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.
Unhealthy posture and slouching incorrectly position the body unnaturally, adding chronic strain on the muscles and ligaments. For example, when sitting or standing at a workstation, individuals start to relax by slumping forward because it feels comfortable; however, they don’t realize that their shoulders are hunching over, and their neck is in an awkward forward position. For every inch the head moves forward, its weight on the neck and upper back muscles increases by 10 pounds. Individuals that stay in this position for a long time often experience neck soreness, tension in the shoulder muscles, and low back discomfort. Chiropractic care, massage, and decompression therapy can realign the spine to its natural position and train individuals to maintain a healthy posture.
Slouching
Posture is the body’s position in space, the relationship of the body’s parts, head, torso, and limbs to each other. Maintaining the natural lumbar curve in the low back is essential to preventing posture-related discomfort symptoms. This natural curve works as a shock absorber, helping to distribute weight along the length of the spine. The most common causes for slouching posture are:
Repetitive motions or tasks can cause physical and mental fatigue, causing individuals to relax their core muscles.
Combined with the repetitiveness, individuals also begin implementing unhealthy movements because it makes the job easier.
Often individuals want to finish their work tasks, and even though they can feel their muscles and body stiffening and tightening up, they continue to work through the discomfort and don’t take a quick break to move around and stretch.
Stressful situations can cause muscle tension.
Carrying heavy bags, purses, backpacks, etc.
Weight fluctuation.
Pregnancy.
Spine
Muscles move the skeletal system and provide resistance against movement.
The musculoskeletal system comprises soft tissue structures that provide active and passive spinal stabilization.
The spine has natural curves to distribute weight/loads evenly.
The cervical and lumbar spine have a lordosis or forward curve.
The thoracic spine and sacrum have a kyphosis or backward curve.
They help to mitigate the forces exerted on passive stabilizing structures like the ligaments, joint capsules, and intervertebral discs.
A prolonged seated or standing position fatigues the muscles that stabilize the spine from the forces of gravity and body weight. When the tired muscles no longer provide stability, the spine must rely on the passive structures of the musculoskeletal system for support. Without the support, the spine gradually loses its natural cervical and lumbar curves and becomes more kyphotic or slouched. Slouching can provide relaxation and relief to the fatigued muscles; however, repetitive or prolonged stress to the passive structures can result in discomfort and injury to those tissues. This is how nerve compression, ligament inflammation, and disc herniations start.
Symptoms of Unhealthy Posture
Head that leans forward or backward.
Headaches.
Jaw pain.
Poor circulation.
Rounded shoulders.
A decline in breathing efficiency.
Muscle fatigue – Certain muscles can change in length, becoming short and tense or long and weak.
The advantages of practicing healthy posture include the following:
Prevents abnormal wear on the joints.
Lessens stress on the ligaments.
Prevents muscle strain and fatigue.
Prevents the spine from becoming misaligned.
Prevents back aches and soreness.
Reduces the risk of chronic diseases or conditions.
Helps maintain fitness and overall health.
Chiropractic Realignment
Our approach starts by correcting the physical problems caused by slouching, which involves chiropractic adjustments, therapeutic massage, and non-surgical decompression therapy. The objective is to fix the root cause to ensure that the treatment lasts and maintains neuromusculoskeletal health.
Examination
The initial assessment looks at an individual’s posture and a physical evaluation to identify the root cause.
When muscles become weak, over or underused, or suffer injury, others tighten or tense up.
A chiropractor looks at how an individual stands from behind and from the sides, noting issues like uneven shoulders, arched back, twisted pelvis, or other symmetry issues.
Treatment
Massage will increase circulation and reduce tension.
Muscle release and relaxation for any overactive muscles.
A chiropractor will perform slow joint movements.
Targeted stretches and strength exercises will correct imbalances, maintain flexibility, and strengthen the core muscles.
Postural training will help individuals learn to use proper body mechanics and to listen to their bodies.
Impact of Stress
References
Defloor, T, and M H Grypdonck. “Sitting posture and prevention of pressure ulcers.” Applied nursing research: ANR vol. 12,3 (1999): 136-42. doi:10.1016/s0897-1897(99)80045-7
Fortner, Miles O et al. “Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics®: a case report utilizing a multimodal mirror image® rehabilitation program.” Journal of physical therapy science vol. 29,8 (2017): 1475-1480. doi:10.1589/jpts.29.1475
Katzman, Wendy B et al. “Age-related hyperkyphosis: its causes, consequences, and management.” The Journal of orthopedic and sports physical therapy vol. 40,6 (2010): 352-60. doi:10.2519/jospt.2010.3099
Korakakis, Vasileios, et al. “Physiotherapist perceptions of optimal sitting and standing posture.” Musculoskeletal science & practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004
Snijders, Chris J et al. “Effects of slouching and muscle contraction on the strain of the iliolumbar ligament.” Manual therapy vol. 13,4 (2008): 325-33. doi:10.1016/j.math.2007.03.001
Yoong, Nicole Kah Mun et al. “Commercial Postural Devices: A Review.” Sensors (Basel, Switzerland) vol. 19,23 5128. 23 Nov. 2019, doi:10.3390/s19235128
Dr. Alex Jimenez, D.C., presents how anti-inflammatory phytochemicals can reduce inflammation and treat other chronic conditions that inflammation is correlated with. We dive into what medicines can trigger inflammatory cytokines and some treatments that work together to reduce chronic inflammation. We refer our patients to certified medical providers incorporating multiple therapies for many individuals suffering from chronic inflammation and its correlating symptoms affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
How Medications Associate With Inflammation
Dr. Alex Jimenez, D.C., presents: When it comes to a person’s health and wellness, it is important to know that when you are introducing them to potential antigenic medication, that person’s immune system is already imbalanced and much more likely to make abnormal immune responses, which then can lead to inflammatory effects in the body’s system. You see them mostly with chimeric human marine antibodies, which are the ones that make antibodies for the immune system, to that point, will elicit a much higher immune response. When this happens, it becomes a challenge to long-term pharmacotherapy. So when people go to their doctors for a prescription, about 20-30% of medication prescriptions are never filled because, most of the time, the prescription will never fill them in the drugstore, which can cascade into various issues.
And when people follow their prescription, sometimes they’ll take it for a little while, and after six months, they stop taking it. So the drop in prescriptions taken for longer than six months is quite low. In the last article, we discussed NSAIDs, DMARDs, and biologics, and we will touch base with acetaminophen. Acetaminophen is another one that’s just really widely used, and it’s because it’s put into all of these different cold and flu, and pain products. They sneak it into many other medications; you must read the labels. This is because some people metabolize acetaminophen quickly, which can become toxic. This can lead to individuals getting random headaches throughout the day and causes their glutathiones to be used promptly. So when looking for cold and flu medicine, it is best to look at the labels for acetaminophen because it doesn’t have anti-inflammatory responses since it is used for pain control.
How Acetaminophen Affects the Immune System
Dr. Alex Jimenez, D.C., presents: So even though we do not know how exactly how the analgesic effects work when people take cold and flu medicines, however, we do know that when people take a ubiquitous amount of acetaminophen, it could increase the pain threshold by inhibiting nitric oxide pathways in the body through mediation through the receptors for NMDA and substance P. We still don’t have a great handle on that, but that’s how it works. So, these drugs can be quite useful in the short term, but long-term use has serious side effects.
When looking for medications, it is important to read the labels that have a black box warning, which is the highest warning that the FDA issues for any potential overlapping risk profiles that the FDA issues. This can include severe liver injuries or serious possible allergic reactions that can develop into chronic inflammation of the muscles and joints. Now there are ways to reduce inflammation and prevent the body from being in more pain by slowly introducing anti-inflammatory botanicals and phytochemicals to detoxify the medication causing these complications.
Some individuals may not realize that constant medication for various pains and issues affecting the body can mask other problems involving the body’s systems. This can include:
Endocrine system
Cardiovascular system
Gastrointestinal system
Reproductive system
When these systems have been affected by medications, they can develop inflammatory markers in the vital organs and cause lead to visceral-somatic dysfunction in the body. When pain medications target pain localized in one location, but the issue is in a different area, this is known as referred pain. Referred pain is where the pain is in one muscle group location but is felt in another area of the body. When the organs are involved, it can cause inflammatory symptoms in the system. To that point, this causes the immune system to be induced into autoimmunity.
How The Immune System Is Induced Into Autoimmunity
Dr. Alex Jimenez, D.C., presents: When the immune system has been induced with autoimmunity, the corticosteroids can develop side effects that can be long termed and delay the healing process. Some of the physical symptoms that are visible with autoimmunity include:
Muscle weakness
Diabetes
High blood pressure
Thin bones
Delay wound healing
Flare-ups
Rheumatoid arthritis
Mood changes
When dealing with these inflammatory symptoms associated with pain, there are fundamental functional treatment approaches that can reduce the inflammatory cytokines causing joint and muscle pain.
Treatments To Target Inflammation
Dr. Alex Jimenez, D.C., presents: Some of the treatments that target inflammation include the following:
Slowly incorporating healthy lifestyle choices into a person’s daily lifestyle can reduce the effects of inflammatory cytokines affecting the vital organs, muscles, and joints. It is important to know that incorporating antioxidants, phytonutrients, and anti-inflammatory supplements can reduce residual symptoms in the body. All these treatments are some of the foundations that can address these inflammatory triggers and help reduce muscle and joint pain associated with inflammation.
Anti-Inflammatory Vitamins & Supplements
Dr. Alex Jimenez, D.C., presents: Another important note about these treatments is that vitamins and supplements can combine to help treat inflammatory effects that are causing issues in the body. These anti-inflammatory botanicals and phytochemical agents can not only act on the different pathways in the body but also have different mechanisms similar to healthy nutritional foods. Incorporating anti-inflammatory botanicals and phytochemical agents into the body will help modulate the inflammatory cascades and provide multiple synergistic activities to the body.
These agents down-regulate the inflammatory pathways caused by NF-kappaB. They can act as modulators that dissociate the cytokines from causing more issues like oxidative stress or infections triggering inflammation. However, we need inflammation to heal the body from wounds and infections. We mustn’t want the cytokines too high to cause inflammatory effects. So incorporating anti-inflammatory botanicals and phytochemicals provides a much safer option to the body and can be used in many chronic inflammatory conditions.
Conclusion
Since many botanicals and phytochemicals have anti-inflammatory properties, it can be difficult to find a good amount that the body needs to reduce chronic inflammation. Since many cultures and places have used many nutritional plants and herbs for years worldwide, it can be exhausting. Some of the botanical supplements include:
Zinc
Green tea extract
Capsaicin
S-adenosylmethionine
Ginger
To summarize how it is important to know which supplements have anti-inflammatory properties, doing research and incorporating small changes into a daily lifestyle can provide amazing results and allow the individual to be pain-free and have good health when combining botanicals and phytonutrients.
The iliopsoas muscle is a primary hip flexor that assists in the femur’s external rotation and maintains the hip joint’s strength and integrity. It also helps to stabilize the lumbar spine and pelvis. Athletes often overuse these muscles with all the sprinting, jumping, kicking, and changing directions when running, causing strains and/or tears. Repetitive hip flexion can result in chronic degenerative tendon changes. Chiropractic care and physical therapy can assist in the early phases of healing, safely transitioning to rehabilitation, and returning to physical activities.
Iliopsoas Muscle
The hip flexors are the group of muscles, including the iliac and psoas major muscles/iliopsoas and the rectus femoris/quadriceps. One of the largest and thickest muscles in the body, the psoas, extends from the lumbar vertebrae, crosses in front of each hip, and attaches to the inside top of the thigh bone. The muscle works by flexing the hip joint and lifting the upper leg towards the body. These fibers can tear if tension is more than the muscle can bear. An iliopsoas strain occurs when one or more of these hip flexor muscles become overly stretched or begin to tear.
Injury
The injury can occur from sports or everyday physical activities. This leads to inflammation, pain, and scar tissue formation. An iliopsoas injury is commonly caused by sudden movements, including sprinting, kicking, and changing direction fast while running. Individuals participating in any sports, especially cycling, running, dance, tennis, martial arts, and soccer, are more likely to experience this injury. Other contributing factors include:
Muscle tightness
Joint stiffness
Muscle weakness
Inadequate core stability
Not warming up correctly
Improper biomechanics
Decreased fitness and conditioning
Individuals will feel a sudden stinging pain or pulling sensation, usually on the front of the hip, groin, or abdominal area. Other symptoms include:
Healing and recovery depend on the severity of the injury. A minor iliopsoas muscle injury can take around three weeks to recover fully. More serious strains and tears take six to eight weeks before returning to activity, as the tissue needs time to repair before starting rehabilitation.
Chiropractic Rehabilitation and Recovery
The first steps when dealing with this injury should be P.R.I.C.E. protection, rest, ice, compression, and elevation. It is important to rest and seek treatment immediately; if left untreated, the condition could worsen, lead to a chronic condition, and require surgery. A chiropractic treatment and rehabilitation plan will consist of the following:
Soft tissue massage
Joint mobilization
A chiropractor may recommend crutches to keep the weight off the hip.
A brace can help compress and stabilize the hip flexor to expedite healing.
A flexibility and strengthening program will be implemented to target the muscles around the hip.
Core strengthening exercises will improve the stability of the pelvis area to prevent any further overuse problems.
Wearing compression clothing could also be recommended, as the clothing helps maintain muscle temperature.
Labral Tear
References
Dydyk AM, Sapra A. Psoas Syndrome. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK551701/
Lifshitz, Liran BPt, MSc, PT; Bar Sela, Shlomo BPt MPE; Gal, Noga BPt, MSc; Martin, RobRoy PhD, PT; Fleitman Klar, Michal BPt. Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current Sports Medicine Reports 19(6):p 235-243, June 2020. | DOI: 10.1249/JSR.0000000000000723
Rauseo, Carla. “THE REHABILITATION OF A RUNNER WITH ILIOPSOAS TENDINOPATHY USING AN ECCENTRIC-BIASED EXERCISE-A CASE REPORT.” International journal of sports physical therapy vol. 12,7 (2017): 1150-1162. doi:10.26603/ijspt20171150
Rubio, Manolo, et al. “Spontaneous Iliopsoas Tendon Tear: A Rare Cause of Hip Pain in the Elderly.” Geriatric orthopedic surgery & rehabilitation vol. 7,1 (2016): 30-2. doi:10.1177/2151458515627309
Chiropractic care has a powerful therapeutic effect on the body’s systems. This includes the nervous, muscular, skeletal, and lymphatic. The lymphatic system is a part of the immune system. It circulates lymph, a fluid comprised of white blood cells that support the immune system, proteins, and fats. The lymphatic system collects toxins, moves waste, and protects the body from foreign invaders. Together with the immune system, the lymphatic system keeps the body balanced. However, imbalances occur due to misalignments, subluxations, compressed nerves, chronic conditions, and injuries. Chiropractic care, massage, and decompression therapy can help mobilize stuck or misaligned joints, reduce muscular tension, alleviate nerve inflammation and discomfort, and restore optimal function.
Spinal Lymphatic Detox
Lymphatic System
The lymphatic system is a network throughout the body. The system drains lymph fluid from the blood vessels into the tissues and empties it back into the bloodstream through the lymph nodes. The main functions of the system include the following:
Regulates fluid levels in the body.
Activates when bacteria or viruses enter.
Manages and removes cancer cells or cell byproducts that could result in disease or disorders.
Absorbs some of the fats from the intestine.
The lymph nodes and other structures like the spleenand thymushouse specialized white blood cells called lymphocytes. These are ready to go and can rapidly multiply and release antibodies when bacteria, viruses, and other stimuli, enter the body.
Fluid Balance
The blood in the vessels is under constant pressure. Nutrients, fluids, and certain cells need to circulate throughout the body to supply the tissues and maintain the system’s defense. The lymphatic system:
Removes all fluids and contents that leak into the tissues.
Eliminates waste products formed in the tissues.
Eliminates bacteria that enter through the skin.
The digestive and respiratory systems are lined with lymphatic tissue because the systems are exposed. The most important sites are the tonsils, the intestinal region, and the appendix. Lymph nodes are the filters. Viruses and cancer cells get trapped and destroyed in the lymph nodes. More lymphocytes are produced when an infection is present, which is why the nodes experience swelling. When the lymphatic system does not drain fluids from the tissues properly, the tissues swell and can cause symptoms of discomfort. If the swelling is only for a short period, it is called edema. If it lasts more than three months, it is called lymphoedema.
Symptoms of Unhealthy Circulation
Unhealthy circulation can include the following symptoms:
Fatigue
Concentration problems
Cold hands or feet
Swelling
Muscle cramps
Numbness
Tingling
Stinging
Throbbing
Development of ulcers on the feet, ankles, and legs.
Chiropractic Care
A chiropractic spinal lymphatic detoxtreatment releases stagnant fluid collected in the joints, muscles, and tissues. A personalized treatment plan will consist of massage therapy to increase circulation, release and relax the muscles and nerves, chiropractic to realign the body, decompression to open the spine, stretching techniques to improve flexibility, and nutritional guidance to support optimal circulation. The benefits include:
Discomfort and pain relief.
Stress and anxiety relief.
Balanced and realigned body.
Relaxed muscles.
Helps with allergy symptoms.
Detoxes bacteria along the spine.
Lymphatic Anatomy
References
Dmochowski, Jacek P et al. “Computational Modeling of Deep Tissue Heating by an Automatic Thermal Massage Bed: Predicting the Effects on Circulation.” Frontiers in medical technology vol. 4 925554. 14 Jun. 2022, doi:10.3389/fmedt.2022.925554
Majewski-Schrage, Tricia, and Kelli Snyder. “The Effectiveness of Manual Lymphatic Drainage in Patients With Orthopedic Injuries.” Journal of sport rehabilitation vol. 25,1 (2016): 91-7. doi:10.1123/jsr.2014-0222
Mihara, Makoto et al. “Combined conservative treatment and lymphatic venous anastomosis for severe lower limb lymphedema with recurrent cellulitis.” Annals of vascular surgery vol. 29,6 (2015): 1318.e11-5. doi:10.1016/j.avsg.2015.01.037
Mortimer, Peter S, and Stanley G Rockson. “New developments in clinical aspects of lymphatic disease.” The Journal of clinical investigation vol. 124,3 (2014): 915-21. doi:10.1172/JCI71608
Weerapong, Pornratshanee et al. “The mechanisms of massage and effects on performance, muscle recovery and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
Dr. Alex Jimenez, D.C., presents how anti-inflammatory botanicals and phytochemicals can reduce inflammatory cytokines that can cause pain-like issues in the body. We dive into how different pharmaceuticals could influence NF-kappaB and how chronic conditions can affect inflammation. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from inflammation, and its correlating symptoms can affect the musculoskeletal system. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
How Does The Body Deal With Inflammation
Dr. Alex Jimenez, D.C., presents: Our objectives are to look at the evidence for using selective phytochemicals and botanicals as anti-inflammatory and analgesic agents. Controlled studies have grown into mass numbers over the years, and we can feel more confident in some of their findings because a lot of these studies have been done with good-quality investigators and well-designed studies. And even though we get those studies published, the problem is that we rarely hear about them. The media needs to pick them up, and they usually don’t make it into the medical community despite their studies. If you compare that to when pharmaceutical research is done, you know it often makes the headlines and news. Let’s look at some of these botanicals and phytochemicals today.
In autoimmune conditions, pain is a huge issue in the body, and we also want to use its analgesic properties. And then, we have to identify the most appropriate phytochemicals and botanicals for specific inflammatory and pain conditions. So, before we jump into that, we want to review some of the mechanisms of the pharmaceuticals that are very commonly prescribed for inflammatory and autoimmune conditions. Even some of the newer biologics we’ve referred to a little bit, we want to look into them and, and look at how they work and some of their drawbacks, and then we’ll delve into these botanicals that are at our disposal. So it is important to remind anyone that all degenerative diseases have this pro-inflammatory state or inflammation as part of their underlying biochemical ideology. And that inflammation is a final common pathway for all these different dysfunctions. Diabetes, Alzheimer’s, atherosclerosis, cancer, and even some psychiatric disorders like schizophrenia and depression all have inflammation as one of their root causes. Now in this module, we’re focusing on the ones that are in the circles and these.
As you know, most chronic diseases are linked to excessive, persistent inflammation. We’ve pounded that point home well enough, as chronic inflammation occurs when the injury is ongoing or when a predisposed immune system just doesn’t shut off. It fails at counter-regulation and acute inflammation, which is beneficial; however, it can turn into a chronic inflammation if left untreated. Many chronic diseases have been associated with excessive or persistent inflammation. When it comes to chronic inflammation develops when an injury or traumatic event is ongoing, causing the muscles to tense up or when the immune system begins to attack the body when there are no pathogens that are affecting the body. And that the conventional pharmacological treatment focuses on specific pathways that are often really downstream in that inflammatory process, and from a functional medicine perspective, we want to look a bit more upstream to figure out what is the cause of chronic inflammation that is causing this many issues to this person and how anti-inflammatory botanicals and phytochemicals can dampen these inflammatory effects in the body.
How Do Pharmaceuticals Affect The Body?
Dr. Alex Jimenez, D.C., presents: One of the factors that can enhance inflammatory markers is pharmaceutical drugs. So, for example, pharmacologic controls like NSAIDs can inhibit the COX enzyme, while leukotriene inhibitors inhibit the LOX enzyme. DMARDs can affect various immune mechanisms that can influence the development of chronic inflammation. Biologics can inhibit multiple cytokines in the body, including the TNF-alpha and steroids, which can affect NF-kappaB and phospholipase-A2. So there are numerous ways to influence the inflammatory pathway and cause muscle and joint pain issues.
Pharmaceuticals are not the only factors that can cause inflammatory triggers to affect the body; it can be the food we eat or the environment that we live in that can trigger NF-kappaB, which disassociates from I-kappaB while going into the nucleus and binding to the DNA. That point leads to the transcription of many different genes. The body’s genes not only make DNA but can make RNA. When the body makes RNA, it is then biotransformed into DNA, leading to the turning of different inflammatory pathways. So when the pharmaceutical starts entering the body, it can inhibit the other cytokines and enzymes from turning on and cause chronic inflammation, thus causing the anti-inflammatory markers to dampen and causing the immune system to focus on the NF-kappaB.
NSAIDs
Dr. Alex Jimenez, D.C., presents: So let’s start looking at the non-steroidal anti-inflammatories or NSAIDs, which are ubiquitous as they are very common for many people to reach for when they are in pain. And the reason they use them is that they do work. NSAIDs inhibit cyclooxygenase enzymes and prevent those inflammatory prostaglandins, which cause inflammation and pain in the muscles or joints. Now paracetamol is on here, or acetaminophen is not technically an NSAID, but we will look at that separately.
But these NSAIDs, you know, aren’t without issues, as 70 million prescriptions for NSAIDs are written in the U.S. annually. And that over-the-counter uses included 30 billion doses of NSAIDs. That’s an enormous amount, and it’s no wonder most of us have taken them; we’re part of that 30 billion. However, that amount can lead to a leaky gut in our body system. We know their association with peptic ulcers and G.I. bleeding while inhibiting that resolving pathway, which is important to shut off the inflammatory response. So let’s look at DMARDs or disease-modifying anti-rheumatic agents. They’re the first-line therapy for rheumatoid arthritis. And one of the reasons they’re the first line of treatment is that they’re inexpensive but are slow acting and do decrease inflammation, but they don’t work very well to relieve pain directly.
So methotrexate is hydroxychloroquine, or Plaquenil is a very well-known one right now, especially with its use today. Still, methotrexate inhibits RNA and DNA synthesis, which has been used as a chemotherapy agent in cancer. And when it inhibits, it affects the dihydrofolate reductase, which is needed to make DNA and RNA; however, it also suppresses T and B-cell activation while inhibiting IL1 beta from binding to its receptors. So, unfortunately, even though they’re the first-line therapy, they come with several fairly severe side effects. But we keep talking about this idea of side effects; it’s no side effects. They’re the direct effects of the medication.
The Effects Of Pharmaceuticals
Dr. Alex Jimenez, D.C., presents: You know, they may be unwanted effects like rashes, stomach upset, liver, bone marrow, toxicity, congenital disabilities, and, of course, which we’ll see repeatedly. Any time that you shut down your immune system, you open yourself up for infections. So you become much more susceptible to infections. So, look at these biological DMARDs, which work as TNF-alpha blockers. These biological DMARDs work by curbing either T-cell activation or blocking TNF, which is the most common one, but they also can stop things like IL-six, deplete T-cells, and work in other ways. These biologics are called biologics because they’re actually monoclonal antibodies. And so these monoclonal antibodies, as antibodies do, they have very strong specific binding affinities.
And so, using antibodies as medications has been a great advance. Now, as we’re going to see, they may not be the ultimate solution for treating autoimmune disease, but they hold a lot of promise, especially when we need their specificity. So there are many chronic conditions that NSAIDs DMARDs or Biologic DMARDs that can mask inflammation and cause pain to the muscles and joints. Some of the chronic conditions include:
Ankylosing-spondylitis
Arthritis
Crohn’s disease
Endometriosis
Psoriasis
Rheumatoid Arthritis
Osteoarthritis
Fibromyalgia
Lupus
Conclusion
Dr. Alex Jimenez, D.C., presents: These pharmaceuticals can reduce the pain that the person is experiencing with these conditions, but they are short-termed and only mask the issue until a person goes into treatment. When a person has an autoimmune or chronic disorder associated with inflammation, the cost of any medication is high. Even though good pharmaceuticals are important, we need to look at treatments that can examine the lesser-known or rarer conditions that can reduce the inflammatory effects that cause joint and muscle pain. Incorporating anti-inflammatory botanicals and supplements like:
Fish oil
Curcumin
Ginger extract
Green Tea Extract
Resveratrol
All have anti-inflammatory properties that can reduce inflammatory cytokines from the muscle and joints and combine with physical therapy. Physical therapy can allow the body to heal itself and will enable the individual to be pain-free naturally.
The hips in the lower portions of the body allow the legs to move the host from one location to another and provide stability to support the upper body’s weight. The hips will enable the torso to twist and turn without feeling pain. This is due to the various muscles and ligaments surrounding the pelvic bone and hip joint socket that allow the motion to be possible. However, when various injuries or factors start to affect the multiple muscles surrounding the pelvis or there is a chronic condition like osteoarthritis that causes wear and tear on the hip joints can cause underlying symptoms associated with the hips and cause many individuals to have difficulty when moving around. Luckily there are ways to improve hip mobility and the surrounding muscles in the hip and pelvic region of the body. Today’s article looks at the causes of the development of tight hips in the body and how different stretches can release tight hip flexor muscles. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from hip pain and its correlating symptoms that can affect the musculoskeletal system in the hips, legs, and lumbar region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Causes The Body To Develop Tight Hips?
Have you been dealing with hip mobility issues? When you sit, do you feel uncomfortable, and your hip muscles become tight? Or do you have a decreased range of motion when moving your hips? It could correlate with your hips if you have been experiencing muscle pain issues in the lower extremities. The hips help stabilize the upper and lower portions of the body while providing the full leg’s range of motion. When a person begins to sit for long periods or twist their body in a weird position, it can cause the muscles that surround the hips to become shortened. Other issues, like chronic conditions, can play a role in developing tight hip flexors. Studies reveal that various pathologies affecting the hips, lumbar spine, and lower extremities could strongly correlate with restricted hip mobility that can cause harmful effects that can affect the hips. To that point, some of the symptoms associated with tight hip flexors include:
Instability
Hypermobility
Limited range of motion
Reduce muscle strength in the groin
Muscle cramps
Sharp, sudden pain in the hips, pelvis, or groin
Low back pain
Piriformis syndrome
Other research studies mentioned that hypermobility disorders could affect the hip joints. Hypermobility disorders like EDS (Ehlers-Danlos syndrome) could cause micro or macro-trauma on the hip joint and affect the ligaments surrounding the hip joint. To that point, it can cause the hip flexor muscles to become tense and potentially affect how a person moves, which then causes soft tissue injuries and chronic pain.
Hip Flexor Stretches-Video
Do you feel tight along your hips? Do you see yourself hobbling around when walking? Or do you feel aches or strains when stretching? Many of these issues correlate with tight hip flexors that could result from hip pain in the lower extremities. When a person has tight hip flexors, it could be due to them constantly sitting down, causing the hip muscles to be shortened, or chronic conditions that can affect the hip joint and muscles. However, there are various ways to prevent tight hip flexors and regain mobility back to the hips. Studies reveal that stretching combined with core stabilization can help improve the hip’s range of motion while ensuring core endurance exercises can help strengthen the surrounding muscles in the hip area. The video above shows stretches targeting the hip flexor muscles and helps improve hip mobility.
Different Stretches To Release Tight Hip Flexors
Studies have shown that the hip flexor muscles are the main contributors to lumbar spine stability when releasing tight hip flexor muscles. So when there are tight hip flexors, it can cause overlapping risk profiles to the lumbar spine, which leads to pain and impairment in performance. The best way to reduce the pain-like symptoms associated with tight hip flexors is by stretching the lower half of the body to reduce muscle strain and tightness in the hip flexors. Additional studies have found that stretching combined with exercises targeting the low back can reduce the pain caused in the low back and help improve stability and strengthen the surrounding muscles located in the hips. Now it is important to remember that stretching for at least 5-10 minutes before and after working out allows the muscles to warm up and improve flexibility. Below are some different stretches that can release tight hip flexors.
High Crescent Lunge
While standing on the mat, take a step forward to allow your right foot to be in a staggard stance *Think in a lunge position.
Bend the front knee gently while keeping the back leg straight, as this allows the heel in the back leg to be lifted off the mat; the bent front knee enables the thigh to be parallel to the floor, and the right foot is pressed flat on the mat.
Square up the hips, so they face toward the mat’s front.
Extend the arm up towards the ceiling to stretch upwards while pressing into the mat to feel the hips stretch
Hold for five breaths before slowly rising out of the lunge position and repeating on the other side.
This stretch helps release tension in the hip flexors and quads while warming up the muscles and increasing blood flow to the legs.
Knee-To Chest Stretch
Lie on the mat with both legs extended out and feet flexed.
Pull on the left knee to the chest while keeping the right leg straight, and the lumbar portion of the back is pressed into the mat.
Hold the position while taking deep breaths for 30 seconds to 2 minutes.
Release slowly and repeat on the right leg *You can lift both knees to your chest and rock slowly from side to side to relieve low back tension as an alternative.
This stretch is extremely helpful for tight hamstrings and allows the tense muscles on the hips and lower back to relax while increasing blood flow back to the muscles.
Piriformis Stretch
On the mat, sit with both legs extended out.
Cross the right leg over the left and place the other flat on the floor while the left foot is flexed
Place the right hand behind the body while the left elbow is on the right knee.
On inhale, press the right leg to the left while allowing the torso to twist on the right.
Take five breaths for a deeper stretch and switch sides to repeat the action with the left hand *If you have low back pain issues, the modified version allows you to use your left hand to pull the right quad in and out to the left and vice versa.
This stretch helps loosen tight muscles in the lower back, hips, and glutes. If you have sciatic nerve pain associated with piriformis syndrome, this stretch helps release muscle tension from the piriformis muscle aggravating the sciatic nerve.
Happy Baby Pose
Lie on the mat with both knees bent and feet on the ground.
On inhale, lift the feet off the ground and grab the outer sections of the feet with your hands.
Then gently pull the feet towards the chest and allow the knees to lower to the ground, on either side of the body, while keeping the back flat on exhale.
Hold the position for at least five breaths.
This stretch helps with the inner thigh muscles or hip adductors and helps them become loose and mobile without feeling any strain or tension.
Bridge Pose
On the mat, lie on your back and sides, and extend your arms while your feet are flat on the floor with your knees bent.
Press with your heels to lift the hips and allow the feet to walk a few steps toward the body. *Keep the feet and knees hip-width apart.
Clasp hands together underneath the body and press them into the mat
Hold the position for five breaths.
This stretch helps take the pressure off the hip muscles while strengthening the glutes and abdominal muscles.
Conclusion
When it comes to releasing tight hip flexors after sitting for a long time or having hip issues affecting your low back or pelvis, Doing different stretches that target the hips can reduce the pain and release tight muscles associated with other conditions that can affect the body. The hips are important to take care of since they provide mobility and stability to the upper and lower portions of the body. They support the upper body’s weight while providing a huge range of motion to the legs. Incorporating these different stretches can reduce the pain that they have been under and help warm up the other muscles that surround the lower extremities.
References
Lee, Sang Wk, and Suhn Yeop Kim. “Effects of Hip Exercises for Chronic Low-Back Pain Patients with Lumbar Instability.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339134/.
Moreside, Janice M, and Stuart M McGill. “Hip Joint Range of Motion Improvements Using Three Different Interventions.” Journal of Strength and Conditioning Research, U.S. National Library of Medicine, May 2012, pubmed.ncbi.nlm.nih.gov/22344062/.
Reiman, Michael P, and J W Matheson. “Restricted Hip Mobility: Clinical Suggestions for Self-Mobilization and Muscle Re-Education.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3811738/.
Neck injuries and whiplash symptoms can be minor and go away within a few days. However, whiplash symptoms can manifest days later and become varied and chronic, ranging from severe pain to cognitive problems. These are collectively called whiplash-associated disorders because of the varied complexity of the symptoms. A common condition is a whiplash nerve injury. These injuries can be severe and require chiropractic treatment.
Whiplash Nerve Injury
Surrounding muscles, tissues, bones, or tendons can cause a whiplash nerve injury. The neck’s spinal nerve roots become compressed or inflamed, leading to cervical radiculopathy symptoms of tingling, weakness, and numbness that can radiate down the shoulder, arm, hand, and fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.
Neurological Cervical Radiculopathy
Neurological problems can become severe and can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed.
Cervical radiculopathy involves one or more of the following neurological deficiencies.
Sensory – Feelings of numbness or reduced sensation. There can also be tingling and electrical sensations.
Motor – Weakness or reduced coordination in one or more muscles.
Reflex – Changes in the body’s automatic reflex responses. An example is a diminished ability or reduced hammer reflex exam.
Symptoms
Because every case is different, symptoms vary depending on the location and severity. Symptoms can flare up with certain activities, like looking down at a phone. The symptoms then go away when the neck is upright. For others, symptoms can become chronic and do not resolve when the neck is resting and supported. Common symptoms include:
Fatigue
Decreased energy levels could be related to sleep problems, depression, stress, pain, concussion, or nerve damage.
Memory and/or concentration problems
Cognitive symptoms could involve difficulty with memory or thinking.
Symptoms can start shortly after the injury or not appear until hours or days later.
Cognitive problems could be from a brain injury or related to various types of stress.
Headaches
This could be neck muscles tightening or a nerve or joint becoming compressed or irritated.
Dizziness
Dizziness could be from neck instability, a concussion/mild traumatic brain injury, and nerve damage.
Vision problems
Blurry vision or other visual deficits could result from any number of causes, including concussion or nerve damage.
Vision problems could also contribute to dizziness.
Ringing in the ears
Also called tinnitus, this can be ringing or buzzing in one or both ears and can range from intermittent and minor to constant and severe.
Whiplash complications such as injury to the brain region that controls hearing, nerve or vascular damage, jaw injury, or stress can lead to tinnitus.
Chiropractic Care
The appropriate chiropractic treatment is unique to each whiplash nerve injury and is directed at the primary dysfunctions detected during the initial examination. A personalized treatment plan addresses factors in an individual’s work, home, and recreational activities. Treatment includes:
Massage manual and percussive for nerve and muscle relaxation
Goldsmith R, Wright C, Bell S, Rushton A. Cold hyperalgesia as a prognostic factor in whiplash-associated disorders: A systematic review. Man Ther. 2012; 17: 402-10.
McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard “Netter diagram” distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.
Murphy DR. History and physical examination. In: Murphy DR, ed. Conservative Management of Cervical Spine Syndromes. New York: McGraw-Hill, 2000:387-419.
Shaw, Lynn, et al. “A systematic review of chiropractic management of adults with Whiplash-Associated Disorders: recommendations for advancing evidence-based practice and research.” Work (Reading, Mass.) vol. 35,3 (2010): 369-94. doi:10.3233/WOR-2010-0996
Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1, 2nd ed. Baltimore, MD: Williams and Wilkens, 1999.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Slouching
Whiplash Nerve Injury
