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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.


Delayed Whiplash Injury Symptoms

Delayed Whiplash Injury Symptoms

Car accidents, even minor ones, can cause musculoskeletal problems, especially in the neck and shoulder area. Depending on the severity, it can be dangerous. When whiplash symptoms do not present immediately, this is known as delayed whiplash. Delayed symptoms can appear anywhere from twenty-four hours to months after the accident. The body is masking the symptoms to react to a traumatic event. Symptoms like:

  • Pain
  • Stiffness
  • Headache
  • Anxiety
  • Present within 24 hours, but this is not always the case.
11860 Vista Del Sol, Ste. 128 Delayed Whiplash Injury Symptoms
 

Delayed Symptoms

With delayed whiplash, symptoms typically don’t appear until 24 hours after the accident. But there are cases of symptoms being delayed up to six months. Whether immediate or delayed, symptoms include:

  • Neck pain and stiffness
  • Headaches
  • Normal head movement is impaired
  • Fatigue
  • Dizziness
  • Blurred vision
  • Depression
  • Anxiety
  • Concentration problems
  • Sleep problems
  • Irritability
  • Chronic pain

Medical treatment should be sought out immediately if any of the below symptoms are experienced:

  • Weakness in the arms
  • The neck pain spreads to the shoulders and arms
  • Unbearable pain
  • Loss of vision
 

Causes of Delayed Whiplash

The most common cause of whiplash is automobile accidents. Even a slow-speed tap can cause delayed whiplash symptoms if the head snaps quickly, and it is not only being hit from behind in automobile accidents that cause whiplash. Rear-end, front-end, and side collisions can cause whiplash and delayed whiplash symptoms. Any time the neck snaps in a quick fashion in any direction there is potential for a neck injury. Some less common causes include:

  • Contact sports
  • Amusement park rides
  • Getting hit on the head
  • Specific types of falls where the head quickly snaps around
  • Cycling accidents
  • Skating/skateboarding accidents
  • Skiing/snowboarding accidents
11860 Vista Del Sol, Ste. 128 Delayed Whiplash Injury Symptoms
 

Symptoms Can Get Worse With Time

Determining whether to seek medical attention if there is no pain or symptoms after the event can be difficult. However, symptoms can get worse over time and cause serious problems in the neck:

  • Small fractures
  • Ruptured discs
  • Pinched nerves

 

Untreated Whiplash

Whiplash can get worse with time when they are not treated. This is why seeking medical care after the event is significant. As a doctor, a chiropractor can diagnose if any serious issues are present and develop the best plan to deal with pain and symptoms. When left untreated chronic whiplash and neck pain can develop. Chronic whiplash is rare but does happen, even with injuries considered not severe. Medical professionals will use X-Rays, MRIs, or CT scans to examine the damage’s extent and prevent the symptoms from worsening.  

Treatment Options

Wearing a neck brace immediately following a neck injury can be an option but there is evidence that some movement of the neck and head should be incorporated, as it is beneficial for the healing process. If the pain is unbearable, wearing a brace could be implemented into a treatment plan.  

 

Ice and Heat

  • Ice and heat will help with stiffness and pain.
  • Ice will help relieve pain and should be used in 15-minute intervals.
  • Heat packs and ointments can help soothe the area, loosen up the muscles, and promote optimal healing.

 

Non-Steroidal Anti-Inflammatory Meds

Advil or Ibuprofen can be taken for pain and inflammation. These meds help the symptoms, but should not be the only pain reliever.

 

Ginger

  • Ginger tea can help those suffering from nausea and dizziness.
  • It contains anti-inflammatory properties.
  • Supplements include green tea, turmeric curcumin, fish oil, and sage.

 

CBD Oil and Ointment

CBD oil or ointments can help relieve pain and relax muscles.

 

Stretching

Gentle stretches can help the healing process and keep the neck muscles loose.  

11860 Vista Del Sol, Ste. 128 Delayed Whiplash Injury Symptoms
 

Chiropractic

Chiropractic can treat whiplash utilizing several different techniques. They will perform tests to diagnose the extent of the injuries and determine what type and the best treatment plan. The plan can include the following:  

Inflammation reduction and Pain relief

Heat, ice, ultrasound, and laser therapy can help reduce pain and inflammation.

 

Spinal Adjustments

Spinal adjustments will help relieve pain from pinched nerves, bulging discs, and strained muscles.

 

Massage

Massage is a common practice in whiplash cases. It helps to kickstart the healing process by:

  • Promoting proper blood and nerve energy circulation
  • Loosens the muscles
  • Flushes out the toxins

 

Stretches and Tips

A chiropractor will train the patient on specific stretches/exercises and pain-relief tips at home. These can include:

 

Physical Therapy

  • Physical therapists can help by focusing on the muscles in the affected area.
  • They will teach the individual stretches and exercises to stretch and strengthen the strained muscles.
  • They can also utilize heat and ice therapy, ultrasound, and laser therapy.

Body Composition

 


 

Hot Yoga and Metabolic Rate

Both internal and external temperatures influence the body’s metabolic rate. The body’s chemical reactions happen more quickly if the temperature is higher. This is because the body works harder to restore average temperature balance. Brief exposure to heat is not enough to increase metabolism. To raise BMR, more prolonged exposure to heat is necessary. This is where hot yoga comes in. Hot yoga involves performing a sequence in a studio that is 105 degrees Fahrenheit with a humidity rate of 40%. It is an intense workout that involves sweating. The high heat:

  • Increases blood flow
  • Warms the muscles for deep stretching
  • Helps the lymphatic system release toxins
  • Raises the body’s Basal Metabolic Rate
 
 
References

Balla, J I. The late whiplash syndrome. The Australian and New Zealand Journal of surgery vol. 50,6 (1980): 610-4. doi:10.1111/j.1445-2197.1980.tb04207.x

Fitz-Ritson D. Phasic exercises for cervical rehabilitation after “whiplash” trauma. Journal of Manipulative and Physiological Therapeutics. 1995 Jan;18(1):21-24.

Seferiadis, Aris, et al. A review of treatment interventions in whiplash-associated disorders. The 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 vol. 13,5 (2004): 387-97. doi:10.1007/s00586-004-0709-1

Whiplash and Chronic Whiplash Injuries Following An Automobile Accident

Whiplash and Chronic Whiplash Injuries Following An Automobile Accident

While bruising, soreness, and scrapes are common, whiplash and chronic whiplash injuries may not show for several days or weeks. While today’s vehicles are safer than ever, they can still only do so much when it comes to the body and musculoskeletal health. Being involved in an automobile accident, even a light tap can give a sudden jolt to the spine that although the individual might not have felt anything like discomfort or pain, it was enough to shift the disc/s out of place or set them up to shift out of place. No one wants to be involved in a car or motorcycle accident, but regardless of good driving habits, or how advanced the safety features on the vehicle might be, the average driver will be involved in three to four automobile accidents in their life.  
11860 Vista Del Sol, Ste. 128 Whiplash and Chronic Whiplash Injuries Following An Automobile Accident
 

Whiplash

Whiplash and chronic whiplash injuries are common in motor vehicle accidents. More than 3 million Americans will see a doctor and a chiropractor for automobile accidents and whiplash effects. It only takes a 2.5 mph hit to cause an injury. And whiplash doesn’t only happen when hit from behind, there are several ways an individual can be subjected to whiplash, including being T-boned, amusement park rides, and falling off a bicycle or a horse.  

Symptoms

Most whiplash symptoms develop in the first twenty-four hours, but this is not always the case. Common symptoms include:
  • Neck pain
  • A stiff neck
  • Intense neck pain when moving, rotating
  • Headaches that start at the base of the head
  • Loss of range of motion
  • Dizziness
  • Fatigue
  • Shoulder pain
  • Arm pain
  • Upper back pain
  • Low back pain
  • Blurred vision
  • Anxiety
  • Nausea
  • Depression
  • Difficulty with concentration
  • Memory difficulties
  • Sleep disorders
 

Facts and Stats

Most individuals realize they have whiplash a day or two after, but for others, it can take a few weeks or even months to present. Whiplash is classified by degree or grade:

Grade 0

The individual has no complaints and there are no symptoms/signs of physical injury.

Grade 1

There is neck pain but there are no physical signs of injury.

Grade 2

There are signs/symptoms of musculoskeletal damage and neck pain is presenting.

Grade 3

There are signs/symptoms of neurological damage and neck pain is presenting. The average amount of time most individuals stay home from work is around 40 days. However, when whiplash pain lasts longer than a few weeks, it is deemed to be chronic whiplash.  
 

Chronic Whiplash

Some individuals with whiplash experience painful symptoms for years. This is true of those that avoid or refuse medical attention and learn to live with it.  
11860 Vista Del Sol, Ste. 128 Whiplash and Chronic Whiplash Injuries Following An Automobile Accident
 

Treatment Options

There are very effective methods for treating whiplash and chronic whiplash injuries. Depending on the extent of the injury/s, developing the right treatment/rehabilitation plan requires individual consultation with a chiropractor to discuss options that can include:

Pain Relief

The pain can be excruciating. Over-the-counter pain relievers like ibuprofen for temporary relief. However, the individual will need extended treatment to ensure it does not become chronic pain.

Neck Brace

Neck braces help limit the pain, but should not be worn for more than three or four days. If worn for too long the neck muscles are prevented from gaining the strength needed to support the head.

Don’t Sit For Too Long

Avoid keeping the head in any one position for too long. This includes sitting in bed, watching TV, or working at a desk. This places a large amount of pressure and stress on the neck, making the pain even more severe and longer-lasting.

Sleeping Properly and Comfortably

For many, it can be difficult to get into a comfortable position when sleeping. Sleeping on the back with the head turned to one side can worsen the pain. Try a high-quality ergonomic pillow that allows the individual to sleep on their side and takes the pressure off of the neck.

Spinal Alignment

Whiplash can cause the spine to shift out of alignment. This can lead to additional problems in the back or shoulders. It�s always a good idea to see a chiropractor that specializes in motor vehicle accident injuries to realign the spine and neck, as well as for rehabilitation to strengthen the muscles and prevent further injuries. See a chiropractor for an evaluation of the injuries and develop a customized treatment plan that works for the individual’s condition.  
11860 Vista Del Sol, Ste. 128 Whiplash and Chronic Whiplash Injuries Following An Automobile Accident
 

Everyone is different

Some individuals can be stiff and sore for a few days and then are okay with not much pain. Some individuals experience severe pain immediately after the wreck, while others have no pain for days or even weeks. Both scenarios are pretty common. Soft tissue injuries can be very deceiving. Some don�t experience any pain for months after the accident. Many don�t think they need to see a doctor or chiropractor because there is no pain or symptoms. However, underneath serious problems could be getting ready to present including:
  • Constant headaches
  • Numbness or pins and needles in the hands or arms
  • Pain between the shoulder blades
  • Poor posture
  • Chronic muscle tension
  • Painful spasms
  • Degeneration of the discs
  • Painful inflamed arthritis
  • The quick development of arthritis
  • Sore, tight, or inflexible muscles
  • Sleep disturbances
  • Fatigue
  • Dizziness

Body Composition


 

A decrease in physical activity

Physical inactivity is a primary factor in the progression of sarcopenia. Resistance exercise can help maintain muscle mass and help build muscular strength. Individuals that are more sedentary can exacerbate the effects of sarcopenia.

A decrease in motor neurons

Aging is accompanied by motor neuron loss resulting from cell death. This leads to a decrease in muscle fiber. This decrease in muscle fibers leads to:
  • Impaired performance
  • A reduction in functional capacity
  • A decreased ability to perform everyday tasks

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*  
References
How the Neck Works:�UpToDate. (2020) �Patient education: Neck pain (Beyond the Basics).�www.uptodate.com/contents/neck-pain-beyond-the-basics Symptoms:PLOS ONE. (2018) �Thoracic dysfunction in whiplash-associated disorders: A systematic review.��www.ncbi.nlm.nih.gov/pmc/articles/PMC5865734/ Causes:�Mayo Clinic. (N.d.) �Whiplash.��www.mayoclinic.org/diseases-conditions/whiplash/symptoms-causes/syc-20378921
Sciatica Flare-Ups: Causes and Chiropractic Care

Sciatica Flare-Ups: Causes and Chiropractic Care

Sciatica is a very common and painful issue. Keeping it in check can be difficult especially with various causes that can generate flare-ups. Individuals managing sciatica need to pay attention and be vigilant of the negative activities/movements that could cause symptoms to reappear. A few common causes include:
  • Excessively tight-fitting pants
  • Improperly lifting heavy objects
  • Poor posture
  • Weight gain
  • Not stretching out
  • Wearing the wrong shoes
Knowing what not to do is just as effective for helping sciatica flare-ups as knowing what is best.  
11860 Vista Del Sol, Ste. 128 Sciatica Flare-Ups: Causes and Chiropractic Care
 

Sciatica Causes

The sciatic nerve is the longest nerve. It comes out the spine through the pelvis, down the leg to the foot. There is one sciatic nerve on each side of the body, and either can become irritated, injured, and inflamed. However, it�s rare that both are irritated at the same time. The underlying causes can vary. Most of the time the cause is a herniated disc that presses against the nerve, causing the pain. Even though this happens in the lower back, an individual might only feel pain in the buttocks and the back of the leg. Other causes of sciatic nerve pain include:
  • Bone spurs
  • Degenerative disc disease
  • Muscle inflammation
  • Muscle spasms
  • Spinal stenosis
  • Spondylolysis

Making Sciatica Flare-ups Worse

What makes sciatica worse depends on the underlying cause. For most, this is a herniated or bulging disc that presses against the nerve. With this type of case, any increase in pressure on the discs can worsen the symptoms. Sitting down in fact puts more pressure on the spinal discs, worsening the pain. Lying down can also worsen symptoms. When the pain is peaking, lying down for a little while can help, but for too long can worsen symptoms. Standing with a neutral spine, and walking around a bit, can help with nerve pain relief and the healing process.  
 

Improper/Poor Posture

Poor posture, especially the rounding of the lower back. This usually happens when sitting. The rounded low back becomes a bad habit that individuals think will help with the pain. This can cause a flare-up. The spine has a natural S-curve and the more an individual can maintain that natural curve, the better off they will be.  
 

Weight Gain

Too much weight can cause flare-ups with added stress/pressure on the spine, especially the low back. Maintaining a healthy weight will help relieve the added pressure, however, many who experience sciatica have trouble exercising. This is where a physical therapist and chiropractor can assist an individual with customized exercise and diet programs to overcome this obstacle. Eating is a way that individuals deal with pain, anxiety, and depression. But weight gain and poor health can worsen sciatica. Individuals that are overweight tend to experience more inflammation throughout the body, making sciatica even worse.  

Stretching

Not stretching, especially as the body gets older tightens the muscles, ligaments, and tendons. And stretching improperly can injure these areas. There are recommended and non-recommended stretches for individuals dealing/managing sciatica. Stretches that require bending the low back can place added pressure on the lumbar spine, causing sciatica flare-ups.  
11860 Vista Del Sol, Ste. 128 Sciatica Flare-Ups: Causes and Chiropractic Care
 

Lifting Heavy Things

Lifting and improperly lifting heavy objects can worsen sciatica. This has to do with the rounding of the low back. Any time the spine is taken out of its natural S-curve, there is undue pressure on the joints and discs. When lifting heavy objects in this position the problem is worsened. When possible avoid lifting anything heavy while dealing with sciatica. It�s healthy to stay active, but there is no need to do intense workouts at home or the gym, especially heavy lifting.  
11860 Vista Del Sol, Ste. 128 Sciatica Flare-Ups: Causes and Chiropractic Care
 

Tight Pants

Tight pants can contribute to sciatica. Whether shorts, jeans, or skirts, wearing overly-tight, form-fitting pants should be avoided until the sciatica is gone. And even after it is not recommended to wear overly tight-fitting clothing, as this can cause blood and nerve circulation problems.

Shoes

Like tight pants, the wrong shoes without adequate support can cause flare-ups. For example, high heels force weight distribution to the front of the feet. For the body to compensate, it�s normal to push the pelvis and hips forward. When the body is in this position for a long time it starts to place stress on the hamstrings, which will exacerbate sciatica. Shoes without adequate support place added stress on the feet, which gets transferred up the leg to the hamstrings. Customized shoe inserts designed especially for individuals with sciatica can help in preventing symptoms.  

Improvement

Sciatica takes time to heal. Avoiding making it worse and taking all the steps to help it heal, can bring the body back to normal within 2 weeks. For most, it takes around 4 weeks for the pain to go away. This depends on various factors. For example, if sciatica develops during pregnancy, it could take longer to get rid of the pain. One sign that shows improvement is called centralization meaning the pain is moving out of the leg and into the spine. This is a good sign that the individual is on the right track.

Body Composition


 

Meal Planning

The convenience of food delivery is wonderful, but remember that frequently eating food prepared away from home increases the risk of weight gain and obesity. Restaurants tend to serve oversized portions and prepare meals with excessive calories, sodium, and sugar. The benefit of eating from home is that individuals have more control over the ingredients and cooking methods used to prepare the food. It helps to plan meals and snacks in advance to make sure they are balanced. Here are the types of foods that should be included in a balanced meal plan:
  • A variety of whole fruits
  • Non-starchy vegetables – leafy greens, red and orange veggies
  • Starchy vegetables – potatoes, green peas, legumes, winter squash
  • Grains, with the goal to make at least � from whole-grain sources
  • Low-fat or fat-free dairy milk, yogurt, cheese
  • Protein from various sources – lean meats, seafood, eggs, nuts & seeds, and soy products
  • Healthy cooking oils – olive oil or canola oil
  • Nuts and nut butter
  • Fresh or frozen fruits
  • Dried herbs and spices

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*  
References
Sciatica. MedlinePlus. medlineplus.gov/sciatica.html. Accessed November 29, 2018. Sciatica Sciatic Nerve Pain During Pregnancy. babyMed. www.babymed.com/pregnancy/sciatica-pain-during-pregnancy. Updated on August 29, 2018. Accessed November 29, 2018. Shiel WC. Degenerative Disc Disease and Sciatica. MedicineNet. www.medicinenet.com/degenerative_disc/article.htm#what_are_the_symptoms_of_radiculopathy_and_sciatica. Last reviewed August 10, 2018. Accessed November 29, 2018.
Spinal Decompression Surgery: Laminotomy and Laminectomy

Spinal Decompression Surgery: Laminotomy and Laminectomy

Spinal decompression surgery could be a treatment option discussion with a doctor to relieve nerve pain brought on by a spinal condition or disorder. Everything to know about the procedures straight from the experts.  
11860 Vista Del Sol, Ste. 128 Spinal Decompression Surgery: Laminotomy and Laminectomy
 

Spinal Decompression Surgery Types: Laminectomy or Laminotomy

Both procedures involve the vertebrae�s lamina, which is an arch of bone that protects the spinal canal.
  • In a laminectomy, the lamina is removed almost entirely.
  • In a laminotomy, it is a partial removal.
Despite the removal, the large muscles of the back provide sustained protection for the nerves below. Therefore, the spinal nerves are still safe and secure following the procedures. Which one is right depends on the situation.  
 
  • A laminectomy is usually performed to treat an arthritic condition of the spinal canal like spinal stenosis.
  • Laminotomy is used almost exclusively to remove a herniated disc.
  • A laminectomy removes more bone and sometimes the inner edge of the facet joint.
  • Ultimately, a surgeon will determine which of the two procedures is best for the individual’s needs and condition.

Decompression Surgery

Spinal stenosis or the narrowing of the spinal canal is usually caused by arthritis and overgrowth of the discs and joints. Similar compression issues respond well to non-surgical treatment. But sometimes surgery is necessary to treat uncommon but potentially severe cases. These include patients with:
  • Bowel or bladder problems caused by the pressure on the spinal nerves
  • Leg weakness that gets worse
  • Inability to walk or move for long periods and distance
The objective of spinal decompression surgery is to create space around the spinal cord and surrounding nerves by removing the compressing structure/s. When the cord and/or nerve/s are compressed, physical and neurological symptoms are experienced down the nerve�s pathway. This includes:
  • Tingling
  • Numbness
  • Electric shock sensations
  • Radiating/spreading pain
  • Weakness
Once the compressed nerves have space to relax and move around symptoms subside.  
11860 Vista Del Sol, Ste. 128 Spinal Decompression Surgery: Laminotomy and Laminectomy
 

Laminectomy process

  • Lumbar laminectomy is the most common procedure to treat spinal stenosis in the low back.
  • It also helps treat herniated discs by allowing the surgeon to easily access the discs to repair any damage.
  • The surgeon removes the lamina and ligaments that have thickened and are causing problems to create more space in the canal.
  • The surgery enlarges the spinal canal so that pressure is relieved.
  • By removing the source of the pressure, the pain caused by the compressed nerves is alleviated.
  • An open laminectomy creates an incision of a couple of inches and exposes the spine.
  • The muscles of the spine and back are cut through to expose the bone.
  • Another technique that surgeons utilize is operating through a tube.
  • They’ve adapted these techniques to be able to decompress both the right and the left sides although they are only operating on one side.
  • Both procedures, minimal and traditional accomplish the same goals.
  • The difference is the minimally invasive approach involves one or more tiny incisions also known as skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them.
  • The traditional approach requires a larger incision and instruments that retract, separate and cut tissues.
 

Laminectomy surgery

  • Laminectomies are performed under general anesthesia using a posterior approach/lying face down during the procedure.
  • It can be open or minimally invasive sometimes called a microlaminectomy.
  • In an open laminectomy, the surgeon makes an incision near the affected spinal area.
  • Once the incision is made, a retractor will move the skin, fat, and muscles to the side so the surgeon can access the spine.
  • Next, they remove or trim the lamina and thickened ligaments to enlarge the space surrounding the compressed nerves.
  • Once done, the retractor is removed and the incision is closed with sutures.
  • Minimally invasive surgery or MIS is performed using special instruments like endoscopes and tubular retractors.
  • These instruments allow for smaller incisions and less cutting.
  • They will also use special eyewear to have a detailed view of the surgical field.
  • Sometimes, the surgeon uses an endoscope or a microscope focused down the tube to perform the surgery.
  • The portion of the lamina is removed, along with any bone overgrowths/osteophytes and ligament tissue.
  • The tubular retractors are taken out so the soft tissue moves back into place, and the incision is closed with dissolving sutures.

Other spinal procedures performed alongside

Laminectomies and laminotomies are typically not performed together. However, a surgeon could perform both if the surgery affects multiple levels of the spine. They can also be combined with other spinal surgeries, that include:

Foraminotomy

  • A foraminotomy is also a decompression procedure. But instead of removing part or all the lamina, the surgeon accesses the nerves through the spine�s foramen or the passageway that nerves pass through on both sides.

Discectomy

  • This decompression surgery involves the removal of all or part of the damaged intervertebral disc and is utilized for herniated discs.

Spinal fusion

  • Fusion is often performed after spinal decompression surgery, as the space that was created by removing spinal structure/s can cause instability to the spine.

Candidates for spinal decompression surgery

Both are common procedures performed by neurosurgeons and orthopedic spine surgeons. Laminectomies are considered one of the most effective treatments for spinal stenosis and spinal canal issues like:
  • Tumors
  • Certain types of infections and abscesses
  • Spinal issues involving bowel/bladder dysfunction
  • The primary reason for laminectomy is spinal stenosis, most common in individuals over the age of 60.
Other considerations and conditions include:
  • Non-invasive treatments that don’t improve the condition that includes medication, massage, and physical therapy
  • Fusion surgery failure
  • Injection treatment failure
  • The presence of tumors in or around the spine
  • An infection like an epidural abscess
  • Neurologic issues
  • Bowel or bladder dysfunction
  • Cauda equina syndrome
Ask questions about the procedure to ensure you are comfortable with the operation. Here are some questions:
  • What are the risks associated?
  • Will the surgery relieve all symptoms?
  • Not having the surgery risks?
  • What is recovery like?
11860 Vista Del Sol, Ste. 128 Spinal Decompression Surgery: Laminotomy and Laminectomy
 

Recovery

  • Open or micro, recovery does take time. Following the doctor�s instructions carefully are essential to make a full, healthy recovery.
  • Individuals should be careful for about a month following the surgery. But does not mean laying down or being sedentary. Movement is crucial to recovery.
  • The patient should not stay in bed or lie on the sofa.
  • Wait a week or two before beginning physical therapy if necessary.
  • Most will have a weak core, poor posture, and poor body mechanics, the goal is to help develop and strengthen these areas.
Things to help with recovery include:
  • Ice/cold packs will help reduce swelling and pain.
  • Try not to sit for too long, as sitting is the least comfortable position after back surgery.
  • Body mechanic awareness means avoiding too much bending or lifting and using the right body mechanics when bending or lifting.
  • Post-operative body movement after surgery is vital and helps prevent post-surgery issues.
Things to do before surgery:

Quitting smoking

  • Especially before surgery. Quitting entirely or at least for at least six weeks before surgery will make recovery easier and healthier.

Losing weight

  • Speak with a doctor about weight. Just 5 pounds can make a significant difference during recovery.

Blood sugar

  • For individuals with diabetes, having an A1C under eight before surgery is ideal.
Every patient�s recovery is different. Recovery time depends on:
  • The complexity of the surgery
  • Personal medical history
  • Health issues
Recovery typically takes about two to four weeks after the surgery. However, it depends on the reason/s for the surgery.

Questions

Post-laminectomy syndrome

  • Post-laminectomy syndrome PLS also known as failed back surgery syndrome is a condition where an individual continues to have pain after surgery. Individuals still having symptoms after should speak with their doctor to determine the next phase of treatment.

How long before exercise?

  • Returning to the gym or getting into an exercise routine will take some time. It is important to follow the doctor�s recommendations and complete the full course of physical therapy before regular exercise activity can resume. Discuss workout plans with the doctor to determine the best timeline for the spine.

Full recovery?

  • Returning to some activity is possible around four weeks after surgery. Full recovery takes longer as each patient�s recovery is unique. Depending on the complexity of the surgery, most return to all activities within 6 to 9 months.

Body Composition Spotlight


 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
American Association of Neurological Surgeons. �Minimally Invasive Spine Surgery.� (n.d.)�www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Minimally-Invasive-Spine-Surgery Foraminotomy. MedlinePlus. medlineplus.gov/ency/article/007390.htm. Reviewed November 27, 2016. Page last updated December 21, 2017. Accessed January 18, 2018. Laminectomy. medlineplus.gov/ency/article/007389.htm. MedlinePlus. Reviewed November 27, 2016. Page last updated December 21, 2017. Accessed January 18, 2018. Mayo Clinic. �Laminectomy.� (n.d.)�www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533 Mayo Clinic. �Laminotomy.� (n.d)�www.mayoclinic.org/diseases-conditions/spinal-stenosis/multimedia/img-20149227
Mental Strategy Exercises For Chronic Pain Relief and Improvement

Mental Strategy Exercises For Chronic Pain Relief and Improvement

Mental strategy exercises for chronic pain relief and improvement. Living with chronic pain is difficult especially if a doctor is saying that it is all taking place in an individual’s head. However, the pain is very real and happening in the brain, literally. Neuroimaging studies show that certain areas of the brain become active when chronic pain presents. This is not the only way to know the brain’s role in how an individual experiences pain. What is also known is:
  • Anxiety, depression, and pain activate similar areas of the brain.
  • Certain psychiatric drugs used to relieve pain can also alter an individual’s mental state.
  • Chronic pain can lead to depression.
  • Clinical depression can cause physical symptoms, including back pain.
A health care provider could recommend/suggest psychological support for chronic pain. Psychological help and mental strategy exercises for chronic pain are not about how to reduce the pain, but more on how to reduce the dominance, interference, and impact of the pain and getting a healthy quality of life back. Consider a few evidence-based, psychological approaches to reduce back pain.  
11860 Vista Del Sol, Ste. 128 Mental Strategy Exercises For Chronic Pain Relief and Improvement
 

Cognitive-behavioral therapy

Cognitive-behavioral therapy or CBT trains an individual to modify specific thoughts and behaviors. Experts consider this approach a gold standard of psychological interventions for pain. It helps:
  • Reduce pain
  • Improves function
  • Improves quality of life
Individuals work on:
  • Pain coping strategies
  • Relaxation skills
  • Setting goals
  • Shifting perspectives on pain
A study found that two years after a two-week, intensive course of cognitive-behavioral therapy, patients took fewer pain meds than they did before the therapy.  
 

Mindfulness meditation

Meditation is not all about sitting with crossed legs, hands resting on the knees, although this is a recommended pose for meditative purposes. A modern approach can be done anywhere, in any position that�s comfortable and will help soothe back pain. By oneself or with help from a therapist mental strategies can include
  • Incorporating breathing techniques
  • Guided imagery
  • Intense focus on thoughts and feelings
A study suggests that mindfulness meditation can be highly beneficial for older adults that are not as able to get an adequate amount of physical activity to improve pain levels. A group of older adults that participated in eight weeks of a mindfulness program, which consisted of four days a week for 30 minutes per session physical function and pain reduction improved.  
11860 Vista Del Sol, Ste. 128 Mental Strategy Exercises For Chronic Pain Relief and Improvement
 

Mindfulness stress reduction

Mindfulness stress reduction is a program that teaches individuals meditation techniques, that include basic stretches and postures. It teaches how to separate the physical and psychological aspects of pain. Medical centers across offer this treatment option for a range of disorders, including chronic back pain. It helps reduce pain intensity and improves function in individuals with arthritis as well as back and neck pain from various causes. It has also been found to be effective for fibromyalgia, which can cause intense widespread pain. A study found that mindfulness stress reduction improved:
  • Wellbeing
  • Pain episodes
  • Sleep problems
  • Fatigue in participants with fibromyalgia
  • More than half reported significant improvement
 

Acceptance and commitment therapy

Acceptance and commitment therapy or ACT teaches acceptance and mindfulness strategies with commitment and behavior mental strategies, to change the way pain is experienced. Numerous studies along with the American Psychological Association validate this approach as an established treatment for chronic pain.  
 

Changing expectations

In one study several chiropractic patients who expected their back pain to improve were 58% more likely to improve than those who did not expect favorable outcomes. This mental strategy of manifesting a positive outcome through the power of positive thinking and beliefs about pain influence an individual’s actions. For example, when thinking that physical activity will cause back pain, individuals are less likely to be active. This is known as fear avoidance. For most individuals with back and neck pain, gentle physical activity is essential because avoiding it will worsen the pain. Having the right mental strategy can go a long way in battling chronic pain, at Injury Medical Chiropractic and Functional Medicine Clinic we can help individuals experiencing/dealing with chronic pain.

Body Composition


 

Depression and physical health

Depression is debilitating and, in severe cases, a life-threatening disease that affects over 16 million people nationwide. Depression causes are not always clear and can be brought on by:
  • Biological factors – genetics
  • Individual brain chemistry
  • Certain medications
  • Stress
  • Unhealthy diet/nutrition
Mental illness and becoming overweight or obese often happen in conjunction, whether as a result of each other or from common risk factors that include:
  • Smoking
  • Poor diet
  • Lack of physical activity
  • Alcohol consumption
Prescribed medications for depression and anxiety disorders are have been shown to be successful in maintaining mental health. However, a side effect of these medications is weight gain. Like genetics, being educated on the potential side effects will help in reducing the risk of, and controlling weight gain when taking medication.  

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*  
References
Pain and Therapy.�(Jun 2020) �Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.��www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/ Journal of Psychosomatic Research. (Jan 2010) �Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.� European Journal of Pain.�(Jan 2019.) �Beliefs about back pain and pain management behaviors, and their associations in the general population: A systematic review.��www.ncbi.nlm.nih.gov/pmc/articles/PMC6492285/
Achieving Better Sleep With Chronic Back Pain

Achieving Better Sleep With Chronic Back Pain

Achieving better sleep with back pain through strategies that will address the pain. The spine is an amazing but highly complicated structure. It is made up of:
  • Bones
  • Joints
  • Ligaments
  • Muscles
All support the body’s weight, protect vital organs and nerve structures while maintaining flexibility. When the spine gets:
  • Injured
  • Strained
  • Sprained
This can make standing up, lying down, and sleeping a consistently painful experience.  
11860 Vista Del Sol, Ste. 128 Achieving Better Sleep With Chronic Back Pain
 

Achieving Sleep Solutions

The connection between sleep disturbance in individuals who suffer from acute or chronic back pain is high. Fortunately, back pain does not have to ruin the sleep experience. There are strategies to achieve better sleep. These include:
  • Adjusting sleep positions
  • Improving sleep hygiene
  • Better understanding the source of pain

Sleep Positions

When back pain presents, finding a comfortable position leads to endless tossing and turning. But sleeping in the wrong position can worsen chronic/acute back pain, or create new injury and pain. Here are some options for alleviating pain:  
 

Back sleeping

Sleeping on the back is the best position anatomically, especially for back pain. It evenly distributes the body’s weight putting less strain on the back. For optimal results, use a soft pillow with minimal height to keep the spine aligned with the neck through the low back. Placing a pillow under the legs can also reduce stress on the low back. Back sleeping is also not recommended for pregnant women in their second or third trimester. This is because the weight can press against the spine causing strain. It can also press on the main vein that carries blood back to the heart from the lower extremities. This can interfere with circulation causing dizziness. For this stage sleeping on the side is recommended.

Side sleeping

Sleeping on the side is considered a safe position for those with back pain. However, this is only if the mattress has proper support. Side sleepers need a mattress that maintains spinal alignment. Any strain while sleeping translates into backaches. Side sleepers should also utilize a pillow with enough height to hold their heads so that the spine stays aligned. To keep the mid-spine from sinking into the mattress, place a pillow in the waist area below the ribcage above the pelvis. This will maintain a neutral position. Using a pillow between the legs and slightly with the knees up toward the torso in a relaxed position along with a body pillow for extra comfort and support.

Stomach sleeping

Stomach sleeping is strongly discouraged by a majority of medical professionals, including the American Chiropractic Association. This is because this flattens the natural curve of the spine, straining the low back placing unnecessary pressure on the neck from twisting the head for prolonged periods. If stomach sleeping is a must use a pillow with a very little height so that the neck stays aligned with the backbone. Also, place a thin pillow under the pelvis, this gives the lower back more support.  
11860 Vista Del Sol, Ste. 128 Achieving Better Sleep With Chronic Back Pain
 

Achieving Pain-Free Sleep

Here are some other strategies for achieving pain-free sleep.

Mattress quality

Mattress quality affects healthy sleep, especially when it comes to back pain. Older, sagging mattresses lose performance factors needed to support the lower back, relieve pressure points, and maintain spinal alignment. Newer mattresses with memory foam, latex, or a hybrid with a core of innerspring, have been proven to help back pain and achieve better sleep.

Getting in and out of bed

Getting into and out of bed can be a challenge. There are techniques that limit movement and put minimal pressure on the back, reducing back pain. One technique works by sitting on the edge of the bed and then leaning to the right or left making sure to keep the spine aligned and ease down onto the mattress. Bring the knees up so the body is entirely on its side. Then, in one smooth movement, gently roll onto the back. To get out of bed do the same steps reversed. Because getting into and out of bed requires sitting or lying on the edge of the mattress, make sure the mattress has enough edge support so it won�t sag when sitting.

Healthy sleep habits

Adopting healthy sleep habits ensures proper sleep. Establish a consistent sleep schedule going to bed and waking up at around the same time every day, including weekends. Schedule at least 7-9 hours of sleep every night. Establish a relaxing nighttime routine around half an hour to an hour before sleep to help release any tension.
  • Take a warm bath
  • Practice yoga or meditation
  • Listen to gentle music
  • Read a little
  • Avoid electronic devices
  • Don�t drink caffeinated drinks from mid-afternoon on
  • Drink warm caffeine-free tea to help the body calm down before sleep
  • Sleep in an environment that is cool, dark, and comfortable
 

Back Pain Types

Pain can be severe or persistent. Understanding the source is one of the first steps toward knowing how to treat and manage it.

Posture

The bones and muscles can slip out of alignment with poor posture and not switching positions to allow the muscles, and bones to relax and recover. This can lead to:
  • Muscle tightness
  • Headaches
  • Back pain upper to lower
  • Muscle fatigue
  • Tingling
  • Numbness

Muscle Strain

Muscle strains happen when the muscles or attaching tendons get damaged. This can happen when lifting something heavy or working out too hard. However, it can also happen during regular activities if the muscles are not warmed up. Muscle strain can cause swelling, bruising/redness, and pain in the muscle/s even when resting.

Nerve Pain

Nerve pain can is unpredictable. Nerve-related back pain usually involves the sciatic nerve. When the sciatic nerve becomes irritated, inflamed, pinched, or compressed, the pain can be felt in the low back and radiate down the leg to the foot.

Fractures and Bone Spurs

Bone pain is usually caused by a fracture or bone spur. Fractures cause a deep ache. Bone spurs, or bony growths that appear on the edge of a bone, often along the spine. If bone spurs press on the nerves, it can cause:
  • Weakness
  • Numbness
  • Tingling in the arms or legs
  • Muscle spasms and cramps
The main cause of bone spurs is joint damage.

Medical Emergency

Sometimes back pain requires a visit to a medical professional to rule out more serious causes, like fractures, tumors, or infections of the spine. Symptoms to look out for include:
  • Fever could indicate an infection
  • Trauma, like a fall, could indicate a fracture
  • A diagnosis of osteoporosis could mean a fracture has occurred
  • Numbness or tingling could indicate nerve irritation/inflammation damage
  • History of cancer
  • Foot drop condition and needing to lift the foot higher to prevent dragging, which could be a sign of a nerve or a muscle condition
  • Pain that presents only at night when sleeping
  • Unexplained weight loss can accompany infection or tumors
  • Advanced age increases the risk for infections, tumors, and abdominal issues

Better Sleep

Around 80% of the world�s population will experience backache, and back pain at some point. When the spine’s bones, joints, ligaments, and muscles become injured, strained, or sprained, it can interfere with sleep. Try some of these strategies to help reduce the pain so sleeping well and waking up refreshed can be achieved.

Body Composition


 

Increase Movement with Exercise

One reason the body could be holding on to extra weight could be from high cortisol levels. Cortisol increases when stressed. Stress can derail exercise routine, diet, and sleep, increasing the chances of becoming overweight/obese. With exercise, the body releases endorphins or hormones that help reduce pain and stress. Exercise does not mean intense gym workouts. It can be as simple as taking small parts of the day, moving around to get the blood flowing, and muscles, tendons, ligaments stretched out. For example, if an individual uses the elevator or escalator regularly, take the stairs instead. Or take a short walk. All it takes is small and consistent adjustments to achieve health.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Cochrane Database of Systematic Reviews. (2010.) �Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica.��pubmed.ncbi.nlm.nih.gov/20556780/ National Library of Medicine. MedlinePlus. (Updated April 30, 2020.) �Back Pain.��medlineplus.gov/backpain.html
Texas Supreme Court’s Decision in “Texas Board of Chiropractic Examiners et al v. Texas Medical Association” Case

Texas Supreme Court’s Decision in “Texas Board of Chiropractic Examiners et al v. Texas Medical Association” Case

After all of these years, I am happy to announce that the Texas Supreme Court has finally made a decision regarding the Texas Board of Chiropractic Examiners et al v. Texas Medical Association case on January 29th, 2021. With great honor and gratitude, I’d like to continue to extend sincere thanks to everyone who worked hard on this case and whose tremendous efforts resulted in the decision. Thanks to the Supreme Court’s decision, chiropractors in Texas can now carry on their jobs accordingly. Below, I have provided a letter from Board President, Mark R. Bronson, D.C., F.I.A.N.M. on behalf of the Texas Board of Chiropractic Examiners stating the Texas Supreme Court’s decision in the Texas Board of Chiropractic Examiners et al v. Texas Medical Association case on January 29th, 2021. – Dr. Alex Jimenez D.C., C.C.S.T.

 


 

February 1, 2021

 

On behalf of the Texas Board of Chiropractic Examiners, I extend our sincere thanks and appreciation to everyone whose efforts resulted in the Texas Supreme Court’s decision in Texas Board of Chiropractic Examiners et al v. Texas Medical Association on January 29, 2021. Special thanks are due to all the attorneys at the Office of the Attorney General who worked on this case over these years.

 

The decision properly affirmed the validity of the Board’s scope of practice rule, which the court clearly said does not exceed our statutory scope of chiropractic practice. The court unequivocally held that the Board�s rules do not violate Occupations Code Chapter 201 or run counter to the chapter’s objectives set by the Texas Legislature, and in fact, carefully observe the statutory boundary between the medical and chiropractic professions. This decision, which recognizes the common sense and long-standing inclusion of associated nerves in chiropractic diagnosis and treatment, preserves and strengthens the essence of chiropractic.

 

Thanks to the court’s decision, our licensees can now fulfill their duties as vital portal-of-entry healthcare providers in Texas without fear. The court’s decision reaffirms the principles of economic freedom that have made Texas the best state in the nation to be a chiropractor.

 

Sincerely,

 

Mark R. Bronson, D.C., F.I.A.N.M. Board President
Texas Board of Chiropractic Examiners

 

 


 

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

 

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas & New Mexico*