Back Clinic Chiropractic Spine Care Team. The spine is designed with three natural curves; the neck curvature or cervical spine, the upper back curvature or thoracic spine, and the lower back curvature or lumbar spine, all of which come together to form a slight shape when viewed from the side. The spine is an essential structure as it helps support the upright posture of humans, it provides the body with the flexibility to move and it plays the crucial role of protecting the spinal cord. Spinal health is important in order to ensure the body is functioning to its fullest capacity. Dr. Alex Jimenez strongly indicates across his collection of articles on spine care, how to properly support a healthy spine. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Middle back pain is usually caused by unhealthy posture, improper lifting or twisting, and minor injuries like muscle strains, sprains, and herniated discs. Thoracic herniated discs are less common than neck or low back herniations because of the thoracic vertebrae’s size and rigidity, but they do happen. Chiropractic care can treat thoracic herniated discs and prevent future episodes.
Thoracic Herniated Disc
The 12 thoracic vertebrae between the neck and the lumbar spine make up the largest and least flexible area. The rib cage adds:
Protection
Support
Stabilization of the spine
Symptoms
Herniated discs happen when the soft, gel-like layer of the shock-absorbing intervertebral disc bulges into or leaks through the disc’s tough outer layer. Due to the location, a herniated disc can cause various issues to the middle back, chest wall, and/or abdominal areas around the injured vertebrae. This displacement can cause:
Inflammation
Compression to the spinal nerves or spinal cord
Tingling
Numbness
Pain
Weakness
If the lower thoracic region is herniated, symptoms can radiate to one or both lower extremities.
Radiculopathy
If the herniation compresses a thoracic spinal nerve, it can cause radiculopathy or pain that radiates down the nerve and out from the spine into the surrounding muscles. The symptoms can present around the rib cage or upper abdominal area. A large disc herniation can compress the spinal cord inside the spinal canal. This is a condition called myelopathywhich can cause:
Numbness
Tingling
Weakness in one or both lower extremities
Sometimes bowel and bladder dysfunction
In severe cases, paralysis
Causes
Degenerative disc disease and trauma like vehicle collisions or falls are the most common causes of thoracic herniation.
Individuals between 30 and 50 are more likely to be affected.
As the body ages, the disc’s soft inner layer loses hydration, making it less effective as a shock absorber.
The tough outer layer loses elasticity, increasing the risk of disc tears.
Chiropractic Care
A chiropractor or neurologic physical therapist can personalize a herniated disc exercise treatment plan to reduce pain, improve strength and posture, and increase mobility.
Therapeutic massage can be useful in managing pain and decreasing inflammation.
Spinal epidural injections can be used with physical therapy to help manage pain and allow the body to heal independently.
Recommendations
Avoid bending, lifting, reaching, and twisting.
Apply an ice pack or cold compress for 15- to 20-minute intervals every two hours.
Sit in chairs with a firm back to support the spine.
When sleeping, place a small pillow under the head and knees to keep the spine in a neutral position to prevent pressure on the herniated region.
Avoid too much rest, which can worsen the injury.
Gentle physical activity will maintain circulation and keep the muscles strong.
Surgery
Most cases of thoracic herniation do not require surgery. Surgery could be recommended if there is intolerable pain, neurological issues, and conservative treatments are not working. A spine specialist can determine if surgery is necessary based on the injury’s size, type, and location. Spinal surgery will remove all or part of the herniated disc compressing a nerve root. Common surgical procedures include:
Court, C., E. Mansour, and C. Bouthors. “Thoracic Disc Herniation: Surgical Treatment.” Orthopaedics & Traumatology: Surgery & Research 104, no. 1 (2018). doi.org/10.1016/j.otsr.2017.04.022.
Dydyk, Alexander M, Ruben Ngnitewe Massa, and Fassil B Mesfin. “Disc Herniation – Statpearls – NCBI Bookshelf.” National Library of Medicine, January 18, 2022. www.ncbi.nlm.nih.gov/books/NBK441822/.
Yoon, Wai Weng, and Jonathan Koch. “Herniated Discs: When Is Surgery Necessary?” EFORT Open Reviews 6, no. 6 (2021): 526–30. doi.org/10.1302/2058-5241.6.210020.
Spondyloarthritis is a group of inflammatory, immune-mediated diseases that cause chronic low back pain, inflammation, irritating aches, and pains. The conditions mostly affect the spine but can affect joints in the arms, legs, hips, skin, eyes, and intestines. Spondylitis types can significantly affect daily function, physical activity and compromise bone health.
Spondylitis Types
The main types include:
Ankylosing spondylitis
Psoriatic arthritis
Enteropathic arthritis
Reactive arthritis
Juvenile spondylitis
Undifferentiated spondylitis
Axial Spondylitis vs. Peripheral Spondylitis Types
Axial means relating to the body’s central region, as in the trunk and head.
Axial spondyloarthritis is arthritis and inflammation in the hips and spine.
The condition starts before age 45.
The pain typically starts in the low back but can begin in the neck or other regions.
Characterized by back pain, usually in the lower back and/or buttocks.
Morning back stiffness lasting 30 minutes or longer.
Sacroiliac joint inflammation can also present.
The back pain gradually progresses.
Lasts longer than three months.
Improves with physical movement, not with rest.
Peripheral spondyloarthritis is arthritis and inflammatory pain in the peripheral joints and tendons and does not include the spine.
Individuals can have peripheral and axial spondylitis symptoms simultaneously.
Diagnosis depends on whether symptoms are primarily peripheral or axial.
Spondylitis and Spondylosis
Spondylosis and spondylitis are similar in they cause pain and inflammation in the back and hips. The difference is in each condition’s triggers.
Spondylitis is a disease in which the body’s immune system degrades joints, causes inflammation, overproduces bone formation, and causes bone fusion.
Spondylosis is a category of arthritis that presents as the spine ages from normal wear and tear.
It happens during the degeneration of the spine’s discs and joints.
It also presents when bone spurs develop on the spine’s vertebrae.
Ankylosing Spondylitis
Ankylosing spondylitis is the most common form of arthritis affecting the spine, other joints, and body regions. The condition causes spinal joint inflammation causing extreme discomfort and chronic pain. In some cases, the inflammation progresses to ankylosis, where spine sections fuse and become immobile. Other body areas that can trigger inflammation include:
The ribs
Heels
Shoulders
Hips
Small joints of the feet and hands.
Ankylosing spondylitis symptoms vary from person to person. Common early symptoms include:
There is general discomfort, appetite loss, and mild fever early in the condition.
Persistent stiffness and pain in the buttocks and low back, gradually progressing over a couple of weeks or months.
The pain and stiffness can travel into the neck and spine within months or years.
The pain is usually spread out and dull.
The stiffness and pain are worse in the morning and night and improve with light exercise or a warm shower.
The pain typically becomes chronic, lasts for a minimum of 3 months, and can be felt on both sides.
Tenderness and pain in the hips, thighs, shoulder blades, heels, and ribs may also occur.
Treatment approaches include applications of ice and heat to reduce swelling, increase circulation, and decrease joint pain, posture exercises, stretches, physical therapy, and medication.
Psoriatic Arthritis
Psoriatic arthritis causes swelling, pain, and inflammation in the small joints of the hands and feet; however, the joints of the knees, ankles, and wrists can also be affected. Psoriasis is a rash that causes scaly skin patches.
Individuals can develop dactylitis when a finger or toe swells between the surrounding joints.
Spinal stiffness and pain can present.
Typically the ends of the finger joints are most affected and experience pain and inflammation.
Medications frequently utilized to treat ankylosing spondylitis can be used.
Exercise helps preserve the range of motion and maintain strength.
Isometric exercises work muscles without joint motion reducing the risk of further injury to inflamed joints.
Occupational and physical therapy can significantly assist in optimizing arthritic joint function.
Enteropathic Spondylitis
Enteropathic Arthritis is chronic inflammatory arthritis linked to inflammatory bowel disease. The most recognized are Crohn’s and ulcerative colitis.
The peripheral limb joints and sometimes the whole spine are the most prevalent body areas afflicted with enteropathic spondylitis.
The main symptom is intestine inflammation, including bowel and joint pain and/or inflammatory back pain.
Other symptoms can include weight loss, blood in the stool, abdominal pain, and/or chronic diarrhea.
Managing enteropathic arthritis typically means managing the underlying bowel disease.
Juvenile Spondyloarthritis
Juvenile spondyloarthritis is a group of childhood rheumatic diseases that cause arthritis before age 16 and can continue through adulthood. Juvenile spondyloarthritis encompasses:
Enteropathic arthritis
Enthesitis-related arthritis
Undifferentiated spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Juvenile ankylosing spondylitis
Juvenile spondyloarthritis causes inflammation and pain in joints in the lower body, like the ankles, hips, knees, and pelvis. Other body areas that could be affected include:
The bowels
Eyes
Skin
Spine
Lethargy and fatigue can also present. The symptoms can be unpredictable and episodic, appearing and disappearing without a specific cause. The condition cycles between flare-ups and remission. Common treatment approaches include:
Medication
Exercise
Posture training
Physical therapy, medication
Ice and heat to decrease joint pain and relax muscles.
In severe cases, surgery could be recommended.
Reactive Arthritis or Reiter’s Syndrome
Reactive arthritis is arthritis that causes pain and inflammation in the mucous membranes, bladder, skin, joints, eyes, and genitals.
Reactive arthritis is believed to be a reaction to an infection, usually in the gastrointestinal or urinary tract.
Reactive arthritis does not affect the sacroiliac joints and spine in most cases.
Reactive arthritis is typically treated with nonsteroidal anti-inflammatory medications, steroids, and rheumatoid arthritis medications.
A physician could prescribe antibiotics if a bacterial infection brought on reactive arthritis.
Undifferentiated Spondyloarthritis
Undifferentiated spondyloarthritis is where the signs and symptoms of spondylitis don’t meet the criteria for a specific rheumatoid disorder. Individuals diagnosed with undifferentiated spondyloarthritis will have one or more of the symptoms that include:
Fatigue
Back inflammation
Back pain
Buttock pain that alternates or presents on both sides.
Swollen toes or fingers
Heel pain
Arthritis in the small joints.
Arthritis in the large limb joints.
Enthesitis or inflammation where the ligament or tendon connects to the bone.
Eye inflammation
Individuals can also present symptoms of other spondylitis types, like psoriatic or ankylosing.
Treatment approaches include:
Exercise
Physical therapy
Posture training
Ice and heat to decrease joint pain and loosen up muscles.
Spondylitis Types Diagnosis of Spondyloarthritis
References
Carron, Philippe, et al. “Peripheral spondyloarthritis: a neglected entity-state of the art.” RMD open vol. 6,1 (2020): e001136. doi:10.1136/rmdopen-2019-001136
Gill, Tejpal, et al. “The intestinal microbiome in spondyloarthritis.” Current opinion in rheumatology vol. 27,4 (2015): 319-25. doi:10.1097/BOR.0000000000000187
Rosenbaum, James T. “The eye in spondyloarthritis✰.” Seminars in arthritis and rheumatism vol. 49,3S (2019): S29-S31. doi:10.1016/j.semarthrit.2019.09.014
Seo, Mi Ryoung et al. “Delayed diagnosis is linked to worse outcomes and unfavorable treatment responses in patients with axial spondyloarthritis.” Clinical rheumatology vol. 34,8 (2015): 1397-405. doi:10.1007/s10067-014-2768-y
Sharip, Aigul, and Jeannette Kunz. “Understanding the Pathogenesis of Spondyloarthritis.” Biomolecules vol. 10,10 1461. 20 Oct. 2020, doi:10.3390/biom10101461
Spinal stenosis is when space somewhere along or within the spine begins to narrow, closing off the ability of normal/comfortable movement and nerve circulation. It can affect different areas, including the cervical/neck, lumbar/low back, and, less commonly, the thoracic/upper or mid-back regions causing tingling, numbness, cramping, pain, muscle weakness, or a combination in the back, leg/s, thighs, and buttocks. There can be various factors causing the stenosis; correct diagnosing is the first step, and where a spinal stenosis MRI comes in.
Spinal Stenosis MRI
Stenosis can be challenging to diagnose as it is more of a symptom/complication than a condition, often caused by herniated discs, bone spurs, a congenital condition, post-surgery, or after an infection. Magnetic resonance imaging/MRI is a common test used in diagnosis.
Diagnosis
A healthcare professional, like a chiropractor, physical therapist, spine specialist, or physician, will begin with understanding symptoms and medical history.
A physical exam will be conducted to learn more about the location, duration, positions, or activities that decrease or worsen the symptoms.
Additional tests include muscle strength, gain analysis, and balance testing to help better understand where the pain is coming from.
To confirm a diagnosis, imaging will be required to see what is going on.
An MRI uses computer-generated imaging to produce images that show bone and soft tissues, like muscles, nerves, and tendons, and if they are compressed or irritated.
A healthcare professional and MRI technician will go over the safety requirements before the imaging.
Because the machine uses powerful magnets, there can be no metal on or in the body, like implanted prostheses or devices that include:
A different imaging test may be used if an individual cannot have an MRI like a CT scan.
An MRI can range from several minutes to an hour or longer, depending on how many positions are necessary to isolate the injured area and get a clear image. The test is painless, but sometimes individuals are asked to maintain a specific position that could be uncomfortable. The technician/s will ask if there is discomfort and offer any help to make the experience as easy as possible.
Treatment
Not all cases of stenosis cause symptoms, but there are treatment options that a healthcare professional can recommend.
Conservative care is the first recommendation that includes chiropractic, decompression, traction, and physical therapy.
Treatment increases muscle strength, improves range of motion, improves posture and balance, decreases discomfort symptoms, and incorporates strategies to prevent and manage symptoms.
Prescription medications could be part of a larger treatment plan.
Surgery could become an option in more severe cases where conservative care is not working.
Spinal Stenosis
References
Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Diagnosis of lumbar spinal stenosis: an updated systematic review of the accuracy of diagnostic tests. 2013. Available from: www.ncbi.nlm.nih.gov/books/NBK142906/
Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK551669/
Gofur EM, Singh P. Anatomy, Back, Vertebral Canal Blood Supply. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK541083/
Lurie, Jon, and Christy Tomkins-Lane. “Management of lumbar spinal stenosis.” BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234
Stuber, Kent, et al. “Chiropractic treatment of lumbar spinal stenosis: a review of the literature.” Journal of chiropractic medicine vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001
When many individuals look for ways to relax after a stressful event in their daily lives, many people have an exercise regime that allows them to take their minds off of their hectic lives. When finding the proper exercise, it is best to consider that everybody is different and has different fitness levels. Many individuals could be dealing with chronic issues that affect them drastically and with so much pain in their bodies. When these chronic issues overlap with muscle and joint pain, it can make the body dysfunctional while potentially being involved in environmental factors. Yoga is a low-impact exercise that helps tone muscles, relax tension in the body, and focus on deep breathing. Today’s article looks at the benefits of yoga for the body, how chiropractic care works together with yoga, and different yoga poses can help manage various chronic issues. We refer patients to certified providers specializing in musculoskeletal treatments to help many individuals with musculoskeletal problems affecting their bodies. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
The Benefits of Yoga For The Body
Have you been dealing with chronic stress affecting your quality of life? Have you been dealing with bladder or gut issues constantly? What about feeling muscle stiffness in your back, neck, shoulders, or pelvic regions? Some of these symptoms are signs that you could risk developing musculoskeletal problems associated with pain. Dealing with musculoskeletal issues related to pain can make a person feel miserable and have stress affecting their bodies. Yoga is a low-impact exercise that doesn’t put pressure on the joints and will provide a full-body workout through strengthening and stretching weak muscles. Yoga has many benefits for many individuals that are dealing with the following:
Studies reveal that environmental factors are involved in non-specified chronic pain in the spine, overlapping musculoskeletal disorders causing many individuals to try to find relief. Many individuals incorporate yoga because it is a safe and effective way to alleviate various forms of back, neck, or pelvic pain causing issues to the body. Yoga utilizes gentle stretching and strengthening of weak, injured muscles while increasing blood circulation to promote healing in the body.
Chiropractic Care & Yoga
When people are dealing with health conditions or injuries that have affected their bodies, it can make them feel frustrated and think their injuries are taking forever to heal. Many individuals don’t realize that incorporating yoga practices provides impressive health benefits while mirroring the similar foundations of chiropractic care. Both chiropractic care and yoga provide many beneficial results to an aching body that needs a good stretch and ready the body to heal itself naturally. Chiropractic care includes spinal manipulation to the spinal joints while reducing inflammation and strengthening weak muscles. Yoga allows the body to increase its flexibility and stamina, reduces stress and blood pressure, and provides a better sense of breathing and balance.
Yoga For Chronic Pain-Video
Have you felt muscle stiffness in your neck, back, or body? Have you felt sluggish or overly stressed from your day-to-day lives? Do you want to improve your balance? If you have been experiencing these issues affecting your quality of life, why not incorporate yoga as part of your exercise regime? The video above shows that yoga poses for chronic pain affect the body, including the neck, back, and pelvic regions. Studies reveal that yoga can help relieve intense neck pain while improving pain-related function disability. Yoga allows the muscles to not only relax but strengthen them as well. Yoga can also help improve the body’s range of motion through deep breathing and give more awareness of how the body holds tension in places a person hasn’t realized they were holding onto.
Yoga Poses For Different Issues
When a person does yoga, they will go through various poses and repeat them constantly as their body begins to get used to the movements. This allows the body to challenge itself and helps the individual focus more on deep breathing. A good example would be an individual taking a yoga class due to experiencing pelvic pain. By going through each yoga pose, many individuals suffering from pelvic pain will reduce the pain intensity while improving their quality of life. Below are some yoga poses that anyone can do to reduce pain associated with their back, neck, or pelvis.
Bridge Pose
Lie on your back
Bend both knees while placing the feet on the floor at hip-width apart
Arm on the sides with palms facing down
Press feet to the floor and lift the hips as you inhale
Engage the legs and buttock
Hold 4-8 breaths and exhale to lower the hips back to the ground slowly
Cobra Pose
Lie on your stomach with hands near the chest just under the shoulders and fingers facing forward
Keep elbows close to sides
Press hands on the floor and slowly lift your head, chest, and shoulders while slightly bending the elbows by inhaling
Exhale to go back down slow and rest your head
Cat-Cow
Be on all fours, hands under the shoulders and knees under hips (Think like a table)
Inhale to lower your core to the floor as your head looks up to the sky
Exhale slowly to lower your chin to the chest as you round your back
Continue fluid motion for a minute
Forward Bend
Be in a standing position, and feet are at a hip distance apart
Lengthen the body as you lean forward while keeping the knees slightly bended
Place hands on either legs, yoga block, or the floor (Whichever makes you comfortable)
Tuck the chin into the chest, letting the neck and head relax
Gently rock your head side to side to relieve tension in the neck and shoulders
Slowly roll up to a standing position allowing the arms and head to be the last to rise
Supine Spinal Twist
Lie on your back while your knees bent and feet flat on the floor
Extend arms out of the side and place palms down on the floor
As you inhale, breathe into the gut and lower limbs
Exhale to lower knees on the left side (Look at the opposite way to slowly stretch the neck and shoulder muscles)
Pay attention to the stretches for 5 breathes as well as the lengthening sensations on the ribs
Return the knees to the middle and repeat on the right side
Child’s Pose
Sit back on the heels with the knees together (For added support, you can use a rolled-up blanket under your knees)
Bend forward and walk hands in front of you
Gently rest your forehead on the floor
Keep arms extended in the front while focusing on relieving tension in the back as the upper body falls to the knees
Stay in that pose for 5 minutes
Conclusion
Incorporating yoga as part of an exercise regime allows the individual to focus on deep breathing while calming the mind. Yoga is a low-impact exercise that helps strengthen weak muscles associated with pain and inflammation. Yoga provides a full-body workout that benefits many people dealing with chronic pain. Utilizing yoga as part of a daily practice might help individuals learn to be calm and practice mindfulness.
Crow, Edith Meszaros, et al. “Effectiveness of Iyengar Yoga in Treating Spinal (Back and Neck) Pain: A Systematic Review.” International Journal of Yoga, Medknow Publications & Media Pvt Ltd, Jan. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4278133/.
Li, Yunxia, et al. “Effects of Yoga on Patients with Chronic Nonspecific Neck Pain: A Prisma Systematic Review and Meta-Analysis.” Medicine, Wolters Kluwer Health, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6407933/.
Saxena, Rahul, et al. “Effects of Yogic Intervention on Pain Scores and Quality of Life in Females with Chronic Pelvic Pain.” International Journal of Yoga, Medknow Publications & Media Pvt Ltd, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5225749/.
Fatigue Ankylosing Spondylitis: Fatigue is a significant complaint for individuals dealing with ankylosing spondylitis. Ankylosing spondylitis is chronic inflammation of the spine’s joints that can cause them to become fused or locked up. The process can cause the spine to stiffen, limiting movement, reducing flexibility, and generating a severe hunched posture. Symptoms can include back pain, stiffness, and the inability to take a deep breath if the ribs are involved. Fatigue can have a variety of causes, but in ankylosing spondylitis, inflammation and cytokines play a significant role. The underlying cause of ankylosing spondylitis is still being researched, but it currently affects around 300,000 Americans.
Fatigue Ankylosing Spondylitis
Most individuals with ankylosing spondylitis experience pain in the lower back but can also feel pain in their hips and neck, have abdominal pain, or experience problems with vision. Inflammatory back pain is usually strongest in the morning but can also come from inactivity.
Spinal Condition and Extreme Exhaustion
The inability to move along with a decreased spinal range of motion impacts body functionality, sleep quality, and respiratory function affecting energy levels and leading to mild to severe fatigue. Studies have shown that 50% – 85% of individuals with ankylosing spondylitis experience fatigue.
Fatigue is brought on by inflammation, as the body generates the same chemicals when fighting a cold or flu; an individual’s body constantly works to reduce inflammation, leaving them drained and unable to perform ordinary tasks. Inflammatory diseases take a significant toll on the whole body, leading to an increased risk of depression and increased fatigue levels.
Exercise, Massage, and Diet
Many individuals find that their symptoms flare up after long periods of inactivity, like sleeping. This can make wanting to fall and stay asleep complicated, exacerbating fatigue and vice versa, creating a vicious cycle. Even though it can be challenging to move, gentle exercise is recommended. Exercise can help slow the disease progression, build muscle, and improve sleep. It is recommended to speak with a spine specialist, doctor, chiropractor, physical therapist, or exercise trainer about a customized exercise treatment program.
Many individuals with ankylosing spondylitis find therapeutic massage helpful in temporarily relieving pain, and stiffness, reducing stress and improving flexibility from increased blood circulation. A combination of gentle chiropractic massage, exercise, ergonomic adjustments, and rheumatology treatment is recommended for many cases. An anti-inflammatory diet comprised of foods like fatty fish, fruits, nuts, and leafy green vegetables can fight inflammation and decrease fatigue.
AS Causes, Symptoms, Diagnosis, Treatment, and Pathology
References
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Li, Ting, et al. “Fatigue in Ankylosing Spondylitis Is Associated With Psychological Factors and Brain Gray Matter.” Frontiers in medicine vol. 6 271. 21 Nov. 2019, doi:10.3389/fmed.2019.00271
Zhang, Jun-Ming, and Jianxiong An. “Cytokines, inflammation, and pain.” International anesthesiology clinics vol. 45,2 (2007): 27-37. doi:10.1097/AIA.0b013e318034194e
Maintaining healthy joints is crucial to preventing injuries from affecting the body. Incorporating physical activities, eating healthy foods, staying hydrated, and getting a routine check-up are ways to ensure that the body is functional, including the joints. The joints in the body act like shock absorbers that soften the impact of any injuries that the body has sustained. However, as the body ages, so do the joints, causing them to become hardened and cause problems in the body. In today’s article, we will look at sacroiliac dysfunction, what issues it affects besides back pain, and how chiropractic care manages sacroiliac dysfunction. We refer patients to certified providers specializing in musculoskeletal therapies to help those with sacroiliac dysfunction. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer
What Is Sacroiliac Dysfunction?
Are you experiencing pain in the pelvis? Do your hips seem tighter than usual? Do you feel muscle stiffness when you twist from side to side? Some of these issues are signs that you might be experiencing sacroiliac dysfunction. Around the pelvic region lies the sacroiliac joint, a weight-bearing solid joint connecting the pelvis to the sacrum. It is surrounded by tough ligaments that support the body as it distributes the weight from the upper body to the lower body. However, like all the other joints in the body, any injury or condition can cause this joint to be unstable and succumb to the pain, causing sacroiliac dysfunction. Sacroiliac dysfunction or sacroiliac joint pain is defined as one of the potential causes of axial low back pain. When there are issues affecting the sacroiliac joints, it’s associated with about a quarter of most low back pain cases. This is due to the problems that overlap with pain associated with the low back. Studies reveal that dysfunction in the sacroiliac joint can relate to leg or back pain, making diagnosing the problem difficult. Back pain associated with sacroiliac dysfunction causes the pelvis to be hypermobile, causing the risk of developing radiating groin pain. Leg pain associated with sacroiliac dysfunction causes muscle tension and stiffness to the low back, legs, or buttock region, mimicking sciatica-like symptoms.
What Other Issues Does It Affect?
Many individuals may not realize that when they are experiencing sacroiliac dysfunction, symptoms show that they overlap with lumbar spine pathologies. However, sacroiliac dysfunction can also affect the pelvic region of the body. Studies reveal that when the muscles around the body’s pelvic area become inflamed or irritated, it can cause stiffness in the sacroiliac joints, thus developing the risk of pelvic pain. Pelvic pain is usually defined as non-menstrual pain that causes functional disability to the lower extremities. Around the pelvic region, the lower sacral nerves provide extensive neurologic connections to the structures throughout the pelvic area that maintain normal pelvic organ function. When issues like sacroiliac dysfunction become the risk of pelvic pain, it may potentially involve pelvic symptoms like constipation. Studies reveal that constipation is significantly associated with a high prevalence of pelvic organ prolapse and low urinary tract symptoms. Other issues that sacroiliac dysfunction correlates with are:
Ankylosing spondylitis
Rheumatoid arthritis
Inflammatory issues
Hip pain
Pelvic pain
Low back pain
Piriformis syndrome
An Overview Of Sacroiliac Joint Pain- Video
Are you experiencing radiating from your lower back down to your leg? How about stiffness in your hips? Are you feeling constipated or have a sense of fullness in your bladder? You may suffer from sacroiliac dysfunction in your pelvic region if you notice these symptoms. The video above explains how to understand sacroiliac joint pain. The sacroiliac joint connects the pelvis and sacrum, surrounded by tough ligaments and muscles that help support the body by distributing weight from the upper body to the lower body. When issues affect the sacroiliac joints can overlap other risk profiles like low back pain, leg pain, and pelvic pain. This can make diagnosing sacroiliac dysfunction difficult because the symptoms are similar to other issues. For example, hip pain is associated with piriformis syndrome while potentially being involved with sciatica. How would hip pain be correlated with piriformis syndrome? The piriformis muscle can become overused and injured and can entrap the sciatic nerve (which runs from the lumbar spine, through the hips, and down to the leg), causing radiating, throbbing pain. Other times referred pain in the low back can affect different areas in the body due to sacroiliac dysfunction. Luckily, there are treatments available to manage sacroiliac dysfunction.
How Chiropractic Care Manages Sacroiliac Dysfunction
When issues of sacroiliac dysfunction become associated with leg or back pain, physicians often misdiagnose it as a soft tissue issue rather than a joint issue. Many doctors might rule out various medical conditions before including sacroiliac dysfunction as part of the diagnosis. Some treatments like massage therapy can help loosen up the tight muscles surrounding the joints relieving the pain and discomfort. At the same time, chiropractic care utilizes spinal manipulation and mobilization to the affected spinal area. Since the sacroiliac joint is an essential part of the musculoskeletal system, chiropractors specialize in this area. Through practical, non-invasive methods, chiropractic care has proven to not only relieve pain in the spine but can also help rehabilitate the spine. Chiropractors are specially trained to guide the individual through several phases of care that help loosen the stiff muscles and strengthen the joints. Chiropractic care will help decrease the pain from returning to the body and let the individual return to their health and wellness journey.
Conclusion
Maintaining healthy joints is crucial to prevent injuries from affecting the body. The sacroiliac joints are part of the musculoskeletal system that connects the pelvic bone to the sacrum. This joint is surrounded by tough ligaments and muscles that support the upper and lower half of the body through weight distribution. When the sacroiliac joint becomes unstable, it can succumb to pain, thus becoming sacroiliac dysfunction. Sacroiliac dysfunction sometimes mimics low back and leg pain, making it difficult to diagnose. Co-morbidities like pelvic pain correlate to sacroiliac dysfunction, causing somato-visceral pain in different body areas. Treatments like chiropractic care can help strengthen the stiff muscles and joints in the body through spinal manipulation and mobilization in practical, non-invasive treatment. Chiropractic care can help rehabilitate the spine while decreasing the pain from returning to the body.
References
Jonely, Holly, et al. “Chronic Sacroiliac Joint and Pelvic Girdle Dysfunction in a 35-Year-Old Nulliparous Woman Successfully Managed with Multimodal and Multidisciplinary Approach.” The Journal of Manual & Manipulative Therapy, Maney Publishing, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4459139/.
Raj, Marc A, et al. “Sacroiliac Joint Pain.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 12 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK470299/.
Singh, Prashant, et al. “Pelvic Floor Symptom Related Distress in Chronic Constipation Correlates with a Diagnosis of Irritable Bowel Syndrome with Constipation and Constipation Severity but Not Pelvic Floor Dyssynergia.” Journal of Neurogastroenterology and Motility, Korean Society of Neurogastroenterology and Motility, 31 Jan. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6326213/.
The body is a set of complex systems, including bones, organs, nerves, muscles, and tissue. Breathing disorders are increasing, including chronic bronchitis, asthma, emphysema, and other conditions. Viscerosomatic reflexes include poor breathing quality brought on by allergies, breathing disorders like COPD that can cause intense coughing, sneezing, hunching, arching of the back, and heaving that causes back pain and referred pain.
The brain sends electronic impulses to the different areas of the body through the spine/nervous system. If the nerves get shifted, stretched, compressed, or knocked out of position, the brain could start sending messages of pain and discomfort, which can also cause other body systems to malfunction. If the body is constantly transmitting pain signals, it can disrupt sleep, dietary habits, and overall well-being. Misalignment can disrupt the information delivered by the nervous system, leading to inflammation, irritation, and imbalances in the body.
Regular chiropractic maintains the nervous system to operate the way it was designed. Proper alignment of the spine and body will improve the nervous system’s health and function, encouraging the brain to release endorphins achieving pain relief, and leading to optimal health. When the nervous system performs optimally, the other systems will follow, including better breathing quality.
Poor Breathing
Breathing difficulties are widespread with various causes that include:
Allergies
Environmental pollutants
Viral and bacterial infections that cause inflammation
An overactive immune response can all contribute to poor breathing quality.
Individuals might not notice that their breathing quality is poor but instead notice they are:
Frequent exhaustion
Having to stop constantly in the middle of activities.
Experience brain fog.
Memory issues/forgetfulness.
Physical performance – endurance, flexibility, and muscle is deteriorating.
The breathing quality impacts how well the body’s systems can carry out their essential functions and be prepared for unexpected events. The body adjusts oxygen intake capacity in line with the energy required to perform physical activity. All bodily systems, including the cardiovascular, immune, and muscular systems, depend on the respiratory system to generate energy.
Immune protection against viruses, bacteria, fungi, and other diseases.
Chiropractic
A crucial part of the respiratory system’s function is transporting nutrients and oxygen throughout the body. Chiropractic treatment releases tension by moving muscle fascia and the spine that may have become stuck, compressed, or shifted out of position, causing poor posture and injury. Chiropractic eliminates toxins and cellular waste from tight, knotted areas by breaking up stagnant tissues.
Circulation Improvement
Chiropractic increases circulation, allowing fresh blood, lymphatic fluid, nutrients, and oxygen to enter the deprived tissues. These regions include:
Muscles in the shoulder, neck, back
Bones and joints across the spine
Body tissues
Ligaments
Tendons
Chiropractic treatment can be manual/mechanical traction/decompression, combined with therapeutic tissue massage, exercise, and diet recommendations.
Decompression De La Espalda
References
McCarty, Justin C, and Berrylin J Ferguson. “Identifying asthma triggers.” Otolaryngologic clinics of North America vol. 47,1 (2014): 109-18. doi:10.1016/j.otc.2013.08.012
Purnomo, Ariana Tulus, et al. “Non-Contact Monitoring and Classification of Breathing Pattern for the Supervision of People Infected by COVID-19.” Sensors (Basel, Switzerland) vol. 21,9 3172. 3 May. 2021, doi:10.3390/s21093172
Schend, Jason, et al. “An Osteopathic Modular Approach to Asthma: A Narrative Review.” The Journal of the American Osteopathic Association vol. 120,11 (2020): 774-782. doi:10.7556/jaoa.2020.121
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