Back Clinic Severe Back Pain Treatment Team. Severe back pain goes beyond the pain that is above the normal sprain and strain. Severe back pain requires in-depth assessment due to the cause/s or ideology that is not easily diagnosed or apparent. This requires additional diagnostic procedures in order to determine the cause of the severity presentations. Nociceptive and neuropathic pain can be further broken down into acute and chronic pain, which differ in form and function.
With acute pain, the severity of pain depends on the level of tissue damage. Individuals have a protective reflex in avoiding this kind of pain. With this type of pain, there is a reflex to pull back quickly after moving or being in a certain position. Acute pain can be a sign of injured or diseased tissue. Once the problem is cured the pain is cured. Acute pain is a form of nociceptive pain. With chronic pain, the nerves continue to send pain messages after the earlier tissue damage has healed. Neuropathy falls into this type.
Understanding Nerve Conditions of the Spine: Causes, Symptoms, and Treatments
The spine is a critical part of the body, serving as a highway for nerves that transmit signals between the brain and the rest of the body. When something goes wrong with these nerves—whether they’re compressed, irritated, or damaged—it can lead to a range of uncomfortable symptoms like pain, numbness, tingling, or weakness. These issues, known as nerve-related spine conditions, can affect the back, arms, or legs and stem from various causes, including injuries, degenerative conditions, or infections. In this article, we’ll explore these conditions, their symptoms, causes, and how they’re diagnosed and treated, with a special focus on integrative approaches like those used by Dr. Alexander Jimenez, a chiropractor and nurse practitioner in El Paso, Texas. We’ll also look at how chiropractic care, targeted exercises, massage therapy, acupuncture, and integrative medicine can promote healing and prevent long-term problems.
What Are Nerve-Related Spine Conditions?
Nerve-related spine conditions happen when the spinal nerves or spinal cord are compressed, irritated, or damaged. The spine is made up of bones called vertebrae, which protect the spinal cord—a bundle of nerves that carries messages to and from the brain. Between the vertebrae are intervertebral discs, which act as cushions, and small openings called foramina, where nerve roots exit the spinal cord to connect to other parts of the body. When these nerves or the spinal cord itself are affected, it can disrupt the signals, leading to symptoms like pain, numbness, tingling, or weakness (Mayo Clinic Health System, n.d.).
Some of the most common nerve-related spine conditions include:
Radiculopathy: Often referred to as a “pinched nerve,” this condition occurs when a nerve root is compressed or irritated as it exits the spine. It can cause pain, numbness, or weakness that radiates along the nerve’s path. For example, lumbar radiculopathy can lead to sciatica, a condition characterized by pain that shoots from the lower back down the leg (Cleveland Clinic, n.d.).
Spinal stenosis refers to the narrowing of the spinal canal, which puts pressure on the spinal cord or nerve roots. It’s often caused by aging or degenerative changes and can lead to symptoms like back pain, numbness, or difficulty walking (HSS Education, n.d.).
Herniated or Bulging Discs: Discs can bulge or herniate (when the inner gel-like material pushes out), pressing on nearby nerves. This can cause pain, tingling, or weakness in the arms or legs, depending on where the disc is located (Penn Medicine, n.d.).
Degenerative Conditions: Conditions like arthritis or bone spurs can narrow the spaces where nerves travel, causing compression and symptoms like pain or stiffness (Health Central, n.d.).
Trauma or Injury: Accidents, such as car crashes or falls, can damage the spine and compress nerves, leading to immediate or delayed symptoms (Verywell Health, n.d.).
Infections or Structural Abnormalities: Infections, tumors, or abnormal spine alignment (like scoliosis) can also press on nerves, causing similar symptoms (MSD Manuals, n.d.).
These conditions can range from mild annoyances to serious issues requiring immediate medical attention, especially if they cause severe symptoms like loss of bladder or bowel control, which may indicate cauda equina syndrome, a medical emergency (Verywell Health, n.d.).
Symptoms of Nerve-Related Spine Conditions
The symptoms of nerve-related spine conditions depend on where the nerve compression or damage occurs and the severity of the condition. Common symptoms include:
Pain: This can be sharp, burning, or aching and may stay in one spot (like the neck or lower back) or radiate to other areas, such as the arms, buttocks, or legs. For example, sciatica often causes burning pain that travels from the lower back to the legs (Penn Medicine, n.d.).
Numbness or Tingling: These sensations, often described as “pins and needles,” can occur in the hands, arms, feet, or legs, depending on the affected nerve (Cleveland Clinic, n.d.).
Weakness: Muscle weakness in the arms, hands, or legs can make it hard to lift objects, walk, or maintain balance. In severe cases, it can cause issues like foot drop, where a person struggles to lift their foot while walking (Johns Hopkins Medicine, n.d.).
Loss of Coordination: Compression of the spinal cord (myelopathy) can affect fine motor skills, making tasks like buttoning a shirt or writing difficult (Verywell Health, n.d.).
Balance Issues: Spinal stenosis or myelopathy can cause trouble walking or maintaining balance, sometimes described as feeling like “walking through mud” (Spine-health, n.d.).
Loss of Bladder or Bowel Control: This is a rare but serious symptom that requires immediate medical attention, as it may signal cauda equina syndrome (HSS Education, n.d.).
Symptoms can develop suddenly, like after an injury, or gradually, as with degenerative conditions like arthritis. If you experience severe or worsening symptoms, especially loss of bladder or bowel control, seek medical care right away.
Causes of Nerve-Related Spine Conditions
Nerve-related spine conditions can have many causes, ranging from natural aging to sudden injuries. Here are some of the main culprits:
Degenerative Changes: As people age, the spine can undergo wear and tear. Osteoarthritis can cause bone spurs, and degenerative disc disease can lead to bulging or herniated discs, both of which can press on nerves (Mayo Clinic Health System, n.d.).
Herniated or Bulging Discs: When a disc’s inner material bulges or herniates, it can push against nearby nerves, causing pain or numbness. This is a common cause of radiculopathy, including sciatica (Penn Medicine, n.d.).
Spinal Stenosis: The spinal canal can narrow due to thickened ligaments, bone spurs, or other changes, putting pressure on the spinal cord or nerve roots (Cleveland Clinic, n.d.).
Trauma: Car accidents, sports injuries, or falls can fracture vertebrae, dislocate joints, or cause swelling that compresses nerves, leading to severe consequences. For example, a car crash can lead to whiplash, which may cause nerve damage in the neck (Solomon Law, n.d.).
Infections: Spinal infections, like abscesses, can press on the spinal cord or nerves, causing pain and neurological symptoms (MSD Manuals, n.d.).
Structural Abnormalities: Conditions like scoliosis (abnormal spine curvature) or tumors can compress nerves, leading to symptoms like pain or weakness (Johns Hopkins Medicine, n.d.).
Inflammatory or Autoimmune Conditions: Diseases like rheumatoid arthritis can cause inflammation that compresses nerves, contributing to symptoms (OrthoTOC, n.d.).
Each cause can lead to different symptoms and requires specific diagnostic and treatment approaches to address the root issue.
Diagnosing Nerve-Related Spine Conditions
Diagnosing nerve-related spine conditions starts with a doctor asking about your symptoms and medical history, followed by a physical exam to check for numbness, weakness, reflexes, and posture. Depending on the findings, additional tests may be needed to pinpoint the cause (Penn Medicine, n.d.). Common diagnostic tools include:
Imaging tests, such as X-rays, CT scans, or MRIs, can reveal the spine’s structure, including bones, discs, and nerves, to identify compression or damage (Spine Info, n.d.).
Nerve Conduction Studies (NCS) and Electromyography (EMG): These tests assess the function of nerves and muscles, and can help confirm nerve damage (Spine Info, n.d.).
Myelogram: A special X-ray or CT scan with contrast dye can highlight pressure on the spinal cord or nerves (Spine Info, n.d.).
Dr. Alexander Jimenez, a chiropractor and nurse practitioner in El Paso, Texas, uses a dual-scope approach to diagnosis, combining his expertise in chiropractic care and advanced nursing. His clinic utilizes advanced neuromusculoskeletal imaging techniques, such as MRIs and CT scans, to obtain a clear picture of the spine’s condition. Dr. Jimenez correlates patient injuries—whether from work, sports, car accidents, or personal incidents—with clinical findings to create a precise diagnosis. This approach ensures that the treatment plan targets the specific cause of the nerve issue, whether it’s a herniated disc, spinal stenosis, or trauma-related damage (Jimenez, n.d.).
Treatment Options for Nerve-Related Spine Conditions
Treatment for nerve-related spine conditions depends on the cause, severity, and symptoms. Most doctors start with conservative (non-surgical) treatments, moving to surgery only if needed. Here’s an overview of common treatments:
Non-Surgical Treatments
Medications: Over-the-counter pain relievers, such as ibuprofen, or prescription medications, like gabapentin, can help manage pain and inflammation (Spine Info, n.d.).
Physical Therapy: Targeted exercises can strengthen muscles, improve posture, and reduce pressure on nerves. Physical therapy is often effective for radiculopathy and spinal stenosis (Cleveland Clinic, n.d.).
Epidural Steroid Injections: These deliver anti-inflammatory medication directly to the affected nerve root, reducing pain and swelling (Penn Medicine, n.d.).
Chiropractic Care: Adjustments and manipulations can realign the spine, relieving pressure on nerves. Dr. Jimenez’s clinic utilizes chiropractic techniques to treat conditions such as sciatica and herniated discs, with a focus on restoring spinal alignment (Jimenez, n.d.).
Massage Therapy: This can relax tight muscles, improve blood flow, and reduce nerve irritation, especially for conditions caused by muscle tension or spasms (Inova, n.d.).
Acupuncture: By stimulating specific points, acupuncture can reduce pain and promote natural healing, often used alongside other treatments (Total Spine Ortho, n.d.).
Activity Modification: Avoiding activities that worsen symptoms, like heavy lifting, can help the spine heal (Penn Medicine, n.d.).
Surgical Treatments
If conservative treatments are not effective, surgery may be necessary. Common procedures include:
Laminectomy: Removes part of a vertebra to create more space for nerves, often used for spinal stenosis (Spine Info, n.d.).
Microdiscectomy: Removes part of a herniated disc that’s pressing on a nerve, commonly used for radiculopathy (Spine Info, n.d.).
Spinal Fusion: Fuses vertebrae together to stabilize the spine, used for severe degenerative conditions or trauma (Inova, n.d.).
Dr. Jimenez’s clinic takes an integrative approach, combining chiropractic care with targeted exercises, massage therapy, and acupuncture to treat nerve-related spine conditions. For example, a patient with sciatica resulting from a herniated disc may receive spinal adjustments to realign the spine, exercises to strengthen core muscles, and acupuncture to alleviate pain. This holistic approach addresses the root cause while promoting long-term healing and preventing future problems (Jimenez, n.d.).
Dr. Alexander Jimenez’s Integrative Approach in El Paso
Dr. Alexander Jimenez, a chiropractor and nurse practitioner in El Paso, Texas, has extensive experience treating nerve-related spine conditions caused by work, sports, personal, or motor vehicle accident injuries. His clinic uses a dual-scope approach, blending chiropractic expertise with advanced medical knowledge to provide comprehensive care. Here’s how his clinic handles these cases:
Treating Different Types of Injuries
Work Injuries: Repetitive motions or heavy lifting at work can lead to conditions like herniated discs or radiculopathy. Dr. Jimenez uses spinal adjustments, targeted exercises, and ergonomic advice to relieve nerve compression and prevent recurrence (Jimenez, n.d.).
Sports Injuries: Athletes may suffer nerve compression from trauma or overuse. The clinic employs chiropractic care, physical therapy, and massage to restore function and reduce pain, helping athletes return to their activities (Jimenez, n.d.).
Personal Injuries: Falls or other accidents can cause nerve damage. Dr. Jimenez’s team uses advanced imaging to assess the injury and creates personalized treatment plans, often including acupuncture and exercise (Jimenez, n.d.).
Motor Vehicle Accident (MVA) Injuries: Car crashes can cause whiplash or other trauma that compresses nerves. The clinic provides detailed diagnostic assessments, including MRIs, to identify nerve damage and offers treatments like spinal adjustments and massage to promote healing (Solomon Law, n.d.; Jimenez, n.d.).
Medical Care and Legal Documentation
Dr. Jimenez’s clinic is skilled in handling the medical and legal aspects of injury cases, especially for MVAs. They provide thorough documentation of injuries, diagnoses, and treatments, which is critical for insurance claims or legal cases. For example, if a patient has radiculopathy from a car accident, the clinic documents the injury’s impact on their daily life, the diagnostic findings (like MRI results), and the treatment plan. This detailed paperwork supports patients in legal proceedings while ensuring they receive proper medical care (Jimenez, n.d.).
Integrative Medicine for Healing and Prevention
Dr. Jimenez’s approach emphasizes integrative medicine, combining chiropractic care with other therapies to address the cause of nerve issues and enhance overall health. For instance:
Chiropractic Adjustments: Realign the spine to relieve nerve pressure, effective for conditions like sciatica or herniated discs.
Targeted Exercises: Strengthen muscles around the spine to improve stability and prevent future injuries.
Massage Therapy: Reduces muscle tension and improves circulation, aiding in nerve healing.
Acupuncture: Stimulates natural pain relief and promotes recovery, especially for chronic pain.
Lifestyle Changes: Advice on posture, ergonomics, and nutrition helps prevent long-term problems (Jimenez, n.d.).
This integrative approach not only treats the immediate symptoms but also focuses on long-term health, reducing the risk of chronic pain or recurring issues.
How Integrative Medicine Promotes Healing
Integrative medicine, as practiced by Dr. Jimenez, combines conventional medical treatments with complementary therapies to address the whole person, not just the symptoms. For nerve-related spine conditions, this approach offers several benefits:
Natural Healing: Chiropractic care and acupuncture stimulate the body’s natural healing processes, reducing reliance on medications (Total Spine Ortho, n.d.).
Pain Reduction: Therapies such as massage and acupuncture can help reduce pain levels, thereby improving quality of life (Inova, n.d.).
Improved Function: Exercises and adjustments restore mobility and strength, helping patients return to normal activities (Cleveland Clinic, n.d.).
Prevention: By addressing underlying causes, like poor posture or weak muscles, integrative medicine reduces the risk of future nerve problems (Jimenez, n.d.).
For example, a patient with spinal stenosis might receive adjustments to improve spinal alignment, exercises to strengthen their core, and massage to relax tight muscles. Over time, these treatments can reduce nerve compression, improve mobility, and prevent the condition from worsening.
Preventing Long-Term Problems
Preventing long-term nerve-related spine issues involves addressing the root causes and maintaining spinal health. Here are some strategies:
Maintain Good Posture: Proper posture reduces strain on the spine and nerves (Mayo Clinic Health System, n.d.).
Stay Active: Regular exercise, especially core-strengthening workouts, supports the spine and prevents injuries (Cleveland Clinic, n.d.).
Utilize ergonomics: Adjust workstations or lifting techniques to prevent repetitive strain (Jimenez, n.d.).
Manage Weight: Excess weight can put pressure on the spine, worsening nerve conditions (Health Central, n.d.).
Seek Early Treatment: Addressing symptoms early with chiropractic care or physical therapy can prevent conditions like radiculopathy from becoming chronic (Spine Info, n.d.).
Dr. Jimenez’s clinic emphasizes these preventive measures, educating patients on lifestyle changes to keep their spines healthy and reduce the risk of future nerve issues.
Conclusion
Nerve-related spine conditions, like radiculopathy, spinal stenosis, and herniated discs, can cause significant discomfort and disrupt daily life. These conditions stem from various causes, including degenerative changes, trauma, infections, or structural issues, and lead to symptoms like pain, numbness, tingling, and weakness. Through proper diagnosis using imaging and clinical assessments, doctors can pinpoint the cause and recommend treatments, ranging from medications and physical therapy to surgery in severe cases. Integrative approaches, like those used by Dr. Alexander Jimenez in El Paso, combine chiropractic care, targeted exercises, massage therapy, and acupuncture to treat injuries from work, sports, or accidents while promoting natural healing. By addressing the root cause and focusing on prevention, these methods can help patients recover and avoid long-term problems. If you’re experiencing symptoms of a nerve-related spine condition, consult a healthcare provider to explore your treatment options and start your journey to recovery.
Dr. Alex Jimenez: Pioneering Integrative Care as a Chiropractor and Nurse Practitioner
Dr. Alex Jimenez, a licensed chiropractor and board-certified nurse practitioner based in El Paso, Texas, brings over 25 years of expertise to his Injury Medical & Chiropractic Clinic practice. His dual licensure provides unique insights into the etiologies, pathogenesis, and treatment of complex clinical conditions, enabling him to deliver patient-centered, integrative care that bridges physical medicine, functional medicine, and advanced diagnostics. Combining chiropractic expertise with nurse practitioner-driven medical management, Dr. Jimenez offers comprehensive treatment protocols tailored to acute and chronic conditions, promoting metabolic resilience, longevity, and whole-person wellness.
Dual Expertise: Chiropractic and Nurse Practitioner Roles
Dr. Jimenez’s practice stands out due to his ability to integrate the biomechanical focus of chiropractic care with a nurse practitioner’s diagnostic and therapeutic scope. As a chiropractor, he specializes in restoring musculoskeletal function, particularly after trauma, neck, back, spine, and soft tissue injuries. His chiropractic interventions emphasize non-invasive techniques, such as spinal decompression, manual adjustments, and functional rehabilitation, to alleviate pain and enhance mobility.
As a board-certified nurse practitioner, Dr. Jimenez employs evidence-based medicine to address systemic and metabolic dysfunctions. His expertise extends to managing chronic degenerative disorders, hormonal imbalances, weight loss, sexual health, and pain syndromes. This dual perspective allows him to identify underlying disease causes, from biomechanical misalignments to physiological imbalances, and design treatment regimens that address symptoms and root causes.
The synergy of these roles enables Dr. Jimenez to offer a holistic approach that is particularly effective for complex conditions such as sciatica, fibromyalgia, disc herniation, spondylolisthesis, and chronic neck or back pain. His integrative protocols combine functional medicine assessments, lifestyle interventions, and advanced diagnostics to achieve homeostasis and physiological balance.
Treatment Protocols: Evidence-Based and Patient-Centered
Drawing from integrative protocols outlined on his website, www.chiromed.com, Dr. Jimenez employs a multidisciplinary approach to patient care. His treatment plans are grounded in evidence-based medicine, functional medicine, and lifestyle wellness strategies, tailored to each patient’s unique health profile, lifestyle, and medical history. Below are key components of his integrative care model:
1. Chiropractic Care and Functional Rehabilitation
Spinal Decompression: Non-surgical decompression therapy is used to relieve pressure on spinal discs, addressing conditions like disc herniation, sciatica, and spinal stenosis. This modality promotes healing by improving blood flow and nutrient delivery to affected areas.
Manual Adjustments: Targeted adjustments correct spinal misalignments, reduce nerve compression, and restore joint mobility. These are particularly effective for whiplash, scoliosis, and poor posture.
Functional Strength Training: Dr. Jimenez designs conditioning programs to enhance recovery and prevent re-injury. These programs are tailored for athletes and individuals seeking optimal performance and incorporate mobility, flexibility, and agility training.
2. Functional Medicine Assessments
Functional medicine tools evaluate metabolic, hormonal, and nutritional status. These assessments identify the root causes of conditions such as fatigue, weight gain, or chronic pain, enabling precise interventions.
Advanced diagnostic protocols, including blood panels and imaging, provide data-driven insights into etiologies and pathogenesis. This allows Dr. Jimenez to address underlying dysfunctions rather than merely masking symptoms.
3. Lifestyle and Nutritional Interventions
Weight Loss and Metabolic Resilience: Dr. Jimenez integrates nutritional counseling and metabolic optimization strategies to support sustainable weight loss and prevent chronic diseases like diabetes or cardiovascular disorders.
Hormone and Sexual Health: Personalized regimens address hormonal imbalances and sexual dysfunction, improving quality of life and overall wellness.
Pain Management: Nutritional and lifestyle modifications complement physical therapies to manage chronic pain syndromes, reducing reliance on pharmaceuticals.
4. Specialized Care for Complex Conditions
Sciatica and Disc Injuries: Dr. Jimenez employs targeted decompression and rehabilitation protocols to alleviate nerve compression and restore function.
Chronic Degenerative Disorders: Conditions like fibromyalgia, arthritis, and spondylolisthesis are managed through integrative plans that combine physical therapy, nutritional support, and metabolic optimization.
Sports and Auto Accident Injuries: Tailored rehabilitation programs address soft tissue damage, shoulder injuries, and whiplash, ensuring rapid recovery and long-term resilience.
5. Advanced Wellness Programs
Dr. Jimenez’s clinic offers comprehensive wellness programs on longevity, skin care, and hair loss. These programs integrate nutritional supplementation, lifestyle coaching, and cutting-edge therapies to promote vitality and aesthetic health.
High-level conditioning programs optimize performance for athletes, incorporating functional strength training and recovery-focused interventions.
Integrative Team and Clinic Highlights
Injury Medical & Chiropractic Clinic is El Paso’s largest mobility, flexibility, and agility center, integrating chiropractors, nurse practitioners, registered nurses, nutritionists, and physical performance trainers. The clinic’s multidisciplinary team collaborates to deliver personalized care, ensuring patients achieve measurable health outcomes. Key services include:
Acupuncture: A Complementary therapy to reduce pain and promote relaxation.
Advanced Nutritional Programs: Evidence-based dietary plans to support metabolic health and recovery.
Physical Performance Training: Programs to enhance fitness, prevent injuries, and optimize athletic performance.
The clinic accepts major insurances, including Aetna, Blue Cross Blue Shield, Cigna, and First Health, making care accessible to a broad patient base.
Insights from Dual Licensure
Dr. Jimenez’s licensure as both a chiropractor and nurse practitioner provides him with a comprehensive understanding of disease processes and treatment modalities. His chiropractic training equips him to address biomechanical dysfunctions, while his nurse practitioner expertise allows him to manage systemic conditions with a medical lens. This dual perspective enhances his ability to:
Clarify Etiologies: By combining musculoskeletal assessments with metabolic and hormonal evaluations, Dr. Jimenez identifies multifactorial causes of conditions, ensuring targeted interventions.
Understand Pathogenesis: His knowledge of disease progression informs proactive treatment plans that halt or reverse degenerative processes.
Design Appropriate Regimens: Integrating physical, nutritional, and medical therapies, Dr. Jimenez creates synergistic treatment plans that address both symptoms and underlying dysfunctions.
This integrative approach is particularly valuable for patients with chronic or multifactorial conditions, as it addresses the interplay between physical, metabolic, and lifestyle factors.
Patient-Centered Care: In-Person and Online
Dr. Jimenez’s practice emphasizes personalized attention, whether patients visit in person at 11860 Vista Del Sol, Suite 128, El Paso, TX 79936, or engage through telehealth. His functional medicine series, accessible via www.dralexjimenez.com, educates patients on holistic health principles, covering topics from spinal health to metabolic optimization. The website features:
Informative Content: Blog posts, articles, and videos provide insights into chiropractic care, functional medicine, and injury rehabilitation.
Patient Testimonials: Success stories highlight the transformative impact of Dr. Jimenez’s care, showcasing outcomes for conditions like sciatica, sports injuries, and chronic pain.
Appointment Booking: A user-friendly interface allows patients to schedule in-person or online consultations, with clear guidance on what to expect during their first visit.
Commitment to Education and Community Health
Dr. Jimenez is dedicated to empowering patients through education. His website is comprehensive, offering evidence-based information on health conditions, treatment options, and wellness strategies. By fostering health literacy, Dr. Jimenez enables patients to make informed decisions and take charge of their well-being.
His commitment extends to the El Paso community, where he aims to expand access to integrative care. Dr. Jimenez promotes proactive health management and preventive care through workshops, online content, and community outreach.
Conclusion
Dr. Alex Jimenez’s dual expertise as a chiropractor and nurse practitioner positions him as a leader in integrative medicine. His ability to bridge physical medicine with systemic health management allows him to address complex clinical issues with precision and compassion. Dr. Jimenez delivers personalized care that promotes healing, resilience, and longevity by leveraging evidence-based protocols, advanced diagnostics, and lifestyle interventions.
For more information or to schedule an appointment, visit www.dralexjimenez.com or contact the clinic at +1-915-412-6677.
Is applying ice the best option for individuals who experience an acute back strain injury?
Temperature Treatment
Ice temperature treatment, also known as cryotherapy or cold therapy, is a treatment that uses freezing temperatures to reduce pain and swelling. It can be applied in a variety of ways, including:
Ice packs:
Ice massage
Coolant sprays
Whirlpools
Ice baths
Ice is usually recommended for acute injuries and is a common and simple way to treat pain and swelling. Individuals can buy freezable gel packs or make their own with ice cubes in a plastic bag or towel. Heat therapy tends to be used more with chronic issues involving muscle spasms to increase blood circulation.
How Ice Relieves Pain and Reduces Inflammation
Ice temperature treatment works by:
Narrowing blood vessels slows blood circulation to the injured area and soft tissues and reduces swelling.
Reduced blood flow also helps control excessive swelling.
Ice has a short-term analgesic-numbing effect. The coldness numbs nerve endings, relieving pain symptoms.
Relieving the pain allows the muscles to relax.
Controlling blood circulation helps control pain by reducing the flow of irritating chemicals that can inundate the injury site. These chemicals are a natural and the correct response to inflammation, but the ice keeps them in check to help control pain.
After a Back Injury
For a back strain injury, ice and anti-inflammatory medication like NSAIDs are the first line of treatment during the inflammatory phase, which usually lasts 24 to 72 hours. Because heat can increase inflammation by increasing blood circulation, it is not recommended as an initial treatment. After the first few days, most doctors and pain specialists recommend using ice or heat, depending on the individual’s preference. While researchers continue to investigate the best ways to treat acute injuries, most doctors still recommend ice as the first line of defense for back injuries.
A review of studies evaluated 20 different treatment categories to learn about their safety and effectiveness. (McIntosh G. & Hall H. 2011) Treatments included over-the-counter pain medications, acupuncture, McKenzie exercises, other back exercises, and temperature treatments. Regarding temperature treatment, the review found moderate evidence that using a heat wrap 5 days after the injury could help relieve pain. However, there was not enough evidence to support the effectiveness of any of the temperature treatments, necessitating more research. (McIntosh G. & Hall H. 2011)
Physical Therapy and Activity
The review found that prolonged rest should be avoided, and gentle exercise and a progressive return to physical activity should be encouraged to achieve the best outcomes for pain relief and restoring function. Staying active significantly reduces time off from work and chronic disability for up to 1 year compared to traditional medical treatment. (McIntosh G. & Hall H. 2011) Research also found that introducing physical therapy early on could expedite recovery. Mobility work, targeted exercises, and strengthening exercises have been shown to relieve pain, reduce injury recurrence, and improve overall function. More research supports physical activity and exercise as effective treatment options for acute lower back strains. However, further research regarding temperature treatments is required. (French S. D. et al., 2006) (See Q. Y. et al., 2021)
Injury Medical Chiropractic and Functional Medicine Clinic
It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Beyond the Surface: Understanding the Effects of Personal Injury
References
McIntosh, G., & Hall, H. (2011). Low back pain (acute). BMJ clinical evidence, 2011, 1102.
French, S. D., Cameron, M., Walker, B. F., Reggars, J. W., & Esterman, A. J. (2006). A Cochrane review of superficial heat or cold for low back pain. Spine, 31(9), 998–1006. https://doi.org/10.1097/01.brs.0000214881.10814.64
See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. https://doi.org/10.11622/smedj.2021086
Back pain is one of the most common reasons for seeking health care. Individuals dealing with back pain but don’t know the cause may have some inflammatory joint disease or autoimmune condition. Can seeing a rheumatologist help?
Rheumatologist
Depending on what’s causing the back pain, individuals may need to see their primary doctor for a referral. Individuals are recommended to see a rheumatologist if they have back pain that doesn’t come from an injury that doesn’t go away after a few weeks, pain that comes back after treatment, or symptoms that suggest a rheumatic condition. Rheumatologists treat severe or persistent back pain and are experts in autoimmune diseases, including lupus, Sjogren’s syndrome, rheumatoid arthritis, ankylosing spondylitis, axial spondylitis, Psoriatic arthritis, and other forms of inflammatory or autoimmune arthritis.
What Do They Do?
A rheumatologist is an internist or pediatrician who has completed special training in treating conditions that are:
Inflammatory
Autoimmune
Related to painful joint disease
The doctors diagnose, treat, and manage these conditions long-term. Depending on diagnosis and care needs, they may also lead or be part of a team that includes other healthcare providers.
Symptoms
When muscles ache, pain presents, or joints hurt, and especially if there are signs of inflammation that don’t go away, seeing a healthcare provider is recommended. Symptoms of inflammation include:
Redness
Swelling
Pain
Stiffness
Loss of joint function
Usually, to see a rheumatologist, individuals need a referral from their primary care provider and may be referred when:
There is no evidence of a back injury.
At-home therapies like heat application, prescription medications, or physical therapy are unsuccessful.
There is uncertainty about what’s causing the back pain, but I suspect it’s rheumatological.
Blood tests for inflammatory markers or certain antibodies yield abnormal results.
There is a diagnosis of a rheumatic condition and recommend a specialist to manage it.
There is a family history of a rheumatic or autoimmune condition that may cause back pain.
Some types of arthritis can cause permanent, progressive joint damage.
Conditions
Conditions that can affect the spine and cause back pain and are treated by a rheumatologist include: (Johns Hopkins Medicine, 2024)
Rheumatoid arthritis (RA)
This often starts in smaller joints of the hands and feet and later moves to the neck and/or back.
It can also affect different body organs and have systemic symptoms.
Ankylosing Spondylitis (AS)
Primarily a disease of the spine, it may also impact the shoulders, hips, knees, and ankles.
Systemic symptoms, including fever and fatigue, can manifest.
Axial Spondylitis
This primarily affects the spine, chest, and pelvis.
It may also cause problems with the connective tissue, eyes, bowel, and skin.
Psoriatic Arthritis (PsA)
Pain in the lower back is common, especially in severe cases.
It can affect other joints and cause psoriasis.
Reactive Arthritis
This is a reaction to infection.
It is more common in the limbs, hands, and feet joints but can involve the spine.
Enteropathic Arthritis
This mainly affects the spine but can include other joints.
It is associated with inflammatory bowel disease.
Autoimmune diseases that don’t specifically target the spine but can also cause back pain include:
Lupus
Sjögren’s syndrome
Hashimoto’s thyroiditis
Finding a Doctor
Individuals may be fine with their primary healthcare provider’s choice regarding which rheumatologist to see. However, they may want to research other options to ensure the right rheumatologist is chosen. Things to look at include:
Search online medical directories.
Visit the websites of the doctors being considered to learn more about their training, approach, and specialties.
Check online reviews.
Check on health insurance coverage.
Ask members of the healthcare team, friends, and family for recommendations.
Contact rheumatologists’ offices to see if they are accepting new patients.
Once decided, pass along the information to the primary care doctor so they can make the referral.
Preparing For The Initial Visit
Before seeing a new rheumatologist, take a few minutes to prepare so you can make the most of the appointment. Individuals will want to have:
A list of back-related symptoms, including frequency and severity.
A list of what makes symptoms better or worse.
A copy of recent test results and records from other doctors.
Individuals can ask their provider/s to send their medical information to the rheumatologist’s office in advance.
A list of treatments that have been tried and how well they worked.
A list of all medications, over-the-counter and prescription, supplements, and herbal products taken.
A list of medication allergies.
Complete medical history and family history of potentially related diseases.
A list of any questions regarding conditions, treatment, etc.
If possible, fill out any paperwork for the new office beforehand to save time on the appointment day.
Injury Medical Chiropractic and Functional Medicine Clinic
Talking with a healthcare provider is important. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. Using an integrated approach to treating injuries and chronic pain syndromes to improve flexibility, mobility, and agility and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers.
Quick Patient Initiation Process
References
Hospital for Special Surgery. (2023). What Is a Rheumatologist and What Conditions Do They Treat? https://www.hss.edu/conditions_what-is-a-rheumatologist.asp#when
Yale University School of Medicine. Dee, J. E. (2021). 5 reasons why a patient should see a rheumatologist. https://medicine.yale.edu/news-article/5-reasons-to-see-a-rheumatologist/
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Autoimmune diseases. Retrieved from https://www.niams.nih.gov/health-topics/autoimmune-diseases
Johns Hopkins Medicine. (2024). Spinal arthritis (arthritis in the back or neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
Can incorporating electrical muscle stimulation help control pain, strengthen muscles, increase physical function, retrain lost movements, and/or manage inflammation for individuals experiencing neck and back pain?
Female doctor placing myostimulation physical therapy equipment on patient’s back
Electric Muscle Stimulation
Electrical muscle stimulation or E-stim is a physical therapy used to reactivate the muscles’ ability to contract. E-stim uses devices that transmit electrical impulses through the skin to target nerves and/or muscles. The most common forms include
Transcutaneous electric nerve stimulation, or TENS, is the most well-known type of electrical stimulation that offers devices that can be used at home or on the go.
Electrical muscle stimulation or EMS.
In physical therapy, E-stim stimulates muscles to contract, strengthening them and encouraging blood circulation.
Blood circulation can directly affect the condition of muscle tissue.
Electrical muscle stimulation is also used in spinal cord injury and other neuromuscular conditions. (Ho, C. H. et al., 2014)
E-stim
During treatment, electrodes are hooked to an electric stimulation machine and placed around the affected neck or back area.
The electrodes will be placed on the skin for most neck or back injuries.
The placement of the electrodes depends on the reason for treatment and the depth or superficiality of the electrical stimulation.
The electrodes are often placed near a motor point of a muscle to ensure the correct contraction.
The therapist will adjust the controls of the stimulation machine to achieve thorough muscle contraction with minimal discomfort.
Stimulation can last 5 – 15 minutes, depending on the treatment plan and injury severity.
Spinal Joint Stabilization
Activation of the muscles may help increase spinal joint stability, improving problems with spinal instability. (Ho, C. H. et al., 2014) Electric muscle stimulation is thought to enhance the exercise program a therapist prescribes to help maintain joint stability. Electrical stimulation may also help build muscle strength and endurance. (Veldman, M. P. et al., 2016) Muscle endurance is the repetitions a muscle can contract before it fatigues.
Healing and Pain Management
Electric muscle stimulation therapy can enhance tissue healing and help manage inflammation by reducing swelling and increasing circulation. It can reduce pain sensations by blocking nerve transmission at the spinal cord. (Johnson, M. I. et al., 2019) A healthcare professional may suggest a TENS or take-home electric stimulation unit to manage symptoms. (Johnson, M. I. et al., 2019)
Treatment
Interdisciplinary therapies tailored to an individual’s specific back or neck pain have been found to provide positive results. Exercise, yoga, short-term cognitive behavioral therapy, biofeedback, progressive relaxation, massage, manual therapy, and acupuncture are recommended for neck or back pain. (Chou, R. et al., 2018) Taking non-steroidal anti-inflammatory medications may also help. Electrical muscle stimulation could be an effective neck or back treatment.
Individuals unsure whether they need or would benefit from electrical should discuss symptoms and conditions with a primary physician, healthcare provider, or specialist to guide them in the right direction and determine the best treatment. Injury Medical Chiropractic and Functional Medicine Clinic focuses on what works for the patient and strives to better the body through researched methods and total wellness programs. Using an integrated approach, we treat injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs personalized to the individual to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective treatments.
Thoracic Spine Pain
References
Ho, C. H., Triolo, R. J., Elias, A. L., Kilgore, K. L., DiMarco, A. F., Bogie, K., Vette, A. H., Audu, M. L., Kobetic, R., Chang, S. R., Chan, K. M., Dukelow, S., Bourbeau, D. J., Brose, S. W., Gustafson, K. J., Kiss, Z. H., & Mushahwar, V. K. (2014). Functional electrical stimulation and spinal cord injury. Physical medicine and rehabilitation clinics of North America, 25(3), 631–ix. https://doi.org/10.1016/j.pmr.2014.05.001
Veldman, M. P., Gondin, J., Place, N., & Maffiuletti, N. A. (2016). Effects of Neuromuscular Electrical Stimulation Training on Endurance Performance. Frontiers in physiology, 7, 544. https://doi.org/10.3389/fphys.2016.00544
Johnson, M. I., Jones, G., Paley, C. A., & Wittkopf, P. G. (2019). The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs). BMJ open, 9(10), e029999. https://doi.org/10.1136/bmjopen-2019-029999
Chou, R., Côté, P., Randhawa, K., Torres, P., Yu, H., Nordin, M., Hurwitz, E. L., Haldeman, S., & Cedraschi, C. (2018). The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 27(Suppl 6), 851–860. https://doi.org/10.1007/s00586-017-5433-8
Back pain is a common issue experienced by people all over the world. The human body’s main structure is the back, divided into three sections: cervical, thoracic, and lumbar. These sections help in body movement, including twisting and turning, moving the extremities, and have a relationship with the gut and central nervous system. The surrounding muscles in the back also provide support and protect the spine. However, normal activities like bending down to pick up a heavy object, sitting down for an extended period, or falling can cause changes that lead to back pain, misalignment, and risk profiles in the upper and lower extremities. Today’s article focuses on the causes of back pain and the treatments available to relieve its effects. We utilize and incorporate valuable information about our patients to certified medical providers using non-surgical treatments to reduce the impact of back pain. We encourage and refer patients to associated medical providers based on their findings while supporting that education is a remarkable and fantastic way to ask our providers the essential questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., comprises this information as an educational service. Disclaimer
An Overview Of Back Pain
Do you have pain in your upper, middle, or lower back? Do you experience aches and pains in the morning? Did lifting something heavy cause you pain? These symptoms could be signs of back pain, a common and costly reason for emergency room visits. Research studies reveal that back pain can have various causes and affect the entire body, either mechanically or non-specifically. The three sections of the back – cervical, thoracic, and lumbar – can all be impacted, causing referred pain in different parts of the body. For instance, cervical (upper) back pain can cause stiffness in the neck, while thoracic (middle) back pain can lead to shoulder and posture issues. Lumbar (low) back pain, the most common type, can cause hip and sciatic problems. Additional research studies reveal that back pain is a complex issue that can severely affect body function, and environmental factors can also influence it.
Causes Of Back Pain
Various factors can be the cause of back pain, thus resulting in spine misalignment. In their book, “The Ultimate Spinal Decompression,” Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., explain that the back muscles play a significant role in protecting the spine. Environmental factors can also impact the spine, leading to potential back pain. The book further notes that wear and tear and disc protrusion on the spine can result in disc herniation and degeneration, also associated with back pain. Some common causes of back pain include:
Visceral-somatic/Somato-visceral pain (Affected organ or muscle causes referred pain to different body parts)
Pregnancy
Further research indicates that various environmental factors, such as physical activity, lifestyle, stress, and work conditions, are associated with back pain and can overlap as risk factors. If left untreated, these environmental factors can lead to chronic conditions and significantly impact a person’s quality of life.
Chiropractic Secrets Exposed- Video
Have you been feeling numbness or tingling in your arms or legs? Do you experience back muscle pain when you stretch? Or do you feel pain in your low back or other parts of your body? These issues are often associated with back pain and, if left untreated, can lead to disability and loss of function. Fortunately, there are many ways to reduce back pain and its associated symptoms and promote natural healing. The video above explains how non-surgical treatments like chiropractic care can help alleviate back pain through manual manipulation. This treatment can realign the spine, stretch out tight muscles, and restore the body’s range of motion.
Treatments For Back Pain
If you are experiencing back pain, various treatments can help ease your symptoms and improve your mobility. You have two options for treating back pain: surgical and non-surgical. Surgical treatment may be necessary if you are experiencing nerve compression or have sustained an injury that requires spinal fusion. Non-surgical treatments can help relieve pressure on your spine, reduce back pain, and even alleviate pain in other areas of your body. Some non-surgical treatments for back pain include:
Physical therapy
Exercise
Chiropractic care
Acupuncture
Spinal Decompression
According to research, non-surgical treatments can alleviate pressure on spinal discs, loosen tight muscles, improve joint mobility, and promote natural healing. Many people supplement these treatments with healthy lifestyle choices, making small adjustments to their routine and paying closer attention to their physical well-being.
Conclusion
Since back pain is a widespread problem affecting people globally, it can be caused by various environmental factors that impact the cervical, thoracic, and lumbar back sections, leading to overlapping risk profiles and affecting different body parts. Tight and strained muscles and a compressed spine are common symptoms of this issue. However, treatments available can effectively reduce pain, stretch tight muscles, and relieve pressure off the spinal disc. By incorporating these treatments, individuals can alleviate back pain and allow their bodies to heal naturally.
References
Allegri, Massimo, et al. “Mechanisms of Low Back Pain: A Guide for Diagnosis and Therapy.” F1000Research, 28 June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4926733/.
Casiano, Vincent E, et al. “Back Pain.” In: StatPearls [Internet]. Treasure Island (FL), 20 Feb. 2023, www.ncbi.nlm.nih.gov/books/NBK538173/.
Choi, Jioun, et al. “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, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339166/.
Kaplan, Eric, and Perry Bard. The Ultimate Spinal Decompression. JETLAUNCH, 2023.
See, Qin Yong, et al. “Acute Low Back Pain: Diagnosis and Management.” Singapore Medical Journal, June 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8801838/.
The various muscles and ligaments that encompass the back help protect the spine’s thoracic region. The spine has three sections: cervical, thoracic, and lumbar, which assist the body with bending, turning, and twisting. For the thoracic spine, various muscles like the rhomboid, trapezoid, and other superficial muscles provide functionality to the scapula or shoulder blades to stabilize the ribcage. When the body succumbs to injuries or traumatic forces, it can develop myofascial pain syndrome associated with upper back pain. Upper back pain can lead to unwanted symptoms affecting their quality of life. Fortunately, various exercises target the upper portion of the back and can strengthen multiple muscles from injuries. Today’s article looks at the effects of upper back pain in the body and shows a few stretches and exercises that can support the various muscle groups in the upper back region. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from upper back pain and its correlating symptoms that can affect the musculoskeletal system in the neck, shoulders, and thoracic region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Effects Of Upper Back Pain In The Body
Have you been experiencing stiffness around or near your shoulder blades? Do you feel muscle strain when you are rotating your shoulders? Or does it hurt when you stretch your upper back in the morning? Many of these issues are signs and symptoms of upper back pain. Studies reveal that back pain is one of the most common complaints many individuals would go for emergency care. Back pain can affect the different regions in the back and cause unwanted symptoms in various areas in the upper back. Additional studies mentioned that persistent pain in the thoracic region could cause hyper-sensitization of the intercoastal nerves that mimic other conditions affecting the back. Some of the causes and effects that can lead to the development of upper back pain include:
When this happens, it can lead to overlapping conditions that mimic other issues and, if not treated right away, leave individuals with chronic disabling symptoms that correlate with upper back pain.
Upper Back Pain Relief-Video
Have you been experiencing stiffness in your shoulders or neck? Do you feel aches and pains when stretching your arms? Or what about feeling muscle strain when lifting a heavy object? Many of these factors correlate with upper back pain affecting the thoracic spine region. When this happens, it can lead to overlapping risk profiles that can develop into different issues that can cause even more pain to the body. There are various ways to prevent upper back pain from causing further issues to the individual and can relieve the pain associated with it. Many people would go to chiropractic therapy to have their spine re-aligned to bring adequate relief or incorporate upper back exercises and stretches to relieve tension accumulated in the neck and shoulder regions. The video above explains how stretches work for different muscle regions in the upper back and provide relief to the thoracic spine.
Exercises For Upper Back Pain
Regarding the upper back, it is important to understand that incorporating various exercises that target the thoracic region can cause prolonged injuries. Studies reveal that different back exercises focus not only on the back but the shoulders, arms, chest, core, and hips providing stability, balance, and coordination to the individual. This allows the muscles in the back region to improve strength and endurance over time when a person continues to work out. More studies reveal that protocols like the McKenzie back exercise are effective programs to treat various musculoskeletal conditions that can cause pain in the back. Many physical therapists use this protocol on their patients to relieve back pain and help improve their muscular structure to have better posture.
Warm Up
Just like any individual that is starting to get back to their health and wellness through exercise, the most important step that anyone has to do is warming up their muscles before getting into a workout. Warming up each muscle group can prevent future injuries and increase blood flow before starting the exercise. Many individuals would incorporate stretches and foam rolling for 5-10 minutes to ensure that each muscle is ready to perform with maximum effort.
Exercises
After the body is warmed up, it is time to begin the exercise regime. Many different exercise movements target each muscle group and help build muscle mass and improve functionality. It is important to build up momentum when it comes to working out. Starting slowly with minimum reps and sets is important to ensure the exercise is done correctly. Afterward, the individual can increase the workout reps and go with a heavier weight. Below are some of the exercise routines that are suited for the upper back.
Superman
Lie on your stomach and extend your arms above the head
Keep neck in a neutral position and lift legs and arms off the floor at the same time
Make sure to use the back and glutes to lift
Briefly pause at the top, then return to starting position
Complete three sets of 10 reps
This exercise helps strengthen the spine and surrounding muscles to support the spine and reduce any future injuries from upper back pain.
Reverse Dumbbell Flies
Grab light weighted dumbbells
Hinge at the waist at 45 degrees while standing
Make sure the arms are hanging down with the weights
Keep the neck in a neutral position while gazing down
Lift the arms (with the dumbbells) out to the side and upwards
Squeeze the shoulders together at the top during this movement
Complete three sets of 8-12 reps
This exercise is excellent for strengthening the muscles that surround the shoulder and upper back.
Rows
Use a resistance band or a light weighted dumbbell.
For the resistance band, affix the band to a stable surface above eye level. For the light weighted dumbbells, extend the arms in front of the body above eye level.
Use an overhead grip when holding the resistance band handles and the light weighted dumbbells.
Pull resistance bands or dumbbells toward the face.
Flare out the upper arms to the sides
Squeeze the shoulders together
Pause for a bit and then return to starting position
Complete three sets of 12 reps
This exercise helps strengthen the shoulder muscles and prevent future injuries from occurring in the upper back.
Conclusion
Some various muscles and ligaments encompass the back and help protect the spine’s thoracic region. These muscles help with the stabilization of the ribcage and help provide the functionality to the upper back. When multiple factors cause traumatic injuries to the upper back, it can lead to pain-like symptoms that can cause overlapping features and affect a person’s quality of life. Luckily, various exercises target the upper back and surrounding muscle groups. Each activity targets all the muscles in the upper back and allows a person to regain health and wellness without constant pain.
References
Atalay, Erdem, et al. “Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study.” Journal of Sports Science & Medicine, U.S. National Library of Medicine, 1 Dec. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721192/.
Casiano, Vincent E, et al. “Back Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Sept. 2022, https://www.ncbi.nlm.nih.gov/books/NBK538173/.
Louw, Adriaan, and Stephen G Schmidt. “Chronic Pain and the Thoracic Spine.” The Journal of Manual & Manipulative Therapy, U.S. National Library of Medicine, July 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534852/.
Mann, Steven J, et al. “McKenzie Back Exercises – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK539720/.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
