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.
What is the recommended way to choose a mattress for individuals with back pain?
Back Pain Mattress
When choosing a back pain mattress, one size does not fit all in selecting one for those with spine pain. Several other factors play a role, as well. However, whether a firm or soft mattress is the best option for individuals whose back pain keeps them up at night, most health experts say the choice is yours and that the mattress that makes you feel most comfortable is likely the best option. The research says that medium firmness seems to provide the most painless sleep. A review gathered information from 24 controlled trials where participants used soft, medium-firm, firm, or custom-inflated mattresses. The results showed that medium-firm and self-adjusted mattresses were best for sleep comfort, quality, and spinal alignment. (Radwan A. et al., 2015)
Medical Status
Selecting the back pain mattress best suited to your spinal condition is more than just how hard or soft the mattress is. Individuals and their healthcare providers should thoroughly review their medical history to tailor the mattress to their needs. Before purchasing a mattress, check the following:
Age
Medical history
Injuries current and past
Current diagnosis or diagnoses
Disease and/or Conditions
Sleeping preferences
For example, symptoms of spinal stenosis tend to present themselves when one is standing and walking but not when lying down. For this reason, mattress firmness is not a big issue only for people with spinal stenosis. However, it must be taken into consideration for those who have degeneration along with spinal stenosis.
Individuals with spinal arthritis without stenosis, disc problems, or non-specific back pain need to consider the relative firmness or softness of the back pain mattress. People with these conditions do better with more support, i.e., a firmer mattress. While everyone needs some back support when they sleep, those who have undergone multiple back surgeries often need less. The tissues have been altered and may be stiffer after several surgeries. In this case, a softer mattress may be more suitable and comfortable.
Mattress Age
Mattress springs break down over time, which makes the bed softer. This can aggravate the spine and back muscles. Based on this, investing in a new mattress makes sense, or pain and stiffness can worsen with the current one. While this will vary among individuals, medical research may help shed some light: A study measured the comfort and quality of sleep for 27 participants with low back pain and stiffness. The participants recorded their sleep comfort and quality in their beds for 21 days and then with a new prescribed mattress and bedding system, which they used for 12 weeks. The study found that the participants showed significant and progressive improvement in back pain and stiffness on the new mattresses and improved sleep quality significantly. (Jacobson B. H. et al., 2010)
Sleeping Position
The position usually slept in makes a difference in the support needed for the back pain mattress. Some recommendations for back sleepers, side and fetal position sleepers, and stomach sleepers:
Side Sleepers
Most people are side sleepers.
They sleep in the fetal position with their knees drawn up toward their chest.
This position tends to place pressure on the hips and shoulders.
For side and fetal sleepers, a slightly softer mattress is recommended.
The foam the mattress is made of conforms to the body, especially in the thoracic and lumbar regions of the spine.
Stomach Sleepers
For the stomach sleeper, soft mattresses can irritate the back.
A soft mattress encourages the abdomen to sink into the bed.
The resulting position is known to increase the arch in the lower back and cause pain.
A medium-firm surface is good for stomach sleepers.
The idea is to derive support from the chosen mattress without the abdominal sinking.
The sinking effect is amplified if you have a large abdomen.
For thin individuals, sinking may not be as much of an issue.
Back Sleepers
For support, place a thin, rolled towel or pillow under the knees and lower back of those who sleep on their backs.
A pillow/s under these areas will help support them and provide more comfort.
Researchers divided the participants according to their usual sleep position. They were assigned to a medium-firm mattress with foam and latex layering based on their preferred sleep position. The participants rated their sleep comfort and quality daily for three months. The researchers found that the new mattresses improved back pain and stiffness. For this reason, they concluded that sleep surfaces relate to sleep discomfort and that replacing a mattress with one uniquely suitable to your spinal condition can reduce and relieve pain. (Jacobson B. H. et al., 2010)
Injury Medical Chiropractic and Functional Medicine Clinic
Choosing the right back pain mattress ultimately comes down to personal preference. Individuals should try various mattresses and see which one they like best. Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Chiropractic Care Can Transform Pain Into Relief
References
Radwan, A., Fess, P., James, D., Murphy, J., Myers, J., Rooney, M., Taylor, J., & Torii, A. (2015). Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep health, 1(4), 257–267. doi.org/10.1016/j.sleh.2015.08.001
Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. doi.org/10.1016/j.apergo.2010.05.004
Can non-surgical treatments help individuals with piriformis syndrome reduce referred sciatica pain and help restore hip mobility?
Piriformis Muscle & Piriformis Syndrome
Within the lower extremities, various muscles, ligaments, tendons, and nerve roots allow the legs, hips, and thighs, enabling individuals to be mobile and help with good posture. One of the muscles, known as the piriformis muscle, is located in the gluteal region of the lower body, which helps the major muscles with every movement and allows the individual to walk, run, and rotate at the hips. (Chang et al., 2024) At the same time, the piriformis muscle is over the sciatic nerve, the longest and largest nerve that travels through the lower limbs down to the heel and provides motor-sensory function to the lower limbs. (Giuffre et al., 2024) Environmental factors like physical inactivity, excessive sitting or standing, lifting heavy objects, or improper posture can affect the piriformis muscle and develop musculoskeletal issues in the lower extremities. We associate with certified medical providers who inform our patients of the effects of piriformis syndrome, which affects their lower body extremities and causes pain and discomfort. While asking important questions to our associated medical providers, we advise patients to incorporate various non-surgical therapies to reduce the pain-like symptoms associated with piriformis syndrome. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Have you experienced a pins and needles sensation in your hips and thighs that make it unbearable to walk? Do you feel radiating pain that travels down to your feet? Or have you noticed tightness in your hips and glutes region when stretching? When environmental factors impact the body, especially in the upper and lower extremities, they can cause overlapping risk profiles that can develop into chronic conditions. So, environmental factors affecting the piriformis muscle can lead to a musculoskeletal condition called piriformis syndrome. Piriformis syndrome is a somatic and neuropathic musculoskeletal condition caused by excessive or prolonged contraction of the piriformis muscle. (Jankovic et al., 2013) Many individuals who have dealt with piriformis syndrome will begin to report pain in the gluteal region that is causing sensations down the leg that can compress the sciatic nerve. (Hicks et al., 2024)
What Triggers Piriformis Syndrome?
Three causing factors can trigger piriformis syndrome in the lower extremities. Environmental factors like excessive movement, physical inactivity, or musculoskeletal conditions can compress the sciatic nerve over time, entrapping it and causing gradual pain. Additionally, trigger points in the muscles caused by repetitive strain can lead to muscle spasms or inflammation to irritate the sciatic nerve, which may present with a different musculoskeletal condition. (Pfeifer & Fitz, 1989) Finally, many people will begin to think that the pain they are experiencing is sciatica pain instead of piriformis syndrome.
Sciatica-Like Symptoms
Now, sciatica and piriformis syndrome are completely different but have similar symptoms that cause them to correlate. Sciatica is caused by spinal issues affecting the lower back that causes radiating pain down the leg. Piriformis syndrome only involves the piriformis muscle pressing one sciatic nerve area, causing overlapping risk profiles. Some of the common symptoms both sciatica and piriformis are associated with include:
Numbness
Tingling & burning sensations
Inflammation
Muscle spasms & tenderness
Pain & discomfort when sitting or standing
Sciatica: Causes, Symptoms, & Tips- Video
Non-Surgical Treatments For Piriformis
Luckily, numerous treatments are non-surgical and can help many individuals with piriformis syndrome find relief. Non-surgical treatments are affordable and non-invasive, customized to the person’s pain. With piriformis syndrome, non-surgical treatments can help improve pain and functionality back to the lower extremities and provide symptomatic relief from the piriformis muscle. (Vij et al., 2021) Some of the non-surgical treatments that are excellent for reducing pain-like symptoms associated with piriformis include:
Physical Therapy: Physical therapies allow the muscles to be mobilized and stretched and decompress the musculoskeletal structures. (Gandolfi et al., 2023)
Acupuncture: A trained acupuncturist incorporates small needles into the acupoints around the piriformis and provides anti-inflammatory effects. (He et al., 2023)
Chiropractic Adjustments: Chiropractors utilize mechanical and manual spinal manipulation to realign the body, stretch and strengthen the affected muscles, and alleviate pain.
Rest: Avoiding strenuous activities and sleeping on the right mattress can help reduce spinal pain associated with piriformis syndrome and improve sleep quality.
Incorporating these non-surgical treatments to reduce piriformis syndrome can help many individuals be more mindful of their bodies daily. They can be part of a daily routine in a person’s health and wellness journey in managing piriformis syndrome and reducing its pain-like symptoms. Doing so allows the lower extremities to be mobile again and the individual to be pain-free.
References
Chang, C., Jeno, S. H., & Varacallo, M. (2024). Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30137781
Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 9(1). doi.org/10.3390/jfmk9010006
Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth, 60(10), 1003-1012. doi.org/10.1007/s12630-013-0009-5
Pfeifer, T., & Fitz, W. F. (1989). [The piriformis syndrome]. Z Orthop Ihre Grenzgeb, 127(6), 691-694. doi.org/10.1055/s-2008-1040313 (Das Piriformis-Syndrom.)
Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. doi.org/10.5812/aapm.112825
Can understanding the anatomy and function of the long thoracic nerve help individuals make informed healthcare decisions after an injury to the nerve?
Long Thoracic Nerve
Also referred to as the posterior thoracic nerve, the long thoracic nerve/LTN is a thin superficial nerve that runs from the cervical spine to the chest wall side of the trunk. It supplies motor function to the thorax’s serratus anterior muscle, helping stabilize the shoulder blade. Injury to this nerve can cause limited or abnormal shoulder and shoulder blade motion, including difficulty raising the arm during overhead reaching.
Anatomy
The long thoracic nerve originates from the ventral rami of cervical nerves C5, C6, and C7. (Waxenbaum JA, Reddy V, Bordoni B. 2023) In some individuals, the root from C7 is absent; in others, a small nerve root branches from C8. The nerve roots from C5 and C6 go through the medial scalene muscle to join the C7 nerve. It travels behind the brachial plexus axillary artery and vein and courses down the lateral side of the thorax. The long thoracic nerve terminates at the lower portion of the serratus anterior muscle, sending small nerve tendrils to each muscle’s projections, which attach to the ribs. Because the long thoracic nerve is located on the lateral side of the chest, it is vulnerable to injury during sports or surgical procedures. The nerve also has a smaller diameter than other cervical and brachial plexus nerves, which increases its potential for injury.
Function
The long thoracic nerve attaches to the underside of the shoulder blade and inserts as muscular slips into the ribs. It supplies motor function to the serratus anterior muscle, essential for normal shoulder motion. When it contracts, it pulls the shoulder blade against the ribs and thorax, helping to move and stabilize the arm as it moves forward and up during shoulder motions. Injury to the long thoracic nerve causes a condition called scapular winging. This occurs when the serratus anterior muscle becomes weakened or paralyzed after injury. (Lung K, St Lucia K, Lui F. 2024)
Susceptibility to Injury
The LTN is relatively unprotected and can be damaged by several things, including:
Heavy backpacks
Sports
Activities the body is not used to, like digging
Using crutches
Conditions
Injury to the long thoracic nerve may occur as a result of trauma, lifting heavy weights above the shoulder, or a surgical procedure. Surgical procedures that may place the nerve at risk for injury may include: (Lung K, St Lucia K, Lui F. 2024)
Axillary lymph node dissection
Improperly placed intercostal drains
Chest tube placements
Mastectomy
Thoracotomy
The long thoracic nerve is protected during these procedures by the surgeon and proper surgical technique, but occasionally, difficulties arise during surgery, and the nerve may become injured. Individuals may also have an anatomical variance that places their nerves in varying positions. The surgeon may not see it and accidentally injure their nerves during surgery.
The superficial long thoracic nerve may also be injured during sports or trauma to the trunk. A blow to the side or a sudden overhead stretch to the shoulder may be enough to damage the nerve, paralyzing the serratus anterior muscle.
Weakness or paralysis of the serratus anterior muscle will result in a winged scapula. To test for this:
Stand about two feet from a wall, facing it.
Place both hands on the wall and gently push against it.
If one of the shoulder blades sticks out abnormally, it could be a winged scapula.
Have a family member or friend stand behind you and check the shoulder blade position.
If you suspect a winged scapula, visit a physician who can assess the condition and determine if there is a long thoracic nerve injury.
Winging the scapula may result in difficulty lifting the arm overhead. The serratus anterior muscle works with other scapular stabilizers, such as the upper trapezius and levator scapula, to properly position the shoulder blade when lifting the arm. Failure of the serratus to stabilize the shoulder blade may make lifting the arm impossible.
Clinical examination is usually used to diagnose a long thoracic nerve injury. X-rays and MRIs cannot show the nerve injury directly, although an MRI can show some secondary signs to help confirm the diagnosis. An electromyographic or EMG test may also be performed to examine the function of the long thoracic nerve.
Treatment and Rehabilitation
Treatment for LTN pain and reduced movement may include:
Rest
Heat or ice
Anti-inflammatory pain medication
Neck support or a pillow
Avoiding strenuous activity and driving
If the long thoracic nerve is severely injured and the serratus anterior is completely paralyzed, the best course of action is to be active and monitor the condition. Full recovery of arm function can take one to two years. If permanent nerve injury has occurred, surgery may be an option to restore shoulder motion and function. Several different kinds of surgery can be used to address winged scapula. (Vetter M. et al., 2017)
One involves transferring the pectoralis major tendon to the scapula (Vetter M. et al., 2017) so it functions as the serratus.
Often, the tendon has to be lengthened, which may be done using part of the hamstring tendon.
After surgery, individuals will likely wear a sling on their arm for a few weeks, and then gentle range-of-motion exercises will be initiated.
After eight to ten weeks, gentle progressive strengthening of the new tendon can begin.
Full shoulder motion and strength recovery are expected six to 12 months after surgery.
Vetter, M., Charran, O., Yilmaz, E., Edwards, B., Muhleman, M. A., Oskouian, R. J., Tubbs, R. S., & Loukas, M. (2017). Winged Scapula: A Comprehensive Review of Surgical Treatment. Cureus, 9(12), e1923. doi.org/10.7759/cureus.1923
Berthold, J. B., Burg, T. M., & Nussbaum, R. P. (2017). Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging. The Journal of the American Osteopathic Association, 117(2), 133–137. doi.org/10.7556/jaoa.2017.025
Can individuals with insomnia find various ways to reduce its effects, such as a full night’s rest and promoting healthy sleep habits?
Insomnia
Many people have often struggled to get a full night’s sleep occasionally, as environmental factors can keep them from falling asleep, making them tired throughout the day. In most cases, many individuals sometimes suffer from a chronic condition known as insomnia. Insomnia is a common sleep disorder, whether short-term or chronic, and it can negatively impact a person’s ability to sleep and stay asleep. (Dopheide, 2020) Insomnia can be in two forms: primary and secondary. Primary insomnia is a fairly common condition that can be resolved without treatment, while secondary insomnia is due to medication side effects or neurological issues that are causing sleep issues. Additionally, insomnia can be developed through various environmental factors like genetic variants, early life stress, major life events, and brain functions and structures that can cause individuals to be vulnerable and have insomnia. (Van Someren, 2021) We associate with certified medical providers who inform our patients of the effects of insomnia that can affect the body when they are not getting enough sleep. While asking important questions to our associated medical providers, we advise patients to incorporate healthy sleeping habits into their treatment plan to reduce insomnia and get proper sleep. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
How It Affects The Body
So, how does insomnia affect the body and a person’s daily routine? Well, when environmental factors start to impact a person, it can cause overlapping risk profiles in the body that can develop into mental disorders like depression. There is a bi-directional relationship between insomnia and depression, as it can cause sleep alterations that can affect the nervous system and develop into chronic conditions. (Riemann et al., 2020) Some of the symptoms that insomnia can affect the body include: (Naha et al., 2024)
Fatigue
Memory impairment
Cardiovascular disorders
Gastrointestinal disorders
PTSD
Daytime napping
However, there are ways to manage insomnia and reduce the co-morbidities.
Exploring Integrative Medicine-Video
Ways To Manage Insomnia
When managing and treating insomnia, many people must recognize the many environmental factors that can lead to its development. Since insomnia is linked with environmental factors, many people start making small routine changes to mitigate its effects. Many people can start by identifying the disorder and other co-morbidities contributing to its development. (Waterman & Selsick, 2023) This, in turn, helps doctors develop a customized treatment plan to manage their insomnia.
Sleep Habits
One of the ways many people deal with insomnia can begin with changing their sleep habits to help reduce the environmental factors affecting their sleep quality. Some of the changes include:
Make sure the bedroom is dark, cool, and has minimal noise
Incorporating these small changes in sleeping habits can help reduce the stressors contributing to insomnia.
Non-Surgical Treatments
Another way for individuals to manage their insomnia is by incorporating non-surgical treatments. Non-surgical treatments like mindfulness meditation, chiropractic care, and acupuncture can help many individuals calm the mind and body by combining deep breathing exercises. (Chan et al., 2021) At the same time, the body and muscles can begin to relax and even help stretch out tense muscles that are affected by insomnia. Many people can utilize non-surgical treatments as part of their routine to live healthy lives and have the best quality of sleep they deserve.
References
Chan, N. Y., Chan, J. W. Y., Li, S. X., & Wing, Y. K. (2021). Non-pharmacological Approaches for Management of Insomnia. Neurotherapeutics, 18(1), 32-43. doi.org/10.1007/s13311-021-01029-2
Dopheide, J. A. (2020). Insomnia overview: epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy. Am J Manag Care, 26(4 Suppl), S76-S84. doi.org/10.37765/ajmc.2020.42769
Riemann, D., Krone, L. B., Wulff, K., & Nissen, C. (2020). Sleep, insomnia, and depression. Neuropsychopharmacology, 45(1), 74-89. doi.org/10.1038/s41386-019-0411-y
Van Someren, E. J. W. (2021). Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev, 101(3), 995-1046. doi.org/10.1152/physrev.00046.2019
Waterman, L., & Selsick, H. (2023). Insomnia and its treatment should be given more importance. Br J Gen Pract, 73(733), 344-345. doi.org/10.3399/bjgp23X734421
Can individuals dealing with narcolepsy find ways to reduce its effects on the musculoskeletal system and improve sleep?
What Is Narcolepsy?
Around the world, many individuals have gotten 8 hours of sleep by doing errands to function throughout the day. Sometimes, it is important to take naps between certain hours of the day to give the body a chance to rest and continue for the rest of the day before going to bed. However, more individuals have experienced sleep disturbances like scrolling through their phones, dealing with chronic conditions like migraines or insomnia, or not having a proper sleep schedule that can negatively impact their sleep. One of the sleep disturbances is narcolepsy, which can cause individuals to have sleep issues throughout the day and even affect their musculoskeletal system. In today’s article, we will be looking at what narcolepsy is, its symptoms, how it affects the muscles, and what treatments can reduce narcolepsy and improve sleep. We associate with certified medical providers who inform our patients of the effects narcolepsy causes on a person and their bodies. While asking important questions to our associated medical providers, we advise patients to include various techniques to reduce the overlapping risk profiles related to narcolepsy and help improve their sleep quality. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
Do you often feel extremely tired throughout the day, and is it causing you to take a nap in weird places? Do your arms and legs feel weak from carrying various objects? Or do you feel general aches or pains in your neck, shoulders, and back? Many of these scenarios are associated with sleep disturbances that can affect the musculoskeletal system. One of the sleep disturbances is narcolepsy, characterized by the onset of rapid eye movement (REM) sleep that can correlate with the lack of orexin neurons from the central nervous system, thus causing daytime sleepiness. (Slowik et al., 2024) Narcolepsy has two forms depending on the severity of the condition: type 1 (narcolepsy with cataplexy) and type 2 (narcolepsy without cataplexy). Depending on the severity of narcolepsy, it can disrupt the brain from generating and regulating REM sleep and cause issues for the body when it is awake during the day. (Thorpy et al., 2024) This chronic sleep disorder can disrupt a person’s quality of life and affect their socio-economic lifestyle.
Symptoms
Narcolepsy has four main symptoms that can affect a person who is experiencing this condition. The four symptoms are:
Excessive daytime sleepiness causes people to fall asleep suddenly during mid-conversation or when doing activities.
Cataplexy: Sudden or temporary episodes of muscle weakness in the upper and lower musculoskeletal quadrants. (Sunwoo, 2021)
Sleep hallucinations: This can cause individuals to hallucinate visions, causing the symptoms to be mistaken for psychotic symptoms. (Hanin et al., 2021)
Sleep paralysis: When the individual is partly awake but cannot move.
Additionally, when narcolepsy starts to affect a person, it could lead to the development of comorbidities like obesity and musculoskeletal issues that may lead to sleep disturbances to take effect. (Maski et al., 2022)
How Does It Affect Muscles?
Now, narcolepsy can affect the musculoskeletal system as the central nervous system has neurons known as orexin to stimulate the body’s muscles, tissues, and vital organs. When narcolepsy starts to affect orexin, it can cause overlapping risk profiles to the muscles that become weak, and environmental factors like obesity and metabolic syndrome can complicate diagnosing narcolepsy. (Dhafar & BaHammam, 2022). Now, as environmental factors do play a huge part in the body, causing people to develop narcolepsy, it is important to realize that when muscle weakness can contribute to the issue, it can lead to disastrous consequences. Strong emotions that are associated with muscle weakness for narcoleptic individuals can cause their body to collapse and lead to cataplexy. Cataplexy in narcoleptic individuals often has a sequence starting from the top of the head down to the legs, causing muscle tone loss, and is frequently mistaken for seizures. (Latorre et al., 2022) Luckily, there are ways to manage narcolepsy and improve sleep quality.
The Non-Surgical Approach To Wellness- Video
Narcolepsy Treatments To Improve Sleep
When it comes to managing narcolepsy and its associated symptoms, many people can make small changes to their daily routine and incorporate treatment to improve their sleep quality and their lifestyle, too. Many individuals with narcolepsy take medication to not only stimulate their central nervous system neurons but also to reduce daytime sleepiness. Additionally, non-surgical treatments like chiropractic care can help stretch and restore muscle weakness associated with narcolepsy to help individuals manage their symptoms. Other treatments include:
Exercise regularly to reduce excessive daytime sleepiness
Eating a well-balanced, healthy meal
Incorporating these small changes as part of a daily routine can help mitigate narcolepsy and its associated symptoms. All in all, many individuals with narcolepsy can manage their symptoms and live a healthier life.
References
Dhafar, H. O., & BaHammam, A. S. (2022). Body Weight and Metabolic Rate Changes in Narcolepsy: Current Knowledge and Future Directions. Metabolites, 12(11). doi.org/10.3390/metabo12111120
Hanin, C., Arnulf, I., Maranci, J. B., Lecendreux, M., Levinson, D. F., Cohen, D., & Laurent-Levinson, C. (2021). Narcolepsy and psychosis: A systematic review. Acta Psychiatr Scand, 144(1), 28-41. doi.org/10.1111/acps.13300
Latorre, D., Sallusto, F., Bassetti, C. L. A., & Kallweit, U. (2022). Narcolepsy: a model interaction between immune system, nervous system, and sleep-wake regulation. Semin Immunopathol, 44(5), 611-623. doi.org/10.1007/s00281-022-00933-9
Maski, K., Mignot, E., Plazzi, G., & Dauvilliers, Y. (2022). Disrupted nighttime sleep and sleep instability in narcolepsy. J Clin Sleep Med, 18(1), 289-304. doi.org/10.5664/jcsm.9638
Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?
Planes of Motion
The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)
Sagittal plane -Divides the body into right and left sides.
Frontal plane – Divides the body into front and back.
Transverse plane – Divides the body into top and bottom sections.
To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.
Sagittal Plane
Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane. Several eating mechanics occur in the sagittal plane. Movements include:
Flexion – A bending movement that decreases the angle at a joint.
Extension – An extending movement that increases the angle at a joint.
Hyperextension – Extending the angle at a joint beyond neutral.
Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin.
Plantarflexion – Pushing the foot down and away from the body.
Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.
Frontal Plane
The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:
Abduction – Moving the body or a limb laterally and away from the body’s midline.
Adduction – Moving the body or a limb towards the body’s midline.
Elevation – Moving the shoulder blades up.
Depression – Moving the shoulder blades down.
Eversion – Rolling the foot towards the inside/medial side.
Inversion – Rolling the foot towards the outside/lateral side.
Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.
Transverse Plane
The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:
Rotation – Moving the torso or a limb around its vertical axis.
Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.
Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.
Training Within the Planes of Motion Benefits
Training in all three planes can help with movement in several ways, providing greater ease in life and sports.
Prepares Body for Daily Tasks
Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.
In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.
Prepares Body for Sports and Physical Activities
Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.
Encourages Variation For Full Body Strengthening
Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.
Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.
Injury Medical Chiropractic and Functional Medicine Clinic
Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. doi.org/10.2165/11534950-000000000-00000
Can individuals experiencing back pain from various factors incorporate MET (muscle energy techniques) to restore mobility?
Factors That Causes Back Pain
More often than not, many individuals have experienced back pain in various parts of their lives. As one of the leading pains that people have dealt with worldwide, many factors can contribute to the development of back pain, and it can affect different musculoskeletal locations in the upper and lower body quadrants. Back pain has often been associated with the workplace or environmental factors. For back pain, the problem can range from all back sections, affecting the muscles, ligaments, tissues, intervertebral joints, or the bone itself. (Wiberg, 1949) People are constantly in motion, and the muscles can be overstretched and tight over time. When that happens, many people seek treatment to reduce back pain’s overlapping risk profiles and restore mobility. Today’s article focuses on the factors associated with back pain and how non-surgical treatments like MET (muscle energy technique) can help reduce back pain and restore mobility. We discuss with certified medical providers who inform our patients how various environmental factors are correlated with back pain and how it can affect the body. While asking informed questions to our associated medical providers, we advise patients to include various non-surgical treatments like MET to be incorporated to reduce overlapping risk profiles associated with back pain. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
How often do you experience pain in different locations in your back after doing some strenuous activities? Do you feel like you are taking many breaks due to feeling tightness or sharp sensations in your back? Or have you felt that your posture is more hunched than normal? Many of these environmental factors scenarios are correlated with back pain, and it can become an issue over time. Back pain can be in two categories: specific and non-specific, and it can impact a person’s quality of life. Non-specific back pain can be associated with mobility impairment in the different back sections, referred to as radiating pain in the lower extremities or musculoskeletal disorders. (Delitto et al., 2012) This causes issues like repetitive loading to the spine and various pain-like symptoms to the back, causing a disbalance to the individual. (Zemková & Zapletalová, 2021) When it comes to environmental factors correlating with back pain, there are numerous ways for it to be developed and, over time, cause discomfort for the individual, as back pain symptoms vary for everyone.
Sleep
When it comes to the connection between sleep and back pain, these two issues can cause a vicious cycle of disturbed sleep and issues like insomnia. (Van Looveren et al., 2021) Now, when it comes to sleep disturbances and back pain, many individuals may be sleeping with the wrong mattress, causing their bodies to can cause pressure on their joints and spinal discs. This causes in-bed sleep behaviors like movements and postures could lead to health complications like pressure sores, apnea, and painful muscle spasms in the back and lower extremities. (Elnaggar et al., 2023) Luckily, there are various ways to reduce back pain, improve sleep quality, and restore body motion.
Understanding Academic Low Back Pain-Video
What Is MET?
When people come in for back pain treatment, non-surgical therapies can help stretch the overworked and tired back muscles and restore mobility to the body’s upper and lower extremities. One of the non-surgical treatments that pain specialists like chiropractors and massage therapists use is MET therapy or muscle energy technique therapy. MET comprises soft tissue manipulation that uses controlled isometric and isotonic contractions. (Sarkar et al., 2021) This helps the body not only improve the physiological function of the muscles but also decrease pain. MET can also be combined with other therapies to help lengthen short muscles, improve the range of motion from the joints, and increase fluid drainage from the body’s peripheral regions. (Batool et al., 2024)
MET Reducing Back Pain
Regarding MET, reducing back pain is possible as MET can be integrated with physical therapy to improve the disability and functionality of the person with back pain. (Wahyuddin et al., 2020) When people start to incorporate MET and non-surgical treatments as part of their routine for their health and well-being, they will begin to notice that the pain they have been experiencing in their back is diminishing over time. This allows them to be more mindful of their backs and bodies while making small changes to their routine. Sleeping better with a correct mattress, exercising more to stretch and strengthen muscles, eating healthier foods, and relaxing more allow people to be pain-free in their health and wellness journey.
References
Batool, K., Mehmood, M., Jafar, M., & Gull, M. (2024). Comparative efficacy of muscle energy technique and Bowen technique on hamstrings muscle tightness in chronic low back pain patients. Pak J Med Sci, 40(9), 2080-2084. doi.org/10.12669/pjms.40.9.8517
Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57. doi.org/10.2519/jospt.2012.42.4.a1
Elnaggar, O., Arelhi, R., Coenen, F., Hopkinson, A., Mason, L., & Paoletti, P. (2023). An interpretable framework for sleep posture change detection and postural inactivity segmentation using wrist kinematics. Sci Rep, 13(1), 18027. doi.org/10.1038/s41598-023-44567-9
Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. doi.org/10.31616/asj.2019.0300
Van Looveren, E., Bilterys, T., Munneke, W., Cagnie, B., Ickmans, K., Mairesse, O., Malfliet, A., De Baets, L., Nijs, J., Goubert, D., Danneels, L., Moens, M., & Meeus, M. (2021). The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade. J Clin Med, 10(17). doi.org/10.3390/jcm10173836
Wahyuddin, W., Vongsirinavarat, M., Mekhora, K., Bovonsunthonchai, S., & Adisaipoapun, R. (2020). Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study. Hong Kong Physiother J, 40(2), 109-119. doi.org/10.1142/S1013702520500109
Wiberg, G. (1949). Back pain in relation to the nerve supply of the intervertebral disc. Acta Orthop Scand, 19(2), 211-221, illust. doi.org/10.3109/17453674908991094
Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International Journal of Environmental Research and Public Health, 18(10), 5400. doi.org/10.3390/ijerph18105400
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