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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.


How Non-Surgical Spinal Decompression Can Help with Pain Management

How Non-Surgical Spinal Decompression Can Help with Pain Management

Can healthcare professionals help individuals with spinal pain by incorporating non-surgical spinal decompression to restore mobility?

Introduction

Many individuals don’t realize that putting unwanted pressure on their spines can lead to chronic pain within their spinal discs that is affecting their spinal mobility. This usually happens with demanding jobs requiring individuals to carry heavy objects, step wrong, or be physically inactive, which causes the surrounding back muscles to be overstretched and leads to referred pain that affects the upper and lower body portions. This can cause individuals to go to their primary doctors to get treated for back pain. This leads to them missing out on their busy work schedules and paying a high price to get treated. Back pain correlating with spinal issues can be a huge problem and make them feel miserable. Fortunately, numerous clinical options are cost-effective and personalized to many individuals dealing with spinal pain that is causing them to find the relief they deserve. Today’s article focuses on why spinal pain affects many people and how spinal decompression can help reduce spinal pain and restore spinal mobility. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce spinal pain affecting their backs. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with spinal issues in the body. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

Why Spinal Pain Is Affecting Many People?

Have you often experienced pain from your back muscles that seem to ache after bending down constantly to pick up objects? Do you or your loved ones feel muscle stiffness in the back and experience numbness in your upper or lower body portions? Or are you experiencing temporary relief after stretching your back muscles, only for the pain to return? Many individuals with back pain never realize that their pain is within their spinal column. Since the spine is an S-curve shape with three different regions in the body, the spinal discs within each spinal segment can become compressed and become misaligned over time. This causes degenerative changes within the spine and can cause the three different spinal regions to develop pain-like issues in the body. When several environmental factors start to be the causes of degeneration of the spinal discs, it can affect the spinal structure. It can become a strong influence affecting their function, predisposing the disc to injuries. (Choi, 2009) At the same time, this can cause a significant impact when getting treated due to its high cost and can start normal age-related changes that cause pathophysiological issues to the vertebral body. (Gallucci et al., 2005)


When many individuals are dealing with spinal pain associated with herniated discs, it can not only cause discomfort but also mimic other musculoskeletal disorders that can cause radiating pain to different locations in the body. (Deyo et al., 1990) This, in turn, causes individuals to suffer constantly and research various treatments to reduce the pain they are experiencing. When spinal pain affects most individuals, many will seek cost-effective therapies to ease the pain they are experiencing and to be mindful of the daily habits they adopt over time and correct them.


Spinal Decompression In-Depth- Video

Do you often feel constant muscle aches and pains in your body that are your general areas of complaint? Do you feel your muscles pull uncomfortably after lifting or carrying a heavy object? Or do you feel constant stress in your neck, shoulders, or back? When many individuals are dealing with general pain, they often assume that it is just back pain when it could be a spinal issue that can be the root cause of the pain they are experiencing. When this happens, many individuals opt for non-surgical treatments due to its cost-effectiveness and how it can be personalized depending on the severity of the pain. One of the non-surgical treatments is spinal decompression/traction therapy. The video above gives an in-depth look at how spinal decompression can help reduce spinal pain associated with low back pain. Spinal pain can increase with age and be provoked by extreme lumbar extension, so incorporating spinal decompression can help reduce pain in the upper and lower extremities. (Katz et al., 2022)


How Spinal Decompression Can Reduce Spinal Pain


When individuals develop spinal issues, spinal decompression can help restore the spine to its original position and help the body naturally heal itself. When something is out of place within the spine, it is important to naturally restore it to its proper place to allow the affected muscles to heal. (Cyriax, 1950) Spinal decompression uses gentle traction to pull the spinal joints to let the spinal disc back in its original position and help increase fluid intake back in the spine. When people start incorporating spinal decompression into their health and wellness routine, they can reduce their spinal pain after a few consecutive treatments.

 

Spinal Decompression Restoring Spinal Mobility

Spinal decompression can also be incorporated with other non-surgical treatments to restore spinal mobility. When pain specialists utilize spinal decompression within their practices, they can help treat various musculoskeletal conditions, including spinal disorders, to allow the individual to regain spinal mobility. (Pettman, 2007) At the same time, pain specialists can use mechanical and manual manipulation to reduce the pain the individual feels. When spinal decompression starts to use gentle traction on the spine, it can help minimize radical pain correlated with nerve entrapment, create negative pressure within the spinal sections, and relieve musculoskeletal disorders causing pain. (Daniel, 2007) When people start thinking more about their health and wellness to reduce their pain, spinal decompression can be the answer through a personalized plan and can help many individuals find the relief they deserve.

 


References

Choi, Y. S. (2009). Pathophysiology of degenerative disc disease. Asian Spine Journal, 3(1), 39-44. doi.org/10.4184/asj.2009.3.1.39

 

Cyriax, J. (1950). The treatment of lumbar disk lesions. Br Med J, 2(4694), 1434-1438. doi.org/10.1136/bmj.2.4694.1434

 

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. doi.org/10.1186/1746-1340-15-7

 

Deyo, R. A., Loeser, J. D., & Bigos, S. J. (1990). Herniated lumbar intervertebral disk. Ann Intern Med, 112(8), 598-603. doi.org/10.7326/0003-4819-112-8-598

 

Gallucci, M., Puglielli, E., Splendiani, A., Pistoia, F., & Spacca, G. (2005). Degenerative disorders of the spine. Eur Radiol, 15(3), 591-598. doi.org/10.1007/s00330-004-2618-4

 

Katz, J. N., Zimmerman, Z. E., Mass, H., & Makhni, M. C. (2022). Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA, 327(17), 1688-1699. doi.org/10.1001/jama.2022.5921

 

Pettman, E. (2007). A history of manipulative therapy. J Man Manip Ther, 15(3), 165-174. doi.org/10.1179/106698107790819873

Disclaimer

Solutions for Chronic Low Back Pain Sufferers

Solutions for Chronic Low Back Pain Sufferers

Can healthcare professionals provide the best non-surgical therapeutic options for individuals with chronic low back pain?

Introduction

Chronic low back pain can happen to numerous individuals, affecting their daily routine and making them miss out on important life events. With the ever-changing world, many individuals, especially working individuals, will experience chronic low back pain at some point due to unbearable stress that seems to affect the surrounding muscles that protect the lumbar spine. This causes many individuals to overstretch or shorten the muscles that are contributing to lower back pain, which can be the causing factor in the development of lower back pain. At the same time, when individuals suffer from low back pain, it can be imposed as a grave economic cost to society. (Pai & Sundaram, 2004) This, in turn, causes many individuals to miss out on work and be financially burdened as the cost of chronic low back pain treatment is high. However, numerous therapeutic options are cost-effective, safe, and effective in reducing chronic low back pain. Today’s post looks at the effects of chronic low back pain and how many individuals can look at various non-surgical options that many individuals can utilize to reduce chronic low back pain. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce chronic low back pain. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with the factors that cause chronic lower back pain. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

The Effects Of Chronic Low Back Pain

Have you been dealing with chronic pain that flares up in your lower back after a hard workday? Do you feel muscle aches or pains that don’t relieve itself after a day of rest? Or do you and your loved ones take any medication to temporarily relieve your back pain, only to have it come back after a few hours? Many people with chronic low back pain will feel symptoms of stiffness, muscle aches, and radiating pain traveling to their lower extremities. When chronic low back pain is associated with musculoskeletal conditions, it can impact their daily routine. To that point, musculoskeletal disorders correlating with chronic low back pain can encompass a spectrum of conditions and increase naturally over time. (Woolf & Pfleger, 2003) When many individuals are dealing with chronic low back pain, it can become a socio-economic burden that leads to disability. (Andersson, 1999) However, there are numerous options for individuals with chronic lower back pain who can find the relief they need to reduce its effects and will be able to get back to their daily routine.

 

 


Understanding Long-Lasting Injuries- Video

Chronic low back pain is when back pain that lasts longer than a few weeks and is one of the most common problems many people experience. When finding relief for chronic low back pain, many individuals will try home remedies to alleviate the pain. However, it can temporarily relieve the issue and mask the symptoms. When individuals see their primary doctor for chronic low back pain, many will seek a personalized plan to reduce chronic low back pain and its associated symptoms. When relieving chronic low back pain, comprehensive pain management treatments often rely on physical therapy, multidisciplinary approaches, and non-surgical options to reduce chronic low back pain. (Grabois, 2005) When understanding how the individual has chronic low back pain, it is important to identify the causes and how it can cause lifelong injuries that can develop into disability. When primary doctors start to utilize non-surgical treatments in their practices, many individuals can find the benefits of non-surgical treatments as they are cost-effective, safe, and gentle on the spine and lumbar region and can be personalized with associated medical providers to reduce pain-like symptoms correlating with chronic low back pain. Check out the video above to learn more about how non-surgical treatments can help reduce chronic low back pain and help revitalize a person’s body through a personalized treatment plan.


Non-Surgical Options For Chronic Low Back Pain

When treating chronic low back pain, non-surgical treatments effectively relieve pain and restore mobility to the back. Non-surgical treatments can be customized to the individual’s pain severity while being cost-effective. When individuals are evaluated for chronic low back pain, they are provided with many healthcare providers to reduce the pain-like symptoms caused by chronic low back pain. (Atlas & Deyo, 2001) Many individuals will incorporate various treatment options like:

  • Exercises
  • Spinal Decompression
  • Chiropractic care
  • Massage Therapy
  • Acupuncture

Many of these treatments are non-surgical and incorporate various mechanical and manual manipulation techniques to stretch and strengthen the weak back muscles, elongate the spine through realignment, and help restore movement while reducing symptoms in the lower extremities. When individuals incorporate non-surgical treatments consecutively, they will have a positive experience and feel better in the long run. (Koes et al., 1996)

 


References

Andersson, G. B. (1999). Epidemiological features of chronic low-back pain. Lancet, 354(9178), 581-585. doi.org/10.1016/S0140-6736(99)01312-4

Atlas, S. J., & Deyo, R. A. (2001). Evaluating and managing acute low back pain in the primary care setting. J Gen Intern Med, 16(2), 120-131. doi.org/10.1111/j.1525-1497.2001.91141.x

Grabois, M. (2005). Management of chronic low back pain. Am J Phys Med Rehabil, 84(3 Suppl), S29-41. www.ncbi.nlm.nih.gov/pubmed/15722781

Koes, B. W., Assendelft, W. J., van der Heijden, G. J., & Bouter, L. M. (1996). Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 21(24), 2860-2871; discussion 2872-2863. doi.org/10.1097/00007632-199612150-00013

Pai, S., & Sundaram, L. J. (2004). Low back pain: an economic assessment in the United States. Orthop Clin North Am, 35(1), 1-5. doi.org/10.1016/S0030-5898(03)00101-9

Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656. www.ncbi.nlm.nih.gov/pubmed/14710506

www.ncbi.nlm.nih.gov/pmc/articles/PMC2572542/pdf/14710506.pdf

 

Disclaimer

Unlock Peak Performance with Central Nervous System Activation

Unlock Peak Performance with Central Nervous System Activation

For individuals about to engage in physical activity or exercise, how does warming up the body help prepare for the work ahead?

Optimize Your Performance with Central Nervous System Activation

Central Nervous System Activation

A proper warm-up before physical activity or working out prepares the mind and body to reduce risks of injury, mentally and physically transition to physical activity work, and enhance performance. A well-designed warm-up also primes the central nervous system/CNS for activity. The central nervous system transmits messages to the muscles to prepare them for action. Central nervous system activation increases motor neuron recruitment and engages the sympathetic nervous system so the body can better handle the physical stressors. The process may seem complex, but priming the nervous system is as simple as warming up with light aerobic activity before getting into more explosive movements.

CNS

The CNS consists of the brain and spinal cord. This central communication system uses another part of the nervous system known as the peripheral nervous system or PNS to transmit and receive messages throughout the body. The PNS is connected to the entire body and the brain and spinal cord (CNS).

  • Nerves run throughout the body, receiving signals from the CNS to the muscles, fibers, and organs, transmitting various information back to the brain. (Berkeley University. N.D.)
  • There are two types of systems within the peripheral nervous system – somatic and autonomic.
  1. Somatic nervous system actions are those controlled by the person through voluntary actions like choosing to pick something up.
  2. The autonomic system is involuntary and generates actions like breathing or heartbeat. (Cleveland Clinic. 2020)

Properly preparing the body for an intense strength training session or other physical activity needs the correct messages to be sent through the autonomic nervous system.

Parasympathetic and Sympathetic States

The autonomic nervous system consists of two subcategories, which are parasympathetic and sympathetic.

  • The sympathetic nervous system helps the body get ready to face stress which includes physical stress. (R. Bankenahally, H. Krovvidi. 2016)
  • The fight, flight, or freeze response describes the sympathetic nervous system’s aspect.
  • The parasympathetic nervous system is responsible for relaxation and de-stressing.

Individuals are recommended to perform a few calming movements and actions after a workout to return the body to a parasympathetic state. This can be:

  • Stretching
  • Lying with the legs elevated
  • Relaxing yoga poses
  • Box breathing
  • Taking a warm shower or bath
  • Foam rolling
  • Massage

Returning the mind and body to a calm state helps with recovery and reduces stress hormone production. (National Academy of Sports Medicine. 2022)

Why Activate the CNS

Activating the CNS can increase performance and prevent injuries. The process wakes up and alerts the body for the activity. Individuals are recommended before beginning a training session, to communicate to the body about the physical stress it is about to endure and to prepare for the work ahead. This is a concept known as post-activation potentiation/PAP. (Anthony J Blazevich, Nicolas Babault. 2019) PAP helps increase force and power production, which enhances physical performance.

  • Whenever an individual trains, the brain adapts and learns what the body is doing and the purpose of the training.
  • Muscle memory describes this interaction.
  • Individuals who have started up a new strength training routine or after an extended break report feeling awkward for the first few sessions, or even weeks, depending on their experience. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)
  • However, after a few sessions, the body is more adept at performing the movements and ready to increase resistance, repetitions, or both.
  • This has to do with the neural drive and muscle memory than it has to do with true potential physical abilities. (Simon Walker. 2021)
  • Training the CNS to be alert and pay attention can increase the development of a healthy mind-muscle connection combined with muscle memory. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)

General Warm-Up

The first step is a general warm-up that should use large muscle groups and be of low intensity so as not to exhaust the body before beginning the actual training. General warm-up benefits central nervous system activation and the entire body include: (Pedro P. Neves, et al., 2021) (D C. Andrade, et al., 2015)

  • Increases blood circulation.
  • Assists the release of oxygen from hemoglobin and myoglobin.
  • Warms the muscles, so they contract more effectively.
  • Increases nerve impulse speed.
  • Increases nutrient delivery.
  • Lowers joints’ resistance through increased synovial fluid/joint lubrication.
  • Increases joint range of motion.
  • Improves joint resiliency.
  • Removes metabolic waste quicker.
  • Reduces risk of injury.

A general warm-up can be simple as any aerobic activity will work. This can include:

  • Performing bodyweight movements – light jumping jacks or jogging in place.
  • Treadmill
  • Rowing machine
  • Stair climber
  • Elliptical trainer

It is recommended to use the rating perceived exertion scale/RPE to determine the general warm-up effort. An exertion rating of between 5 to 6 is equivalent to moderate walking or a slow jog. Individuals should be able to speak clearly without taking a pause.

Try this strategy before the next workout to see increased performance and reduced injury risks.


Ankle Sprains Recovery


References

The nervous system. Berkeley University.

Cleveland Clinic. Nervous system: What it is, types, symptoms.

Bankenahally R, Krovvidi H. (2016) Autonomic nervous system: anatomy, physiology, and relevance in anesthesia and critical care medicine. BJA Education. 16(11):381-387. doi:10.1093/bjaed/mkw011

National Academy of Sports Medicine. Sympathetic vs. parasympathetic overtraining.

Blazevich, A. J., & Babault, N. (2019). Post-activation Potentiation Versus Post-activation Performance Enhancement in Humans: Historical Perspective, Underlying Mechanisms, and Current Issues. Frontiers in physiology, 10, 1359. doi.org/10.3389/fphys.2019.01359

Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor perspectives in medicine, 8(6), a029769. doi.org/10.1101/cshperspect.a029769

Walker S. (2021). Evidence of resistance training-induced neural adaptation in older adults. Experimental gerontology, 151, 111408. doi.org/10.1016/j.exger.2021.111408

P. Neves, P., R. Alves, A., A. Marinho, D., & P. Neiva, H. (2021). Warming-Up for Resistance Training and Muscular Performance: A Narrative Review. IntechOpen. doi: 10.5772/intechopen.96075

Andrade, D. C., Henriquez-Olguín, C., Beltrán, A. R., Ramírez, M. A., Labarca, C., Cornejo, M., Álvarez, C., & Ramírez-Campillo, R. (2015). Effects of general, specific, and combined warm-up on explosive muscular performance. Biology of sport, 32(2), 123–128. doi.org/10.5604/20831862.1140426

Regenerative Cells for Arthritis: What You Should Know

Regenerative Cells for Arthritis: What You Should Know

As the body ages, individuals want to stay active and maintain a healthy pain free lifestyle. Can regenerative cells for arthritis and cartilage damage be the future of neuromusculoskeletal medicine and joint healing?

Regenerative Cells for Arthritis: What You Should Know

Regenerative Cells For Arthritis and Cartilage Damage

Individuals want to continue to do the physical activities they love, which require healthy joints. Scientists are learning how to harness the abilities of regenerative cells to repair and regrow damaged and deteriorated cartilage. Current stem cell treatment of cartilage problems has not been shown to reverse the effects of arthritis and while studies show clinical improvement, further research is necessary. (Bryan M. Saltzman, et al., 2016)

Cartilage and How It Gets Damaged

Cartilage is a type of connective tissue. In the joints, there are a few types of cartilage. The most commonly referred to is the smooth lining known as articular or hyaline cartilage. This type forms a smooth layer of cushion on the end of a bone at the joint. (Rocky S. Tuan, et al., 2013)

  • The tissue is very strong and has the ability to compress and absorb energy.
  • It is very smooth allowing a joint to glide effortlessly through a limb’s range of motion.
  • When joint cartilage is damaged, the cushioning can wear down.
  • In traumatic injuries, a sudden force can cause the cartilage to break off and/or suffer damage, that exposes the underlying bone.
  • In osteoarthritis – degenerative or wear-and-tear arthritis,  the smooth layer can wear down thin and unevenly.
  • Eventually, the cushion wears away, the joints become inflamed and swollen and movements become stiff and painful.

There are treatments for arthritis and cartilage damage, but these treatments are usually focused on relieving symptoms by smoothing down the damaged cartilage or replacing the joint surface with an artificial implant, like knee replacement or hip replacement surgeries. (Robert F. LaPrade, et al., 2016)

Regenerative Cells

Regenerative stem cells are special cells that have the ability to multiply and develop into different types of tissue. In an orthopedic surgery setting for joint problems, stem cells are obtained from adult stem cell primary sources which are bone marrow and fatty tissue. These cells have the ability to develop into cartilage cells, called chondrocytes. (Rocky S. Tuan, et al., 2013)

  • They also help by stimulating the body to reduce inflammation, stimulate cell repair, and improve blood circulation.
  • This process is caused by cellular signals and growth factors to stimulate the body to activate the healing processes.
  • Once stem cells have been obtained, they need to be delivered to the area of cartilage damage.

Cartilage is a complex tissue that is described as a scaffold structure that is composed of collagen, proteoglycans, water, and cells. (Rocky S. Tuan, et al., 2013)

  • To regenerate cartilage, the complex tissues must also be reconstructed.
  • There are studies on types of tissue scaffolds engineered to recreate a similar type of cartilage structure.
  • The stem cells can then be injected into the scaffold, in hopes of restoring a normal type of cartilage.

Non-Surgical Arthritis Treatments

Standard treatments such as cortisone shots or physical therapies work as well and provide benefits that could be utilized in combination with regenerative cells for arthritis and cartilage damage in the near future. Data takes time and therefore how this impacts the long-term health of a joint needs continued research in terms of tissue engineering and cell delivery to determine the best approach to help individuals.


Arthritis


References

LaPrade, R. F., Dragoo, J. L., Koh, J. L., Murray, I. R., Geeslin, A. G., & Chu, C. R. (2016). AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. The Journal of the American Academy of Orthopaedic Surgeons, 24(7), e62–e78. doi.org/10.5435/JAAOS-D-16-00086

Saltzman, B. M., Kuhns, B. D., Weber, A. E., Yanke, A., & Nho, S. J. (2016). Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist. American journal of orthopedics (Belle Mead, N.J.), 45(5), 280–326.

Tuan, R. S., Chen, A. F., & Klatt, B. A. (2013). Cartilage regeneration. The Journal of the American Academy of Orthopaedic Surgeons, 21(5), 303–311. doi.org/10.5435/JAAOS-21-05-303

A Guide to Understanding Back Pain Specialists

A Guide to Understanding Back Pain Specialists

Back problems and discomfort symptoms are a common ailment that many types of healthcare providers diagnose and treat it. Can knowing a little about what each back pain specialist does and what they have to offer help in choosing a provider?

Back Pain Specialists

Back Pain Specialists

Nowadays individuals have options for treating back pain. Primary healthcare providers, general practitioners, pediatricians, and emergency room workers are usually the first to examine the injury or problem. If they are unable to properly diagnose or treat the injury, they will refer the individual to a specialist. Specialists include:

  • Osteopaths
  • Chiropractors
  • Orthopedists
  • Rheumatologists
  • Neurologists
  • Neurosurgeons.

They specialize in chronic conditions and diseases like arthritis or problems like herniated discs. Complementary and alternative providers treat individuals solely or with help from a care team. They look at the whole body and focus on improving overall function.

Family and General Practitioners

When neck or back pain begins a regular doctor that’s usually a family or general practitioner/GP or primary care provider PCP is a recommended place to start. They will:

  • Order diagnostic tests.
  • Recommend exercises and stretches.
  • Prescribe medication.
  • Refer the patient to a physical therapist or other back pain specialist.

However, studies suggest general providers can be uninformed and slow to adopt new back treatments. (Paul B. Bishop, Peter C. Wing. 2006) It is recommended to research possible treatment options, ask a lot of questions during an appointment, and ask or request a referral to a specialist.

Pediatricians

Pediatricians diagnose and treat children. They cover a wide range of issues including back problems and injuries. As with a general practitioner or primary care provider, a child’s pediatrician is the place to start. Depending on the child’s needs, they’ll refer them to the proper specialist.

Emergency Healthcare Providers

When there is serious neck or back trauma, individuals need to go to the emergency room. Trauma can include automobile collisions, sports accidents, work accidents, and/or personal home accidents. Someone with a possible spinal injury should not be moved. (W Yisheng, et al., 2007) Go to the ER if there is back pain with loss of bowel or bladder control, or the legs become progressively weaker. These are symptoms of an emergency condition known as cauda equina syndrome. (American Association of Neurological Surgeons. 2023)

Orthopedists

Orthopedists and orthopedic surgeons treat the musculoskeletal system, which includes:

  • Muscles
  • Bones
  • Joints
  • Connective tissues
  • Cartilage

Common orthopedic issues include:

  • Repetitive stress injuries
  • Sports injuries
  • Bursitis
  • Tendonitis
  • Ruptured discs
  • Nerve impingement
  • Scoliosis
  • Osteoporosis
  • Osteoarthritis

Orthopedics can overlap with other specialties. As orthopedists and rheumatologists both treat arthritis and orthopedic surgeons and neurosurgeons do some of the same procedures that include spinal fusions and discectomies.

Rheumatologists

A rheumatologist treats autoimmune, inflammatory, and musculoskeletal conditions that can include different types of arthritis, lupus, and Sjogren’s syndrome. A primary care provider may refer a patient to a rheumatologist if they have symptoms that include:

  • Sacroiliitis – inflammation of the sacroiliac joint at the base of the spine.
  • Axial spondylosis – a form of spinal arthritis.
  • Axial spondylosis – spinal arthritis that causes the bones to fuse together.
  • Rheumatologists can also treat spinal stenosis or advanced osteoarthritis as they overlap with orthopedists.

Neurologists

A neurologist specializes in the function of the nervous system. They treat disorders of the brain, spinal cord, and nerves that include:

  • Parkinson’s disease
  • Multiple sclerosis
  • Alzheimer’s disease
  • Chronic back or neck pain

They are experts in the origins of pain. (David Borsook. 2012) However, a neurologist does not perform spine surgery.

Neurosurgeons

A neurosurgeon specializes in nervous system surgical procedures that include the brain, spine, and spinal cord. However, neurosurgeons do not provide overall treatment for back pain because they are usually the last to be seen after exhausting all other treatment options.

Osteopaths

An osteopath is a licensed physician who practices medicine using conventional treatments and osteopathic manipulative medicine. They have the same education as an MD plus 500 hours of musculoskeletal system studies. (National Library of Medicine. 2022) They take the same exams and are licensed as an MD. Many osteopaths are primary care providers. For back pain, they will focus on:

  • Posture rehabilitation and training.
  • Stretching
  • Therapeutic massage
  • Spinal manipulation

The goal is to relieve pain and muscle tension, increase mobility, and improve musculoskeletal function.

Physiatrists

Physiatrists are holistic providers that focus on physical function. They can be thought of as a primary care provider plus a physical therapist. These back pain specialists provide rehabilitation for various types of conditions and injuries including:

  • Back pain
  • Sports injuries
  • Stroke
  • Often they will coordinate a team of specialists to develop a targeted treatment plan.

Chiropractor

Chiropractic is a hands-on alternative medicine. The goal is to restore neuromusculoskeletal function by realigning the spine to its proper form. They do this with spinal manipulations, non-surgical mechanical decompression, traction, and massage techniques. (Michael Schneider, et al., 2016)

  • The purpose of most chiropractic adjustments is to relax and retrain tight muscles and increase flexibility.
  • Chiropractic helps to relieve stiff muscles and restore range of motion.

Individuals may not be referred to a chiropractor if they:

  • Have loose-joints
  • Have connective tissue problems or conditions.
  • Have osteoporosis/thinning bones

All types of back pain specialists provide various forms of therapy that may be able to help.


Spinal Decompression in Depth


References

Bishop, P. B., & Wing, P. C. (2006). Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. The spine journal : official journal of the North American Spine Society, 6(3), 282–288. doi.org/10.1016/j.spinee.2005.10.008

Yisheng, W., Fuying, Z., Limin, W., Junwei, L., Guofu, P., & Weidong, W. (2007). First aid and treatment for cervical spinal cord injury with fracture and dislocation. Indian journal of orthopaedics, 41(4), 300–304. doi.org/10.4103/0019-5413.36991

American Association of Neurological Surgeons. Caudia Equina Syndrome.

Borsook D. (2012). Neurological diseases and pain. Brain : a journal of neurology, 135(Pt 2), 320–344. doi.org/10.1093/brain/awr271

National Library of Medicine. Doctor of osteopathic medicine.

Schneider, M., Murphy, D., & Hartvigsen, J. (2016). Spine Care as a Framework for the Chiropractic Identity. Journal of chiropractic humanities, 23(1), 14–21. doi.org/10.1016/j.echu.2016.09.004

Fixed Sagittal Imbalance

Fixed Sagittal Imbalance

Individuals with fixed sagittal imbalance, a condition where the normal curve of the lower spine is greatly reduced or absent altogether that can cause pain and difficulty balancing. Can chiropractic treatment, physical therapy, and exercise help improve the condition?

Fixed Sagittal Imbalance

Fixed Sagittal Imbalance

The condition is commonly known as flat back syndrome and can be present at birth or can happen as a result of surgery or a medical condition.

  • It can also happen for other reasons, including degenerative disc disease, traumatic injury, or as a result of spinal surgery. (Columbia University Irving Medical Center. 2023)
  • Individuals with flat back syndrome position their head and neck too far forward.
  • A major symptom is difficulty standing for long periods of time.

Symptoms

The spine has two curves. The lumbar spine in the lower back and cervical spine in the neck curve inward. The thoracic spine in the upper back curves outward. The curves are part of the spine’s natural alignment. They help the body balance and maintain the center of gravity.

  • If these curves begin to disappear the body can have trouble and difficulty standing up straight.
  • The loss of curvature causes the head and neck to pitch forward, making it hard to walk and do regular normal activities.
  • Individuals have to flex their hips and knees and adjust their pelvis in order to stand up straight. (Columbia University Irving Medical Center. 2023)
  • There is a tendency to stoop forward which gradually increases and can even feel like the body is falling forward.
  • By the end of the day, the body is exhausted from the strain of trying to maintain balance.

Causes

Some causes of fixed sagittal imbalance include: (Columbia University Irving Medical Center. 2023)

  • Congenital – present at birth.
  • Degenerative disc disease.
  • Ankylosing spondylitis – a type of inflammatory arthritis of the spine.
  • Compression fractures of the vertebrae – for example, caused by osteoporosis.
  • The condition used to be common after spine surgery to correct scoliosis/abnormal curvature of the spine.
  • The devices implanted could cause flat back syndrome, especially for older individuals.
  • However, new and updated surgical techniques have decreased the complications.

Diagnosis

A doctor will ask about medical history, injuries, or back surgery. This will followed by a physical exam, that can include:

  • A musculoskeletal exam.
  • A neurologic exam.
  • A gait examination will assess standing and walking ability.
  • The gait exam is done because the gait can change to compensate for the loss of the curvature.
  • X-ray imaging will show spinal alignment.
  • Other possible sources of symptoms will be considered before a diagnosis can be confirmed.

Treatment

Treatment often involves physical therapy and exercise, bracing to provide increased support, and sometimes surgery.

  • Physical therapy typically begins with stretching and targeted strengthening exercises to improve posture.
  • The goal is to reverse the pattern of muscle imbalance that keeps the lower back flat.
  • Exercises to strengthen the neck, rear shoulder muscles, back, core, and buttocks can include: (National Health Service. n.d.)
  • Abdominal stretches
  • Hamstring stretches.
  1. Hamstring stretches improve the alignment of the lumbar spine.
  2. Hold the stretch for about 30 seconds at a time.
  3. Repeat three to five times once or twice a day.
  • Back extensions
  • Chest stretches
  • Planking
  • Side-lying leg raises
  • Seated rows in a gym or pull-ups

In severe cases, patients may need corrective surgery. A few options include: (Columbia University Irving Medical Center. 2023)

A chiropractor and/or physical therapist can recommend exercises and other forms of treatment. (Won-Moon Kim, et al., 2021)


Life-Changing Chiropractic Relief


References

Columbia University Irving Medical Center. Flatback syndrome.

National Health Service. Common posture mistakes and fixes.

Lee, B. H., Hyun, S. J., Kim, K. J., Jahng, T. A., Kim, Y. J., & Kim, H. J. (2018). Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities. Journal of Korean Neurosurgical Society, 61(2), 251–257. doi.org/10.3340/jkns.2017.0181

Kim, W. M., Seo, Y. G., Park, Y. J., Cho, H. S., & Lee, C. H. (2021). Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome. International journal of environmental research and public health, 18(20), 10923. doi.org/10.3390/ijerph182010923

Sciatic Endometriosis

Sciatic Endometriosis

Can combining chiropractic treatment with the common therapies of medication, exercise, and/or physical therapy help relieve sciatic endometriosis pain symptoms?

Sciatic Endometriosis

Sciatic Endometriosis

Sciatic endometriosis is a condition in which endometrial cells (tissue that resembles the lining of the uterus) grow outside of the uterine lining and compress the sciatic nerve. This places stress and pressure on the nerve causing back, pelvic, hip, and leg pain, especially before and during the menstrual cycle. It can also cause pain, irregular periods, and infertility. (The American College of Obstetricians and Gynecologists. 2021)

  • These areas of endometrial tissue growth are also known as lesions or implants.
  • Women with sciatic endometriosis often experience leg pain and weakness around the time of their menstrual cycle. (Lena Marie Seegers, et al., 2023)
  • Sciatic endometriosis can also cause pain when urinating, during a bowel movement, during sex, and fatigue, and irregular vaginal bleeding.

The Sciatic Nerve

  • Typically, endometrial lesions grow and attach to the ovaries, fallopian tubes, bladder, intestines, rectum, or peritoneum/abdominal cavity lining. (The American College of Obstetricians and Gynecologists. 2021)
  • The abnormal growth may be caused by higher-than-normal levels of estrogen.
  • Researchers believe that endometriosis is related to retrograde menstruation, which causes menstrual blood to flow back into the pelvis instead of out through the vagina. (World Health Organization. 2023)
  • Sometimes, the cells grow in the area of the pelvis right above the sciatic nerve. (Adaiah Yahaya, et al., 2021)
  • The sciatic nerve is the longest nerve in the body and travels down the back of each leg. (Johns Hopkins Medicine. 2023)
  • When endometrial lesions place pressure on the sciatic nerve, they can cause irritation and inflammation leading to severe pelvic pain, which makes it harder to conceive. (Liang Yanchun, et al., 2019)

Symptoms

Some women with endometriosis experience no symptoms or misinterpret the symptoms as typical premenstrual syndrome/PMS signs. The most common signs and symptoms of sciatic endometriosis include:

  • Difficulty walking or standing.
  • Loss of sensation, muscle weakness, and reflex alteration.
  • Limping.
  • Balance problems.
  • Bloating and nausea.
  • Constipation or diarrhea before or after a period.
  • Painful, heavy, and/or irregular periods.
  • Bleeding between periods.
  • Pain during sex, urination, and bowel movements.
  • Pain in the stomach, pelvis, lower back, hips, and buttocks. (MedlinePlus. 2022)
  • Weakness, numbness, tingling, burning, or dull aching sensations in the back of one or both legs.
  • Foot drop or trouble lifting the front of the foot. (Center for Endometriosis Care. 2023)
  • Infertility.
  • Fatigue.
  • Depression and anxiety.

Diagnosis

Endometriosis, including sciatic endometriosis, typically cannot be diagnosed with a pelvic examination or ultrasound by themselves. A healthcare provider may need to perform a biopsy using laparoscopy and discuss menstrual cycles, symptoms, and medical history.

  • The laparoscopy procedure involves making tiny incisions and taking a tissue sample with tools attached to a thin tube with a camera. (MedlinePlus. 2022)
  • Imaging tests, like magnetic resonance imaging/MRI, and computed tomography/CT scans, can help provide essential information about the location and size of any endometrial lesions. (The American College of Obstetricians and Gynecologists. 2021)

Treatment

Symptoms can sometimes be temporarily relieved with over-the-counter/OTC pain relievers. Depending on the condition and severity a healthcare provider may prescribe hormonal treatment to prevent new endometrial implants from growing. These can include:


Sciatica In Depth


References

The American College of Obstetricians and Gynecologists. Endometriosis.

Seegers, L. M., DeFaria Yeh, D., Yonetsu, T., Sugiyama, T., Minami, Y., Soeda, T., Araki, M., Nakajima, A., Yuki, H., Kinoshita, D., Suzuki, K., Niida, T., Lee, H., McNulty, I., Nakamura, S., Kakuta, T., Fuster, V., & Jang, I. K. (2023). Sex Differences in Coronary Atherosclerotic Phenotype and Healing Pattern on Optical Coherence Tomography Imaging. Circulation. Cardiovascular imaging, 16(8), e015227. doi.org/10.1161/CIRCIMAGING.123.015227

World Health Organization. Endometriosis.

Yahaya, A., Chauhan, G., Idowu, A., Sumathi, V., Botchu, R., & Evans, S. (2021). Carcinoma arising within sciatic nerve endometriosis: a case report. Journal of surgical case reports, 2021(12), rjab512. doi.org/10.1093/jscr/rjab512

Johns Hopkins Medicine. Sciatica.

Yanchun, L., Yunhe, Z., Meng, X., Shuqin, C., Qingtang, Z., & Shuzhong, Y. (2019). Removal of an endometrioma passing through the left greater sciatic foramen using a concomitant laparoscopic and transgluteal approach: case report. BMC women’s health, 19(1), 95. doi.org/10.1186/s12905-019-0796-0

MedlinePlus. Endometriosis.

Center for Endometriosis Care. Sciatic endometriosis.

Chen, S., Xie, W., Strong, J. A., Jiang, J., & Zhang, J. M. (2016). Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats. European journal of pain (London, England), 20(7), 1044–1057. doi.org/10.1002/ejp.827

Siquara de Sousa, A. C., Capek, S., Howe, B. M., Jentoft, M. E., Amrami, K. K., & Spinner, R. J. (2015). Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases. Neurosurgical focus, 39(3), E15. doi.org/10.3171/2015.6.FOCUS15208