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.
Can spinal decompression treatments be incorporated for individuals with lumbosacral pain and improve posture?
Introduction
Many individuals only realize they have poor posture once they perform a movement that causes pain in the lumbosacral region of their body. Have you or your loved ones experienced muscle aches or strains after relaxing in a weird position? Or do you begin to notice that you are hunched over when walking from one location to another? Many of these scenarios correspond to how we present ourselves with our posture. Our posture helps support the upper body’s weight while stabilizing the lower body through the spine and ensuring that our body is in an upright position when we are in motion. However, as we age, so do our bodies and spine, which then causes us to be in a hunched position, causing our posture to degenerate. This causes lumbosacral pain to develop along the body’s lower extremities, leading to overlapping risk profiles that cause mobility issues, poor posture, and disability if not treated right away. When this happens, the surrounding muscles, ligaments, and tissues around the lumbar spine will begin to develop pain-like symptoms and can make a person’s life miserable. Luckily there are various techniques and treatments to improve poor posture and reduce lumbosacral pain affecting many individuals. Today’s article looks at how lumbosacral pain affects a person’s posture and how spinal decompression and MET therapy can reduce lumbosacral pain and restore good posture. Additionally, we work hand-in-hand with certified medical providers who incorporate our patient’s information to treat and minimize lumbosacral pain associated with poor posture. We also inform them that spinal decompression combined with MET therapy can help with lumbosacral pain while improving good posture back to the body. We encourage our patients to ask profound questions while seeking education from our associated medical providers about their pain-like issues. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
Lumbosacral Pain Affects Posture
Have you noticed you are constantly slouching or being in a hunched position, only to feel muscle aches and strains in your lumbar-sacral region? Do you feel symptoms of tingling and numbness in your hips and buttock region after sitting down excessively? Or do you feel referred pain in one location and have to shift your weight to compensate for the pain? These pain-like symptoms and scenarios correspond to lumbosacral pain affecting your posture. The lumbosacral spine region has a natural curve that functions as a shock absorber to mitigate the body’s mechanical weight and stress when in motion. (Adams & Hutton, 1985) At the same time, it is susceptible to being constantly injured as the spinal disc is being compressed and can be herniated or damaged over time, manifesting into lumbosacral pain. So how does lumbosacral pain associate with poor posture? When individuals are dealing with low back problems associated with lumbosacral pain, the spinal disc in the lumbosacral region starts to have balancing issues when in motion. (Huang, Jaw, & Young, 2022) When people are dealing with difficulties balancing their gait cycle, it can cause their walking performance and postural control to be dysfunctional and cause the body to be misaligned, thus causing musculoskeletal issues to arise and affecting the lower body and its extremities. The surrounding muscles surrounding the lumbosacral region will begin to experience stiffness in the trunk region, which can cause musculoskeletal changes to the surrounding muscles when individuals start to be in an upright position. (Creze et al., 2019) When poor posture affects the trunk muscles, the surrounding accessory muscles start acting to compensate for the pain. To that point, lumbosacral pain associated with poor posture could lead to abdominal, low back, hip, and pelvic pain. However, many individuals can find various therapies and relieving techniques to improve posture, strengthen the surrounding muscles, and reduce pain-like symptoms.
Building A Stronger Body- Video
Many individuals can seek out various non-invasive therapies to alleviate the issue when it comes to improving posture and reducing lumbosacral pain. These therapies are cost-effective and personalized to the person’s pain. Treatments like chiropractic care and decompression can help restore good posture while realigning the body out of subluxation and help stretch the affected muscles. Coincidentally, non-surgical therapies can be combined with other treatments like physical therapy to strengthen the trunk muscles surrounding the lumbosacral region, thus reducing the load on the lumbosacral spine. (Callaghan, Gunning, & McGill, 1998) When people focus on their health and well-being, non-surgical therapies can provide a positive and safe experience with a team that can help reduce the pain the person has been dealing with their entire lives. The video above explains how these treatments work together to help you build a stronger body while revitalizing your energy and enhancing your health and wellness.
Spinal Decompression Reducing Lumbosacral Pain
When it comes to reducing lumbosacral pain associated with poor posture, many individuals can incorporate non-surgical treatments like spinal decompression and combine them with a personalized treatment plan to reduce the pain-like symptoms. What spinal decompression does to lumbosacral pain is that it helps mitigate intra-disc pressure while increasing disc space within the lumbosacral spinal region. (Amjad et al., 2022) Spinal decompression can help improve leg mobility and stretch out the affected muscles to kick-start the body’s natural healing process. Spinal decompression can even combine with physical therapy to help strengthen the lumbosacral region’s abdominal muscles and enable many individuals with poor posture to be mindful of how they present themselves.(Mielenz et al., 1997)
MET Therapy & Spinal Decompression Restoring Posture
When pain specialists like chiropractors and massage therapists incorporate spinal decompression treatment to reduce lumbosacral pain, they also utilize various techniques to strengthen the lumbosacral muscles to restore proper posture to the body. Many pain specialists use MET (muscle energy techniques) therapy to maintain while stretching the muscles and fascia in the affected areas. MET therapy combined with spinal decompression can help improve muscle shortness in the lumbar fascial tissue, improve posture, and even increase the lumbar and pelvic range of motion. (Tamartash & Bahrpeyma, 2022) These two non-surgical treatments can help many people by addressing their posture and movement dysfunction while strengthening their core stabilized muscles to reduce pain. (Norris & Matthews, 2008) Many individuals who want to regain their health and wellness can make small changes in their routine to improve their posture and be more mindful of their bodies to reduce the chances of lumbosacral pain returning.
References
Adams, M. A., & Hutton, W. C. (1985). The effect of posture on the lumbar spine. J Bone Joint Surg Br, 67(4), 625-629. doi.org/10.1302/0301-620X.67B4.4030863
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Callaghan, J. P., Gunning, J. L., & McGill, S. M. (1998). The relationship between lumbar spine load and muscle activity during extensor exercises. Phys Ther, 78(1), 8-18. doi.org/10.1093/ptj/78.1.8
Creze, M., Bedretdinova, D., Soubeyrand, M., Rocher, L., Gennisson, J. L., Gagey, O., Maitre, X., & Bellin, M. F. (2019). Posture-related stiffness mapping of paraspinal muscles. J Anat, 234(6), 787-799. doi.org/10.1111/joa.12978
Huang, C. C., Jaw, F. S., & Young, Y. H. (2022). Radiological and functional assessment in patients with lumbar spinal stenosis. BMC Musculoskelet Disord, 23(1), 137. doi.org/10.1186/s12891-022-05053-x
Mielenz, T. J., Carey, T. S., Dyrek, D. A., Harris, B. A., Garrett, J. M., & Darter, J. D. (1997). Physical therapy utilization by patients with acute low back pain. Phys Ther, 77(10), 1040-1051. doi.org/10.1093/ptj/77.10.1040
Norris, C., & Matthews, M. (2008). The role of an integrated back stability program in patients with chronic low back pain. Complement Ther Clin Pract, 14(4), 255-263. doi.org/10.1016/j.ctcp.2008.06.001
Tamartash, H., & Bahrpeyma, F. (2022). Evaluation of Lumbar Myofascial Release Effects on Lumbar Flexion Angle and Pelvic Inclination Angle in Patients with Non-Specific Low Back Pain. Int J Ther Massage Bodywork, 15(1), 15-22. doi.org/10.3822/ijtmb.v15i1.709
How does spinal decompression help reduce somatosensory pain associated with individuals dealing with back and leg pain?
Introduction
As we all know, the human body is a complex system that works together to perform various actions without feeling pain or discomfort. With muscles, organs, tissues, ligaments, bones, and nerve roots, each component has its job and interacts with other body parts. For instance, the spine collaborates with the central nervous system to instruct the muscles and organs to function correctly. Meanwhile, the nerve roots and muscles work together to provide mobility, stability, and flexibility to the upper and lower body extremities. However, as time passes, the body ages naturally, and this can lead to unwanted issues. Normal and traumatic factors can interfere with the neuron signals from the brain and cause somatosensory pain in the upper and lower extremities. This pain-like sensation can affect each body section, making the individual miserable. Luckily, there are ways to reduce somatosensory pain and provide relief to the body. Today’s article explores how somatosensory pain can impact the lower extremities, particularly the legs and back, and how non-surgical treatments like spinal decompression can alleviate somatosensory pain in the lower extremities. At the same time, we work hand-in-hand with certified medical providers who use our patient’s information to treat and mitigate somatosensory pain affecting the legs and back. We also inform them that non-surgical treatments like spinal decompression can help alleviate residual pain-like symptoms from the lower extremities. We encourage our patients to ask essential and important questions while seeking education from our associated medical providers about their pain. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
How Does Somatosensory Pain Affect The Legs & Back?
Are you experiencing numbness or tingling in your legs or back that disappears after a few minutes? Do you feel questionable pain in your lumbar spine after work? Or do you feel a warm sensation in the back of your legs that turns into sharp shooting pain? These issues may be related to the somatosensory system within the central nervous system, which provides voluntary reflexes to muscle groups. When normal movements or traumatic forces cause problems to the somatosensory system over time, it can lead to pain that affects the body’s extremities. (Finnerup, Kuner, & Jensen, 2021) This pain may be accompanied by burning, pricking, or squeezing sensations that affect the lumbar region. Many factors can be associated with somatosensory pain, which is part of the central nervous system and works with the spinal cord. When the spinal cord becomes compressed or aggravated due to injury or normal factors, it can lead to low back and leg pain. For example, a herniated disc in the lumbosacral area can cause nerve roots to send pain signals to the brain and cause abnormalities in the back and legs. (Aminoff & Goodin, 1988)
When people are dealing with back and leg pain from somatosensory pain, it can cause them to be miserable by reducing their quality of life and leading to a life of disability. (Rosenberger et al., 2020) At the same time, individuals dealing with somatosensory pain will also begin to feel inflammatory effects from the affected muscle area in the legs and back. Since inflammation is a body’s natural response when dealing with pain, the inflammatory cytokines can cause a cascading effect from the brain through the spinal cord, causing leg and back pain. (Matsuda, Huh, & Ji, 2019) To that point, somatosensory pain is associated with inflammation caused by normal or traumatic factors that can cause overlapping risk factors contributing to leg and back pain. Luckily, numerous treatments can reduce these overlapping risk factors caused by somatosensory pain and help restore the lower body extremities’ function.
Move Better, Live Better- Video
When the body is dealing with somatosensory pain, it can cause many individuals to think they are only dealing with one source of pain from one muscle area. Still, it can lead to multifactorial issues that affect different body locations. This is known as referred pain, where one body section deals with pain but is in a different area. Referred pain can also be combined with somato-visceral/visceral-somatic pain, where the affected muscle or organ affects one or the other, causing more pain-like issues. However, numerous treatments can reduce somatosensory pain from causing more leg and back problems. Non-surgical therapies like chiropractic care and spinal decompression can help mitigate the effects of somatosensory pain affecting the lower body extremities causing leg and back pain. These treatments allow the pain specialist to incorporate various therapeutic techniques to stretch the affected muscles and realign the spine to its original position. Many individuals can see an improvement in their mobility and daily activities as the pain-like symptoms associated with somatosensory pain are reduced. (Gose, Naguszewski, & Naguszewski, 1998) When individuals dealing with somatosensory pain start thinking about their health and wellness to ease the pain they are experiencing, they can look into non-surgical treatments as they are cost-effective, safe, and provide a positive outcome. Additionally, non-surgical treatments can be personalized to the individual’s pain and begin to see improvement after a few treatment sessions. (Saal & Saal, 1989) Check out the video above to learn more about how non-surgical treatments can be combined with other therapies to improve a person’s well-being.
Spinal Decompression Reduces Somatosenosory Pain
Now spinal decompression is a non-surgical treatment that can help reduce somatosensory pain affecting the legs and back. Since somatosensory pain correlates with the spinal cord, it can affect the lumbosacral spine and lead to back and leg pain. With spinal decompression, it utilizes gentle traction to gently pull the spine, which then can reduce the symptoms associated with somatosensory pain. Spinal decompression can help improve the somatosensory system by reducing pain and alleviating aggravated nerve root compression to relieve the legs and back. (Daniel, 2007)
Additionally, spinal decompression can be combined with other non-surgical treatments, like chiropractic, as it can help with reducing the effects of nerve entrapment and help restore the joint’s ROM (range of motion). (Kirkaldy-Willis & Cassidy, 1985) Spinal decompression can create a positive experience for many individuals dealing with leg and back pain associated with somatosensory pain while getting back their health and wellness.
References
Aminoff, M. J., & Goodin, D. S. (1988). Dermatomal somatosensory evoked potentials in lumbosacral root compression. J Neurol Neurosurg Psychiatry, 51(5), 740-742. doi.org/10.1136/jnnp.51.5.740-a
Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. doi.org/10.1186/1746-1340-15-7
Finnerup, N. B., Kuner, R., & Jensen, T. S. (2021). Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev, 101(1), 259-301. doi.org/10.1152/physrev.00045.2019
Gose, E. E., Naguszewski, W. K., & Naguszewski, R. K. (1998). Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Neurol Res, 20(3), 186-190. doi.org/10.1080/01616412.1998.11740504
Kirkaldy-Willis, W. H., & Cassidy, J. D. (1985). Spinal manipulation in the treatment of low-back pain. Can Fam Physician, 31, 535-540. www.ncbi.nlm.nih.gov/pubmed/21274223
Matsuda, M., Huh, Y., & Ji, R. R. (2019). Roles of inflammation, neurogenic inflammation, and neuroinflammation in pain. J Anesth, 33(1), 131-139. doi.org/10.1007/s00540-018-2579-4
Rosenberger, D. C., Blechschmidt, V., Timmerman, H., Wolff, A., & Treede, R. D. (2020). Challenges of neuropathic pain: focus on diabetic neuropathy. J Neural Transm (Vienna), 127(4), 589-624. doi.org/10.1007/s00702-020-02145-7
Saal, J. A., & Saal, J. S. (1989). Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine (Phila Pa 1976), 14(4), 431-437. doi.org/10.1097/00007632-198904000-00018
Can decompression relieve intervertebral disc stress from individuals dealing with lumbar issues, restoring spinal mobility?
Introduction
The spine’s intervertebral disc acts like a shock absorber to the spine when axial overload is placed on the spine. This allows many individuals to carry, lift, and transport heavy objects without feeling discomfort or pain throughout the day. It is crucial that the spine not only stays functional but also provides stability and mobility for the intervertebral discs to allow these motions. However, as the body ages naturally, so do the intervertebral discs, as they lose water retention and begin to crack under pressure. To this point, the intervertebral discs start not to be functional as normal or traumatic actions cause pain-like issues to the spine and can lead to a life of disability. When repetitive motions cause unwanted pressures, the intervertebral discs become compressed and, over time, can lead to pain-like spinal issues. At the same time, the surrounding muscles, tissues, ligaments, and joints start to get affected in the lumbar region, which then leads to low back pain conditions associated with the lower extremities. Today’s article looks at intervertebral disc stress, how it affects spinal mobility, and how treatments like spinal decompression can restore spinal mobility while reducing intervertebral disc stress. At the same time, we work hand-in-hand with certified medical providers who use our patient’s information to treat and mitigate pain-like symptoms associated with intervertebral disc stress. We also inform them that non-surgical treatments like decompression can help mitigate pressure on the spinal discs. We also explain to them how decompression can help restore spinal mobility to the body and how the treatment can be added to their routine. We encourage our patients to ask essential and important questions while seeking education from our associated medical providers about their pain. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
Intervertebral Disc Stress
Have you been experiencing radiating pain shooting down to your legs that is making it difficult to walk? Do you often feel muscle aches and strains from holding heavy objects that you have to lean your back a bit to relieve the pain? Or do you feel pain in one location in your body that travels to a different location? Many of these pain-like scenarios are correlated with intervertebral disc stress on the spine. In a normal healthy body, the intervertebral disc has to take on the spinal load when the body is in an abnormal position without pain or discomfort. However, as the body ages naturally, the intervertebral discs degenerate over time, and the intradiscal pressure within the spinal disc cavity decreases. (Sato, Kikuchi, & Yonezawa, 1999) To that point, the body and intervertebral discs begin to become stiff over time, causing the surrounding muscles, ligaments, and tissues to be overstretched and ache when unwanted pressure starts to cause musculoskeletal issues to develop over time. At the same time, degeneration and aging have a causal relationship, which causes dramatic changes to the composition and structure of the spinal disc. (Acaroglu et al., 1995) These changes cause stress on the intervertebral disc, which then causes the spine to be less mobile.
How Does It Affect Spinal Mobility
When the intervertebral disc is dealing with mechanical stress from unwanted pressure, as stated earlier, it can develop into dramatic changes to its composition and structure. When people are dealing with spinal mobility issues, it causes segmental instability, which then causes influence the entire lumbar motion of the spine and causes the intervertebral disc to be highly stressed and cause disability. (Okawa et al., 1998) When high ‘stress’ is concentrated within the intervertebral discs, over time, it can cause musculoskeletal pain to the lumbar spine, leading to further disruption to the lower extremities. (Adams, McNally, & Dolan, 1996) When there is degeneration within the intervertebral disc associated with mechanical stress, it can affect the spine’s mobility function. For working individuals, it can have a huge impact on them. When dealing with stress correlated with the intervertebral discs, individuals will develop low back pain problems that can cause a huge burden when they are getting treated. Low back pain associated with intervertebral disc stress can cause a socioeconomic risk factor for lumbar pain and disability. (Katz, 2006) When dealing with low back problems, people will find temporary remedies to continue working while dealing with the pain until they have to be admitted for treatment. This causes an unnecessary stress factor for the individual because they would have to take time off work to feel better. However, it is important to get treated for intervertebral disc stress early on before more issues begin to occur, as there are non-surgical treatments that are cost-effective and safe to restore spinal mobility.
Why Choose Chiropractic-Video
When it comes to treating low back pain associated with intervertebral disc stress, many individuals try out many home remedies and treatments to alleviate the pain. However, those at-home treatments provide temporary relief. Individuals who are experiencing spinal mobility issues can find the relief they are looking for by incorporating non-surgical therapies into their daily routines. Non-surgical treatments are cost-effective and can provide a positive outcome to many individuals as their health and wellness plans can be personalized. (Boos, 2009) This allows the individual to finally find the relief they seek and create a positive relationship with their primary doctor. Non-surgical treatments can also be combined with other therapies to relieve the individual’s pain further and reduce the chances of the problem returning. Treatments like chiropractic care, massage therapy, and spinal decompression are some non-surgical treatments that can help mitigate intervertebral stress and restore spinal mobility. The video above explains how these treatments can find the root cause of the problem and address the issues in a safe and positive environment.
How Decompression Relieves Intervertebral Disc Stress
Non-surgical treatments like spinal decompression can help with reducing the intervertebral disc stress that is causing low back pain issues in the lumbar region. Spinal decompression uses gentle traction on the spine to reduce the stress on the intervertebral disc. Spinal decompression allows many people to reduce their chances of going to surgery for their pain and, after a few sessions, have the pain intensity decreased significantly. (Ljunggren, Weber, & Larsen, 1984) Additionally, spinal decompression can create negative intradiscal pressure in the spinal column by allowing the nutrients and fluids to rehydrate the affected disc while promoting the body’s natural healing process. (Sherry, Kitchener, & Smart, 2001)
Decompression Restoring Spinal Mobility
Spinal decompression can also help restore spinal mobility to the lumbar region. When pain specialists incorporate spinal decompression into their practices, they can help by using various techniques to restore joint mobility. When pain specialists start to use these different techniques on the individual’s body, they can help stretch out the surrounding muscles, ligaments, and tissues that were affected around the spine and help restore mobility to the joint. (Gudavalli & Cox, 2014) Combined with spinal decompression, these techniques allow the individual to be more mindful of their bodies and alleviate the pain they have been dealing with for a while. By incorporating decompression as part of their routine, many individuals can return to their activities pain-free without worrying.
References
Acaroglu, E. R., Iatridis, J. C., Setton, L. A., Foster, R. J., Mow, V. C., & Weidenbaum, M. (1995). Degeneration and aging affect the tensile behavior of human lumbar anulus fibrosus. Spine (Phila Pa 1976), 20(24), 2690-2701. doi.org/10.1097/00007632-199512150-00010
Adams, M. A., McNally, D. S., & Dolan, P. (1996). ‘Stress’ distributions inside intervertebral discs. The effects of age and degeneration. J Bone Joint Surg Br, 78(6), 965-972. doi.org/10.1302/0301-620x78b6.1287
Boos, N. (2009). The impact of economic evaluation on quality management in spine surgery. Eur Spine J, 18 Suppl 3(Suppl 3), 338-347. doi.org/10.1007/s00586-009-0939-3
Gudavalli, M. R., & Cox, J. M. (2014). Real-time force feedback during flexion-distraction procedure for low back pain: A pilot study. J Can Chiropr Assoc, 58(2), 193-200. www.ncbi.nlm.nih.gov/pubmed/24932023
Katz, J. N. (2006). Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am, 88 Suppl 2, 21-24. doi.org/10.2106/JBJS.E.01273
Ljunggren, A. E., Weber, H., & Larsen, S. (1984). Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scand J Rehabil Med, 16(3), 117-124. www.ncbi.nlm.nih.gov/pubmed/6494835
Okawa, A., Shinomiya, K., Komori, H., Muneta, T., Arai, Y., & Nakai, O. (1998). Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine (Phila Pa 1976), 23(16), 1743-1749. doi.org/10.1097/00007632-199808150-00007
Sato, K., Kikuchi, S., & Yonezawa, T. (1999). In vivo intradiscal pressure measurement in healthy individuals and in patients with ongoing back problems. Spine (Phila Pa 1976), 24(23), 2468-2474. doi.org/10.1097/00007632-199912010-00008
Sherry, E., Kitchener, P., & Smart, R. (2001). A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain. Neurol Res, 23(7), 780-784. doi.org/10.1179/016164101101199180
How can physicians create a positive experience for LGTBQ+ individuals seeking inclusive health care for muscle pain?
Introduction
Finding proper treatment for many body pain conditions should not be challenging when numerous factors and conditions can impact a person’s lifestyle. When it comes to these factors can range from their home environment to their medical conditions, which then harms their well-being and not being heard when informed about their situation. This can cause barriers to be built up and causes the individual not to be seen or heard when seeking treatment for their pain. However, many individuals within the LGBTQ+ community can seek numerous personalized solutions to improve their general well-being and have a positive experience that suits their needs. This article explores how inclusive health care can positively impact the LGBTQ+ community and how non-surgical treatments like chiropractic care can be incorporated into a person’s personalized inclusive health care plan. Additionally, we communicate with certified medical providers who integrate our patient’s information to reduce general pain through inclusive healthcare treatment. We also inform them that non-surgical treatments can be a positive experience for them to minimize general body pain. We encourage our patients to ask amazing questions while seeking education from our associated medical providers about their pain conditions in a safe and positive environment. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
What Is Inclusive Health Care?
Have you been dealing with constant stress that is causing pain in your body? Do you feel like there are barriers that are preventing you from getting the relief you need from your pain? Or are many environmental factors preventing you from getting back your health and wellness? Many individuals seeking treatment for general pain or conditions affecting their health and wellness will often research which care treatment suits their wants and needs in a positive and safe manner while being inclusive. Healthcare treatments like inclusive health care can provide a positive and safe outcome for members of the LGBTQ+ community. Inclusive health care can help many healthcare professionals establish an inclusive code of conduct within the LGBTQ+ community to improve health-specific outcomes. (Moran, 2021) Now inclusive health care is defined as removing barriers to health care services that should be equally accessible and affordable to many individuals regardless of age, sexual orientation, and gender identity. For many people within the LGBTQ+ community, many individuals identify as gender minorities. A gender minority is an individual who identifies as gender non-conforming and whose gender identity or expression differs from the conventional gender binary. Inclusive health care is an important aspect for the LGBTQ+ community as it can benefit people in getting the treatment they deserve.
How Does Inclusive Health Care Benefits The LGTBQ+ Community?
Regarding inclusive health care, many healthcare providers must respect their patients and their needs when coming in for a general check-up. Since many individuals in the LGBTQ+ community are already dealing with enough stress, especially young people, it is important to have a calm, safe, and non-judgmental environment promoting safety and inclusion. (Diana & Esposito, 2022) There are many ways that inclusive health care can provide beneficial results to the individual and health care provider. Some may include:
What pronouns the individual preferred
What the individual wants to be identified
Being respectful of the patient’s needs
Building a trusted relationship with the individual
When individuals in the LGBTQ+ community have inclusive health care in a positive environment, it can create a positive experience for them as it can improve mental health and general well-being and make a huge impact that can be life-saving. (Carroll & Bishop, 2022) The Injury Medical Chiropractic and Functional Medicine Team is committed to building a positive and safe space for individuals in the LGBTQ+ community that need inclusive health care to reduce pain-like symptoms through personalized treatment plans.
How Can Chiropractic Care Transform Pain To Relief-Video
With many individuals looking for the right kind of treatment for general pain and discomfort, many people will look into non-surgical therapies. Non-surgical treatments can be beneficial for many individuals in the LGBTQ+ community as it is safe and can provide individuals with an understanding of what is impacting their bodies. Non-surgical treatments like chiropractic care, spinal decompression, and MET therapy can alleviate pain-like symptoms associated with musculoskeletal disorders through a personalized treatment plan catered to the person. Many health professionals who are respectful and provide a supportive environment for LGBTQ+ individuals seeking inclusive health has been reported an increase in their confidence, and a decrease in their anxiety, which can potentially decrease uncertainty for future visits. (McCave et al., 2019) Creating a safe, positive environment for individuals seeking inclusive health care can help them reduce the pain they have been experiencing while easing their minds. The video explains how non-surgical treatments like chiropractic care can help reduce musculoskeletal pain associated with stress and help realign the body out of subluxation. Additionally, these small changes in creating a safe and inclusive environment when receiving health care can make a lasting and positive impact on many individuals. (Bhatt, Cannella, & Gentile, 2022)
Utilizing Beneficial Treatments For Inclusive Health Care
When it comes to non-surgical treatments being part of inclusive treatment, it is critical to reduce the health disparities and to ensure that many LGBTQ+ individuals receive the needed medical they deserve. (Cooper et al., 2023) Since many individuals face unique health challenges, from body and gender dysmorphia to common muscle strains associated with musculoskeletal disorders, many individuals can seek non-surgical treatments like chiropractic care. Chiropractic care can help meet the individual’s needs by supporting their musculoskeletal health and general well-being. (Maiers, Foshee, & Henson Dunlap, 2017) Chiropractic care can reduce musculoskeletal conditions that many LGBTQ+ individuals have and can be aware of what factors are affecting their bodies in a safe and positive environment. Non-surgical treatments can be combined with other therapies in inclusive health care for LGBTQ+ individuals. They can provide a safe environment in the clinic and improve their care quality by being cost-effective. (Johnson & Green, 2012) Inclusive health care can help make LGBTQ+ individuals a safe and positive space to make them get the treatment they deserve without negativity.
References
Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innov Clin Neurosci, 19(4-6), 23-32. www.ncbi.nlm.nih.gov/pubmed/35958971
Carroll, R., & Bisshop, F. (2022). What you need to know about gender-affirming healthcare. Emerg Med Australas, 34(3), 438-441. doi.org/10.1111/1742-6723.13990
Cooper, R. L., Ramesh, A., Radix, A. E., Reuben, J. S., Juarez, P. D., Holder, C. L., Belton, A. S., Brown, K. Y., Mena, L. A., & Matthews-Juarez, P. (2023). Affirming and Inclusive Care Training for Medical Students and Residents to Reduce Health Disparities Experienced by Sexual and Gender Minorities: A Systematic Review. Transgend Health, 8(4), 307-327. doi.org/10.1089/trgh.2021.0148
Diana, P., & Esposito, S. (2022). LGBTQ+ Youth Health: An Unmet Need in Pediatrics. Children (Basel), 9(7). doi.org/10.3390/children9071027
Johnson, C. D., & Green, B. N. (2012). Diversity in the chiropractic profession: preparing for 2050. J Chiropr Educ, 26(1), 1-13. doi.org/10.7899/1042-5055-26.1.1
Maiers, M. J., Foshee, W. K., & Henson Dunlap, H. (2017). Culturally Sensitive Chiropractic Care of the Transgender Community: A Narrative Review of the Literature. J Chiropr Humanit, 24(1), 24-30. doi.org/10.1016/j.echu.2017.05.001
McCave, E. L., Aptaker, D., Hartmann, K. D., & Zucconi, R. (2019). Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners. MedEdPORTAL, 15, 10861. doi.org/10.15766/mep_2374-8265.10861
Moran, C. I. (2021). LGBTQ population health policy advocacy. Educ Health (Abingdon), 34(1), 19-21. doi.org/10.4103/efh.EfH_243_18
In many individuals with spinal issues, how does spinal decompression compared with traditional care restore muscle strength?
Introduction
Many people unknowingly put pressure on their spines during daily activities, causing intervertebral disc compression and tightness in surrounding ligaments, muscles, nerve roots, and tissues. Repetitive motions and aging can also lead to intervertebral disc cracking and misalignment, resulting in pain and discomfort in the three common areas: the back, neck, and shoulders. Spinal stenosis is a spinal condition where the spinal cord is compressed and narrow and can cause symptoms of muscle weakness and pain to the upper and lower body extremities if left untreated. This article explores how non-surgical treatments like advanced oscillation and spinal decompression can restore muscle strength and alleviate the effects of spinal stenosis. By working with certified medical providers who use our patients’ information to treat individuals suffering from spinal stenosis. We inform them about non-surgical treatments to regain spinal mobility and restore muscle strength. We encourage our patients to ask essential questions while seeking education from our associated medical providers about their situation. Dr. Alex Jimenez, D.C., provides this information as an educational service. Disclaimer
Spinal Stenosis Causing Muscle Strength Issues
Do you find yourself struggling to hold onto objects while doing activities? Are you experiencing strange sensations like numbness or tingling in your arms or legs? Or you’re dealing with chronic back and neck pain that won’t go away. These issues can all be related to problems with your spine, which can cause your muscles to weaken and lead to conditions like low back pain, sciatica, and spinal stenosis.
Research shows that spinal stenosis is a common condition caused by nerve root impingement or ischemia in the spinal canal. This can lead to pain, weakness, sensory loss in your extremities, and tingling or numbness in your hands or feet. Additionally, studies have found that spinal stenosis in the lumbar spine can increase your risk of developing locomotive syndrome, which can further affect the muscle strength in your arms and legs. {Kasukawa, 2019}
Strong muscles are important for daily movements, such as using your arms, legs, hands, and feet. However, spinal stenosis affects your muscle strength. In that case, it can cause various issues, including numbness or tingling in your upper and lower limbs, severe pain when walking but relief when sitting or resting, decreased grip strength, sciatic pain that mimics and reduced walking distance. While spinal stenosis can be caused by normal or traumatic factors that affect the mobility, flexibility, and stability of the upper and lower muscle quadrants in the body, several available treatments can alleviate the effects of spinal stenosis and help restore muscle strength to the body.
Discovering The Benefits Of Chiropractic Care-Video
Many people experiencing musculoskeletal pain symptoms related to spinal stenosis use over-the-counter medication, hot/cold therapy, and stretching to alleviate the referred pain. Traditional surgery is an effective option to remove the damaged disc that is aggravating the nerve root and relieve the spinal column. However, this surgery is typically only recommended when other treatments have failed and can be expensive. {Herrington, 2023} Nevertheless, numerous cost-effective non-surgical treatments are available to help reduce the pain-like symptoms caused by spinal stenosis and alleviate associated symptoms. Chiropractic care and spinal decompression are non-surgical treatments that use mechanical and manipulated techniques to realign the body and minimize nerve entrapment that causes pain-like symptoms. The video above provides more information about how non-surgical treatments can assist many individuals in maintaining mobility and flexibility by providing a personalized treatment plan to prevent the recurrence of musculoskeletal and spinal conditions.
Advanced Oscillation For Spinal Stenosis
Many people opt for non-surgical treatments such as chiropractic care, massage therapy, spinal decompression, and advanced oscillation to alleviate pain. In “The Ultimate Spinal Decompression,” written by Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., it is noted that advanced oscillation therapy can be tailored to an individual’s needs, helping to minimize pain symptoms caused by spinal stenosis. Advanced oscillation settings can help reduce inflammation and muscle spasms associated with spinal stenosis while promoting the replenishment of nutrients in the spine. In addition, advanced oscillation can help the body restructure and re-tone the targeted spinal structures, loosening them up and reducing nerve entrapment. Advanced oscillation is one of the non-surgical treatments that synergizes well with spinal decompression.
Spinal Decompression To Restore Muscle Strength
Now spinal decompression has a unique ability to reduce the effects of spinal stenosis as it is safe on the spine, cost-effective, and non-invasive. What spinal decompression therapy does to the body is like advanced oscillation. It uses gentle traction to reduce intervertebral disc pressure through negative pressure, allowing oxygen, fluids, and nutrients to the spinal disc and releasing the aggravating nerve root. {Choi, 2015} Spinal decompression can also help restore disc height from the spine, allowing the compressed disc causing spinal stenosis to be put back into its original space. {Kang, 2016} When many individuals start thinking about their health and wellness, non-surgical treatments can give them a positive experience and improve their pain.
References
Choi, J., Lee, S., & Hwangbo, G. (2015). Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. Journal of Physical Therapy Science, 27(2), 481–483. doi.org/10.1589/jpts.27.481
Herrington, B. J., Fernandes, R. R., Urquhart, J. C., Rasoulinejad, P., Siddiqi, F., & Bailey, C. S. (2023). L3-L4 Hyperlordosis and Decreased Lower Lumbar Lordosis Following Short-Segment L4-L5 Lumbar Fusion Surgery is Associated With L3-L4 Revision Surgery for Adjacent Segment Stenosis. Global Spine Journal, 21925682231191414. doi.org/10.1177/21925682231191414
Kang, J.-I., Jeong, D.-K., & Choi, H. (2016). Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. Journal of Physical Therapy Science, 28(11), 3125–3130. doi.org/10.1589/jpts.28.3125
Kaplan, E., & Bard, P. (2023). The Ultimate Spinal Decompression. JETLAUNCH.
Kasukawa, Y., Miyakoshi, N., Hongo, M., Ishikawa, Y., Kudo, D., Kijima, H., Kimura, R., Ono, Y., Takahashi, Y., & Shimada, Y. (2019). Lumbar spinal stenosis associated with progression of locomotive syndrome and lower extremity muscle weakness. Clinical Interventions in Aging, Volume 14, 1399–1405. doi.org/10.2147/cia.s201974
Munakomi, S., Foris, L. A., & Varacallo, M. (2020). Spinal Stenosis And Neurogenic Claudication. PubMed; StatPearls Publishing. www.ncbi.nlm.nih.gov/books/NBK430872/
In many people with facet joint syndrome, how does spinal decompression compare to traditional spinal surgery alleviate low back pain?
Introduction
Many people around the globe experience lower back pain for various reasons, such as lifting or carrying heavy objects, sedentary jobs, or traumatic events that can cause spinal injuries. The spine has a crucial role in providing mobility and flexibility without discomfort. The facet joints and spinal discs work together to generate healthy movement and stability within each segment. However, when the muscles, ligaments, and tissues surrounding the spinal disc are overstretched or compressed due to normal or traumatic factors, it can aggravate the nerve roots and cause discomfort. As we age or carry excess weight, our spinal discs can experience wear and tear, leading to facet joint syndrome. This syndrome is often associated with lower back pain caused by injured facet joints. This article will explore how facet joint syndrome is linked to lower back pain and how non-surgical treatments can help alleviate it. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from facet joint syndrome affecting spine mobility and causes low back pain. We also inform them about non-surgical treatments to regain spinal mobility and reduce pain-like symptoms that correlate with this spinal condition. We encourage patients to ask essential questions and seek education from our associated medical providers about their situation. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
Facet Joint Syndrome
Are you experiencing pain that radiates down to your legs, especially when standing? Do you constantly hunch over, affecting your posture during everyday activities? Have you noticed numbness or loss of sensation in your feet or buttocks? As we age or experience traumatic injuries, the facet joints on either side of our spine can become damaged, resulting in a condition called facet joint syndrome. Research indicates that environmental conditions can cause joint degeneration, leading to symptoms similar to other spinal conditions. Cartilage erosion and inflammation on the spine are common signs of facet joint syndrome, often associated with musculoskeletal disorders like low back pain.
Low Back Pain Associated With Facet Syndrome
Research studiesmusculoskeletal disorders like low back pain are associated with facet syndrome. When the facet joints start to degenerate from repetitive overuse motions caused by everyday activities, it can cause micro instabilities to the facet joints while compressing the surrounding nerve roots. When this happens, many individuals will experience low back pain and sciatic nerve pain conditions that cause them to be unstable while walking. Additional research studies stated that low back pain associated with facet syndrome can cause symptoms of restricted movement, reduce the quality of life and greatly impact the entire lumbar vertebral structure. Since low back pain is a common problem many individuals have, the combination with facet syndrome can trigger reactive muscle spasms, a protective mechanism in the spine to cause the individual to have difficulty moving comfortably and experience severe sudden pain. To that point, low back pain associated with facet syndrome causes the person to be dealing with constant ongoing pain, making a normal lifestyle almost difficult.
Discover The Benefits Of Chiropractic Care-Video
Low back pain associated with facet joint syndrome should not make life difficult. Numerous treatments pertain to relieving the pain-like symptoms and help slow the process of facet syndrome from causing more issues to the spine. Non-surgical treatments like chiropractic care can help reduce the effects of facet syndrome as they can provide benefits to restore spinal mobility. The video above explores the benefits of chiropractic care, as chiropractors will discuss the recommended course of personalized treatment with you. Non-surgical treatments are safe, gentle on the spine, and cost-effective as they help regain your body’s mobility from facet syndrome. At the same time, non-surgical treatments like chiropractic care can be combined with other non-surgical therapies that can help restart the body’s natural healing process to allow the compressed spinal disc and joint to be rehydrated.
Spinal Decompression Alleviating Facet Syndrome
According to research studies, non-surgical treatments like spinal decompression can help reduce the effects of facet syndrome as it can help improve the spine;’s mobility through gentle traction and can help stretch out the affected muscles associated with low back pain by taking pressure off the aggravating nerve root. In “The Ultimate Spinal Decompression,” Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., mentioned that when individuals are going in for spinal decompression, they might experience a “popping sensation” as the jammed facet joints are being open for treatment. This is normal for early facet arthropathy and can occur within the first few treatment sessions. At the same time, spinal decompression can gently stretch the adjacent compressed nerve root and find instant relief. After the treatment, many individuals can combine other treatments like physical therapy to reduce the painful symptoms from returning. Non-surgical treatments like spinal decompression and chiropractic care can help revitalize the spine affected by facet joint syndrome and help restore a person’s quality of life.
The lumbosacral plexus is located on the posterolateral wall of the lesser pelvis, next to the lumbar spine. A plexus is a network of intersecting nerves that share roots, branches, and functions. The sacral plexus is a network that emerges from the lower part of the spine. The plexus then embeds itself into the psoas major muscle and emerges in the pelvis. These nerves provide motor control to and receive sensory information from portions of the pelvis and leg. Sacral nerve discomfort symptoms, numbness, or other sensations and pain can be caused by an injury, especially if the nerve roots are compressed, tangled, rubbing, and irritated. This can cause symptoms like back pain, pain in the back and sides of the legs, sensory issues affecting the groin and buttocks, and bladder or bowel problems. Injury Medical Chiropractic and Functional Medicine Clinic can develop a personalized treatment plan to relieve symptoms, release the nerves, relax the muscles, and restore function.
Sacral Plexus
Anatomy
The sacral plexus is formed by the lumbar spinal nerves, L4 and L5, and sacral nerves S1 through S4.
Several combinations of these spinal nerves merge together and then divide into the branches of the sacral plexus.
Everybody has two sacral plexi – plural of plexus – one on the right side and left side that is symmetrical in structure and function.
Structure
There are several plexi throughout the body. The sacral plexus covers a large area of the body in terms of motor and sensory nerve function.
Spinal nerves L4 and L5 make up the lumbosacral trunk, and the anterior rami of sacral spinal nerves S1, S2, S3, and S4 join the lumbosacral trunk to form the sacral plexus.
Anterior rami are the branches of the nerve that are towards the front of the spinal cord/front of the body.
At each spinal level, an anterior motor root and a posterior sensory root join to form a spinal nerve.
Each spinal nerve then divides into an anterior – ventral – and a posterior – dorsal – rami portion.
Each can have motor and/or sensory functions.
The sacral plexus divides into several nerve branches, which include:
Superior gluteal nerve – L4, L5, and S1.
Inferior gluteal nerve – L5, S1, and S2.
The sciatic nerve – is the largest nerve of the sacral plexus and among the largest nerves in the body – L4, L5, S1, S2, and S3
The common fibular nerve – L4 through S2, and tibial nerves – L4 through S3 are branches of the sciatic nerve.
Posterior femoral cutaneous nerve – S1, S2, and S3.
Pudendal nerve – S2, S3, and S4.
The nerve to the quadratus femoris muscle is formed by L4, L5, and S1.
The obturator internus muscle nerve – L5, S1, and S2.
The piriformis muscle nerve – S1 and S2.
Function
The sacral plexus has substantial functions throughout the pelvis and legs. The branches provide nerve stimulation to several muscles. The sacral plexus nerve branches also receive sensory messages from the skin, joints, and structures of the pelvis and legs.
Motor
Motor nerves of the sacral plexus receive signals from the brain that travel down the column of the spine, out to the motor nerve branches of the sacral plexus to stimulate muscle contraction and movement. Motor nerves of the sacral plexus include:
Superior Gluteal Nerve
This nerve provides stimulation to the gluteus minimus, gluteus medius, and tensor fascia lata, which are muscles that help move the hip away from the center of the body.
Inferior Gluteal Nerve
This nerve provides stimulation to the gluteus maximus, the large muscle that moves the hip laterally.
Sciatic Nerve
The sciatic nerve has a tibial portion and a common fibular portion, which have motor and sensory functions.
The tibial portion stimulates the inner part of the thigh and activates muscles in the back of the leg and the sole of the foot.
The common fibular portion of the sciatic nerve stimulates and moves the thigh and knee.
The common fibular nerve stimulates muscles in the front and sides of the legs and extends the toes to straighten them out.
Pudendal Nerve
The pudendal nerve also has sensory functions that stimulate the muscles of the urethral sphincter to control urination and the muscles of the anal sphincter to control defecation.
The nerve to the quadratus femoris stimulates the muscle to move the thigh.
The nerve to the obturator internus muscle stimulates the muscle to rotate the hips and stabilize the body when walking.
The nerve to the piriformis muscle stimulates the muscle to move the thigh away from the body.
Conditions
The sacral plexus, or areas of the plexus, can be affected by disease, traumatic injury, or cancer. Because the nerve network has many branches and portions, symptoms can be confusing. Individuals may experience sensory loss or pain in regions in the pelvis and leg, with or without muscle weakness. Conditions that affect the sacral plexus include:
Injury
A traumatic injury of the pelvis can stretch, tear, or harm the sacral plexus nerves.
Bleeding can inflame and compress the nerves, causing malfunction.
Neuropathy
Nerve impairment can affect the sacral plexus or parts of it.
Neuropathy can come from:
Diabetes
Vitamin B12 deficiency
Certain medications – chemotherapeutic meds
Toxins like lead
Alcohol
Metabolic illnesses
Infection
An infection of the spine or the pelvic region can spread to the sacral plexus nerves or produce an abscess, causing symptoms of nerve impairment, pain, tenderness, and sensations around the infected region.
Cancer
Cancer developing in the pelvis or spreading to the pelvis from somewhere else can compress or infect the sacral plexus nerves.
Treatment of the Underlying Medical Condition
Rehabilitation begins with the treatment of the underlying medical condition causing the nerve problems.
Cancer treatment – surgery, chemotherapy, and/or radiation.
Antibiotic treatment for infections.
Neuropathy treatment can be complicated because the cause may be unclear, and an individual can experience several causes of neuropathy simultaneously.
Major pelvic trauma like a vehicle collision can take months, especially if there are multiple bone fractures.
Motor and Sensory Recovery
Sensory problems can interfere with walking, standing, and sitting.
Adapting to sensory deficits is an important part of treatment, rehabilitation, and recovery.
Chiropractic, decompression, massage, and physical therapy can relieve symptoms, restore strength, function, and motor control.
Sciatica Secrets Revealed
References
Dujardin, Franck et al. “Extended anterolateral transiliac approach to the sacral plexus.” Orthopaedics & traumatology, surgery & research: OTSR vol. 106,5 (2020): 841-844. doi:10.1016/j.otsr.2020.04.011
Eggleton JS, Cunha B. Anatomy, Abdomen and Pelvis, Pelvic Outlet. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK557602/
Garozzo, Debora et al. “In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.” Journal of brachial plexus and peripheral nerve injury vol. 9,1 1. 11 Jan. 2014, doi:10.1186/1749-7221-9-1
Gasparotti R, Shah L. Brachial and Lumbosacral Plexus and Peripheral Nerves. 2020 Feb 15. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 20. Available from: www.ncbi.nlm.nih.gov/books/NBK554335/ doi: 10.1007/978-3-030-38490-6_20
Norderval, Stig, et al. “Sacral nerve stimulation.” Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke vol. 131,12 (2011): 1190-3. doi:10.4045/tidsskr.10.1417
Neufeld, Ethan A et al. “MR Imaging of the Lumbosacral Plexus: A Review of Techniques and Pathologies.” Journal of Neuroimaging: official journal of the American Society of Neuroimaging vol. 25,5 (2015): 691-703. doi:10.1111/jon.12253
Staff, Nathan P, and Anthony J Windebank. “Peripheral neuropathy due to vitamin deficiency, toxins, and medications.” Continuum (Minneapolis, Minn.) vol. 20,5 Peripheral Nervous System Disorders (2014): 1293-306. doi:10.1212/01.CON.0000455880.06675.5a
Yin, Gang, et al. “Obturator Nerve Transfer to the Branch of the Tibial Nerve Innervating the Gastrocnemius Muscle for the Treatment of Sacral Plexus Nerve Injury.” Neurosurgery vol. 78,4 (2016): 546-51. doi:10.1227/NEU.0000000000001166
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