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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.


Pathology of Lumbar Disc Degeneration: Expert Guide

Pathology of Lumbar Disc Degeneration: Expert Guide

Can healthcare providers help many individuals with lumbar disc degeneration find relief through spinal decompression treatments?

Introduction

Many individuals often do everyday motions that can allow the spine to bend, twist, and turn in various ways without feeling pain and discomfort. However, as the body ages, so does the spine, as the spinal discs begin the natural process of degeneration. Since the spinal discs in the spinal column absorb the vertical pressure weight, it stabilizes the upper and lower extremities and provides motion. To that point, when many individuals suffer from various injuries or environmental factors that cause the spinal disc to be compressed, it can lead to low back issues that cause pain and discomfort when a person is doing an activity. Since low back pain is one of the three most common problems that many people worldwide have dealt with, it can become a socio-economic issue that can lead to a life of disability and misery. Low back pain is often correlated with disc degeneration, and the surrounding ligaments and muscle tissues can affect the upper and lower extremities. This causes referred pain to the different musculoskeletal groups, causing many people to seek treatment that can not only be affordable but also effective in reducing the pain. Today’s article looks at the anatomy of the lumbar disc, how disc degeneration affects the lumbar spine, and how spinal decompression can reduce lumbar disc degeneration from causing more pain to the lower back. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease the pain-like symptoms associated with lumbar disc degeneration causing low back pain. We also inform our patients that there are non-surgical options to reduce these pain-like issues correlated with disc degeneration and restore lumbar mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

 

The Anatomy Of The Lumbar Disc

Do you feel tension or stiffness in your lower back after waking up in the morning? Do you feel sudden or gradual pain from bending down to lift a heavy object that is affecting your lower back? Or do you feel the pain in one location or another in your back that is causing you pain and discomfort in your lumbar spinal region? Many of these pain-like issues are often correlated with disc degeneration combined with low back pain. The spinal disc’s anatomy comprises three elements that work together in a specific pattern to resist forces placed in the lumbar spine. (Martin et al., 2002) Since the lumbar spine is the thickest portion of the back, the spinal disc supports the upper body’s weight while stabilizing the lower body. However, the spinal disc will shrink over time when the body ages. Since degeneration is a natural process, many individuals will begin to feel less mobile, which can cause many issues within the lumbar spine.

 

How Disc Degeneration Affects The Lumbar Spine

 

When disc degeneration occurs in the lumbar spine, the spinal disc begins to decrease in volume, and the nutrients that hydrate the disc start to deplete and become compressed. When disc degeneration affects the lumbar spine, the nerve roots from the central system are affected. They can be associated with any particular group of pathological conditions that may irritate the surrounding nerves and produce pain-like symptoms. (Bogduk, 1976) To that point, this causes referred pain in the lower limbs and radiating pain in the lower back. At the same time, glycosphingolipid antibodies are activated in the immune system, causing inflammatory effects. (Brisby et al., 2002) When people are dealing with low back pain associated with disc degeneration, many people will feel their lower back lock up, causing limited mobility and stiffness. At the same time, the surrounding muscle and soft tissues are overstretched and tightened. The spinal disc will also affect the nerve fibers surrounding the spine, leading to nociceptive lower back pain. (Coppes et al., 1997) However, many individuals can find available treatments to reduce low back pain associated with disc degeneration.

 


An Overview Of Spinal Decompression- Video


Spinal Decompression Can Reduce Lumbar Disc Degeneration

Many individuals can seek out non-surgical treatments to reduce low back pain associated with disc degeneration as it is cost-effective and, through consecutive treatments, can start feeling better. Some non-surgical treatments like spinal decompression can help rehydrate the spinal disc through gentle traction and promote natural healing. Spinal decompression can be manual or mechanical, using negative pressure to increase disc height. (Vanti et al., 2021) This allows many individuals to feel the relief they deserve and feel better over time. Spinal decompression can reduce disc degeneration, stabilize the lumbar spine, and help regain spinal mobility back to the lower portions. (Daniel, 2007) When many individuals begin to take care of their bodies and reduce the chances of low back pain from returning to cause more issues to the back.

 


References

Bogduk, N. (1976). The anatomy of the lumbar intervertebral disc syndrome. Med J Aust, 1(23), 878-881. www.ncbi.nlm.nih.gov/pubmed/135200

Brisby, H., Balague, F., Schafer, D., Sheikhzadeh, A., Lekman, A., Nordin, M., Rydevik, B., & Fredman, P. (2002). Glycosphingolipid antibodies in serum in patients with sciatica. Spine (Phila Pa 1976), 27(4), 380-386. doi.org/10.1097/00007632-200202150-00011

Coppes, M. H., Marani, E., Thomeer, R. T., & Groen, G. J. (1997). Innervation of “painful” lumbar discs. Spine (Phila Pa 1976), 22(20), 2342-2349; discussion 2349-2350. doi.org/10.1097/00007632-199710150-00005

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. doi.org/10.1186/1746-1340-15-7

Martin, M. D., Boxell, C. M., & Malone, D. G. (2002). Pathophysiology of lumbar disc degeneration: a review of the literature. Neurosurg Focus, 13(2), E1. doi.org/10.3171/foc.2002.13.2.2

Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. doi.org/10.1186/s40945-021-00102-5

 

Disclaimer

Advanced Sciatica: Recognizing Nerve Damage Symptoms

Advanced Sciatica: Recognizing Nerve Damage Symptoms

For individuals dealing with chronic sciatica, when pain and other symptoms significantly impact daily activities and the ability to walk, can a musculoskeletal healthcare provider help relieve and manage symptoms through a multidisciplinary treatment plan?

Advanced Sciatica: Recognizing Nerve Damage Symptoms

Chronic Sciatica

Sciatica is a common condition that results from compression of the sciatic nerve in the lower back or leg. Chronic sciatica occurs when symptoms last for 12 months or longer.

Advanced Sciatica Symptoms

Advanced or chronic sciatica usually produces pain that radiates or travels down the back of the leg. Long-term sciatic nerve compression can result in:

  • Leg pain
  • Numbness
  • Tingling
  • Electrical or burning sensations
  • Weakness
  • Weakness
  • Instability of the legs, which can impact the ability to walk.
  1. Severe nerve compression can progress to leg paralysis if the nerve is significantly damaged from chronic compression. (Antonio L Aguilar-Shea, et al., 2022)
  2. Sciatica can progress to nerve damage of the smaller nerves and travel into the legs and feet. Nerve damage/neuropathy can result in pain, tingling, and loss of sensation. (Jacob Wycher Bosma, et al., 2014)

Disabling Sciatica Treatment Options

When sciatica becomes disabling, affecting an individual’s ability to walk, more involved treatment is needed to bring relief. Many cases of chronic and disabling sciatica are caused by problems with the lumbar spine. Compression of the nerve roots that form the sciatic nerve can occur from bulging or herniated discs or spinal stenosis. If symptoms of sciatica persist beyond 12 months with little or no relief from physical therapy, non-surgical mechanical decompression, stretches and exercises, or pain management techniques, surgical procedures may be needed. (Lucy Dove, et al., 2023)

Lumbar decompression surgery encompasses several procedures to create more space in the lumbar spine and relieve nerve compression. Lumbar decompression surgery can include: (Mayfield Clinic. 2021)

Discectomy

  • This procedure removes a portion of a damaged disc between vertebrae to alleviate root compression from a bulging or herniated disc.

Laminectomy

  • This procedure removes the lamina, a portion of the vertebrae causing nerve compression, especially if there is a bone spur due to arthritic and degenerative changes in the spine.

Foraminotomy

  • This procedure widens the foramina, the openings in the vertebrae where the nerve roots exit to relieve compression.

Spinal Fusion

  • This procedure takes two or more vertebrae fusing them together with metal rods and screws for stabilization.
  • The procedure can be performed if:
  • An entire disc is removed.
  • Multiple laminectomies were performed.
  • One vertebra has slipped forward over another.

Daily Relief Management for Advanced Sciatica

Achieving relief from advanced sciatica symptoms at home can include regularly practicing methods like taking a hot bath or shower massage, and applying a heating pad to the lower back or glutes to relax tight muscles to help release the tightness surrounding the sciatic nerve.

  • Corrective or therapeutic exercises like sciatic nerve glides can help reduce tension along the nerve while low-back exercises that move the spine into forward or backward bending can reduce compression. (Witold Golonka, et al., 2021)
  • Medications like nonsteroidal anti-inflammatory drugs/NSAIDs, muscle relaxants, or nerve-pain medications may be recommended. (Antonio L Aguilar-Shea, et al., 2022)
  • Advanced sciatica may not be as responsive to conservative treatment methods, as the injury has set in and the nerve and surrounding tissues have become significantly restricted.
  • Sciatica symptoms lasting longer than 12 months require more involved treatment like injections or surgery to address symptoms effectively. (Antonio L Aguilar-Shea, et al., 2022)

Healing Chronic Sciatica

If the underlying cause can be effectively treated then chronic sciatica can be healed. Chronic sciatica often results from spinal conditions like herniated discs or lumbar spinal stenosis. These conditions narrow the space around the nerve roots that exit from the spinal cord and merge to form the sciatica nerve. Surgery is performed to open the space in the spine. (Mayfield Clinic. 2021) Sometimes sciatica is brought on by less common causes like a tumor or a spinal infection. In these cases, symptoms will not resolve until the underlying cause is addressed. Tumors may need to be surgically removed while infections require aggressive antibiotics to prevent spreading to other regions of the body. (Hospital for Special Surgery. 2023)

Pain Specialist Treatment Plan Development

Ongoing pain, numbness, tingling, and weakness are all symptoms that should be addressed with a healthcare provider. A pain specialist can help create a treatment plan that involves: (Hospital for Special Surgery. 2023)

  • Physical therapy
  • Therapeutic massage
  • Chiropractic decompression and spinal adjustments
  • Targeted stretches and exercises
  • Referrals to specialized healthcare providers
  • Injections
  • Medications

Sciatica Causes and Treatments


References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-González, R., & Paredes, I. (2022). Sciatica. Management for family physicians. Journal of family medicine and primary care, 11(8), 4174–4179. doi.org/10.4103/jfmpc.jfmpc_1061_21

Bosma, J. W., Wijntjes, J., Hilgevoord, T. A., & Veenstra, J. (2014). Severe isolated sciatic neuropathy due to a modified lotus position. World journal of clinical cases, 2(2), 39–41. doi.org/10.12998/wjcc.v2.i2.39

Dove, L., Jones, G., Kelsey, L. A., Cairns, M. C., & Schmid, A. B. (2023). How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 32(2), 517–533. doi.org/10.1007/s00586-022-07356-y

Mayfield Clinic. ( 2021). Spinal decompression laminectomy & foraminotomy.

Golonka, W., Raschka, C., Harandi, V. M., Domokos, B., Alfredson, H., Alfen, F. M., & Spang, C. (2021). Isolated Lumbar Extension Resistance Exercise in Limited Range of Motion for Patients with Lumbar Radiculopathy and Disk Herniation-Clinical Outcome and Influencing Factors. Journal of clinical medicine, 10(11), 2430. doi.org/10.3390/jcm10112430

Hospital for Special Surgery. (2023). Sciatica.

Hospital for Special Surgery. (2023). Pain management.

Choosing the Right Pain Management Specialist

Choosing the Right Pain Management Specialist

For individuals dealing with chronic pain conditions can having a better understanding of pain management specialists help in developing effective multidisciplinary treatment plans?

Choosing the Right Pain Management Specialist

Pain Management Specialists

Pain management is a growing medical specialty that takes a multi-disciplinary approach to treating all types of pain. It is a branch of medicine that applies scientifically proven techniques and methods to relieve, reduce, and manage pain symptoms and sensations. Pain management specialists evaluate, rehabilitate, and treat a spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, chronic pain conditions, and more. Many primary healthcare providers refer their patients to pain management specialists if pain symptoms are ongoing or significant in their manifestation.

Specialists

Healthcare providers specializing in pain management recognize the complex nature of pain and approach the problem from all directions. Treatment at a pain clinic is patient-centric but depends on the clinic’s available resources. Currently, there are no set standards for the types of disciplines needed, another reason treatment options vary from clinic to clinic. Experts say that a facility should offer patients:

  • A coordinating practitioner specializing in pain management and consulting specialists on the patient’s behalf.
  • A physical rehabilitation specialist.
  • A psychiatrist to help the individual deal with any accompanying depression or anxiety, especially when dealing with chronic pain. (American Society of Regional Anesthesia and Pain Medicine. 2023)

Other Medical Specialties

Other specialties represented in pain management are anesthesiology, neurosurgery, and internal medicine. A coordinating healthcare provider may refer an individual for services from:

A healthcare provider should have completed additional training and credentialing in pain medicine and be an MD with board certification in at least one of the following (American Board of Medical Specialties. 2023)

  • Anesthesiology
  • Physical rehabilitation
  • Psychiatry
  • Neurology

A pain management physician should also have their practice limited to the specialty they hold the certification.

Management Goals

The field of pain management treats all types of pain as a disease. Chronic, such as headaches; acute, from surgery, and more. This allows for applying science and the latest medical advances to pain relief. There are now many modalities, including:

  • Medication
  • Interventional pain management techniques – nerve blocks, spinal cord stimulators, and similar treatments.
  • Physical therapy
  • Alternative medicine
  1. The objective is to minimize and make symptoms manageable.
  2. Improve function.
  3. Increase the quality of life. (Srinivas Nalamachu. 2013)

A pain management clinic will go through the following:

  • Evaluation.
  • Diagnostic tests, if necessary.
  • Physical therapy – increases the range of motion, strengthens the body, and prepares individuals to return to work and daily activities.
  • Interventional treatment – injections or spinal cord stimulation.
  • Referral to a surgeon if indicated by the tests and evaluation.
  • Psychiatry to deal with depression, anxiety, and/or other issues that accompany chronic pain symptoms.
  • Alternative medicine to support and enhance the other treatments.

Individuals who do well with a pain management program

Individuals who have:

  • Back pain
  • Neck pain
  • Had multiple back surgeries
  • Failed surgeries
  • Neuropathy
  • Individuals determined that surgery does not benefit their condition.

A better understanding of pain syndromes by communities and insurance companies and increased pain studies will help increase insurance coverage for treatments and technology to improve interventional outcomes.


Chiropractic Care for Leg Instability


References

American Society of Regional Anesthesia and Pain Medicine. (2023). The specialty of chronic pain management.

American Academy of Pain Medicine (2023). About the American Academy of Pain Medicine.

American Board of Medical Specialties. (2023). The Most Trusted Medical Specialty Certification Organization.

Nalamachu S. (2013). An overview of pain management: the clinical efficacy and value of treatment. The American journal of managed care, 19(14 Suppl), s261–s266.

American Society of Interventional Pain Physicians. (2023). Pain Physician.

Non-Surgical Solutions for Back Pain: How to Overcome Pain

Non-Surgical Solutions for Back Pain: How to Overcome Pain

For individuals with back pain, how can health practitioners incorporate non-surgical solutions to reduce spinal pain?

Introduction

The spine is one of the most important structures in the human body, providing host mobility and stability when vertical pressure is pressing on the spinal structure. The spine is surrounded by various muscles, ligaments, and tissues that help support the upper and lower body portions and extremities. When normal factors like heaving lifting, improper stances, obesity, or pre-existing conditions start to affect the body, it can cause the spinal structure to potentially cause unwanted issues that lead to back, neck, and shoulder pain. When experiencing these three common body pains often correlate with other associated symptoms that can affect the other extremities. When this happens, many individuals begin to miss out on work or daily activities that can cause them to be miserable, and they even try to look for various solutions to reduce the pain they are experiencing. Today’s article looks at one of the common body pains like back pain and how it can cause numerous issues that affect a person’s ability to function, and how non-surgical solutions can not only reduce the pain-like effects but also provide the necessary relief that many people deserve in their health and wellness journey. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease the pain-like symptoms associated with spinal issues causing back pain. We also inform our patients that there are non-surgical options to reduce these pain-like issues and restore spinal mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

 

Back Pain Affecting The Spine

Do you often experience radiating pain in your lower back that causes symptoms of numbness or tingling sensations down to your legs and feet? Do you feel muscle stiffness in the morning while getting up, only to slowly disappear throughout the day? Or do you feel symptoms of muscle aches and pain when carrying a heavy object from one location to another? Many individuals, more often than not, have dealt with back pain associated with various factors. With back pain being in the top three common problems in the workforce, many individuals have dealt with the common problem in multiple ways. From improper heavy lifting to excessive sitting at a desk, back pain can cause musculoskeletal issues that many are trying to find relief. Low back pain can either be acute or chronic, depending on the severity. It can lead to mobility impairment within the thoracic, lumbar, and sacroiliac spinal regions, causing referred pain to the lower extremities. It can lead to a life of impairment without any symptoms or signs of serious medical or psychological conditions associated with environmental factors. (Delitto et al., 2012) Back pain is also associated with spinal conditions like inflammation, asymmetric loading, and muscle strain, which can cause the spinal structures to be compressed, thus causing disc herniations. (Zemková & Zapletalová, 2021

 

 

Additionally, back pain is a multifactorial musculoskeletal condition that causes many individuals to be in a socio-economic situation that can decrease their quality of life. Many examples of back pain are correlated with altered motor control within the spinal erector muscles that causes impaired proprioception in the spine. (Fagundes Loss et al., 2020) When this happens to many individuals, they often experience a hindrance of lumbar stability, body balance, posture, and postural control. At the same time, when many working individuals are having severe back pain associated with everyday factors, the amount of pain they are in can change the threshold of the mechanoreceptors that are transmitting the pain signals through the spinal cord. To this point, back pain can affect the neuromuscular response and affect normal musculoskeletal functionality. Fortunately, numerous treatments can help reduce back pain and provide relief to spinal pain that is affecting many individuals.

 


The Role Of Chiropractic Care- Video

 How many times a day do you experience back pain associated with stiffness, general aches, or pains that are affecting your ability to work? Do you notice you hunching more when moving from one location to another? Or do you feel aches and pain in your back after stretching in the morning? Many individuals dealing with these common environmental factors are closely associated with back pain. Back pain is in the top three most common problems many individuals have experienced at some point in their lives. More often than not, many people have dealt with back pain by using home remedies to reduce the pain-like effects. However, research studies reveal that when many individuals start to ignore the pain, it can lead them to a life of disability and cause numerous amounts of distress if not treated right away. (Parker et al., 2015) Hence, non-surgical treatments can not only reduce the pain associated with back pain but also help restore spinal mobility. Non-surgical treatments like chiropractic care incorporate spinal manipulation, which can positively affect the spine. (Koes et al., 1996) What chiropractic care does is that it includes mechanical and manual manipulation techniques to stretch out tight muscles and reduce trigger points from reforming. The video above shows how chiropractic care can positively affect the individual while being part of a health and wellness journey to reducing back pain.


Non-Surgical Spinal Decompression For Back Pain

Just like chiropractic care, spinal decompression is another non-surgical treatment that uses traction to gently pull and stretch the spine to alleviate compressed spinal discs associated with back pain and help stretch out tight muscles. When many people start to incorporate spinal decompression as part of their routine, they will notice that spinal decompression can reduce intradiscal pressure within the negative range. (Ramos, 2004) What this does is that when the spinal discs are being pulled by gentle traction, all the fluids and nutrients that were not hydrating the disc flow back and help kickstart the body’s natural healing process. When many people begin to utilize spinal decompression for their back pain, they will notice a huge reduction in their pain after a few consecutive sessions. (Crisp et al., 1955) When many people start to combine other various non-surgical therapies with spinal decompression, they will be able to regain their spinal mobility while being more mindful of what environmental factors are affecting their spine and not repeat the issue to allow back pain to return.


References

Crisp, E. J., Cyriax, J. H., & Christie, B. G. (1955). Discussion on the treatment of backache by traction. Proc R Soc Med, 48(10), 805-814. www.ncbi.nlm.nih.gov/pubmed/13266831

www.ncbi.nlm.nih.gov/pmc/articles/PMC1919242/pdf/procrsmed00390-0081.pdf

Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57. doi.org/10.2519/jospt.2012.42.4.a1

Fagundes Loss, J., de Souza da Silva, L., Ferreira Miranda, I., Groisman, S., Santiago Wagner Neto, E., Souza, C., & Tarrago Candotti, C. (2020). Immediate effects of a lumbar spine manipulation on pain sensitivity and postural control in individuals with nonspecific low back pain: a randomized controlled trial. Chiropr Man Therap, 28(1), 25. doi.org/10.1186/s12998-020-00316-7

Koes, B. W., Assendelft, W. J., van der Heijden, G. J., & Bouter, L. M. (1996). Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine (Phila Pa 1976), 21(24), 2860-2871; discussion 2872-2863. doi.org/10.1097/00007632-199612150-00013

Parker, S. L., Mendenhall, S. K., Godil, S. S., Sivasubramanian, P., Cahill, K., Ziewacz, J., & McGirt, M. J. (2015). Incidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes. Clin Orthop Relat Res, 473(6), 1988-1999. doi.org/10.1007/s11999-015-4193-1

Ramos, G. (2004). Efficacy of vertebral axial decompression on chronic low back pain: study of dosage regimen. Neurol Res, 26(3), 320-324. doi.org/10.1179/016164104225014030

Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International Journal of Environmental Research and Public Health, 18(10), 5400. doi.org/10.3390/ijerph18105400

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Therapeutic Solutions for Upper Crossed Syndrome: What You Need to Know

Therapeutic Solutions for Upper Crossed Syndrome: What You Need to Know

Can various therapeutic options provide relief for individuals with upper crossed syndrome to restore muscle strength?

Introduction

Many individuals often suffer neck and shoulder pain from poor posture, improper heavy lifting, musculoskeletal conditions, auto accidents, whiplash, etc. The surrounding muscles that connect the neck and shoulders help protect the cervical and thoracic region of the spine and can succumb to injuries that can cause pain-like symptoms causing discomfort to the individual. Neck, shoulder, and back pain are the three most common issues many individuals have experienced. These musculoskeletal disorders can also correlate with pre-existing conditions; many people will feel pain and discomfort while trying to find the relief they seek. One of the most common issues people often experience is upper crossed syndrome, which can be associated with neck and shoulder pain. Today’s article explains what upper cross syndrome is and how it affects the neck and shoulders while also diving into how different therapeutic options like spinal decompression and chiropractic care can reduce the effects of upper cross syndrome. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to mitigate upper-crossed syndrome in the neck and shoulders. We also inform our patients that there are many therapeutic options, like chiropractic care and spinal decompression, to minimize muscle pain in the neck and shoulders. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with upper-crossed syndrome. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

 

What Is Upper Crossed Syndrome?

 

Have you been dealing with muscle pain in your shoulders or neck after being on the computer for a while? Do you feel stiffness in your shoulders that rotating them causes temporary relief? Or does it hurt when you turn your head from side to side? Many of these pain-like scenarios are often associated with upper-cross syndrome. Many people don’t often realize that upper crossed syndrome is a musculoskeletal condition that affects the neck, shoulder, and chest muscles and causes them to be weak and tight due to poor posture. The upper crossed syndrome can cause referred pain to the upper extremities, leading to cervicogenic headaches, limited range of motion, trigger points in the muscles, and muscle imbalance. (Moore, 2004) When many people are dealing with upper crossed syndrome due to poor posture, it can lead to many issues in the neck and shoulders.

 

How Does It Affect The Neck & Shoulders?

Now, why does upper crossed syndrome affect the neck and shoulders? Many people unintentionally hunched over when looking at their phones, being on the computer, or relaxing at home. This causes specific muscles in the neck and shoulder region, like the serratus and lower trapezius muscles, to become weak while the pectoral and neck muscles are tight. (Chu & Butler, 2021) This, in turn, causes the shoulders to be more rounded and hunched, causing the neck and head to crane forward. When people are dealing with upper crossed syndrome, many would often complain about pain-like symptoms like:

  • Headaches
  • Neck Strain
  • Muscle tightness
  • Upper back pain
  • Restricted range of motion
  • Numbness/Tingling sensations in the arms

The upper crossed syndrome can also occur gradually over time and cause nerve compression to the upper extremities. When the upper neck and shoulder muscles start to affect the surrounding nerve roots, which then leads to nerve dysfunction in the sensory and motor skills when a person picks up an object. (Lee & Lim, 2019) However, many individuals dealing with upper-crossed syndrome can seek treatment to relieve muscle pain in their neck and shoulders.

 


An Overview Of Upper Crossed Syndrome- Video

Since upper cross syndrome is a musculoskeletal condition that affects the neck and shoulders, it can result in muscle imbalance and pain in the individual. Many people, especially in the working field, develop this syndrome by being hunched over for an extended period. (Mujawar & Sagar, 2019) This causes the head to be more forward, the neck posture to be curved and hunched, and the shoulders to be rounded. The video above explains upper-crossing syndrome, its causes, and how it is treated. 


Spinal Decompression Reducing Upper Crossed Syndrome

 

Numerous treatments can help restore muscle strength and reduce muscle pain in the neck and shoulders. Treatments like spinal decompression can help reduce upper crossed syndrome by slowly using gentle traction to the cervical spine region and gently stretching the neck muscles to provide relief. Spinal decompression is one of the non-surgical treatments that many individuals with headaches associated with upper crossed syndrome can find the comfort they seek through pain reduction and improve their quality of life. (Eskilsson et al., 2021) At the same time, spinal decompression can be part of a personalized treatment plan that many individuals can add to their daily routine to prevent the pain from returning. (Saunders, 1983)

 

Chiropractic Care Restoring Muscle Strength

Just like spinal decompression, chiropractic care is a non-surgical treatment that can be combined with various stretching techniques to restore the neck’s range of motion and reduce pain associated with upper-crossed syndrome. (Mahmood et al., 2021) Chiropractic care incorporates manual and mechanical techniques like MET (muscle energy techniques) and spinal manipulation to realign the spine out of subluxation. When chiropractors integrate MET to manage upper crossed syndrome, many individuals find that their pain has decreased, their cervical range of motion is improved, and their neck disability is reduced. (Gillani et al., 2020) When many individuals start thinking about their health and wellness, they can make small changes to improve their posture and be more mindful of their bodies to reduce the chances of upper-cross syndrome returning.

 


References

Chu, E. C., & Butler, K. R. (2021). Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract, 11(2), 322-326. doi.org/10.3390/clinpract11020045

Eskilsson, A., Ageberg, E., Ericson, H., Marklund, N., & Anderberg, L. (2021). Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain – a retrospective cohort study. Acta Neurochir (Wien), 163(9), 2425-2433. doi.org/10.1007/s00701-021-04913-0

Gillani, S. N., Ain, Q., Rehman, S. U., & Masood, T. (2020). Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc, 70(3), 394-398. doi.org/10.5455/JPMA.300417

Lee, E. Y., & Lim, A. Y. T. (2019). Nerve Compression in the Upper Limb. Clin Plast Surg, 46(3), 285-293. doi.org/10.1016/j.cps.2019.03.001

Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad, A. (2021). Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc, 71(10), 2304-2308. doi.org/10.47391/JPMA.03-415

Moore, M. K. (2004). Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther, 27(6), 414-420. doi.org/10.1016/j.jmpt.2004.05.007

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Saunders, H. D. (1983). Use of spinal traction in the treatment of neck and back conditions. Clin Orthop Relat Res(179), 31-38. www.ncbi.nlm.nih.gov/pubmed/6617030

 

Disclaimer

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Individuals dealing with back pain problems could be suffering from a bulging disc. Could knowing the difference between slipped and herniated disc symptoms help with treatments and finding relief?

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Bulging Disc Pain

Back pain can become debilitating if not treated properly. A bulging disc is a common cause of cervical, thoracic, and lower back pain symptoms. It happens when one of the fluid-filled cushions between the vertebrae begins to shift out of place. Instead of being aligned with the edges, the disc bulges over. This begins to generate pressure on the nerves causing pain and inflammation.

  • Bulging discs are often caused by age, but repetitive movements and/or lifting heavy objects can contribute to the condition.
  • Symptoms can resolve on their own, but individuals are recommended to consult with a physical therapist and/or chiropractor to make sure the disc healed properly, otherwise, it can lead to worsening and/or further injuries.

Bulging Disc vs. Herniated Disc

Bulging and herniated discs cause pain symptoms.

  1. Bulging – the intervertebral disc moves out of place but stays intact.
  2. Herniated – the thick outer layer of the disc ruptures, causing the cushioning gel inside to leak onto the spinal nerves.

Location of Symptoms

  • A bulging disc can happen anywhere along the spine.
  • However, most occur between the last five vertebrae in the lower back.
  • This is the lumbar spine. (American Academy of Orthopaedic Surgeons. 2022)
  • This is because the lower back is subject to all kinds of pressure and movement with daily activities, increasing the chances of pain and injuries.
  • The next most common place is the neck/cervical spine where there are constant movements making it prone to injury and pain symptoms.

Causes

Bulging discs are most often caused by body aging and normal wear and tear. As time goes on the intervertebral discs naturally degenerate, known as degenerative disc disease. This can cause the discs to pull downward, causing them to bulge from their placement. (Penn Medicine. 2018) Factors that can cause or worsen the condition include:

  • Practicing unhealthy postures.
  • Repetitive motions.
  • Lifting heavy objects
  • Spinal injuries.
  • Medical history of spinal or disc disease in the family.

Treatment

Treating a bulging disc takes time and patience. (American Academy of Neurological Surgeons. 2023)

Examination

Individuals with back pain that interferes with daily functions or has lasted longer than six weeks, should see a healthcare provider for a diagnosis. They will order a magnetic resonance imaging scan/MRI, which can show where a disc is protruding. (American Academy of Neurological Surgeons. 2023)

Rest

  • For bulging disc pain, resting the back is necessary. However,
  • Many patients benefit from a day or two of bed rest. (American Academy of Orthopaedic Surgeons. 2022)
  • After that, start light activities like walking. Avoid any movements that make your pain worse.

NSAIDs

  • NSAID pain medications like Advil, Motrin, or Aleve can keep pain symptoms and inflammation reduced.
  • However, this is for short-term use, as the underlying cause still needs to be addressed.
  • A healthcare provider will recommend safe dosage and how long these medications should be taken. (American Academy of Orthopaedic Surgeons. 2022)

Physical Therapy

Steroid Injection

  • An epidural steroid injection can provide relief for individuals still experiencing symptoms after six weeks.
  • A healthcare provider will inject cortisone into the spine to reduce inflammation and pain. (American Academy of Orthopaedic Surgeons. 2022)

Surgery

  • If conservative treatments don’t work, a healthcare provider may recommend surgery, like a microdiscectomy.
  • This procedure uses small incisions to remove all or part of a bulging disc.
  • Most individuals with a bulging disc will not require surgery. (American Academy of Neurological Surgeons. 2023)

Inflammation: Integrative Medicine Approach


References

Penn Medicine. (2018) Bulging disc vs. herniated disc: What’s the difference?

American Academy of Orthopaedic Surgeons. (2022) Herniated disk in the lower back.

American Academy of Neurological Surgeons. (2023) Herniated disc.

National Institutes of Health. (2022) Spinal Manipulation: What You Need To Know.

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Individuals who engage in a regular fitness regimen can begin to lose interest and motivation. Can knowing the signs of exercise burnout help individuals rediscover their motivation?

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Exercise Burnout

When maintaining fitness and health becomes a chore and doing anything else is better than working out, individuals could be experiencing exercise burnout. Here are a few signs an individual is getting burned out.

Procrastination

One sign is constantly putting things off.

  • An individual may put on workout clothes, set up the equipment, etc.
  • However, the workout never happens as the individual continues to find other things to do.
  • At some point, they decide it’s too late and they’ll work out tomorrow.

Solution

Simplify the workout. Make some small goals or adjustments and keep the workout light. (Nemanja Lakicevic, et al., 2020) An example could be:

  • Focus only on stretching.
  • Take a walk around the block.
  • Go up and down some stairs equivalent to a few laps.
  • Do 10 pushups, 10 squats, and 10 lunges, or other exercises and that’s it.

No Longer Interesting

When burned out, exercise is not interesting and disenchanting. (Franklin Velasco, Rafael Jorda. 2020) Trainers will suggest finding something positive about the workouts.

Solution

Switch to a new or different activity. (Nemanja Lakicevic, et al., 2020)

  • When the interest and passion are nowhere to be found don’t engage in the usual workouts, as this can further decrease motivation.
  • This is the time to change up the routine and go for a leisurely bicycle or rollerblade, skateboard, etc., session.
  • Go to a park, just walk around, and forget about exercise just taking in everything.
  • Play a game with a friend or toss a ball around.

Exhaustion

Not just physical, but mental fatigue could be a sign of exercise burnout.

Solution

  • Rest.
  • Individuals may think they have to work out every day and stick to the regimen or else they’ve failed.
  • This type of mindset can lead to burnout and added stress.
  • The body and mind require adequate recovery time.
  • Forget about structured exercise for a day, and see how the mind and body feel the next day.
  • Two or three days off in a row can make a significant difference in motivation and offer a new perspective on the workout routine.

Low Energy Levels After Exercise

Workouts, although tiring in a good way, should energize the individual. Most workouts should leave the body feeling better than before. When the body feels worse or energy levels are low, this could be a sign of overtraining that could lead to exercise burnout.

Solution

  • This could be the time to ease off of the fitness regimen.
  • Forget intense workouts and/or heavy-weight training.
  • This is the time to soothe the body.
  • Light yoga workouts or Pilates could help.
  • This is a form of active recovery, allowing the mind and body to rest from the overwork.

Mood Changes and/or Irritability

When the mind and body are overworked and over-trained, it can cause moodiness, irritability, and frustration that leads to burnout.

Solution

Do something that feels good. This could include:

  • A therapeutic massage.
  • A spa session.
  • Taking a long nap.
  • Soaking the feet.
  • Taking a therapeutic bath.
  • Meditation

Burnout can happen, the objective is to keep the solutions simple like taking a few days off or trying something new to come back feeling refreshed and energized.


Multidisciplinary Evaluation and Treatment


References

Lakicevic, N., Gentile, A., Mehrabi, S., Cassar, S., Parker, K., Roklicer, R., Bianco, A., & Drid, P. (2020). Make Fitness Fun: Could Novelty Be the Key Determinant for Physical Activity Adherence?. Frontiers in psychology, 11, 577522. doi.org/10.3389/fpsyg.2020.577522

Velasco, F., & Jorda, R. (2020). Portrait of Boredom Among Athletes and Its Implications in Sports Management: A Multi-Method Approach. Frontiers in psychology, 11, 831. doi.org/10.3389/fpsyg.2020.00831