In today’s big data informational era, there are many disorders, diseases, and clinical presentations that demonstrate concomitant associations, coincidences, correlations, causations, overlapping profiles, overlapping risk profiles, co-morbidities, and risks of associated disorders that clinically intermingle in presentations and outcomes.
The clinician is mandated by the depth of our present clinical understandings and our oath to our patients to see the complete clinical picture within these integrated clinical paradigms and to treat accordingly.
Somatic dysfunction is defined as the “impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements.”
A viscerosomatic reflexis the resultant of the effect of afferent stimuli arising from a visceral disorder on the somatic tissues. The reflex is initiated by afferent impulses from visceral receptors; these impulses are transmitted to the dorsal horn of the spinal cord, where they synapse with interconnecting neurons. These, in turn, convey the stimulus to sympathetic and peripheral motor efferents, thus resulting in sensory and motor changes in somatic tissues of skeletal muscle, viscera, blood vessels, and skin.
As an example only,visceral afferents play an important part in the maintenance of internal equilibrium and the related mutual adjustments of visceral function. They are also responsible for the conduction of pain impulses that may be caused by distention of a viscus, anoxia (particularly of muscle), irritating metabolites, stretching or crushing of blood vessels, irritation of the peritoneum, contraction of muscular walls, and distention of the capsule of a solid organ.” Because pain-sensitive nerve end- ings are not numerous in viscera, pain sensation or a visceral reflex response may result from the combined input of several different types of receptors rather than as a specific response to a particular receptor. A variety of visceral receptors have been mucosal and epithelial receptors, which respond to mechanical and epithelial stimuli; tension receptors in the visceral muscle layers, which respond to mechanical distention, such as the degree of filling; serosal receptors, which are slow adapting mechanoreceptors in mesentery or
serosa and which monitor visceral fullness; Pacinian corpuscles in mesentery and pain receptors; and free nerve endings in viscera and blood vessels.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
Our information scopeis limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez DC or contact us at 915-850-0900.
Can individuals reduce stress affecting their daily routine through treatments to restore their gut health?
Introduction
Everybody in the entire world has dealt with stress at some point in their lives and has experienced general aches and pains in their bodies. This is due to the hormone cortisol, which helps regulate the entire body’s response. Stress has two forms, acute and chronic, and depending on the scenario a person is under, itcorrelates with stress and can even impact the major body systems. When dealing with acute stress, the muscles start to tense up at the stressor and go into a fight-or-flight mode until the stressor is gone and the individual can begin to relax. However, if the individual is dealing with chronic stress, it can cause numerous overlapping issues that can lead to digestive issues affecting the gut system. When the gut system is acting up from the cortisol hormone in its chronic form, many people will begin to notice small changes that are affecting their health and well-being. Today’s article examines why gut issues induce stress, how individuals can reduce stress naturally, and how people can restore their gut health. We talk with certified associated medical providers who provide our patients’ information to assess gut issues associated with stress that is affecting their health and wellness. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of stress correlating to gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
Why Gut Issues Induced Oxidative Stress?
How often does your body tense up and slowly relax after a stressful situation? Do you experience general aches or pains in your muscles and joints? Or do you feel tenderness and discomfort in your gut? When people are experiencing chronic oxidative stress in their bodies, they sometimes don’t realize that their gut also plays a part. This is because the gut is known as “the second brain” and helps regulate the immune response while protecting the body from unwanted pathogens. However, dealing with a large amount of stress from environmental factors can cause alterations in the immune system’s response and disrupt the delicate balance between the individual and the gut microbiota. (Sharifa et al., 2023) Since gut issues can vary from person to person, it is important to note that when environmental factors cause overlapping risk profiles, it can modify or change the gut microbiota composition of the host.
The gut system, which harbors a large number of beneficial microbial cells, plays a crucial role in the human body. These cells help stimulate the immune system’s maturity and play a role in cognitive performance and stress tolerance. (Marttinen et al., 2020) However, when a person has a poor diet, not physically active, or leads a stressful lifestyle due to their jobs, these environmental factors can cause the development of gut issues over time and contribute to the increase of oxidative stress in the body. (Vasquez et al., 2019) Additionally, many people dealing with chronic stress will often notice their skin feeling a bit warmer, they feel bloated, they will often experience fatigue throughout the day, and experience weight changes. So when the gut system is experiencing high levels of stress from environmental factors, the intestinal epithelial permeability will begin to activate the T-cells that will destroy the immunosuppressive cytokines which leads to systemic inflammation to the body. (Ni et al., 2022) However, there are numerous ways to reduce stress and to help restore gut health naturally.
Fighting Inflammation Naturally- Video
How To Reduce Stress Naturally
When it comes to reducing stress naturally, the first step is to recognize the stressors. Many individuals can start off small by making small changes to their health and wellness. Incorporating meditation, journalling, chiropractic care, acupuncture, massage therapy, and exercise can help relax the mind, reduce stress from the body, and alleviate musculoskeletal issues that are correlated with the gut and stress. These treatments can help reduce the tension from the muscles being affected by stress, while stretching and relaxing them. Additionally, these therapies are non-surgical, customized to the patient, and help realign the spine to promote healing. By recognizing the stressor, many individuals can make the small changes they need to reduce their stress and prevent them from returning.
How To Restore Gut Health
Restoring gut health is crucial to prevent inflammatory issues from reoccurring in the body. The gut microbiota, which contains trillions of bacteria aiding in digestion and nutrient transport, needs to be replenished with good bacteria and reduced bad bacteria to dampen the inflammatory effects caused by stress. One effective way to restore gut health in the body is by incorporating probiotic-rich foods into your diet. These include yogurt, kefir, sauerkraut, and kimchi. These dietary modifications can influence the gut bacteria and restore the gut structure. (Madison & Kiecolt-Glaser, 2019)
At the same time, probiotics can help stabilize stress cortisol levels and boost the good bacterial microbiota to improve body function by lowering the inflammatory cytokines. (Madabushi et al., 2023) This, in turn, helps restore the gut flora to the gut system. At the same time, when individuals incorporating a healthy diet filled with anti-inflammatory foods and pro/prebiotics can help not only reduce oxidative stress correlated with gut issues but also implement management techniques for stress and exercises that can help improve a person’s quality of life, reduce inflammation from the gut and body, and help enhance the immune response. (Jawhara, 2024) When individuals start to think about their health and well-being, making small changes can lead to positive results and help make sure that no gut issues associated with stress can reoccur. Figuring out what stressors are impacting the gut and making these changes can help prevent them from returning in the future and help that individual live a healthier lifestyle.
References
Jawhara, S. (2024). How Do Polyphenol-Rich Foods Prevent Oxidative Stress and Maintain Gut Health? Microorganisms, 12(8). doi.org/10.3390/microorganisms12081570
Madabushi, J. S., Khurana, P., Gupta, N., & Gupta, M. (2023). Gut Biome and Mental Health: Do Probiotics Work? Cureus, 15(6), e40293. doi.org/10.7759/cureus.40293
Madison, A., & Kiecolt-Glaser, J. K. (2019). Stress, depression, diet, and the gut microbiota: human-bacteria interactions at the core of psychoneuroimmunology and nutrition. Curr Opin Behav Sci, 28, 105-110. doi.org/10.1016/j.cobeha.2019.01.011
Marttinen, M., Ala-Jaakkola, R., Laitila, A., & Lehtinen, M. J. (2020). Gut Microbiota, Probiotics and Physical Performance in Athletes and Physically Active Individuals. Nutrients, 12(10). doi.org/10.3390/nu12102936
Ni, Q., Zhang, P., Li, Q., & Han, Z. (2022). Oxidative Stress and Gut Microbiome in Inflammatory Skin Diseases. Front Cell Dev Biol, 10, 849985. doi.org/10.3389/fcell.2022.849985
Sharifa, M., Ghosh, T., Daher, O. A., Bhusal, P., Alaameri, Y. A., Naz, J., Ekhator, C., Bellegarde, S. B., Bisharat, P., Vaghani, V., & Hussain, A. (2023). Unraveling the Gut-Brain Axis in Multiple Sclerosis: Exploring Dysbiosis, Oxidative Stress, and Therapeutic Insights. Cureus, 15(10), e47058. doi.org/10.7759/cureus.47058
Vasquez, E. C., Pereira, T. M. C., Campos-Toimil, M., Baldo, M. P., & Peotta, V. A. (2019). Gut Microbiota, Diet, and Chronic Diseases: The Role Played by Oxidative Stress. Oxid Med Cell Longev, 2019, 7092032. doi.org/10.1155/2019/7092032
Can individuals dealing with back pain find treatment to reduce gut pain associated with SIBO to improve body health?
Introduction
Many individuals have noticed that when it comes to improving their health and well-being, many will incorporate small changes into their daily routines. From exercising for at least 30 minutes to incorporating healthy nutritional foods into their diet, many people don’t realize that the best way to have a healthy style starts with the gut. The gut system helps the body digest food and nutrients to be transported to the body, helps regulate growth and metabolism, and provides immune support to all the organ systems. However, when harmful pathogens and environmental factors start to impact the gut, it can cause the development of harmful pathogens inside the gut system and, over time, cause overlapping risk profiles in the body. This leads to gut dysfunction and musculoskeletal issues in the individual and can cause pain and discomfort if not treated right away. Luckily, numerous ways exist to improve gut health and reduce musculoskeletal issues. Today’s article focuses on a gut issue known as SIBO, how SIBO is correlated with back pain, and what treatments can help reduce SIBO. We talk with certified associated medical providers who provide our patients’ information to assess and identify how SIBO is correlated with back pain. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of SIBO and help restore gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
What is SIBO?
How often do you feel general aches or pain in your gut or around your lower back? Do you constantly feel tired throughout the day, even after a full night’s rest? Or have you been constantly feeling constipated or bloated after eating a meal? Many of these scenarios are associated with a gut issue known as SIBO or small intestinal bacterial overgrowth. Before diving into what SIBO is, it is important to see the gut’s main function to the body. Known as the second brain of the body, the gut system is home to trillions of good bacteria that help with food digestion and protect the body from bad bacteria. When environmental factors like poor dieting, physical inactivity, or inflammatory effects affect the body, the gut’s delicate ecosystem is also affected. This can cause gut dysfunction to the body and, over time, when it is not being treated, lead to SIBO.
SIBO is the presence of excess bad bacteria in the small intestines, which causes protective barriers that help the small intestines weaken. (Sorathia et al., 2024) Additionally, SIBO can correlate with conditions as it can accompany other gut issues by stimulating the immune system. (Banaszak et al., 2023) When the immune system becomes hyperactively stimulated by SIBO, it can cause the inflammatory cytokines to mass produce and cause a ripple effect on the entire body. Since inflammation is the body’s natural response to remove harmful pathogens that cause issues, mass production of inflammatory cytokines in the gut can cause toxins and bad bacteria to enter the bloodstream and travel to different body areas to cause pain. At the same time, SIBO can disrupt the gut-brain axis, which leads to intestinal motility changes and secretion, thus causing overlapping risk profiles like back pain to affect the body. (Carter et al., 2023)
Eating Right to Feel Better- Video
How Does Back Pain Correlate With SIBO?
Now, many people are wondering how back pain is correlated with SIBO. Since SIBO causes the immune system to be hyperactive and mass-produce inflammatory cytokines to reduce the integrity and function of the gastrointestinal barrier, it can cause chronic inflammation and induce pain, which includes musculoskeletal conditions like back pain. (Hui et al., 2023) Additionally, the gut-brain axis being over-runed by SIBO and chronic inflammation being an overlapping risk factor can cause negative influences on the gut microbiome composition, and how the individual reacts to the changes can lead to abnormal bone growth and reabsorption due to the excess bacteria. (Geng et al., 2023) The excess bacteria produced by SIBO can affect intervertebral disc homeostasis and, when combined with environmental factors, can further enhance the inflammatory damage to the back muscles. (Yao et al., 2023) However, there are ways to not only reduce the back pain but also treat SIBO from causing more issues in the gut.
Treatments To Reduce SIBO
When it comes to treating SIBO, it depends on what treatment a person will be combined. The main goals for creating a treatment plan for SIBO are:
Reducing the bad bacteria
Bio-transform the gut
Preventing a relapse
Additionally, many individuals can make small changes in their routine by making dietary changes that can modify the intestinal microbiota. (Souza et al., 2022) This, in turn, helps promote gut health and replenish the nutrients while restoring the good bacteria to the gut. Regarding back pain associated with SIBO, chiropractic care can help individuals decrease or alleviate musculoskeletal symptoms by realigning the spine while massaging the muscles. This can help increase circulation while soothing the inflammatory effects caused by SIBO. Chiropractic care can be implemented as part of a person’s customizable treatment plan through a whole body approach by incorporating lifestyle changes and restoring gut health. By making these small changes with the right treatments to manage the overlapping symptoms caused by SIBO, many individuals can make these small changes to their routine to prevent SIBO from reappearing and causing issues in the body.
References
Banaszak, M., Gorna, I., Wozniak, D., Przyslawski, J., & Drzymala-Czyz, S. (2023). Association between Gut Dysbiosis and the Occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms, 11(3). doi.org/10.3390/microorganisms11030573
Carter, J., Bettag, J., Morfin, S., Manithody, C., Nagarapu, A., Jain, A., Nazzal, H., Prem, S., Unes, M., McHale, M., Lin, C. J., Hutchinson, C., Trello, G., Jain, A., Portz, E., Verma, A., Swiderska-Syn, M., Goldenberg, D., & Kurashima, K. (2023). Gut Microbiota Modulation of Short Bowel Syndrome and the Gut-Brain Axis. Nutrients, 15(11). doi.org/10.3390/nu15112581
Geng, Z., Wang, J., Chen, G., Liu, J., Lan, J., Zhang, Z., & Miao, J. (2023). Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res, 18(1), 601. doi.org/10.1186/s13018-023-04081-0
Hui, J., Chen, Y., Li, C., Gou, Y., Liu, Y., Zhou, R., Kang, M., Liu, C., Wang, B., Shi, P., Cheng, S., Yang, X., Pan, C., Jia, Y., Cheng, B., Liu, H., Wen, Y., & Zhang, F. (2023). Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. Adv Genet (Hoboken), 4(4), 2300192. doi.org/10.1002/ggn2.202300192
Souza, C., Rocha, R., & Cotrim, H. P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World J Clin Cases, 10(15), 4713-4716. doi.org/10.12998/wjcc.v10.i15.4713
Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. doi.org/10.1111/os.13626
Can individuals incorporate proper posture in their workouts to provide effective results and reduce muscle pain in their bodies?
Introduction
Many people have started participating in various physical activities to improve their health and wellness. Additionally, engaging in different physical activities can provide numerous beneficial properties for the body as it can help strengthen the various muscles, bones, and ligaments that have succumbed to multiple injuries, strains, or conditions that cause many individuals to be in pain. When many people with musculoskeletal conditions start incorporating exercises as part of their treatment, maintaining proper posture while doing each set of stretches or exercises for each muscle can help reduce any unwanted strain or pulls that can cause more harm than good. Today’s post focuses on how maintaining proper posture can help make any workouts more efficient, how adequate posture can provide stability and strength to weak muscles, and how incorporating proper posture in a customized treatment plan can prevent numerous injuries from reoccurring. We discuss with certified associated medical providers who consolidate our patients’ information to assess many individuals to understand the importance of proper posture. We also inform and guide patients while asking their associated medical provider intricate questions to integrate non-surgical treatments to reduce the overlapping symptoms correlating with poor posture and help create a customized treatment plan that utilizes proper posture during exercises. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Maintaining Posture Is Important For Effective Workouts
How often do you feel muscle strain on your shoulders, neck, and lower back after a strenuous long day? Do you notice that you feel more hunched over that you feel muscle aches and discomfort? Or do you feel discomfort when stretching your muscles that it causes temporary relief? More often than not, when the world has been on its entire feet or sitting down all day from working, school, or commuting to different locations, many individuals will often slip into an unhealthy habit of slouching when relaxing after a hard day. This, in turn, can cause many individuals to develop neck and back issues that often correlate with an increased stress load in the neck and lower back area. (Hansraj, 2014) Hence, postural correction and its beneficial effects on the back and neck are limited. However, when manual and physical therapists incorporate a PSB (postural-structural-biomechanical) model, it can help ascertain the various causes of musculoskeletal conditions and play an important role in clinical assessment and managing multiple muscle pains. (Lederman, 2011)
So why is it important to exercise to maintain proper posture? Well, when many individuals are in a hunched position from looking at their phones or leaning a lot more while being on the computer or driving, itcan cause the muscles in the neck, shoulders, and upper back to be in a static position, causing the muscles to be overused. (Abd El-Azeim et al., 2022) Additionally, say a person is working out to relieve stress, they would have to maintain a proper posture to prevent injuries and use the equipment to achieve muscular activity. When doing an effective workout, many individuals can improve their posture through muscle stretching exercises that can help improve postural alignment, which plays a role in preventing and treating musculoskeletal pain disorders. (Matsutani et al., 2023) At the same time, maintaining proper posture while working out can provide effective, good-quality movement and neutral spinal alignment.(Katzman et al., 2021)
Discovering The Benefits Of Chiropractic Care- Video
Proper Posture Stabilizes Weak Muscles
At the same time, having proper posture can help stabilize weak muscles in the upper and lower body quadrants. This is because environmental factors like obesity, repetitive movements, andexcessive sitting or standing can cause the muscles to be overused and weak over time when a person is not taking a break. This causes strength imbalances between the muscle groups, causing the accessory muscles to take over the main muscle’s job function and causing the spine to compensate and exaggerate the body’s natural curve. Hence why, exercises, especially core exercises, can help distribute the weight of the overbearing load and can help many individuals reduce the forward lean motion while decreasing muscle strain and fatigue on the upper and lower quadrants. Core exercises can help induce muscular contractions while influencing neuromuscular potentiation. (Lyons et al., 2021) This can help strengthen the weak muscles and stabilize the other muscles so the body can be realigned to invoke proper posture. Also, poor posture can correlate with lumbar spine and pelvis instability as the muscles can become weak. (Kim & Yim, 2020) Incorporating stability exercises into the weak muscles can help many individuals improve their posture when performing exercises.
Incorporating Proper Posture In A Customed Treatment Plan
When it comes to musculoskeletal pain conditions, many individuals can seek out pain specialists like chiropractors, acupuncturists, massage therapists to ease the pain in the muscles from an initial visit. Visiting a chiropractic care office or going to a gym and being assigned to a personal trainer can help practice healthy habits in maintaining and incorporating proper posture in a customized treatment plan. A chiropractic team can help mitigate the pain through spinal adjustments that can help the body realign itself and can work with other associated medical professionals to come up with a customer treatment plan that can help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues and prevent future pain symptoms from reoccurring. Additionally, a physical therapist can work together with a chiropractor to incorporate targeted exercises to help improve posture while stretching and strengthening the targeted muscles. This, in turn, helps with improving neuromuscular improvement to maintain correct posture. When many individuals develop improper posture over time, it can lead to dire consequences, as muscle pain can cause overlapping risk profiles in the body. Making small adjustments to how people sit or stand can help maintain proper posture. That way, the body can realign itself over time, and many can have a pain-free, healthy lifestyle.
References
Abd El-Azeim, A. S., Mahmoud, A. G., Mohamed, M. T., & El-Khateeb, Y. S. (2022). Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: a randomized controlled trial. Eur J Phys Rehabil Med, 58(5), 757-766. doi.org/10.23736/S1973-9087.22.07361-0
Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int, 25, 277-279. www.ncbi.nlm.nih.gov/pubmed/25393825
Katzman, W. B., Parimi, N., Gladin, A., Wong, S., & Lane, N. E. (2021). Long-Term Efficacy of Treatment Effects After a Kyphosis Exercise and Posture Training Intervention in Older Community-Dwelling Adults: A Cohort Study. J Geriatr Phys Ther, 44(3), 127-138. doi.org/10.1519/JPT.0000000000000262
Kim, B., & Yim, J. (2020). Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med, 251(3), 193-206. doi.org/10.1620/tjem.251.193
Lederman, E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. J Bodyw Mov Ther, 15(2), 131-138. doi.org/10.1016/j.jbmt.2011.01.011
Lyons, K. D., Parks, A. G., Dadematthews, O., Zandieh, N., McHenry, P., Games, K. E., Goodlett, M. D., Murrah, W., Roper, J., & Sefton, J. M. (2021). Core and Whole Body Vibration Exercise Influences Muscle Sensitivity and Posture during a Military Foot March. Int J Environ Res Public Health, 18(9). doi.org/10.3390/ijerph18094966
Matsutani, L. A., Sousa do Espirito Santo, A., Ciscato, M., Yuan, S. L. K., & Marques, A. P. (2023). Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial. Trials, 24(1), 384. doi.org/10.1186/s13063-023-07422-w
Can individuals with stiff person syndrome incorporate non-surgical treatments to reduce muscle stiffness and restore muscle mobility?
Introduction
The musculoskeletal system allows the body’s extremities to be mobile, provides stability to the host, and has an outstanding relationship with the other body systems. The musculoskeletal system’s muscles, tissues, and ligaments help protect the body’s vital organs from environmental factors. However, many individuals often deal with repetitive motions in the upper and lower body extremities that can cause pain and discomfort. Additionally, environmental factors, illnesses, and injuries can affect the musculoskeletal system and play a part in co-morbidities in overlapping risk profiles. These issues can cause the musculoskeletal system to develop a condition known as stiff person syndrome. Today’s articles focus on what stiff person syndrome is, the symptoms it is associated with, and how non-surgical treatments can help alleviate the symptoms of stiff person syndrome. We discuss with certified associated medical providers who consolidate our patients’ information to assess stiff person syndrome and its associated symptoms affecting the musculoskeletal system. We also inform and guide patients while asking their associated medical provider intricate questions to integrate non-surgical treatments to reduce the overlapping symptoms correlating with stiff person syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Stiff Person Syndrome
Have you been dealing with muscle stiffness in your lower extremities affecting your mobility? Have you noticed that your posture is rigid due to ongoing muscle spasms in your lower back? Or have you felt tightness in your back muscles? Many pain-like symptoms are associated with back pain, a common musculoskeletal condition; however, they can also correlate with a rare condition known as stiff person syndrome. Stiff person syndrome is a rare autoimmune disorder that is progressive and is characterized by rigidity and stimulus-triggered painful muscle spasms that affect the lower body and extremities. (Muranova & Shanina, 2024) There are three classifications that a person is experiencing with stiff person syndrome, and they are:
Classic Stiff Person Syndrome
Partial Stiff Person Syndrome
Stiff Person Syndrome Plus
Since stiff person syndrome is a rare condition, many individuals may not exhibit any objective findings early on, which then causes a delayed diagnosis that can impact a person’s quality of life (Newsome & Johnson, 2022). At the same time, since stiff person syndrome is a rare autoimmune disease, it can affect the musculoskeletal system with associated pain-like symptoms.
The Symptoms
Some symptoms associated with stiff person syndrome that can develop over time are muscle stiffness and painful muscle spasms. This is because the neuron receptors from the central nervous system can become haywire and cause non-specific somatic symptoms that make the individuals deal with comorbid chronic pain and myofascial tenderness in the muscles. (Chia et al., 2023) This is because stiff person syndrome can spread into different areas of the musculoskeletal system and can gradually develop over time. For muscle stiffness associated with stiff person syndrome, the muscles can become stiff over time, causing pain and discomfort, thus leading to many individuals developing abnormal posture, making it difficult to be mobile. Muscle spasms can affect the entire body itself or in a specific location and cause intense pain that lasts for hours. However, many individuals can incorporate non-surgical treatments to reduce the pain-like symptoms in the musculoskeletal system.
Movement Medicine: Chiropractic Care- Video
Non-Surgical Treatments For Stiff Person Syndrome
When it comes to reducing the musculoskeletal pain symptoms of stiff person syndrome, many individuals can begin to go to their primary doctor for early diagnosis and develop a customized treatment plan to manage the pain-like symptoms and provide a positive impact in creating awareness of this rare condition. (Elsalti et al., 2023) By assessing the pain-like symptoms of stiff person syndrome, many people can incorporate non-surgical treatments to manage the musculoskeletal pain symptoms and improve a person’s quality of life. Non-surgical treatments are cost-effective and can be combined with other therapies to restore mobility. One of the primary goals for managing stiff person syndrome is through pain management, symptom relief, and improved quality of life. (Cirnigliaro et al., 2021)
Chiropractic Care For Stiff Person Syndrome
One of the non-surgical treatments that can help reduce symptoms of muscle spasms and muscle stiffness is chiropractic care. Chiropractic care incorporates mechanical and manual manipulation to stretch and mobilize the joint-muscle function while reducing pain and discomfort. (Coulter et al., 2018) For individuals suffering from stiff person syndrome, chiropractic care can help reduce muscle stiffness and muscle spasms in the upper and lower extremities and relieve the pain. Additionally, incorporating non-surgical treatments like chiropractic care and combined therapies can help manage the musculoskeletal pain associated with stiff person syndrome and improve a person’s quality of life.
References
Chia, N. H., McKeon, A., Dalakas, M. C., Flanagan, E. P., Bower, J. H., Klassen, B. T., Dubey, D., Zalewski, N. L., Duffy, D., Pittock, S. J., & Zekeridou, A. (2023). Stiff person spectrum disorder diagnosis, misdiagnosis, and suggested diagnostic criteria. Ann Clin Transl Neurol, 10(7), 1083-1094. doi.org/10.1002/acn3.51791
Cirnigliaro, F. A., Gauthier, N., & Rush, M. (2021). Management of refractory pain in Stiff-Person syndrome. BMJ Case Rep, 14(1). doi.org/10.1136/bcr-2020-237814
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J, 18(5), 866-879. doi.org/10.1016/j.spinee.2018.01.013
Elsalti, A., Darkhabani, M., Alrifaai, M. A., & Mahroum, N. (2023). Celebrities and Medical Awareness-The Case of Celine Dion and Stiff-Person Syndrome. Int J Environ Res Public Health, 20(3). doi.org/10.3390/ijerph20031936
Newsome, S. D., & Johnson, T. (2022). Stiff person syndrome spectrum disorders; more than meets the eye. J Neuroimmunol, 369, 577915. doi.org/10.1016/j.jneuroim.2022.577915
Do individuals with muscle pain know the difference between heat stroke and heat exhaustion and can find ways to stay cool?
Introduction
As the temperature rises worldwide, many individuals are enjoying their time outside and getting more sun in their lives. However, rising temperatures also mean the rise of heat-related illnesses. The two most common heat-related illnesses are heat stroke and heat exhaustion, which can impact an individual’s musculoskeletal system and have different symptoms in terms of severity. Today’s article focuses on the differences between these two heat-related illnesses, how they affect the musculoskeletal system and treatments to stay cool while reducing muscle pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess heat-related illnesses associated with muscle pain. We also inform and guide patients while asking their associated medical provider intricate questions to integrate treatments and ways to stay cool when temperatures rise and reduce muscle pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Heat Exhaustion VS Heat Stroke
By understanding the differences between heat stroke and heat exhaustion is crucial. Do you often feel overheated after simple activities? Have you experienced muscle pain or cramps? Or do you struggle to cool down? These are all signs of heat-related illnesses. Heat-related illnesses often occur when the body cannot dissipate heat, leading to dysfunctional thermoregulation. (Gauer & Meyers, 2019) The two most common types are heat exhaustion and heat stroke. While they share similar causes, they differ significantly in terms of severity, symptoms, and treatment. (Prevention, 2022)
Heat exhaustion is a mild condition that often occurs when the human body loses excessive water and salt from profusely sweating. This causes the external temperatures to be more moderate when associated with intense physical activity. (Leiva & Church, 2024) Additionally, when a person is dealing with heat exhaustion, some of the symptoms that they will experience include:
Heavy sweating
Fatigue
Headaches
Muscle cramps
Pale, cool, moist skin
Fast, weak pulse
Even though heat exhaustion is a mild heat-related condition, it can develop into severe heat-related conditions like heat stroke if not treated immediately. Heat stroke is a severe heat-related illness that is not only life-threatening buthas two forms that can affect a person’s body temperature: classic and exertional. Classic heat stroke often affects elderly individuals who have chronic medical conditions, while exertional heat stroke affects healthy individuals who are doing strenuous physical activities. (Morris & Patel, 2024) Some of the symptoms associated with heat stroke include:
High body temperature (104°F or higher)
Hot, red, dry skin
Rapid, strong pulse
Confusion
Seizures
Loss of consciousness
How Do Both Conditions Affect The Muscles?
Both heat-related illnesses can have a significant effect on the musculoskeletal system and cause muscle pain to not only the extremities but also the entire body system. The issue affects the musculoskeletal system and can lead to painful muscle cramps, involuntary muscle contractions, and muscle pain. Since muscle pain is a multi-factorial condition, heat-related illnesses like heat stroke and exhaustion can influence a person’s lifestyle and comorbid health factors. (Caneiro et al., 2021) When that happens, many individuals can seek treatments to stay cool from heat exhaustion and heat stroke and reduce muscle pain.
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Treatments For Staying Cool & Reduce Muscle Pain
While it is important to understand the difference between heat stroke and heat exhaustion due to the crucial timing and effective interventions, finding various treatments to reduce muscle pain and find ways to stay cool is important. Many individuals can wear technology to monitor the person’s physiological status actively and prevent injuries while providing early detection for heat-related illnesses. (Dolson et al., 2022) This can reduce the chances of muscle pain and help regulate body temperature. For individuals dealing with heat exhaustion, they can:
Move to a cooler environment
Be well-hydrated with water and electrolyte-rich drinks
Rest
Wear cool clothes to lower body temperature
For individuals dealing with heat stroke, they can:
Call emergency services immediately
Apply cool clothes or ice packs to the body
Monitor vital signs
Both treatments can ensure positive results in preventing life-threatening situations that can affect the musculoskeletal system.
Conclusion
Given the significant impact both heat stroke and heat exhaustion can have on the musculoskeletal system, it’s essential to take proactive measures. Proper hydration, cooling, and rest can help manage and alleviate muscle pain associated with these heat-related illnesses. By staying informed, maintaining hydration, and taking proactive steps to protect yourself from excessive heat, you can significantly reduce the chances of these heat-related illnesses affecting your outdoor activities.
References
Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. doi.org/10.1016/j.bjpt.2020.06.003
Dolson, C. M., Harlow, E. R., Phelan, D. M., Gabbett, T. J., Gaal, B., McMellen, C., Geletka, B. J., Calcei, J. G., Voos, J. E., & Seshadri, D. R. (2022). Wearable Sensor Technology to Predict Core Body Temperature: A Systematic Review. Sensors (Basel), 22(19). doi.org/10.3390/s22197639
Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?
Introduction
The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Osteoarthritis Affecting Joint Mobility
Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.
Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.
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Cycling For Osteoarthritis
Engaging in physical activities may seem daunting when managing osteoarthritis symptoms, but it can help restore joint mobility while reducing the pain associated with osteoarthritis. One of the physical activities that has little impact and does not impact the joints is cycling. Cycling for osteoarthritis has many beneficial properties as it can:
Strengthen surrounding muscles
Retain joint mobility
Improve range of motion
Weight management
Enhancing cardiovascular health
Cycling can help the individual focus on strengthening the lower extremity muscles surrounding the joints, which can help improve pain and functionality. (Katz et al., 2021) This, in turn, helps provide better support and stability to the joints, thus reducing overload on the body while minimizing the risk of injuries. Additionally, cycling can help improve many individuals looking for a healthier change and increase bone mineral density in the joints, thus decreasing the risk of fractures. (Chavarrias et al., 2019)
Cycling Reducing Joint Pain
Cycling is a safe and effective exercise for anyone, whether they’re just starting or haven’t been active for a while. The key to optimal recovery and joint functionality is to consult a doctor. This ensures that cycling is a safe option for you, helps you choose the right bike, and provides guidance on how to start slowly, warm up and stretch, maintain proper form, and stay consistent with the cycling sessions. This professional guidance is crucial, as it allows many individuals with joint pain to achieve complete functional recovery to their joints. (Papalia et al., 2020) Cycling is an excellent way to manage osteoarthritis and its associated symptoms. For many individuals with osteoarthritis, this low-impact exercise can be a game-changer, promoting muscle strengthening, improving joint range of motion, and helping alleviate osteoarthritis symptoms.
References
Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Perez-Gomez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8). doi.org/10.3390/medicina55080452
Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325(6), 568-578. doi.org/10.1001/jama.2020.22171
Molnar, V., Matisic, V., Kodvanj, I., Bjelica, R., Jelec, Z., Hudetz, D., Rod, E., Cukelj, F., Vrdoljak, T., Vidovic, D., Staresinic, M., Sabalic, S., Dobricic, B., Petrovic, T., Anticevic, D., Boric, I., Kosir, R., Zmrzljak, U. P., & Primorac, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int J Mol Sci, 22(17). doi.org/10.3390/ijms22179208
Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. doi.org/10.3389/fimmu.2022.907750
Noriega-Gonzalez, D., Caballero-Garcia, A., Roche, E., Alvarez-Mon, M., & Cordova, A. (2023). Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med, 12(11). doi.org/10.3390/jcm12113703
Papalia, R., Campi, S., Vorini, F., Zampogna, B., Vasta, S., Papalia, G., Fossati, C., Torre, G., & Denaro, V. (2020). The Role of Physical Activity and Rehabilitation Following Hip and Knee Arthroplasty in the Elderly. J Clin Med, 9(5). doi.org/10.3390/jcm9051401
How do healthcare professionals provide a clinical approach in the role of nursing to reducing pain in individuals?
Introduction
The practice of Registered Nurses (RN), Advanced Practice Registered Nurses (APRN), and Licensed Practical Nurses (L.P.N.) is governed by the Nurse Practice Act. Nurses working in the specializations above must keep up their practice skills and knowledge, which includes familiarity with the rules and regulations that pertain to their profession. Practicing practical nursing is authorized for Licensed Practical Nurses (L.P.N.s). Today’s article looks at the role of nursing. We discuss with certified associated medical providers who consolidate our patients’ information to assess any pain or discomfort they are experiencing. We also inform and guide patients while asking their associated medical provider intricate questions to integrate into their personalized treatment plan to manage the pain. Dr. Jimenez, DC, includes this information as an academic service. Disclaimer.
The Roles In Nursing
The Nurse Practice Act describes practical nursing as “the performance of selected various actions, including the administration of numerous treatments and medications, in the care of the ill, injured, and providing the promotion of wellness, health maintenance and prevention of illnesses while following under the direction of a registered nurse, a licensed physician, osteopathic physician, podiatric physician, or a licensed dentist.” It was revised in 2014 and now teaches broad health and wellness concepts to non-nursing students and the public. The main goal for an RN is to complement the access to health care for individuals in pain or who are dealing with chronic issues. (Cassiani & Silva, 2019)
Many individuals are under the supervision of a registered nurse, doctor, or dentist, individuals who have completed a prelicensure practical nursing education program approved by the Board, a professional nursing education program, and graduate practical nursing students qualifying as professional nursing students; however, licensed practical nurses who have not completed the specified course under Rule 64 B9-12.005, FAC, may perform a limited scope of intravenous therapy. This range consists of:
Intravenous Therapy Within the Scope of the Practical Nurse:
Calculate and adjust the flow rate of IV therapy.
Observe and report both subjective and objective signs of various reactions to IV administration to the patient.
Must inspect the insertion site, change the dressing, and remove the intravenous needle or catheter from the peripheral veins
Hanging bags or bottles of hydrating fluid.
Intravenous Therapy Outside the Scope of the Practical Nurse:
Initiation of blood and blood products
Initiation or administration of cancer chemotherapy
Initiation of plasma expanders
Initiation of administration of investigational drugs
Making IV solution
IV pushes, except for heparin flushes and saline flushes
It is appropriate for licensed practical nurses to provide treatment for patients undergoing such therapy, even though this rule restricts the practice of licensed practical nurses. 64B-12.005 Requirements for Competency and Knowledge required for the LPN to be qualified to give IV therapy. If the IV Therapy Course Guidelines published by the National Federation of Licensed Practical Nurses Education Department are completed, an LPN may be certified to administer IV therapy. The LPN can take part in further training to provide IV therapy via central lines while supervised by an RN. “The Central Lines. The Board acknowledges that a Licensed Practical Nurse, as defined in subsection 64B9-12.002, FAC, may provide intravenous therapy via central lines under a registered professional nurse’s supervision with the necessary education and training. Four hours of instruction is the minimum required for appropriate education and training. The thirty hours of education for intravenous therapy needed for this rule’s subsection may include four hours of training. At the very least, didactic and clinical practicum instruction in the following areas must be included in the education and training mandated by this subsection:
Central venous anatomy and physiology
CVL site assessment
CVL dressing and cap changes
CVL flushing
CVL medication and fluid administration
CVL blood drawing
CVL complications and remedial measures
The Licensed Practical Nurse will be evaluated on clinical practice, competency, and theoretical knowledge and practice after completing the intravenous therapy course via central lines. A Registered Nurse must witness the clinical practice assessment and file a proficiency statement on a Licensed Practical Nurse. The Licensed Practical Nurse will be evaluated on clinical practice, competence, and theoretical knowledge and practice. A Registered Nurse who oversees the clinical practice assessment must sign a proficiency statement attesting to the Licensed Practical Nurse’s competence in administering intravenous treatment through central lines. The applicant’s Licensed Practical Nurse personnel file must contain the proficiency statement. 64B9-12.005 code.
Professional nursing is practiced by registered nurses (RNs). The Nurse Practice Act defines this as “the performance of those numerous acts requiring substantial specialized knowledge, judgment, and nursing skill based upon the applied principles of psychological, biological, physical, and social sciences.” Professional nursing goes beyond hands-on care to include nursing diagnosis, planning, supervision, and training other staff members in the theory and execution of any tasks mentioned above. Additionally, nurses must use numerous experiences to assist patients with an understanding of empathy to make them feel comfortable and safe. (Torres-Vigil et al., 2021)
Delegations & Certificates For Nursing
The delegation of responsibilities to another healthcare provider or a competent unlicensed individual is permitted by the Florida Nurse Practice Act. When assigning a task or activity, the registered nurse (RN) or licensed practical nurse (L.P.N.) must consider appropriateness. They had to consider the possibility of patient injury, the difficulty of the work, the outcome’s predictability or unpredictability, and the resources—including staff and equipment—available in the patient environment. The RN and the LPN may assign tasks outside the supervising or delegating nurse’s scope of practice. These tasks include determining the nursing diagnosis or interpreting nursing assessments, developing the plan of care, establishing the goals of nursing care, and assessing the progress of the care plan. The role of nursing is to promote advocacy and create a direct relationship with patients. (Ventura et al., 2020)
464.0205 Retired Volunteer Nurse Certificate
A retired practical or registered nurse may apply for a retired volunteer certificate from the Board of Nursing to work with underprivileged, impoverished, or critically ill populations. They are directly supervised by a physician, advanced practice registered nurse, registered nurse, director of a county health department, and:
Provides services under the certificate only in sponsored settings that the Board has approved
The scope of practice for a certified volunteer is limited to primary and preventive health care by the Board.
A retired volunteer nurse shall not:
Administer controlled substances
Supervise other nurses
Receive monetary compensation
464.012 Advanced Practice Registered Nurse (APRN)
“The Barbara Lumpkin Prescribing Act” was proposed towards the end of 2018. This Act helps many practitioners convert a certificate to a license, and it takes effect on October 1, 2018. This Act established a transition timeline and process for practitioners certified as advanced registered nurse practitioners or clinical nurse specialists as of September 30, 2018, to practice as advanced practice registered nurses (APRNs). Until the department and Board complete the transition from certification to licensure, established under this Act, an advanced registered nurse practitioner who is holding a certificate to practice on September 30, 2018, may continue to practice with all the rights, authorizations, and responsibilities under this licensure section as an advanced practice registered nurse. They may also use the applicable title under s.464.015 after this Act’s effective date.
The Board of Nursing requires the following to establish an APRN license:
A nurse who wants to become an advanced practice registered nurse must apply to the APRN department, provide documentation that they meet the requirements set out by the Board, and have a valid license to practice professional nursing or an active multistate license to practice professional nursing by s. 464.0095.
Accreditation by a relevant specialty board. To become a certified nurse in any nursing department and to renew your current state license, you must first obtain this certification. For a duration deemed suitable for preparing for and passing the national certification examination, the Board may, by rule, grant certified registered nurse anesthetists, clinical nurse specialists, certified nurse practitioners, psychiatric nurses, and certified nurse midwives provisional state licensure.
Completing a master’s program in a clinical nursing specialty field and training in particular practitioner skills. For candidates who will graduate on or after October 1, 1998, paragraph (4)(a) requires completion of a master’s degree program to be eligible for initial certification as a certified nurse practitioner.
The Board of Nursing defines APRN’s role/duties:
Prescribe, dispense, administer, or order any medication; however, an advanced practice registered nurse is only permitted to prescribe or dispense the controlled substance as specified in s.893.03 if they have completed a master’s or doctoral program that provides training in specialized practitioner skills and leads to a master’s or doctoral degree in clinical nursing.
Initiate appropriate therapies for certain conditions.
Performed additional functions as may be determined by rule under s.464.003.
Order diagnostic tests and physical and occupational therapy.
Order any medication for administration to a patient in a facility.
Beyond the general duties mentioned in subsection (3), an APRN is qualified to carry out the following tasks within their area of expertise:
Within the confines of established protocol, the certified nurse practitioner may carry out any or all of the following actions:
Manage selected medical problems.
Order physical and occupational therapy.
Initiate, monitor, or alter therapies for certain acute illnesses.
To monitor and manage patients with stable chronic diseases.
Established behavioral problems and diagnoses and made treatment recommendations.
The Stature goes on to define the functions of anesthetists and nurse midwives. Refer to the Statue for more details.
Obtaining & Maintaining Nursing License
A license may be acquired through testing, endorsement, or the Nurse Licensure Compact’s enactment. Upon application and a non-refundable payment fee determined by the Board, the department will grant the necessary license by endorsement to engage in professional or practical nursing to the applicant who can provide proof to the Board that they:
Possesses a valid license to practice professional or practical nursing in another state or territory in the United States, provided that the requirements for licensure in that state were either more stringent or substantially equivalent to those in Florida when the applicant obtained their original license.
Fulfills the requirements outlined in s.464.008 for licensing and has passed a state, regional, or national exam that is at least as difficult as the one administered by the department.
Has spent two of the previous three years actively practicing nursing in a different state, territory, or jurisdiction within the United States without having any action taken against their license by any jurisdiction’s licensing body. Under this paragraph, applicants who obtain a permit must finish a board-approved Florida laws and rules course within six months of receiving their license. After reviewing the findings of the national criminal background check, the applicant will be granted the relevant license by endorsement as soon as the department determines that the applicant has no criminal history.
It will be assumed that any exams and requirements from other US states and territories are roughly the same or more demanding than those from this state. This assumption will materialize on January 1, 1980. The Board may, however, establish rules designating some states and territories, the qualifications and exams for which shall not be deemed to be substantially similar to those of this state.
When an individual submission of the appropriate application and fees, as well as the successful completion of the criminal background check that is required under subsection (4), an applicant for licensure by endorsement who is relocating to this state due to the official military orders of their spouse with a military connection and who is a member of the Nurse Licensure Compact in another state will have all the requirements satisfied.
The applicant must submit a set of fingerprints to the department on a form and per departmental rules. The applicant must also pay the department a sum equal to the expenses the Department of Health paid for the applicant’s criminal background check. For a statewide criminal history check, the Department of Health will send the applicant’s fingerprints to the Florida Department of Law Enforcement, and the Florida Department of Law Enforcement will forward the fingerprints to the FBI for a nationwide criminal history check. When an applicant satisfies all other requirements for licensure and has no criminal record, the Department of Health will review the results of the criminal history check, issue a license, and refer all other applicants who have a criminal history back to the Board for a decision on whether or not to issue a permit and under what circumstances.
Until the investigation is finished, at which point the requirements of s.464.018 will take effect, the department will not grant an endorsement license to any applicant who is being investigated in another state, jurisdiction, or territory of the United States for an act that would violate this part or chapter 456. After completing all necessary data collection and verification, the department will issue a license within 30 days. It will also develop an electronic applicant notification process and provide electronic notifications upon application receipt and completion of background checks. Suppose the applicant must appear before the Board because of information on their application or because of screening, data gathering, and verification procedures. In that case, the 30-day license issuance time will be extended. The qualifications for licensure by endorsement in this section do not apply to an individual with an active multistate license in another state under s. 464.0095.
Licensure By Examination
Anyone who wants to take the licensing exam to become a registered nurse must apply to the department. The department will assess each candidate who:
The applicant has fulfilled the requirements by filling out the application form and paying the $150 fee set by the Board. Additionally, they have paid the $75 examination fee set by the Board and the actual cost per applicant to the department for purchasing the exam from the NCSBN (National Council of State Boards of Nursing) or a comparable national organization.
Possesses enough information as of October 1, 1989, or later, which the department needs to provide to conduct a statewide criminal records correspondence check with the Department of Law Enforcement.
Possesses a high school diploma or its equivalent, is in good mental and physical health, and has fulfilled the prerequisites for:
Graduation from an approved program
Graduation from a pre-licensure nursing education program equivalent to an approved program determined by the Board.
Graduated on or after July 1, 2009, from an accredited program
Graduation before July 1, 2009, from a pre-licensure nursing education program whose graduates were eligible for examination.
Completing courses in a professional nursing education program may satisfy the educational criteria for licensing as a licensed practical nurse. Possesses the ability to communicate in English, as assessed by a department exam. Unless rejected by s.464.018, any applicant who passes the exam and has completed the educational requirements listed in subsection (1) is eligible to become a licensed practical nurse or registered professional nurse, as the case may be.
Regardless of the jurisdiction in which the examination is administered, any applicant who fails the test three times in a row will need to finish a remedial course approved by the Board to be eligible for reexamination. The candidate may be permitted to attempt the test up to three times after completing the remedial course before being forced to undertake remediation. After the remedial process, the applicant has six months to petition for a reexamination. By regulation, the Board will set requirements for remedial education.
An applicant who completes an approved program must be enrolled in and complete a board-approved licensure examination preparing course if they choose not to take the license examination within six months of graduation. The applicant cannot use federal or state financial aid to cover any course-related expenses; they are solely responsible for covering them. The Board will set rules for the preparatory courses for licensing exams. Section 464.0095 exempts an individual from the licensure requirements if they currently have an active multistate license in another state (2).
Licensure Upon Enactment of the Nurse Licensure Compact
Florida passed the Nurse Licensure Compact into law. This allows nurses to participate in 26 states’ licensing compacts. The call to remove the burdensome and redundant system of duplicate licensure and to advance public safety and health advantages led to the enactment of this law. The official statement is as follows:
“This agreement becomes operative and legally binding on December 31, 2018, whichever comes sooner, or on the day it is enacted into law by at least 26 states. Within six months following the implementation date of this compact, any member states that were also parties to the previous Nurse Licensure Compact (“prior compact”) that this compact replaced are considered to have withdrawn from the previous compact.”
Until a party state is withdrawn from the prior compact, each party state to this one shall respect a nurse’s multistate licensure privilege to practice in that party state granted under the preceding compact. Any party state may opt out of the compact by passing a law canceling it. A party state’s departure becomes effective six months after the repealing Act is passed. Any cooperative arrangement, including nurse licensure agreements, between a party state and a nonparty state that complies with the other conditions of this compact remains valid and unaffected by this compact. The party states may alter this contract. Only when it is incorporated into the laws of every party, state a modification to this compact is binding on the party states and becomes effective. Before all party states adopt this compact, representatives of nonparty states to the agreement will be invited to engage in commission activities without being able to vote.
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Continuing Nursing Education Requirement
Licenses need to be renewed every biennium or every two years. One contact hour must be completed for each calendar month of the licensure cycle in a given year. The hours stipulated in subsection (1) at the designated times must include the following continuing education courses as a necessary component:
A 2-hour course in prevention of medical errors must be completed each biennium.
A 1-hour course in HIV/AIDS in the first biennium only
A 2-hour course in Florida laws and rules in each biennium
Effective August 1, 2017, a 2-hour course in recognizing impairment in clinical approach and every other biennium after that.
On or after January 1, 2019, a 2-hour course on human trafficking and each biennium after that.
A 2-hour course in domestic violence is required every third biennium.
In addition, the Florida Board of Nursing requires general hours of continuing education to fulfill the requirement of one contact hour for each calendar month of the licensure cycle. These hour requirements are updated on their website. In addition to the courses mentioned above, they currently demand 16 hours of continuing education in general nursing.
Nurse Licensee With Two Licenses & CE Requirements
A licensee with an RN and an LPN license may fulfill CE requirements by completing the necessary RN-specific continuing education. Visit the Board of Nursing website for further information regarding the rules, as mentioned earlier, and the exceptions.
Standards For Continuing Education
Learner Objectives: The objectives should outline the anticipated behavioral outcomes of the learners and be measurable, reachable, and pertinent to the state of nursing practice today. The goals will dictate the curriculum, mode of instruction, and assessment strategy.
Subject Matter: The content must be specifically created to satisfy the participants’ learning needs, levels, and objectives. The information will be arranged logically and incorporate advice from subject-matter experts. Appropriate subject matter for continuing education offerings should include information from one or more of the following. It should represent the learner’s professional educational needs to address the consumer’s health care demands:
Nursing areas and special health care problems.
Biological, physical, behavioral, and social sciences.
Legal aspects of healthcare
Management/administration of health care personnel and patient care
Teaching/ learning process of health care personnel and patients
Evaluation: It must be demonstrated in a way that satisfies the Board that participants are given the chance to assess the educational opportunities, delivery strategies, facilities, and resources utilized in the offering. At the end of the learning process, self-directed learning activities—such as computer programs, web-based courses, internet research, and home study—must be used to assess student knowledge. There must be ten questions or more in the assessment. For the learner to be eligible for the contact hours, they must receive an evaluation score of at least 70%. The provider is required to grade the assessment.
References
Cassiani, S. H. B., & Silva, F. (2019). Expanding the role of nurses in primary health care: the case of Brazil. Rev Lat Am Enfermagem, 27, e3245. doi.org/10.1590/1518-8345.0000.3245
Torres-Vigil, I., Cohen, M. Z., Million, R. M., & Bruera, E. (2021). The role of empathic nursing telephone interventions with advanced cancer patients: A qualitative study. Eur J Oncol Nurs, 50, 101863. doi.org/10.1016/j.ejon.2020.101863
Ventura, C. A. A., Fumincelli, L., Miwa, M. J., Souza, M. C., Wright, M., & Mendes, I. A. C. (2020). Health advocacy and primary health care: evidence for nursing. Rev Bras Enferm, 73(3), e20180987. doi.org/10.1590/0034-7167-2018-0987
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