Back Clinic Complex Injuries Chiropractic Team. Complex injuries happen when people experience severe or catastrophic injuries, or whose cases are more complex due to multiple trauma, psychological effects, and pre-existing medical histories. Complex injuries can be serial injuries of the upper extremity, severe soft tissue trauma, and concomitant (naturally accompanying or associated), injuries to vessels or nerves. These injuries go beyond the common sprain and strain and require a deeper level of assessment that may not be easily apparent.
El Paso, TX’s Injury specialist, chiropractor, Dr. Alexander Jimenez discusses treatment options, as well as rehabilitation, muscle/strength training, nutrition, and getting back to normal body functions. Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living.
Chiari malformation is a condition that causes brain tissue to extend out and settle into the spinal canal. It protrudes out where the skull and neck meet. It occurs because part of the skull is too small or shaped in a unique way that allows part of the brain to settle into the foramen magnum. The foramen magnum is a large opening at the bottom of the skull. The brain’s nerves go through into the spinal canal and join the spinal cord. However, only the nerves should be present. The brain should not be able to push/press/leak through. When it does this is Chiari malformation.
Causes
Chiari malformation can be caused by structural problem/s with the:
Brain
Skull
Spinal canal
Structural conditions/issues can be present at birth, which are congenital defects. This is also called primary Chiari malformation and is not caused by any other condition. Secondary Chiari malformations are caused by something else, most often through surgery. This is extremely rare, but it is possible to develop after having surgery to remove a tumor in the skull or neck region. A surgeon could have removed too much bone while removing the tumor. This allowed the brain to settle into the open space.
Types
There are 4 types and are categorized by how much brain tissue protrudes into the spinal canal.
Type I
This is the adult version and is also the most common.
It is usually first noticed and discovered from an examination for something else. Most individuals don’t realize that they have Chiari malformation unless the symptoms are severe. With Type I a part of the brain, specifically the cerebellar tonsils settle into the foramen magnum.
Type II
Type II is also known as Arnold-Chiari malformation. This is the pediatric version. Symptoms are more severe with Type II because more brain tissue comes through. With this type, the cerebellar tonsils and some of the brainstem protrude. With Type II myelomeningocele, which is a form of spina bifida is a concern. What happens is the vertebrae and spinal canal do not close correctly before birth, so the spinal cord has no protection.
Type III
This type also affects children and is more severe than types 1 or 2. Here a significant portion of the brain, including the cerebellum and the brainstem protrude all the way through the foramen into the spinal canal.
The symptoms vary based on the type and severity. The most common symptom is a headache. Individuals with a Chiari malformation usually have headaches in the occipital region of the brain. This is the back of the head, right where the skull joins the cervical spine/neck. The headaches can be aggravated being in certain positions and actions, tilting the head back, and coughing. Typical symptoms include:
However, Chiari malformation can interrupt the flow of cerebrospinal fluid. Cerebrospinal fluid is necessary to protect the brain and spinal cord. If the normal flow is disrupted it becomes more difficult for the brain and spinal cord to send/receive nerve messages. The pressure built up can also cause nerve issues/problems. For some individuals, symptoms can come and go. This depends on how much cerebrospinal fluid has built up. Individuals with Type I sometimes don’t have any symptoms. It all depends on the severity.
Diagnosis
Diagnosis is done with a magnetic resonance imaging test or MRI. The MRI will show the various parts of the brain, skull, spinal cord, and spinal canal. They will be able to see abnormalities that could point to Chiari malformation.
Treatment
The recommended treatment depends on the severity. If pain is presenting a doctor could recommend pain medications to help manage the pain. Non-steroidal anti-inflammatory meds could also be recommended to reduce inflammation. Analgesics or pain killers can be recommended. Often both non-steroidal anti-inflammatories and analgesics are available in over-the-counter and prescription. The doctor will figure out the best medication treatment plan.
Surgery can be used to relieve symptoms and is the only way to relieve the pressure on the spinal cord and nerves. The goal is to stop the malformation from worsening. Surgeons use a posterior fossa decompression procedure. The surgeon removes part of the skull to make more room for the brain to sit in. This takes the pressure off the brain and spinal cord, and should reduce the neurological symptoms and problems. The surgeon may increase the size of the dura or the sac around the brain.
Laminectomies at C1 and C2, which are the first and second levels of the neck and are utilized to make more room for the brain. The surgeon will place a patch that is made from animal or synthetic tissue that will grow into the dura. The patch makes the dura bigger, which allows more room for the brain. Not all surgeries involve the dural patch.
Neck Pain Chiropractic Care
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate 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 also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to 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 or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
PODCAST: Dr. Alex Jimenez, Kenna Vaughn, Lizette Ortiz, and Daniel “Danny” Alvarado discuss nutrition and fitness during these times. During quarantine, people have become more interested in improving their overall health and wellness by following a proper diet and participating in exercise. The panel of experts in the following podcast offers a variety of tips and tricks on how you can improve your well-being. Moreover, Lizette Ortiz and Danny Alvarado discuss how they’ve been helping their clients achieve their optimal well-being during these COVID times. From eating fruits, vegetables, lean meats, good fats, and complex carbohydrates to avoiding sugars and simple carbohydrates like white pasta and bread, following a proper diet and participating in exercise and physical activity is a great way to continue to promote your overall health and wellness. – Podcast Insight
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Dr. Alex Jimenez RN, DC, MSACP, CCST
PODCAST: Dr. Alex Jimenez and Dr. Marius Ruja discuss the importance of personalized medicine genetics and micronutrients for overall health and wellness. Following a proper diet and participating in exercise alone isn’t enough to make sure that the human body is functioning properly, especially in the case of athletes. Fortunately, there are a variety of tests available that can help people determine if they have any nutritional deficiencies that may be affecting their cells and tissues. Vitamin and mineral supplements can also ultimately help improve an individual’s overall health and wellness. While we may not be able to change certain aspects of our genes, Dr. Alex Jimenez and Dr. Marius Ruja discuss that following a proper diet and participating in exercise while taking the proper supplements, can benefit our genes and promote well-being. – Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
PODCAST: Ryan Welage and Alexander Jimenez, both medical students at the National University of Health Sciences, discuss the several new approaches that they developed in order to help people continue to engage and participate in exercise from the comfort of their own homes. Using their advanced understanding of functional medicine, biomechanics, and nutrition, they undertake explaining simple methods and techniques for complex movement protocols. Moreover, Alexander Jimenez and Ryan Welage discuss how diet can be an essential element in overall health and wellness. Dr. Alex Jimenez offers additional guidelines with the Functional Fitness Fellas, among further advice. – Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
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