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.
Your spine goes through a lot each day. It provides structural support and houses the central nervous system which carries impulses from the brain throughout the body. When it isn�t working as it should, the entire body can be affected. Chiropractic has long been praised as a way to keep the back healthy. Well, now we�ll get down to the nitty-gritty and examine just why it is so good for your spine.
It Improves Your Posture
Posture is not only good for your spine; it is beneficial for the entire body. It keeps the body in proper alignment which, in turn, allows the muscles to work as they should.
This prevents abnormal wearing on the surfaces of the joints and allows joint and muscles to work more effectively and efficiently. Good posture helps to avoid injury and even helps with proper organ function.
However, many people have poor posture and don�t even realize it. Chiropractic can help align the body and improving position which dramatically benefits the spine. The patient then enjoys an improved range of motion and even more energy as the body does not have to work so hard to compensate for misalignments and poor posture.
It Helps To Relieve Pain
As much as 90 percent of people experience back pain at some point. Considering all that the back goes through in a typical day, it isn�t much of a stretch to think that there might be some pain involved at times. It is especially true if the back is not correctly aligned.
Chiropractic thought of as a treatment for back pain, but what many people don�t realize is that it is also used to treat pressure in the knees, ankles, feet, hands, and jaw. Pain in the body�will often try to compensate by adjusting to take the pressure off of certain areas.
It can cause misalignment which can impact the entire system, causing pain and stiffness. A Doctor of Chiropractic may treat these problems with various chiropractic techniques, specific exercise recommendations, and even dietary changes to relieve the pain.
Get Healthy Green Road Sign with Dramatic Clouds, Sun Rays and Sky.
It Strengthens The Spine To Support The Body
The spine is the primary support for the body. When it breaks down, the body suffers. Regular chiropractic treatment ensures that the spinal column remains in proper alignment which, in turn, keeps the body in proper alignment.
It helps with joint health as well as the health of the related muscles and ligaments. Your chiropractor can also recommend stretching and strength building exercises to help keep your spine healthy and supple.
Chiropractic helps to keep the back flexible which aids in preventing injury. A healthy spine is also less likely to become misaligned or experience pain. It can significantly improve your quality of life as you are more flexible and mobile.
It Improves Overall Health
Chiropractic is right for your spine which means it is good for your overall health. While many people think that its only purpose is to treat back pain, chiropractic focuses on total body wellness.
All too often problems within the body are interrelated. For instance, back pain could be the result of an altered gait due to an ankle injury.� A misaligned neck could cause a headache due to awkward sleep positions (or even the wrong pillow).
Chiropractors do treat the symptoms, but they also delve into the problem to discover the root so that true healing can occur. It not only makes the spine healthy but the entire body as well.
Spinal trauma consists of spine fractures, or spinal fractures, and spinal cord injuries. Approximately 12,000 spinal trauma cases are reported in the United States every year. While the most prevalent causes of spinal cord injuries and spine fractures are automobile accidents and falls, spinal trauma can also be attributed to assault, sports injuries, and work-related accidents. Diagnosis of spinal trauma includes imaging and assessment of nerve function, such as reflex, motor, and sensation. The following article discusses the role of emergency radiology in spinal trauma. Chiropractic care can help provide diagnostic evaluations for spinal trauma.
Abstract
Spinal trauma is very frequent injury with different severity and prognosis varying from asymptomatic condition to temporary neurological dysfunction, focal deficit or fatal event. The major causes of spinal trauma are high- and low- energy fall, traffic accident, sport and blunt impact. The radiologist has a role of great responsibility to establish the presence or absence of lesions, to define the characteristics, to assess the prognostic influence and therefore treatment. Imaging has an important role in the management of spinal trauma. The aim of this paper was to describe: incidence and type of vertebral fracture; imaging indication and guidelines for cervical trauma; imaging indication and guidelines for thoracolumbar trauma; multidetector CT indication for trauma spine; MRI indication and protocol for trauma spine.
Introduction
The trauma of the spine weighs heavily on the budget of social and economic development of our society. In the USA, 15�40 cases per million populations with 12,000 cases of paraplegia every year, 4000 deaths before admission and 1000 deaths during hospitalization are estimated. The young adult population is the most frequently involved in road accidents, followed by those at home and at work, with a prevalence of falls from high and sports injuries.1
Imaging has an important role in the management of spinal trauma. Quick and proper management of the patients with trauma, from diagnosis to therapy, can mean reduction of the neurological damage of vital importance for the future of the patient. Radiologists have a role of great responsibility to establish the presence or absence of lesions, defining the characteristics, assessing the prognostic influence and therefore treatment.
The aim of this paper was to describe:
incidence and type of vertebral fracture
imaging indication and guidelines for cervical trauma
imaging indication and guidelines for thoracolumbar trauma
multidetector CT (MDCT) pattern for trauma spine
MRI pattern for trauma spine.
Spinal trauma, including spine fractures and spinal cord injuries, represent about 3 percent to 6 percent of all skeletal injuries. Diagnostic assessments are fundamental towards the complex diagnosis of spinal trauma. While plain radiography is the initial diagnostic modality used for spine fractures and/or spinal cord injuries, CT scans and MRI can also help with diagnosis. As a chiropractic care office, we can offer diagnostic assessments, such as X-rays, to help determine the best treatment.
Dr. Alex Jimenez D.C., C.C.S.T.
Vertebral Fracture Management and Imaging Indication and Evaluation
The rationale of imaging in spinal trauma is:
To diagnose the traumatic abnormality and characterize the type of injury.
To estimate the severity, potential spinal instability or damaged stability with or without neurological lesion associated, in order to avoid neurological worsening with medical legal issue.
To evaluate the state of the spinal cord and surrounding structures (MR is the gold standard technique).
Clinical evaluation involving different specialities�emergency medicine, trauma surgery, orthopaedics, neurosurgery and radiology or neuroradiology�and trauma information is the most important key point in order to decide when and which type of imaging technique is indicated.2
A common question in patients with spine trauma is: is there still a role for plain-film X-ray compared with CT?
In order to clarify when and what is more appropriate for spinal trauma, different guidelines were published distinguishing cervical and thoracolumbar level.
Cervical Spinal Trauma: Standard X-Ray and Multidetector CT Indication
For cervical level, controversy persists regarding the most efficient and effective method between cervical standard X-ray with three film projections (anteroposterior and lateral view plus open-mouth odontoid view) and MDCT.
X-ray is generally reserved for evaluating patients suspected of cervical spine injury and those with injuries of the thoracic and lumbar areas where suspicion of injury is low. Despite the absence of a randomized controlled trial and thanks to the high quality and performance of�MDCT and its post-processing (multiplanar reconstruction and three-dimensional volume rendering), the superiority of cervical CT (CCT) compared with cervical standard X-ray for the detection of clinically significant cervical spine injury is well demonstrated.
Figure 1. (a�l). A 20-year-old male involved in a motorbike accident. The multidetector CT with multiplanar reformatted and three- dimensional volume-rendering reconstructions (a�d) showed traumatic fracture of C6 with traumatic posterior spondylolisthesis grade III with spinal cord compression. The MRI (e�h) confirmed the traumatic fracture of C6 with traumatic posterior spondylolisthesis grade III with severe spinal cord compression. The post-surgical treatment MRI control (i�l) showed the sagittal alignment of cervical level and severe hyperintensity signal alteration of the spinal cord from C3 to T1.
In order to reduce the patient radiation exposure, it is important to determine and to select patients who need imaging and those who do not, through the clinical evaluation and probability of cervical spine injury, using only MDCT for the appropriate patient as is more cost-effective screening.3
First of all, it is necessary to distinguish the type of trauma:
minor trauma (stable patient, mentally alert, not under the influence of alcohol or other drugs and who has no history or physical findings suggesting a neck injury)
major and severe trauma (multitrauma, unstable patient with a simple temporary neurological dysfunction, with focal neurological deficit or with a history or mechanism of injury sufficient to have exceeded the physiologic range of motion).
Second, it is important to establish if trauma risk factors are presents, such as:
violence of trauma: high-energy fall (high risk) or low-energy fall (low risk)
age of the patient: <5years old, >65 years old�
associated lesions: head, chest, abdomen (multitrauma) etc.
clinical signs: Glasgow Coma Scale (GCS), neurological deficit, vertebral deformation.
Combining these elements, patients can be divided into �low risk� and �high risk� for cervical injury.
The first group consists of patients who are awake (GCS 15), alert, cooperative and non-intoxicated without any distract- ing injury.
The second group consists of unconscious, sedated, intoxicated or non-cooperative patients or those with a distracting injury or an altered mental state (GCS ,15) with a 5% chance of cervical spine injuries.3,4
CCT has a wider indication than X-ray for patients at very high risk of cervical spine injury (major trauma or multitrauma). No evidence suggests CCT instead of X-ray for a patient who is at low risk for cervical spine injury.5
Figure 2. (a�g). A 30-year-old male involved in a motorbike accident. The multidetector CT with multiplanar reformatted and three-dimensional volume-rendering reconstructions (a�d) showed traumatic burst fracture of L1 (A2-type Magerl class) with posterior bone fragment dislocation into spinal canal. The MRI (e�g) confirmed the burst fracture of L1 with moderate spinal cord compression.
Figure 3. (a�d) A 50-year-old male involved in a motorbike accident with acute spinal cord compression symptoms on anticoagulation treatment. The MRI showed an acute haemorrhagic lesion at the C2�C4 posterior epidural space, hypointense on sagittal T1 weighted (a) and hyperintense on T2 weighted (b) with spinal cord compression and dislocation on axial T2* (c) and T2 weighted (d).
In 2000, the National Emergency X-Radiography Utilization (NEXUS) study, analysing 34,069 patients, established low-risk criteria to identify patients with a low probability of cervical spine injury, who consequently needed no cervical spine�imaging. To meet the NEXUS criteria, a patient must have the following conditions:
no tenderness at the posterior midline of the cervical spine
no focal neurologic deficit
normal level of alertness
no evidence of intoxication
no clinically apparent painful injury that might distract the patient from the pain of a cervical spine injury.6
If all of these roles are present, the patient does not need to undergo X-ray because he has a low possibility of having a cervical spine injury with a sensitivity of 99% and a specificity of 12.9%.7
In 2001, the Canadian C-spine rule (CCSR) study developed a second decision rule using the risk factor of the trauma: three high-risk criteria (age $ 65 years, dangerous mechanism and paraesthesias in extremities), five low-risk criteria (simple rear-end motor vehicle collision, sitting position in emergency department, ambulatory at any time, delayed onset of neck pain and absence of midline cervical spine tenderness) and the ability of the patient to actively rotate his or her neck to determine the need for cervical spine radiography. In practice, if one of these risk factors is present, the patient needs to undergo imaging evaluation. On the other hand, if the risk factors are not present, the use of the NEXUS criteria plus a functional evaluation of the cervical spine is needed (left and right cervical spine rotation .45�); if this functional evaluation is possible, imaging is unnecessary. If an incomplete cervical movement is present, then the patient needs to be checked with imaging. The results showed the criteria to have a sensitivity of up to 100% and a specificity of up to 42.5%.8
Applying these criteria, before cervical spine imaging, the authors report a decrease of about 23.9% in the number of negative CCT, and applying a more liberal NEXUS criteria including the presence or absence of pain, limited range of motion or posterolateral cervical spine tenderness, they report a decrease of up to 20.2% in the number of negative studies.2
If these clinical criteria cannot be applied, CCT must be performed.
Major and severe traumas request a direct CCT screening, especially because there could be associated lesions, according to the high-risk criteria developed by Blackmore and Hanson to identify patients with trauma at high risk of c-spine injury who would benefit from CT scanning as the primary radiological investigation9 Figure 1.
Thoracolumbar Spinal Trauma: Standard X-Ray and Multidetector CT Indication
For thoracolumbar level, MDCT is a better examination for depicting spine fractures than conventional radiography. It has wider indication in the diagnosis of patients with thoracolumbar trauma for bone evaluation. It is faster than X-ray, more sensitive, thanks to multiplanar reformatted or volume-rendering reconstruction detecting small cortical fracture, and the sagittal alignment can be evaluated with a wide segment evaluation.10
It can replace conventional radiography and can be performed alone in patients who have sustained severe trauma.10
In fact, thoracolumbar spinal injuries can be detected during visceral organ-targeted CT protocol for blunt traumatic injury.
Figure 4. A 55-year-old female involved in a car accident with acute left cervical brachialgia. The sagittal T2 weighted (a) and axial T2 weighted (b) MRI showed a post-traumatic posterolateral herniated disc with spinal cord compression and soft hyper signal alteration on the C3�C4 spinal cord.
Thanks to multidetector technology, images reconstructed using a soft algorithm and wide-display field of view that covers the entire abdomen using a visceral organ-targeted protocol with 1.5-mm collimation are sufficient for the evaluation of spine fractures in patients with trauma, given that multiplanar reformatted images are provided without performing new CT study and without increasing radiation dose11 Figure 2.
With MDCT there is no information about spinal cord status or ligament lesion or acute epidural haematoma; it can only evaluate bone status. Spinal cord injury is suspected only by clinical data.
CCT is strictly recommended in patients affected by blunt cerebrovascular injuries. Both lesions can be strictly correlated and generally; contrast medium administration to exclude hemorrhagic brain lesion and cervical fracture is not needed.10
Magnetic resonance imaging, or MRI, is a medical diagnostic assessment technique utilized in radiology to create pictures of the anatomy and the physiological processes of the human body. Alongside radiography and CT scans, MRI can be helpful in the diagnosis of spinal trauma, including spine fractures and spinal cord injuries. Magnetic resonance imaging may not be necessary for all cases of spinal trauma. However, it could provide detailed information on the other soft tissues of the spine.�
Dr. Alex Jimenez D.C., C.C.S.T.
Spinal Trauma and MRI
Even if MDCT is the first imaging modality in a patient with trauma, MRI is essential for the soft assessment of the ligament, muscle or spinal cord injury, spinal cord, disc, ligaments and neural elements, especially using T2 weighted sequences with fat suppression or T2 short tau inversion recovery (STIR) sequence.12 MRI is also used to classify burst fracture, obtaining information about the status of the posterior ligamentous complex, a critical determinant of surgical indication even if the diagnosis of ligament injuries remains complex, and its grade is also underestimated using high-field MRI.13
Figure 5. A 65-year-old female involved in domestic trauma with spinal cord symptoms. The sagittal T1 weighted (a) and T2 weighted (b) MRI showed a traumatic T12�L1 spinal cord contusion hypointense on T1 weighted and hyperintense on T2 weighted.
In the management of patients with polytrauma, MDCT total-body scan is necessary in an emergency condition, and�MRI whole-spine indication is secondary to the clinical status of the patient: spinal cord compression syndrome Figure 3�5�MRI protocols recommended for patients affected by spinal injury and trauma are the following:13,14
Sagittal T1 weighted, T2 weighted and STIR sequence for the�bone marrow and spinal cord injury or spinal cord compression evaluation owing to epidural haematoma or traumatic herniated disc
Sagittal gradient echo T2* sequence for haemorrhage evaluation of the spinal cord or into the epidural�subdural space
Sagittal diffusion-weighted imaging helpful when evaluating spinal cord injury, differentiating cytotoxic from vasogenic�oedema, assisting in detecting intramedullary haemorrhage. It can help to evaluate the degree of compressed spinal cord.
Axial T1 weighted and T2 weighted sequence for the right localization of the injury. Recently, for patients affected by acute blunt trauma and cervical spinal cord injury, the axial T2 weighted sequence has been shown to be important for trauma-predicting outcomes. On axial T2 weighted imaging, five patterns of intramedullary spinal cord signal alteration can be distinguished at the injury�s epicentre. Ordinal values ranging from 0 to 4 can be assigned to these patterns as Brain�and Spinal Injury Center scores, which encompassed the spectrum of spinal cord injury severity correlating with neurological symptoms and MRI axial T2 weighted imaging. This score improves on current MRI-based prognostic descriptions for spinal cord injury by reflecting functionally and anatomically significant patterns of intramedullary T2 signal abnormality in the axial plane.15
Figure 6. A 20-year-old female involved in domestic trauma with back pain resistance to medical therapy. The standard antero- posterior�laterolateral X-ray (a) showed no vertebral fractures. The MRI showed a bone marrow alteration at lumbar vertebral body hyperintense on T2 weighted (T2W) (a), hypointense on T1 weighted (T1W) (b) and short tau inversion recovery (STIR) (c).
MRI has also an important role in case of discordance between clinical status and CT imaging. In the absence of vertebral fracture, patients can suffer from back pain resistant to medical therapy owing to bone marrow traumatic oedema that can be detected only using STIR sequence on MRI Figure 6.
In spinal cord injury without radiologic abnormalities (SCI- WORA), MRI is the only imaging modality that can detect intramedullary or extramedullary pathologies or show the absence of neuroimaging abnormalities.16 SCIWORA refers to spinal injuries, typically located in the cervical region, in the absence of identifiable bony or ligamentous injury on complete, technically adequate, plain radiographs or CT. SCIWORA should be suspected in patients subjected to blunt trauma who report early or transient symptoms of neurologic deficit or who have existing findings upon initial assessment.17
Vertebral Fracture Type and Classification
The rationale of imaging is to distinguish the vertebral fracture type into two groups:
� vertebral compression fracture as vertebral body fracture compressing the anterior cortex, sparing the middle posterior columns associated or not with kyphosis � burst fracture as comminuted fracture of the vertebral body extending through both superior and inferior endplates with kyphosis or posterior displacement of the bone into the canal. and to distinguish which type of treatment the patient needs; by imaging, it is possible to classify fractures into stable or�unstable fracture, giving indication to conservative or surgical therapy.
Figure 7. (a�f) A 77-year-old female involved in domestic trauma with back pain resistance to medical therapy. The multidetector CT (a) showed no vertebral fractures. The MRI showed a Magerl A1 fracture with bone marrow oedema at T12�L1 vertebral body hypointense on T1 weighted (b), hyperintense on T2 weighted (c) and short tau inversion recovery (d) treated by vertebroplasty (e�f).
Figure 8. (a�d) A 47-year-old male involved in a motorbike accident with back pain resistance to medical therapy. The MRI showed a Magerl A1 fracture with bone marrow oedema at T12 vertebral body hypointense on T1 weighted (a) hyperintense on T2 weighted (b) and short tau inversion recovery (c) treated by assisted-technique vertebroplasty�vertebral body stenting technique (d).
Using MDCT and MRI, thanks to morphology and injury distribution, various classification systems have been used for identifying those injuries that require surgical intervention, distinguishing among stable and unstable fractures and surgical and non-surgical fractures.1
Denis proposed the �three-column concept�, dividing the spinal segment into three parts: anterior, middle and posterior columns. The anterior column comprises the anterior longitudinal ligament and anterior half of the vertebral body; the middle column comprises the posterior half of the vertebral body and posterior longitudinal ligament; and the posterior column comprises the pedicles, facet joints and supraspinous ligaments. Each column has different contributions to stability, and their damages may affect stability differently. Generally, if two or more of these columns are damaged, the spine becomes unstable.18
Magerl divided the vertebral compression fracture (VCF) into three main categories according to trauma force: (a) compression injury, (b) distraction injury and (c) rotation injury. Type A has conservative or non-surgical mini-invasive treatment indication.19
The thoracolumbar injury classification and severity score (TLICS) system assigns numerical values to each injury based on the categories of morphology of injury, integrity of the posterior ligament and neurological involvement. Stable injury patterns (TLICS,4) may be treated non-operatively with�brace immobilization. Unstable injury patterns (TLICS.4) may be treated operatively with the principles of deformity correction, neurological decompression if necessary and spinal stabilization.20
The Aebi classification is based on three major groups: A = isolated anterior column injuries by axial compression, B = disruption of the posterior ligament complex by distraction posteriorly and C = corresponding to group B but with rotation. There is an increasing severity from A to C, and within each group, the severity usually increases within the subgroups from 1 to 3. All these pathomorphologies are supported by the mechanism of injury, which is responsible for the extent of the injury. The type of injury with its groups and subgroups is able to suggest the treatment modality.21
Thoracolumbar Fracture and Mini-Invasive Vertebral Augmentation Procedure: Imaging Target
Recently, different mini-invasive procedures called assisted- technique vertebroplasty (balloon kyphoplasty KP or kyphoplasty-like techniques) have been developed in order to obtain pain relief and kyphosis correction as alternative treatment for non-surgical but symptomatic vertebral fracture.
The rationale of these techniques is to combine the analgesic and vertebral consolidation effect of vertebroplasty with the restoration of the physiological height of the collapsed vertebral body, reducing the kyphotic deformity of the vertebral body, delivering cement into the fractured vertebral body with a vertebral stabilization effect compared with conservative therapy (bed rest and medical therapy).22
From interventional point of view, imaging has an important role for treatment indication together with clinical evaluation. Both MDCT and MRI are recommended Figure 7 and 8.
In fact, MDCT has the advantage of diagnosing VCF with kyphosis deformity easily, while MRI with STIR sequence is useful to evaluate bone marrow oedema, an important sign of back pain.
Patients affected by vertebral fracture without bone marrow oedema on STIR sequence are not indicated for interventional procedure.
According to imaging, Magerl A1 classification fractures are the main indication of treatment.
However, the treatment must be performed within 2�3 weeks from trauma in order to avoid sclerotic bone response: the younger the fractures, the better the results and easier the treatment and vertebral augmentation effect. To exclude sclerotic bone reaction, CT is recommended.
Conclusion
The management of spinal trauma remains complex. MDCT has a wide indication for bone evaluation in patients affected by severe trauma or patients with high risk of spine injury. MRI has a major indication in the case of spinal cord injury and the absence of bone lesion. Diagnostic assessment of spinal trauma, including radiography, CT scans, and MRI are fundamental towards the diagnosis of spine fractures and spinal cord injury for treatment. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
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Griffith B, Bolton C, Goyal N, Brown ML, Jain R. Screening cervical spine CT in a level I trauma center: overutilization? AJR Am J Roentgenol 2011; 197: 463�7.doi: 10.2214/ AJR.10.5731
Hanson JA, Blackmore CC, Mann FA, Wilson AJ. Cervical spine injury: a clinical decision rule to identify high-risk patients for helical CTscreening. AJR Am J Roentgenol 2000; 174: 713�17.
Saltzherr TP, Fung Kon Jin PH, Beenen LF, Vandertop WP, Goslings JC. Diagnostic imaging of cervical spine injuries following blunt trauma: a review of the literature and practical guideline. Injury 2009; 40: 795�800. doi: 10.1016/j.injury.2009.01.015
Holmes JF, Akkinepalli R. Computed to- mography versus plain radiography to screen for cervical spine injury: a meta-analysis. J Trauma 2005; 58: 902�5. doi: 10.1097/01. TA.0000162138.36519.2A
Hoffman JR, Wolfson AB, Todd K, Mower WR. Selective cervical spine radiography in blunt trauma: methodology of the National Emergency X-Radiography Utilization Study (NEXUS). Ann Emerg Med 1998; 32: 461�9. doi: 10.1016/S0196-0644(98)70176-3
Dickinson G, Stiell IG, Schull M, Brison R, Clement CM, Vandemheen KL, et al. Retro- spective application of the NEXUS low-risk criteria for cervical spine radiography in Canadian emergency departments. Ann Emerg Med 2004; 43: 507�14. doi: 10.1016/j. annemergmed.2003.10.036
Stiell IG, Wells GA, Vandemheen KL, Clem- ent CM, Lesiuk H, De Maio VJ, et al. The Canadian C-spine rule for radiography in
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of complete cervical helical computed to- mographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. J Trauma 1999; 47: 896�902. doi: 10.1097/00005373-199911000-00014
10. Wintermark M, Mouhsine E, Theumann N, Mordasini P, van Melle G, Leyvraz PF, et al. Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology 2003; 227: 681�9. doi: 10.1148/radiol.2273020592
11. Kim S, Yoon CS, Ryu JA, Lee S, Park YS, Kim SS, et al. A comparison of the diagnostic performances of visceral organ-targeted ver- sus spine-targeted protocols for the evalua- tion of spinal fractures using sixteen-channel multidetector row computed tomography: is additional spine-targeted computed tomog- raphy necessary to evaluate thoracolumbar spinal fractures in blunt trauma victims? J Trauma 2010; 69: 437�46. doi: 10.1097/ TA.0b013e3181e491d8
12. Pizones J, Castillo E. Assessment of acute thoracolumbar fractures: challenges in mul- tidetector computed tomography and added value of emergency MRI. Semin Musculoskelet Radiol 2013; 17: 389�95. doi: 10.1055/s- 0033-1356468
13. Emery SE, Pathria MN, Wilber RG, Masaryk T, Bohlman HH. Magnetic resonance imag- ing of posttraumatic spinal ligament injury. J Spinal Disord 1989; 2: 229�33. doi: 10.1097/ 00002517-198912000-00003
14. Zhang JS, Huan Y. Multishot diffusion- weighted MR imaging features in acute trauma of spinal cord. Eur Radiol 2014; 24: 685�92. doi: 10.1007/s00330-013-3051-3
15. Talbott JF, Whetstone WD, Readdy WJ, Ferguson AR, Bresnahan JC, Saigal R, et al. The Brain and Spinal Injury Center score: a novel, simple, and reproducible method for assessing the severity of acute cervical spinal cord injury with axial T2-weighted MRI findings. J Neurosurg Spine 2015; 23: 495�504. doi: 10.3171/2015.1.SPINE141033
16. Boese CK, Oppermann J, Siewe J, Eysel P, Scheyerer MJ, Lechler PJ. Spinal cord injury without radiologic abnormality in children: a systematic review and meta-analysis. Trauma Acute Care Surg 2015; 78: 874�82. doi: 10.1097/TA.0000000000000579
17. Brown RL, Brunn MA, Garcia VF. Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg 2001; 36: 1107�14. doi: 10.1053/jpsu.2001.25665
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19. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 1994; 3: 184�201.
20. Patel AA, Dailey A, Brodke DS, Daubs M, Harrop J, Whang PG, et al; Spine Trauma Study Group. Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples. J Neurosurg Spine 2009; 10: 201�6. doi: 10.3171/2008.12.SPINE08388
21. Aebi M. Classification of thoracolumbar fractures and dislocations. Eur Spine J 2010; 19(Suppl. 1): S2�7. doi: 10.1007/s00586-009-1114-6
22. Muto M, Marcia S, Guarnieri G, Pereira V. Assisted techniques for vertebral cementoplasty: why should we do it? Eur J Radiol 2015; 84: 783�8. doi: 10.1016/j.ejrad.2014.04.002
My treatment with Dr. Alex Jimenez has tremendously helped me. It gives me just, a sense of relief knowing that I can come and see him and all of his employees and great masseuses and everyone, can just release all the tension. It just brings me back to life.�
April Hermosillo
Have you ever experienced back pain which triggers or radiates shooting pain into the buttocks or legs? Millions of people in the United States suffer from this common health issue known as sciatica. Sciatica is a general diagnostic term used to describe radiating pain, tingling sensations, numbness or weakness which runs across the length of the sciatic nerve.
Sciatica originates along the lower back and then travels from the buttocks into one or both legs. Instead of a dull achy pain, this type of pain is characterized as a sharp, shooting pain that worsens through prolonged periods of sitting. The sciatic nerve is the largest nerve in the human body comprised of many nerve roots which come together once they exit the spine. When the sciatic nerve becomes compressed, due to a variety of possible causes, symptoms will manifest and radiate down the leg.
What is Sciatica?
Sciatica is a collection of symptoms, including pain, tingling and burning sensations at the lower back and/or legs, weakness, and numbness, caused by a combination of: pressure on the sciatic nerve, inflammation to the sciatic nerve or the region directly surrounding the nerve, an irritation to the sciatic nerve, and/or a pinching of the sciatic nerves. As the largest nerve in the human body, the sciatic nerve can be easily affected.
Sciatic nerve pain is a common health issue that affects many people on a regular basis. Its consequences can range from a mild nuisance to a debilitating pain which interferes with an individual’s physical activities.� Sciatica symptoms manifest in many different ways, including:
Lower back pain
Leg Pain
Buttock pain
A sensation of tingling or �pins & needles� running down the�leg, and even into the toes
Numbness in the legs or feet
Muscle weakness in the legs
Aching or burning feeling in the legs
Pain or numbness in the�big toe, or any of the toes
Any combination of the list above
As you may see, though some individuals could experience pain from the lower back all the way down to their feet, it can be isolated to a segment of this area. Fortunately, a variety of treatment approaches are available to help treat sciatica. Below, we will discuss some of the most common causes of sciatica as well as demonstrate the best treatment approach.�Chiropractic care is one of the most common alternative treatment options utilized to provide sciatic nerve pain relief without prescriptions or surgery.
Causes of Sciatica
Sciatic nerve pain may not always be felt immediately following an injury or condition due�to an accident. Some people experience sciatica that seems to come and go, while for others, it might take years before their symptoms manifest at all. This is partly because pain is processed by only 10 percent of the�nervous system. A patient may also feel relief from their pain, but because the underlying cause of their sciatica hasn’t been fixed, the pain will come back. Below is a list of some of the causes of sciatica.
Subluxation or misalignment of the vertebrae
Disc degeneration, herniation, bulge, protrusion or other damage
A tumor pressing on the sciatic nerve
Injury to muscles
Pregnancy
Slipping, falling, or other impacts
Internal bleeding
Bad posture, either from sitting, standing or sleeping
Osteoarthritis
Spinal stenosis, a narrowing of the spinal canal the sciatic nerves pass through,
Playing sports
Poor lifting techniques
Other normal daily activities
While there are many possible causes for sciatica, the most frequent is a subluxation, or misalignment of the vertebrae in the lumbar spine,�or low back. A subluxation that is left untreated will result in the wear-and-tear of the spine, which in turn may lead�to disc protrusions, disc degeneration, disc herniations, and at some stages, even osteoarthritis. Chiropractic care will gently fix subluxations in the spine, allowing the nervous system to perform at an optimal level so that true recovery can occur.
Another common cause�of sciatica is a disc herniation. Spinal stenosis, which is a consequence of severe degeneration or alignment problems can also cause sciatic nerve pain. A condition called piriformis syndrome occurs when a tight piriformis muscle compresses the sciatic nerve. Determining the reason for sciatica is essential in understanding how to care for the health issue. Untreated sciatica can lead to problems such as:
Constipation
Difficulty getting pregnant
Digestion Problems
Edema or leg swelling
Erectile dysfunction (ED)
Incontinence
Irritable bowel syndrome (IBS)
Menstrual problems
Urinary problems
And more
Leaving sciatica untreated for any length of time can be damaging to your health, and the problem may worsen over time. The use of drugs and/or medications to help cope with your sciatic pain may only offer temporary relief from the symptoms as the real underlying source of your sciatica may not have been treated accordingly.�Diagnosis typically includes a comprehensive examination using a range of motion testing, neurological testing, imaging with MRI or X-Rays, and occasionally, further testing using nerve conduction velocity and electromyography evaluations.
Treatment for sciatica may vary depending on the cause of the symptoms. A chiropractor may use a series of spinal adjustments and manual manipulations�to help take pressure from the sciatic nerve. Other chiropractic care techniques and methods include the flexion distraction diversified technique, traction, and lumbar decompression. Passive and active exercises can also help treat sciatica. Exercises can also be recommended to restore strength, mobility, and flexibility. In severe cases of sciatica, the healthcare professional may recommend surgery.�
Sciatica occurs when an injury or condition results in the compression or impingement of the sciatic nerve, the largest nerve in the human body. When this happens, a collection of symptoms, including pain, tingling and burning sensations, as well as numbness, can develop. Chiropractic care is a well-known, alternative treatment option which can help carefully release the tension in the spine, reducing sciatic nerve pain.
Dr. Alex Jimenez D.C., C.C.S.T.
�
Chiropractic Care and Sciatica
The European Spine Journal printed the findings from a clinical trial demonstrating that chiropractic care led to a 72 percent success rate in treating sciatica and its associated symptoms compared to only a 20 percent success rate from physical therapy, and a 50 percent success rate from corticosteroid injections when treating sciatic nerve pain.
Sciatica is a widespread problem that many patients experience. Chiropractic care can find the source of the health issue in order to begin treatment and deliver pain relief accurately.�Sciatica can be painful and hinder you from living life to the fullest. Contact a chiropractor now to determine whether this is the ideal solution for you.
If you or somebody you know is suffering from sciatica and any of its associated symptoms, please recommend this article to them.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Dr. Alex Jimenez has great techniques to relieve the discomfort, the inflammation, the swelling, not only does he have a great technique to help with the horrible symptoms of sciatica, he also offers you great information when it comes to foods, anti-inflammatories, and we don’t go to prescription medications. So if you are looking for sciatica relief without the invasive procedures…you need to come see Dr. Jimenez.
Sandra Rubio
Are you currently suffering from debilitating sciatica symptoms? Chiropractic care may help you to find relief for your�sciatic nerve pain.�A doctor of chiropractic, or DC, regularly treats sciatica.
Sciatica is a collection of symptoms rather than a single condition, characterized by pain that originates from the lower back or buttock and travels down one or both legs into the feet. Sciatic nerve pain varies in frequency and intensity; minimum, moderate, severe and intermittent, constant, regular or irregular. Sciatica symptoms can happen when a spine illness, such as spinal stenosis or a bulging/ruptured disk, causes compression into the sciatic nerve or nearby nerves.
When this kind of compression occurs, it could lead to sensations of numbness or shooting pain. From the buttocks, back of the thighs, calves, and toes, sciatica pain may radiate down at times. Sciatic nerve pain is very similar to electrical shocks, and it may be dull, achy, sharp, toothache-like, and have pins�and needles feeling. Other symptoms include numbness, burning, and tingling sensations. Sciatica can be radiating or recognized as neuropathy pain, or neuralgia.
The misconception that sciatica is a disease�is common. However, sciatica is a symptom of a disease. Chiropractic care is a popular treatment which can help treat sciatica. The guide below discusses a comprehensive overview and a chiropractic treatment guide for sciatica.
Common Causes of Sciatica
Sciatica is commonly brought on by compression of the sciatic nerve in the lower back. Disorders known to activate sciatic nerve pain include lumbar spine subluxations, also known as misaligned vertebral bodies, herniated or bulging discs, also known as slipped disks, pregnancy and childbirth, tumors, and even non-spinal ailments such as diabetes, constipation, or sitting on an item�in the back pocket of your�pants.
One�frequent cause of sciatica is piriformis syndrome. Piriformis syndrome involves the piriformis muscle. The piriformis muscle and the thighbone located at the lower part of the backbone�connect and also assists in hip rotation. The sciatic nerve runs along these structures.
This muscle is vulnerable to injury from a difference in leg length, a slip and fall, or hip arthritis. Such circumstances can cause spasm and cramping to develop in the muscle, leading to inflammation and pain which can potentially end up pinching the sciatic nerve. Sciatic nerve wracking may lead to the loss of feeling,�called sensory loss, paralysis of a single limb or group of muscles, called monoplegia, and insomnia.�
Sciatic Nerve Pain Diagnosis
Before you discover you may need to see a healthcare professional for your sciatica symptoms, a chiropractor can be a good choice to start treatment for sciatic nerve pain. You may first want to visit your doctor to go over your symptoms and to find an accurate diagnosis of your condition. As soon as you’ve got a clear identification of the reason for sciatica, there are many conservative, or non-invasive treatment choices for sciatica which you can try, most of which may be used by a doctor of chiropractic, or chiropractor.
The physician’s first step when diagnosing sciatica is primarily to ascertain what is causing the individual’s relapse since there are lots of ailments that cause sciatica. Forming a diagnosis entails a review of the individual’s health history and a physical and neurological evaluation.
Diagnostic testing involves an x-ray, MRI, CT scan and/or electrodiagnostic tests,�including nerve conduction velocity and electromyography. These examinations and evaluations help to detect possible contraindications to other treatments and spinal adjustments. As described above sciatica may have many distinct causes, including the following:
Herniated discs
Spondylolisthesis
Tumors about the sciatic nerve
Pelvic injuries
Degenerative disc disease
If your healthcare professional says your condition can be treated with chiropractic care, then you may be able to find relief after proceeding with a couple of sessions, possibly more depending on the patient’s source of their symptoms. In the case that chiropractic care isn’t the ideal choice for the illness, your physician can research other treatment options.
Many research studies have demonstrated that chiropractic care is safe and effective for the treatment of lower back pain. Chiropractic is a healthcare profession which focuses on the non-surgical treatment of a variety of injuries and/or conditions associated with the musculoskeletal and nervous system, including sciatic nerve pain. Referred to as a collection of symptoms rather than a single health issue, sciatica can be treated by addressing the underlying problem with chiropractic care.
Dr. Alex Jimenez D.C., C.C.S.T.
Chiropractic Care for Sciatica
Chiropractic care is a form of complementary and alternative medicine, CAM, which relies on the idea that the body has an inherent intelligence that is interrupted by spinal ailments. The philosophy also teaches that these disruptions will be the foundation for all illness in the human body.
Chiropractic care�developed from the late 19th century as a means of adjusting spinal dislocations, referred to as subluxations by chiropractors, restoring the body’s natural integrity. Though several chiropractors still adhere to such beliefs, most chiropractors combine many different kinds of treatment modalities used in traditional medicine.
The objective of chiropractic treatment for sciatica is to assist your human body’s capacity to heal itself, without the need for�drugs and/or medications or surgical interventions. It’s based upon the scientific principle that motion contributes to pain,�structure, and function. Chiropractic care is well-known for being non-invasive, or non-surgical and prescription-free.
The treatment modalities utilized on a patient depends on the reason for their sciatica. A sciatica treatment program may include many distinct treatment�modalities, such as ice/cold therapies, ultrasound, TENS, and spinal adjustments as well as manual manipulations. Below, we will describe the treatment modalities used for sciatica.�
Treatment Modalities for Sciatica
Should you find that you need chiropractic care for sciatic nerve pain, your sciatica chiropractic treatment program plan may contain one or more of the following treatment modalities used by chiropractors, including:
Ultrasound is mild warmth created by sound waves which penetrate deep into tissues. Circulation increases and helps reduce cramping pain, swelling and muscle spasms.
TENS, or transcutaneous electrical nerve stimulation, is a small box-like, stainless-steel, mobile muscle stimulating machine. Variable intensities of electric stimuli control pain and reduce muscle spasms. Many healthcare professionals use versions of this TENS units.
Spinal adjustments and manual manipulations are the most common treatment modality used by chiropractors for sciatica. Manipulation helps to restore misaligned vertebral bodies back into their position in the spine and supports the restricted movement of the spinal column. Adjustment helps to decrease nerve-wracking responsible for causing pain, muscle soreness, other ailments, and inflammation. Adjustments should not be painful. Spinal adjustments and manual manipulations are�proven to be secure and effective.
A chiropractor may recommend the use of cold or heat therapies to relieve inflammation, stop spasms and loosen tight muscles associated with sciatic nerve pain. These can often be performed at home with proper guidance from a healthcare professional.
During training, students of chiropractic comprehend many modification methods enabling them to take care of various sorts of subluxations, injuries, and disorders. Techniques combine minimal strain and gentle pressure. Mastery of every treatment modality is an art which needs skill and accuracy. Spinal adjustments and manual manipulations are the treatments that distinguish chiropractic care.
Other disorders can lead to sciatica beyond the scope of chiropractic care. After diagnosis,� The person is referred to a different specialization if the doctor of chiropractic determines the patient’s disease requires additional treatment. Sometimes, co-manage is in the patient’s interest, and the chiropractor may continue to treat the patient with another doctor.
Pain relief for sciatica is possible. Seek sciatica chiropractic treatment for your symptoms. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Nothing had really worked until I started seeing Dr. Alex Jimenez. The way he cares about his patients, that is what keeps on bringing me back. He does a great job and he really cares about his patients. – Araceli Pizana
Arthritis is considered to be quite a common health issue, however, it’s still not very well understood by many healthcare professionals today. As a matter of fact, arthritis isn’t a single disorder, but rather, it is an informal way of referring to joint pain or a joint disorder. There are approximately more than 100 distinct kinds of arthritis and associated problems. People of all ages, sexes and races can develop arthritis as it is the chief cause of disability in the United States. Over 50 million adults and 300,000 children have some type of arthritis while it often happens and is most common among women.
Common arthritis joint symptoms include pain, swelling and inflammation, stiffness and decreased range of movement. Symptoms of arthritis may come and go where these can range from mild, moderate or severe. They may also remain about the exact same for many years or it might advance and become worse over time. Arthritis may result in chronic pain which can make it difficult to perform tasks. Arthritis can additionally cause joint alterations. Frequently, although these modifications may be visible, such as knobbly finger joints, the extent of the health issue can be observed on x-rays. Some kinds of arthritis have an effect on skin, eyes, lungs, kidneys and the heart as well as the joints.
Common Types of Arthritis
The two most common types of arthritis which result in pain are osteoarthritis and rheumatoid arthritis. Osteoarthritis generally occurs in people over the age of 60, however, it may also be a consequence of trauma from an injury, overuse and improper body movement mechanics. This sort of arthritis is characterized by the loss of cartilage that’s responsible for lubricating joints and distributing forces of motion. When you don’t have enough of it, the bones can begin to rub together and cause pain. Moreover, bone fragments may break away and may cause bone spurs to grow.�The hands, knees, hips and back are the most common sites for osteoarthritis.
Being the most common type of arthritis, osteoarthritis is considered to be one of the most prevalent causes for chronic pain symptoms. Common causes which can ultimately increase the risk of developing osteoarthritis�include: excess weight, family history, age and previous injury, such as an anterior cruciate ligament, or ACL, tear, for instance. Osteoarthritis can be prevented by avoiding injury and repetitive movements, maintaining a healthy weight and remaining active.
Rheumatoid arthritis generally occurs when the human body’s own immune system strikes; in other words, it’s an autoimmune disease.�A healthy immune system functions by protecting the human body from intruders that can cause disease.�Researchers believe that a combination of environmental factors and genetics can cause autoimmunity. Smoking is an illustration of an ecological risk factor that can cause arthritis in people with specific genes.
Nevertheless, in the case of an autoimmune disease, the immune system may go mistakenly attacking the joints, causing uncontrolled inflammation and potentially causing erosion of the cartilage in the bones.�With this kind of arthritis, the lining of the joints become irritated and inflamed. Moreover, rheumatoid arthritis might damage other parts of the human body, including the eyes and internal organs. Symptoms include pain, swelling and soreness, inflammation, stiffness, and tenderness. Rheumatoid arthritis is found in the hands, wrists and toes, even in the hips and knees, if not treated properly. Other symptoms of rheumatoid arthritis include: fever, weight loss, diminished appetite and continual exhaustion.
While there is no cure for osteoarthritis or rheumatoid arthritis, a variety of treatment approaches can help people manage the symptoms of those afflictions. As a matter of fact, research studies have shown that chiropractic care can help manage arthritis. Chiropractic care consists of both passive and active treatment modalities. With these common types of arthritis, early diagnosis and treatment are fundamental. Slowing down the progress of the disease can help decrease and prevent permanent damage.�Remission is the goal and it might be accomplished via the utilization of a combination of therapies. The objective of treatment is to decrease pain, improve functioning, and prevent joint damage.
Through chiropractic care, a doctor of chiropractic, or chiropractor, will review goals together with the patient as well as perform a full assessment of their condition to develop a specific treatment plan to meet their individual requirements and needs. A specialized treatment program for arthritis will help manage pain and improve strength, flexibility and mobility. Below, we will discuss the types of chiropractic treatment modalities and how these can help with arthritis.
Dr. Alex Jimenez’s Insight
Before, arthritis was considered to be a natural consequence of aging, however, patients today can find a variety of treatment options to help manage the symptoms associated with this painful disease. Arthritis is simply defined as the swelling or inflammation of the joints. Osteoarthritis is the most common type of arthritis and it is most prevalent in older patients. Rheumatoid arthritis is the second most common type of arthritis, characterized as an autoimmune disease where the patient’s own immune system attacks the joints. This type of arthritis is most prevalent in younger patients. Chiropractic care is a safe and effective, alternative treatment option which can help manage the symptoms associated with arthritis.
Chiropractic Care for Arthritis Pain
Chiropractic care is a great treatment approach to manage and relieve pain caused by arthritis. Chiropractic care is a well-known, alternative treatment option which focuses on the diagnosis, treatment and prevention of a variety of injuries and conditions associated with the musculoskeletal and nervous system, including osteoarthritis and rheumatoid arthritis. Routine chiropractic care offers arthritis patients a safe and effective, non-invasive, non-addictive alternative treatment option to prescription opioids or over-the-counter pain drugs, or OTCs, that are generally given to patients to help them manage their own arthritis pain.
Chiropractic care utilizes spinal adjustments and manual manipulations, among other treatment approaches. Chiropractic spinal adjustments and manual manipulations reduce misalignments of the spine, also referred to as subluxations, as well as joint restrictions in the spinal column and other joints, improving the functioning of the bones, joints and nervous system. By enhancing your nervous system function, spinal health and increasing mobility, your body gets the ability to better manage symptoms caused by arthritis or rheumatoid arthritis. Furthermore, chiropractic care may use passive treatment methods to help manage symptoms associated with arthritis.�The passive treatment methods for arthritis are:
Transcutaneous electric nerve stimulation (TENS)
Electrical stimulation
Ultrasound
Superficial heat
Cryotherapy or ice packs
TENS can considerably help reduce pain from arthritis, tricking the brain into believing there’s no pain. Pain, muscle spasms, inflammation and soft tissue edema is reduced by electric stimulation. Ultrasound is a deep heating modality which helps deep joint tissues. It assists with swelling and inflammation as well as improving the structure of connective tissue. Heat reduces inflammation and swelling. Ice or cryotherapy packs will also be effective for arthritic pain. It’s useful for swelling and decreasing local inflammation. These passive treatment methods may be used alongside other alternative treatment options.
A doctor of chiropractor, or chiropractor, may even recommend a series of lifestyle changes to help promote healing and speed up the recovery process. If you are afflicted with pain, an exercise or physical activity program will address any impairments that could be contributing to the patient’s painful symptoms. Moreover, a chiropractor may also recommend nutritional advice. Research studies have found that some types of foods may cause pain and inflammation in arthritis patients.
Nobody should be living with pain. If you are experiencing challenges when performing daily tasks due to your arthritis pain, make sure to seek immediate medical attention from a qualified and experienced chiropractor, to achieve relief from your symptoms.�The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
It’s going very, very well. I do feel a lot of relief. What I like about here is that he genuinely cares about his patients and he educates you. He’s constantly talking to you about why he’s doing what he’s doing. He’s very good as a doctor, he’s awesome. – Araceli Norte
Low back pain is a common health issue for many people. Nearly everybody will experience lower back pain at any moment in their own lives. This pain can differ from mild to severe and it might be short-term or long-term. When it happens, low back pain can make many everyday tasks difficult to participate and engage in. That all too familiar annoyance, however, can tremendously limit time spent relaxing, working, and even that of relationships.
Moreover, low back pain might also lead to irritability as well as a whole onslaught of additional medical health issues if not treated appropriately. The prevalence of low back pain has become a common problem, amounting to one of the most common reasons for doctor office visits each year. Before considering what type of treatment approach to follow for your back pain, it’s important to understand the anatomy of the spine and how low back pain occurs.
Understanding the Spine
The World Health Organization estimates that in the United States alone, approximately 149 million days of work are lost as a consequence of low back pain. Back pain is considered to be one of the main sources of disability and shortage of work, and it appears in 60 to 70 percent of people in industrialized nations. Understanding your spine and the way it works can help you know some of the problems which exist from aging or injury, including spinal conditions.
Many demands are placed on your own spine. It holds up your head, shoulders, and upper body. It supplies you with the necessary components to help the human body stand up right, and provides flexibility and mobility to bend and twist. Furthermore, it protects your spinal cord. Back pain differs from one person to another. The pain might have a slow beginning or come on suddenly. The pain may be continuous or irregular. Usually, back pain resolves on its own in a few weeks. However, if you’re experiencing persistent low back pain, then you may have already realized how important it is to look for treatment. Chiropractic care is a well-known treatment option which can help offer relief from your low back pain.
What is Chiropractic Care?
Chiropractic care is a popular, alternative treatment approach which primarily focuses on the diagnosis, treatment and prevention of a variety of injuries and/or conditions, associated with the musculoskeletal and nervous systems. Through the use of specific treatment modalities, including spinal adjustments and manual manipulations, among others, a qualified and experienced chiropractor can help relieve low back pain by carefully correcting spinal misalignments, or subluxations.
By realigning the spine, chiropractic care can help promote the human body’s natural healing capabilities, without the need for drugs and/or medications as well as surgical interventions. Although low back pain can happen due to a variety of causes, chiropractic care can include various treatment modalities which are devoted to the management of numerous injuries and disabilities or conditions, including low back pain.
A chiropractor will perform specific treatments based on the individual’s needs, treating the body as a whole rather than simply reducing the symptoms. Many healthcare professionals recommend seeking chiropractic care for low back pain first before considering other, more aggressive treatment approaches. There are two components for chiropractic care techniques and methods: passive treatments to lower the patient’s pain in sequence to it becoming more manageable, and active treatments that the patient participates in independently.
Passive Treatment
If you’re experiencing low back pain, then it could be debilitating, making it difficult for you to go about your day normally. For that reason, it’s very important to seek immediate medical attention from a qualified and experienced healthcare professional, such as a chiropractor or physical therapist, to reduce your pain as much as possible so that you can actively participate in your treatment. These tools are often referred to as passive treatment because they are performed to a patient by the healthcare professional, including:
Electrical stimulation, such as TENS Units
Heat/ice packs
Ultrasound
Iontophoresis
Dry needling
Manual remedies
Massage
Hydrotherapy
Healthcare professionals use some of the methods, such as hot/cold packs and massage therapy, to improve blood flow to the affected area, thus reducing swelling and stiffness. Additionally, a chiropractor may utilize electric stimulation therapy, a painless remedy that gives miniature electric waves through your nervous system to relieve pain, reduce muscle strain, and encourage your body to create hormones which are anabolic. A variety of patients may also benefit from hydrotherapy. This involves executing low-intensity moves in water which alleviates strain on muscles while allowing you to move your joints without any distress.
Active Treatment
Active treatment involves exercises performed by the person and are often utilized at the following phases of chiropractic and passive treatments following the very low back pain has subsided enough so that the patient may perform them without any excessive distress. There are numerous different kinds of exercises that a chiropractor or professional physical therapist may recommend, like extending, balance training, and strength training. A variety of them can assist you with your strength, flexibility, mobility and range of motion, but a few help build the muscles around the painful region to provide those regions of the human body collectively with support to reduce low back pain.
Dr. Alex Jimenez’s Insight
A doctor of chiropractic, or chiropractor, will make sure to properly evaluate a patient before making any form of diagnosis or developing a treatment plan. An assessment can include analyzing the patient’s health history, a physical examination, including orthopedic and neurological tests, as well as advanced diagnostic tests. A chiropractor, or doctor of chiropractic, will then perform a variety of treatment modalities to treat a patient’s low back pain, depending on the specific cause of their symptoms.
What to Expect During a Chiropractor Visit
After you initially visit a chiropractor’s office, your doctor may ask you a couple of questions concerning your health, history, and lower back pain particularly. With this information, you will help your chiropractor provide you with the best treatment plan possible so that you see long-term results for your low back pain as quickly as possible.
Your doctor of chiropractic, or chiropractor, can also offer you an extensive examination. Depending upon your symptoms, your chiropractor may assess your own strength, coordination, flexibility, balance, posture, blood pressure, and heart and respiration rates. This may include using their hands to palpate your spine and surrounding area, along with a visual analysis of your movements.
You are going to learn excellent exercises to perform in your home so you may decrease your low back pain, stop re-injury, decrease strain, and accelerate your healing period. Your chiropractor will recommend specific equipment and will devote a good deal of time educating you about your source of pain and pain management plans. They’ll also implement hands-on exercises to supply you immediate relief.
When you’re well prepared to alleviate or remove your own pain, then seek immediate medical attention, so that a qualified and experienced chiropractor or professional physical therapist can help you live a pain-free life. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Acute Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
My treatment with Dr. Alex Jimenez has been helping me by simply making me less tired. I’m not experiencing as many headaches. The headaches are going down dramatically and my back feels much better. I would highly recommend Dr. Alex Jimenez. He’s very friendly, his staff is very friendly and everybody goes well beyond what they can do to help you. –Shane Scott
Neck pain can develop due to a variety of reasons, and it can vary tremendously from mild to severe. Most of the population has suffered from this well-known nagging health issue; however, did you know that headaches can sometimes be caused by neck pain? While these headaches are commonly referred to as cervicogenic headaches, other types, such as cluster headaches and migraines, have also been determined to be caused by neck pain.
Therefore, it’s fundamental to seek a proper diagnosis if you’ve experienced headaches or neck pain to determine the root cause of your symptoms and decide which treatment option will be best for your specific health issue. Healthcare professionals will assess your upper back, or the cervical spine, including your neck, the base of the skull and cranium, and all the surrounding muscles and nerves to find the source of your symptoms. Before seeking help from a doctor, it’s essential to understand how neck pain can cause headaches. Below, we will discuss the anatomy of the cervical spine or neck and demonstrate how neck pain is connected to headaches.
How Neck Pain Causes Headaches
The muscles between the shoulder blades, the upper portion of the shoulders, and those surrounding the neck, or cervical spine, may all cause neck pain if they become too tight or stiff. This can generally occur due to trauma or damage from an injury, as well as in consequence of bad posture or poor sitting, lifting, or work habits. The tight muscles will make your neck joints feel stiff or compressed, and it can even radiate pain toward your shoulders. Over time, the balance of the neck muscles changes, and those specific muscles that support the neck become weak. They can ultimately begin to make the head feel heavy, increasing the risk of experiencing neck pain as well as headaches.
The trigeminal nerve is the primary sensory nerve that carries messages from the face to your brain. Furthermore, the roots of the upper three cervical spinal nerves, found at C1, C2, and C3, share a pain nucleus, which routes pain signals to the brain and the trigeminal nerve. Because of the shared nerve tracts, pain is misunderstood and thus “felt” by the brain as being located in the head. Fortunately, many healthcare professionals are experienced in assessing and correcting muscular imbalances, which may lead to neck pain and headaches. Moreover, they can help to relieve muscle tension, enhance muscle length and joint mobility, and retrain correct posture.
What Causes Neck Pain and Headaches?
Cervicogenic headaches, otherwise known as “neck headaches,” are caused by painful neck joints, tendons, or other structures surrounding the neck, or cervical spine, which may refer to pain to the bottom of the skull, to your face or head. Researchers believe that neck headaches, or cervicogenic headaches, account for approximately 20 percent of all headaches diagnosed clinically. Cervicogenic headaches and neck pain are closely associated, although other types of headaches can also cause neck pain.
This type of head pain generally starts because of an injury, stiffness, or lack of proper functioning of the joints found at the top of your neck, as well as tight neck muscles or swollen nerves, which could trigger pain signals that the brain then interprets as neck pain. The usual cause of neck headaches is dysfunction in the upper three neck joints, or 0/C1, C1/C2, C2/C3, including added tension in the sub-occipital muscles. Other causes for cervicogenic headaches and neck pain can include:
Cranial tension or trauma
TMJ (JAW) tension or altered bite
Stress
Migraine headaches
Eye strain
The Link Between Migraines and Neck Pain
Neck pain and migraines also have an intricate connection with each other. While in some cases, severe trauma, damage, or injury to the neck can lead to severe headaches like migraines; neck pain might result from a migraine headache in different situations. However, it’s never a good idea to assume that one results from the other. Seeking treatment for neck pain when the reason for your concern is a migraine often will not lead to effective pain management or pain relief. The best thing you can do if you’re experiencing neck pain and headaches is to seek immediate medical attention from specialized healthcare professional to determine your pain’s cause and the symptoms’ root cause.
Unfortunately, neck pain, as well as a variety of headaches, are commonly misdiagnosed or even sometimes go undiagnosed for an extended period. One of the top reasons neck pain may be so challenging to treat primarily because it takes a long time for people to take this health issue seriously and seek a proper diagnosis. When a patient seeks a diagnosis for neck pain, it may already have been a persistent problem. Waiting an extended amount of time to take care of your neck pain, especially after an injury, may lead to acute pain and even make the symptoms more difficult to control, turning them into chronic pain. Also, the most frequent reasons people seek treatment for neck pain, and headaches include the following:
Chronic migraines and headaches
Restricted neck function, including difficulties moving the head
Soreness in the neck, upper back, and shoulders
Stabbing pain and other symptoms, particularly in the neck
Pain radiating from the neck and shoulders to the fingertips
Aside from the symptoms mentioned above, individuals with neck pain and headaches can also experience additional symptoms, including nausea, diminished eyesight, difficulty concentrating, severe fatigue, and even difficulty sleeping. While there are circumstances in which the cause of your headaches or neck pain may be apparent, such as being in a recent automobile accident or suffering from sport-related trauma, damage, or injuries, in several instances, the cause may not be quite as obvious.
Because neck pain and headaches can also develop as a result of bad posture or even nutritional problems, it’s fundamental to find the origin of the pain to increase the success of treatment, in addition to enabling you to prevent the health issue from happening again in the future. It’s common for healthcare professionals to devote their time working with you to ascertain what could have caused the pain in the first place.
A Health Issue You Can’t Ignore
Neck pain is typically not a problem that should be ignored. You may think that you’re only experiencing minor neck discomfort and that it’s irrelevant to any other health issues you may be having. Still, you can’t know for sure more frequently than not until you receive a proper diagnosis for your symptoms. Patients seeking immediate medical attention and treatment for their neck-centered problems are surprised to learn that some of the other health issues they may be experiencing may be correlated, such as neck pain and headaches. Thus, even if you think you can “live with” not being able to turn your neck completely, other health issues can develop, and these problems might be more challenging to deal with.
There are circumstances in which a pinched nerve in the neck is the main reason for chronic tension headaches, where a previous sports injury that was not adequately addressed before is now the cause of the individual’s limited neck mobility and in which a bruised vertebrae at the base of the neck induces throbbing sensations throughout the spine, which radiates through the shoulders into the arms, hands, and fingers. You might also blame your chronic migraines on a hectic schedule and stressful conditions. However, it might be a consequence of poor posture and the hours you spend hunched over a computer screen. Untreated neck pain might lead to problems you never expect, such as balance problems or trouble gripping objects. This is because all the neural roots located on the upper ligaments of the cervical spine or neck are connected to other parts of the human body, from your biceps to each of your tiny fingers.
Working with a healthcare professional to relieve the root cause of your neck pain and headaches may significantly enhance your quality of life. It may be able to eliminate other symptoms from turning into a significant problems. While another health issue or nutritional deficiency generally causes the most common causes of chronic migraines, you might also be amazed to learn how often the outcome may be resolved with concentrated exercises and stretches recommended by a healthcare professional, such as a chiropractor. Additionally, you may understand that the health issues you’ve been having often develop from compressed, pinched, irritated, or inflamed nerves in your upper cervical nerves.
Dr. Alex Jimenez’s Insight
Although it may be difficult to distinguish the various types of headaches, neck pain is generally considered to be a common symptom associated with head pain. Cervicogenic headaches are very similar to migraines, however, the primary difference between these two types of head pain is that a migraine occurs in the brain while a cervicogenic headache occurs in the base of the skull or in the cervical spine, or neck. Furthermore, some headaches may be caused by stress, tiredness, eyestrain and/or trauma or injury along the complex structures of the cervical spine, or neck. If you are experiencing neck pain and headaches, it’s important to seek help from a healthcare professional in order to determine the true cause of your symptoms.
Treatment for Neck Pain and Headaches
Foremost, a healthcare professional must determine the cause of an individual’s symptoms through the use of appropriate diagnostic tools as well as to make sure they have the utmost success in relieving the headache and neck pain without prolonging the duration of the symptoms and extra cost of incorrect therapy. Once an individual’s source of neck pain and headaches has been diagnosed, the kind of treatment a patient receives should depend on the type of headache. As a rule of thumb, treatment starts once the diagnosis has been made. A healthcare professional will work with you to create a treatment plan appropriate for your specific health issues. You’ll be taken through procedures that help build flexibility and strength in your sessions.
Chiropractic care is a well-known alternative treatment option focusing on diagnosing, treating, and preventing various musculoskeletal and nervous system injuries and conditions. A chiropractic doctor or chiropractor can help treat neck pain and headache symptoms by carefully correcting any spinal misalignments, or subluxations, in the cervical spine or neck, through spinal adjustments and manual manipulations, among other therapeutic techniques. Chiropractors and physical therapists may also utilize a combination of gentle Muscle Energy Techniques, muscle building, joint slides, Cranio-sacral therapy, and specific posture and muscle re-education to lower the strain being placed on the structures surrounding the cervical spine. The staff will also help you understand how to better position yourself during your daily life to prevent relapses, like ergonomic and posture tips. Contact a healthcare professional for them to be able to assist you immediately.
In cases where alternative treatment options have been utilized without any results or sometimes used together with other complementary treatment approaches, pain drugs and medications may be contemplated, such as non-steroidal anti-inflammatory drugs (NSAIDs) and anti-seizure agents such as gabapentin, tricyclic anti-depressants, or migraine prescriptions. If pain medications prove ineffective, injections may be contemplated, including peripheral nerve blocks, atlantoaxial joint blocks administered at C1-C2, or aspect joint blocks administered in C2-C3. Surgical interventions may also be other treatment options. However, healthcare professionals suggest attempting all other treatment options before considering surgery. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please ask Dr. Jimenez or contact us at 915-850-0900.
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
Back pain is one of the most prevalent causes of disability and missed days at work worldwide. Back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once. The spine is a complex structure of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and aggravated conditions, such as herniated discs, eventually lead to back pain symptoms. Sports or automobile accident injuries are often the most frequent cause of back pain; however, sometimes, the simplest movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through spinal adjustments and manual manipulations, ultimately improving pain relief.
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