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Treatments

Back Clinic Treatments. There are various treatments for all types of injuries and conditions here at Injury Medical & Chiropractic Clinic. The main goal is to correct any misalignments in the spine through manual manipulation and placing misaligned vertebrae back in their proper place. Patients will be given a series of treatments, which are based on the diagnosis. This can include spinal manipulation, as well as other supportive treatments. And as chiropractic treatment has developed, so have its methods and techniques.

Why do chiropractors use one method/technique over another?

A common method of spinal adjustment is the toggle drop method. With this method, a chiropractor crosses their hands and pressed down firmly on an area of the spine. They will then adjust the area with a quick and precise thrust. This method has been used for years and is often used to help increase a patient’s mobility.

Another popular method takes place on a special drop table. The table has different sections, which can be moved up or down based on the body’s position. Patients lie face down on their back or side while the chiropractor applies quick thrusts throughout the spinal area as the table section drops. Many prefer this table adjustment, as this method is lighter and does not include twisting motions used in other methods.

Chiropractors also use specialized tools to assist in their adjustments, i.e., the activator. A chiropractor uses this spring-loaded tool to perform the adjustment/s instead of their hands. Many consider the activator method to be the most gentle of all.

Whichever adjustment method a chiropractor uses, they all offer great benefits to the spine and overall health and wellness. If there is a certain method that is preferred, talk to a chiropractor about it. If they do not perform a certain technique, they may recommend a colleague that does.

A Clinical Approach and Its Implications on Opioid Use Disorder

A Clinical Approach and Its Implications on Opioid Use Disorder

by | Chiropractic, Chiropractic Examination, Chronic Pain, Conditions Treated, Health, Imaging & Diagnostics, Injury Care, Screening Tests, Treatments, Viscerosomatic Reflex

Discover the importance of a clinical approach to opioid use disorder in developing effective intervention strategies.

Overcoming Barriers in Managing Opioid Use Disorder: Strategies for Effective Care

Many people today have a serious health problem called opioid use disorder (OUD). It is part of a bigger group of problems called substance use disorders (SUD). Treating OUD can be hard because everyone has different problems, such as other health issues or pain. Plans should be made for each patient by doctors and other health care workers. They also have to keep up with the latest laws, ethics, and ways to keep patient information safe. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is an example of a general rule that applies to all patients. However, there are extra rules for people who are getting help with drug or alcohol problems.

This guide talks about how to deal with problems that come up when managing OUD. We talk about patient-centered care, how to talk to patients, stigma, team-based approaches, and the law. Health care providers can help patients get better faster by using these methods. Keywords like “managing opioid use disorder,” “overcoming stigma in OUD,” and “patient-centered care for SUD” bring out important points that make it easier to find and understand.

Learning Objectives

  • Explain treatment planning methods that use patient-focused choices and proven ways to talk.
  • Name the three kinds of stigma and how they affect people with mental health issues, SUD, and especially OUD.
  • Talk about legal, ethical, and privacy concerns in caring for people with OUD.

Effective Treatment Planning with Patient-Centered Decisions

People with complex issues, like mental health problems, SUD, and pain, need special care. Each person shows up differently, so health systems are now focusing on care that puts the patient first.

Patient-centered care means building teams with doctors, patients, and families. They work together to plan, give, and check health care. This way ensures the patient’s needs are met, and their wishes, likes, and family situations are respected. It focuses on shared choices about treatments while seeing the patient as a whole person in their daily life (Dwamena et al., 2012; Bokhour et al., 2018).

Studies show key steps for a good patient-centered plan:

  • Take a full patient history and a check-up, reviewing old and new treatments.
  • Find all available drug and non-drug options.
  • Check the patient’s current health, recent changes, and patterns.
  • Look at risks for misusing or abusing opioids.

If starting opioids or if the patient is already on them, think about opioid stewardship. This means checking harms, benefits, risks, side effects, pain control, daily function, drug tests, stop plans, and ways to spot OUD. These programs, sometimes called analgesia stewardship, help manage opioids safely (Harle et al., 2019; Coffin et al., 2022). Guides exist to set them up (American Hospital Association, n.d.; Shrestha et al., 2023).

Integrative chiropractic care can play a big role here. It uses spinal adjustments and targeted exercises to get proper spinal alignment. This helps reduce pain without relying only on drugs, making it a good fit for OUD patients with pain. For example, adjustments fix spine issues that cause pain, and exercises strengthen muscles to keep alignment right.

A Nurse Practitioner (NP) adds full management and ergonomic advice. They look at work setups to prevent pain, such as how to sit or lift. NPs coordinate care by reviewing options such as therapy, meds, and lifestyle changes, ensuring everything works together.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, with over 30 years in chiropractic and as a family nurse practitioner, observes that blending these methods cuts opioid use. At his El Paso clinic, he uses functional medicine to address root causes through nutrition and non-invasive treatments. He notes that poor posture from modern life worsens pain, leading to OUD risks. His teams help patients with self-massage and VR for recovery, reducing drug needs (Jimenez, n.d.a; Jimenez, n.d.b).

Evidence-Based Ways to Communicate

Good talking skills are key to building a patient-centered plan (Schaefer & Block, 2009). There are proven methods for starting conversations and getting patients involved.

One method is BATHE:

  • Background: Ask, “How have things been since your last visit?”
  • Affect: Ask, “How does this make you feel?”
  • Trouble: Ask, “What bothers you most?”
  • Handling: Ask, “How are you coping?”
  • Empathy: Say, “That sounds hard.”

This uses open questions to let patients lead and feel supported (Stuart & Lieberman, 2018; Thomas et al., 2019).

Another is GREAT:

  • Greetings/Goals: Start with hello and set aims.
  • Rapport: Build trust.
  • Evaluation/Expectation/Examination/Explanation: Check and explain.
  • Ask/Answer/Acknowledge: Listen and respond.
  • Tacit agreement/Thanks: Agree and thank.

This guide talks well (Brindley et al., 2014).

Motivational interviewing is also useful. It’s a team-style talk to boost a patient’s desire to change. Build a bond, focus on the issue, spark a desire for change, and plan steps (Frost et al., 2018).

These methods emphasize listening, clear communication, and a structured approach to planning. For OUD patients with pain or mental issues, mix techniques for the best results.

Dr. Jimenez shares that in his practice, these talks help patients see non-drug options, such as chiropractic adjustments. He finds that empathy reduces stigma and fear, encouraging openness about OUD (Jimenez, n.d.a).

Understanding Stigma in Mental Health and Substance Use Disorders

Stigma blocks good talk for many with mental health or SUD. It’s attitudes, beliefs, actions, and systems that lead to unfair views and bad treatment (Cheetham et al., 2022).

Studies show stigmas like linking mental illness to violence (Perry, 2011). Media on shootings with mentally ill people strengthens this (McGinty et al., 2014; McGinty et al., 2016; Schomerus et al., 2022). For SUD, people think they’re more dangerous than those with schizophrenia or depression (Schomerus et al., 2011). Society blames people with SUDs more and avoids them (McGinty et al., 2015; Corrigan et al., 2012).

Views come from knowledge, contact with affected people, and the media. Public ideas are tied to norms on causes, blame, and danger. Race, ethnicity, and culture shape attitudes too (Giacco et al., 2014).

Health workers have biases. A survey of VA mental health providers showed awareness of race issues but avoidance of talks, using codes like “urban,” and thinking training stops racism (McMaster et al., 2021).

There are three stigma types:

  • Structural Stigma: The ways Society and institutions keep prejudice. In health, it’s worse care, less access to behavioral health. Less funding for mental vs. physical issues (National Academies of Sciences, Engineering, and Medicine, 2016).
  • Public Stigma: General or group attitudes, like police or church norms. Laws reinforce it, like broad mental illness rules implying all are unfit (Corrigan & Shapiro, 2010).
  • Self-Stigma: When people internalize stigmas, it leads to low self-worth and shame. “Why try” affects independent living (Corrigan et al., 2009; Clement et al., 2015).

Dr. Jimenez observes that stigma makes OUD patients hide symptoms, delaying care. In his integrative work, he addresses this through education on holistic options, showing that recovery is possible without judgment (Jimenez, n.d.b).

Overcoming Stigma and Addressing Social Factors

To fight stigma, use education, behavior changes, and better care. Laws like the ADA and MHPAEA help ensure equal coverage and prevent discrimination (U.S. Congress, 2009; U.S. Congress, 2008; U.S. Department of Health and Human Services, n.d.; Busch & Barry, 2008; Haffajee et al., 2019).

These address social determinants of health (SDOH), such as coverage, access, quality, education, and stability (Centers for Disease Control and Prevention, n.d.).

Community programs help too:

  • West Virginia’s Jobs and Hope: Training, jobs, education, transport, skills, record clearing for SUD people (Jobs and Hope, n.d.).
  • Belden’s Pathway: Rehab for failed drug tests, leading to jobs (Belden, n.d.).

Education boosts provider confidence in OUD meds, reducing barriers (Adzrago et al., 2022; Hooker et al., 2023; Campbell et al., 2021).

Overcoming stigma is key to success in mental health and SUD.

Interprofessional Team Work

Teams improve outcomes for patients with chronic pain and mental health or SUD (Joypaul et al., 2019; Gauthier et al., 2019).

Teams include doctors, nurses, NPs, pharmacists, PAs, social workers, PTs, therapists, SUD experts, and case managers.

Each helps uniquely:

  • Pharmacists watch meds, spot interactions.
  • Case managers link specialists, find resources, and support families (Sortedahl et al., 2018).
  • Teams set goals, max non-opioid treatments (Liossi et al., 2019).

Integrative chiropractic care includes adjustments and exercises for alignment, easing pain naturally.

NPs give full care, ergonomic tips to avoid pain triggers, and coordinate options.

Dr. Jimenez’s clinic shows this. As a DC and FNP-BC, he leads teams with therapists, nutritionists, and coaches. He observes interprofessional work cuts opioid use by addressing the roots with functional medicine, VR, and nutrition. For OUD, he blends chiropractic care for pain, NP coordination for plans, and stigma-fighting through team support (Jimenez, n.d.a; Jimenez, n.d.b).

The Power of Chiropractic Care in Injury Rehabilitation-Video

Legal and Ethical Issues in SUD Care

Providers must know laws and ethics for mental/SUD patients, like discrimination, aid, and privacy (Center for Substance Abuse Treatment, 2000).

Key Federal laws:

  • Americans with Disabilities Act (ADA) of 1990.
  • Rehabilitation Act of 1973.
  • Workforce Investment Act of 1998.
  • Drug-Free Workplace Act of 1988.

ADA and Rehabilitation ban discrimination in government and in business services like hotels, shops, and hospitals. Protect those with impairments limiting life activities (U.S. Department of Health and Human Services, n.d.).

Provisions:

  • Protect “qualified” people who meet the requirements.
  • Reasonable accommodations for jobs.
  • No hire/retain if there is a direct threat.
  • No denial of benefits, access, or jobs in funded places.

For SUD: Alcohol users are protected if qualified, no threat. Ex-drug users in rehab are the same. Current illegal drug users are protected for health/rehab, not others. Programs can deny if used during.

Workforce Act centralizes job programs; no refusal to SUD people (U.S. Congress, 1998).

Drug-Free Act requires drug-free policies for federal funds/contracts: statements, awareness, actions on violations (U.S. Code, n.d.).

States have their own laws; check the local laws.

Public Aid laws:

  • Contract with America Act (1996): No SSI/DI if SUD key factor (U.S. Congress, 1996).
  • Adoption Act (1997): 15-month foster reunification limit (U.S. Congress, 1997).
  • Personal Responsibility Act (1996): Work after 2 years of aid, drug screens (U.S. Department of Health and Human Services, 1996).

These push work, sobriety.

Dr. Jimenez notes that legal awareness helps his practice by ensuring holistic plans comply and by reducing OUD risks through a non-drug focus (Jimenez, n.d.a).

Keeping Patient Info Private

Privacy is vital. Laws include:

  • HIPAA (1996): Protects PHI, sets use/disclosure rules (U.S. Department of Health and Human Services, n.d.).
  • 42 CFR Part 2: Extra for SUD records. No disclosure of name or status without consent. Fines for breaks. Applies to federal-aided programs (Substance Abuse and Mental Health Services Administration, n.d.).

Consent needs: program name, receiver, patient name, purpose, info type, revoke note, expire date, signature, and date.

This fights discrimination fears, encouraging treatment (Center for Substance Abuse Treatment, 2000).

Wrapping Up

As we navigate the ongoing challenges of opioid use disorder (OUD), it’s clear that effective management requires a multifaceted approach that prioritizes patient well-being over quick fixes. From embracing patient-

It is clear that treating opioid use disorder (OUD) well requires a multi-faceted approach that puts the patient’s health and safety above quick fixes. Healthcare professionals play a pivotal role in transforming lives by implementing patient-centered decision-making and evidence-based communication, and by eradicating the three types of stigma—structural, public, and self—that hinder recovery. Interprofessional teams help people get the full treatment they need, and privacy laws like HIPAA and 42 CFR Part 2 make sure that people with disabilities can get help without being discriminated against.

Chiropractic therapy focuses on spinal adjustments and specific exercises to support proper alignment. It is a non-invasive way to ease pain and reduce dependence on opioids. Nurse Practitioners (NPs) make this better by providing comprehensive care, offering ergonomic advice to prevent injuries, and coordinating multiple treatment options, such as lifestyle changes and therapy. Dr. Alexander Jimenez, DC, APRN, FNP-BC, emphasizes in his clinical practice that these integrative approaches not only address physical symptoms but also empower patients through education and tailored strategies, leading to enduring recovery and diminished opioid consumption (Jimenez, n.d.a; Jimenez, n.d.b).

As we look ahead, new advancements in OUD therapy by 2025 show a trend toward making it easier to get and more tailored to each person. For instance:

  • Drugs like methadone, buprenorphine, and naltrexone that the FDA has approved are still the best way to treat OUD. They help with cravings and withdrawal symptoms and help people stay stable over time.
  • Precision medicine goes beyond one-size-fits-all methods by tailoring treatments to each person’s social, psychological, and genetic factors. This should lead to better results.
  • The World Health Organization’s 2025 updates put more emphasis on psychosocial support, with a focus on preventing overdoses in the community and making it easier for people to get care.
  • Declining Trends: The first yearly drop in opioid-related deaths since 2018 happened in 2023. This is a good sign because it shows that ongoing work in treatment, education, and lawmaking is having an effect.

We might be able to make OUD a treatable illness instead of a life sentence by combining these new ideas with collaborative care and reducing stigma. Policymakers, communities, and healthcare professionals must continue to advocate for equitable access to ensure that all individuals receive the evidence-based treatment they need. Overcoming problems in OUD management is about more than just getting better; it’s also about getting your dignity, hope, and a good quality of life back.

References

Clinical Approach Benefits for Pain Management in Opioid Therapy

Clinical Approach Benefits for Pain Management in Opioid Therapy

by | Chiropractic, Chiropractic Examination, Chronic Pain, Conditions Treated, Health, Imaging & Diagnostics, Injury Care, Screening Tests, Treatments, Viscerosomatic Reflex

Discover how a clinical approach to opioid therapy can transform pain management strategies for patients in a healthcare setting.

Key Points on Safe Pain Management with Opioids

  • Pain Affects Many People: Research suggests that about 100 million adults in the U.S. deal with pain, and this number might grow due to aging, more health issues like diabetes, and better survival from injuries. It’s important to address pain early to prevent it from becoming long-term (Institute of Medicine, 2011).
  • Non-Opioid Options First: Evidence leans toward starting with treatments like exercise, therapy, or over-the-counter meds before opioids, as they can be just as effective for common pains like backaches or headaches, with fewer risks (National Academies of Sciences, Engineering, and Medicine, 2019).
  • Team-Based Care Works Best: Studies show teams of doctors, nurses, and therapists can improve pain relief and daily life, though results vary. This approach seems likely to help more than solo care, especially for ongoing pain (Gauthier et al., 2019).
  • Opioids When Needed, But Carefully: Guidelines recommend low doses, short times, and regular check-ins to balance relief with risks like addiction. It’s complex, so talk openly with your doctor (Centers for Disease Control and Prevention, 2022).
  • Alternatives Like Chiropractic and NP Support: Integrative methods, such as chiropractic adjustments for spine alignment and ergonomic tips from nurse practitioners, can reduce reliance on meds. Clinical observations from experts like Dr. Alexander Jimenez highlight non-invasive approaches to managing pain effectively.

Understanding Pain Types

Pain can be short-term (acute), medium-term (subacute), or long-lasting (chronic). Acute pain often lasts less than three months and comes from injuries. If not treated well, it might turn chronic, affecting daily activities. Always respect someone’s pain experience—it’s personal and influenced by life factors (Raja et al., 2020).

Assessing Pain Simply

Doctors use tools like questions about when pain started, what makes it worse, and how it feels. Scales help rate it, from numbers (0-10) to faces showing discomfort. For kids or elders, special tools watch for signs like faster heartbeats (Wong-Baker FACES Foundation, 2022).

Treatment Basics

Start with non-drug options like rest, ice, or physical therapy. For chronic pain, meds like acetaminophen or therapies like yoga help. Opioids are for severe cases but come with risks—use them wisely (Agency for Healthcare Research and Quality, n.d.).

Role of Experts

According to clinical observations by Dr. Alexander Jimenez, DC, APRN, FNP-BC, who runs a multidisciplinary practice in El Paso, Texas (https://dralexjimenez.com/), combining chiropractic care with exercises targets root causes, such as misaligned spines, reducing opioid needs. As a nurse practitioner, he coordinates care and offers ergonomic advice to prevent pain from daily habits (LinkedIn Profile).

Comprehensive Guide to Safe and Effective Pain Management Using Opioid Therapy

Millions of people struggle with pain, which affects everything from hobbies to employment. Finding safe strategies to deal with pain is crucial, whether it’s a recent injury or persistent discomfort. This comprehensive handbook examines how to measure pain, available treatments, and responsible opioid use recommendations. We’ll discuss team-based treatment, non-opioid alternatives, and perspectives from professionals like Dr. Alexander Jimenez, who prioritizes holistic approaches. To help you locate trustworthy information online, keywords like “pain management strategies,” “opioid therapy guidelines,” and “non-opioid pain relief” are interwoven.

Introduction to Pain in America

The Institute of Medicine estimates that around 100 million American adults face acute or chronic pain daily. This number is expected to climb due to an aging population, rising rates of conditions like diabetes, heart disease, arthritis, and cancer, plus better survival from serious injuries and more surgeries that can lead to post-op pain (Institute of Medicine, 2011).

As people learn more about pain relief options and gain better access through laws like the Affordable Care Act (ACA), more folks—especially older ones—seek help. Passed in 2010, the ACA requires insurers to cover essential pain management benefits, including prescription drugs, chronic disease care, mental health support, and emergency services (111th Congress, 2009-2010). To use these effectively, healthcare providers need a solid grasp of pain assessment, classification, and treatment.

What Is Pain?

The International Association for the Study of Pain defines it as an unpleasant feeling associated with real or potential tissue damage. It’s subjective, shaped by biology, emotions, and social life. People learn about pain through experiences—some seek help right away, others try home remedies first. Respect their stories (Raja et al., 2020).

Pain falls into three main types, though definitions overlap:

  • Acute Pain: Lasts less than 3 months, or 1 day to 12 weeks; often limits daily activities for a month or less.
  • Subacute Pain: Sometimes seen as part of acute, or separate; lasts 1-3 months, or 6-12 weeks.
  • Chronic Pain: Persists over 3 months, or limits activities for more than 12 weeks (Banerjee & Argáez, 2019).

Poorly managed short-term pain can become chronic, so early action is important (Marin et al., 2017).

Assessing Pain Thoroughly

Pain is complex, influenced by body, mind, and environment. A full check includes history, physical exam, pain details, other health issues, and mental states like anxiety.

Basic pain evaluation covers:

  • When it started (date/time).
  • What caused it (injury?).
  • How does it feel (sharp, dull?)?
  • How bad it is.
  • Where is it?
  • How long does it last?
  • What worsens it (moving?).
  • What helps it?
  • Related signs (swelling?).
  • Impact on daily life.

Mnemonics help remember these. Here’s a table comparing common ones:

Mnemonic Breakdown
COLDERRA Characteristics, Onset, Location, Duration, Exacerbation, Radiation, Relief, Associated signs
OLDCART Onset, Location, Duration, Characterization, Aggravating factors, Radiation, Treatment
PQRST Provoked, Quality, Region/Radiation, Severity, Timing

 

Pain scales provide information but aren’t diagnoses because they’re subjective. Single-dimensional ones focus on intensity:

  • Verbal: Mild, moderate, severe.
  • Numeric: 0 (none) to 10 (worst).
  • Visual: Like Wong-Baker FACES®, using faces for kids, adults, or those with barriers (Wong-Baker FACES Foundation, 2022). An emoji version works for surgery patients (Li et al., 2023).

Multi-dimensional scales check intensity plus life impact. The McGill Pain Questionnaire uses words like “dull” to rate sensory, emotional, and overall effects; shorter versions exist (Melzack, 1975; Main, 2016). For nerve pain, PainDETECT helps (König et al., 2021). Brief Pain Inventory scores severity and interference with mood/life (Poquet & Lin, 2016).

For babies, watch heart rate, oxygen, and breathing. Tools like CRIES rate crying, oxygen need, vitals, expression, sleep (Castagno et al., 2022). FLACC for ages 2 months-7 years checks face, legs, activity, cry, consolability (Crellin et al., 2015). Older kids use Varni-Thompson or draw pain maps (Sawyer et al., 2004; Jacob et al., 2014).

Elders face barriers like hearing loss or dementia. PAINAD assesses breathing, sounds, face, body, and consolability on a 0-10 scale (Malara et al., 2016).

The Joint Commission sets standards across various settings, which affect tool choice (The Joint Commission, n.d.).

Building Treatment Plans

Plans depend on pain type, cause, severity, and patient traits. For acute: meds, distraction, psych therapies, rest, heat/ice, massage, activity, meditation, stimulation, blocks, injections (National Academies of Sciences, Engineering, and Medicine, 2019).

Re-check ongoing acute pain to avoid chronic shift. Goals: control pain, prevent long-term opioids. Barriers: access to docs/pharmacies, costs, follow-ups.

For chronic: meds, anesthesia, surgery, psych, rehab, CAM. Non-opioids include:

  • Oral Meds:
    • Acetaminophen.
    • NSAIDs (celecoxib, etc.).
    • Antidepressants (SNRIs like duloxetine; TCAs like amitriptyline).
    • Anticonvulsants (gabapentin, etc.).
    • Muscle relaxers (cyclobenzaprine).
    • Memantine.
  • Topical: Diclofenac, capsaicin, lidocaine.
  • Cannabis: Medical (inhaled/oral/topical); phytocannabinoids (THC/CBD); synthetics (dronabinol) (Agency for Healthcare Research and Quality, n.d.).

Opioid use has risen, raising concerns (National Academies of Sciences, Engineering, and Medicine, 2019).

Key plan elements:

  • Quick recognition/treatment.
  • Address barriers.
  • Involve patients/families.
  • Reassess/adjust.
  • Coordinate transitions.
  • Monitor processes/outcomes.
  • Assess outpatient failure risk.
  • Check opioid misuse (Wells et al., 2008; Society of Hospital Medicine, n.d.).

Team Approach to Pain

Studies support the use of interprofessional teams for better results (Gauthier et al., 2019). Teams include docs, nurses, NPs, pharmacists, PAs, social workers, PTs, behavioral therapists, and abuse experts.

A 2017 report showed that teams improved pain/function from baseline, though not always compared with controls (Banerjee & Argáez, 2017). A meta-analysis found that teams were better at reducing pain after 1 month and sustained benefits at 12 months (Liossi et al., 2019).

Integrative chiropractic care fits here. It involves spinal adjustments—gentle manipulations to correct misalignments—and targeted exercises, such as core strengthening, to maintain alignment and reduce pressure on nerves/muscles. Dr. Alexander Jimenez observes that this helps sciatica/back pain without opioids, using tools like decompression (dralexjimenez.com).

Nurse Practitioners (NPs) provide comprehensive management, including ergonomic advice (e.g., better sitting postures) to prevent strain. They coordinate by reviewing options, referring to specialists, and overseeing plans, as seen in Dr. Jimenez’s practice, where his FNP-BC role includes telemedicine for holistic care (LinkedIn, n.d.).

Beyond Adjustments: Chiropractic and Integrative Healthcare- Video

Managing Opioids Safely

CDC’s 2022 guidelines cover starting opioids, dosing, duration, and risks (Centers for Disease Control and Prevention, 2022).

1. Starting Opioids:

Maximize non-opioids first—they match opioids for many acute pains (back, neck, etc.). Discuss benefits/risks (Recommendation 1, Category B, Type 3).

Evaluate/confirm diagnosis. Non-drug examples:

  • Back: Exercise, PT.
  • Low back: Psych, manipulation, laser, massage, yoga, acupuncture.
  • Knee OA: Exercise, weight loss.
  • Hip OA: Exercise, manuals.
  • Neck: Yoga, massage, acupuncture.
  • Fibromyalgia: Exercise, CBT, massage, tai chi.
  • Tension headache: Manipulation.

Review labels, use the lowest dose/shortest time. Set goals, exit strategy. For ongoing, optimize non-opioids (Recommendation 2, A, 2).

2. Choosing/Dosing Opioids:

Immediate-release (hydromorphone, etc.) over ER/LA (methadone, etc.). Studies show no edge for ER/LA; avoid for acute/intermittent (Recommendation 3, A, 4).

No rigid thresholds—guideposts. Risks rise with dose; avoid high if benefits dim (Recommendation 4, A, 3).

Taper slowly to avoid withdrawal (anxiety, etc.). Collaborate on plans; use Teams. If there is disagreement, empathize and avoid abandonment (Recommendation 5, B, 4).

3. Duration/Follow-Up:

For acute, prescribe just enough—often 3 days or less. Evaluate every 2 weeks. Taper if used for days. Avoid unintended long-term (Recommendation 6, A, 4).

Follow-up 1-4 weeks after start/escalation; closer for high-risk (Recommendation 7, A, 4).

4. Risks/Harms:

Screen for SUD/OUD. Offer naloxone for overdose risk (Recommendation 8, A, 4).

Check PDMPs for scripts/combos (Recommendation 9, B, 4).

Toxicology tests are performed annually to assess interactions (Recommendation 10, B, 4).

Caution with benzodiazepines (Recommendation 11, B, 3).

For OUD, use DSM-5 (2+ criteria/year); offer meds like buprenorphine (Recommendation 12, A, 1) (Hasin et al., 2013; American Psychiatric Association, 2013).

OUD signs: Larger amounts, failed cuts, time spent, cravings, role failures, social issues, activity loss, hazardous use, continued despite problems, tolerance, withdrawal.

Treatment: Meds, counseling, groups. Coordinate with specialists.

Conclusion

Finally, relying only on opioids is not necessary for efficient pain management. We can improve the lives of millions of people by giving priority to non-opioid alternatives like acetaminophen, physical therapy, or mindfulness and by taking opioids only when necessary under strict supervision. Teams of professionals, such as physicians, nurses, pharmacists, and specialists like chiropractors, collaborate to develop individualized strategies that lower dangers like addiction. By emphasizing spinal adjustments and targeted exercises, integrative chiropractic therapy may help restore normal alignment and reduce pain naturally, often eliminating the need for medication. Complete management, ergonomic guidance to prevent problems, and treatment coordination for optimal outcomes are all ways nurse practitioners provide value.

According to experts like Dr. Alexander Jimenez, these approaches target underlying issues using non-invasive treatments and functional medicine, promoting long-term well-being. Future developments in pain management seem promising, including FDA-approved non-opioid medications and distraction technologies such as virtual reality. In the end, everyone is empowered to address pain head-on, enhancing everyday activities and general health, when patients are included in decision-making and kept informed. Early evaluation and balanced treatment are crucial; discuss your options with your healthcare professional to determine what is best for you.

References

Gut Health During the Holidays: Keep It Balanced

Gut Health During the Holidays: Keep It Balanced

by | Basal Metabolic Index (BMI), Diets, Fasting, Functional Medicine, Gastro Intestinal Health, Gluten Free Diet, GMO, Gut and Intestinal Health, Health, Health Coaching, Health News El Paso, Heart Health, Herbs, Hyper Thyroid, Hypo Thyroid, Integrative Functional Wellness, Integrative Medicine, Leaky Gut, Mental Health, Metabolic Syndrome, Nutrition, Nutritional Genomics, Oxidative Stress, Probiotics, Sleep Hygiene, Stress, Supplements, Turmeric, Vitamins, Weight Loss, Wellness

Maintaining Gut Health During the Holidays: Causes, Symptoms, and Integrative Solutions

Gut Health During the Holidays: Keep It Balanced

A woman grates cheese for a holiday meal.

The holiday season brings joy, family time, and lots of food. But it can also lead to stomach problems. Many people face issues like bloating, gas, indigestion, heartburn, diarrhea, and constipation. These happen because of rich foods, extra drinks, stress, and changes in daily habits. All this can upset your digestive system and the good bacteria in your gut. This can cause reflux, cramps, or even make conditions like IBS worse.

During holidays, people often eat more fatty, sugary, and heavy meals. They might drink more alcohol, too. Stress from planning and less sleep add to the mix. Diets may have less fiber from fruits and veggies. These factors strain the gut and change its bacterial balance. This leads to swelling in the stomach. Integrative health experts, like chiropractors and nurse practitioners, can help. They examine the main causes and offer ways to address them. This includes managing stress with mindfulness and exercise, giving diet tips for more fiber and water, and using supplements like probiotics and Vitamin D. They might also use hands-on therapy to calm the nervous system. This helps control symptoms and boosts long-term gut health.

Common Causes of Holiday Gut Issues

Holidays change how we eat and live. Large, rich meals with lots of fat and spice can trigger acid reflux. This causes stomach acid to flow back into the esophagus, causing heartburn. Overeating and indulgent foods add to discomfort. Foods high in fat, sugar, and alcohol can cause gas and bloating.

Stress plays a big role, too. High stress can slow or speed up digestion. It releases hormones, such as cortisol, that slow blood flow to the gut and cause swelling. Holiday stress affects the gut-brain link, making issues like IBS or GERD worse.

Alcohol and fizzy drinks are common triggers. They can lead to bloating and cramps. In winter, cold weather slows digestion and reduces blood flow to the gut. Less thirst means people drink less water, causing dehydration and constipation.

Diets shift to more sugary and processed foods. This harms the gut microbiome, the beneficial bacteria that help digest food. Low fiber from missing fruits and veggies adds to constipation.

  • Overindulgence in food and drink: 61% of people link issues to this.
  • Eating different foods: 59% say this worsens symptoms.
  • Stress and low moods: 50% eat more due to winter blues.
  • Specific items like Brussels sprouts, cream, or fizzy drinks.

These causes combine to make gut problems common. About 67% of adults face issues like reflux or indigestion during the holidays. A third say symptoms get worse at Christmas.

Symptoms to Watch For

Gut troubles show up in many ways. Bloating feels like fullness or pressure from overeating or fatty meals. Gas comes from swallowed air, carbonated drinks, or certain foods. Indigestion and heartburn happen when acid backs up.

Constipation is common due to low fiber intake and reduced activity. Diarrhea might be caused by food poisoning or by rich foods. Cramps and pain can signal IBS flare-ups.

Other signs include:

  • Abdominal pain or excessive gas.
  • Loss of appetite or overeating.
  • Reflux or GERD symptoms, such as chest burning.
  • Changes in bowel habits lasting more than a few days.

If symptoms last for more than 2 weeks or include blood, weight loss, or severe pain, see a doctor.

How Holidays Affect the Gut Microbiome

The gut microbiome is trillions of bacteria that help digest food and keep you healthy. Holidays can disrupt this balance. Sugary and fatty foods alter the types of bacteria, leading to inflammation.

Stress reduces the number of good bacteria and allows bad bacteria to grow. Alcohol harms the gut lining and bacteria. Low fiber starves beneficial bacteria.

This imbalance causes:

  • Slower digestion and bloating.
  • Weakened immune system.
  • More inflammation that lasts into the new year.

Winter adds to this with fewer diverse foods and more indoor time.

The Role of Integrative Practitioners

Integrative experts focus on whole-body health. They identify root causes such as stress or diet. Chiropractors and nurse practitioners use natural ways to help.

The brain-gut connection explains why. Stress affects the gut, and gut issues affect mood. Treatments calm the stress response and reduce swelling.

Dr. Alexander Jimenez, a chiropractor and nurse practitioner, observes that gut health links to inflammation and chronic issues. He uses functional medicine to assess diet, lifestyle, and genes. In his practice, he combines adjustments with nutrition to restore balance. He notes that holiday eating causes dysbiosis, leading to fatigue and pain. His approach includes supplements and lifestyle changes for long-term health.

Stress Management Techniques

Stress worsens gut issues, so managing it helps. Try mindfulness practices, such as deep breathing or meditation. Yoga calms the nervous system.

  • Take walks after meals to aid digestion.
  • Plan ahead to avoid rushing.
  • Get 7–9 hours of sleep a night.
  • Use apps for breathing exercises.

These boost the “rest and digest” response.

Dietary Advice for Better Gut Health

Eat more fiber to keep things moving. Choose fruits, veggies, and whole grains. Stay hydrated with at least 8 cups of water daily.

Tips include:

  • Use smaller plates for portion control.
  • Eat slowly and chew well.
  • Add fermented foods like yogurt or kimchi for probiotics.
  • Limit sugar, fat, and alcohol.
  • Follow the 80/20 rule: be healthy 80% of the time and indulge 20%.

Dr. Jimenez recommends personalized nutrition to correct gut imbalances.

Supplements and Manual Therapy

Supplements like probiotics help restore gut bacteria. Vitamin D supports immune and gut health, especially in winter.

Manual therapy, such as chiropractic adjustments, helps balance the nervous system. This reduces inflammation and aids digestion. Dr. Jimenez uses this in his integrative practice for post-holiday recovery.

  • Probiotics from food or pills.
  • Digestive enzymes for heavy meals.
  • Fiber supplements, if needed.

Preventing Issues and Long-Term Health

Prevent problems by planning meals and staying active. Avoid trigger foods like dairy or gluten if sensitive.

For the long term, keep healthy habits year-round. This reduces inflammation and boosts energy. Integrative care helps maintain balance.

Dr. Jimenez sees that addressing gut health prevents chronic diseases. His observations show nutrition and adjustments improve outcomes.

Holidays don’t have to hurt your gut. With smart choices and expert help, you can enjoy the season and feel satisfied.

References

Mayo Clinic Healthcare. (n.d.). A guide to digestive health during the festive season. Mayo Clinic Healthcare.

King Edward VII’s Hospital. (n.d.). Christmas cramps: A third of Brits with digestive problems say symptoms get worse over Christmas. King Edward VII’s Hospital.

GI Associates & Endoscopy Center. (n.d.). The Effect of Holiday Stress on the Gastrointestinal System. GI Associates & Endoscopy Center.

News-Medical.net. (2025). How the holidays can impact digestion and gut health. News-Medical.net.

Guts UK. (2025). How to look after your gut health at Christmas. Guts UK.

King Edward VII’s Hospital. (n.d.). How to have a gut friendly Christmas. King Edward VII’s Hospital.

Guts UK. (2021). Understanding your guts at Christmas. Guts UK.

Blue Cross Blue Shield of Michigan. (n.d.). How Harmful are the Holidays to my Gut Health?. Blue Cross Blue Shield of Michigan.

Rush University Medical Center. (n.d.). Keep Your Stomach Happy This Holiday Season. Rush University Medical Center.

Northeastern Gastroenterology Associates. (n.d.). Tips for Managing Digestive Distress During the Holidays. Northeastern Gastroenterology Associates.

United Digestive. (n.d.). Why Your Digestive System Needs Extra Care During the Winter Months. United Digestive.

Healthline. (n.d.). See Tips (and Treats) for a Healthy Gut During the Holidays. Healthline.

Northwestern Medicine. (n.d.). Holiday Stress and Gut Health. Northwestern Medicine.

Star Imaging. (n.d.). Winter’s Impact on Digestive Health: Tips & Seasonal Remedies. Star Imaging.

Mayo Clinic Healthcare. (n.d.). A guide to digestive health during the festive season. Mayo Clinic Healthcare.

Guts UK. (2025). How to look after your gut health at Christmas. Guts UK.

United Digestive. (n.d.). Why Your Digestive System Needs Extra Care During the Winter Months. United Digestive.

Bare Chiropractic. (n.d.). Post-Holiday Gut Health and Inflammation Support. Bare Chiropractic.

Covenant Health. (n.d.). How to Manage Gut Health During the Holidays. Covenant Health.

Digestive Disease Consultants. (n.d.). Keeping Your Digestive System Happy During the Holidays: Tips to Prevent Unhealthy Habits. Digestive Disease Consultants.

HealthCert. (n.d.). Supporting gut health through the holidays. HealthCert.

University of Minnesota. (n.d.). Gut health during the holidays. University of Minnesota.

GI Associates & Endoscopy Center. (n.d.). The Effect of Holiday Stress on the Gastrointestinal System. GI Associates & Endoscopy Center.

Physicians Weekly. (n.d.). How the Holidays Hinder Digestive Health. Physicians Weekly.

Harvard Health Publishing. (2019). Brain-gut connection explains why integrative treatments can help relieve digestive ailments. Harvard Health Publishing.

Injury Specialists. (n.d.). Injury Specialists. Injury Specialists.

LinkedIn. (n.d.). Dr. Alexander Jimenez DC, APRN, FNP-BC, IFMCP, CFMP, ATN ♛. LinkedIn.

Clinical Approach Insights to Identify Substance Use Disorder

Clinical Approach Insights to Identify Substance Use Disorder

by | Chiropractic, Chiropractic Examination, Chronic Pain, Conditions Treated, Health, Imaging & Diagnostics, Injury Care, Screening Tests, Treatments, Viscerosomatic Reflex

Discover the clinical approach for substance use disorder, a vital method in addressing challenges related to addiction treatment.

Integrative Management of Substance Use Disorder (SUD) and Musculoskeletal Health: A Collaborative Model for Chiropractors and Nurse Practitioners

Substance use disorder (SUD) is a chronic, treatable medical condition that affects the brain, behavior, and the entire body, including the musculoskeletal system. For many patients, SUD overlaps with chronic pain, injury, emotional distress, and functional limitations. An integrative care model that combines evidence‑based SUD screening and treatment with chiropractic care and nurse practitioner (NP)–led primary care can reduce risk, improve function, and support long‑term recovery (American Medical Association [AMA], n.d.; National Institute on Drug Abuse [NIDA], n.d.; National Institute of Mental Health [NIMH], 2025).

This article explains what SUD is, how it is identified and categorized, how clinicians can manage it using practical workflows, and how integrative chiropractic and NP care can address overlapping risk profiles and musculoskeletal consequences.

What Is Substance Use Disorder (SUD)?

SUD is a medical condition in which the use of alcohol, medications, or other substances leads to significant impairment or distress in daily life. It is not a moral failing or a lack of willpower; it is a chronic, brain‑ and body‑based disease that is treatable (NIDA, n.d.; NIMH, 2025).

SUD exists on a spectrum from mild to severe. People with SUD may:

  • Use more of the substance than they planned

  • Try and fail to cut down or stop

  • Spend a lot of time obtaining, using, or recovering from the substance

  • Continue to use even though it harms health, work, relationships, or safety (American Psychiatric Association, 2022; NIMH, 2025)

Person‑first, non‑stigmatizing language

Stigma can keep people from seeking care. Using respectful, person‑first language reduces shame and supports engagement. NIDA and the AMA recommend (NIDA, n.d.; AMA, n.d.):

  • Say “person with a substance use disorder,” not “addict” or “drug abuser.”

  • Say “substance use” or “misuse,” not “abuse.”

  • Focus on SUD as a chronic, treatable condition.

Categories and Diagnostic Features of SUD

DSM‑5‑TR framework: Mild, moderate, severe

Diagnostic criteria for SUD come from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM‑5‑TR) (American Psychiatric Association, 2022; NIAAA, 2025). A diagnosis is based on the number of symptoms present over 12 months.

Typical criteria include (paraphrased):

  • Using more or for longer than intended

  • Unsuccessful efforts to cut down

  • Spending a lot of time obtaining, using, or recovering

  • Cravings or strong urges

  • Role failures at work, school, or home

  • Social or interpersonal problems caused or worsened by use

  • Giving up important activities

  • Using in physically hazardous situations

  • Continued use despite physical or psychological problems

  • Tolerance

  • Withdrawal

Severity is determined by symptom count (American Psychiatric Association, 2022; NIAAA, 2025):

  • Mild: 2–3 symptoms

  • Moderate: 4–5 symptoms

  • Severe: 6 or more symptoms

Substance‑specific categories

Clinically, SUD is further categorized by substance type (NIDA, n.d.; NIMH, 2025):

  • Alcohol use disorder (AUD)

  • Opioid use disorder (e.g., heroin, oxycodone, hydrocodone)

  • Stimulant use disorder (e.g., cocaine, methamphetamine)

  • Sedative, hypnotic, or anxiolytic use disorder (e.g., benzodiazepines)

  • Cannabis, tobacco, hallucinogen, or inhalant use disorders

Each category has similar behavioral criteria but unique medical risks, withdrawal profiles, and treatment options (NIDA, n.d.; NIAAA, 2025).

Risk and severity categories for clinical workflows

For practical care, validated screening tools classify risk that guide next steps (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

  • Low/no risk: Negative screen or very low scores

  • Moderate risk: At‑risk use with potential consequences (e.g., falls, crashes, future disease)

  • Substantial/severe risk: High scores suggest likely SUD and active harm

For example, adult risk zones using tools like AUDIT and DAST (AMA, n.d.):

  • Low risk/abstain: AUDIT 0–7; DAST 0–2

  • Moderate risk: AUDIT 8–15; DAST 3–5

  • Substantial/severe risk: AUDIT ≥16; DAST ≥6

These categories help teams decide when to give brief interventions, when to intensify care, and when to refer to specialty treatment.

Epidemiology and Public Health Impact

National surveys show that millions of people in the United States live with SUD, yet only a fraction receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). The 2022 National Survey on Drug Use and Health reported high rates of both substance use and serious mental illness, often co‑occurring (SAMHSA, 2023).

Key points from recent federal data (SAMHSA, 2023; NIMH, 2025):

  • SUD commonly co‑occurs with depression, anxiety, and other mental disorders.

  • Co‑occurring conditions worsen medical outcomes and increase healthcare use.

  • Early identification and integrated treatment can improve function, reduce complications, and lower long‑term costs.

Identifying Patients With SUD: Screening and Assessment

Early, routine identification is critical. Primary care teams, NPs, and chiropractic clinics that integrate behavioral health can all play a role (AMA, n.d.; NIDA, n.d.; NIAAA, 2025).

Building a safe, trauma‑informed environment

Before asking about substance use, the team should (AMA, n.d.; NIDA, n.d.):

  • Explain that “we screen everyone” as part of whole‑person care.

  • Emphasize confidentiality within legal limits.

  • Use a calm, nonjudgmental tone and body language.

  • Offer patients the option not to answer any question.

  • Acknowledge that stress, trauma, pain, and life pressures often contribute to substance use.

This aligns with trauma‑informed care principles promoted by SAMHSA and helps patients feel safe enough to share (AMA, n.d.).

Validated screening tools

Evidence‑based tools are preferred over informal questioning. Common options include (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

For adults:

  • AUDIT or AUDIT‑C (Alcohol Use Disorders Identification Test) – screens for unhealthy alcohol use and risk of AUD.

  • DAST‑10 (Drug Abuse Screening Test) – screens for non‑alcohol drug use problems.

  • TAPS Tool (Tobacco, Alcohol, Prescription medication, and other Substances) – combined screen and brief assessment.

For adolescents:

  • CRAFFT 2.1+N – widely used for youth; captures risk behaviors and problems.

  • S2BI (Screening to Brief Intervention) and BSTAD – brief tools validated for ages 12–17 (NIDA, n.d.; AMA, n.d.).

For alcohol‑specific quick screens:

  • AUDIT‑C (3 questions) or full AUDIT

  • NIAAA Single Alcohol Screening Question (SASQ):
    “How many times in the past year have you had 4 (for women) or 5 (for men) or more drinks in a day?” (NIAAA, 2025)

Results guide risk categorization and next steps.

Role of the care team

In integrated practices, roles can be divided (AMA, n.d.):

  • Medical assistants or nurses

    • Administer pre‑screens and full questionnaires.

    • Flag positive or concerning responses.

  • Nurse practitioners / primary care clinicians

    • Review screening results.

    • Deliver brief interventions using motivational interviewing.

    • Conduct or oversee further assessment.

    • Prescribe and manage pharmacotherapy for SUD when indicated.

    • Coordinate referrals and follow‑up.

  • Behavioral health clinicians (on‑site or virtual)

    • Perform biopsychosocial in-depth evaluations.

    • Provide psychotherapy and relapse‑prevention skills.

    • Support motivational enhancement and family engagement.

  • Chiropractors and physical‑medicine providers

    • Screen for substance misuse related to pain, function, and injury patterns.

    • Observe red flags (frequent lost prescriptions, inconsistent pain reports, sedation, falls).

    • Communicate concerns to the NP or primary medical provider.

Dr. Alexander Jimenez, DC, APRN, FNP‑BC, exemplifies this dual role. As both a chiropractor and a family practice NP, he combines neuromusculoskeletal assessment with medical screening and functional medicine evaluation to identify root causes of chronic pain and unhealthy substance use patterns (Jimenez, n.d.).

Clinical clues that may suggest SUD

Beyond formal tools, clinicians should stay alert for patterns such as (AMA, n.d.; NIMH, 2025):

  • Frequent injuries, falls, or motor vehicle accidents

  • Repeated missed appointments or poor adherence to treatment

  • Drowsiness, agitation, slurred speech, or odor of alcohol

  • Unexplained weight loss, infections, or liver abnormalities

  • Social and financial instability, job loss, or legal problems

In chiropractic and musculoskeletal settings, repeated injuries, delayed healing, inconsistent exam findings, or “pain behaviors” that do not match imaging or biomechanics may prompt gentle, supportive screening and medical referral.

Understanding Long Lasting Injuries- Video

Comprehensive Assessment and Risk Stratification

Once a screen is positive, the next level is a more detailed assessment. This should examine substance type, frequency, amount, impact, withdrawal, mental health, physical comorbidities, and function (AMA, n.d.; NIMH, 2025).

Structured assessment tools

Clinicians may use (AMA, n.d.; NIDA, n.d.; NIAAA, 2025):

  • Full AUDIT for alcohol

  • DAST‑10 for general drugs

  • CRAFFT or GAIN for adolescents

  • Checklists based directly on DSM‑5‑TR criteria to rate symptom count and severity (NIAAA, 2025).

These tools allow classification into mild, moderate, or severe SUD and support shared decision‑making regarding level of care.

Co‑occurring mental health conditions

SUD frequently co‑occurs with (NIMH, 2025):

  • Major depressive disorder

  • Anxiety disorders

  • Posttraumatic stress disorder (PTSD)

  • Bipolar disorder

  • Attention‑deficit/hyperactivity disorder

Co‑occurring disorders can:

  • Increased risk for self‑medication with substances

  • Worsen treatment outcomes if not recognized

  • Require integrated treatment plans (NIMH, 2025)

NPs, behavioral health clinicians, and chiropractors with integrative training should maintain a low threshold for mental health screening and referral.

Managing Patients With SUD: A Practical Clinical Process

Effective SUD care is chronic‑disease care: ongoing, team‑based, and tailored to readiness to change (AMA, n.d.; SAMHSA, 2023).

Core elements of management

Key components include (AMA, n.d.; NIDA, n.d.; NIMH, 2025):

  • Routine screening and re‑screening

  • Brief interventions and motivational interviewing

  • Harm‑reduction strategies

  • Medications for certain SUDs (when appropriate)

  • Evidence‑based behavioral therapies

  • Peer and family support

  • Long‑term follow‑up and relapse‑prevention planning

Brief intervention and motivational interviewing

For patients with low to moderate risk, brief intervention can be delivered in 5–15 minutes and often by NPs or primary care clinicians (AMA, n.d.; NIAAA, 2025). Using motivational interviewing, clinicians:

  • Ask open‑ended questions (“What do you enjoy about drinking? What concerns you about it?”)

  • Reflect and summarize the patient’s own statements

  • Ask permission before giving advice

  • Help patients set realistic, patient‑chosen goals (cutting down, abstaining, or seeking treatment)

This approach respects autonomy and builds internal motivation for change.

Determining level of care

The American Society of Addiction Medicine (ASAM) describes a continuum of care (AMA, n.d.; SAMHSA, 2023):

  • Prevention/early intervention

    • Brief interventions in primary care

    • Self‑management support and education

  • Outpatient services

    • Office‑based counseling and medications for AUD or opioid use disorder (OUD)

    • Integrated behavioral health visits

  • Intensive outpatient / partial hospitalization

    • Several therapy sessions per week, day or evening programs

  • Residential/inpatient services

    • 24‑hour structured care for severe or complex cases

  • Medically managed intensive inpatient services

    • Medically supervised detoxification and stabilization

NPs and primary care teams decide the appropriate level based on risk severity, co‑occurring medical and psychiatric conditions, social supports, and patient preference (AMA, n.d.; NIMH, 2025).

Medications for SUD

For some patients, medications support recovery by reducing cravings, blocking rewarding effects, or stabilizing brain function (SAMHSA, 2020; AMA, n.d.; NIAAA, 2025). Examples include:

  • Alcohol use disorder

    • Acamprosate – supports abstinence after detox

    • Disulfiram – creates an unpleasant reaction to alcohol, discouraging use

    • Naltrexone blocks the rewarding effects of alcohol

  • Opioid use disorder

    • Buprenorphine – a partial opioid agonist that reduces cravings and overdose risk; often prescribed in primary care with appropriate DEA registration

    • Methadone – full agonist, dispensed in specialized opioid treatment programs

    • Naltrexone (extended‑release) – opioid antagonist that prevents relapse after detox

  • Overdose prevention

    • Naloxone – rapid opioid‑overdose reversal, recommended for anyone at risk (AMA, n.d.).

NPs managing patients with SUD work within state scope‑of‑practice rules and in collaboration with addiction specialists where needed.

Behavioral therapies and peer support

Evidence‑based therapies include (AMA, n.d.; NIDA, n.d.):

  • Cognitive behavioral therapy (CBT)

  • Dialectical behavior therapy (DBT)

  • Motivational enhancement therapy

  • The Matrix Model (especially for stimulants)

  • Family‑based therapy for adolescents

Peer support groups (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery) can reinforce coping skills, hope, and accountability.

Long‑term follow‑up

SUD is chronic; relapse risk can persist for years. Best practice includes (AMA, n.d.; NIMH, 2025):

  • Follow‑up within 2 weeks after treatment initiation

  • Monthly to quarterly visits as patients stabilize

  • Peer support and care management between visits

  • Rapid re‑engagement after any relapse or lapse

NASW, NIDA, and NIMH stress that relapse should be treated as a signal to adjust care—not as failure (NIDA, n.d.; NIMH, 2025).

How SUD Affects the Body and the Musculoskeletal System

SUD impacts nearly every organ system. Many effects directly or indirectly worsen neuromusculoskeletal health and pain.

General systemic effects

Common systemic consequences include (NIDA, n.d.; NIMH, 2025; SAMHSA, 2023):

  • Cardiovascular disease and hypertension

  • Liver disease and pancreatitis (especially with alcohol)

  • Respiratory disease (especially with tobacco and some drugs)

  • Endocrine and hormonal disruption

  • Immune dysfunction and higher infection risk

  • Sleep disturbances and fatigue

  • Worsening of mood, anxiety, and cognitive function

These changes affect healing capacity, resilience, and the way patients perceive pain.

Musculoskeletal and pain‑related effects

Substance use and SUD can influence the musculoskeletal system through several pathways:

  • Increased injury risk

    • Impaired judgment, coordination, and reaction time increase the risk of falls, motor vehicle accidents, and sports injuries.

    • Heavy alcohol use is associated with fractures, soft tissue injuries, and delayed healing (AMA, n.d.; SAMHSA, 2023).

  • Bone, joint, and muscle changes

    • Alcohol and some drugs can impair bone density and quality, increasing osteoporosis and fracture risk.

    • Nutritional deficiencies associated with SUDs weaken connective tissue and muscle function.

    • Sedentary behavior and deconditioning are common in people with long‑standing SUD.

  • Chronic pain and central sensitization

    • Chronic alcohol or opioid use can alter pain pathways in the central nervous system, raising pain sensitivity.

    • Opioid‑induced hyperalgesia can make pain seem worse even at stable or increasing doses.

  • Functional and ergonomic stress

    • Disrupted sleep, poor posture, and prolonged sitting or immobility (for example, in recovery environments or during unemployment) can lead to spinal stress, neck and low back pain, and muscle imbalance.

Clinically, Dr. Jimenez and similar integrative providers often see patients with combined profiles: chronic low back or neck pain, sedentary work, ergonomic strain, poor sleep, high stress, and escalating reliance on medications, including opioids or sedatives. Addressing both the mechanical and behavioral contributors can change the trajectory of pain and SUD risk (Jimenez, n.d.).

Integrative Chiropractic Care in the Context of SUD

Philosophy of integrative chiropractic care

Integrative chiropractic care focuses on restoring alignment, mobility, and neuromuscular control while considering lifestyle, nutrition, sleep, and emotional stress. In the model used by Dr. Jimenez, chiropractic adjustments are combined with functional medicine strategies, targeted exercise, and collaborative medical care (Jimenez, n.d.).

For patients with or at risk of SUD, this approach offers:

  • Non‑pharmacologic pain management

  • Improved movement, posture, and ergonomics

  • Education that empowers patients to self‑manage pain

  • Reduced reliance on habit‑forming medications

Spinal adjustments and targeted exercises

Spinal and extremity adjustments aim to:

  • Restore joint mobility

  • Reduce mechanical irritation of nerves and soft tissues

  • Improve segmental alignment and overall posture

Targeted exercises are prescribed to:

  • Strengthen deep stabilizing muscles (core, gluteal, cervical stabilizers)

  • Correct muscle imbalances and faulty patterns

  • Increase flexibility and joint range of motion

  • Enhance proprioception, balance, and movement control

Examples of targeted exercise strategies often used in integrative chiropractic and rehab clinics include (Jimenez, n.d.):

  • Lumbar stabilization and core‑strengthening sequences

  • Hip mobility and glute activation drills for low back and sciatica‑like pain

  • Cervical and scapular stabilization for neck and shoulder pain

  • Postural retraining, including ergonomic break routines for prolonged sitting

By reducing biomechanical stress and enhancing functional capacity, these interventions may decrease pain intensity, frequency, and flare‑ups, which in turn can lower the drive to self‑medicate with substances.

Reducing overlapping risk profiles

Many risk factors for SUD and for chronic musculoskeletal pain overlap, including (NIMH, 2025; NIDA, n.d.; Jimenez, n.d.):

  • Chronic stress and trauma

  • Poor sleep and circadian disruption

  • Sedentary lifestyle and obesity

  • Repetitive strain and poor ergonomics

  • Social isolation and low self‑efficacy

Integrative chiropractic care can help shift these shared risk profiles by:

  • Encouraging regular physical activity and graded movement

  • Coaching ergonomic and postural strategies at work and home

  • Teaching breathing, stretching, and relaxation routines that reduce muscle tension and sympathetic overdrive

  • Collaborating with NPs and behavioral health clinicians to align interventions with mental health and SUD treatment plans

In Dr. Jimenez’s practice, this often includes structured flexibility, mobility, and agility programs that are adapted to age and functional status, with close monitoring to avoid over‑reliance on medications, including opioids and sedatives (Jimenez, n.d.).

The Nurse Practitioner’s Role in Comprehensive SUD and Musculoskeletal Care

NPs are well-positioned to coordinate SUD care and integrate it with musculoskeletal and chiropractic treatment.

Comprehensive medical management

NP responsibilities typically include (AMA, n.d.; NIMH, 2025; NIAAA, 2025):

  • Conducting and interpreting SUD screening and risk stratification

  • Performing physical exams and ordering labs or imaging

  • Diagnosing SUD and co‑occurring conditions

  • Prescribing non‑addictive pain strategies and medications where indicated

  • Managing or co‑managing medications for AUD or OUD (per training and regulations)

  • Monitoring for drug–drug and drug–disease interactions

  • Coordinating with behavioral health and community resources

In integrative settings like Dr. Jimenez’s clinic, the NP role is blended with functional medicine principles, looking at nutrition, metabolic health, hormonal balance, and inflammation that influence both pain and SUD risk (Jimenez, n.d.).

Ergonomic and lifestyle counseling

NPs also provide individualized counseling on:

  • Workplace ergonomics (desk height, chair support, screen position)

  • Safe lifting strategies and body mechanics

  • Activity pacing and graded return to work or sport

  • Sleep hygiene and circadian rhythm support

  • Nutrition strategies that support musculoskeletal healing and brain health

These interventions lower the mechanical load on the spine and joints, reduce fatigue, and increase a patient’s sense of control—all of which help reduce triggers for substance use and relapse.

Care coordination and team communication

NPs often serve as the central coordinator who (AMA, n.d.; NIMH, 2025):

  • Ensures all team members (chiropractor, physical therapist, behavioral health, addiction medicine, primary care, or specialty providers) share a coherent plan

  • Tracks progress on pain, function, substance use, mood, and quality of life

  • Adjusts the plan as conditions change

  • Supports families and caregivers in understanding both SUD and musculoskeletal needs

In a model like Dr. Jimenez’s, this may involve regular case conferences, shared EHR notes, and integrated treatment plans that align spinal rehabilitation with SUD recovery goals (Jimenez, n.d.).

Practical Clinical Pathway: From First Contact to Long‑Term Recovery

For clinics that combine chiropractic and NP services, a practical, stepwise pathway for patients with possible SUD and musculoskeletal complaints can look like this (AMA, n.d.; NIDA, n.d.; NIAAA, 2025; NIMH, 2025; Jimenez, n.d.):

Step 1: Initial visit and global screening

  • Intake includes questions on pain, function, injuries, sleep, mood, and substance use.

  • Staff administer brief tools (for example, AUDIT‑C and DAST‑10 for adults, CRAFFT for adolescents).

  • The chiropractor documents neuromusculoskeletal findings; the NP reviews medical and behavioral health risks.

Step 2: Identification of SUD risk

  • Negative or low‑risk screens → brief positive health message and reinforcement of low‑risk behavior.

  • Moderate risk → NP provides brief intervention, motivational interviewing, and a follow‑up plan.

  • Substantial or severe risk → NP initiates comprehensive assessment, safety planning, and possible referral to specialized services.

Step 3: Integrated treatment planning

The team crafts a unified plan that may include:

  • Spinal adjustments and targeted exercises to correct alignment and biomechanics

  • Gradual increase in physical activity with pain‑sensitive pacing

  • Non‑pharmacologic pain strategies (manual therapy, exercise therapy, education)

  • Behavioral health referral for CBT, trauma‑informed treatment, or other modalities

  • Consideration of medications for AUD or OUD, if indicated

  • Harm‑reduction measures (for example, naloxone prescription for those at overdose risk)

Step 4: Ergonomics and lifestyle

  • NP and chiropractor jointly review workplace and home ergonomics, posture, and activity patterns.

  • Patients learn micro‑break routines, stretching, and strengthening sequences for high‑risk tasks (for example, lifting or prolonged sitting).

  • Nutrition, stress‑management, and sleep interventions are introduced or refined.

Step 5: Monitoring and long‑term follow‑up

  • Regular follow‑up visits evaluate:

    • Pain levels and functional capacity

    • Substance use patterns and cravings

    • Mood, sleep, and quality of life

    • Adherence to exercise and ergonomic plans

  • The team updates the treatment plan to respond to progress, setbacks, or new diagnoses.

  • Patients are coached to view flare-ups or lapses as opportunities to learn and adjust, not as failures.

This kind of coordinated, integrative approach can reduce repeated injuries, unnecessary imaging or surgeries, and long‑term dependence on medications, including opioids.

Clinical Insights from an Integrative Practice Model

Although each practice is unique, Dr. Alexander Jimenez’s clinic illustrates several principles that can guide others (Jimenez, n.d.):

  • Whole‑person assessment: History taking includes injuries, lifestyle, trauma, nutrition, environment, and psychosocial stressors.

  • Functional movement focus: Care plans emphasize flexibility, mobility, agility, and strength to restore capacity rather than just relieve symptoms.

  • Non‑invasive first: Chiropractic adjustments, functional exercise, and lifestyle interventions are prioritized before invasive procedures or long‑term controlled substances.

  • Integrated roles: As both DC and FNP‑BC, Dr. Jimenez unifies neuromusculoskeletal, primary care, and functional medicine perspectives in a single, coordinated plan.

  • Patient empowerment: Education, coaching, and accessible care options help patients take a proactive role in maintaining spinal health and reducing SUD risk.

This model aligns with national guidance on behavioral health integration and SUD management in medical settings while adding the musculoskeletal and ergonomic expertise of chiropractic care (AMA, n.d.; NIDA, n.d.; NIMH, 2025).

Key Takeaways

  • SUD is a chronic, treatable medical condition that often co‑occurs with mental disorders and chronic pain.

  • Validated screening tools and non‑stigmatizing, trauma‑informed communication are core to early identification.

  • Risk and severity categories (mild, moderate, severe) guide brief intervention, level of care, and referral decisions.

  • SUD significantly affects the body, including bone health, soft tissue integrity, injury risk, and chronic pain pathways.

  • Integrative chiropractic care—with spinal adjustments, targeted exercises, and ergonomic guidance—can reduce pain, improve function, and lower overlapping risk factors for SUD.

  • Nurse practitioners provide comprehensive SUD management, coordinate care, and deliver ergonomic and lifestyle counseling that complements chiropractic treatment.

  • A collaborative, long‑term, patient‑centered model—such as the one exemplified by Dr. Alexander Jimenez—offers a promising pathway to healthier spines, healthier brains, and healthier lives.

Conclusion

Substance use disorder is a complex medical condition that requires compassion, evidence‑based screening, and coordinated care across multiple disciplines. For healthcare professionals—whether chiropractors, nurse practitioners, primary care physicians, or behavioral health specialists—the opportunity to identify and support patients with SUD begins with understanding what it is, how to recognize it, and how to respond with respect and proven interventions.

The integration of chiropractic care and nurse practitioner-led primary care offers a distinctive advantage for patients struggling with both chronic pain and substance use. When a patient presents with a work injury, auto accident, or years of poor ergonomics, they may not volunteer that they are also wrestling with alcohol dependence, prescription opioid misuse, or stimulant use. Yet these challenges often coexist. The musculoskeletal system bears the weight of increased fracture risk, muscle wasting, poor healing, and heightened pain sensitivity. The mind and nervous system are equally affected, with sleep disruption, mood changes, and reduced resilience to stress all fueling the cycle of pain and substance use.

Clinics and practices that integrate screening, brief intervention, and coordinated treatment have a powerful tool to interrupt this cycle. Spinal adjustments restore mechanical function. Targeted exercises rebuild strength and proprioception. Ergonomic guidance prevents re‑injury. Nurse practitioners coordinate medications, monitor for drug interactions, and counsel on lifestyle factors that support both spine health and recovery from SUD. Behavioral health clinicians provide therapy, peer support, and relapse prevention. Together, this team addresses root causes, not just symptoms.

The clinical model exemplified by providers like Dr. Alexander Jimenez demonstrates that a single clinician with dual expertise—chiropractic and family practice nurse practitioner credentials—can seamlessly weave these threads into a coherent, patient‑centered plan. Patients benefit from continuity, alignment of goals, and a provider who understands both the biomechanics of a herniated disc and the neurobiology of addiction. Larger practices can achieve similar results through deliberate team communication, shared decision‑making, and a commitment to non‑stigmatizing, trauma‑informed care.

The evidence is clear: early identification saves lives and improves outcomes. Validated screening tools are quick and accurate. Motivational interviewing and brief interventions work. Medications for alcohol and opioid use disorders are safe and effective when used thoughtfully. Non‑pharmacologic approaches—exercise, manual therapy, stress management, social support—are powerful and underutilized. And when musculoskeletal and behavioral health care are woven together, patients heal faster, return to function sooner, and are far less likely to relapse into substance misuse.

For healthcare teams willing to expand their lens beyond isolated complaints—beyond “just” back pain or “just” anxiety—the reward is profound: patients who reclaim their health, their relationships, and their sense of purpose. This is the promise of integrative, collaborative, evidence‑based care for substance use disorder and musculoskeletal health.

References

Real-Life Posture Rehab for a Stronger Spine

Real-Life Posture Rehab for a Stronger Spine

by | Back Pain, Chiropractic, Chiropractic Examination, Chronic Pain, Exercise, Health, Integrative Medicine, Physical Rehabilitation, Posture, Sciatica Nerve Pain, Spinal Decompression Treatments, Spinal Hygiene, Spine Care, Stress, Treatments

Real-Life Posture Rehab: How El Paso Back Clinic Helps You Move Better Every Day

Real-Life Posture Rehab for a Stronger Spine

Move around and change posture positions throughout the day.

Improving posture is one of the fastest ways to feel stronger, breathe easier, and protect your spine—especially if you live with long commutes, heavy work, or hours at a desk, like many people in El Paso. At El Paso Back Clinic, Dr. Alexander Jimenez, DC, APRN, FNP-BC, and his team see every day how targeted physical activity, along with integrative chiropractic and nurse practitioner (NP) care, can turn slouching and stiffness into confident, upright movement. El Paso, TX Doctor Of Chiropractic+1

This article explains, in simple language:

  • What good posture really is

  • Recommended physical activities and exercises to enhance posture

  • How yoga, Pilates, and mind-body practices improve alignment

  • Easy desk and “tech neck” fixes

  • How integrative chiropractic care supports posture

  • How nurse practitioners help with medical, ergonomic, and lifestyle support

  • How the El Paso Back Clinic combines all of this in real-world care

What “Good Posture” Means (and Why It Matters in Daily Life)

Good posture means your body is stacked in a natural, balanced way:

  • Ears over shoulders

  • Shoulders over hips

  • Hips over knees and ankles

  • Spine holding its natural curves (neck, mid-back, low back)

When posture is poor—like slouching over a phone or leaning forward at a desk—stress builds up in your neck, shoulders, and back. Over time, this can lead to:

  • Chronic neck and back pain

  • Tension headaches

  • Fatigue and shallow breathing

  • Tight hip flexors and weak glutes

  • Early joint wear and tear

Research and clinical guides show that specific exercises and posture-friendly habits can reduce pain and improve alignment by strengthening postural muscles and keeping you moving throughout the day. Healthline+2Harvard Health+2

At El Paso Back Clinic, Dr. Jimenez often reminds patients that posture is not about “standing stiff.” It is about a strong, relaxed, and mobile spine that can handle work, sports, and life in the desert heat. El Paso, TX Doctor Of Chiropractic+1

Core Principles of Posture-Focused Exercise

Most effective posture plans share the same core goals:

  • Strengthen the core and back—so your spine has solid support

  • Activate glutes and shoulders—to counter slumping and hip stress

  • Improve flexibility—especially in chest, hip flexors, and hamstrings

  • Train body awareness—so you notice and correct slouching

  • Add low-impact cardio—to boost circulation and recovery

Think of Your Program in Simple Pieces

Try to include each week:

  • 2–3 days of core and back strengthening

  • 2–3 days of mobility and stretching

  • 2–4 days of low-impact cardio like walking or swimming

  • Daily micro-breaks from sitting or driving

That may sound like a lot, but many of these can be done in 10–20 minute blocks and woven into your normal day.

Foundational Strength Exercises for Better Posture

Many posture programs start with bodyweight moves you can do at home—no machines, no fancy equipment. Sources on physical therapy and spine health support these exercises. Healthline+2Primal Physical Therapy+2

Planks (Front and Side Planks)

Why they help:
Planks strengthen your deep core, shoulders, and glutes. A strong core keeps your spine from sagging or arching too much.

Basic front plank:

  • Start on your forearms and toes

  • Keep your body in a straight line from head to heels

  • Gently pull your belly toward your spine

  • Hold 20–30 seconds, rest, repeat 2–3 times

Side planks add extra stability for your sides and hips, which support upright posture. Woodlands Sports Medicine

Bird-Dog

Why it helps:
Bird-dog builds core and back strength while training balance and control.

How to do it:

  • Start on hands and knees

  • Extend your right arm forward and left leg back

  • Keep your hips level; don’t twist

  • Hold 3–5 seconds, then switch sides

  • Do 8–10 reps per side

Physical therapists often use this exercise to improve posture and relieve back pain. Primal Physical Therapy+1

Glute Bridges

Why they help:
Bridges work the glutes and hamstrings and relieve stress on the lower back.

  • Lie on your back, knees bent, feet flat

  • Press through your heels and lift your hips

  • Squeeze your glutes at the top

  • Hold 3–5 seconds, then lower

  • Repeat 10–15 times

Strong glutes help balance tight hip flexors from long periods of sitting, which is very common among drivers and office workers in El Paso. Primal Physical Therapy+1

Superman Exercise

Why it helps:
The Superman move targets the “posterior chain,” the muscles along the back of your body that help prevent slouching. Woman & Home

  • Lie face down

  • Lift your chest, arms, and legs slightly off the floor

  • Hold briefly and lower with control

  • Start with 5–8 reps

This move is especially useful if you sit a lot or look down at screens, as it helps your back muscles stay active.

Rowing Movements (Bands or Dumbbells)

Why they help:
Rowing exercises strengthen the upper back and shoulder stabilizers that pull your shoulders back.

  • Use a resistance band or light dumbbells

  • Pull your elbows back and squeeze your shoulder blades together

  • Avoid shrugging your shoulders toward your ears

  • Do 2–3 sets of 10–15 reps

Row-type motions are commonly recommended in posture rehab plans. Primal Physical Therapy+1

Mobility and Stretching: Releasing the “Posture Brakes”

If strength is the “engine,” tight muscles are the “brakes.” You need both to work well. Stretching and mobility exercises help open areas that tend to tighten up, such as the chest, neck, hips, and upper back. Illinois Back Institute+1

Key Posture Stretches

  • Chest Opens / Doorway Stretch

    • Stand in a doorway with your forearms on the frame

    • Gently lean forward until you feel a stretch across your chest

    • Hold 20–30 seconds

  • Chin Tucks barringtonortho.com+1

    • Sit or stand tall

    • Gently slide your chin straight back (like a mini “double chin”)

    • Hold 3–5 seconds

    • Repeat 10 times

  • Cat-Cow

    • On hands and knees

    • Slowly round your back toward the ceiling, then gently arch it

    • Move with your breath for 8–10 cycles

  • Hip Flexor Stretch

    • In a half-kneeling position, gently shift your hips forward

    • Keep your torso upright; avoid over-arching your back

    • Hold 20–30 seconds on each side

These stretches are simple but powerful when done daily—especially if you spend long hours driving I-10 or sitting at a workstation in El Paso. Illinois Back Institute+1

Mind-Body Practices: Yoga, Pilates, and Tai Chi

Mind-body exercises are excellent for posture because they combine strength, flexibility, and body awareness.

Yoga for Alignment and Awareness

Yoga routines often include:

  • Mountain Pose (Tadasana)—teaches what upright alignment feels like

  • Child’s Pose and Cat-Cow – gently move and decompress the spine

  • Bridge Pose – strengthens glutes and back

  • Chest opener poses—counter phone and computer hunching

Research-based guides show yoga can improve postural muscle endurance and help people become more aware of how they carry themselves. Healthline+1

Pilates for Core Control

Pilates focuses on:

  • Deep core strength

  • Controlled breathing

  • Smooth, precise movements

Many physical therapy and rehab programs use Pilates-style exercises to support spinal alignment and postural stability. Primal Physical Therapy+1

Tai Chi for Balance and Relaxed Upright Posture

Tai chi uses slow, flowing movements with calm breathing. It helps:

  • Improve balance and coordination

  • Encourage relaxed, upright posture

  • Reduce stress and muscle guarding

Chiropractic resources often recommend swimming, walking, yoga, and tai chi as ideal companions to chiropractic care. Muscle and Joint Chiropractic+1

Everyday Physical Activities That Support Posture

You don’t have to become a gym athlete to help your posture. Many everyday activities, done with good form, support a healthier spine.

Helpful posture-friendly options include:

  • Walking:

    • Encourages natural spinal motion

    • Easy to fit into breaks or evenings

  • Swimming:

    • Full-body, low-impact workout

    • Strengthens back and shoulder muscles with less joint stress

  • Dancing:

    • Builds coordination and body awareness

    • Helps you practice an upright chest and an active core

  • Cycling (with proper bike fit):

    • Strengthens hips and legs

    • Supports overall fitness and endurance

Clinics that treat back pain often highlight walking and swimming as key activities for long-term spinal health. Illinois Pain & Spine Institute+1

Desk, Phone, and “Tech Neck”: Quick Fixes You Can Actually Use

Long hours on a computer or phone are a major reason posture has become such a problem. Harvard Health and orthopedic clinics stress the importance of frequent movement breaks and simple desk exercises. Harvard Health+2barringtonortho.com+2

Desk-Friendly Posture Break Routine

Try this mini-routine a few times each day:

  • Chin tucks – 10 reps

  • Shoulder blade squeezes – hold 5 seconds × 10 reps

  • Seated Cat-Cow – 5–10 slow breaths

  • Forward fold stretch next to your desk—hold 20–30 seconds

Simple Ergonomic Tips

  • Keep feet flat on the floor

  • Hips and knees are near 90 degrees

  • Screen at or just below eye level

  • Use a small lumbar support or rolled towel behind your low back

  • Stand and walk at least every 30–60 minutes

Recent expert tips also support using standing desks, wireless headphones for “walking meetings,” and light resistance bands at your station to keep postural muscles awake. Harvard Health+1

How Integrative Chiropractic Care at El Paso Back Clinic Supports Posture

Chiropractic care focuses on the spine, joints, and nervous system. Integrative chiropractic care goes further, combining adjustments with corrective exercises, lifestyle coaching, and medical input from NPs. Advanced Spine & Posture+1

What a Posture-Focused Chiropractic Visit Often Includes

At El Paso Back Clinic, a posture evaluation usually involves: El Paso Back Clinic® • 915-850-0900+1

  • Posture and movement exam

    • Checking head position, shoulder level, spinal curves, and gait

  • Spinal and extremity adjustments

    • Gentle, specific forces to restore joint motion and alignment

  • Soft-tissue work

    • Releasing tight muscles and fascia that pull you out of alignment

  • Corrective exercises

    • Planks, bridges, bird-dogs, rows, and targeted stretches

  • Ergonomic and lifestyle coaching

    • Coaching for desk work, lifting, driving, and sleep positions

Studies and clinical reports note that regular chiropractic adjustments can:

The Nurse Practitioner’s Role in Supporting Posture

At El Paso Back Clinic, Dr. Jimenez works not only as a chiropractor but also as a board-certified family nurse practitioner, which provides a broader, medically informed perspective on posture-related problems. El Paso, TX Doctor Of Chiropractic+1

A nurse practitioner can:

  • Review your full medical history

    • Identify arthritis, osteoporosis, nerve issues, or autoimmune conditions that affect posture.

  • Order and interpret imaging and labs

    • X-rays, MRIs, and blood work when appropriate

  • Prescribe or adjust medications

    • Short-term pain or muscle-relaxant use when necessary

  • Coordinate referrals

    • Physical therapy, pain management, and surgical consults if needed

  • Give lifestyle and ergonomic counseling

    • Weight management, sleep, stress, and work setup

  • Use telemedicine for follow-up

    • To keep you on track with your exercise and pain management plan

This integrative model makes it easier to catch red flags early, adjust plans safely, and provide each patient with a personalized path rather than a one-size-fits-all list of exercises.

How Dr. Alexander Jimenez Combines Physical Activity, Chiropractic Care, and NP Expertise

With decades of experience in personal injury, sports, and functional medicine, Dr. Jimenez has seen the same pattern again and again: posture improves the most when hands-on care, smart exercise, and patient education are combined. El Paso, TX Doctor Of Chiropractic+2El Paso, TX Doctor Of Chiropractic+2

In his clinical observations at El Paso Back Clinic:

  • Patients with neck and back pain do best when:

    • They receive specific spinal adjustments

    • PLUS core and hip strengthening

    • PLUS stretching and mobility work

  • Low-impact activities like walking, swimming, yoga, and tai chi speed up recovery and help keep adjustments holding longer. Muscle and Joint Chiropractic+2Illinois Pain & Spine Institute+2

  • Agility and functional training (such as controlled squats, lunges, and balance drills) help patients return to sports, warehouse work, or family life with greater resilience.

  • Posture work is often integrated with nutrition, sleep, and stress management, because tired, inflamed bodies struggle to maintain good alignment. El Paso, TX Doctor Of Chiropractic+1

This dual license (DC + APRN, FNP-BC) allows Dr. Jimenez to move comfortably between spine mechanics and whole-person health, which is ideal for complex posture and pain cases.

Sample Weekly Posture-Boosting Plan (General Example)

This is a general example for educational purposes, not a personal prescription. Always consult your provider—especially if you have pain, injuries, or medical conditions.

Weekly Outline

Day 1 – Core and Glutes

  • Front plank: 3 × 20–30 seconds

  • Glute bridges: 3 × 12–15

  • Bird-dog: 2 × 10 per side

  • 10 minutes of chest and hip flexor stretches

Day 2 – Yoga and Mobility

  • 20–30 minutes of yoga (Mountain, Child’s Pose, Cat-Cow, gentle twists) Healthline+1

  • Chin tucks: 2 × 10

  • Shoulder blade squeezes: 2 × 10

Day 3 – Upper Back and Cardio

  • Resistance band or dumbbell rows: 3 × 12

  • Wall angels: 2 × 10 Outside Online

  • 20–30 minutes of brisk walking

Day 4 – Pilates-Style Core

  • 20 minutes of Pilates or core routine (e.g., dead bugs, “hundreds,” side-lying leg lifts) Primal Physical Therapy+1

  • 10 minutes of hamstring and hip stretches

Day 5 – Mind-Body and Balance

  • 20–30 minutes of tai chi or a gentle balance practice

  • Single-leg stands: 3 × 20 seconds per leg

Day 6 – Whole-Body Low-Impact

Day 7 – Recovery and Reset

  • Gentle stretching or yoga flow

  • Posture check around your home and car: adjust chairs, pillows, and monitor height

Patients at El Paso Back Clinic often have a plan customized to their injury type (auto accident, work injury, or sports strain) and their job or sport. El Paso Back Clinic® • 915-850-0900+1

Safety Tips: When to Get Help

Stop and get professional care if posture exercises cause:

  • Sharp or stabbing pain

  • Numbness or tingling in arms or legs

  • New weakness or loss of coordination

  • Trouble walking or standing

  • Loss of bladder or bowel control (emergency—seek urgent care)

A chiropractor can evaluate your spine and joints; a nurse practitioner can check for underlying medical causes. At El Paso Back Clinic, the team works together to decide whether you need imaging, medication, rehab, or a referral to another specialist. El Paso, TX Doctor Of Chiropractic+1

Bringing It All Together

To enhance posture and protect your spine:

  • Strengthen your core, back, and glutes with planks, bridges, bird-dogs, rows, and Supermans

  • Stretch your chest, neck, and hips to release tight, “slouching” muscles

  • Use mind-body practices like yoga, Pilates, and tai chi to build body awareness

  • Add low-impact activities like walking and swimming to support overall spine health

  • Fix your desk and phone habits with regular movement breaks and better ergonomics

At El Paso Back Clinic, integrative chiropractic care and nurse practitioner support bring all of these pieces together. With Dr. Alexander Jimenez’s dual training, patients receive:

  • Spinal and joint adjustments

  • Corrective exercise and posture coaching

  • Medical evaluation, imaging, and medication management when needed

  • Telemedicine and follow-up plans that fit real life in El Paso

The goal is simple: help you stand taller, move with less pain, and feel stronger in everything you do—from lifting kids or boxes at work to walking the trails of the Franklin Mountains.

References

Advanced Medical Group. (2025, March 5). Can a chiropractor help with posture? Advanced Medical Group.
https://advancedmedicalgroupnj.com/can-a-chiropractor-help-with-posture/ Advanced Medical Group

Advanced Spine & Posture. (2024). Poor posture and chiropractic adjustments. Advanced Spine & Posture.
https://advancedspineandposture.com/blog/poor-posture-and-chiropractic-adjustments/ Advanced Spine & Posture

Alter Chiropractic. (n.d.-a). 7 ways to improve posture naturally. Alter Chiropractic.
https://alterchiropractic.com/7-ways-to-improve-posture-naturally/

Alter Chiropractic. (n.d.-b). Enhance your posture with professional care. Alter Chiropractic.
https://alterchiropractic.com/enhance-your-posture-with-professional-care/

Artisan Chiropractic Clinic. (n.d.). Improve your posture with chiropractic adjustments: The benefits and techniques. Artisan Chiropractic Clinic.
https://www.artisanchiroclinic.com/improve-your-posture-with-chiropractic-adjustments-the-benefits-and-techniques/

Barrington Orthopedic Specialists. (2020, June 9). Three simple exercises you can do at work to improve your posture. Barrington Ortho.
https://www.barringtonortho.com/blog/three-simple-exercises-you-can-do-at-work-to-improve-your-posture barringtonortho.com

Cronkleton, E. (2025, April 14). Posture exercises: 12 exercises to improve your posture. Healthline.
https://www.healthline.com/health/posture-exercises Healthline

Fitness Education. (n.d.). Exercises to improve posture. Fitness Education.
https://www.fitnesseducation.edu.au/blog/health/exercises-to-improve-posture/

Fitness Stack Exchange. (n.d.). How to retain a proper posture when sitting, standing, walking? Fitness Stack Exchange.
https://fitness.stackexchange.com/questions/22489/how-to-retain-a-proper-posture-when-sitting-standing-walking

Harvard Health Publishing. (n.d.-a). In a slump? Fix your posture. Harvard Medical School.
https://www.health.harvard.edu/staying-healthy/in-a-slump-fix-your-posture Harvard Health

Harvard Health Publishing. (n.d.-b). Is it too late to save your posture? Harvard Medical School.
https://www.health.harvard.edu/exercise-and-fitness/is-it-too-late-to-save-your-posture

Illinois Back & Pain Center. (2024, July 22). Activities that can improve your posture. Illinois Back & Pain Center.
https://illinoisbackpain.com/activities-that-can-improve-your-posture/ Illinois Back Institute

Jimenez, A. (n.d.-a). El Paso, TX doctor of chiropractic. DrAlexJimenez.com.
https://dralexjimenez.com/ El Paso, TX Doctor Of Chiropractic

Jimenez, A. (n.d.-b). Dr. Alex Jimenez DC, Injury Medical & Chiropractic Clinic | Chiropractors El Paso TX. ElPasoBackClinic.com.
https://elpasobackclinic.com/dr-alex-jimenez-dc-injury-medical/ El Paso Back Clinic® • 915-850-0900

Jimenez, A. (n.d.-c). Why choose Dr. Jimenez and clinical team? DrAlexJimenez.com.
https://dralexjimenez.com/why-choose-dr-jimenez-and-clinical-team/ El Paso, TX Doctor Of Chiropractic

Outside Online. (2025, November 16). 3 exercises for better posture, approved by a physical therapist. Outside.
https://www.outsideonline.com/health/training-performance/exercises-for-better-posture/ Outside Online

Outside Online. (2023, August 26). 3 thoracic mobility exercises to improve your posture and form. Outside.
https://www.outsideonline.com/health/training-performance/thoracic-mobility-exercises/ Outside Online

Primal Physical Therapy. (2025, September 2). 6 best physical therapy posture exercises to reduce pain. Primal Physical Therapy.
https://primalphysicaltherapy.com/best-physical-therapy-posture-exercises/ Primal Physical Therapy+1

Primal Physical Therapy. (2024, July 25). Physical therapy techniques for chronic back pain relief. Primal Physical Therapy.
https://primalphysicaltherapy.com/physical-therapy-techniques-for-chronic-back-pain-relief/ Primal Physical Therapy

Sanctuary Wellness Institute. (2024, May 27). What are the best stretches for posture? Sanctuary Wellness Institute.
https://sanctuarywellnessinstitute.com/blog/what-are-the-best-stretches-for-posture/ sanctuarywellnessinstitute.com

Texas Spine & Sports Therapy Center. (n.d.). 5 muscle strengthening exercises to do at home for posture. Texas Spine & Sports Therapy Center.
https://texasspineandsportstherapy.com/5-muscle-strengthening-exercises-to-do-at-home-for-posture/

Thrive Chiropractic Cedar Falls. (2024, March 5). 7 exercises that complement quality chiropractic care. Thrive Chiropractic Cedar Falls.
https://www.thrivecedarfalls.com/lowbackpain/quality-chiropractic-care-exercises/

Tooele Muscle & Joint Chiropractic. (2024, August 29). 6 physical activities that complement your chiropractic treatments. Muscle & Joint Chiropractic.
https://tooelechiropractor.com/physical-activities-complement-chiropractic/ Muscle and Joint Chiropractic

Woodlands Sports Medicine. (n.d.). 10 exercises to improve posture and relieve lower back pain. Woodlands Sports Medicine.
https://www.woodlandssportsmedicine.com/blog/10-exercises-to-improve-posture-and-relieve-lower-back-pain Woodlands Sports Medicine

Woman & Home. (2025, August). The Superman exercise is so simple, yet improves posture and back strength “like nothing else.” Woman & Home.
https://www.womanandhome.com/health-wellbeing/fitness/superman-exercise/ Woman & Home

Functional Wellness and Healing from Autoimmune Conditions

Functional Wellness and Healing from Autoimmune Conditions

by | Chiropractic, Chronic Pain, Functional Medicine, Health, Holistic Medicine, Treatments, Viscerosomatic Reflex, Wellness

Learn about the role of functional wellness in addressing autoimmune conditions and supporting overall health.

Understanding Autoimmune Conditions: How Functional Wellness Can Transform Your Health

Faster Recovery After Spine Surgery Strategies

Faster Recovery After Spine Surgery Strategies

by | Auto Accident Injuries, Back Pain, Chiropractic, Chiropractic Examination, Federal Employee Work Injuries, Head Pain and Trauma, Healthcare Providers, Herniated Disc, Imaging & Diagnostics, Lawyers, Med-Legal Corner, Personal Injury, Physical Rehabilitation, Professionals, Protective Services, Sciatica Nerve Pain, Scoliosis, Spinal Decompression Treatments, Spinal Hygiene, Spine Care, Sports Injuries, Sports Injury, Treatments, Veterans, Whiplash, Whiplash, Work Related Injuries

Faster Recovery After Spine Surgery: Enhanced Surgical Recovery (ESR) Programs at El Paso Back Clinic® in El Paso, TX

Faster Recovery After Spine Surgery Strategies

The doctor administers a local anesthetic into the patient’s affected area, using ultrasound to visualize the spine’s anatomical components.

Spine surgery can help treat serious back problems, such as pain from injuries, disc issues, or aging. At El Paso Back Clinic® in El Paso, TX, we focus on helping patients recover faster and more safely through modern methods. Enhanced Surgical Recovery (ESR), also called Enhanced Recovery After Surgery (ERAS), is a team-based plan that reduces the need for strong pain medications, shortens hospital stays, and lowers the risk of readmission. Led by Dr. Alexander Jimenez, DC, APRN, FNP-BC, our clinic combines chiropractic care, nurse practitioner expertise, and new tools to support healing. This article explains the main parts of ESR for spine surgery, how it cuts opioid use, shortens hospital stays, and reduces readmissions. We also cover the big roles of integrative chiropractic care and nurse practitioners, plus exciting new tech like virtual reality (VR) for building strength after surgery.

Many people in El Paso face back pain from work, accidents, or daily life. Surgery may be necessary, but traditional methods can make recovery challenging. ESR improves this process by planning care before, during, and after the operation. It uses simple steps, such as teaching patients, eating better, and moving early. Studies show these measures can cut opioid use a lot and help people go home sooner (Dagal et al., 2023). At El Paso Back Clinic®, we work with surgeons to add non-drug options for even better results.

What Is Enhanced Surgical Recovery (ESR)?

ESR is a proven plan to make surgery recovery easier and quicker. It started in other surgeries, but now helps a lot with spine operations, such as fusions or disc repairs. The idea is to lower body stress and speed natural healing. Instead of staying in bed and taking many pain pills, patients move soon and use gentler pain control.

Key parts of ESR include:

  • Team Approach — Doctors, nurses, chiropractors, and therapists all work together.
  • Step-by-Step Care — Planning starts before surgery and continues at home.
  • Personal Plans — Care fits each person’s health needs.

Research shows ESR helps with many spine issues, from small fixes to big ones (Zaed et al., 2023). Reviews find that most programs use around 12 key steps, such as better pain management and early walking (Berk et al., 2025).

Main Components of ESR for Spine Surgery

ESR has steps before, during, and after surgery to make things smoother.

Before Surgery (Pre-Op)

Getting ready early helps avoid problems.

  • Teaching Patients: Learn what to expect, how to manage pain, and why moving matters. This lowers worry and helps follow the plan (Zaed et al., 2023).
  • Better Nutrition: Check for low energy or anemia. Eat protein and carbs to build strength. Nutritious food helps healing (Soffin et al., 2022).
  • Pain Prep: Start gentle meds like acetaminophen. Quit smoking to lower risks (American Association of Nurse Anesthesiology, n.d.).
  • Prehab Exercises: Build strength with walks or stretches.

These make surgery safer.

During Surgery (Intra-Op)

The team uses ways to protect the body.

  • Better Anesthesia: Short drugs to wake up fast. Add non-opioid options (Dagal et al., 2023).
  • Careful Fluids: Just the right amount to avoid issues.
  • Small Cuts: Less muscle damage for quicker recovery (Dietz et al., 2019).
  • Pain Blocks: Numb the area for hours after.

Patients feel better right away.

After Surgery (Post-Op)

Focus on rapid healing.

  • Early Walking: Get up soon and walk daily (Zaed et al., 2023).
  • Mixed Pain Control: Use non-opioids, ice, and movement.
  • Quick Eating: Start foods and drinks early.
  • Checks for Safety: Watch for clots or other issues.

These steps lower risks.

How ESR Reduces Opioid Use

Strong pain drugs like opioids help, but can lead to problems like addiction. ESR cuts its use by at least half (Dagal et al., 2023). At El Paso Back Clinic®, we add chiropractic methods for even less need.

  • Mixed Pain Options: Non-opioids first, like NSAIDs and nerve meds. Some programs use almost no IV opioids (HCA Healthcare, n.d.).
  • Teaching Non-Drug Ways: Ice, breathing, and adjustments.
  • Blocks and Early Move: Numb areas and walk to ease pain.

In fusions, opioids dropped considerably without worse pain (Dagal et al., 2023). This helps avoid side effects and promotes natural healing.

Shortening Hospital Stays with ESR

Long hospital time raises costs and risks. ESR cuts stay by 1-2 days (HCA Healthcare Today, 2022).

  • Early Movement: Prevents issues and builds strength.
  • Fast Nutrition: Energy for recovery.
  • Good Pain Control: Less bedtime.
  • Team Reviews: Go home when ready.

One example shows noticeable shortened stays (Dagal et al., 2023). Patients heal better at home.

Lowering Readmission Rates

Going back to the hospital is tough. ESR lowers this risk (HCA Healthcare Today, 2022).

  • Home Care Teaching: Know warning signs.
  • Follow-Ups: Calls from our team at El Paso Back Clinic®.
  • Fewer Problems: Better prep means fewer infections.
  • Full Care: Controls swelling early.

Fewer complications overall (Berk et al., 2025).

Integrative Chiropractic Care at El Paso Back Clinic®

Chiropractic care fits perfectly with ESR. At our clinic, Dr. Jimenez uses hands-on adjustments to align and relieve symptoms.

  • Before Surgery: Improve posture and movement.
  • Pain Without Drugs: Soft tissue work eases tension.
  • After Surgery: Reduce scar tissue and build mobility (New York City Spine, n.d.).
  • Nerve Help: Better signals for less pain.

We complement therapy for smoother recovery (Active Health Center, n.d.).

Role of Nurse Practitioners

Nurse practitioners (NPs) like Dr. Jimenez coordinate care.

  • Team Links: Connect everyone.
  • Teaching and Meds: Focus on safe, non-opioid options.
  • Tracking Progress: Adjust plans.

NPs help stick to ESR paths (American Association of Nurse Anesthesiology, n.d.).

New Tech: Virtual Reality (VR) for Recovery

VR uses games and guides to make rehab more enjoyable. It helps spine patients build strength.

  • Fun Exercises: Improves engagement and movement.
  • Less Pain Feel: Distraction helps.
  • Strength Gains: Tailored for muscles and focus.
  • Home Options: Practice alone.

Recent studies show VR speeds recovery after spine issues, like in cervical cases or general neurorehab (Bolton et al., 2025; various 2025 trials).

Insights from Dr. Alexander Jimenez at El Paso Back Clinic®

Dr. Alexander Jimenez, DC, APRN, FNP-BC, leads El Paso Back Clinic® with dual expertise in chiropractic and nursing. He uses team care for pain management and rehab after injuries or surgery. His plans include adjustments, nutrition, and integrative methods for better mobility without heavy drugs. He stresses whole-body healing for lasting results (Dr. Alex Jimenez, n.d.; LinkedIn, n.d.).

Conclusion

ESR programs accelerate spine surgery recovery and make it safer. With education, nutrition, movement, and team support, they reduce opioids, shorten stays, and lower readmissions. At El Paso Back Clinic® in El Paso, TX, we add chiropractic care and NP guidance for full support. New VR tech adds exciting ways to build strength. If facing spine surgery, ask about ESR and our integrative options. Contact us at 915-850-0900 for help.

References

Active Health Center. (n.d.). Rehabilitation after surgery: Integrating chiropractic care into recovery. https://activehealthcenter.com/rehabilitation-after-surgery-integrating-chiropractic-care-into-recovery/

American Association of Nurse Anesthesiology. (n.d.). Enhanced recovery after surgery. https://www.aana.com/practice/clinical-practice/clinical-practice-resources/enhanced-recovery-after-surgery/

Berk, M., et al. (2025). Enhanced recovery after surgery (ERAS) in spine surgery: A systematic review and meta-analysis. https://pmc.ncbi.nlm.nih.gov/articles/PMC12592135/

Bolton, W.S., et al. (2025). Recovr reality – Recover after injury or surgery to the brain and spinal cord with virtual Reality: ideal stage 2a clinical feasibility study. https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-024-01499-3

Dagal, A., et al. (2023). Adoption of enhanced surgical recovery (ESR) protocol for lumbar fusion decreases in-hospital postoperative opioid consumption. https://pmc.ncbi.nlm.nih.gov/articles/PMC10189339/

Dietz, N., et al. (2019). Enhanced recovery after surgery (ERAS) protocols: Time to change practice?. https://www.medrxiv.org/content/10.1101/2020.08.16.20175943v1.full

Dr. Alex Jimenez. (n.d.). El Paso, TX, doctor of chiropractic. https://dralexjimenez.com/

HCA Healthcare. (n.d.). With ESR, our patients report…. https://www.hcadam.com/api/public/content/f42a4095a6f9451baa991b5a56cad568?v=4786eda4&download=true

HCA Healthcare Today. (2022). HCA Healthcare’s innovative approach to surgical recovery. https://hcahealthcaretoday.com/2022/12/13/hca-healthcares-innovative-approach-to-surgical-recovery-promotes-better-outcomes-decreased-opioid-usage-and-faster-recovery-times-for-patients/

LinkedIn. (n.d.). Dr. Alexander Jimenez, DC, APRN, FNP-BC. https://www.linkedin.com/in/dralexjimenez/

New York City Spine. (n.d.). How a chiropractor can aid spinal fusion recovery. https://newyorkcityspine.com/how-a-chiropractor-can-aid-spinal-fusion-recovery/

Soffin, E. M., et al. (2022). Enhanced recovery after surgery (ERAS) protocol in spine surgery. https://pmc.ncbi.nlm.nih.gov/articles/PMC9293758/

Zaed, I., et al. (2023). Enhanced recovery after surgery (ERAS) protocols for spine surgery – review of literature. https://pmc.ncbi.nlm.nih.gov/articles/PMC10156499/

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