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.
For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?
Back Pain When Walking
Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.
Muscle Issues
Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)
Strains
Occur when the fibers in the back are overstretched or torn.
Pain from muscle strains is usually worse during activity and better when resting.
Sprains
It occurs when the ligaments that connect bone to bone become detached.
If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.
Fatigue
It can happen from overexertion and lead to lower back pain when walking.
It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.
Degenerative Disc Disease
Between each vertebra is a disc that provides cushioning between the bones.
As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)
Sciatica
Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)
Numbness
Tingling
Muscle cramps
Leg muscle weakness
Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.
Lumbar Spinal Stenosis
Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
It causes the space surrounding the spinal cord to narrow.
Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.
Hyperlordosis
Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)
Prevention Strategies
Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)
Wear shoes made for walking.
Perform gentle lower back stretches before walking.
Start slowly by walking for a few minutes, then gradually increase the time.
Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
Warm up and cool down by walking slowly at the beginning and end of the walk.
This allows the back and leg muscles to warm up before exercise and recover afterward.
Walk at a slow to moderate pace/speed that allows one to converse.
Standing up straight while walking or standing upright reduces pressure on the lower back.
Alternative Exercise
If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)
Elliptical Trainer
This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.
Recumbent Biking
will keep the back upright, which is recommended if there is more pain when bending forward.
Upright Stationary Biking
This is recommended if the back pain improves when bending forward.
Walking In A Pool
This activity provides benefits while reducing pressure on the spine.
To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).
Water Aerobics
This activity provides cardiovascular health benefits with decreased pressure on the back.
Injury Medical Chiropractic & Functional Medicine Clinic
See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your 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.
Beyond Adjustments: Chiropractic and Integrative Healthcare
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
For individuals managing chronic pain conditions, can incorporating a personal TENS device help?
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.
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
For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?
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.
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.
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
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
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., 2015) Steps 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
For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?
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)
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)
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.
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
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?
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
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
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:
Angle size
Gender: Scoliosis is more common and likely to progress in females
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
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
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