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Back Clinic Health Team. The level of functional and metabolic efficiency of a living organism. In humans, it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological, and social changes in an environment. Dr.Alex Jimenez D.C., C.C.S.T, a clinical pain doctor who uses cutting-edge therapies and rehabilitation procedures focused on total health, strength training, and complete conditioning. We take a global functional fitness treatment approach to regain complete functional health.

Dr. Jimenez presents articles both from his own experience and from a variety of sources that pertain to a healthy lifestyle or general health issues. I have spent over 30+ years researching and testing methods with thousands of patients and understand what truly works. We strive to create fitness and better the body through researched methods and total health programs.

These programs and methods are natural and use the body’s own ability to achieve improvement goals, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. As a result, individuals live a fulfilled life with more energy, a positive attitude, better sleep, less pain, proper body weight, and education on maintaining this way of life.

Clinical Approach Insights to Identify Substance Use Disorder

Clinical Approach Insights to Identify Substance Use Disorder

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

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

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

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

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

What Is Substance Use Disorder (SUD)?

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

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

  • Use more of the substance than they planned

  • Try and fail to cut down or stop

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

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

Person‑first, non‑stigmatizing language

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

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

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

  • Focus on SUD as a chronic, treatable condition.

Categories and Diagnostic Features of SUD

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

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

Typical criteria include (paraphrased):

  • Using more or for longer than intended

  • Unsuccessful efforts to cut down

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

  • Cravings or strong urges

  • Role failures at work, school, or home

  • Social or interpersonal problems caused or worsened by use

  • Giving up important activities

  • Using in physically hazardous situations

  • Continued use despite physical or psychological problems

  • Tolerance

  • Withdrawal

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

  • Mild: 2–3 symptoms

  • Moderate: 4–5 symptoms

  • Severe: 6 or more symptoms

Substance‑specific categories

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

  • Alcohol use disorder (AUD)

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

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

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

  • Cannabis, tobacco, hallucinogen, or inhalant use disorders

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

Risk and severity categories for clinical workflows

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

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

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

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

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

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

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

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

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

Epidemiology and Public Health Impact

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

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

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

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

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

Identifying Patients With SUD: Screening and Assessment

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

Building a safe, trauma‑informed environment

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

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

  • Emphasize confidentiality within legal limits.

  • Use a calm, nonjudgmental tone and body language.

  • Offer patients the option not to answer any question.

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

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

Validated screening tools

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

For adults:

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

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

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

For adolescents:

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

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

For alcohol‑specific quick screens:

  • AUDIT‑C (3 questions) or full AUDIT

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

Results guide risk categorization and next steps.

Role of the care team

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

  • Medical assistants or nurses

    • Administer pre‑screens and full questionnaires.

    • Flag positive or concerning responses.

  • Nurse practitioners / primary care clinicians

    • Review screening results.

    • Deliver brief interventions using motivational interviewing.

    • Conduct or oversee further assessment.

    • Prescribe and manage pharmacotherapy for SUD when indicated.

    • Coordinate referrals and follow‑up.

  • Behavioral health clinicians (on‑site or virtual)

    • Perform biopsychosocial in-depth evaluations.

    • Provide psychotherapy and relapse‑prevention skills.

    • Support motivational enhancement and family engagement.

  • Chiropractors and physical‑medicine providers

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

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

    • Communicate concerns to the NP or primary medical provider.

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

Clinical clues that may suggest SUD

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

  • Frequent injuries, falls, or motor vehicle accidents

  • Repeated missed appointments or poor adherence to treatment

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

  • Unexplained weight loss, infections, or liver abnormalities

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

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

Understanding Long Lasting Injuries- Video

Comprehensive Assessment and Risk Stratification

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

Structured assessment tools

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

  • Full AUDIT for alcohol

  • DAST‑10 for general drugs

  • CRAFFT or GAIN for adolescents

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

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

Co‑occurring mental health conditions

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

  • Major depressive disorder

  • Anxiety disorders

  • Posttraumatic stress disorder (PTSD)

  • Bipolar disorder

  • Attention‑deficit/hyperactivity disorder

Co‑occurring disorders can:

  • Increased risk for self‑medication with substances

  • Worsen treatment outcomes if not recognized

  • Require integrated treatment plans (NIMH, 2025)

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

Managing Patients With SUD: A Practical Clinical Process

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

Core elements of management

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

  • Routine screening and re‑screening

  • Brief interventions and motivational interviewing

  • Harm‑reduction strategies

  • Medications for certain SUDs (when appropriate)

  • Evidence‑based behavioral therapies

  • Peer and family support

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

Brief intervention and motivational interviewing

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

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

  • Reflect and summarize the patient’s own statements

  • Ask permission before giving advice

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

This approach respects autonomy and builds internal motivation for change.

Determining level of care

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

  • Prevention/early intervention

    • Brief interventions in primary care

    • Self‑management support and education

  • Outpatient services

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

    • Integrated behavioral health visits

  • Intensive outpatient / partial hospitalization

    • Several therapy sessions per week, day or evening programs

  • Residential/inpatient services

    • 24‑hour structured care for severe or complex cases

  • Medically managed intensive inpatient services

    • Medically supervised detoxification and stabilization

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

Medications for SUD

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

  • Alcohol use disorder

    • Acamprosate – supports abstinence after detox

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

    • Naltrexone blocks the rewarding effects of alcohol

  • Opioid use disorder

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

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

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

  • Overdose prevention

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

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

Behavioral therapies and peer support

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

  • Cognitive behavioral therapy (CBT)

  • Dialectical behavior therapy (DBT)

  • Motivational enhancement therapy

  • The Matrix Model (especially for stimulants)

  • Family‑based therapy for adolescents

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

Long‑term follow‑up

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

  • Follow‑up within 2 weeks after treatment initiation

  • Monthly to quarterly visits as patients stabilize

  • Peer support and care management between visits

  • Rapid re‑engagement after any relapse or lapse

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

How SUD Affects the Body and the Musculoskeletal System

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

General systemic effects

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

  • Cardiovascular disease and hypertension

  • Liver disease and pancreatitis (especially with alcohol)

  • Respiratory disease (especially with tobacco and some drugs)

  • Endocrine and hormonal disruption

  • Immune dysfunction and higher infection risk

  • Sleep disturbances and fatigue

  • Worsening of mood, anxiety, and cognitive function

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

Musculoskeletal and pain‑related effects

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

  • Increased injury risk

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

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

  • Bone, joint, and muscle changes

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

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

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

  • Chronic pain and central sensitization

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

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

  • Functional and ergonomic stress

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

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

Integrative Chiropractic Care in the Context of SUD

Philosophy of integrative chiropractic care

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

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

  • Non‑pharmacologic pain management

  • Improved movement, posture, and ergonomics

  • Education that empowers patients to self‑manage pain

  • Reduced reliance on habit‑forming medications

Spinal adjustments and targeted exercises

Spinal and extremity adjustments aim to:

  • Restore joint mobility

  • Reduce mechanical irritation of nerves and soft tissues

  • Improve segmental alignment and overall posture

Targeted exercises are prescribed to:

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

  • Correct muscle imbalances and faulty patterns

  • Increase flexibility and joint range of motion

  • Enhance proprioception, balance, and movement control

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

  • Lumbar stabilization and core‑strengthening sequences

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

  • Cervical and scapular stabilization for neck and shoulder pain

  • Postural retraining, including ergonomic break routines for prolonged sitting

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

Reducing overlapping risk profiles

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

  • Chronic stress and trauma

  • Poor sleep and circadian disruption

  • Sedentary lifestyle and obesity

  • Repetitive strain and poor ergonomics

  • Social isolation and low self‑efficacy

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

  • Encouraging regular physical activity and graded movement

  • Coaching ergonomic and postural strategies at work and home

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

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

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

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

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

Comprehensive medical management

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

  • Conducting and interpreting SUD screening and risk stratification

  • Performing physical exams and ordering labs or imaging

  • Diagnosing SUD and co‑occurring conditions

  • Prescribing non‑addictive pain strategies and medications where indicated

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

  • Monitoring for drug–drug and drug–disease interactions

  • Coordinating with behavioral health and community resources

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

Ergonomic and lifestyle counseling

NPs also provide individualized counseling on:

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

  • Safe lifting strategies and body mechanics

  • Activity pacing and graded return to work or sport

  • Sleep hygiene and circadian rhythm support

  • Nutrition strategies that support musculoskeletal healing and brain health

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

Care coordination and team communication

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

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

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

  • Adjusts the plan as conditions change

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

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

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

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

Step 1: Initial visit and global screening

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

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

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

Step 2: Identification of SUD risk

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

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

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

Step 3: Integrated treatment planning

The team crafts a unified plan that may include:

  • Spinal adjustments and targeted exercises to correct alignment and biomechanics

  • Gradual increase in physical activity with pain‑sensitive pacing

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

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

  • Consideration of medications for AUD or OUD, if indicated

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

Step 4: Ergonomics and lifestyle

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

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

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

Step 5: Monitoring and long‑term follow‑up

  • Regular follow‑up visits evaluate:

    • Pain levels and functional capacity

    • Substance use patterns and cravings

    • Mood, sleep, and quality of life

    • Adherence to exercise and ergonomic plans

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

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

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

Clinical Insights from an Integrative Practice Model

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

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

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

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

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

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

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

Key Takeaways

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

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

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

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

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

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

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

Conclusion

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

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

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

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

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

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

References

Real-Life Posture Rehab for a Stronger Spine

Real-Life Posture Rehab for a Stronger Spine

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

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

Real-Life Posture Rehab for a Stronger Spine

Move around and change posture positions throughout the day.

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

This article explains, in simple language:

  • What good posture really is

  • Recommended physical activities and exercises to enhance posture

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

  • Easy desk and “tech neck” fixes

  • How integrative chiropractic care supports posture

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

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

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

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

  • Ears over shoulders

  • Shoulders over hips

  • Hips over knees and ankles

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

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

  • Chronic neck and back pain

  • Tension headaches

  • Fatigue and shallow breathing

  • Tight hip flexors and weak glutes

  • Early joint wear and tear

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

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

Core Principles of Posture-Focused Exercise

Most effective posture plans share the same core goals:

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

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

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

  • Train body awareness—so you notice and correct slouching

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

Think of Your Program in Simple Pieces

Try to include each week:

  • 2–3 days of core and back strengthening

  • 2–3 days of mobility and stretching

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

  • Daily micro-breaks from sitting or driving

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

Foundational Strength Exercises for Better Posture

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

Planks (Front and Side Planks)

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

Basic front plank:

  • Start on your forearms and toes

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

  • Gently pull your belly toward your spine

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

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

Bird-Dog

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

How to do it:

  • Start on hands and knees

  • Extend your right arm forward and left leg back

  • Keep your hips level; don’t twist

  • Hold 3–5 seconds, then switch sides

  • Do 8–10 reps per side

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

Glute Bridges

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

  • Lie on your back, knees bent, feet flat

  • Press through your heels and lift your hips

  • Squeeze your glutes at the top

  • Hold 3–5 seconds, then lower

  • Repeat 10–15 times

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

Superman Exercise

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

  • Lie face down

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

  • Hold briefly and lower with control

  • Start with 5–8 reps

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

Rowing Movements (Bands or Dumbbells)

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

  • Use a resistance band or light dumbbells

  • Pull your elbows back and squeeze your shoulder blades together

  • Avoid shrugging your shoulders toward your ears

  • Do 2–3 sets of 10–15 reps

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

Mobility and Stretching: Releasing the “Posture Brakes”

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

Key Posture Stretches

  • Chest Opens / Doorway Stretch

    • Stand in a doorway with your forearms on the frame

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

    • Hold 20–30 seconds

  • Chin Tucks barringtonortho.com+1

    • Sit or stand tall

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

    • Hold 3–5 seconds

    • Repeat 10 times

  • Cat-Cow

    • On hands and knees

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

    • Move with your breath for 8–10 cycles

  • Hip Flexor Stretch

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

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

    • Hold 20–30 seconds on each side

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

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

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

Yoga for Alignment and Awareness

Yoga routines often include:

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

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

  • Bridge Pose – strengthens glutes and back

  • Chest opener poses—counter phone and computer hunching

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

Pilates for Core Control

Pilates focuses on:

  • Deep core strength

  • Controlled breathing

  • Smooth, precise movements

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

Tai Chi for Balance and Relaxed Upright Posture

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

  • Improve balance and coordination

  • Encourage relaxed, upright posture

  • Reduce stress and muscle guarding

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

Everyday Physical Activities That Support Posture

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

Helpful posture-friendly options include:

  • Walking:

    • Encourages natural spinal motion

    • Easy to fit into breaks or evenings

  • Swimming:

    • Full-body, low-impact workout

    • Strengthens back and shoulder muscles with less joint stress

  • Dancing:

    • Builds coordination and body awareness

    • Helps you practice an upright chest and an active core

  • Cycling (with proper bike fit):

    • Strengthens hips and legs

    • Supports overall fitness and endurance

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

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

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

Desk-Friendly Posture Break Routine

Try this mini-routine a few times each day:

  • Chin tucks – 10 reps

  • Shoulder blade squeezes – hold 5 seconds × 10 reps

  • Seated Cat-Cow – 5–10 slow breaths

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

Simple Ergonomic Tips

  • Keep feet flat on the floor

  • Hips and knees are near 90 degrees

  • Screen at or just below eye level

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

  • Stand and walk at least every 30–60 minutes

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

How Integrative Chiropractic Care at El Paso Back Clinic Supports Posture

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

What a Posture-Focused Chiropractic Visit Often Includes

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

  • Posture and movement exam

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

  • Spinal and extremity adjustments

    • Gentle, specific forces to restore joint motion and alignment

  • Soft-tissue work

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

  • Corrective exercises

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

  • Ergonomic and lifestyle coaching

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

Studies and clinical reports note that regular chiropractic adjustments can:

The Nurse Practitioner’s Role in Supporting Posture

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

A nurse practitioner can:

  • Review your full medical history

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

  • Order and interpret imaging and labs

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

  • Prescribe or adjust medications

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

  • Coordinate referrals

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

  • Give lifestyle and ergonomic counseling

    • Weight management, sleep, stress, and work setup

  • Use telemedicine for follow-up

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

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

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

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

In his clinical observations at El Paso Back Clinic:

  • Patients with neck and back pain do best when:

    • They receive specific spinal adjustments

    • PLUS core and hip strengthening

    • PLUS stretching and mobility work

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

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

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

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

Sample Weekly Posture-Boosting Plan (General Example)

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

Weekly Outline

Day 1 – Core and Glutes

  • Front plank: 3 × 20–30 seconds

  • Glute bridges: 3 × 12–15

  • Bird-dog: 2 × 10 per side

  • 10 minutes of chest and hip flexor stretches

Day 2 – Yoga and Mobility

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

  • Chin tucks: 2 × 10

  • Shoulder blade squeezes: 2 × 10

Day 3 – Upper Back and Cardio

  • Resistance band or dumbbell rows: 3 × 12

  • Wall angels: 2 × 10 Outside Online

  • 20–30 minutes of brisk walking

Day 4 – Pilates-Style Core

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

  • 10 minutes of hamstring and hip stretches

Day 5 – Mind-Body and Balance

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

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

Day 6 – Whole-Body Low-Impact

Day 7 – Recovery and Reset

  • Gentle stretching or yoga flow

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

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

Safety Tips: When to Get Help

Stop and get professional care if posture exercises cause:

  • Sharp or stabbing pain

  • Numbness or tingling in arms or legs

  • New weakness or loss of coordination

  • Trouble walking or standing

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

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

Bringing It All Together

To enhance posture and protect your spine:

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

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

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

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

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

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

  • Spinal and joint adjustments

  • Corrective exercise and posture coaching

  • Medical evaluation, imaging, and medication management when needed

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

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Functional Wellness and Healing from Autoimmune Conditions

Functional Wellness and Healing from Autoimmune Conditions

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

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

Understanding Autoimmune Conditions: How Functional Wellness Can Transform Your Health

Pain Management Techniques Explained in a Clinical Setting

Pain Management Techniques Explained in a Clinical Setting

by | Chiropractic, Chiropractic Examination, Chronic Pain, Health, Treatments, Viscerosomatic Reflex

Understand the importance of pain management in a clinical setting in fostering recovery and improving patients’ overall health.

Understanding Pain: Causes, Categories, and Effective Management Strategies

Pain is a universal experience that can range from mild discomfort to debilitating agony, affecting millions worldwide. Environmental factors often play a key role in how pain develops, particularly in muscles and joints, where things like weather changes or stress can trigger or worsen symptoms. This comprehensive guide explores the origins of pain, its various categories with real-life examples, and how healthcare professionals manage it in clinical settings through both surgical and non-surgical therapies. Drawing from expert insights, including those from Dr. Alexander Jimenez, DC, APRN, FNP-BC, we delve into integrative approaches that promote natural healing and prevent long-term issues.

Research indicates that pain isn’t solely from physical trauma; external influences like humidity or pollution can heighten sensitivity in the body. It appears that addressing these factors through lifestyle adjustments and targeted therapies can significantly improve outcomes. The evidence points toward a balanced approach that combines medical interventions with natural methods to help individuals regain control over their health.

Key Insights on Pain and Its Management

  • Environmental Triggers Are Common: Factors such as cold temperatures or air pollution can trigger inflammation in muscles and joints, increasing the risk of pain.
  • Pain Comes in Many Forms: From acute, sharp stabs to chronic, dull aches, understanding the categories helps choose the right treatment.
  • Clinical Care Varies: Specialists use non-surgical options such as exercise and acupuncture for many cases, reserving surgery for severe cases.
  • Integrative Methods Work Well: Experts like Dr. Jimenez show how chiropractic care and massage can address root causes, fostering natural recovery.

Pain management in clinics follows guidelines that prioritize patient safety and effectiveness, as outlined in resources on defining and managing pain (U.S. Department of Justice, Drug Enforcement Administration, 2023).

—

Pain affects everyone differently, but understanding its roots can empower better handling. This article expands on the biology of pain, environmental influences, categories, and management techniques, incorporating clinical observations from professionals like Dr. Alexander Jimenez. We’ll cover detailed examples, case studies, and tables to make the information accessible and actionable.

The Biology of Pain: How It Develops in the Body

Pain starts as a protective mechanism. When the body detects harm, nerves send signals to the brain, which processes them as pain to prompt action, like pulling away from heat. However, this system can go awry, especially with environmental factors involved.

Nociceptors, the body’s pain sensors, are found in skin, muscles, joints, and organs. They respond to stimuli such as temperature and pressure. When activated, they trigger inflammation, which can swell tissues and press on nerves, amplifying discomfort (International Association for the Study of Pain, 2022). In muscles, this might cause tightness or spasms; in joints, it leads to stiffness or swelling.

Chronic pain, lasting over three months, often persists beyond the initial injury due to sensitized nerves. This sensitization lowers the pain threshold, making everyday activities hurtful (International Association for the Study of Pain, 2022). For instance, a minor joint strain can progress to ongoing arthritis if environmental stressors, such as humidity, exacerbate inflammation.

How Pain Affects Muscles and Joints Specifically

Muscles, made of fibers that contract for movement, can develop pain from overuse or tension. Environmental factors cause micro-tears or inflammation, leading to conditions like myalgia. Joints, cushioned by cartilage and synovial fluid, suffer when pressure changes cause fluid shifts, resulting in arthritis-like pain (Arthritis Foundation, 2024).

Case Study: A 45-year-old office worker experiences shoulder pain from poor ergonomics (static posture) combined with stress, leading to muscle knots and joint misalignment. Over time, this evolves into chronic upper back pain, affecting daily life.

Environmental Factors Contributing to Pain Development

Environmental factors are crucial in the onset and progression of pain, especially in muscles and joints. These factors interact with biology, making some people more susceptible.

Weather and Climate Influences

Weather changes significantly impact pain. Low temperatures constrict blood vessels, reducing flow to muscles and causing stiffness. High humidity increases joint fluid pressure, leading to swelling and ache (Arthritis Foundation, 2024). Barometric pressure drops before storms can trigger migraines or joint pain by altering tissue expansion.

Examples:

  • In osteoarthritis, patients report worse knee pain during cold, damp weather due to increased joint rigidity (PMC, 2025a).
  • Fibromyalgia sufferers experience muscle flares from temperature swings, with cold lowering pain thresholds by 11.3°C compared to healthy individuals (PMC, 2025a).

Studies show modest correlations between pain and humidity, pressure, and wind speed (Arthritis Foundation, 2024). For muscles, cold induces spasms; for joints, humidity exacerbates inflammation.

Stress and Psychosocial Elements

Stress releases cortisol, promoting inflammation that affects muscles and joints. Chronic stress from work or life events heightens pain perception, leading to tension headaches or back pain (MDPI, 2022). Low social support or discrimination correlates with thicker brain structures involved in pain processing, such as the insula, making discomfort more intense (Nature, 2024).

Examples:

  • Job insecurity causes muscle tension in the neck and shoulders, evolving into chronic pain.
  • Discrimination experiences are associated with greater hippocampal volume and greater pain in patients with knee osteoarthritis (Nature, 2024).

Pollution and Toxins

Air pollution, including particulates and toxins such as acrolein, increases inflammation, worsening joint pain in rheumatic diseases (ScienceDirect, 2024a). Smoking aggravates arthritis by activating immune cells, predicting higher pain in spinal injuries (ScienceDirect, 2024a).

Examples:

  • Urban dwellers exposed to pollution have more emergency visits for joint pain.
  • Vitamin D deficiency due to reduced sunlight exposure is associated with muscle hypersensitivity (ScienceDirect, 2024a).

Work and Lifestyle Environments

Poor ergonomics, such as prolonged sitting, strains muscles and joints, leading to musculoskeletal pain (MDPI, 2022). Repetitive tasks lead to back pain by reducing movement variability (IASP, n.d.a).

Examples:

  • Factory workers develop joint pain from repetitive lifting.
  • Sedentary lifestyles in air-conditioned offices can cause dry-air-related stiffness.

Sociocultural Factors

Lower income and education are associated with higher pain levels due to limited access to healthy environments (Nature, 2024). Household size and employment status explain variance in pain-related brain structures.

To mitigate, strategies include weather-appropriate clothing, stress management, and pollution avoidance. Tables below summarize factors.

Environmental Factor Description Impact on Muscles Impact on Joints Examples
Weather (Temperature) Changes in ambient heat/cold Constriction, spasms Stiffness, reduced mobility OA knee pain in cold
Humidity High moisture levels Swelling, tension Fluid pressure increase Arthritis flares in damp weather
Stress Psychosocial pressures Tension, knots Inflammation from cortisol Neck pain from job stress
Pollution Air toxins Inflammation, hypersensitivity Rheumatic exacerbations Joint pain in urban areas
Work Conditions Ergonomic issues Strain, fatigue Misalignment Back pain from sitting

Deeper Dive into Physicochemical Factors

Physicochemical factors, such as pollution and toxins, directly alter pain pathways. Air pollution exacerbates neuropathic pain by sensitizing nerves (ScienceDirect, 2024a). Toxic compounds such as 4-HNE activate receptors, triggering neurogenic inflammation in joints.

Biological factors, such as viral infections, lead to arthritis-like joint pain (ScienceDirect, 2024a). Smoking induces hyperalgesia through serotonergic changes.

Psychosocial factors, such as stress, promote chronicity, while environmental enrichment reduces pain by lowering stress (ScienceDirect, 2024a).

Case Study: A patient with rheumatoid arthritis experiences worse joint pain during pollution spikes, managed by indoor air filters and an anti-inflammatory diet.

Categories of Pain: Descriptions and Examples

Pain is classified by duration, cause, and location to guide treatment (Healthline, 2018).

Acute Pain

Short-term, lasting days to weeks, from injury. Sharp or intense, it alerts the body (Healthline, 2018).

Examples:

  • Muscle strain from lifting heavy objects.
  • Joint pain from a sprained ankle.

Chronic Pain

Lasts months or years, often without a clear cause. Mild to severe, impacting life (Healthline, 2018).

Examples:

  • Low back pain from poor posture.
  •  Arthritis causes ongoing joint pain.

Nociceptive Pain

From tissue damage, activating nociceptors. Acute or chronic (WebMD, 2025).

Subtypes:

  • Somatic: Skin, muscles, bones. Aching or throbbing.
    • Examples: Muscle pull, joint fracture.
  • Visceral: Organs. Dull, cramping.
    • Examples: Appendicitis, but it can also refer to muscle pain.

Neuropathic Pain

From nerve damage. Burning, tingling (WebMD, 2025).

Examples:

  • Diabetic neuropathy in the feet (joint-related).
  • Sciatica from spinal nerve compression (muscle/joint).

Other Categories (IASP Definitions)

  • Allodynia: Pain from non-painful stimuli, e.g., light touch on sunburned muscle (IASP, 2022).
  • Hyperalgesia: Amplified pain from normal stimuli, e.g., pinprick on an inflamed joint.
  • Nociplastic Pain: Altered nociception without damage, e.g., fibromyalgia muscle pain.
Category Duration Cause Sensation Muscle/Joint Example
Acute Short Injury Sharp Strained hamstring
Chronic Long Ongoing Dull Chronic knee arthritis
Nociceptive Somatic Varies Tissue Aching Bone fracture joint pain
Neuropathic Varies Nerve Burning Sciatica leg muscle
Nociplastic Chronic Altered processing Widespread Fibromyalgia joint tenderness

Case Study: An athlete with acute nociceptive pain from a joint sprain transitions to chronic pain if left untreated, demonstrating category evolution.

Exploring Integrative Medicine- Video

Pain Management in Clinical Settings

Healthcare specialists follow evidence-based rationale for pain management, emphasizing multimodal approaches to minimize risks like addiction (SAMHSA, 2024). The MATE Act requires training on safe prescribing, focusing on opioid use disorders and pain treatment (DEA, 2023).

Non-Surgical Therapies

These are first-line for many, using meds, therapy, and complementary methods.

  • Medications: NSAIDs for inflammation, acetaminophen for mild pain (NEJM, 2019).
  • Physical Therapy: Exercises strengthen muscles and improve joint mobility.
  • Complementary: Acupuncture and massage reduce tension (PMC, 2024).
  • Behavioral: Mindfulness for stress-related pain.

Clinical rationale: Reduces opioid reliance, promotes natural healing (ScienceDirect, 2024b).

Examples: Massage post-injury eases muscle tension; breathing techniques lower anxiety in the clinic.

Surgical Therapies

For severe cases, such as joint replacement. Post-op management includes multimodal analgesia (JAMA, 2021).

  • Opioids: Short-term for breakthrough pain.
  • Non-Drug: Music therapy reduces opioid needs by 31% (PMC, 2024).

Rationale: Balances relief with safety, per guidelines (DEA, 2023).

Therapy Type Examples Benefits Clinical Rationale
Non-Surgical Meds NSAIDs Reduce inflammation Low risk for chronic pain
Physical Therapy Exercises Strengthen muscles Prevents long-term weakness
Surgical Post-Op Opioids + Music Pain relief Minimizes addiction risk

Case Study: Patient with joint pain undergoes non-surgical acupuncture, avoiding surgery.

Insights from Dr. Alexander Jimenez

Dr. Jimenez, with 30+ years in chiropractic and functional medicine, observes correlations such as perimenopausal estrogen drops causing joint pain or TBI leading to posture issues and muscle aches (LinkedIn, n.d.; DrAlexJimenez.com, n.d.).

His integrative approach addresses causes:

  • Targeted Exercise: Rehab programs build strength and prevent recurrence.
  • Massage Therapy: Relieves soft tissue tension.
  • Acupuncture: Promotes healing in sciatica.

Prevents long-term problems through nutrition and monitoring (DrAlexJimenez.com, n.d.).

Case Study: TBI patient regains mobility via chiropractic adjustments and exercises.

Prevention and  Future Trends

Prevention involves environmental awareness, regular physical activity, and a healthy diet. Future trends include wearables for trigger monitoring.

This guide, drawing from diverse sources, shows pain as manageable with informed care.

Conclusion: Embracing a Future Free from Chronic Pain

Pain is a complex signal influenced by biology, environment, and lifestyle, as we have covered in this lengthy piece. It is not only a transient discomfort. Understanding these things, such as the distinctions between nociplastic, neuropathic, and nociceptive pain, and how pollution and barometric pressure may cause muscles and joints to expand, empowers us to take control. The 2024 recommendations (American College of Surgeons et al., 2024) stress that proactive, multimodal approaches in both surgical and non-surgical settings are highly valued for treating pain to reduce symptoms, prevent worsening, and avoid the onset of chronic illnesses.

Health care providers are crucial in this situation. They use ERAS protocols to support rehabilitation after surgery and integrative therapies to help individuals feel better every day. El Paso chiropractor Dr. Alexander Jimenez, DC, APRN, FNP-BC, has shown that addressing the root causes with acupuncture, massage therapy, chiropractic adjustments, and targeted workouts promotes the body’s natural healing process and prevents long-term issues. His case correlations demonstrate that while environmental stresses, including metabolic imbalances or repetitive work strains, often cause chronic pain, these effects may be reduced with evidence-based, individualized therapies.

Restoring equilibrium and enhancing general health, rather than masking the issue, are the ultimate objectives of effective pain management. You may end the cycle of suffering by recognizing the environmental sources of your pain, appropriately categorizing it, and looking for all-encompassing answers. You may still have a more mobile, healthy, and contented life if you make the proper decisions and seek professional help, regardless of how long you’ve experienced joint pain or how recently you were injured. Speak with a professional as soon as possible, implement your own strategy, and begin a better, less painful future.

References

Telemedicine Nutritional Counseling: Personalized Plans

Telemedicine Nutritional Counseling: Personalized Plans

by | Adrenal Fatigue (AF), Anti Aging, Basal Metabolic Index (BMI), Diets, Fasting, Functional Medicine, GMO, Gut and Intestinal Health, Health, Health Coaching, Hyper Thyroid, Hypo Thyroid, Ketogenic Diet Explained, Metabolic Syndrome, Nutrition, Nutritional Genomics, Probiotics, Supplements, Vitamins, Wellness

Unlocking Wellness at El Paso Back Clinic®: Telemedicine’s Role in Nutritional Counseling and Integrative Chiropractic Care

Telemedicine Nutritional Counseling: Personalized Plans

The Nutritionist prepares for an online telemedicine session.

Introduction

In the heart of El Paso, Texas, staying healthy doesn’t always mean long drives to the doctor’s office. At El Paso Back Clinic®, led by Dr. Alex Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, we make wellness easy with telemedicine. This tech uses video calls and apps to connect you with our experts for nutritional advice, right from your home. It’s perfect for busy El Paso families dealing with back pain, sports injuries, or just wanting more energy.

Our nutritional counseling via telemedicine isn’t just general tips—it’s custom-made for you. We help with meal plans that fight inflammation, support weight management, or boost recovery after an injury. Think personalized recipes, like anti-inflammatory Player Bowls packed with veggies and lean proteins, shared during your virtual session. We also link to services for medically tailored meals, delivered to your door in El Paso, to support conditions like diabetes or heart health.

What sets us apart at El Paso Back Clinic® is our blend of chiropractic care and functional medicine. Chiropractic adjusts your spine to ease pain and improve movement, while functional medicine digs into root causes, like poor diet or stress. Through telemedicine, we combine these for full-body plans, including food advice, supplements, and simple exercises. This helps your body heal naturally, without heavy meds or surgery.

Dr. Alex Jimenez, with his dual skills as a chiropractor and nurse practitioner, sees this work wonders every day. From our clinics in East Side, Central, and Northeast El Paso, he notes that patients with sciatica or chronic back pain recover faster when nutrition supports their adjustments. Simple swaps, such as adding omega-3-rich foods, reduce swelling and speed healing (Jimenez, 2023a).

This article explores how telemedicine powers nutritional guidance at El Paso Back Clinic®. We’ll cover the basics, how to prep for sessions, and the strength of our integrative approach. You’ll get real tips and insights to start your wellness journey with us.

  • Why Choose El Paso Back Clinic® for Telemedicine Nutrition?
    • Convenient virtual visits from anywhere in El Paso.
    • Expert team focused on back health, sports wellness, and functional nutrition.
    • Personalized care that fits your Texas lifestyle.

What Is Telemedicine for Nutritional Counseling at Our Clinic?

At El Paso Back Clinic®, telemedicine means meeting our registered dietitians or nutrition specialists online, without the need to visit our Vista Del Sol or Gateway East locations. Log in from your phone or computer for a one-on-one chat about your eating habits. We ask about your daily routine, health background, and goals, then create a plan tailored to El Paso life—maybe quick meals for shift workers or family-friendly options.

For instance, if you’re dealing with high blood pressure, we might suggest low-sodium Tex-Mex twists, like grilled chicken fajitas with fresh salsa. We send recipes via email or our secure app, where you can scan barcodes for nutrition info. Sessions are flexible—schedule around your job at the border or kids’ soccer practice.

Research supports this method. One study adapted tools like the NUTRI-TEC system for interactive care, helping patients track meals and meet goals from home (Hutton et al., 2020). Dr. Jimenez uses similar tech in our clinic for injury recovery. After a slip-and-fall, patients use video check-ins to adjust their diets, such as adding collagen-rich broths for joint support (Jimenez, 2023b).

  • What Happens in a Typical Session?
    • Quick health assessment and goal discussion.
    • Review of your food diary or lab results.
    • Custom tips with follow-up resources.

Personalized Meal Plans Through Virtual Consults at El Paso Back Clinic®

One of the best parts of our telemedicine service is creating meal plans tailored to your needs. Upload your blood work or a week’s food log to our portal, and during the call, Dr. Jimenez or our team will review it. We spot issues, like low iron from skipping veggies, and recommend fixes—perhaps spinach salads with local El Paso produce.

Our apps make it smart and simple. They generate weekly menus that avoid allergens or fit budgets. If you’re vegan, we swap in beans for meat. This keeps you on track, as plans feel realistic for daily life.

For ongoing issues like IBS, we focus on gut-soothing foods, such as probiotic yogurt or herbal teas. The U.S. Department of Health and Human Services (HHS) reports that virtual plans improve outcomes for diabetes and other conditions (U.S. Department of Health and Human Services, 2023a). In our functional medicine wing, we go deeper with at-home tests, then tweak via app. Dr. Jimenez has seen autoimmune patients reduce flares by ditching inflammatory foods, guided by labs (Jimenez, 2024).

  • How We Build Your Plan Step by Step:
    • Snap photos of your meals to share.
    • Talk about tastes, allergies, and schedules.
    • Receive a shopping list with H-E-B or Walmart picks.

Delivering Educational Resources Remotely from El Paso Back Clinic®

Learning about nutrition should be engaging, not overwhelming. At our clinic, telemedicine delivers education in fun ways. Watch videos on portion control or join live webinars on beating sugar cravings. We host group sessions for El Paso locals on topics like healthy grilling for summer barbecues.

These build real skills. Learn to spot hidden fats on labels or follow virtual demos for easy smoothies. For families, we include kid tips, like hiding greens in pasta sauce.

HHS highlights group support for setting goals, where folks share successes like choosing water over soda (U.S. Department of Health and Human Services, 2023a). Dr. Jimenez’s online classes teach how vitamins from fruits aid nerve repair after back strains, with slides you can revisit (Jimenez, 2023c).

  • Our Favorite Educational Tools:
    • Fun quizzes on balanced eating.
    • Video recipe collections.
    • Digital journals for tracking habits.

Coordinating Medically Tailored Meals with Our Telemedicine Services

When cooking is tough due to pain or other factors, we connect you with medically tailored meals (MTMs). These are ready-made dishes designed for your health, like low-carb options for blood sugar control, delivered across El Paso.

Our providers handle the setup, ensuring meals align with your plan. Track and provide feedback via the app for adjustments. This helps post-surgery patients and those with arthritis get the nutrients they need without effort.

HHS explains that MTMs address medical and social needs to improve management (U.S. Department of Health and Human Services, 2023a). At El Paso Back Clinic®, we combine MTMs with chiropractic care to ensure complete healing. For scoliosis patients, anti-inflammatory meals with spices like turmeric can ease discomfort and support adjustments (Jimenez, 2023b).

  • Benefits of MTMs Through Us:
    • Customized for your diet restrictions.
    • Weekly deliveries to your El Paso address.
    • Easy app-based reviews for changes.

Preparing Patients and Families for Success at El Paso Back Clinic®

Ready for your first telemedicine nutrition session? We make prep simple. Check your device’s camera and internet, then gather notes on symptoms, meds, and recent eats.

Bring your family in—especially if they share meals. This way, everyone learns, like planning group hikes with healthy snacks. HHS notes shared plans create family-wide habits (U.S. Department of Health and Human Services, 2023b).

For tech newbies, we offer phone backups or easy guides. Dr. Jimenez tells families in El Paso to log meals together to reduce stress and boost energy (Jimenez, 2024).

  • Your Prep Checklist:
    • Set up a quiet spot and charge gadgets.
    • Jot down questions in advance.
    • Include cooks or eaters in the call.

Functional Medicine’s Virtual Boost at Our El Paso Clinic

Functional medicine at El Paso Back Clinic® targets why you’re unwell—like gut issues causing fatigue. Telemedicine makes it accessible: Review home test results online, then get plans with foods, supplements, and lifestyle tweaks.

Our shared apps monitor sleep or activity, allowing real-time changes. Being Functional describes how this tracks markers like blood sugar without trips (Being Functional, n.d.).

Dr. Jimenez, with certifications in functional medicine, transforms care here. For hormone imbalances, he guides diets via portal, watching energy improvements (Jimenez, 2023c).

  • Key Functional Tools We Use:
    • Mailed home testing kits.
    • App logs for daily progress.
    • Connections to worldwide experts.

Chiropractic Meets Nutrition Online at El Paso Back Clinic®

Our chiropractic services fix spine issues for less pain, but nutrition multiplies the benefits. Virtually, we recommend foods like nuts for muscle relaxation after adjustments.

Grove Chiropractic notes that omega-3s reduce stiffness, complementing our alignments (Grove Chiropractic, n.d.). We stress hydration for disc health—aim for eight glasses daily.

Dr. Jimenez blends this expertly. Sciatica sufferers get guided stretches and bone-supporting supplements, shortening recovery (Jimenez, 2023a).

  • Top Nutrient-Chiro Combos:
    • Vitamin D for strong bones.
    • Turmeric to curb swelling.
    • Fiber for gut health linked to back wellness.

An Integrative Approach: Blending Services at El Paso Back Clinic®

Our strength is integrating telemedicine, functional medicine, and chiropractic. Virtual sessions review labs, craft diets, and add exercises—all in our secure app.

The Well-House Chiropractic uses telehealth for balanced coaching to avoid overwhelm (The Well-House Chiropractic, 2023a). Advanced Integrated Health emphasizes root fixes for enduring health (Advanced Integrated Health, n.d.).

Dr. Jimenez’s method shines: Structure from chiropractic, internal healing from functional, and access via tele. For sports injuries, we mix rehab moves, berry-rich antioxidant foods, and online follow-ups (Jimenez, 2023d).

This saves time and money, empowering El Paso residents.

  • Our Integrated Advantages:
    • Comprehensive plans for mind and body.
    • Instant adjustments through video.
    • Reduced need for ongoing meds.

Real-World Examples from El Paso Back Clinic® Patients

Meet Maria, an El Paso teacher with neck pain. Our telemedicine nutritionist recommended anti-inflammatory meals; functional tests revealed low magnesium, which we corrected with seeds. Chiropractic eased her posture, plus yoga tips. Soon, she felt vibrant.

Dr. Jimenez shares athlete stories: A local runner with knee issues received nutrient boosts and adjustments via the app, and was back on the trails quickly (Jimenez, 2024).

We use portals like NUTRI-TEC to track intake, helping meet intake goals (Hutton et al., 2020).

  • Patient Success Highlights:
    • Blood sugar stability with MTMs.
    • IBS relief through gut-focused plans.
    • Faster rehab with targeted supplements.

Challenges and Solutions in Our Telemedicine Program

Tech hiccups? We suggest backups like phone calls. Privacy? Our platforms are secure.

For those new to apps, start simple. Costs? Many insurances cover; check HHS resources (U.S. Department of Health and Human Services, 2023a).

Dr. Jimenez helps rural El Paso areas with text reminders, closing gaps (Jimenez, 2023b).

  • Overcoming Common Issues:
    • Test runs with our support team.
    • Low-data modes for spotty connections.
    • Affordable options and payment plans.

The Future of Wellness at El Paso Back Clinic®

Looking ahead, we’ll add AI for meal ideas and VR for exercise demos. More coverage for our virtual functional-chiro mixes.

Dr. Jimenez envisions a broader reach for El Paso’s underserved, such as border workers, through expanded networks (Jimenez, 2023d).

Conclusion

At El Paso Back Clinic®, telemedicine enables personalized, convenient, and effective nutritional counseling. Paired with our chiropractic and functional medicine, it heals from the inside out. Visit us at our East Side location (11860 Vista Del Sol, Ste 128, 915-412-6677), or start virtually. Email [email protected] or call 915-850-0900. Let Dr. Jimenez and our team guide your path to better health.

References

Advanced Integrated Health. (n.d.). Virtual functional medicine consultations and care.

Being Functional. (n.d.). Functional medicine and telehealth: The benefits of virtual care.

Grove Chiropractic. (n.d.). Integrating chiropractic care with nutrition for optimal wellness.

Hutton, K., Brown, T., & Chapman, I. (2020). Engaging hospitalised patients in their nutrition care using technology: Development of the NUTRI-TEC intervention. BMC Health Services Research, 20(1), Article 501.

Jimenez, A. (2023a). Chiropractic and injury care. Injury Specialists.

Jimenez, A. (2023b). Nutrition and wellness in recovery. Injury Specialists.

Jimenez, A. (2023c). Functional medicine insights. LinkedIn.

Jimenez, A. (2023d). Telemedicine for injury recovery. LinkedIn.

Jimenez, A. (2024). Integrative health observations. LinkedIn.

The Well-House Chiropractic. (2023a). Functional nutrition 101: Heal from the inside out for lasting wellness.

The Well-House Chiropractic. (2023b). Functional nutrition & health coaching – Holistic nutritionist in Missouri.

U.S. Department of Health and Human Services. (2023a). Getting started: Understanding telehealth for nutrition care.

U.S. Department of Health and Human Services. (2023b). Preparing patients to receive nutrition care using telehealth.

El Paso Back Clinic. (n.d.). Services and about us.

Functional Wellness and Symptom Relief from Menopause

Functional Wellness and Symptom Relief from Menopause

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

Embrace functional wellness to enhance your quality of life. Find valuable insights to help you feel your best during menopause.

Flourishing Through Menopause: A Comprehensive Guide to Functional Wellness, Chiropractic Care, and Integrative Therapies for Symptom Relief

Introduction: Understanding Functional Wellness During Menopause

Menopause represents one of the most significant transitions in a woman’s life, marking the end of reproductive years while ushering in a new chapter of health and wellness. For millions of women worldwide, this natural biological process brings with it a constellation of symptoms that can significantly impact quality of life, from hot flashes and mood changes to joint pain and musculoskeletal discomfort. The clinical rationale for functional wellness becomes particularly important during menopause, as this approach addresses the root causes of symptoms rather than simply masking them with medications. nourishhousecalls+1​

Functional wellness emphasizes a holistic, patient-centered approach that considers the interconnected nature of body systems, lifestyle factors, and environmental influences. During the menopausal transition, when hormonal fluctuations can trigger cascading effects throughout the body, this integrative perspective offers women comprehensive strategies to manage symptoms while optimizing overall health. Rather than viewing menopause as a disease requiring treatment, functional wellness recognizes it as a natural process that can be supported through targeted nutrition, physical therapies, stress management, and lifestyle modifications. clevelandclinic+2​

The musculoskeletal system deserves special attention during menopause, as declining estrogen levels directly impact joint health, bone density, muscle mass, and connective tissue integrity. Research indicates that approximately 71% of perimenopausal women experience musculoskeletal pain, making it one of the most common yet often overlooked symptoms of this life transition. Joint stiffness, muscle aches, and widespread body pain can significantly diminish quality of life and limit physical activity precisely when exercise becomes most crucial for maintaining health. orthopedicsri+2​

Nonsurgical treatments such as chiropractic care, acupuncture, and massage therapy offer evidence-based options for addressing menopausal symptoms without the potential side effects associated with pharmaceutical interventions. These therapies can be combined with nutritional strategies, exercise programs, and lifestyle modifications to create personalized care plans that address each woman’s unique needs and health goals. dutchessbraincore+2​

What is Menopause?

Menopause is a natural biological process that marks the permanent end of menstrual cycles and fertility. It is clinically defined as occurring after 12 consecutive months of amenorrhea (absence of menstruation) not linked to a pathological cause. While menopause itself is a single point in time—the moment when a full year has passed without a menstrual period—the transition encompasses several years of hormonal changes that can produce symptoms affecting virtually every system in the body. pmc.ncbi.nlm.nih+1​

The average age of menopause for women in the United States is 51 years old, though this can vary significantly between individuals. Some women experience menopause in their early 40s, while others may not reach this milestone until their late 50s. The timing is influenced by genetics, lifestyle factors, and overall health status. myobgynvegas​

The Biological Mechanism of Menopause

Menopause results from the natural depletion of ovarian follicles over a woman’s reproductive lifespan. Each woman is born with a finite number of eggs, and as these are gradually used during monthly ovulation or naturally degenerate, the ovaries’ capacity to produce hormones diminishes. The pathophysiology involves a rapid decline in the number of primary ovarian follicles, resulting in an inadequate number to respond to follicle-stimulating hormone (FSH). ncbi.nlm.nih+1​

When the ovaries can no longer respond adequately to FSH signals from the pituitary gland, several hormonal changes occur: pmc.ncbi.nlm.nih+1​

  • Estrogen production declines significantly, though small amounts may still be produced through conversion from testosterone released by the adrenal glands.

  • Progesterone production decreases and eventually stabilizes at very low levels.

  • FSH and luteinizing hormone (LH) levels remain elevated for years after menopause onset due to the lack of negative feedback from ovarian hormones

  • Testosterone levels do not change as dramatically early in menopause, leading to a relative increase in the testosterone-to-estrogen ratio (ncbi.nlm).nih​

This hormonal shift affects virtually every organ system in the body, as estrogen receptors are present throughout tissues, including the brain, heart, bones, joints, skin, and reproductive tract. arthritis+1​

flourish-through-the-change-a-holistic-guide-to-menopause_6701b368.pdf

The Phases of Menopause

The menopausal transition unfolds over three distinct phases, each characterized by different hormonal patterns and symptom experiences.columbusobgyn+3​

Perimenopause: The Transitional Phase

Perimenopause represents the years leading up to menopause when the body begins its transition away from reproductive function. This phase typically begins 8 to 10 years before menopause, often starting in a woman’s mid-40s, though it can begin earlier. During perimenopause, hormone levels fluctuate unpredictably, creating a rollercoaster of symptoms that can be challenging to manage. mcpress.mayoclinic+2​

The early perimenopause stage is characterized by: columbusobgyn​

  • Shortened follicular phase leading to more frequent menstrual cycles

  • Occasional hot flashes lasting from seconds to minutes

  • Mild changes in skin elasticity and breast tenderness

  • Subtle mood variations and increased stress sensitivity

As perimenopause progresses into the middle and late transition stages, women typically experience: columbusobgyn​

  • Menstrual cycles that vary by seven or more days from normal patterns

  • More frequent and potentially more severe hot flashes

  • Increased vaginal dryness and sleep disruption

  • Daily hot flashes and night sweats that may feel more intense and last longer

  • Heightened anxiety or mood fluctuations

Menopause: The Defining Moment

Menopause itself is not a phase but rather a single point in time—the day when a woman has gone 12 consecutive months without a menstrual period. At menopause, the body’s production of estrogen, progesterone, and testosterone is significantly reduced, while FSH and LH levels are elevated. samitivejhospitals+2​

Postmenopause: The Years Beyond

Postmenopause begins immediately after menopause is confirmed and continues for the remainder of a woman’s life. Most menopausal symptoms gradually decrease in intensity during postmenopause, with some women experiencing significant relief within the first few years. However, certain changes require ongoing attention: joinmidi+1​

  • Bone density continues to decline due to reduced estrogen’s effects on bone remodeling.

  • Cardiovascular health becomes more vulnerable as estrogen’s protective effects diminish.

  • Genitourinary changes may persist or develop, including vaginal atrophy and urinary symptoms joinmidi​

Common Symptoms of Menopause

Menopause produces a wide spectrum of symptoms that vary dramatically between individuals. myobgynvegas+2​

Vasomotor Symptoms

Hot flashes and night sweats are among the most recognizable menopausal symptoms, affecting approximately 75% to 80% of women with varying severity. Hot flashes typically begin as a sudden sensation of warmth spreading through the upper body and face, often accompanied by flushing, sweating, and heart palpitations. templehealth+2​

Mood and Cognitive Changes

Hormonal fluctuations during menopause significantly impact brain function and emotional regulation: endocrine​

  • Mood swings ranging from irritability to sadness

  • Anxiety and increased stress sensitivity

  • Brain fog is characterized by difficulty concentrating and memory lapses

  • Depression or persistent low mood

These symptoms result from estrogen’s relationship with serotonin and other neurotransmitters that regulate mood. endocrine​

Sleep Disturbances

Sleep problems affect more than 60% of menopausal women: integratedchiropracticofboca+1​

  • Night sweats interrupt sleep cycles

  • Insomnia may develop independently of vasomotor symptoms

  • Sleep apnea risk increases during and after menopause womens-health-concern​

Genitourinary Symptoms

As estrogen declines, significant changes occur in the vulva, vagina, and urinary tract: ncbi.nlm.nih+1​

  • Vaginal dryness and thinning of vaginal tissue

  • Increased urinary tract infections

  • Urinary urgency and incontinence

Musculoskeletal Symptoms

Nearly half of menopausal patients experience musculoskeletal symptoms like joint pain: tandfonline+1​

  • Joint pain and stiffness

  • Muscle aches and loss of grip strength

  • Frozen shoulder

  • Loss of lean muscle mass

How Menopause Affects Hormones in the Body

Understanding the hormonal changes that occur during menopause provides crucial insight into why symptoms develop. samitivejhospitals+1​

Estrogen: The Primary Change

Estrogen is the primary female hormone with receptors distributed throughout the body. During menopause, estrogen levels drop dramatically—often to less than 10 pg/mL—creating widespread effects. aarp+2​

Estrogen’s decline affects multiple systems: pmc.ncbi.nlm.nih​

  • Brain: Impacts mood regulation, memory, and cognitive function

  • Bones: Accelerates bone resorption, increasing osteoporosis risk

  • Heart: Removes protective effects on blood vessels

  • Joints: Reduces cartilage protection and synovial fluid production

Progesterone and Testosterone

Progesterone production decreases during perimenopause as ovulation becomes irregular, then stabilizes at low levels after menopause. Testosterone levels do not decrease as dramatically during early menopause, creating a relative increase in the testosterone-to-estrogen ratio. samitivejhospitals+1​

FSH, LH, and Cortisol

FSH and LH levels increase significantly as the pituitary attempts to stimulate unresponsive ovaries. Cortisol levels may be elevated during menopause, contributing to sleep disturbances, weight gain, and mood changes. ncoa+2​

How Fluctuating Hormones Affect the Musculoskeletal System

The musculoskeletal system is profoundly affected by the hormonal changes of menopause, yet these effects are often overlooked or misattributed to normal aging. Research has established what experts now term the “musculoskeletal syndrome of menopause.” dralisongrimaldi+2​

The Role of Estrogen in Joint and Bone Health

Estrogen plays a vital role in maintaining musculoskeletal health through multiple mechanisms: jointrehab+2​

  • Cartilage Protection: Estrogen helps keep cartilage flexible and supports the production of synovial fluid, which lubricates joints. As estrogen levels decline, cartilage may degrade more rapidly. orthopedicsri​
  • Anti-Inflammatory Effects: Estrogen exhibits anti-inflammatory properties by inhibiting the release of inflammatory cytokines, such as TNF-α and IL-1β. When estrogen declines, inflammation increases throughout the body. pmc.ncbi.nlm.nih+2​
  • Bone Remodeling: Estrogen deficiency leads to accelerated osteoclast activity and increased bone resorption, resulting in bone loss of up to 20% during the menopausal transition. puregym+1​

Prevalence of Musculoskeletal Pain

The overall prevalence of musculoskeletal pain in perimenopausal women is approximately 71%. A study including more than 40,000 women found that osteoarthritis was more common among women who had undergone menopause at least one year prior, compared with those who had a recent menstrual period (31% vs. 24%). rheumatologyadvisor+2​

Specific Musculoskeletal Effects

  • Joint Pain and Osteoarthritis: The decline in estrogen accelerates the progression of osteoarthritis, particularly in weight-bearing joints. pmc.ncbi.nlm.nih+1​
  • Muscle Loss (Sarcopenia): Research indicates that compared to women in early perimenopause, those with menopause have 10% less muscle mass in their arms and legs. puregym​
  • Bone Density Loss: Weakened bones are more prone to fractures, increasing the risk of injury in the spine, hips, and wrists. orthopedicsri+1​
  • Weight Gain Impact: Many women experience weight gain during menopause, which can add extra stress to joints. Visceral fat increases from 5-8% to 10-15% of total body weight. puregym​

Chiropractic Care for Menopausal Symptoms

Chiropractic care offers a safe, effective, and natural approach to managing menopausal symptoms, particularly those affecting the musculoskeletal system. accidentcarechiropractic+2​

How Chiropractic Care Supports Menopausal Women

  • Hormone Regulation Through Nervous System Support: The spine houses the nerves that control the endocrine system. The hypothalamus plays a significant role in hormone production, and misalignments in the spine can interfere with its functioning. By correcting subluxations, chiropractic care can help regulate hormone production and improve menopausal symptoms. raleighchiropractic+3​
  • Reduced Nervous System Stress: Chiropractic adjustments relieve pressure on the spine and restore proper nervous system function, supporting the body’s ability to regulate hormones more efficiently. familychiropracticcolumbus+1​
  • Improved Circulation: Chiropractic adjustments improve circulation by freeing up restrictions in the spine, helping reduce hot flashes and night sweats. dutchessbraincore+1​
  • Stress Management and Better Sleep: Chiropractic care promotes relaxation, stimulates the parasympathetic nervous system, and improves sleep quality in menopausal women. integratedchiropracticofboca+2​

Evidence for Chiropractic Care

Studies published in the Journal of Vertebral Subluxation Research found that chiropractic care was effective in reducing hot flashes, night sweats, and mood swings in menopausal women. The Journal of Manipulative and Physiological Therapeutics reported improved sleep quality in menopausal women receiving chiropractic treatment. dutchessbraincore​

Acupuncture Benefits for Menopause

Acupuncture, rooted in Traditional Chinese Medicine, involves inserting thin needles into specific points to stimulate energy flow and restore balance. pmc.ncbi.nlm.nih+1​

Research on Acupuncture and Menopause

A study of Japanese women in menopause found that menopausal symptoms were significantly reduced with individualized acupuncture treatments, exclusively due to improvement of musculoskeletal symptoms. Participants experienced relief from fatigue, chronic neck pain, and low back pain. pmc.ncbi.nlm.nih​

How Acupuncture Works

Acupuncture provides benefits through several mechanisms: pmc.ncbi.nlm.nih+1​

  • Pain Modulation: Stimulates the release of natural painkillers (endorphins)

  • Inflammation Reduction: Decreases inflammatory markers

  • Hormonal Effects: May help regulate cortisol and melatonin

  • Nervous System Regulation: Activates the parasympathetic nervous system

The number of menopausal women is expected to increase from 467 million in 1990 to 1.2 billion in 2030, suggesting acupuncture’s role as an integrative therapy will continue to grow. pmc.ncbi.nlm.nih​

Massage Therapy for Menopausal Relief

Massage therapy provides valuable benefits for both physical and emotional well-being during menopause. pubmed.ncbi.nlm.nih+2​

Evidence for Massage Therapy

A randomized controlled trial found that both massage and aromatherapy were effective in reducing menopausal symptoms. Research demonstrates that therapeutic massage: pubmed.ncbi.nlm.nih​

  • Decreases the severity of sleep disturbance related to menopause

  • Reduces insomnia and anxiety-depressive symptoms pmc.ncbi.nlm.nih​

  • Improves overall mood through endorphin release and cortisol reduction westernregionhealth​

Benefits of Massage During Menopause

  • Stress Reduction: Massage reduces stress and anxiety by promoting endorphin release and reducing cortisol levels. westernregionhealth​
  • Muscle Pain Relief: Massage targets muscle knots and tension, providing relief from discomforts common during menopause. westernregionhealth​
  • Sleep Enhancement: Massage significantly improves sleep patterns and reduces sleep disturbances. pmc.ncbi.nlm.nih+1​

Physical Therapy and Exercise for Menopausal Health

Physical therapy and exercise represent cornerstones of managing menopausal musculoskeletal symptoms. resilienceorthopedics+2​

The Importance of Exercise

Exercise is one of the best treatments for menopause and joint pain: resilienceorthopedics​

  • Joint Health: Strengthens supporting muscles and promotes synovial fluid circulation.

  • Bone Density: Weight-bearing exercises stimulate bone building uclahealth+1​

  • Muscle Preservation: Resistance training counters sarcopenia puregym​

Types of Exercise for Menopausal Women

  • Resistance Training: The most recommended exercise for menopausal joint pain. Women over 60 with osteoporosis who participated in strength training showed significant improvements in bone density. uchealth+1​
  • Weight-Bearing Exercise: Walking, dancing, and stair climbing promote bone strength. Specialists recommend at least 150 minutes per week of moderate cardiovascular activity. nyulangone​
  • Mind-Body Exercise: Yoga, tai chi, and Pilates significantly improve bone mineral density, sleep quality, anxiety, depression, and fatigue in perimenopausal and postmenopausal women. pmc.ncbi.nlm.nih+1​

Aligned & Empowered: Chiropractic Conversations on Women’s Health-Video

Nutrition and Diet for Menopausal Wellness

Nutrition plays a crucial role in managing symptoms and supporting long-term health. pmc.ncbi.nlm.nih+2​

Anti-Inflammatory Dietary Approaches

An anti-inflammatory diet emphasizes: pmc.ncbi.nlm.nih+1​

  • Vegetables: Leafy greens, cruciferous vegetables

  • Fruits: Berries, cherries, citrus

  • Fatty fish: Rich in omega-3 fatty acids

  • Nuts and seeds: Walnuts, flaxseeds

  • Healthy fats: Extra virgin olive oil, avocado

  • Herbs and spices: Turmeric, ginger

The Mediterranean diet has shown particular benefits for menopausal women, associated with better bone mineral density and improved symptoms. rebellehealth+1​

Key Nutrients

  • Calcium: Recommendations of 1200-1300 mg daily for postmenopausal women. pubmed.ncbi.nlm.nih+1​
  • Vitamin D: Intake between 800-900 IU daily, combined with calcium, increases bone mineral density and reduces fracture risk. frontiersin+1​
  • Omega-3 Fatty Acids: Possess anti-inflammatory properties that reduce joint pain. Women who consumed more omega-3 fatty acids had fewer menopausal symptoms. goodrx+1​
  • Protein: Higher intake (approximately 1.2 g/kg body weight) is associated with a 32% lower risk of frailty. pmc.ncbi.nlm.nih​

Sleep Hygiene for Menopausal Women

Sleep disturbances affect more than half of menopausal women. swanstudy+1​

Evidence-Based Sleep Strategies

Research emphasizes addressing sleep issues early during the menopausal transition. Recommended strategies include: swanstudy​

  • Establish a Regular Sleep Schedule: Go to bed and wake up at the same time each day. womens-health-concern+1​
  • Create an Optimal Sleep Environment: Keep the bedroom cool, dark, and quiet; use cooling sheets; consider a fan. healthline+2​
  • Develop a Relaxing Routine: Allow time to unwind; avoid screens for at least one hour before bed. ncoa+1​
  • Mind Dietary Habits: Avoid caffeine after lunchtime; limit alcohol; avoid spicy foods close to bedtime. swanstudy+1​
  • Cognitive Behavioral Therapy for Insomnia (CBT-I): The most effective treatment for chronic insomnia during menopause. womens-health-concern​

Lifestyle Changes for Managing Symptoms

Beyond specific therapies, broader lifestyle changes significantly impact the menopausal experience. whsobgyn+2​

Stress Management

Effective techniques include: nature+1​

  • Mindfulness meditation: Significantly reduces anxiety, depression, and menopausal symptoms

  • Yoga: Improves psychological symptoms, sleep, and musculoskeletal pain

  • Deep breathing exercises: Helps manage hot flashes

Smoking Cessation and Alcohol Moderation

Women who smoke experience more frequent and severe hot flashes. Alcohol can trigger hot flashes and disrupt sleep; limiting intake to no more than one serving per day is recommended. nyulangone​

Weight Management

Maintaining a healthy weight reduces joint stress, helps manage hot flashes, and supports cardiovascular health. medlineplus+1​

Dr. Alexander Jimenez’s Clinical Observations on Integrative Menopause Care

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CFMP, IFMCP, based in El Paso, Texas, brings over 25 years of expertise in integrative medicine to menopausal care. His dual licensure as a Family Practice Nurse Practitioner and Chiropractor enables patient-centered care, bridging physical medicine, functional medicine, and advanced diagnostics. a4m+1​

The Functional Medicine Approach

Dr. Jimenez’s practice emphasizes functional medicine principles, viewing the body as one integrated system. Key elements include: dralexjimenez+1​

  • Comprehensive health assessments evaluating genetics, lifestyle, and environmental factors

  • Personalized treatment plans tailored to individual health profiles

  • Integration of conventional and complementary therapies

  • Patient empowerment through education and active participation

Integrative Treatment Protocols

Dr. Jimenez’s protocols integrate multiple modalities: a4m+1​

  • Chiropractic adjustments for spinal alignment and nerve function

  • Acupuncture and electro-acupuncture for pain and hormonal balance

  • Targeted exercise programs focusing on flexibility, mobility, and strength

  • Massage therapy for muscle tension and stress management

  • Nutritional counseling supporting hormonal balance and bone health

As Dr. Jimenez emphasizes in his clinical practice, addressing root causes rather than simply treating symptoms produces lasting improvement. His team at Injury Medical & Chiropractic Clinic in El Paso collaborates to deliver personalized treatment plans, ensuring each patient receives care tailored to their unique needs. dralexjimenez+1​

For more information about Dr. Jimenez’s integrative approach, visit https://dralexjimenez.com/ or connect on LinkedIn.

Conclusion: Embracing Functional Wellness Through the Menopausal Transition

Menopause represents a significant life transition that, with the right support, can be navigated successfully. The clinical rationale for functional wellness is particularly compelling during this time, as hormonal changes create interconnected effects throughout the body that benefit from integrative, whole-person care. nourishhousecalls+1​

The musculoskeletal syndrome of menopause, affecting up to 71% of perimenopausal women, responds well to integrative approaches, including: tandfonline+1​

  • Chiropractic care for spinal alignment and nervous system support

  • Acupuncture for pain relief and hormonal balance

  • Massage therapy for muscle tension and stress reduction

  • Physical therapy and exercise for strength, flexibility, and bone health

  • Anti-inflammatory nutrition to reduce systemic inflammation

  • Sleep hygiene to support recovery and hormonal regulation

  • Stress management through mind-body practices

By embracing functional wellness principles and utilizing evidence-based integrative therapies, women can not only manage menopausal symptoms but truly flourish through this natural life transition. The goal is not merely symptom relief but optimal health, vitality, and quality of life for the years ahead.

References

 

Functional Wellness: Key Understanding for CPT2 Deficiency

Functional Wellness: Key Understanding for CPT2 Deficiency

by | Chiropractic, Chronic Pain, Functional Medicine, Health, Supplements, Treatments, Viscerosomatic Reflex, Vitamins

Explore CPT2 deficiency and learn how to improve functional wellness and lifestyle for affected individuals.

Understanding CPT2 Deficiency: A Complete Guide to Symptoms, Causes, and Holistic Treatment Options

Introduction

The human body is like a well-designed machine, with numerous systems working together to maintain our health and keep us moving. One important part of this machine is how our bodies turn food into energy. This process is particularly important when we need more energy, such as when we haven’t eaten in a while or when we’re working out. Carnitine palmitoyltransferase 2, or CPT2 for short, is an important enzyme that helps make energy. If this enzyme doesn’t function properly, it can cause a condition called CPT2 deficiency, which can affect muscles, bones, and overall health (MedlinePlus Genetics, 2008).

This article discusses CPT2, its function in the body, and the consequences of insufficient levels. We will also examine how the environment can exacerbate symptoms and discuss non-surgical treatments, including chiropractic care, acupuncture, nutrition, supplements, and targeted exercises. This article will include the clinical observations of Dr. Alexander Jimenez, DC, APRN, FNP-BC, a board-certified chiropractor and family practice nurse practitioner from El Paso, Texas, who specializes in functional medicine and holistic approaches to treating musculoskeletal and metabolic conditions (Jimenez, n.d.).

What Is CPT2 and How Does It Function in the Body?

The Basics of CPT2

CPT2 stands for carnitine palmitoyltransferase 2, an enzyme that plays a crucial role in enabling the body to utilize fat as an energy source (MedlinePlus Genetics, 2008). Enzymes are special proteins that speed up chemical reactions in the body, and CPT2 is one of the most important enzymes involved in a process called fatty acid oxidation.

Understanding Fatty Acid Oxidation

Fatty acid oxidation is the body’s way of breaking down fats to create energy. Think of it like burning wood to create heat—the body “burns” fats to create the energy it needs to function. This process is especially important during certain times (MedlinePlus Genetics, 2008):

  • During periods of fasting (when you haven’t eaten for several hours)

  • During long periods of exercise

  • When the body is stressed by illness or infection

  • During times when blood sugar levels are low

Fatty acids are a major source of energy for the heart and muscles. When we eat food, some of it gets stored as fat. Later, when the body needs extra energy, it can break down these stored fats to fuel important activities (MedlinePlus Genetics, 2008).

The Role of Mitochondria

Inside almost every cell in the body are tiny structures called mitochondria. These are often referred to as the “powerhouses” of cells because they produce most of the energy the body requires. For the body to use fats for energy, those fats must enter the mitochondria, where they can be broken down (MedlinePlus Genetics, 2008).

However, there’s a problem: long-chain fatty acids (the most common type of fat stored in the body) cannot enter mitochondria by themselves. This is where CPT2 becomes important.

The Carnitine Shuttle System

The body utilizes a specialized transport system called the carnitine shuttle to transport long-chain fatty acids into mitochondria. This system involves three main proteins (DiMauro & DiMauro, 2003):

  1. Carnitine Palmitoyltransferase 1 (CPT1): Located on the outer mitochondrial membrane, this enzyme attaches fatty acids to a special molecule called carnitine. This allows the fatty acids to cross the first barrier.

  2. Carnitine-Acylcarnitine Translocase (CACT): This protein acts like a shuttle, carrying the fatty acid-carnitine combination across the inner mitochondrial membrane.

  3. Carnitine Palmitoyltransferase 2 (CPT2): Located on the inner mitochondrial membrane, this enzyme removes the carnitine from the fatty acids and adds a substance called coenzyme A. This final step prepares the fatty acids for breakdown into energy.

Think of this system like a relay race. CPT1 is the first runner who picks up the baton (attaches carnitine to the fatty acid). CACT is the second runner who carries the baton across the track (moves it through the membrane). CPT2 is the final runner who takes the baton to the finish line (removes carnitine and prepares the fatty acid for energy production) (DiMauro & DiMauro, 2003).

Why CPT2 Is So Important

Without CPT2 working properly, the final step in this relay race cannot happen. The fatty acids get stuck—they can make it into the mitochondria, but they cannot be converted into a form that can be used for energy. This backup can lead to several problems (MedlinePlus Genetics, 2008):

  • The body cannot use stored fats for energy efficiently

  • Long-chain fatty acids and their carnitine attachments build up in cells

  • This buildup can damage muscles, the heart, and the liver

  • The body has to rely more heavily on glucose (sugar) for energy

  • During times when glucose runs low, the body struggles to produce enough energy

What Is CPT2 Deficiency?

Defining the Condition

CPT2 deficiency is a genetic disorder that occurs when the CPT2 enzyme either doesn’t work properly or isn’t produced in sufficient amounts. This condition prevents the body from utilizing certain fats for energy, which can lead to serious health issues, particularly during periods when the body requires additional energy (MedlinePlus Genetics, 2008).

CPT2 deficiency is an autosomal recessive disorder, which means a person must inherit two copies of the faulty gene (one from each parent) to have the condition. People who inherit only one faulty gene are called carriers and usually don’t have symptoms (Baby Detect, 2022).

empowered-living-a-comprehensive-guide-for-adults-with-cpt2-deficiency_67784a2d.pdf

Types of CPT2 Deficiency

There are three main forms of CPT2 deficiency, each with different levels of severity (Baby Detect, 2022):

1. Lethal Neonatal Form

This is the most severe form and appears within the first few days after birth. Babies with this form may have (Baby Detect, 2022):

  • Severe liver failure

  • Heart problems (cardiomyopathy)

  • Seizures

  • Very low blood sugar (hypoglycemia)

  • Kidney problems

  • Brain development issues

  • Unfortunately, this form is often fatal within the first month of life

2. Severe Infantile Hepatocardiomuscular Form

This form usually appears within the first year of life and includes (Baby Detect, 2022):

  • Liver problems

  • Heart muscle disease

  • Seizures

  • Low blood sugar

  • Muscle weakness

  • Attacks triggered by fasting or illness

3. Myopathic Form (Muscle Form)

This is the most common form and is usually milder than the other two types. It typically appears anywhere from childhood to adulthood and is characterized by (Vladutiu, 1999):

  • Episodes of muscle pain (myalgia)

  • Muscle stiffness and weakness

  • Breakdown of muscle tissue (rhabdomyolysis)

  • Dark, rust-colored urine (myoglobinuria) caused by muscle proteins released into the bloodstream

  • Symptoms triggered by prolonged exercise, fasting, cold exposure, or stress

  • Normal health between episodes

The myopathic form is the most common disorder of fat metabolism affecting skeletal muscle and is the most frequent cause of inherited myoglobinuria. Men are more likely to be affected than women, though scientists aren’t entirely sure why (Baby Detect, 2022).

The Most Common Genetic Variant

About 60 percent of people with the myopathic form of CPT2 deficiency have a specific genetic change called S113L (or Ser113Leu). This variant reduces the activity of the CPT2 enzyme but doesn’t eliminate it completely, which is why this form tends to be less severe than the neonatal or infantile forms (MedlinePlus Genetics, 2008).

How CPT2 Deficiency Affects the Body and Musculoskeletal System

Energy Crisis in Muscles

Muscles are highly active tissues that require a lot of energy to function properly. Normally, muscles can switch between using glucose and fatty acids for fuel depending on what’s available. However, people with CPT2 deficiency cannot efficiently use fatty acids, which creates several problems (Rare Disease Advisor, 2021):

  1. Limited Fuel Options: During prolonged exercise or fasting, when glucose stores are depleted, the muscles of individuals with CPT2 deficiency cannot tap into fat stores for energy. This leads to an energy crisis in the muscle cells.

  2. Muscle Pain and Weakness: Without adequate energy, muscles cannot contract properly. This leads to muscle pain (myalgia), stiffness, and weakness during or after physical activity.

  3. Rhabdomyolysis: When the energy shortage becomes severe, muscle cells begin to break down. This process, called rhabdomyolysis, releases muscle proteins (especially myoglobin) into the bloodstream. Myoglobin can damage the kidneys and cause the urine to turn dark brown or rust-colored (Adult-Onset CPT II Deficiency, 2023).

Effects on Different Body Systems

The Musculoskeletal System

The musculoskeletal system, which includes all the bones, muscles, tendons, and ligaments, is significantly affected by CPT2 deficiency. According to Dr. Alexander Jimenez’s clinical observations, patients with metabolic conditions affecting muscle function often experience (Jimenez, n.d.):

  • Muscle Fatigue: Muscles tire more easily during physical activity

  • Exercise Intolerance: Difficulty performing activities that require sustained muscle use

  • Muscle Stiffness: Particularly after periods of rest following exercise

  • Joint Pain: While CPT2 deficiency primarily affects muscles, the resulting muscle weakness can alter how a person moves, leading to compensatory patterns that stress joints

  • Postural Changes: Chronic muscle weakness may lead to poor posture, which can cause additional strain on the spine and other structures

The Cardiovascular System

Although the myopathic form of CPT2 deficiency primarily affects skeletal muscles (the muscles we control voluntarily), the heart muscle can also be affected in severe cases. The heart requires constant energy to pump blood throughout the body, and when fat metabolism is impaired, cardiac function may be compromised (Baby Detect, 2022).

The Liver and Metabolism

The liver plays a central role in regulating energy metabolism. In CPT2 deficiency, the inability to properly break down fatty acids can lead to fat accumulation in the liver and impaired production of ketones—molecules that can serve as an alternative energy source when glucose is low. This contributes to hypoketotic hypoglycemia (low blood sugar with low ketone levels), which can cause weakness, confusion, and other symptoms (MedlinePlus Genetics, 2008).

The Kidneys

During episodes of rhabdomyolysis, large amounts of myoglobin are released into the bloodstream. The kidneys must filter this protein, but too much myoglobin can clog the tiny filtering units in the kidneys, potentially leading to acute kidney injury or even kidney failure if not treated promptly (Adult-Onset CPT II Deficiency, 2023).

Biochemical Consequences

At the cellular level, CPT2 deficiency causes several biochemical problems (MedlinePlus Genetics, 2008):

  1. Accumulation of Long-Chain Acylcarnitines: These are fatty acids still attached to carnitine. They build up because CPT2 cannot remove the carnitine. High levels of these substances can be toxic to cells.

  2. Low Ketone Production: Normally, when fats are broken down, they produce ketones that can be used as fuel by the brain and other organs. When fat breakdown is blocked, ketone levels remain low (hypoketosis).

  3. Hypoglycemia: With reduced ability to use fats and produce ketones, the body becomes more dependent on glucose. During fasting or prolonged exercise, blood sugar levels can drop dangerously low.

  4. Oxidative Stress: The accumulation of unprocessed fatty acids and reduced energy production can lead to oxidative stress, which damages cells and tissues.

Environmental Factors That Can Cause and Show Signs of CPT2 Deficiency

One of the most important things to understand about the myopathic form of CPT2 deficiency is that symptoms usually don’t appear all the time. Instead, they are triggered by certain environmental and physiological factors that increase the body’s need for energy from fat metabolism. Understanding these triggers is crucial for preventing attacks and effectively managing the condition.

Prolonged Exercise

Exercise is one of the most common triggers of symptoms in people with CPT2 deficiency. However, not all types of exercise are equally likely to cause problems (MedLink Neurology, 2025):

Why Exercise Triggers Symptoms:

  • During exercise, muscles use large amounts of energy

  • After the first 15-30 minutes of sustained exercise, the body shifts from using primarily glucose to using more fatty acids for fuel

  • People with CPT2 deficiency cannot make this shift efficiently

  • As glucose stores deplete, an energy crisis develops in the muscles

  • This can lead to muscle pain, stiffness, weakness, and rhabdomyolysis

Types of Exercise Most Likely to Trigger Symptoms:

  • Endurance activities (running, cycling, swimming long distances)

  • Activities lasting more than 30-60 minutes

  • Exercise performed without adequate pre-fueling with carbohydrates

  • Activities that engage large muscle groups

Exercise Characteristics:
According to research, the duration of exercise required to trigger an attack varies among individuals. In one study, exercise lasting 15-60 minutes was sufficient for attacks in 9 out of 13 patients, while 3 patients required 1-4 hours, and 1 patient needed more than 4 hours (Phenotype of CPT II Deficiency, 2018).

Dr. Jimenez emphasizes the importance of understanding each patient’s exercise tolerance and developing individualized activity plans that build strength and endurance without triggering metabolic crises (Jimenez, n.d.).

Fasting and Prolonged Periods Without Food

Fasting or going too long without eating is another major trigger for CPT2 deficiency symptoms (MedLink Neurology, 2025).

Why Fasting Is Problematic:

  • After several hours without food, blood glucose levels begin to drop

  • The body normally responds by breaking down stored fats to provide energy

  • People with CPT2 deficiency cannot efficiently use these fats

  • As glucose stores deplete without fat oxidation to compensate, energy levels plummet

  • This can lead to hypoglycemia, muscle weakness, and other symptoms

Fasting Scenarios That May Trigger Symptoms:

  • Skipping meals, especially breakfast

  • Sleeping late and delaying breakfast

  • Prolonged illness that reduces appetite

  • Medical procedures requiring fasting

  • Intentional fasting or very low-calorie diets

Dr. Jimenez’s Clinical Insight:
Dr. Jimenez notes that in his functional medicine practice, understanding a patient’s eating patterns and timing is crucial for managing metabolic conditions. He often recommends frequent, small meals rich in complex carbohydrates to maintain stable blood sugar levels and prevent metabolic stress (Jimenez, 2022).

Cold Exposure

Exposure to cold temperatures is another environmental trigger for symptoms of CPT2 deficiency (MedLink Neurology, 2025; Nutrition and Exercise in CPT Deficiency, 2021).

Why Cold Triggers Symptoms:

  • When exposed to cold, the body must generate heat to maintain its core temperature

  • Heat production requires significant energy

  • The body increases fat metabolism to fuel this thermogenic response

  • People with CPT2 deficiency cannot efficiently increase fat oxidation

  • This creates an energy deficit that can trigger muscle breakdown

Cold Exposure Scenarios:

  • Winter sports and activities

  • Swimming in cold water

  • Working in cold environments

  • Inadequate clothing in cold weather

  • Sudden temperature changes

Infections and Illness

Infections and illnesses are particularly dangerous triggers for people with CPT2 deficiency because they can rapidly lead to severe complications (Battling Recurrent Rhabdomyolysis, 2024).

Why Infections Trigger Symptoms:

  • Infections increase the body’s metabolic demands

  • Fever further increases energy requirements

  • Illness often reduces appetite, leading to inadequate carbohydrate intake

  • The combination of increased energy needs and decreased food intake creates a metabolic crisis

  • Infections trigger inflammatory responses that can worsen muscle damage

Types of Infections That May Trigger Symptoms:

  • Respiratory infections (colds, flu, pneumonia)

  • Gastrointestinal infections

  • Urinary tract infections

  • Any infection causing fever

Clinical Importance:
Research has shown that prompt identification and treatment of infections are crucial for minimizing muscle breakdown in individuals with CPT2 deficiency. Early intervention with appropriate antibiotics and supportive care can prevent severe complications (Battling Recurrent Rhabdomyolysis, 2024).

Emotional and Physical Stress

Both psychological and physical stress can trigger symptoms in susceptible individuals (MedLink Neurology, 2025; Nutrition and Exercise in CPT Deficiency, 2021).

How Stress Affects the Body:

  • Stress triggers the release of hormones like cortisol and adrenaline

  • These hormones mobilize energy stores, including fats

  • Prolonged stress increases overall metabolic demands

  • In people with CPT2 deficiency, this increased demand cannot be met through fat metabolism

  • Chronic stress can lead to gradual muscle weakness and increased susceptibility to acute attacks

Types of Stress That May Trigger Symptoms:

  • Psychological stress (work pressure, relationship problems, anxiety)

  • Physical stress (surgery, trauma, extreme physical demands)

  • Sleep deprivation

  • Dehydration

Dr. Jimenez incorporates stress management into his holistic treatment protocols, recognizing that the mind-body connection plays a significant role in managing metabolic and musculoskeletal conditions (Jimenez, n.d.).

Certain Medications

Some medications can trigger or worsen symptoms in people with CPT2 deficiency by interfering with energy metabolism or increasing muscle breakdown (MedLink Neurology, 2025).

Medications That May Trigger Symptoms:

  • Valproate (an anti-seizure medication)

  • High doses of diazepam (a sedative)

  • Ibuprofen and other NSAIDs

  • Certain anesthesia drugs

  • Statins (cholesterol-lowering drugs)

Why These Medications Are Problematic:

  • Some interfere with mitochondrial function

  • Others increase the breakdown of muscle tissue

  • Some may affect enzyme activity or energy metabolism pathways

Menstruation

Women with CPT2 deficiency may experience worsening of symptoms during menstruation (Carnitine Palmityl Transferase Deficiency, 2024).

Why Menstruation May Trigger Symptoms:

  • Hormonal changes affect metabolism

  • Increased energy demands during this time

  • Possible effects of hormones on enzyme regulation

  • Some women report increased muscle pain and weakness during their menstrual periods

Dehydration and Low Fluid Intake

Inadequate hydration can contribute to muscle problems in people with CPT2 deficiency (Nutrition and Exercise in CPT Deficiency, 2021).

How Dehydration Affects the Body:

  • Reduces blood flow to muscles

  • Decreases the body’s ability to remove metabolic waste products

  • Can impair kidney function, especially during rhabdomyolysis episodes

  • May worsen muscle cramping and pain

Combined Triggers

It’s important to note that many severe episodes of rhabdomyolysis occur when multiple triggers are present at the same time. For example (MedLink Neurology, 2025):

  • Exercising in cold weather without adequate food intake

  • Prolonged skiing while fasting

  • Working out while fighting off an infection

  • Strenuous activity combined with stress and inadequate sleep

Understanding and avoiding these environmental triggers is a cornerstone of managing CPT2 deficiency. Dr. Jimenez emphasizes patient education about trigger identification and avoidance as part of his comprehensive treatment approach (Jimenez, n.d.).

Thermal Instability of the S113L Variant

Recent research has provided important insights into why environmental factors, such as fever and prolonged exercise, trigger attacks in individuals with the most common genetic variant (S113L) of CPT2 deficiency.

Studies have shown that the S113L variant of the CPT2 enzyme is thermally unstable—meaning it loses its function more rapidly at higher temperatures compared to the normal enzyme. At body temperature (37°C/98.6°F), the mutated enzyme works reasonably well. However, at 40-45°C (104-113°F), which can occur during fever or intense exercise, the enzyme breaks down much more quickly (Stabilization of S113L Variant, 2016).

This thermal instability helps explain why fever and prolonged exercise are such potent triggers of symptoms. The combination of increased energy demands and decreased enzyme function creates the perfect storm for a metabolic crisis.

Unlocking Vitality: Chiropractic Wisdom and the Science of Functional Healing-Video

How Nonsurgical Treatments Like Chiropractic Care and Acupuncture Can Help Reduce CPT2 Deficiency Symptoms

While there is currently no cure for CPT2 deficiency, various nonsurgical treatments can help manage symptoms, improve quality of life, and reduce the frequency and severity of attacks. Dr. Alexander Jimenez’s clinical approach demonstrates how integrating chiropractic care, acupuncture, and other complementary therapies with conventional medical management can provide comprehensive support for people with metabolic myopathies like CPT2 deficiency.

Understanding the Role of Complementary Therapies

Before exploring specific treatments, it’s important to understand that CPT2 deficiency is a metabolic disorder that requires medical management. However, the symptoms of CPT2 deficiency—particularly muscle pain, weakness, stiffness, and decreased mobility—can be significantly improved with therapies that address musculoskeletal function, pain management, and overall wellness (Jimenez, n.d.).

Dr. Jimenez’s practice philosophy emphasizes treating the whole person, not just the underlying metabolic defect. His approach recognizes that people with CPT2 deficiency experience (Jimenez, n.d.):

  • Chronic muscle pain and stiffness

  • Reduced physical function and mobility

  • Poor posture due to muscle weakness

  • Joint problems from altered movement patterns

  • Anxiety and stress related to managing a chronic condition

  • Nutritional challenges

  • Difficulty maintaining physical fitness

Chiropractic Care for CPT2 Deficiency

Chiropractic care focuses on the diagnosis and treatment of musculoskeletal disorders, particularly those affecting the spine and nervous system. For people with CPT2 deficiency, chiropractic care can address several important issues.

How Chiropractic Care Helps

1. Spinal Alignment and Nervous System Function

The nervous system controls every function in the body, including muscle contraction, energy metabolism, and pain perception. When the spine is misaligned, it can interfere with nerve signals and contribute to muscle dysfunction, pain, and reduced mobility (Chiropractic BioPhysics, 2024).

Dr. Jimenez explains that proper spinal alignment is foundational to optimal body function. Through gentle chiropractic adjustments, misalignments (subluxations) can be corrected, which (Jimenez, n.d.):

  • Reduces pressure on nerves

  • Improves communication between the brain and muscles

  • Enhances overall body function

  • Reduces pain

  • Improves mobility

For people with CPT2 deficiency, optimizing nervous system function is particularly important because their muscles are already compromised by metabolic dysfunction. Any additional stress on the neuromuscular system can worsen symptoms.

2. Muscle Pain and Tension Relief

People with CPT2 deficiency often experience chronic muscle pain, tension, and spasms, particularly after exercise or during metabolic stress. Chiropractic adjustments can help by (Understanding Soft Tissue Injuries, 2024):

  • Reducing muscle tension

  • Improving blood flow to muscles

  • Decreasing inflammation

  • Releasing trapped nerves that may contribute to pain

Studies have shown that chiropractic care can significantly reduce pain in people with musculoskeletal conditions. One study found that pain scores dropped from 55.3 to 24.5 following chiropractic treatment (Understanding Soft Tissue Injuries, 2024).

3. Improved Mobility and Function

Muscle weakness and pain in CPT2 deficiency can lead to reduced mobility and compensatory movement patterns that stress joints and other structures. Chiropractic care helps by (Chiropractors Treat Musculoskeletal Pain, 2025):

  • Restoring proper joint mobility

  • Correcting postural imbalances

  • Improving overall movement patterns

  • Enhancing functional capacity

Dr. Jimenez emphasizes that improved mobility allows patients to maintain appropriate levels of physical activity, which is important for overall health, muscle function, and metabolic control (Jimenez, n.d.).

4. Reducing Medication Dependence

Many people with chronic musculoskeletal pain rely on pain medications, which can have side effects and may interfere with metabolic function. Research shows that chiropractic care can help reduce the use of pain medications, including opioids and over-the-counter analgesics (Chiropractic Care and Medication Use, 2025).

For people with CPT2 deficiency, this is particularly important because some pain medications (like ibuprofen) can actually worsen symptoms or trigger rhabdomyolysis episodes (MedLink Neurology, 2025).

Dr. Jimenez’s Chiropractic Approach

Based on his clinical observations and integrative medicine training, Dr. Jimenez uses several chiropractic techniques in his practice (Jimenez, n.d.):

  • Specific Spinal Adjustments: Gentle, precise adjustments to correct misalignments and restore proper spinal function

  • Postural Assessment and Correction: Detailed analysis of posture and customized protocols to address imbalances

  • Functional Movement Assessment: Evaluation of how patients move and identification of dysfunctional patterns that may contribute to symptoms

  • Patient Education: Teaching patients about proper body mechanics, posture, and movement to prevent injury and optimize function

Soft Tissue Therapies

In addition to spinal adjustments, soft tissue therapies are a crucial component of chiropractic care for individuals with CPT2 deficiency.

Types of Soft Tissue Therapy

1. Myofascial Release

This technique involves applying sustained pressure to tight or restricted areas in muscles and fascia (the connective tissue surrounding muscles). Benefits include (Soft Tissue Manipulation in Chiropractic, 2022):

  • Reduced muscle tension

  • Improved circulation

  • Release of trigger points (tight knots in muscles)

  • Enhanced flexibility and range of motion

2. Trigger Point Therapy

Trigger points are hyper-irritable spots in muscles that can cause local and referred pain. Trigger point therapy targets these areas (10 Chiropractic Techniques, 2025):

  • Release muscle tension

  • Reduce pain

  • Improve muscle function

  • Prevent the formation of new trigger points

For people with CPT2 deficiency who experience frequent muscle pain and spasms, trigger point therapy can provide significant relief.

3. Muscle Energy Techniques

These techniques involve the patient actively using their muscles in specific directions against resistance provided by the practitioner. This helps to (Soft Tissue Therapy and Muscle Release, 2024):

  • Lengthen shortened muscles

  • Strengthen weak muscles

  • Improve joint mobility

  • Restore proper muscle balance

4. Instrument-Assisted Soft Tissue Mobilization

This technique uses specialized instruments to detect and treat areas of soft tissue restriction. Benefits include (Soft Tissue Therapy and Muscle Release, 2024):

  • Breaking up scar tissue

  • Reducing fascial restrictions

  • Improving blood flow

  • Enhancing tissue healing

Clinical Application for CPT2 Deficiency

Dr. Jimenez notes that soft tissue therapies must be carefully applied in people with metabolic myopathies. Because their muscles are more vulnerable to damage, techniques must be gentle and progressive. His approach includes (Jimenez, n.d.):

  • Starting with very gentle techniques and gradually increasing intensity as tolerated

  • Avoiding aggressive deep tissue work that could trigger rhabdomyolysis

  • Combining soft tissue therapy with appropriate nutrition to support muscle recovery

  • Monitoring for signs of excessive muscle breakdown

Acupuncture for CPT2 Deficiency

Acupuncture is an ancient healing practice that involves inserting very thin needles into specific points on the body to promote healing and reduce pain. Modern research has validated many of acupuncture’s benefits for musculoskeletal conditions and pain management.

How Acupuncture Helps

1. Pain Relief

Acupuncture is well-established as an effective treatment for various types of pain. Research shows it can (Acupuncture Promotes ATP Metabolism, 2025):

  • Activate the body’s natural pain-relieving systems

  • Release endorphins (natural pain-killing chemicals)

  • Reduce inflammation

  • Decrease pain signals sent to the brain

For people with CPT2 deficiency who experience chronic muscle pain, acupuncture can provide relief without the side effects of medications.

2. Improved Muscle Function

Studies have shown that acupuncture can improve muscle function through several mechanisms (Acupuncture Plus Low-Frequency Stimulation, 2016):

  • Increasing blood flow to muscles

  • Enhancing oxygen delivery to muscle tissue

  • Stimulating muscle regeneration

  • Preventing muscle atrophy (wasting)

Research has demonstrated that acupuncture combined with low-frequency electrical stimulation can counteract muscle atrophy and enhance muscle regeneration, making it potentially beneficial for individuals with muscle weakness resulting from metabolic conditions (Acupuncture Plus Low-Frequency Stimulation, 2016).

3. Enhanced Metabolism and Energy Production

Recent research has revealed that acupuncture can influence cellular metabolism and energy production. Studies show that acupuncture (Acupuncture Promotes ATP Metabolism, 2025):

  • Activates specific signaling pathways involved in energy metabolism

  • Promotes mitochondrial function

  • Increases ATP (energy) production in muscle cells

  • Enhances the body’s ability to use available fuel sources

This is particularly relevant for people with CPT2 deficiency, whose primary problem is impaired energy metabolism in muscles.

4. Stress Reduction and Nervous System Balance

Acupuncture has well-documented effects on the nervous system and stress response. It can (Evaluation of Acupuncture for Sepsis Myopathy, 2020):

  • Reduce cortisol and other stress hormones

  • Balance the autonomic nervous system

  • Improve sleep quality

  • Reduce anxiety

  • Enhance overall sense of well-being

Since stress is a known trigger for CPT2 deficiency symptoms, acupuncture’s stress-reducing effects may help prevent attacks.

5. Support for Muscle Recovery

Research has shown that acupuncture can (Effect of Acupuncture on Carnitine, 2012):

  • Reduce exercise-induced muscle soreness

  • Speed recovery after muscle injury

  • Reduce inflammation in muscle tissue

  • Support the body’s natural healing processes

Dr. Jimenez’s Integrated Approach with Acupuncture

Dr. Jimenez incorporates both traditional acupuncture and electro-acupuncture (which adds mild electrical stimulation) into his treatment protocols. His clinical observations suggest that acupuncture can be particularly helpful for patients with CPT2 deficiency (Jimenez, n.d.):

  • Providing safe, non-pharmaceutical pain relief

  • Supporting muscle function without triggering metabolic stress

  • Enhancing overall energy levels

  • Reducing the frequency of symptom flare-ups

  • Improving quality of life

Safety Considerations for Complementary Therapies

While chiropractic care and acupuncture can be beneficial for people with CPT2 deficiency, safety must always be the priority. Dr. Jimenez emphasizes several important considerations (Jimenez, n.d.):

  1. Gentle Approach: All manual therapies should start gently and progress slowly. Aggressive treatment could potentially trigger rhabdomyolysis.

  2. Communication: Patients should inform their practitioners about their CPT2 deficiency and any symptoms they experience during or after treatment.

  3. Monitoring: Watch for signs of excessive muscle breakdown, such as severe muscle pain, weakness, or dark urine following treatment.

  4. Integrated Care: These complementary therapies should be used in conjunction with, not as an alternative to, conventional medical management.

  5. Individualization: Treatment plans should be tailored to each person’s specific symptoms, the severity of their deficiency, and overall health status.

  6. Timing: Avoid intensive manual therapies during acute attacks or periods of metabolic stress.

A Holistic Treatment Plan Incorporating Multiple Modalities

Dr. Jimenez’s clinical approach to CPT2 deficiency demonstrates the power of integrating multiple treatment modalities into a comprehensive, holistic plan. His functional medicine perspective recognizes that optimal management requires addressing multiple aspects of health simultaneously.

The Foundation: Conventional Medical Management

Any holistic treatment plan for CPT2 deficiency must be built on a foundation of appropriate conventional medical management, including (Myopathic CPT II Deficiency, 2023):

  • Proper diagnosis through genetic testing and metabolic studies

  • Regular monitoring by healthcare providers

  • Dietary modifications (discussed in detail below)

  • Emergency protocols for acute attacks

  • Avoidance of known triggers

Component 1: Spinal Adjustments and Postural Correction

As previously discussed, maintaining optimal spinal alignment is essential for the proper functioning of the nervous system and overall musculoskeletal health.

Dr. Jimenez’s Approach Includes:

  • Regular chiropractic adjustments to maintain spinal alignment

  • Postural assessments and corrections

  • Home exercises to support proper posture

  • Ergonomic recommendations for work and daily activities

  • Education about body mechanics

Frequency and Progression:

The frequency of adjustments is tailored to each patient’s individual needs. Some people may initially benefit from weekly adjustments, then transition to monthly maintenance care. Others may need more or less frequent visits depending on their symptoms and response to treatment (Jimenez, n.d.).

Component 2: Soft-Tissue Therapies

Soft tissue work addresses the muscles, fascia, and other connective tissues that are directly affected by CPT2 deficiency.

Integrated Soft-Tissue Protocol:

  • Gentle myofascial release techniques

  • Trigger point therapy as needed

  • Muscle energy techniques to restore balance

  • Gradual progression in intensity as tolerated

  • Use of heat or cold therapy to support healing

Dr. Jimenez’s Clinical Insight:

In his practice, Dr. Jimenez has observed that patients with metabolic myopathies respond best to gentle, consistent soft tissue work rather than aggressive, infrequent treatments. He emphasizes the importance of “working with the body, not against it” (Jimenez, n.d.).

Component 3: Acupuncture and Electro-Acupuncture

Acupuncture is integrated into the treatment plan to address pain, support muscle function, reduce stress, and enhance overall energy metabolism.

Typical Acupuncture Protocol:

  • Initial assessment to identify specific patterns of imbalance

  • Selection of acupuncture points based on symptoms and traditional Chinese medicine principles

  • Treatment sessions typically last 20-30 minutes

  • Frequency usually ranges from once weekly to once monthly, depending on individual needs

  • May include electro-acupuncture for enhanced effects on muscle function

Point Selection for CPT2 Deficiency:

While specific point selection varies by individual, commonly used points for muscle weakness, pain, and metabolic support include points along the Spleen, Kidney, Liver, and Bladder meridians, which are associated with muscle function, energy metabolism, and overall vitality in traditional Chinese medicine (Jimenez, n.d.).

Component 4: Nutrition and Dietary Management

Nutrition is arguably the most important component of managing CPT2 deficiency. The right dietary approach can significantly reduce the frequency and severity of attacks while supporting overall health.

Fundamental Nutritional Principles

1. High Carbohydrate Intake

People with CPT2 deficiency should consume a diet rich in carbohydrates to provide readily available glucose for energy (CPT2 Fact Sheet, n.d.).

Recommendations:

  • Carbohydrates should make up 65-70% of total daily calories

  • Focus on complex carbohydrates that provide sustained energy

  • Include carbohydrates in every meal and snack

Good Carbohydrate Sources:

  • Whole grains (brown rice, quinoa, oats, whole wheat)

  • Starchy vegetables (potatoes, sweet potatoes, corn, peas)

  • Legumes (beans, lentils, chickpeas)

  • Fruits

  • Low-fat dairy products

2. Low to Moderate Fat Intake

Since people with CPT2 deficiency cannot efficiently use long-chain fatty acids, dietary fat should be limited, typically to no more than 20-30% of total calories (Carnitine Palmitoyltransferase Deficiencies, 1999).

Important Considerations:

  • Avoid very low-fat diets, as some fat is essential for health

  • Include essential fatty acids (omega-3 and omega-6)

  • Focus on easily metabolized fats

3. Medium-Chain Triglyceride (MCT) Oil

MCT oil is a special type of fat that can be more easily metabolized by people with CPT2 deficiency. Medium-chain fatty acids (typically 6-12 carbons long) can enter mitochondria without requiring the CPT system (North Dakota CPT-2 Fact Sheet, 2008).

MCT Oil Benefits:

  • Provides an alternative fat source that doesn’t require CPT2

  • Can help meet essential fat needs

  • May provide sustained energy

  • Generally well-tolerated in moderate amounts

How to Use MCT Oil:

  • Start with small amounts (1 teaspoon) and increase gradually

  • Can be added to foods like oatmeal, smoothies, or used in cooking

  • Should be introduced under medical supervision

  • Too much can cause digestive upset

Important Note: Some research suggests that while MCTs can be beneficial, care should be taken as the body’s capacity to metabolize medium-chain fatty acids through CPT-independent pathways may still be limited (Characterisation of CPT, 1997).

4. Frequent, Regular Meals

To prevent hypoglycemia and maintain stable energy levels, individuals with CPT2 deficiency should eat regularly and on a consistent schedule (CPT2 Deficiency Treatment, 2023).

Meal Timing Recommendations:

  • Eat every 3-4 hours during the day

  • Never skip breakfast

  • Include a bedtime snack to prevent overnight fasting

  • May need to wake during the night for a snack in severe cases

  • Plan ahead for situations that might delay meals

5. Adequate Protein

Protein is important for maintaining muscle mass and supporting overall health. People with CPT2 deficiency should consume adequate protein from lean sources (North Dakota CPT-2 Fact Sheet, 2008).

Protein Recommendations:

  • Include lean protein sources at each meal

  • Good choices include chicken, turkey, fish, lean beef, eggs, low-fat dairy, and legumes

  • Protein should make up about 15-20% of total calories

Dr. Jimenez’s Nutritional Philosophy

Dr. Jimenez’s approach to nutrition in metabolic conditions emphasizes personalization and the principles of functional medicine. He notes that while general dietary guidelines are important, each person’s nutritional needs may vary based on (Jimenez, 2022):

  • Severity of their enzyme deficiency

  • Activity level

  • Other health conditions

  • Food preferences and cultural considerations

  • Metabolic testing results

His nutritional counseling includes:

  • Detailed dietary assessment

  • Personalized meal planning

  • Education about reading food labels

  • Strategies for dining out and social situations

  • Regular monitoring and adjustments

Component 5: Vitamins and Supplements

Specific vitamins and supplements can support metabolic function, muscle health, and overall well-being in people with CPT2 deficiency.

Evidence-Based Supplements for Metabolic and Musculoskeletal Support

1. L-Carnitine

L-carnitine is the compound that CPT enzymes use to shuttle fatty acids into mitochondria. Supplementation with L-carnitine is sometimes recommended for people with CPT2 deficiency, though its benefits remain somewhat controversial (Carnitine Palmitoyltransferase Deficiencies, 1999).

Potential Benefits:

  • May help maintain normal carnitine levels

  • Could support the remaining functional enzyme activity

  • May help with overall energy metabolism

Considerations:

  • Should only be used under medical supervision

  • Dosing varies but typically ranges from 1-3 grams per day

  • Not all studies show clear benefits

  • May not be helpful for all forms of CPT2 deficiency

2. Coenzyme Q10 (CoQ10)

CoQ10 is a compound that plays a crucial role in the production of energy within mitochondria. It acts as an antioxidant and supports the electron transport chain (the final step in energy production) (Dietary Supplements for Mitochondrial Disorders, 2025).

Potential Benefits:

  • Supports mitochondrial function

  • Provides antioxidant protection

  • May improve energy production

  • It could help reduce muscle fatigue

Typical Dosing:

  • 100-300 mg daily

  • Should be taken with fat-containing meals for better absorption

  • Ubiquinol form may be better absorbed than ubiquinone

3. B-Complex Vitamins

B vitamins play essential roles in energy metabolism and are particularly important for people with metabolic disorders (Folate, Vitamin B6, and Vitamin B12, 2023).

Key B Vitamins for Metabolic Support:

  • Vitamin B1 (Thiamine): Helps metabolize carbohydrates

  • Vitamin B2 (Riboflavin): Involved in energy production and fatty acid metabolism

  • Vitamin B3 (Niacin): Supports energy metabolism

  • Vitamin B6 (Pyridoxine): Important for amino acid and carbohydrate metabolism

  • Vitamin B12 (Cobalamin): Essential for energy production and nervous system function

  • Folate: Works with B12 in various metabolic processes

Benefits for CPT2 Deficiency:

  • Support optimal metabolism of carbohydrates (the primary fuel source)

  • Help the body efficiently use available energy sources

  • Support nervous system health

  • May reduce homocysteine levels

  • Support muscle function

4. Vitamin D

Vitamin D is essential for maintaining muscle function, promoting bone health, and supporting the immune system (Natural Products for Metabolic Syndrome, 2024).

Benefits:

  • Supports muscle strength and function

  • Important for bone health (especially important if activity is limited)

  • Modulates inflammation

  • Supports immune function

Typical Dosing:

  • Based on blood level testing

  • Often 1,000-4,000 IU daily for maintenance

  • Higher doses may be needed if deficient

5. Magnesium

Magnesium is involved in more than 300 enzymatic reactions in the body, including many related to energy metabolism and muscle function (The 5 Best Vitamins to Boost Metabolism, 2024).

Benefits:

  • Supports muscle relaxation and reduces cramping

  • Important for energy production

  • Supports nervous system function

  • May help reduce muscle pain

Typical Dosing:

  • 200-400 mg daily

  • Different forms have different absorption rates (magnesium glycinate is often well-tolerated)

6. Alpha-Lipoic Acid

This antioxidant supports mitochondrial function and glucose metabolism (Dietary Supplements for Mitochondrial Disorders, 2025).

Benefits:

  • Supports mitochondrial function

  • Provides antioxidant protection

  • May improve glucose metabolism

  • Supports nerve health

Typical Dosing:

  • 200-600 mg daily

7. Vitamin E

As a fat-soluble antioxidant, vitamin E can help protect cell membranes from oxidative damage (Natural Products for Metabolic Syndrome, 2024).

Benefits:

  • Antioxidant protection

  • Supports muscle health

  • May reduce oxidative stress

8. Omega-3 Fatty Acids (DHA and EPA)

While overall fat intake should be limited in CPT2 deficiency, essential fatty acids, such as omega-3s, are important for health (Natural Products for Metabolic Syndrome, 2024).

Benefits:

  • Reduce inflammation

  • Support cardiovascular health

  • Support brain function

  • May help with muscle recovery

Important Note: Omega-3 supplements should be used cautiously and in consultation with a healthcare provider, as they are long-chain fatty acids. However, in small amounts, their anti-inflammatory and other health benefits may outweigh concerns.

9. Vitamin C

This water-soluble antioxidant supports immune function, collagen synthesis, and may help with muscle recovery (Natural Products for Metabolic Syndrome, 2024).

Benefits:

  • Antioxidant protection

  • Supports immune function

  • Important for connective tissue health

  • May help with muscle recovery

Dr. Jimenez’s Supplement Protocol

Based on his clinical experience and functional medicine training, Dr. Jimenez typically recommends (Recommended Chiropractic Supplements, 2022; Jimenez, n.d.):

Foundation Supplements:

  • High-quality multivitamin-multimineral complex to cover basic nutritional needs

  • B-complex vitamins to support energy metabolism

  • Vitamin D (dose based on blood levels)

  • Magnesium for muscle and metabolic support

Targeted Supplements (based on individual needs):

  • CoQ10 for mitochondrial support

  • L-carnitine (if recommended by physician)

  • Alpha-lipoic acid for antioxidant and metabolic support

  • Omega-3 fatty acids in appropriate amounts

  • Vitamin E for antioxidant protection

Important Considerations:

  • All supplements should be pharmaceutical-grade and third-party tested for quality

  • Dosing should be individualized based on blood testing and individual needs

  • Regular monitoring is important to assess effectiveness and adjust as needed

  • Supplements should never replace a healthy diet

  • Always inform all healthcare providers about supplements being taken

Component 6: Targeted Exercise and Physical Therapy

While exercise can trigger symptoms in CPT2 deficiency, engaging in appropriate physical activity is essential for maintaining muscle strength, cardiovascular health, and overall well-being. The key is finding the right type, intensity, and duration of exercise.

Principles of Exercise for CPT2 Deficiency

1. Focus on Short-Duration, High-Intensity Activities

Research has shown that exercise relying primarily on anaerobic metabolism (which doesn’t require fat oxidation) is safer for people with CPT2 deficiency (Nutrition and Exercise in CPT Deficiency, 2021).

Why This Works:

  • During the first few minutes of intense exercise, muscles use stored ATP and phosphocreatine

  • Glycolysis (breaking down glucose) provides energy for roughly 5-30 seconds to 2-3 minutes of intense activity

  • These energy systems don’t require fat oxidation

  • After about 30 minutes of continuous moderate exercise, the body shifts toward greater fat utilization, which is problematic for people with CPT2 deficiency

Safe Exercise Types:

  • Resistance training (weight lifting with appropriate rest between sets)

  • High-intensity interval training (HIIT) with short work periods (30 seconds to 2 minutes) and adequate rest

  • Sprint intervals

  • Power-based activities

  • Activities that can be performed in short bursts with rest

2. Avoid Prolonged Endurance Exercise

Activities that require sustained effort for more than 30 minutes are more likely to trigger symptoms because they increasingly rely on fat metabolism (Nutrition and Exercise in CPT Deficiency, 2021).

Activities to Approach with Caution:

  • Long-distance running

  • Cycling for extended periods

  • Swimming long distances

  • Extended aerobic exercise classes

3. Ensure Adequate Carbohydrate Fueling

Never exercise on an empty stomach or in a fasted state. Pre-exercise nutrition is crucial (Home-Based Aerobic Training in Metabolic Myopathies, 2016).

Pre-Exercise Nutrition:

  • Eat a carbohydrate-rich snack or meal 1-2 hours before exercise

  • Good choices include oatmeal, bananas, whole-grain toast, and energy bars

  • Stay well-hydrated

During Exercise:

  • For activities lasting more than 30 minutes, consider consuming fast-acting carbohydrates during exercise

  • Sports drinks, gels, or easily digestible carbohydrate snacks can help

Post-Exercise Nutrition:

  • Consume carbohydrates and protein within 30-60 minutes after exercise

  • This supports muscle recovery and replenishes energy stores

4. Start Slowly and Progress Gradually

For individuals who have been sedentary or are just starting an exercise program, it’s essential to begin slowly and increase intensity and duration gradually (Home-Based Aerobic Training in Metabolic Myopathies, 2016).

Progression Guidelines:

  • Begin with very short-duration activities (5-10 minutes)

  • Gradually increase duration by no more than 10% per week

  • Monitor symptoms carefully

  • If symptoms occur, reduce intensity and duration

5. Monitor for Warning Signs

Stop exercise immediately if any of the following occur:

  • Excessive muscle pain or cramping

  • Unusual muscle weakness

  • Dark or rust-colored urine

  • Extreme fatigue

  • Dizziness or confusion

Research-Supported Exercise Protocols

Several studies have demonstrated that appropriately designed exercise programs can be safe and beneficial for people with metabolic myopathies, including CPT2 deficiency.

Case Study: Interval and Resistance Training

A 14-year-old patient with CPT2 deficiency underwent a 6-month supervised exercise program consisting of (Nutrition and Exercise in CPT Deficiency, 2021):

  • Interval training: 1 minute running alternating with 5 minutes walking, gradually progressed from 15 to 30 minutes total

  • Resistance training: Upper and lower body exercises, 3 sets of 8 repetitions with 2 minutes rest between sets

  • Frequency: 3 days per week

  • Heart rate maintained above 70% maximum

  • Proper dietary support with adequate carbohydrates

Results:

  • Resting metabolic rate increased by 8.1%

  • Respiratory quotient improved to the normal range

  • Peak oxygen uptake increased by 8.3%

  • Aerobic performance improved

  • No muscle pain or rhabdomyolysis occurred

  • Blood creatine kinase levels remained normal

This study demonstrates that when exercise is properly designed and combined with appropriate nutrition, people with CPT2 deficiency can safely improve their fitness and metabolic function.

Study: Home-Based Aerobic Training

A study of patients with various metabolic myopathies showed that 12 weeks of home-based moderate-intensity aerobic training (cycle ergometer, 4 days/week, 65-70% maximum heart rate) resulted in (Home-Based Aerobic Training in Metabolic Myopathies, 2016):

  • Improved peak oxygen uptake

  • Enhanced skeletal muscle oxygen extraction

  • Faster oxygen uptake kinetics

  • Reduced the oxygen cost of exercise

  • Improved exercise tolerance

  • No adverse events

Dr. Jimenez’s Exercise Prescription

Based on his clinical experience and review of the research, Dr. Jimenez recommends an individualized exercise approach for patients with CPT2 deficiency (Jimenez, n.d.):

Initial Assessment:

  • Comprehensive evaluation of current fitness level

  • Review of past experiences with exercise

  • Identification of any exercise-related symptoms or attacks

  • Assessment of movement patterns and any compensatory issues

  • Baseline strength and flexibility testing

Exercise Program Components:

Resistance Training (Primary Focus):

  • 2-3 days per week

  • Focus on major muscle groups

  • 8-12 repetitions per set

  • 2-3 sets per exercise

  • 2-3 minutes rest between sets

  • Progressive overload applied carefully

  • Emphasis on proper form and controlled movements

Interval Training (As Tolerated):

  • 1-2 days per week

  • Short work intervals (30 seconds to 2 minutes)

  • Active recovery periods (3-5 minutes)

  • Total session duration: 15-30 minutes

  • Heart rate monitored to ensure appropriate intensity

Flexibility and Mobility Work:

  • Daily gentle stretching

  • Yoga or tai chi (modified as needed)

  • Focus on maintaining joint mobility

  • Helps reduce muscle tension and improve movement quality

Balance and Coordination:

  • Important for preventing falls and injuries

  • Can be incorporated into other workouts

  • Particularly important if any neuropathy is present

Progression and Monitoring:

  • Start conservatively with very manageable loads and durations

  • Increase demands by no more than 10% per week

  • Regular check-ins to assess response

  • Blood work (creatine kinase levels) as needed

  • Adjust the program based on the individual response

Safety Protocols:

  • Always exercise with proper carbohydrate fueling

  • Stay well-hydrated

  • Avoid exercise during illness or metabolic stress

  • Stop immediately if warning signs appear

  • Have a plan for managing potential attacks

Component 7: Stress Management and Mind-Body Therapies

Since stress is a known trigger for CPT2 deficiency symptoms, stress management is an important component of a comprehensive treatment plan.

Stress and Metabolic Function

Stress affects the body in multiple ways that can worsen CPT2 deficiency (Jimenez, 2022):

  • Increases metabolic demands

  • Triggers release of stress hormones that mobilize fat stores

  • Can disrupt sleep, leading to fatigue

  • May affect eating patterns

  • Can contribute to muscle tension and pain

  • Weakens immune function, increasing infection risk

Stress Management Strategies

1. Mind-Body Practices

  • Meditation

  • Deep breathing exercises

  • Progressive muscle relaxation

  • Guided imagery

  • Mindfulness practices

2. Gentle Movement Practices

  • Tai chi

  • Gentle yoga

  • Qi gong

  • Walking in nature

3. Lifestyle Modifications

  • Adequate sleep (7-9 hours per night)

  • Time management to reduce stress

  • Setting appropriate boundaries

  • Regular relaxation time

  • Social support and connection

4. Professional Support

  • Counseling or therapy if needed

  • Support groups for people with metabolic conditions

  • Health coaching

Dr. Jimenez’s Integrative Approach

Dr. Jimenez emphasizes that managing CPT2 deficiency requires addressing not just the physical aspects but also the emotional and psychological dimensions. His practice incorporates (Jimenez, n.d.):

  • Education about the stress-symptom connection

  • Teaching practical stress management techniques

  • Encouraging patients to prioritize self-care

  • Providing ongoing support and encouragement

  • Helping patients develop realistic expectations and goals

Component 8: Patient Education and Empowerment

A critical component of any treatment plan is educating patients about their condition and empowering them to take an active role in their care.

Key Educational Topics

Understanding CPT2 Deficiency:

  • Basic genetics and inheritance

  • How the enzyme deficiency affects the body

  • Why symptoms occur

  • Prognosis and long-term outlook

Trigger Identification and Avoidance:

  • Recognizing personal triggers

  • Strategies for avoiding triggers

  • Planning ahead for situations that might be challenging

Dietary Management:

  • Understanding nutritional needs

  • Meal planning and preparation

  • Reading food labels

  • Dining out strategies

  • Special situations (travel, social events)

Exercise Guidelines:

  • Safe exercise principles

  • How to monitor intensity

  • Warning signs to stop

  • Progressive training principles

Emergency Management:

  • Recognizing signs of an acute attack

  • When to seek medical care

  • What to tell emergency personnel

  • Emergency contacts and medical information cards

Empowerment Through Knowledge

Dr. Jimenez believes that educated patients achieve better outcomes. His practice includes (Jimenez, n.d.):

  • Detailed explanations of all aspects of the condition

  • Written materials that patients can reference at home

  • Access to reliable online resources

  • Encouragement to ask questions

  • Collaborative decision-making about treatment plans

  • Regular follow-up to reinforce education and address new questions

Clinical Observations from Dr. Alexander Jimenez, DC, APRN, FNP-BC

Dr. Alexander Jimenez brings a unique perspective to the management of CPT2 deficiency and other metabolic conditions through his dual credentials as both a Doctor of Chiropractic and a board-certified Family Practice Nurse Practitioner. His practice in El Paso, Texas, specializes in functional medicine and integrative approaches to complex chronic conditions.

Dr. Jimenez’s Philosophy of Care

Dr. Jimenez’s approach is grounded in several core principles (Jimenez, n.d.; A4M Profile, 2016):

1. Treat the Whole Person, Not Just the Disease

He recognizes that people with CPT2 deficiency are more than their diagnosis. His assessments include evaluation of:

  • Physical symptoms and functional limitations

  • Nutritional status and dietary patterns

  • Emotional and psychological well-being

  • Social support and life circumstances

  • Environmental factors

  • Genetic predispositions

  • Lifestyle factors

2. Address Root Causes

While CPT2 deficiency itself is caused by a genetic mutation that cannot currently be cured, Dr. Jimenez focuses on addressing all the factors that contribute to symptom expression and overall health. This includes (Jimenez, 2022):

  • Optimizing nutrition to compensate for metabolic limitations

  • Correcting musculoskeletal imbalances that may worsen symptoms

  • Reducing inflammation throughout the body

  • Supporting optimal mitochondrial function with targeted nutrients

  • Balancing the nervous system

  • Addressing any concurrent health issues

3. Use Natural, Non-Invasive Therapies First

Consistent with both chiropractic and functional medicine principles, Dr. Jimenez prioritizes natural approaches that support the body’s innate healing abilities. This means (Jimenez, n.d.):

  • Using spinal adjustments to optimize nervous system function

  • Employing dietary modifications before resorting to medications when possible

  • Teaching lifestyle modifications that support long-term health

  • Using supplements to address nutritional deficiencies and support metabolic function

  • Incorporating mind-body therapies for stress management

However, he also recognizes when conventional medical interventions are necessary and works collaboratively with other healthcare providers to ensure comprehensive care.

4. Empower Patients

Dr. Jimenez believes that patients who understand their condition and actively participate in their care achieve the best outcomes. He invests a significant amount of time in education and works to establish strong therapeutic relationships with his patients (Jimenez, n.d.).

Key Clinical Observations

Based on his years of clinical experience treating patients with metabolic and musculoskeletal conditions, Dr. Jimenez has made several important observations about CPT2 deficiency and similar conditions:

1. The Importance of Individualization

No two patients with CPT2 deficiency are exactly alike. Even people with the same genetic mutation may have very different symptom patterns, triggers, and responses to treatment. Dr. Jimenez emphasizes that treatment plans must be highly individualized (Jimenez, n.d.).

2. Nutrition Is the Foundation

Of all the interventions available, appropriate nutrition has the most profound impact on symptoms and quality of life for people with CPT2 deficiency. Dr. Jimenez notes that patients who strictly adhere to dietary recommendations, particularly maintaining adequate carbohydrate intake and avoiding prolonged fasting, experience far fewer attacks and better overall function (Jimenez, 2022; Nutrition Drives Health Recovery, 2025).

3. Spinal Health Affects Overall Function

Dr. Jimenez has observed that patients with CPT2 deficiency often develop secondary musculoskeletal problems due to muscle weakness, altered movement patterns, and reduced activity levels. Maintaining optimal spinal alignment and nervous system function through chiropractic care can help minimize these secondary issues and optimize the function of an already compromised musculoskeletal system (Jimenez, n.d.).

4. Chronic Inflammation Is Common

Many patients with metabolic conditions, including CPT2 deficiency, show signs of chronic low-grade inflammation. This inflammation can worsen symptoms and contribute to other health problems. Dr. Jimenez’s treatment protocols often include anti-inflammatory strategies such as (Treating Inflammation Naturally, 2020; Jimenez, 2022):

  • An anti-inflammatory diet emphasizing whole foods, colorful vegetables, and omega-3 fatty acids

  • Supplements with anti-inflammatory properties (omega-3s, curcumin, antioxidants)

  • Stress reduction

  • Adequate sleep

  • Regular gentle movement

5. The Mind-Body Connection Matters

Dr. Jimenez emphasizes that there is a strong connection between psychological stress and physical symptoms in metabolic conditions. Patients who effectively manage stress through various techniques tend to experience fewer symptom flare-ups and achieve better overall outcomes (Jimenez, n.d.).

6. Early Intervention Is Key

When patients are diagnosed early and begin appropriate management strategies before significant complications develop, their outcomes are significantly improved. Dr. Jimenez advocates for newborn screening and early intervention when CPT2 deficiency is suspected (Jimenez, n.d.).

7. Patient Support and Education Improve Adherence

Managing CPT2 deficiency requires significant lifestyle modifications that can be challenging to maintain. Dr. Jimenez has found that patients who receive ongoing support, education, and encouragement are more likely to adhere to treatment recommendations in the long term (Jimenez, n.d.).

Dr. Jimenez’s Metabolic Syndrome Research

Dr. Jimenez has also studied metabolic syndrome extensively, which shares some features with CPT2 deficiency in terms of metabolic dysfunction. His research has emphasized (Jimenez Presents: Effects of Metabolic Syndrome, 2022):

  • The importance of looking at metabolic health comprehensively

  • How inflammation, insulin resistance, and metabolic dysfunction interconnect

  • The value of functional medicine approaches in addressing root causes

  • How dietary modifications can significantly impact metabolic health

  • The role of exercise in improving metabolic function

These insights inform his approach to all metabolic conditions, including CPT2 deficiency.

Integrative Medicine Framework

Dr. Jimenez utilizes the Institute for Functional Medicine’s clinical approach, which involves (Jimenez, n.d.; A4M Profile, 2016):

Detailed Assessment:

  • Comprehensive health history

  • Timeline of symptoms and health events

  • Assessment of all body systems

  • Evaluation of lifestyle factors

  • Review of environmental exposures

  • Genetic information, when available

  • Advanced laboratory testing, including:

    • Comprehensive metabolic panels

    • Inflammatory markers

    • Nutritional status

    • Hormone levels

    • Mitochondrial function markers

Personalized Treatment Plans:
Based on the comprehensive assessment, Dr. Jimenez develops individualized treatment plans that address multiple aspects of health simultaneously, typically including:

  • Dietary modifications

  • Targeted supplementation

  • Chiropractic care and manual therapies

  • Exercise recommendations

  • Stress management strategies

  • Sleep optimization

  • Environmental modifications as needed

Ongoing Monitoring and Adjustment:

  • Regular follow-up visits

  • Repeat laboratory testing to track progress

  • Adjustment of treatment plans based on response

  • Patient education and support throughout the process

Collaboration and Referral

Dr. Jimenez emphasizes that managing complex conditions like CPT2 deficiency requires a team approach. He collaborates with (Jimenez, n.d.):

  • Primary care physicians

  • Metabolic specialists and geneticists

  • Nutritionists and dietitians

  • Physical therapists

  • Mental health professionals

  • Other specialists as needed

When a patient’s needs exceed his scope of practice or would be better served by another specialist, he promptly provides referrals while continuing to provide supportive care in his areas of expertise.

Emergency Management and When to Seek Medical Care

While the focus of this article is on nonsurgical management and prevention, it’s crucial that people with CPT2 deficiency and their families understand how to recognize and respond to acute attacks.

Recognizing an Acute Attack

Seek immediate medical attention if any of the following occur (Battling Recurrent Rhabdomyolysis, 2024; Myopathic CPT II Deficiency, 2023):

Symptoms of Rhabdomyolysis:

  • Severe muscle pain and weakness

  • Muscle swelling

  • Dark brown or rust-colored urine (myoglobinuria)

  • Reduced urine output

  • Extreme fatigue

  • Confusion or altered mental status

  • Fever

  • Rapid heartbeat

  • Nausea and vomiting

Symptoms of Hypoglycemia:

  • Shakiness

  • Sweating

  • Confusion

  • Dizziness

  • Weakness

  • Rapid heartbeat

  • Irritability

  • Blurred vision

Emergency Treatment

If rhabdomyolysis is suspected, immediate medical treatment is essential to prevent kidney damage and other complications. Emergency treatment typically includes (Battling Recurrent Rhabdomyolysis, 2024; Myopathic CPT II Deficiency, 2023):

1. Intravenous Glucose

  • Rapid administration of IV glucose to stop lipolysis (fat breakdown)

  • Typically 10% dextrose solution

  • Started immediately, even if blood sugar appears normal

  • Prevents further muscle breakdown

2. Aggressive Fluid Resuscitation

  • Large volumes of IV fluids to flush myoglobin through the kidneys

  • Helps prevent kidney damage

  • Maintains adequate urine output

3. Monitoring

  • Creatine kinase (CK) levels to assess the severity of muscle breakdown

  • Kidney function tests

  • Electrolyte levels (especially potassium, which can rise to dangerous levels)

  • Urine output

  • Cardiac monitoring

4. Treatment of Complications

  • Correction of electrolyte imbalances

  • Management of acute kidney injury if present

  • Treatment of any infections or other triggers

  • Possible dialysis if kidney failure develops

5. Discontinuation of Triggering Medications

  • Stop any drugs that may have contributed to the attack

Medical Alert Information

People with CPT2 deficiency should (CPT2-CACT Emergency Protocol, n.d.):

  • Wear a medical alert bracelet or necklace

  • Carry a medical information card

  • Inform all healthcare providers about their condition

  • Have an emergency action plan

  • Educate family members about recognizing symptoms and seeking help

Living Well with CPT2 Deficiency: Practical Tips

While CPT2 deficiency requires careful management, many individuals with the condition lead full and active lives. Here are practical tips for daily living:

Meal Planning

  • Plan meals and snacks in advance

  • Prep carbohydrate-rich snacks to have readily available

  • Never leave home without portable snacks (granola bars, fruit, crackers)

  • Set phone alarms as reminders to eat regularly

  • Keep emergency snacks in your car, office, and bag

Exercise and Physical Activity

  • Start any new exercise program gradually

  • Always eat before exercising

  • Carry fast-acting carbohydrates during longer activities

  • Exercise with a buddy who knows about your condition

  • Stop immediately if you experience warning symptoms

  • Keep an exercise log to identify your personal tolerance

Travel

  • Pack plenty of appropriate snacks

  • Plan for regular meal times even when traveling

  • Carry a letter from your doctor explaining your condition

  • Research restaurants and food options at your destination

  • Bring a cooler for perishable snacks on long trips

Social Situations

  • Don’t be embarrassed to eat when you need to

  • Educate close friends and family about your needs

  • Offer to bring a dish to potlucks to ensure appropriate options

  • Check menus ahead of time when going out

  • Speak up about your dietary needs

Work and School

  • Educate supervisors, teachers, or coaches about your condition

  • Have snacks available in your workspace or locker

  • Take regular breaks to eat

  • Adjust physical education or work demands as needed

  • Have an emergency plan in place

Managing Stress

  • Practice regular stress management techniques

  • Get adequate sleep

  • Maintain work-life balance

  • Seek support when needed

  • Prioritize self-care

Conclusion

CPT2 deficiency is a genetic metabolic disorder that impairs the body’s ability to utilize long-chain fatty acids as a source of energy. This can cause muscle pain, weakness, and possibly dangerous episodes of rhabdomyolysis, especially after long periods of activity, fasting, being cold, being sick, or being stressed. CPT2 deficiency primarily impacts the musculoskeletal system; however, it may also affect the heart, liver, and kidneys. The key to treating CPT2 insufficiency is to support the body through various types of therapy while being aware of and avoiding factors that exacerbate it. A complete treatment plan must include:

  1. Regular check-ups by doctors, the right diagnostic tests, and traditional medical treatments as needed are all part of good medical care.
  2. Nutritional optimization is a diet that is high in carbs and low to moderate in fat, which people often follow to maintain their energy levels and prevent hypoglycemia. Medium-chain triglyceride oil could be another source of fat.
  3. Chiropractors adjust the spine to enhance the nervous system’s function, align the musculoskeletal system more effectively, reduce pain, and improve overall function. You can use soft tissue therapy to treat trigger points and relax tight muscles.
  4. Acupuncture, whether traditional or electroacupuncture, may aid in pain management, improve muscular function, reduce stress levels, and potentially enhance cellular metabolism.
  5. Targeted supplementation: CoQ10, magnesium, vitamin D, B-complex vitamins, L-carnitine (with medical supervision), and antioxidants are all essential vitamins and supplements that can help maintain healthy muscles and support the body’s optimal metabolism.
  6. Anaerobic metabolism-based, short-duration, high-intensity exercises are often safer than long-duration endurance exercises. When done correctly and with sufficient carbohydrates, resistance and interval training may help maintain strength and fitness without triggering attacks.
  7. Mind-body therapies, getting enough sleep, and other practical strategies can help prevent symptoms of stress from worsening.
  8. Patient education: Patients who are informed about their disease, recognize triggers, know when to consult a doctor, and are involved in decisions about their treatment tend to achieve better results.

Dr. Alexander Jimenez’s clinical approach demonstrates how combining traditional medical care with functional medicine, chiropractic adjustments, acupuncture, a balanced diet, and lifestyle changes can be effective. His experience as a family nurse practitioner and chiropractor equips him with the skills to treat both the physical symptoms of CPT2 deficiency and the underlying metabolic issues that cause them. Holistic therapy approaches can significantly improve quality of life, reduce the frequency and severity of episodes, and empower individuals with CPT2 deficiency to lead active and fulfilling lives by addressing the body as an interconnected system rather than focusing solely on the enzyme deficiency. Even though the myopathic type of CPT2 deficiency is very difficult, most people with it can stay healthy and do most of their daily activities with the right care, education, and support. It’s essential to work closely with skilled medical professionals, understand your own triggers and limits, maintain a balanced diet, and take charge of your health.

References

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