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.
The low back is made up of five vertebrae, L1 to L5. Pain in the low back is common, specifically because of all the sitting at work, school, and home. Individuals dealing with low back pain know how difficult it can be to sit without discomfort and have found that a low back support pillow can help.
Low Back Support Pillow
A lumbar pillow is a pillow that supports the low back region of the spine. Different types include:
Specially shaped pillows made from materials like memory foam.
Lumbar pillows can be used on any chair at the office or home.
They are also helpful for travel with small-sized versions that can be packed and easy to carry.
How Lumbar Pillows Help
According to the CDC, the average adult spends around 6.5 and 8 hours a day sitting. Constant sitting hurts the body, specifically the spine and the back muscles, and is a significant cause of muscle stress. Properly supporting the low back helps remove the stress and strain. A low back support pillow can help correct sitting posture.
Pillow Options
There are plenty of options for low-back support pillow shapes, sizes, fillings, and materials. These include:
Some look like a half-cylinder in shape, rectangular, and curved.
Personal preference and comfort are different for everybody, and it could take some trial and error to find the right lumbar pillow. Some pillows are customizable, allowing the ability to add or remove filling as needed. Talking with a spine specialist, orthopedist or chiropractor can help in figuring out what type is best. Pillows come in various price ranges, with some at $10-15, while others can cost $100 or more. However, any pillow that provides enough support for the low spine’s natural curvature can work. It is important to be comfortable and supported to prevent pain and injury no matter where you sit.
Body Composition
Fermentable and Nonfermentable Fiber
The entire body can host trillions of beneficial bacteria. The majority live in the intestines and are referred to as the gut microbiome. Also known as the forgotten organ, these bacteria have a say in the body’s composition and overall health. The beneficial bacteria thrive on fermentable fiber, and fermentation in the gut produces short-chain fatty acids like:
“Association Between Sitting Time and Cardiometabolic Risk Factors After Adjustment for Cardiorespiratory Fitness, Cooper Center Longitudinal Study, 2010–2013.” Centers for Disease Control, Atlanta, GA. December 2016. www.cdc.gov/pcd/issues/2016/16_0263.htm
“Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees.” BMC Public Health, London, UK. May 2021. pubmed.ncbi.nlm.nih.gov/33957889/
One of the most common tendons in the body that gets injured is the Achilles tendon, and this tendon tends to rupture when a person is doing recreational sports. Most people have opted for treatment for their Achilles tendon through surgery; however, low laser therapy can help the Achilles tendon recover a bit faster while providing beneficial properties during treatment. Low laser therapy has positive effects on the affected area where the pain resides and has helped progress the body’s natural healing process.
Achilles Tendon and Symptoms
The Achilles tendon is a strong fibrous cord connected at the back of the calf muscles to the heel bone. When a person does recreational sports, the Achilles tendon stretches during the activity. However, when the Achilles tendon is overly stretched during the exercise, it can rupture completely or partially depending on how strenuous the body is being put through.
Some of the symptoms of a ruptured Achilles include:
A feeling of being kicked in the calf
A popping or snapping sound where the injury occurred.
Pain and swelling near the heel.
The inability to bend the foot downwards
The inability to stand on the toes
When these symptoms occur in the Achilles tendon, it is due to the lack of blood flow that the body is not providing. Studies have found that when the Achilles tendon is ruptured, it is a severe injury due to the scarce blood supply, and it could take weeks or even months before it is completely healed.
Low Laser Treatments and Benefits
Patients with a ruptured Achilles heel can get low laser therapy to help relieve the pain from the ruptured tendon. Studies found that when patients are being treated with low laser therapy has shown beneficial results. The results showed how the application of low laser treatment is very effective. The therapy provides a consequent relief from the motor function pain to the heel while also providing anti-inflammatory properties to the affected area. What this does is that the low-intensity laser concentrates on the inflammatory markers of the affected area, thus providing an increased blood flow (angiogenesis) in the treated area and decreasing inflammation. Low laser therapy can even help accelerate and enhance the repair of the injured Achilles tendon with frequent treatment sessions.
Conclusion
Overall, the Achilles tendon is one of the most frequent tendons that gets ruptured when a person is doing recreational sports. The healing process can take to about a week to a month for the tendon to properly heal. But through low laser therapy, the Achilles tendon can be repaired while providing relief from inflammation and enhancing the injured tendon recovery process.
Jesus, Julio Fernandes de, et al. “Low-Level Laser Therapy on Tissue Repair of Partially Injured Achilles Tendon in Rats.” Photomedicine and Laser Surgery, U.S. National Library of Medicine, 15 May 2015, pubmed.ncbi.nlm.nih.gov/24831690/.
Nogueira, Adelmário Cavalcanti, and Manoel de Jesus Moura Júnior. “The Effects of Laser Treatment in Tendinopathy: A Systematic Review.” Acta Ortopedica Brasileira, Sociedade Brasileira De Ortopedia e Traumatologia, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4544521/.
Today, we are constantly tapping, scrolling, clicking, using our hands, fingers, and thumbs on smartphones, tablets, computers, etc. Constant repetitive use has increased the development of carpal tunnel syndrome. If tingling, numbness, soreness, or electrical sensations have begun to develop in the hands, especially the index finger, thumb, or palm, carpal tunnel prevention measures can help before it becomes severe.
Pinched Nerve
Carpal tunnel syndrome is the medical terminology for a pinched nerve. It is the median nerve that passes through the narrow carpal tunnel passageway of ligaments and bones at the base of the hand. This tunnel houses the median nerve and the tendons that allow the fingers to bend. The median nerve generates physical sensation in the index, middle, ring finger, and palm near the thumb. Compression of the nerve or inflammation can cause tingling, numbness, and pain in any and/or all of the hand areas. It can also cause the fingers to bend awkwardly; however, this symptom develops over time. There are so many different causes of carpal tunnel syndrome that it is almost impossible to avoid with the constant overuse/repetition of the hands.
Work – tasks, typing, mouse use, writing, scanning, etc.
School
Injury
Doctors recommended approach for carpal tunnel prevention is to take action at the first sign/symptom. The most effective preventative measures include:
Using a computer mouse – moving, clicking, using the scrolling wheel, etc.
Writing
Cooking – chopping, slicing, mixing, squeezing, etc.
Drawing
Make sure to take frequent breaks from the motion.
Carpal tunnel is more likely to develop if the nerves and muscles are overused for a long time without stopping. When focused on a task, we often don’t realize how the repetitive motions cause strain until a sting or pinch makes us stop. Taking a hand break is essential to give the muscles, tendons, ligaments, and nerves time to relax and stay loose. The break only has to be a few minutes to be effective.
Repetitive Movements and Proper Hand Form/Posture
Repetitive hand or wrist motions in everyday activities sometimes cannot be helped. It is recommended to try to switch hands when performing the task, space it out over the day, take frequent breaks, stretch, and gently shake out the hands throughout the day. Make sure any pressure on the hands or wrists is as light as possible and evenly distributed. Keep the wrists straight or slightly bent and use light tools if possible. Proper posture is crucial for carpal tunnel prevention. Many individuals don’t realize the back, neck, and wrists are intricately connected. Poor posture like hunching over the computer, shoulders rolled forward, and forward neck posture can cause the nerves and muscles of the arm to become compressed, causing tingling, numbing, pain symptoms because they’re not properly aligned. The compression can run down the arms and affect the wrists and hands as well.
Carpal Tunnel Prevention Supportive Accessories
It is also recommended to consider integrating supportive accessories, like ergonomic keyboards, mice, wrist splints, keypad cushions, etc. These tools can support the body and keep the wrists and hands healthy, comfortable, and pain-free. Wrist splints can help by keeping the wrist in a straight, neutral position without thinking about it. This reduces stress on the area and absorbs the pressure of everyday tasks on the carpal tunnel and median nerve. Individuals can also wear the splint at night to support and train the wrist to stay straight throughout the day. Taking action before the symptoms become severe is highly recommended. Talk to a chiropractor or physical therapist for exercises, stretches, and general tips to help with carpal tunnel prevention.
Body Composition
A Snack and A Meal
Without proper planning, the calories an individual consumes from snacks can add up. A recent survey found that snacking contributes 586 calories for men and 421 calories for women per day. Weight loss, weight gain, and weight maintenance come down to calories in vs. calories out.
Eating snacks that are too high in calories or snacking too much can disrupt and derail health goals.
It’s essential to know what a snack consists of, what to look for on a label, and how to plan.
Snacks come in a range of calories, depending on individual goals.
For many, 100-200 calories are recommended for snacks.
Individuals that need increased calories may require a higher calorie snack.
The number of snacks eaten per day depends on individual needs and goals.
It’s best to plan and factor snacks into the overall meal plan to avoid overeating.
LeBlanc, Kim Edward, and Wayne Cestia. “Carpal tunnel syndrome.” American family physician vol. 83,8 (2011): 952-8.
Page, Matthew J et al. “Splinting for carpal tunnel syndrome.” The Cochrane database of systematic reviews vol. 2012,7 CD010003. 11 Jul. 2012, doi:10.1002/14651858.CD010003
Shiri, Rahman, and Kobra Falah-Hassani. “Computer use and carpal tunnel syndrome: A meta-analysis.” Journal of the neurological sciences vol. 349,1-2 (2015): 15-9. doi:10.1016/j.jns.2014.12.037
The body needs consistent energy to get through the day. The central nervous system runs from the brain, down through the spine, and then towards every organ and region of the body. The central nervous system works by sending signals to the organs or the body’s moving parts. But when there is a kink, misalignment, damage, or injury in the spine or other joints, the signals don’t get sent or received correctly.
Pressure builds on the nerves causing the signals/messages sent from the brain to the body to start to slow down and the body’s responses. This includes not just physical reactions but the body’s metabolism. Slow metabolism causes the body to become sluggish and slow. Regular chiropractic adjustments can remove the kinks restoring proper energy flow. When the body’s cells and organs are sending and receiving the signals correctly, the body gets the full force of the energy that the body has stored.
Energy Drain
Spinal misalignments can cause a multitude of symptoms. The most common problem is pain. Misalignments can also lead to energy-draining problems. These include:
Headaches
Difficulty concentrating
Joint pain
Inflammation
The body absorbs toxins from the air, water, food, or direct contact. A buildup of toxins can make the body sluggish. Chiropractic adjustments release these toxins so that the body can rid itself of them. Being out of alignment and balance requires the body to use more energy to get anything done. Even easy to do activities, chores, tasks, etc. When the body’s natural balance is restored, the result is more available energy.
Stress Management
Stress management is vital as chronic stress increases the risk of developing health problems. Learning to manage stress can help increase energy. Therapeutic massage can help with stress relief. A chiropractor will determine the best type of massage for each individual’s situation. The physiological effects of massage to reduce stress include:
Increased endorphins, serotonin, dopamine.
Decreased cortisol.
Increased tissue elasticity.
Endorphins, serotonin, and dopamine are neurotransmitters that are released by the autonomic system when stimulated.
Endorphins are responsible for relieving anxiety.
Serotonin prevents depression and gives a sense of well-being.
Dopamine increases motivation and prevents self-doubt.
When the body lacks these positive hormones, an individual can become stressed, anxious, and overwhelmed. A therapeutic massage stimulates the autonomic system, increasing the release of positive hormones. Increasing the level of positive hormones reduces stress and anxiety and improves overall mood.
When a decrease in cortisol occurs, stress is also reduced. Cortisol is a negative hormone released from the adrenal gland when stimulated by the brain’s hypothalamus region. The adrenal gland is located on top of the kidneys. Cortisol is released into the blood and is transported around the body. Cortisol increases:
Stress
Anxiety
Depression
Responsible for the fight or flight response.
When large amounts of cortisol are released in response to pain, stress levels increase, and the immune system is suppressed. A massage helps flush out the cortisol from the blood and replace it with the positive hormone endorphins, serotonin, and dopamine, decreasing stress and increasing relaxation.
Central Nervous System and Chiropractic
Chiropractic looks for the root cause of the problem and addresses that issue. Individuals can keep their bodies stay in balance by:
Chiropractic treatment can help improve quality of life and overall health.
Body Composition
Neglecting A Healthy Diet
Individuals might begin a weight loss journey by going to the gym, which is great, but neglecting a healthy diet is just wasting energy. Fat loss happens when the body is in a caloric/energy deficit. This means an individual has to take in fewer calories than the body is using. According to the CDC, individuals need to reduce food intake by at least 500 calories a day to lose around a pound of body fat a week.
Individuals that start increasing exercise/workouts make the body instinctively want to increase calorie intake.
Eating more calories than are burned means the individual is wasting the workout.
For example, the body needs a 2,100 calorie diet to maintain its weight, and on average, an individual eats 2,100 calories.
This means the weight won’t change much, if at all.
If an individual burns 300 calories from a workout, the body needs 2,400 calories to maintain weight.
If no changes are made to the diet, the individual will be in a negative -300 caloric deficit.
Suppose an individual starts increasing their caloric intake because they think their metabolism is speeding up, which is not how it works, then the individual negates any energy deficit that they worked for, leading to no fat loss.
References
Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395
Kültür, Turgut et al. “Evaluation of the effect of chiropractic manipulative treatment on oxidative stress in sacroiliac joint dysfunction.” Turkish Journal of physical medicine and rehabilitation vol. 66,2 176-183. 18 May. 2020, doi:10.5606/tftrd.2020.3301
Salleh, Mohd Razali. “Life event, stress, and illness.” The Malaysian Journal of medical sciences: MJMS vol. 15,4 (2008): 9-18.
Back pain usually comes from lifting an object the wrong way or awkwardly moving the body, injuring the spinal structures or muscles. However, sometimes it could be signs/symptoms of a more serious medical condition. The back pain could be caused by:
How to know when the root cause of back pain is from something else in the body? There are two types of pain that pain specialists look at. These are visceral pain and somatic pain. Visceral pain comes from damage or injury to the organs or organ tissues. This internal pain can radiate to the spine from conditions like:
Pancreatitis
Ulcerative colitis
Crohn’s disease
Gall stones
Cancers
Kidney pain
Urinary tract infections
Somatic pain is injury or damage to the muscles, skin, and soft tissues. It can be caused by:
Regular wear and tear
Aging
Injury
Sedentary lifestyle
However, visceral pain can cause somatic/bodily pain to flare up. The stress the body is going through because of the medical condition can cause inflammation.
Kidney Infections and Stones
The kidneys are located in the rear of the body toward the middle of the back. The kidneys:
Filter waste products from the body
Regulate bodily fluids
Perform other vital functions.
Kidney infections and kidney stones can easily mimic a sprain or strain in the back. Infections or stones can also present with other symptoms like:
Side and groin pain could accompany the back pain.
The pain does not go away after shifting positions or lying down.
Urinary Tract Infection UTI
Upper urinary tract infections in the kidneys or ureters can cause back pain. Upper UTIs happen when a lower UTI in the bladder or urethra goes unnoticed or does not respond to antibiotic treatment. Infections can occur at any age, with women and older men being more susceptible. The pain usually presents in the lower back and groin area. Other possible symptoms include:
Pain in the back, sides of the lower abdomen between the lower ribs and hips.
Fever
Vomiting
Frequent urination in small amounts
Burning during urination
Strong urge to urinate
Foul-smelling urine
Cloudy urine
Fatigue.
The pain can feel like:
Cramping pain
Pressure
Soreness
Pancreatitis
Pancreatitis is inflammation of the pancreas, the long flat organ located in the upper abdomen behind the stomach. It assists digestion and sugar management. The American Pancreatic Associationreports acute pancreatitis can make individuals feel sick with moderate to severe abdominal pain that can radiate to the back and often worsens after eating. The pain is felt in the upper to middle back. Other possible symptoms include:
Abdominal pain that radiates to the back
Abdominal pain after eating
Fever
Nausea
Vomiting
Tenderness in the abdomen
The pain can feel like a pulled muscle or joint pain that increases and decreases at first and then strengthens after eating or lying down.
Inflammatory Bowel Diseases IBD
Ulcerative colitis and Crohn’s disease are inflammatory bowel diseases not to be confused with irritable bowel syndrome.
Ulcerative colitis affects the colon.
Inflamed intestinal areas characterize Crohn’s disease.
Both can cause spreading back pain.
A study found 25% of individuals with IBD have chronic back pain. Other possible symptoms include:
The pain can feel mild or severe, like a cramp in the lower abdomen around the low back. It can present in cycles as a flare-up, then goes away. It’s essential to read the body’s warning signs and not push through the pain or ignore it. If any back pain goes on for more than a week, consult a doctor or chiropractor for a thorough examination. A pain specialist could be recommended if there is chronic back pain from a severe medical condition. A primary doctor or specialist helps keep the medical condition in check, while a pain specialist and/or chiropractor can alleviate chronic musculoskeletal pain from inflammation, irritation, and overstimulated nerves.
Body Composition
Personalized Lifestyle Medicine
Personalized lifestyle medicine develops customized treatment/health plans to fit the individual. It includes:
Research on how the body works as an integrated system.
Combines new technology approaches in medicine.
The relationship between nutrients and gene expression.
Life and behavioral sciences.
Nutrigenomics testing helps individuals understand the influence of dietary components on their genes, which can help prevent the development of certain chronic diseases.
The body is a well-working machine that can endure anything that is thrown in its way. However, when it gets an injury, the body’s natural healing process will ensure that the body can get back to its daily activities. The healing process of an injured muscle varies throughout the body. Depending on how severe the damage is and how long the healing process will take, the body can recover to a mere few days to a few months. One of the most gruelly healing processes that the body has to endure is a ruptured calcaneal tendon.
The Calcaneal Tendon
The calcaneal tendon or the Achilles tendon is a thick tendon that is located in the back of the leg. This muscle-tendon is what makes the body move while walking, running, or even jumping. Not only that, the calcaneal tendon is the strongest tendon in the body, and it connects the gastrocnemius and soleus muscles at the heel bone. When the calcaneal tendon is ruptured, the healing process can last from weeks to months until it is fully healed.
The Healing Effects of Low Laser Therapy
One of the ways that can help the damaged calcaneal tendons’ healing process is low laser therapy. Studies have shown that low laser therapy can speed up the damaged tendon repair after a partial lesion. Not only that but the combination of ultrasound and low laser therapy has been studied to be the physical agents for treating tendon injuries. The studies showed that the combination of low laser therapy and ultrasound has beneficial properties during the recovery process of treating calcaneal tendon injuries.
The study found that when patients are being treated for their calcaneal tendons, their hydroxyproline levels around the treated area are significantly increased with ultrasound and low laser therapy. The body’s natural biochemical and biomechanical structures on the injured tendon increase, thus affecting the healing process. Another study has shown that low laser therapy can help reduce fibrosis and prevent oxidative stress in the traumatized calcaneal tendon. The study even showed that after the calcaneal tendon is traumatized, inflammation, angiogenesis, vasodilation, and the extracellular matrix are formed in the affected area. So when patients are being treated with low laser therapy for about fourteen to twenty-one days, their histological abnormalities are alleviated, reducing collagen concentration and fibrosis; preventing oxidative stress from increasing in the body.
Conclusion
Overall, it is said that the effects of low laser therapy can help speed up the healing process of repairing the calcaneal tendon. The promising results have been proven since low laser therapy can help repair the damaged tendon, reducing oxidative stress and preventing fibrosis from escalating, causing more problems on the injured tendon. And with the combination of ultrasound, the calcaneal tendon can recover faster so the body can continue its everyday activities without any prolonged injuries.
References:
Demir, Huseyin, et al. “Comparison of the Effects of Laser, Ultrasound, and Combined Laser + Ultrasound Treatments in Experimental Tendon Healing.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, 2004, pubmed.ncbi.nlm.nih.gov/15278933/.
Fillipin, Lidiane Isabel, et al. “Low-Level Laser Therapy (LLLT) Prevents Oxidative Stress and Reduces Fibrosis in Rat Traumatized Achilles Tendon.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, Oct. 2005, pubmed.ncbi.nlm.nih.gov/16196040/.
Wood, Viviane T, et al. “Collagen Changes and Realignment Induced by Low-Level Laser Therapy and Low-Intensity Ultrasound in the Calcaneal Tendon.” Lasers in Surgery and Medicine, U.S. National Library of Medicine, 2010, pubmed.ncbi.nlm.nih.gov/20662033/.
Waking up with neck soreness, stiffness, achiness, and pain can take a toll throughout the day. Individuals, that experience this regularly wonder what happened while laying down in bed? Individuals can wake up with one or a combination of these symptoms after sleeping. A few ways to prevent neck pain after sleeping and self-care to relieve any symptoms.
What Is Happening?
The spine keeps the body upright and moving and regularly resists gravity and other forces acting upon it. The neck, aka the cervical spine, is a little more delicate. The neck has the important job of holding up the head. The human head weighs around 10 to 12 lbs, and that’s using proper posture. According to a study, the head’s weight can increase up to 60 lbs. with a 60-degree tilt. This can happen from looking down at a phone for too long. All that weight makes the muscles that support the head and neck work overtime contributing to fatigued muscles.
Then when sleeping, cervical spinal misalignment starts to set in, producing torticollis. Torticollis, aka wry neck, is a condition where the neck gets twisted or tilted at an awkward angle. Babies can be born with it, known as congenital torticollis, and individuals can develop it from various sources. It can be temporary, chronic, and it can be caused by acute trauma. Torticollis is not considered a condition like ankylosing spondylitis but more like a symptom with overlapping sources.
The neck’s ligaments can become irritated and inflamed.
Neck muscle spasms can cause soreness and inflammation.
Either of these can be caused by sleeping in an awkward position or by using the wrong pillow.
Waking With Neck Pain
When waking up with neck pain, it could be that the pillow no longer provides sufficient support, the pillow is too thick, placing the neck in an awkward position, the individual’s sleeping position strains the muscles and ligaments, or a combination. It is usually a pillow that is too soft with no support that causes neck pain. Maintaining spinal alignment when sleeping is just as crucial as during the day, as it helps to prevent overly taxing the muscles and ligaments.
How to control posture when sleeping?
The pillow could be the answer. A firm pillow will keep the spine in a straight line from the atlas, which is the first cervical vertebra/C1, down to the coccyx or the tailbone. The way an individual sleeps also affects how they wake up. The most recommended sleeping position for individuals with morning neck pain is on the back. Back sleeping might not work for everyone as it can aggravate conditions like sleep apnea. If that is the case, sleeping on the side is the next recommended position. It is recommended to avoid sleeping on the stomach. The head could slip down the pillow edge causing the head to be in a tilted position. This can place added pressure on the nerves that start in the neck, leading to further neck pain or radiculopathy pain that spreads out to the arms or legs.
What To Do?
If neck pain presents after waking, get some ice or a cold pack on it. Try 20 minutes on, 20 minutes off. This will reduce inflammation. Also, over-the-counter nonsteroidal anti-inflammatory medications like ibuprofen can help. If neck pain continues, switch from ice to heat also 20 minutes on, 20 off. If the pain is caused by spasming muscle/s, heat can relax the area and increase blood circulation. A gentle massage on and around the area can help spread the circulation and ease the spasm.
Stretching the neck
Stretching the neck will keep the muscles loose and reduce the risk of ligament, muscle and tendon strains, and torticollis.
Body composition change and losing fat mass are also related to sleep. Losing fat requires the body to be in a caloric deficit. This means having the body use more energy than the body takes in. This is accomplished by restricting calories through diet or increasing calories used through physical activity/exercise. However, most individuals utilize a combination. This can be referred to as calories in/calories out. Losing sleep can sabotage fat loss goals by stealing both the calories in and calories out.
References
Hansraj, Kenneth K. “Assessment of stresses in the cervical spine caused by posture and position of the head.” Surgical technology international vol. 25 (2014): 277-9.
Preventing Neck Pain from Sleeping: National Sleep Foundation. (n.d.) “How to Prevent Neck Pain While Sleeping.” sleep.org/articles/prevent-neck-pain-while-sleeping/
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