus on specific areas and gradually build.

Risk Factors

Certain precautions must be taken before getting osteoarthritis massage therapy. Although there are a few serious risks, certain individuals are not suitable candidates and should not receive massage therapy. The conditions include: (Medical Massage Therapy Resource & Reference. 2023)

  • Damaged nerves.
  • Damaged blood vessels.
  • Infection and inflammation in the area to be massaged.
  • Open wounds.
  • Fever.
  • Taking a blood thinner.
  • Deep vein thrombosis – blood clots.
  • Bleeding disorders.
  • Osteoporosis – weak and brittle bones.
  • Recent fractures – broken bones.
  • Tumors.
  • Cancer.
  • Individuals who have recently undergone surgery.
  • Individuals with a skin condition that is contagious, like warts or herpes, or noncontagious, like psoriasis, could be aggravated by touch or pressure.
  • Individuals who have cancer, fragile skin, heart problems, or dermatomyositis are recommended to discuss osteoarthritis massage therapy with their healthcare provider.

Research on the effects of massage therapy on various health conditions is ongoing. Massage therapy promotes relaxation while reducing stress, which can help with chronic joint issues like osteoarthritis.


Arthritis Explained


References

Ergonomic Trends. 20 most common types of massages and their benefits explained.

Perlman, A., Fogerite, S. G., Glass, O., Bechard, E., Ali, A., Njike, V. Y., Pieper, C., Dmitrieva, N. O., Luciano, A., Rosenberger, L., Keever, T., Milak, C., Finkelstein, E. A., Mahon, G., Campanile, G., Cotter, A., & Katz, D. L. (2019). Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. Journal of general internal medicine, 34(3), 379–386. doi.org/10.1007/s11606-018-4763-5

Medical Massage Therapy Resource & Reference. When not to get a massage: 26 reasons you cannot get a massage.

Therapeutic Solutions for Upper Crossed Syndrome: What You Need to Know

Therapeutic Solutions for Upper Crossed Syndrome: What You Need to Know

Can various therapeutic options provide relief for individuals with upper crossed syndrome to restore muscle strength?

Introduction

Many individuals often suffer neck and shoulder pain from poor posture, improper heavy lifting, musculoskeletal conditions, auto accidents, whiplash, etc. The surrounding muscles that connect the neck and shoulders help protect the cervical and thoracic region of the spine and can succumb to injuries that can cause pain-like symptoms causing discomfort to the individual. Neck, shoulder, and back pain are the three most common issues many individuals have experienced. These musculoskeletal disorders can also correlate with pre-existing conditions; many people will feel pain and discomfort while trying to find the relief they seek. One of the most common issues people often experience is upper crossed syndrome, which can be associated with neck and shoulder pain. Today’s article explains what upper cross syndrome is and how it affects the neck and shoulders while also diving into how different therapeutic options like spinal decompression and chiropractic care can reduce the effects of upper cross syndrome. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to mitigate upper-crossed syndrome in the neck and shoulders. We also inform our patients that there are many therapeutic options, like chiropractic care and spinal decompression, to minimize muscle pain in the neck and shoulders. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with upper-crossed syndrome. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

 

What Is Upper Crossed Syndrome?

 

Have you been dealing with muscle pain in your shoulders or neck after being on the computer for a while? Do you feel stiffness in your shoulders that rotating them causes temporary relief? Or does it hurt when you turn your head from side to side? Many of these pain-like scenarios are often associated with upper-cross syndrome. Many people don’t often realize that upper crossed syndrome is a musculoskeletal condition that affects the neck, shoulder, and chest muscles and causes them to be weak and tight due to poor posture. The upper crossed syndrome can cause referred pain to the upper extremities, leading to cervicogenic headaches, limited range of motion, trigger points in the muscles, and muscle imbalance. (Moore, 2004) When many people are dealing with upper crossed syndrome due to poor posture, it can lead to many issues in the neck and shoulders.

 

How Does It Affect The Neck & Shoulders?

Now, why does upper crossed syndrome affect the neck and shoulders? Many people unintentionally hunched over when looking at their phones, being on the computer, or relaxing at home. This causes specific muscles in the neck and shoulder region, like the serratus and lower trapezius muscles, to become weak while the pectoral and neck muscles are tight. (Chu & Butler, 2021) This, in turn, causes the shoulders to be more rounded and hunched, causing the neck and head to crane forward. When people are dealing with upper crossed syndrome, many would often complain about pain-like symptoms like:

  • Headaches
  • Neck Strain
  • Muscle tightness
  • Upper back pain
  • Restricted range of motion
  • Numbness/Tingling sensations in the arms

The upper crossed syndrome can also occur gradually over time and cause nerve compression to the upper extremities. When the upper neck and shoulder muscles start to affect the surrounding nerve roots, which then leads to nerve dysfunction in the sensory and motor skills when a person picks up an object. (Lee & Lim, 2019) However, many individuals dealing with upper-crossed syndrome can seek treatment to relieve muscle pain in their neck and shoulders.

 


An Overview Of Upper Crossed Syndrome- Video

Since upper cross syndrome is a musculoskeletal condition that affects the neck and shoulders, it can result in muscle imbalance and pain in the individual. Many people, especially in the working field, develop this syndrome by being hunched over for an extended period. (Mujawar & Sagar, 2019) This causes the head to be more forward, the neck posture to be curved and hunched, and the shoulders to be rounded. The video above explains upper-crossing syndrome, its causes, and how it is treated. 


Spinal Decompression Reducing Upper Crossed Syndrome

 

Numerous treatments can help restore muscle strength and reduce muscle pain in the neck and shoulders. Treatments like spinal decompression can help reduce upper crossed syndrome by slowly using gentle traction to the cervical spine region and gently stretching the neck muscles to provide relief. Spinal decompression is one of the non-surgical treatments that many individuals with headaches associated with upper crossed syndrome can find the comfort they seek through pain reduction and improve their quality of life. (Eskilsson et al., 2021) At the same time, spinal decompression can be part of a personalized treatment plan that many individuals can add to their daily routine to prevent the pain from returning. (Saunders, 1983)

 

Chiropractic Care Restoring Muscle Strength

Just like spinal decompression, chiropractic care is a non-surgical treatment that can be combined with various stretching techniques to restore the neck’s range of motion and reduce pain associated with upper-crossed syndrome. (Mahmood et al., 2021) Chiropractic care incorporates manual and mechanical techniques like MET (muscle energy techniques) and spinal manipulation to realign the spine out of subluxation. When chiropractors integrate MET to manage upper crossed syndrome, many individuals find that their pain has decreased, their cervical range of motion is improved, and their neck disability is reduced. (Gillani et al., 2020) When many individuals start thinking about their health and wellness, they can make small changes to improve their posture and be more mindful of their bodies to reduce the chances of upper-cross syndrome returning.

 


References

Chu, E. C., & Butler, K. R. (2021). Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract, 11(2), 322-326. doi.org/10.3390/clinpract11020045

Eskilsson, A., Ageberg, E., Ericson, H., Marklund, N., & Anderberg, L. (2021). Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain – a retrospective cohort study. Acta Neurochir (Wien), 163(9), 2425-2433. doi.org/10.1007/s00701-021-04913-0

Gillani, S. N., Ain, Q., Rehman, S. U., & Masood, T. (2020). Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc, 70(3), 394-398. doi.org/10.5455/JPMA.300417

Lee, E. Y., & Lim, A. Y. T. (2019). Nerve Compression in the Upper Limb. Clin Plast Surg, 46(3), 285-293. doi.org/10.1016/j.cps.2019.03.001

Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad, A. (2021). Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc, 71(10), 2304-2308. doi.org/10.47391/JPMA.03-415

Moore, M. K. (2004). Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther, 27(6), 414-420. doi.org/10.1016/j.jmpt.2004.05.007

Mujawar, J. C., & Sagar, J. H. (2019). Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med, 23(1), 54-56. doi.org/10.4103/ijoem.IJOEM_169_18

Saunders, H. D. (1983). Use of spinal traction in the treatment of neck and back conditions. Clin Orthop Relat Res(179), 31-38. www.ncbi.nlm.nih.gov/pubmed/6617030

 

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