Back Clinic Injury Care Chiropractic and Physical Therapy Team. There are two approaches to injury care. They are active and passive treatment. While both can help get patients on the road toward recovery, only active treatment has a long-term impact and keeps patients moving.
We focus on treating injuries sustained in auto accidents, personal injuries, work injuries, and sports injuries and provide complete interventional pain management services and therapeutic programs. Everything from bumps and bruises to torn ligaments and back pain.
Passive Injury Care
A doctor or a physical therapist usually gives passive injury care. It includes:
Acupuncture
Applying heat/ice to sore muscles
Pain medication
It’s a good starting point to help reduce pain, but passive injury care isn’t the most effective treatment. While it helps an injured person feel better in the moment, the relief doesn’t last. A patient won’t fully recover from injury unless they actively work to return to their normal life.
Active Injury Care
Active treatment also provided by a physician or physical therapist relies on the injured person’s commitment to work. When patients take ownership of their health, the active injury care process becomes more meaningful and productive. A modified activity plan will help an injured person transition to full function and improve their overall physical and emotional wellness.
Spine, neck, and back
Headaches
Knees, shoulders, and wrists
Torn ligaments
Soft tissue injuries (muscle strains and sprains)
What does active injury care involve?
An active treatment plan keeps the body as strong and flexible as possible through a personalized work/transitional plan, which limits long-term impact and helps injured patients work toward a faster recovery. For example, in injury Medical & Chiropractic clinic’s injury care, a clinician will work with the patient to understand the cause of injury, then create a rehabilitation plan that keeps the patient active and brings them back to proper health in no time.
For answers to any questions, you may have, please call Dr. Jimenez at 915-850-0900
Spinal vertebral compression fractures are a common injury in older individuals brought on from a lowered bone density. Hip and wrist fractures get most of the attention when it comes to osteoporosis. However, spinal fractures happen almost twice as often and affect around 700,000 individuals yearly. This is according to the American Academy of Orthopaedic Surgeons or the AAOS. These types of fractures are also known as:
Fragility fractures
Vertebral compression fractures
Osteoporotic compression fractures. These usually happen as a result of thinning and weakening bones caused by osteoporosis.
The Academy of Orthopedic Surgeons notes that changes in the body’s musculoskeletal bone structure can go unnoticed for years. This leads to the vertebrae narrowing and flattening, rounding the spine as a result, creating compression. Because of the weakened bone, the pressure, even from everyday low-impact movements like reaching, bending or twisting. There are strategies that can help prevent osteoporosis and osteoporotic compression fractures.
More Movement and Physical Activity
One prevention strategy that is highly recommended is more movement and physical activity. This does not include occasional gentle movements like taking a break from sitting. Improving the spine’s health means using the full range of motion and loading the bones so they can get build strength. This could be walking more, which creates spinal resistance. Also using light weights with high repetitions with five to ten pounds of a load is enough to challenge the spine without generating muscle stress.
Individuals think they need to rest more as they get older, but to build and maintain bone density to prevent osteoporotic compression fractures more physical activity is needed. Moving around for 10 to 15 minutes every hour is a good way to start. Incorporating more activity, and focusing on healthy diet changes will help shed excess weight. This will decrease pressure on the spine, reducing the risk of fractures. For individuals with osteoporosis of the spine, it is important to review any exercise plans with a physician or doctor of chiropractic to ensure that they are safe. The wrong types of movement or too much stress on a fragile spine can definitely cause a fracture.
Medications and Other Conditions
There are medications that can help build bone density, but there are also medications for conditions that can actually cause faster bone density loss. Individuals could be taking a medication that’s good for one issue/condition, but not realize it may be associated with a reduction in bone density. This is why it is important to review prescriptions with a doctor with bone density loss side effects in mind. Medications that can cause bone loss include:
Anti-seizure drugs like carbamazepine and phenytoin
Diuretics like furosemide
Also, review any underlying conditions that could affect osteoporosis. As an example, the National Institutes of Health or NIH note that individuals with diabetes, specifically type 1, can have poor bone quality increasing their risk of fractures.
Adding Calcium To The Diet
An adequate intake of calcium is essential for osteoporosis prevention and helps lower the risk of fragility fractures. A low calcium intake contributes significantly to lower bone density and faster bone loss with age. Vitamin D also helps in bone injury prevention.
Treatment
Compression fracture/s diagnosis are confirmed through imaging tests like:
X-rays
Magnetic resonance imaging MRI scan
Bone scan
Computed tomography CT scan
Bone density testing with dual-energy x-ray absorptiometry DEXA will determine bone mineral density. If a scan reveals there is a vertebral compression fracture, the most common approach is no treatment. According to the Academy of Orthopedic Surgeons, most individuals with this type of injury improve within three months with a combined rest period and limited pain medication use.
Some individuals are recommended to wear braces to restrict movement so the fracture can heal without any added compression or stress. For those that do not respond to non-surgical treatment, minimally invasive surgery could become an option. In both cases, a doctor will suggest similar aforementioned strategies to help strengthen the bones and prevent worsening or creating new issues.
More flab on the middle that gets harder to burn off
Performance at work, the gym, or on the road slows down or begins to reverse
Workouts, sporting events, physical activity that the body was able to bounce back from quite easily now take twice as long to recover from
Things start to change when the body enters its 30’s. Whether light exercise, playing weekend games, local sports, etc, the key is to just stay active. By paying close attention to nutrition and making minor adjustments, individuals can maintain and improve body composition, stay strong and healthy in their 30s and be ready for the future.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, 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 musculoskeletal system’s injuries or disorders. 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 or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
The shoulder joint consists of different muscles for moving, protection, and a wide range of motion. When one or more of these muscles is pulled or strained, it can affect the smallest movements. A pulled shoulder muscle can make simple activities difficult, painful, and impossible. Minor shoulder injuries can heal on their own with home remedies. A serious shoulder muscle injury should be addressed by a medical professional. The shoulder is a ball-and-socket joint. Pulling a muscle in the shoulder can be caused by:
Injury
Overuse
General wear and tear
Pulled Shoulder Muscle Causes
Pulling a shoulder muscle can happen quickly, like falling on the shoulder or from a car accident. It can also develop from months or years of working a job where individuals perform repetitive motions with the shoulders and overuse the muscles to the point of strain. No matter the cause, rehabilitation and recovery depend on the type and severity of the injury.
Common Shoulder Muscle Injuries
Several muscles and tendons surround the shoulder joint, and because the shoulder can move so freely, it is a common area for a pull or strain. Different shoulder muscle injuries fall under being pulled or strained.
Rotator Cuff Tear
Shoulder Tear
Shoulder Sprain
Shoulder Strain
Pulled Muscle in the shoulder blade
A Pulled Muscle or Something Else
Unless an individual is a medical professional or has experienced this type of pain before, it can be hard to tell exactly its cause. Shoulder pain can have other or combined causes like inflammation of the tendons and joints, or the joint itself could be causing the injury. Here are a few ways to investigate what is causing shoulder pain.
Pulled Shoulder Muscle Symptoms
Pain in the shoulder blade area is characterized by dull, sore, or aching pain.
Sometimes shooting pain in the area between the shoulder blades will present, causing pain in the front or back of the shoulder.
Shoulder instability of the muscles or tendons.
The shoulder feels fragile.
Movement causes pain
A bump can develop at the top of the shoulder near the end of the collarbone.
General symptoms include:
Pain when the shoulder is at rest
Pain when the specific muscle is used
Tenderness
Possible swelling of the area
Inability to use the muscle at all
The Seriousness of a Pulled Shoulder Muscle
The majority of the time, a pulled shoulder muscle is not serious. If the pain is not severe and is not the result of an accident, it is okay to utilize home remedies to reduce pain and help the shoulder heal. However, some symptoms could indicate a serious injury or medical problem. If you experience shoulder pain and any of the following, seek immediate medical attention.
Severe and intense pain
Severe, abrupt pain that has no obvious cause
Shortness of breath
Chest numbness or pain
Seeing clearly
Difficulty speaking
Sudden swelling, pain, or redness
Individuals who experience shoulder pain that does not get better over time seek professional help, even if the pain is mild. A professional will develop the right treatment plan, reduce pain, and generate a healthy recovery, getting the individual back to normal and optimal health.
Treatment and Recovery Options
Treatment and recovery plans are different for everyone. This is because it depends on the severity of the pull and the individual’s overall health. Many find that the pain is reduced with home remedies in two or three weeks. Chiropractic treatment for a pulled shoulder muscle can provide relief within one or two weeks.
Home Remedies for Pulled Shoulder Muscles
Depending on the severity and how much pain is presenting, NSAIDs like Ibuprofen can help reduce pain and swelling. Individuals can also incorporate the following:
Rest
The shoulder should rest for 2 or 3 days. This gets the healing process started and prevents further injuring the area.
Wrap or Sling
During the days of rest, keeping the shoulder from moving can be difficult. To avoid this, wrap the shoulder or utilize a sling to support the arm. Remember that these should not be used for more than 2 or 3 days.
Ice for Swelling
If there is swelling, applying ice to the area can help reduce the inflammation. Apply for 20 minutes every hour. The swelling should begin reducing in a day or two.
Gentle Stretching
Working out the muscles after 2 or 3 days of rest is important. Stretches will help the muscle group strengthen and heal. Not stretching the muscles and not using them for an extended time could worsen the injury and increase further injury.
Stretching the Shoulder
As aforementioned, not moving/stretching can cause more problems in the long run. Not using the muscle can cause it toatrophy, which means that it will take longer to heal with the surrounding muscles weakening. Gentle stretches for a pulled shoulder muscle include:
Cross-Body Shoulder Stretch
Bring the affected arm across the body at an angle
Cup the elbow of the affected arm with the other hand
Use that hand to pull the arm toward the body gently
Bend slightly forward, support the body by placing the non-injured arm on a table or chair
Allow the injured arm to hang straight down.
Start swinging the arm in small circles clockwise that gradually grow wider
Do for 1 minute, then switch counterclockwise for another minute
Repeat 4 to 8 times throughout the day
Chiropractic
If home remedies are not enough, then chiropractic can help. Chiropractors use a variety of treatment modalities for pulled shoulder muscles. These include:
Chiropractic adjustments
Electrical stimulation
Manual stretching
Ultrasound
Cold laser therapy to reduce pain and swelling
Health coaching
Posture exercises
Physical rehabilitative therapy
If the pain is persistent, it could indicate more than a pulled muscle is causing the pain. This could be a pinched nerve or a joint issue. A doctor of chiropractic can develop the best recovery option to get to the root cause.
Body Composition
Women and muscle distribution
Research reveals that women could have a higher distribution of type 1 muscle fibers and lower distribution of type 2 muscle fibers which are more prevalent in men. Type 1 muscle fibers are slow-twitch muscles and are extremely useful in long-endurance activities like long-distance running. Type 1 muscle fibers are also the first ones that activate during any exercise. Type 2 are the fast-twitch muscle fibers and get activated when performing powerful or explosive bursts of movements like sprinting.
Because of these muscle-fiber differences, men are likely to excel in training that involves explosive, powerful routines. However, a study found that women can gain more muscle mass using a total body strength training program than men. For optimal results, mix up the workout with a variety of resistance and strength training routines. This will allow for greater muscle mass growth.
References
Kim, Jun-hee et al. Comparison of the Shoulder External Rotator Strength and Asymmetry Ratio Between Workers With and Without Shoulder Impingement Syndrome. Journal of strength and conditioning research, 10.1519/JSC.0000000000003343. 17 Sep. 2019, doi:10.1519/JSC.0000000000003343
Verniba, Dmitry, and William H Gage. Stepping threshold with platform-translation and shoulder-pull postural perturbation methods.Journal of biomechanics vol. 94 (2019): 224-229. doi:10.1016/j.jbiomech.2019.07.027
The body’s muscles function to produce force and motion. The trapezius muscle is one of the largest, which makes it highly susceptible to injury/s and spasms. A trapezius muscle spasm is when the muscle starts to contract. This muscle group is based around the neck and shoulders and is used to move the scapula shoulder bone.
Causes of Trapezius Muscle Spasms
A few causes for this muscle to become inflamed/irritated include:
Poor posture
Injury
Stress
Tension
Improper lifting
Symptoms
The effects feel similar to a pulled shoulder muscle. Common symptoms include:
Upper body stiffness
Shoulder pain
Neck pain
Arm numbness/tingling
Lack of shoulder flexibility
Spasm and Pinched Nerve Difference
A muscle spasm and pinched nerve might seem or feel similar, but they are different. A muscle spasm makes the area tight and can cause muscle twitching. They vary in intensity with some spasms being mild and others excruciating. In some cases, a spasm can cause a nerve to get pinched if the knot contorts tightly around a nerve and if it is big enough. Conversely, a pinched nerve can also cause twitching, but it typically results in severe pain. Pinched nerves can also cause tingling sensations and numbness depending on the severity it could cause muscle spasms.
Treating The Spasms
There are a few ways to treat this naturally.
Heat and Ice Therapy
One way to calm a muscle spasm is using heat and ice. The heat will increase nerve and blood circulation keeping the muscles flexible, and the warmth will soothe the injury. This helps prevent the muscles from spazzing and generating pain. Ice therapy also increases blood circulation but the focus is on reducing inflammation. The nerves become slightly frozen which stops the tingling, significantly reducing the pain.
If pain presents around the trapezius, immediately put an ice pack on.It should be applied every few hours in 15-minute sessions. Once the pain subsides, heat therapy can be applied. A heating pad placed around the area, a warm/hot bath, or standing in the shower if possible with a massage setting letting the warm/hot water hit the muscle. But it must be consistent, doing it for about 20-minute sessions three times a day.
Stretches and Exercises
Stretches and exercises can help keep the muscle flexible and prevent any tightening.
Upper Trapezius Stretch
This stretch will move the upper trapezius area, promoting flexibility and preventing the muscle from becoming stiff.
Sit in a chair with proper posture
Holding onto the chair with the left hand, wrap the right arm over the top of the head so that the hand touches the left ear.
Gently pull the head toward the right and hold.
Slowly move the head back and repeat with the other hand.
Shoulder Shrugs
Moving the shoulders up and down throughout the day stretches the trapezius.
It releases tension and strengthens the muscle to protect it.
This exercise should be done every few hours for about a minute or two.
Also occasionally rolling the shoulders will help stretch the smaller components of the trapezius.
Cobra Pose
This yoga pose is for relieving tension.
It can be very helpful for those suffering from severe spasms or from a pinched nerve.
The first thing is to lie face-down on the floor.
Keeping the feet straight behind, use the hands to gently push the upper body up so that the spine slightly curves.
Make sure that the hands are situated in front of the body and firm on the ground.
Hold for a few seconds and then release.
Repeat the process three more times.
Therapeutic Massage
The soothing motions from a massage will calm irritated areas and encourage them to heal quicker.
At first, because of the tenderness around the area, a massage could present with pain.
The massage therapist needs to press on the area to increase blood circulation so that toxins get flushed out.
While it might hurt the individual soon notices that the swelling and pain are reducing.
Chiropractors specialize in the musculoskeletal system and understand how the muscles, bones, and joints all work together. For muscle spasms, they investigate the problem and look at other areas of the body that could be contributing to or worsening the condition. For some, muscle spasms could be brought on by a misplaced joint pressing on the area. A chiropractor will palpate the areas to ensure this is not the case. And if there is a problem, they will perform a joint manipulation. This realigns the joint back in place and reduces muscle spasm symptoms. Over time the muscles become healthier because chiropractic releases toxins and improves the range of motion.
Body Composition
Anti-Inflammatory Diet
Often, muscle spasms are the result of inflammation. When a muscle swells, it can place pressure on surrounding nerves. The more intense the inflammation the more pressure/stress on the nerves. This can make moving and functioning very difficult because of the pain. To naturally reduce inflammation consider an anti-inflammatory diet. This type of diet is filled with antioxidants, vitamins, and minerals that will work to reduce swelling. Although it might not completely repair the muscle injury, it can reduce symptoms and stop oxidative stress. Foods to eat more of are:
Cherries
Tomatoes
Almonds
Blueberries
Oranges
Salmon
Kale
Turmeric
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*
When individuals stop working on their back pain therapy, the pain can come back. Don’t give up on the process and trust the therapists/providers. Many people experience their first episode of low back pain between the ages of 20 and 40. Often they are not sure what caused their back problems. There are a variety of factors that could be contributors like:
Old running shoes
A heavy box that was inappropriately lifted and carried
Exercise strain
Too much sitting
Poor posture
Work injury
Personal injury
Sports injury
After some time with the pain, a visit to the doctor is in order, hoping for clear answers and strong medicine. A diagnosis of non-specific back pain and a prescription for physical therapy is given. This is because doctors are now required to prescribe non-medication, non-invasive therapeutic approaches for any type of pain first. After three to four weeks of physical therapy, and there is still no improvement or signs of improvement will a doctor recommend medication/s and/or surgery.
Physical Therapy
Nonspecific back pain describes back pain that is not associated with a clear cause like:
Osteoporosis
Inflammatory arthritis
Tumor
Fracture
Infection
Structural deformity
Non-specific back pain is very common and often acute, meaning the symptoms usually go away on their own within a month. Physical therapy also known as PT can help expedite the healing process. Physical therapy can improve a variety of back-related problems, including those caused by disease and structural abnormalities. A study found that physical therapy works as well as surgery for lumbar spinal stenosis or the narrowing of the spinal canal in the low back.
Don’t Give Up On The Program
Unfortunately, many individuals do not follow through with the full course of physical therapy. Reasons include:
Time
Cost
Inconvenience
Low level of physical activity before treatment
Depression
Anxiety
Poor social support
Increased pain during exercise
The problem with stopping physical therapy is that individuals can end up right where they began. Not following a treatment plan can have negative effects on outcomes and healthcare costs. Progress depends on how much follow-through an individual does on their own. Don’t give up on the program and maintain rehabilitative progress.
Scientifically Backed Benefits
Scientific proof means measuring results objectively to determine if a treatment works. Physical therapy has consistently proven to be highly effective. Researchers found that physical therapy led to positive health benefits when treating back pain. Specifically, individuals that followed a physical therapy program to the end had:
For example, spine stabilization exercises during an episode of low back pain can decrease pain, disability, and the risk of another episode.
The Right Physical Therapy Clinic
Do research to find the best therapeutic clinic or professional. It is perfectly understandable to be picky about physical therapy. Several studies have shown that a healthy relationship between patients and physical therapists improves outcomes. When choosing a clinic, individuals should be aware that there are different models. The differences can influence the experience.
Some therapists treat more than one person at a time. This means the exercises will be shown how to do them properly, then the individual will be expected to continue on their own with the therapist returning to see the progress and start the next exercise.
Some therapists see the patient once, then an assistant takes over. Assistants will help with the exercise programs.
There are some clinics that could be out of network or do not accept insurance. Individuals can pay more, but the benefit is more one-on-one time/care with a physical therapist.
If an individual does not like the experience with one model, try another.
Remember that individuals need to advocate for their own health, treatment, and progress.
If an individual is not improving, then they need to have a discussion with the physical therapist.
The therapist can then problem solve and try a new treatment or refer the patient for additional care like imaging, medications, or a different intervention altogether. Don’t give up, relief from back pain is possible.
Don’t Give Up On Body Health
Body composition analysis an effective tool during physical therapy
Body composition is essential for understanding physiological makeup and to help guide a treatment plan to target specific areas in physical therapy programs. InBody analysis is non-invasive and convenient, making it ideal when used in conjunction with physical therapy rehabilitation programs. The InBody test provides results that can be used to educate and engage individuals to help track improvements throughout the physical therapy course. In less than 60 seconds, the test results are easy-to-understand, accurate, and objective. This helps to evaluate and monitor progress during rehabilitation. With the test a physical therapist can:
Assess muscle distribution
Focus on areas weakened by injury or surgery
Identify fluid imbalances related to inflammation
Monitor changes to determine the efficacy of the therapy program
Guide recommendations for long-term success
Don’t give up!
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*
References
PLOS One.�(Jun 2016) �The Influence of Physical Therapy Guideline Adherence on Healthcare Utilization and Costs among Patients with Low Back Pain: A Systematic Review of the Literature.��pubmed.ncbi.nlm.nih.gov/27285608/Pain and Therapy.�(Jan 2020) �Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.��link.springer.com/article/10.1007/s40122-020-00149-5Spine.�(Apr 2012) �Management Patterns in Acute Low Back Pain: the Role of Physical Therapy.��www.ncbi.nlm.nih.gov/pmc/articles/PMC3062937/
Spinal decompression surgery could be a treatment option discussion with a doctor to relieve nerve pain brought on by a spinal condition or disorder. Everything to know about the procedures straight from the experts.
Spinal Decompression Surgery Types: Laminectomy or Laminotomy
Both procedures involve the vertebrae�s lamina, which is an arch of bone that protects the spinal canal.
In a laminectomy, the lamina is removed almost entirely.
In a laminotomy, it is a partial removal.
Despite the removal, the large muscles of the back provide sustained protection for the nerves below. Therefore, the spinal nerves are still safe and secure following the procedures. Which one is right depends on the situation.
A laminectomy is usually performed to treat an arthritic condition of the spinal canal like spinal stenosis.
Laminotomy is used almost exclusively to remove a herniated disc.
A laminectomy removes more bone and sometimes the inner edge of the facet joint.
Ultimately, a surgeon will determine which of the two procedures is best for the individual’s needs and condition.
Decompression Surgery
Spinal stenosis or the narrowing of the spinal canal is usually caused by arthritis and overgrowth of the discs and joints. Similar compression issues respond well to non-surgical treatment. But sometimes surgery is necessary to treat uncommon but potentially severe cases. These include patients with:
Bowel or bladder problems caused by the pressure on the spinal nerves
Leg weakness that gets worse
Inability to walk or move for long periods and distance
The objective of spinal decompression surgery is to create space around the spinal cord and surrounding nerves by removing the compressing structure/s. When the cord and/or nerve/s are compressed, physical and neurological symptoms are experienced down the nerve�s pathway. This includes:
Tingling
Numbness
Electric shock sensations
Radiating/spreading pain
Weakness
Once the compressed nerves have space to relax and move around symptoms subside.
Laminectomy process
Lumbar laminectomy is the most common procedure to treat spinal stenosis in the low back.
It also helps treat herniated discs by allowing the surgeon to easily access the discs to repair any damage.
The surgeon removes the lamina and ligaments that have thickened and are causing problems to create more space in the canal.
The surgery enlarges the spinal canal so that pressure is relieved.
By removing the source of the pressure, the pain caused by the compressed nerves is alleviated.
An open laminectomy creates an incision of a couple of inches and exposes the spine.
The muscles of the spine and back are cut through to expose the bone.
Another technique that surgeons utilize is operating through a tube.
They’ve adapted these techniques to be able to decompress both the right and the left sides although they are only operating on one side.
Both procedures, minimal and traditional accomplish the same goals.
The difference is the minimally invasive approach involves one or more tiny incisions also known as skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them.
The traditional approach requires a larger incision and instruments that retract, separate and cut tissues.
Laminectomy surgery
Laminectomies are performed under general anesthesia using a posterior approach/lying face down during the procedure.
It can be open or minimally invasive sometimes called a microlaminectomy.
In an open laminectomy, the surgeon makes an incision near the affected spinal area.
Once the incision is made, a retractor will move the skin, fat, and muscles to the side so the surgeon can access the spine.
Next, they remove or trim the lamina and thickened ligaments to enlarge the space surrounding the compressed nerves.
Once done, the retractor is removed and the incision is closed with sutures.
Minimally invasive surgery or MIS is performed using special instruments like endoscopes and tubular retractors.
These instruments allow for smaller incisions and less cutting.
They will also use special eyewear to have a detailed view of the surgical field.
Sometimes, the surgeon uses an endoscope or a microscope focused down the tube to perform the surgery.
The portion of the lamina is removed, along with any bone overgrowths/osteophytes and ligament tissue.
The tubular retractors are taken out so the soft tissue moves back into place, and the incision is closed with dissolving sutures.
Other spinal procedures performed alongside
Laminectomies and laminotomies are typically not performed together. However, a surgeon could perform both if the surgery affects multiple levels of the spine. They can also be combined with other spinal surgeries, that include:
Foraminotomy
A foraminotomy is also a decompression procedure. But instead of removing part or all the lamina, the surgeon accesses the nerves through the spine�s foramen or the passageway that nerves pass through on both sides.
Discectomy
This decompression surgery involves the removal of all or part of the damaged intervertebral disc and is utilized for herniated discs.
Spinal fusion
Fusion is often performed after spinal decompression surgery, as the space that was created by removing spinal structure/s can cause instability to the spine.
Candidates for spinal decompression surgery
Both are common procedures performed by neurosurgeons and orthopedic spine surgeons. Laminectomies are considered one of the most effective treatments for spinal stenosis and spinal canal issues like:
Tumors
Certain types of infections and abscesses
Spinal issues involving bowel/bladder dysfunction
The primary reason for laminectomy is spinal stenosis, most common in individuals over the age of 60.
Other considerations and conditions include:
Non-invasive treatments that don’t improve the condition that includes medication, massage, and physical therapy
Ask questions about the procedure to ensure you are comfortable with the operation. Here are some questions:
What are the risks associated?
Will the surgery relieve all symptoms?
Not having the surgery risks?
What is recovery like?
Recovery
Open or micro, recovery does take time. Following the doctor�s instructions carefully are essential to make a full, healthy recovery.
Individuals should be careful for about a month following the surgery. But does not mean laying down or being sedentary. Movement is crucial to recovery.
The patient should not stay in bed or lie on the sofa.
Wait a week or two before beginning physical therapy if necessary.
Most will have a weak core, poor posture, and poor body mechanics, the goal is to help develop and strengthen these areas.
Things to help with recovery include:
Ice/cold packs will help reduce swelling and pain.
Try not to sit for too long, as sitting is the least comfortable position after back surgery.
Body mechanic awareness means avoiding too much bending or lifting and using the right body mechanics when bending or lifting.
Especially before surgery. Quitting entirely or at least for at least six weeks before surgery will make recovery easier and healthier.
Losing weight
Speak with a doctor about weight. Just 5 pounds can make a significant difference during recovery.
Blood sugar
For individuals with diabetes, having an A1C under eight before surgery is ideal.
Every patient�s recovery is different. Recovery time depends on:
The complexity of the surgery
Personal medical history
Health issues
Recovery typically takes about two to four weeks after the surgery. However, it depends on the reason/s for the surgery.
Questions
Post-laminectomy syndrome
Post-laminectomy syndrome PLS also known as failed back surgery syndrome is a condition where an individual continues to have pain after surgery. Individuals still having symptoms after should speak with their doctor to determine the next phase of treatment.
How long before exercise?
Returning to the gym or getting into an exercise routine will take some time. It is important to follow the doctor�s recommendations and complete the full course of physical therapy before regular exercise activity can resume. Discuss workout plans with the doctor to determine the best timeline for the spine.
Full recovery?
Returning to some activity is possible around four weeks after surgery. Full recovery takes longer as each patient�s recovery is unique. Depending on the complexity of the surgery, most return to all activities within 6 to 9 months.
Body Composition Spotlight
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*
The shoulder is subject to different irritations, injuries, and conditions. Shoulder impingement is a common ailment but is often confused with other shoulder problems. Properly treating impingement syndrome needs proper diagnosis first. Most shoulder impingement cases do not require surgery. Conservative treatment like chiropractic focuses on pain reduction while increasing the range of motion. This is achieved with manual manipulation, soft tissue therapy, cold laser therapy, and spinal adjustments for shoulder posture realignment.
Shoulder Impingement Symptoms
Shoulder impingement often gets confused with a pinched nerve or a rotator cuff tear. The symptoms can be similar, but the treatment options differ. This is why it�s important to know the specific shoulder issue presenting. This can be done by recognizing the symptoms and performing a shoulder impingement self-exam. Symptoms include:
Pain when lifting the arm straight out.
Pain when lifting the arm overhead.
Pain along the outside of the shoulder, the front, back, or side.
Dull throbbing pain.
Trouble sleeping specifically individuals that sleep with their arm over their head.
Shoulder Impingement Self Exams
There are self-exams at home to help determine if it is in fact shoulder impingement. These exams are just to get a better idea, but a professional chiropractic diagnosis is recommended.
Exam 1
Take the hand of the affected arm and place it on the opposite shoulder, creating a V shape at the elbow.
Keeping the hand on the opposite shoulder, raise the elbow straight out in front bringing it up toward the face.
If pain presents in the shoulder while moving the elbow up, then shoulder impingement could be a possibility.
Exam 2
Stand up with hands down at the sides.
Turn the hand of the affected shoulder inward, so the thumb faces back instead of forward.
Keep the thumb pointing backward, raise the arm straight up in front and over the head.
Note if there is any discomfort or pain.
Bring the hand back down to the side.
Next, turn the hand so that the palm is facing forward.
Again, raise the arm in an arc, ending above the head.
If pain presents while raising the arm with the thumb back, but feel relief with the palm facing forward, it is likely a shoulder impingement.
Chiropractic Relief
If there is some sort of impingement different treatment options exist. Many doctors treat shoulder impingement with injections and pain management. Studies show that conservative treatment, like chiropractic, have shown positive results for shoulder impingement cases.
Chiropractic improves joint function and mobility while treating the underlying root cause. A chiropractor will use a multi-approach depending on the cause. A combination of adjustments, anti-inflammatory protocols, and active release techniques can be used.
Chiropractic Adjustment
One of the first things chiropractors look at is the spine. This is because poor posture, and slumping shoulders, can be a major contributor to impingement. Chiropractors perform a posture assessment and, if necessary a spinal adjustment to achieve proper alignment is the beginning to get the body back in balance.
Anti-Inflammation Protocols
Next, is the shoulder itself. Deep tissue massage and anti-inflammation techniques like cold laser therapy or ultrasound can relieve pain, and reduce inflammation. Once the pain has decreased, the chiropractor will move on to active release techniques.
Active Release Technique
Usually the result of the muscles or tendons becoming inflamed and irritated, the active release technique is used to separate any scar tissue from the soft tissue. The active release technique is performed with a combination of movement and manipulation. This increases healing through proper blood flow and circulation.
Healing Naturally
Here is an example of a potential treatment plan. All treatment plans are different depending on:
Individual health
Activity level
Medical history
Age
Injury
Rest and Pain Reduction
The first step in healing is rest. Individuals will be recommended to cease any overhead arm activity and any activity that causes inflammation of the shoulder.
Pain reduction treatment. This could be:
Ultrasound
Laser therapy
Massage
Other forms of pain relief and inflammation reduction
Adjustments/Alignment
Chiropractic adjustments performed on the upper cervical spine, upper back, and shoulder area will address the overall cause.
Posture assessments will determine if the spine needs adjusting and if it is a cause of the impingement.
The exercises are also called shoulder impingement rehab protocols.
Rehab Protocol
The stretches and exercises are an essential part of the healing process. The specific exercises will depend on the individual’s specific treatment plan but are made to be gentle on the body without any special equipment. If you have any questions call our chiropractic and physical therapy clinic to talk to a trained professional.
Body Composition
Strength Training
Strength training is defined as a technique/method of improving the body’s muscular strength. This is achieved by gradually increasing the resistance force through the use of free weights, machines, or body weight. This means the body gets stronger and more capable of performing regular, work, and sports activities without experiencing weakness, fatigue, discomfort, and pain. Examples could include:
Carrying groceries or children
Moving furniture, household objects, etc.
Running
Jumping
Other physical activities
Strength training has numerous benefits, including:
Increased physical performance
Improved blood pressure
Improved metabolism
Reduced fat mass
Increased bone strength/density
Improved cognitive ability
Prevention and management of type 2 diabetes
Improved cholesterol levels
Reduction of pain associated with chronic conditions
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*
Cauda equina syndrome is an emergency that needs to be treated as soon as possible. It is a form of spinal nerve compression, but if left untreated, it can lead to permanent paralysis of one or both legs and permanent loss of bowel/bladder control. Lower back pain after sitting for too long or improperly lifting something heavy happens to most if not all of us.
However, sometimes pain in the lower back can be an indicator of something more serious. Especially, for individuals that are dealing with or managing back pain. One condition is cauda equina syndrome. It�s not like sciatica or arthritis, but it does have specific symptoms that individuals should be aware of.
Cauda Equina Syndrome
The term comes from Latin that means horse�s tail. The cauda equina forms the group of nerves that run through the lumbar spinal canal. Generally, the condition means two things:
There is nerve compression of most of the lumbar spinal canal
Compression symptoms like numbness or weakness in the leg/s
How cauda equina syndrome differs from typical compression of the lumbar spinal canal is that it can be caused by different issues, from fractures, tumors, and infections. More commonly, it is disc herniations that cause the problems. The key difference is the degree of nerve compression, and the number of nerves compressed.
For example, compression of a single nerve will not cause loss of bladder function. But compression of multiple nerves, especially the sacral nerves can cause loss of function. Nerve compression that leads to pain or numbness can be treated differently. Surgery is reserved for severe cases and for individuals that are not improving with non-invasive treatment.
Sneaky Presentation
One of the major factors is long-term compression that individuals do not realize they have. Individuals are more likely to be aware of symptoms from another spinal condition before cauda equina syndrome presents. However, the condition presents quickly but often other overlapping back problems mask cauda equina syndrome.
Causes
The syndrome can be brought on from anything that compresses the nerves. Most commonly, it is a root compression from degenerative processes, specifically lumbar disc herniations. Other causes include:
A doctor will examine any significant changes in bladder, bowel, or leg function that are considered red flags prompting an early and complete assessment. A physician will ask for a complete/detailed history of the onset and progression of symptoms.
The second is a close physical examination which includes testing sensation and strength along with a rectal exam to assess voluntary contraction. Also checking the body’s reflexes, assess walking gait and alignment. If most or all of the symptoms are presenting this will set in motion spinal imaging or an MRI. If the symptoms, exam, and imaging match, it will lead to an emergency admission to the hospital.
Body Composition Spotlight
Obesity and Osteoarthritis Connection
A variety of factors contribute to the development of osteoarthritis, including genetic factors and lifestyle choices. Research supports obesity is a significant risk factor in the development of osteoarthritis. It is pretty straightforward as body weight increases this equals increased load on the spine, and joints, especially the weight-bearing ones like the hips and knees. Increased pressure leads to early wearing, tearing, and eventual development of osteoarthritis. Added weight affects the body’s biomechanics and gait patterns.
However, obesity has also been shown to be a risk factor even on the non-weight-bearing joints. This is based on adipose tissue, which is more than just insulation. Adipose tissue is metabolically active and is involved in the secreting adipokines and cytokines which promote an inflammatory response. Pro-inflammatory adipokines and cytokines can have detrimental effects on joint tissue including damage to cartilage, synovial joints, and subchondral bone. The effect of inflammation on the joints in the body can contribute to the development of osteoarthritis.
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*
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