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Spine Care

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.


Spinal Health After MVAs and Chiropractic Care

Spinal Health After MVAs and Chiropractic Care

Rainy Weather and Motor Vehicle Accidents: Understanding the Risks and Recovery

Spinal Health After MVAs and Chiropractic Care

Rainy weather can make driving more hazardous, increasing the likelihood of minor car accidents that may result in injuries such as spinal misalignment or soft tissue damage. These accidents, while often not severe, can still cause significant health issues if not treated properly. This article examines how rain creates hazardous driving conditions, how these conditions contribute to minor accidents, and how such accidents can lead to injuries that impact spinal health. It also highlights the expertise of Dr. Alexander Jimenez, a chiropractor and nurse practitioner in El Paso, Texas, who specializes in treating auto accident injuries using a unique combination of chiropractic care, medical diagnostics, and integrative medicine to promote recovery and overall health.

How Rainy Weather Increases Accident Risks

Rainy weather creates a cascade of challenges for drivers, making roads more dangerous and increasing the likelihood of minor accidents. Wet roads reduce tire traction, making it harder for vehicles to stop or steer effectively. According to the Texas Department of Insurance, rain is a leading cause of weather-related accidents due to slippery surfaces and reduced visibility (Texas Department of Insurance, n.d.). When tires lose grip on wet roads, vehicles may slide or hydroplane, especially during sudden stops or turns, which can lead to low-speed collisions, such as fender-benders or rear-end accidents (Chicago Lawyer, 2023).

Reduced visibility is another major issue. Heavy rain can obscure a driver’s view, even with windshield wipers on high, making it difficult to see other vehicles, pedestrians, or road signs (Lawyer Schwartz, n.d.). This limited visibility often forces drivers to react more slowly, increasing the risk of minor accidents, such as bumping into another car while braking or changing lanes (Knowles Law Firm, n.d.). Additionally, rain can make roads uneven by creating puddles or washing out gravel, which affects vehicle control and alignment, further contributing to accidents (Springs Auto, n.d.).

These conditions create a chain reaction: wet roads and poor visibility lead to compromised driving conditions, which in turn increase the likelihood of minor accidents. Even low-speed collisions can cause jolts to the body, resulting in injuries that affect spinal alignment and soft tissues, such as muscles and ligaments (Joyce & Macdonald, n.d.). For example, a sudden stop on a slippery road can cause a rear-end collision, leading to whiplash, a common injury where the neck jerks forward and backward, straining muscles and misaligning the spine (Salinas Trial Law, n.d.).

References

The Link Between Minor Accidents and Spinal Injuries

Minor car accidents, such as those caused by rainy weather, may seem harmless, but they can still cause significant injuries. The sudden forces from even a low-speed collision can strain the body, particularly the spine and surrounding tissues. Whiplash is one of the most common injuries, occurring when the head and neck are jolted rapidly, stretching muscles, ligaments, and tendons beyond their normal range (South Sound Law Group, n.d.). This can lead to spinal misalignment, where the vertebrae shift out of their proper position, potentially pressing on nerves and causing pain or discomfort (Jimenez, 2025).

Soft tissue injuries, such as sprains or strains in the neck, back, or shoulders, are also common. These injuries occur when the muscles or ligaments are stretched or torn due to the impact (Because You Want to Win, n.d.). Over time, untreated soft tissue damage can contribute to spinal misalignment by creating uneven tension around the spine, which can lead to chronic pain or reduced mobility (HSI, n.d.). For instance, a minor rear-end collision on a wet road might cause a driver to tense up, resulting in muscle strain that pulls the spine out of alignment.

Spinal misalignments, or subluxations, can disrupt the nervous system, leading to symptoms like headaches, numbness, or tingling in the arms or legs (Jimenez, 2025). If left untreated, these injuries can worsen, causing long-term issues like chronic back pain or reduced range of motion. Early intervention is crucial in preventing minor injuries from developing into chronic conditions, and professionals like Dr. Alexander Jimenez specialize in identifying and treating these issues before they escalate.

References

Dr. Alexander Jimenez: A Leader in Auto Accident Recovery

Dr. Alexander Jimenez, a chiropractor and board-certified family nurse practitioner in El Paso, Texas, has over 25 years of experience treating injuries from motor vehicle accidents (MVAs). His unique dual licensure allows him to combine chiropractic expertise with medical diagnostics, offering a comprehensive approach to recovery (Jimenez, 2025). At his Injury Medical & Chiropractic Clinic, Dr. Jimenez uses advanced tools and integrative medicine to address both the symptoms and root causes of injuries, helping patients regain mobility and prevent long-term complications.

Clinical Correlation and Dual Diagnosis

Dr. Jimenez’s approach involves a dual diagnosis process, combining chiropractic assessments with medical evaluations. He utilizes advanced imaging techniques, including X-rays, MRIs, and CT scans, to detect spinal misalignments, disc herniations, and soft tissue damage (Jimenez, 2025). These tools help him correlate a patient’s symptoms, like neck pain or numbness, with objective findings, ensuring accurate treatment plans. For example, a patient with whiplash might show cervical misalignment on an MRI, which Dr. Jimenez can address with targeted spinal adjustments.

His nurse practitioner training enables him to assess systemic issues, such as inflammation or hormonal imbalances, that may impede recovery. By combining chiropractic and medical perspectives, Dr. Jimenez creates personalized treatment plans that address both biomechanical (spine and muscle) and physiological (body-wide) factors (Jimenez, 2025). This dual approach ensures that injuries are treated holistically, thereby reducing the risk of chronic pain.

Advanced Diagnostics and Imaging

Dr. Jimenez relies on advanced diagnostics to guide his treatments. X-rays and MRIs reveal structural issues, such as misaligned vertebrae or herniated discs, while electromyography (EMG) and functional movement screens assess nerve damage or muscle dysfunction (Jimenez, 2025). These tools are especially important for minor accident injuries, which may not be apparent in standard exams but can cause significant problems if left untreated. For instance, a low-speed collision might cause a subtle ligament tear that can only be detected by an MRI, allowing Dr. Jimenez to tailor his treatment to the specific injury.

Chiropractic and Integrative Medicine

Chiropractic care is central to Dr. Jimenez’s approach, using spinal adjustments to correct misalignments and relieve nerve pressure. These adjustments restore joint mobility and reduce pain, enabling patients to recover without the need for surgery or long-term medication (Jimenez, 2025). He also incorporates soft tissue therapies, such as massage and myofascial release, to reduce muscle tension and improve circulation, which accelerates the healing process.

Integrative medicine enhances his treatments by addressing overall health and well-being. Dr. Jimenez provides nutritional guidance to reduce inflammation, offers acupuncture to alleviate pain, and recommends rehabilitation exercises to strengthen muscles and improve flexibility (Jimenez, 2025). For example, a patient with a soft tissue injury might receive spinal adjustments to realign the spine, nutritional advice to reduce inflammation, and exercises to restore mobility, ensuring a comprehensive recovery.

Legal Paperwork and Personal Injury Cases

Dr. Jimenez’s dual licensure makes him uniquely qualified to handle the legal aspects of personal injury cases. He provides detailed medical reports that document injuries, treatments, and progress, which are essential for insurance claims or legal proceedings (Jimenez, 2025). His reports include objective evidence from imaging and diagnostic tests, giving attorneys and insurance companies clear proof of injury. This thorough documentation helps patients secure fair compensation while focusing on their recovery and rehabilitation.

References

Recovering from Minor Accidents with Chiropractic Care

Chiropractic care is highly effective for recovering from minor accident injuries, especially those caused by rainy weather. Spinal adjustments correct misalignments, reducing pressure on nerves and alleviating pain (Jimenez, 2025). Soft tissue therapies, like massage, help heal strained muscles and ligaments, while rehabilitation exercises strengthen the body to prevent future injuries. Dr. Jimenez’s integrative approach also includes acupuncture and nutritional counseling to support overall health, addressing inflammation and stress that can worsen injuries.

Early intervention is crucial. Seeking care within 72 hours of an accident can prevent minor injuries from becoming chronic (Jimenez, 2025). For instance, a patient with whiplash resulting from a rainy-day collision may receive adjustments to correct cervical misalignment, soft tissue therapy to reduce muscle tension, and nutritional guidance to combat inflammation, ultimately leading to a faster recovery and improved long-term health.

References

Conclusion

Rainy weather increases the risk of minor car accidents by creating slippery roads and reducing visibility, which can lead to collisions that may cause spinal misalignments and soft tissue injuries. These injuries, if untreated, can lead to chronic pain or reduced mobility. Dr. Alexander Jimenez’s expertise as a chiropractor and nurse practitioner enables him to provide comprehensive care, utilizing advanced diagnostics, chiropractic adjustments, and integrative medicine to address both the symptoms and underlying causes of injuries. His ability to handle medical and legal aspects ensures patients recover fully while navigating personal injury cases. By seeking early treatment, individuals can restore their health and prevent long-term complications.

 

References

Because You Want to Win. (n.d.). How poor weather causes crashes. Retrieved July 21, 2025, from https://www.becauseyouwanttowin.com/how-poor-weather-causes-crashes/

Chicago Lawyer. (2023). Understanding the impact of weather on low-speed collisions. Retrieved July 21, 2025, from https://www.chicagolawyer.com/blog/understanding-the-impact-of-weather-on-low-speed-collisions/

HSI. (n.d.). Safe driving in hazardous weather. Retrieved July 21, 2025, from https://hsi.com/blog/safe-driving-hazardous-weather

Jimenez, A. (2025). Injury medical & chiropractic clinic. Retrieved July 21, 2025, from https://dralexjimenez.com/

Jimenez, A. (2025). LinkedIn profile. Retrieved July 21, 2025, from https://www.linkedin.com/in/dralexjimenez/

Joyce & Macdonald. (n.d.). How can poor weather conditions impact your car accident case? Retrieved July 21, 2025, from https://joyce-macdonald.com/blog/how-can-poor-weather-conditions-impact-your-car-accident-case/

Knowles Law Firm. (n.d.). How weather can impact driving safety. Retrieved July 21, 2025, from https://www.knowleslawfirm.com/how-weather-can-impact-driving-safety/

Lawyer Schwartz. (n.d.). Weather conditions that affect auto accidents. Retrieved July 21, 2025, from https://www.lawyerschwartz.com/weather-conditions-that-effect-auto-accidents

Salinas Trial Law. (n.d.). How weather conditions contribute to car accidents. Retrieved July 21, 2025, from https://www.salinastriallaw.com/blog/how-weather-conditions-contribute-to-car-accidents/

South Sound Law Group. (n.d.). The impact of road conditions on motor vehicle accident claims. Retrieved July 21, 2025, from https://southsoundlawgroup.com/the-impact-of-road-conditions-on-motor-vehicle-accident-claims/

Springs Auto. (n.d.). How weather conditions affect your vehicle’s alignment. Retrieved July 21, 2025, from https://springs-auto.com/blog/how-weather-conditions-affect-your-vehicles-alignment/

Texas Department of Insurance. (n.d.). Driving in bad weather. Retrieved July 21, 2025, from https://www.tdi.texas.gov/pubs/videoresource/fsbadweather.pdf

Why Choose The El Paso Back Clinic

Why Choose The El Paso Back Clinic

El Paso, TX’s Leading Spine and Back Injury Specialist: Dr. Alex Jimenez, DC, APRN, FNP-C, IFMCP

Welcome to El Paso’s premier destination for advanced spine and back injury care, led by Dr. Alex Jimenez, a board-certified Family Practice Nurse Practitioner (FNP-C) and Chiropractor (DC). At www.dralexjimenez.com and www.chiromed.com, Dr. Jimenez and his team deliver cutting-edge, evidence-based treatments that integrate chiropractic care, functional medicine, and advanced rehabilitation protocols to address complex neuromusculoskeletal conditions. Our mission is to restore mobility, alleviate pain, and empower patients to live vibrant, pain-free lives through personalized, holistic care.

Specialized Spine and Back Injury Care

Dr. Jimenez’s practice is renowned for its expertise in treating intricate spine and back injuries, including herniated discs, severe sciatica, scoliosis, spinal stenosis, and chronic low back pain. By combining his chiropractic expertise with his advanced training as a Family Practice Nurse Practitioner and Institute for Functional Medicine Certified Practitioner (IFMCP), Dr. Jimenez offers a unique, integrative approach to spine care that addresses both symptoms and underlying causes.

Complex Spine Care Treatments

Dr. Jimenez utilizes cutting-edge techniques to address complex spine conditions in his chiropractic and rehabilitation clinic.

  • Chiropractic Spinal Adjustments use precise manual and instrument-assisted adjustments to restore spinal alignment, reduce nerve compression, and improve mobility. A 2020 study in Spine Journal found that spinal manipulative therapy significantly reduces pain and disability in patients with chronic low back pain (Rubinstein et al., 2020).
  • Decompression Therapy: Non-surgical spinal decompression to relieve pressure on herniated discs and pinched nerves, promoting disc healing and pain relief. Research in Journal of Physical Therapy Science (2017) supports its efficacy for lumbar disc herniation (Choi et al., 2017).
  • Regenerative Therapies: Platelet-rich plasma (PRP) and stem cell support therapies to enhance tissue repair and reduce inflammation in degenerative spine conditions. A 2019 meta-analysis in Pain Physician confirmed PRP’s effectiveness in managing lumbar pain (Sanapati et al., 2019).
  • Electro-Acupuncture: Targeted electrical stimulation of acupuncture points to reduce pain and promote healing in sciatica and chronic back pain. A 2018 study in Evidence-Based Complementary and Alternative Medicine demonstrated its benefits for neuropathic pain (Li et al., 2018).
  • Customized Rehabilitation Programs: Tailored exercises focusing on flexibility, core strength, and spinal stability to prevent re-injury and enhance long-term recovery.

Family Nurse Practitioner Services at www.chiromed.com

As a Family Practice Nurse Practitioner, Dr. Jimenez offers comprehensive medical evaluations and functional medicine protocols to complement spine care:

  • Functional Medicine Assessments: In-depth evaluations using the Living Matrix Functional Medicine Assessment to identify root causes of chronic spine pain, including inflammation, nutritional deficiencies, and hormonal imbalances. A 2021 study in Frontiers in Medicine highlighted functional medicine’s role in improving outcomes for chronic pain patients (Beidelschies et al., 2021).
  • Nutritional Therapy: Personalized nutrition plans to reduce inflammation and support spinal health, incorporating anti-inflammatory diets rich in omega-3s and antioxidants. Research in Nutrients (2020) supports dietary interventions for reducing chronic pain (Kaushik et al., 2020).
  • Hormone Optimization: Addressing hormonal imbalances that exacerbate pain and delay healing, such as cortisol dysregulation in chronic stress. A 2019 study in Journal of Clinical Endocrinology & Metabolism linked cortisol imbalances to chronic pain syndromes (Hannibal et al., 2019).
  • Lifestyle Medicine: Guidance on stress management, sleep optimization, and ergonomic adjustments to support spine health and prevent injury recurrence.

Why Choose Dr. Jimenez for Spine and Back Injury Care?

Dr. Jimenez’s dual expertise as a chiropractor and nurse practitioner, combined with his IFMCP certification, sets him apart as El Paso’s top spine care specialist. Key differentiators include:

  • Holistic, Evidence-Based Approach: Integrating chiropractic care, functional medicine, and advanced diagnostics to address the whole person, not just symptoms.
  • Non-Invasive Protocols: Natural, non-surgical solutions should be prioritized to avoid the risks and recovery time associated with invasive procedures. A 2022 study in The Lancet emphasized the efficacy of non-invasive treatments for chronic low back pain (Foster et al., 2022).
  • Collaborative Care Network: Partnerships with leading orthopedic surgeons, neurologists, and rehabilitation specialists ensure seamless referrals when advanced interventions are needed.
  • Patient-Centered Plans: Using advanced diagnostics like MRI analysis, electromyography (EMG), and functional health assessments to create targeted treatment plans tailored to each patient’s unique needs.

Conditions Treated

Our clinic specializes in a wide range of spine- and back-related conditions, including:

  • Herniated Discs: Comprehensive care to reduce disc protrusion, alleviate nerve compression, and restore spinal function.
  • Severe Sciatica: Targeted therapies to relieve radiating leg pain and improve mobility.
  • Scoliosis: Customized bracing and exercise programs to manage spinal curvature and prevent progression.
  • Spinal Stenosis: Decompression and strengthening protocols to alleviate pain and improve quality of life.
  • Chronic Low Back Pain: Multifaceted treatment plans addressing biomechanical, inflammatory, and lifestyle factors.

Transform Your Spine Health Today

Whether you’re recovering from a traumatic spine injury, managing chronic back pain, or seeking preventive care, Dr. Alex Jimenez and his team are here to guide you. Contact us today at www.dralexjimenez.com or www.chiromed.com to schedule a consultation and discover how our integrative approach can transform your health. With evidence-based protocols and a compassionate, patient-centered philosophy, we help you live pain-free and thrive in El Paso’s vibrant community.

Benefits of Chiropractic and Nurse Practitioners in MVC Treatment

Benefits of Chiropractic and Nurse Practitioners in MVC Treatment

What are the advantages of having a team of nurse practitioners and chiropractors help maintain the health of your spine after a car accident?

Benefits of Chiropractic and Nurse Practitioners in MVC Treatment

Benefits of Chiropractic and Nurse Practitioners for Motor Vehicle Collisions

One of the main causes of spinal injuries, such as whiplash, herniated discs, and soft tissue injury, which can cause severe pain and impair movement, is motor vehicle collisions (MVCs). For both short-term symptoms and long-term rehabilitation, these injuries frequently necessitate a multimodal therapy strategy. While nurse practitioners, as advanced practice registered nurses, conduct medical evaluations, write prescriptions, and oversee overall health management, chiropractors focus on musculoskeletal care, including spine adjustments and manual therapies. These professionals’ collaboration aims to provide a comprehensive, patient-centered strategy for spine health following MVC. (Kent, R., et al., 2023)

For those recuperating from auto accident injuries, a chiropractic and nurse practitioner team can offer thorough spinal health care with an emphasis on pain management and increased mobility.

  1. A chiropractic and nurse practitioner team can offer a comprehensive approach to spinal health after a car accident by addressing pain, improving mobility, and facilitating faster recovery.
  2. Chiropractors focus on spinal alignment and joint mobility.
  3. Nurse practitioners provide broader medical oversight and patient education.
  4. The team approach can lead to more effective and personalized care for individuals recovering from car accident injuries. (Riva, J. J., et al., 2010)

Key advantages of this collaborative approach

A chiropractor and nurse practitioner (NP) therapy team can combine their skills to provide comprehensive care for spine health following a motor vehicle collision (MVC) and address acute and long-term requirements.

Care that is multidisciplinary and holistic

  • Collaboration between chiropractors and NPs to address structural and systemic issues enhances treatment outcomes, particularly for spine injuries related to motor vehicle collisions (MVC), as well as for chronic headaches and neck discomfort. (Riva, J. J., et al., 2010)

Plans for Treatment That Are Unique to You

  • Chiropractors and NPs create personalized patient treatment plans, focusing on their specific injuries and overall health, including pre-existing conditions and medication needs. This approach enhances outcomes by tailoring care to the patient’s unique circumstances.

Managing Pain Without Relying Too Much on Drugs

  • By using non-invasive methods to alleviate pain, chiropractic therapy may help reduce the use of opioids. NPs can prescribe short-term pain relief and monitor side effects, ensuring safe use and reducing dependency risks. Natural pain management combined with medical supervision lessens dependence and side effects. (Prater, C., Tepe, M., & Battaglia, P. 2020)

Quicker Recuperation and Rehabilitation

  • As demonstrated in the treatment of auto accidents, chiropractic adjustments can lessen muscle spasms and restore joint function. By referring patients to physical therapy and tracking their progress, NPs can hasten recovery and reduce the likelihood of developing persistent back pain. This integrated therapy not only reduces chronic back pain and other long-term problems, but it also accelerates healing.

Help with Insurance and the Law

  • Chiropractic and medical providers must carefully record injuries and treatments for insurance claims or legal cases after an MVC to ensure just reimbursement and coverage for care.

Why It Works After MVC

Following a motor vehicle collision (MVC), a chiropractor and nurse practitioner team offers a patient-centered approach to spine health. This team enhances recovery, lowers chronic risks, and improves patient outcomes by fusing NP’s medical management with chiropractic knowledge. This method ensures rapid alleviation and long-term health, especially helpful for complex spine injuries due to MVC.

Injury, Chiropractic, and Functional Medicine Clinic

Dr. Jimenez, a nurse practitioner, uses medical knowledge and chiropractic care to treat various conditions. The clinic provides tailored care programs incorporating functional medicine, acupuncture, electroacupuncture, and sports medicine. The clinic focuses on strength, agility, and flexibility for treating chronic pain syndromes and injuries. Patients of all ages and abilities benefit from comprehensive care plans and in-person and virtual health coaching, ensuring tailored treatment and wellness outcomes.


Personal Injury Rehabilitation


References

Kent, R., Cormier, J., McMurry, T. L., Johan Ivarsson, B., Funk, J., Hartka, T., & Sochor, M. (2023). Spinal injury rates and specific causation in motor vehicle collisions. Accident; analysis and prevention, 186, 107047. https://doi.org/10.1016/j.aap.2023.107047

Riva, J. J., Muller, G. D., Hornich, A. A., Mior, S. A., Gupta, A., & Burnie, S. J. (2010). Chiropractors and collaborative care: An overview illustrated with a case report. The Journal of the Canadian Chiropractic Association, 54(3), 147–154.

Prater, C., Tepe, M., & Battaglia, P. (2020). Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain. Journal of primary care & community health, 11, 2150132720953680. https://doi.org/10.1177/2150132720953680

Pseudoarthrosis After Spinal Fusion Explained

Pseudoarthrosis After Spinal Fusion Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis After Spinal Fusion Explained

Pseudoarthrosis of the cervical and lumbar spine

Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:

  • Issues with the instruments used to stabilize the bone
  • Lack of bone growth
  • The number of vertebrae being fused.

The patient’s health and lifestyle play a role in failed fusions, which can include

  • Diabetes
  • Inflammatory health conditions increase the risk
  • Smoking
  • Long-term steroid use

In many cases, revision surgery is needed.

Surgery-Related

During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:

  • Plates
  • Rods
  • Screws
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. A rigid frame secured outside the body helps to stabilize the bones.

If the fusion fails, it could be caused by one or more of the following surgical issues:

Number of Vertebrae Being Fused

Hardware

  • The surgeon must carefully plan and use the right hardware.
  • The type of hardware used during a spinal fusion may influence bone healing.
  • The instruments can come loose or break, interfering with the fusion process.
  • Spinal osteoporosis, having thin, weak bones, can affect fixation.
  • Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.

Bone Graft

  • The type of bone graft used may affect the fusion.
  • For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
  • Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
  • The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.

Risk Factors

  • The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
  • Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)

The risk of pseudoarthrosis increases if the individual has any of the following: (Scoliosis Research Society, 2023)

  • Previous pseudoarthrosis
  • Obesity
  • Chronic steroid use
  • Malnutrition
  • Inflammatory diseases

Inflammatory conditions that can lead to bone loss and non-optimal bone healing include: (Torres H. M. et al., 2023)

  • Diabetes (Jiao H, Xiao E, & Graves DT, 2015)
  • Inflammatory bowel disease
  • Psoriasis
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease/COPD
  • Periodontitis
  • Systemic lupus erythematosus/SLE

Symptoms

  • The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
  • If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
  • Rarely does a pinched nerve affect both arms.
  • The pain may return shortly after the procedure.
  • The pain may develop gradually or not appear for many months.
  • However, it’s more likely to appear after several months when the individual returns to their usual activities.

Diagnosis

  • The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
  • They’ll assess mobility and the type of movement that causes pain.
  • Then, they order diagnostic imaging to see the spine and identify the cause of pain.
  • Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.

Treatment

Treatment for pseudoarthrosis will likely start with:

  • Physical therapy
  • Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
  • Medication
  • Injections
  • If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
  • Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Enhancing Health Together


References

Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. https://doi.org/10.1186/s12891-024-07531-w

Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. https://doi.org/10.1055/s-0041-1722853

Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. https://doi.org/10.14444/4029

Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1

Scoliosis Research Society. (2023). Pseudoarthrosis. https://www.srs.org/Patients/Conditions/Pseudoarthrosis

Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. https://doi.org/10.1007/s11914-023-00824-4

Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. https://doi.org/10.1007/s11914-015-0286-8

Supine Position: Essential Guide for Patients

Supine Position: Essential Guide for Patients

For individuals experiencing back pain, can lying in the supine position help bring relief?

Supine Position: Essential Guide for Patients

Supine Position

The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)

Medical Uses

Examinations

  • Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)

Procedures

Surgery

  • Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures.
  • It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)

Overall Health

Natural Position

  • Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.

Back Pain Relief

  • Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)

Acid Reflux

  • However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)

Sleep Apnea

  • The supine position can worsen sleep apnea in some individuals.

Clinical Uses

  • A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
  • If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
  • This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
  • Many bed exercises begin in this position for rehabilitation.

Back Care

Here are a few recommendations to relieve low back pain using the supine position.

  • First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
  • Start breathing and relaxing, allowing the tension to drain out of the muscles.
  • In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
  • At that point, the fingertips should feel the transverse abdominal muscle engage.
  • Release and repeat 10 times.

After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.

For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.

Variations

Lawn Chair Position

  • This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.

Frog-Leg Position

  • The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Thoracic Spine Pain


References

ScienceDirect. (2009). Supine Position. Morrey’s The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5

Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.

STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.

MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position

Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf

Cobb Angle: Understanding Spinal Curvature Measurement

Cobb Angle: Understanding Spinal Curvature Measurement

The Cobb angle is a mathematical measurement tool for assessing the curvature of the spine. Along with physical exams and other tests, how is it used to evaluate scoliosis and kyphosis of the spine?

Cobb Angle: Understanding Spinal Curvature Measurement

Cobb Angle

The Cobb angle is used to quantify the curvature of the spine, particularly in conditions like scoliosis. It measures the degree of side-to-side spinal curvature, a deformity called scoliosis. The angle’s size helps determine what kind of treatment is needed. Monitoring may be all that’s necessary for mild curvature. With severe scoliosis, treatment may require spinal fusion surgery. Named for orthopedic surgery pioneer John Robert Cobb, it describes the distance a scoliotic curve may deviate from being straight. (Botterbush K. S. et al., 2023) Generally, it takes at least 10 degrees of deviation from straight before scoliosis is confirmed.

X-Ray and Interpretation

An X-ray is taken to measure the Cobb angle. Side and back views are taken. The healthcare provider or examiner then views the X-rays and locates the most affected vertebra in the curve, the apical vertebra. In a scoliotic curve, the apical vertebra is the spinal bone with the greatest degree of rotation that takes the biggest curve away from the center of a normal spine column.

Visualizing the Angle

The apical vertebra is where two lines drawn from the X-rays meet. Two lines are drawn along the edge of the top and bottom bones of the curve. The lines extend out as follows:

  • On the top bone, the line starts on the high side, continues along the top edge, and then slopes down according to the angle of the vertebra. (Jin, C. et al., 2022)
  • On the bottom vertebra, the line starts on the low side, continues along the bottom edge, and slopes upward.
  • The Cobb angle is found by measuring the angle of the two intersecting lines where they meet.

Then, the top and bottom vertebrae of the side-to-side curve are identified to create a number for the Cobb angle. These bones have the most tilt but the least rotation and displacement and are located above and below the apical vertebra. Computer software is commonly used to calculate the Cobb angle. (Jin, C. et al., 2022) Treatment is based on the:

10 Degrees Cobb Angle 

Scoliosis is diagnosed when the Cobb angle reaches 10 degrees or more. However, this is not generally considered a significant curvature (American Association of Neurological Surgeons, 2024). In around 80% of cases, the scoliosis is considered idiopathic or without congenital or other underlying causes.

Less Than 25 Degrees Cobb Angle

If a scoliotic curve is less than 25 degrees, individuals may only need to visit their healthcare provider periodically so long as the scoliosis is monitored. These are mild cases, often without symptoms, but there is a chance that the curvature can progress. This usually means reassessing the Cobb angle every four to six months in a growing child or adolescent. (National Scoliosis Foundation, 2015) A 5-degree or more progression can change the diagnosis and treatment. (Jin, C. et al., 2022)

Between 25 and 40 Degrees Cobb Angle

A Cobb angle of 25 to 40 degrees usually requires wearing a back brace and intensive physical therapy. The goal of these treatments is to help halt the curve’s progression. Braces are generally worn 16 to 23 hours every day. (National Scoliosis Foundation, 2015) The healthcare provider will provide a referral for physical therapy. Many report excellent results with the Schroth or other scoliosis-specific exercise methods. A study found that core stabilization exercise programs can decrease Cobb angles in adolescents with idiopathic scoliosis. (Ko K. J. & Kang S. J. 2017)

Scoliosis in Adults

Scoliosis is diagnosed in adults, usually in those who have had the condition, treated or not, that was identified in their youth. A study that followed various cases for 20 years found disease progression occurred in 40% of adults but was usually less than one degree per year. However, degenerative scoliosis can also occur in individuals aged 65 and older. (American Association of Neurological Surgeons, 2024)

40 Degrees or More Cobb Angle

Surgery may be recommended once the Cobb angle reaches 40 to 50 degrees. A spinal fusion is often used to force the curve to stop developing. In adults, surgery may be needed if the angle reaches 50 degrees and they experience complications, such as nerve damage or bowel/bladder dysfunction. Risk factors in adults include older age, a history of smoking, and a diagnosis of other conditions, including being overweight. (American Association of Neurological Surgeons, 2024)

Variations

Variations occur in measuring scoliosis, and it is important to understand the difference between a change in scoliosis and a change in the tools or measurement. Equipment errors, imaging errors, and the subjective reading of the healthcare provider can change the values. (Jin, C. et al., 2022) Scoliosis measurement software and intelligent medical devices continue to improve how scoliosis is evaluated and treated. Physical exams, symptoms, and careful monitoring of changes in posture or function are still critical to an accurate diagnosis. The healthcare provider will explain the Cobb angle and other test results.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Academic Low Back Pain: Impact and Chiropractic Solutions


References

Botterbush, K. S., Zhang, J. K., Chimakurty, P. S., Mercier, P., & Mattei, T. A. (2023). The life and legacy of John Robert Cobb: the man behind the angle. Journal of neurosurgery. Spine, 39(6), 839–846. https://doi.org/10.3171/2023.7.SPINE23146

Jin, C., Wang, S., Yang, G., Li, E., & Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel, Switzerland), 22(9), 3258. https://doi.org/10.3390/s22093258

National Scoliosis Foundation. (2015). Scoliosis Media & Community Guide. https://www.scoliosis.org/nsf2/wp-content/uploads/2015/06/ScoliMediaGuide_9June3.pdf

American Association of Neurological Surgeons. (2024). Scoliosis. https://www.aans.org/patients/conditions-treatments/scoliosis/

Ko, K. J., & Kang, S. J. (2017). Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. Journal of Exercise Rehabilitation, 13(2), 244–249. https://doi.org/10.12965/jer.1734952.476

Back Cracking for Pain Relief and Relaxation

Back Cracking for Pain Relief and Relaxation

Are there benefits to back cracking, risks, and how can it be done safely?

Back Cracking for Pain Relief and Relaxation

Back Cracking

Back cracking is intentionally applying pressure or twisting movements, producing a popping or cracking sound in the spine. Back cracking involves stretching or extending the spine. In most cases, it is considered safe when done gently as it can provide temporary relief from back pain and stiffness by:

  • Stretching the ligaments and muscles around the spine
  • Releasing gas bubbles that may be causing pressure
  • Improving joint mobility

Mechanism of Action

  • Cracking your back creates small gas bubbles in the synovial fluid (the lubricating fluid in the joints).
  • These bubbles form when the pressure in the joints is suddenly released, causing a popping or cracking sound.

It is generally safe, but there are certain conditions under which individuals should avoid cracking their backs.

Popping Sound

Research has used a new type of magnetic resonance imaging (MRI), cine MRI, to study the noise source. Cine MRI produces moving images.

  • This study using this MRI found that the formation of bubbles makes a popping sound.
  • The popping sound does not come from the popping of bubbles in the synovial fluid, as previously believed. (Kawchuk G. N. et al., 2015)
  • When someone cracks their back, the force pulls the bones of the joint apart, causing the pressure within the joint to drop and form a bubble, which eventually dissipates. (Kawchuk G. N. et al., 2015)

Crepitus

  • Crepitus is the medical term for cracking or popping noise from joints.
  • It is not a condition or disease but can be a symptom of one.
  • Other terms include clicking or crunching.

Is It Safe To Perform Daily?

Back cracking once a day is generally considered safe. But if it causes pain or swelling, then stop and contact a healthcare provider. If someone feels the need to crack their back more throughout the day, it could be a sign that they need to see a professional chiropractic healthcare provider. (AICA Orthopedics, 2022) Individuals may crack their backs to address certain conditions or to relieve various discomfort symptoms that can include: (National Center for Complementary and Integrative Health, 2025)

  • Headache
  • Neck pain
  • Lower back pain
  • Sciatica

Individuals may often experience mild side effects like headache, stiffness, or pain. These side effects tend to resolve within a day. Though back cracking can provide temporary relief for some conditions, some serious side effects like neurological problems or strokes have been reported. (National Center for Complementary and Integrative Health, 2025)

Stretches and Movements

When someone needs to crack their back, they can perform a spine stretch. Here are a couple of stretches and movements. (American Academy of Orthopedic Surgeons, 2022)

Sitting Rotation Stretch

  • Sit on the floor with both legs straight.
  • Cross the right foot over the left leg.
  • Rotate the upper body to the right side and press against the right knee with the left elbow.
  • Hold the stretch for 30 seconds and come back to the center.
  • Repeat on the other side.

Knee to Chest

  • Lie flat on the ground.
  • Lift one leg and bring the knee to the chest, pulling the knee in with your hands.
  • Hold for five seconds.
  • Repeat with the other leg.

Several back-cracking assistive devices, such as poles and wheels, are available. Talk to a healthcare provider to determine the right type and ensure it is safe for you and your condition or injury.

Individuals Who Should Avoid Back Cracking

Back cracking can cause additional stress or damage to the joints in those with back injuries or other conditions. Individuals with these conditions should avoid back cracking (AICA Orthopedics, 2022)

  • Numbness or tingling of the arms or legs.
  • Osteoporosis
  • Spinal cancer
  • Spinal abnormalities
  • Individuals who have a high stroke risk.

A Professional Back Adjustment

A chiropractor is a healthcare provider who specializes in spine and spinal adjustments. They adjust the spine and other areas of the body to correct misalignment problems, reduce and relieve pain, and allow the body to recover independently. (National Library of Medicine. MedlinePlus, 2023) The chiropractor will take a health history to learn about previous injuries and conditions. Then, they will evaluate the patient and determine the best course of action. Although a chiropractor performs spinal adjustments, they may also incorporate other treatments, including: (National Library of Medicine. MedlinePlus, 2023)

  • Stretching
  • Non-surgical decompression and traction
  • Acupuncture
  • Muscle Energy Technique (MET)
  • Exercise routines
  • Heat
  • Ice
  • Electrical stimulation
  • Dietary supplements
  • Nutrition and lifestyle counseling

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Chiropractic Secrets


References

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470

AICA Orthopedics. (2022). Is cracking your back bad? https://aica.com/is-cracking-your-back-bad/

National Center for Complementary and Integrative Health. (2025). Spinal manipulation: what you need to know. Retrieved from https://www.nccih.nih.gov/health/spinal-manipulation-what-you-need-to-know

American Academy of Orthopedic Surgeons. (2022). Spine conditioning program. https://orthoinfo.aaos.org/en/recovery/spine-conditioning-program/

National Library of Medicine. MedlinePlus.  (2023). Chiropractic. Retrieved from https://medlineplus.gov/chiropractic.html

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