Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.
It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.
It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.
Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.
Do individuals with muscle pain know the difference between heat stroke and heat exhaustion and can find ways to stay cool?
Introduction
As the temperature rises worldwide, many individuals are enjoying their time outside and getting more sun in their lives. However, rising temperatures also mean the rise of heat-related illnesses. The two most common heat-related illnesses are heat stroke and heat exhaustion, which can impact an individual’s musculoskeletal system and have different symptoms in terms of severity. Today’s article focuses on the differences between these two heat-related illnesses, how they affect the musculoskeletal system and treatments to stay cool while reducing muscle pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess heat-related illnesses associated with muscle pain. We also inform and guide patients while asking their associated medical provider intricate questions to integrate treatments and ways to stay cool when temperatures rise and reduce muscle pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Heat Exhaustion VS Heat Stroke
By understanding the differences between heat stroke and heat exhaustion is crucial. Do you often feel overheated after simple activities? Have you experienced muscle pain or cramps? Or do you struggle to cool down? These are all signs of heat-related illnesses. Heat-related illnesses often occur when the body cannot dissipate heat, leading to dysfunctional thermoregulation. (Gauer & Meyers, 2019) The two most common types are heat exhaustion and heat stroke. While they share similar causes, they differ significantly in terms of severity, symptoms, and treatment. (Prevention, 2022)
Heat exhaustion is a mild condition that often occurs when the human body loses excessive water and salt from profusely sweating. This causes the external temperatures to be more moderate when associated with intense physical activity. (Leiva & Church, 2024) Additionally, when a person is dealing with heat exhaustion, some of the symptoms that they will experience include:
Heavy sweating
Fatigue
Headaches
Muscle cramps
Pale, cool, moist skin
Fast, weak pulse
Even though heat exhaustion is a mild heat-related condition, it can develop into severe heat-related conditions like heat stroke if not treated immediately. Heat stroke is a severe heat-related illness that is not only life-threatening buthas two forms that can affect a person’s body temperature: classic and exertional. Classic heat stroke often affects elderly individuals who have chronic medical conditions, while exertional heat stroke affects healthy individuals who are doing strenuous physical activities. (Morris & Patel, 2024) Some of the symptoms associated with heat stroke include:
High body temperature (104°F or higher)
Hot, red, dry skin
Rapid, strong pulse
Confusion
Seizures
Loss of consciousness
How Do Both Conditions Affect The Muscles?
Both heat-related illnesses can have a significant effect on the musculoskeletal system and cause muscle pain to not only the extremities but also the entire body system. The issue affects the musculoskeletal system and can lead to painful muscle cramps, involuntary muscle contractions, and muscle pain. Since muscle pain is a multi-factorial condition, heat-related illnesses like heat stroke and exhaustion can influence a person’s lifestyle and comorbid health factors. (Caneiro et al., 2021) When that happens, many individuals can seek treatments to stay cool from heat exhaustion and heat stroke and reduce muscle pain.
Secrets Of Optimal Wellness-Video
Treatments For Staying Cool & Reduce Muscle Pain
While it is important to understand the difference between heat stroke and heat exhaustion due to the crucial timing and effective interventions, finding various treatments to reduce muscle pain and find ways to stay cool is important. Many individuals can wear technology to monitor the person’s physiological status actively and prevent injuries while providing early detection for heat-related illnesses. (Dolson et al., 2022) This can reduce the chances of muscle pain and help regulate body temperature. For individuals dealing with heat exhaustion, they can:
Move to a cooler environment
Be well-hydrated with water and electrolyte-rich drinks
Rest
Wear cool clothes to lower body temperature
For individuals dealing with heat stroke, they can:
Call emergency services immediately
Apply cool clothes or ice packs to the body
Monitor vital signs
Both treatments can ensure positive results in preventing life-threatening situations that can affect the musculoskeletal system.
Conclusion
Given the significant impact both heat stroke and heat exhaustion can have on the musculoskeletal system, it’s essential to take proactive measures. Proper hydration, cooling, and rest can help manage and alleviate muscle pain associated with these heat-related illnesses. By staying informed, maintaining hydration, and taking proactive steps to protect yourself from excessive heat, you can significantly reduce the chances of these heat-related illnesses affecting your outdoor activities.
References
Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. doi.org/10.1016/j.bjpt.2020.06.003
Dolson, C. M., Harlow, E. R., Phelan, D. M., Gabbett, T. J., Gaal, B., McMellen, C., Geletka, B. J., Calcei, J. G., Voos, J. E., & Seshadri, D. R. (2022). Wearable Sensor Technology to Predict Core Body Temperature: A Systematic Review. Sensors (Basel), 22(19). doi.org/10.3390/s22197639
Can fruit help with a sweet craving for individuals trying to limit sugar?
Fruits Low In Sugar
Fruits and their natural sugars: Whether following a low-carbohydrate diet or having diabetes and watching your A1C, many have heard that fruit is either bad or okay because of its natural sugars. Sugars in fruit are natural. How they affect blood sugar depends on various factors, like which foods they’re paired with and if diabetes is a factor. Counting carbs or noting the glycemic index or glycemic load of foods being eaten, understanding low-sugar fruits can help make choices that best fit your dietary needs. Certain fruits are considered lower in sugar because they contain fewer carbohydrates and sugar, allowing you to consume a larger portion.
One serving of fruit has about 15 grams of carbohydrates.
A serving is one small apple, half a medium-sized banana, or a cup of berries.
Fruits like berries can be eaten in more significant portions for the same amount of carbohydrates but less sugar.
Fruits
Low-sugar fruits include:
Lemons and Limes
Rhubarb
Apricots
Cranberries
Guava
Raspberries
Blackberries
Kiwi
Figs
Tangerines
Grapefruit
Natural Sugar
How much fruit an individual eats may differ if they follow a specific low-carb meal plan or are counting or modifying their carbohydrate intake because of diabetes. Adults should consume two cups of fruit or juice or a half-cup of dried fruit daily. (U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015) Most fruits have a low glycemic index/GI because of the amount of fiber they contain and because the sugar is mostly fructose. However, dried fruits like raisins, dates, sweetened cranberries, melons, and pineapples have a medium glycemic index. Sweetened dried fruits have an even higher glycemic index.
Fruits from Lowest to Highest Content
Fruits are a healthy way to satisfy a sweet craving. The fruits listed are ranked from lowest to highest sugar content, providing a quick way to assess sugar content. The fruits lowest in sugar have some of the highest nutritional values, plus antioxidants and other phytonutrients.
Limes and Lemons
Limes contain:
1.1 grams of sugar
7 grams of carbs
1.9 grams of fiber per fruit
Lemons contain:
1.5 grams of sugar
5.4 grams of carbs
1.6 grams of fiber per fruit
Rhubarb
Rhubarb contains:
1.3 grams of sugar
5.5 grams of carbs
2.2 grams of fiber per cup
Apricots
Apricots contain:
3.2 grams of sugar
3.8 grams of carbs
0.7 grams of fiber per small apricot
Apricots are available fresh in spring and early summer. They can be eaten whole, skin and all. However, watch portions of dried apricots as they shrink when dried.
Cranberries
Cranberries contain:
3.8 grams of sugar
12 grams of carbs
3.6 grams of fiber per cup when fresh.
While they’re low in sugar, be aware that they are usually sweetened when dried or used in a recipe.
Guavas
Guava contains:
4.9 grams of sugar
7.9 grams of carbs
3 grams of fiber per fruit
They can be sliced or dipped in salty sauce, including the rind.
Berries
These fruits generally have the lowest sugar content and are among the highest in fiber, antioxidants, and other nutrients. Berries, lemon, and lime can be added to flavor water.
Raspberries
Raspberries contain:
5.4 grams of sugar
14.7 grams of carbs
8 grams of fiber per cup
Eat a handful, or use them as a topping or ingredient. Fresh in summer or frozen year-round.
Blackberries
Blackberries contain:
7 grams of sugar
13.8 grams of carbs
7.6 grams of fiber per cup
Strawberries contain:
7.4 grams of sugar
11.7 grams of carbs
3 grams of fiber per cup
Berries are excellent choices for a snack, a fruit salad, or an ingredient in a smoothie, sauce, or dessert.
Blueberries
Blueberries contain:
15 grams of sugar
21 grams of carbs
3.6 grams of fiber per cup
While blueberries are higher in sugar than other berries, they’re packed with powerful antioxidants.
Kiwis
Kiwis contain:
6.2 grams of sugar
10.1 grams of carbs
2.1 grams of fiber per kiwi
Kiwis have a mild flavor, and the seeds and skin can be eaten.
Figs
Figs contain:
6.5 grams of sugar
7.7 grams of carbs
1.2 grams of fiber per small fig
These figures are for fresh figs, and it may be harder to estimate for dried figs of different varieties, which can have 5 to 12 grams of sugar per fig.
Tangerines
Tangerines contain:
8 grams of sugar
10.1 grams of carbs
1.3 grams of fiber per medium fruit
These low-sugar citrus fruits have less sugar than oranges and are great for salads. They are also portable, making them healthy additions to packed lunches and snacks.
Grapefruit
Grapefruit contains:
8.5 grams of sugar
13 grams of carbs
2 grams of fiber per half fresh grapefruit
Individuals can enjoy fresh grapefruit in a fruit salad or by itself, adjusting the amount of sugar or sweetener.
Low-Carb Diets
Individuals following a low-carb eating plan should remember that while some popular diet plans factor in the glycemic index or glycemic load of foods, others only factor in the number of carbohydrates.
20 Grams of Carbohydrates or Less
Individuals will likely not consume fruit or rarely substitute it for other food items with less than 20 grams of carbohydrates daily.
Nutrients are obtained from vegetables.
Some diets don’t even allow low-sugar fruits in the first phase.
20-50 Grams of Carbohydrates
These eating plans allow 20 to 50 grams of carbs daily, allowing room for one daily fruit serving.
50-100 Grams of Carbohydrates
If the eating plan allows 50 to 100 grams of carbs per day, individuals may be able to follow the FDA guidelines for two fruit servings a day, as long as other resources of carbohydrates are limited.
Other popular plans, like the Paleo diet and Whole30, don’t place a limit on fruit.
Although not necessarily a low-carb diet, Weight Watchers also allows fruit.
In general, individuals following a low-carb diet are recommended to try to eat fruits low in sugar.
Diabetes
Fruit choices when managing diabetes will depend on the type of diet being followed. For example, when counting carbohydrates, individuals should know that 1/2 cup of frozen or canned fruit has about 15 grams of carbohydrates.
Enjoy 3/4 to 1 cup of fresh berries, melon, or 17 grapes for the same carbs.
If using the plate method, add a small piece of whole fruit or 1/2 cup of fruit salad to the plate.
When using the glycemic index to guide food choices, remember that most fruits have a low GI and are encouraged.
Melons, pineapples, and dried fruits have medium GI index values, so watch portion size.
Individuals with diabetes may want to consult their primary doctor or a registered dietitian to help design an eating plan that incorporates fruit appropriately.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at health.gov/dietaryguidelines/2015/guidelines/
Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?
Introduction
The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Osteoarthritis Affecting Joint Mobility
Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.
Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.
Chiropractic Solutions For Osteoarthritis-Video
Cycling For Osteoarthritis
Engaging in physical activities may seem daunting when managing osteoarthritis symptoms, but it can help restore joint mobility while reducing the pain associated with osteoarthritis. One of the physical activities that has little impact and does not impact the joints is cycling. Cycling for osteoarthritis has many beneficial properties as it can:
Strengthen surrounding muscles
Retain joint mobility
Improve range of motion
Weight management
Enhancing cardiovascular health
Cycling can help the individual focus on strengthening the lower extremity muscles surrounding the joints, which can help improve pain and functionality. (Katz et al., 2021) This, in turn, helps provide better support and stability to the joints, thus reducing overload on the body while minimizing the risk of injuries. Additionally, cycling can help improve many individuals looking for a healthier change and increase bone mineral density in the joints, thus decreasing the risk of fractures. (Chavarrias et al., 2019)
Cycling Reducing Joint Pain
Cycling is a safe and effective exercise for anyone, whether they’re just starting or haven’t been active for a while. The key to optimal recovery and joint functionality is to consult a doctor. This ensures that cycling is a safe option for you, helps you choose the right bike, and provides guidance on how to start slowly, warm up and stretch, maintain proper form, and stay consistent with the cycling sessions. This professional guidance is crucial, as it allows many individuals with joint pain to achieve complete functional recovery to their joints. (Papalia et al., 2020) Cycling is an excellent way to manage osteoarthritis and its associated symptoms. For many individuals with osteoarthritis, this low-impact exercise can be a game-changer, promoting muscle strengthening, improving joint range of motion, and helping alleviate osteoarthritis symptoms.
References
Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Perez-Gomez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8). doi.org/10.3390/medicina55080452
Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325(6), 568-578. doi.org/10.1001/jama.2020.22171
Molnar, V., Matisic, V., Kodvanj, I., Bjelica, R., Jelec, Z., Hudetz, D., Rod, E., Cukelj, F., Vrdoljak, T., Vidovic, D., Staresinic, M., Sabalic, S., Dobricic, B., Petrovic, T., Anticevic, D., Boric, I., Kosir, R., Zmrzljak, U. P., & Primorac, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int J Mol Sci, 22(17). doi.org/10.3390/ijms22179208
Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. doi.org/10.3389/fimmu.2022.907750
Noriega-Gonzalez, D., Caballero-Garcia, A., Roche, E., Alvarez-Mon, M., & Cordova, A. (2023). Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med, 12(11). doi.org/10.3390/jcm12113703
Papalia, R., Campi, S., Vorini, F., Zampogna, B., Vasta, S., Papalia, G., Fossati, C., Torre, G., & Denaro, V. (2020). The Role of Physical Activity and Rehabilitation Following Hip and Knee Arthroplasty in the Elderly. J Clin Med, 9(5). doi.org/10.3390/jcm9051401
High temperatures can disrupt the body’s sleep cycles, leading to health problems. Can knowing strategies and remedies help manage sleep quality?
Hot Weather Sleep
Sleep is important for refreshing the mind and body and being productive in school, work, relationships, and overall health. With record-breaking temperatures becoming the norm, consistently sleeping healthy is becoming difficult as forecasters predict another scorching summer with above-average temperatures. 2023 was the hottest year ever recorded. (National Oceanic and Atmospheric Administration. 2024) Studies show that high temperatures make it hard to fall asleep and stay asleep, which can negatively affect the immune system, cardiovascular system, cognitive performance, and mood. (Zheng, G., Li, K., and Wang, Y. 2019) (Obradovich, N. et al., 2017) Throughout the night, the body cycles through different sleep stages. (National Heart, Lung, and Blood Institute, 2022)
Because the body’s temperature regulation is less effective during certain stages, a hot environment can cause waking so the body can thermoregulate. The right temperature is imperative for a healthy night’s sleep. For optimal sleep, it is recommended that the bedroom temperature be between 65 and 69 degrees Fahrenheit. However, this isn’t always possible without air conditioning, which increases electricity bills. Here are other strategies to help keep the body cool for better sleep in hot weather.
Cooler Sleeping Environment
Thinking creatively about sleeping arrangements can help. Try to find the place that is the coolest and has the most airflow. Shutters or curtains during the day can help keep the room dark and cooler, and opening the windows can increase airflow. (Fergus Nicol, 2019) Using a fan can help improve air circulation, and putting ice behind the fan can blow cooler air for improved sleep.
Cooling Pillows and Breathable Pajamas
Pajamas and bedding made from breathable fabrics can help keep the body cool, and cooling mattress toppers or pillows can also help. Cooling pillows have gel overlays that absorb body heat and cool the head and neck. Keep an ice pack on the bedside table and a towel and ice to keep the body cool.
Take a Slightly Warm Shower
Taking a cold shower can cool the body down quickly, but studies have shown that showering in warm water before bed can make it easier to fall asleep. (Tai, Y. et al., 2021) The warm shower signals the body into cooling mode, which can help promote sleep as the body temperature falls at night. However, the water shouldn’t be too warm, which could exacerbate sweating.
Sleep Hygiene
It can be difficult to create the perfect sleep environment in hot weather. A healthy going-to-bed routine is essential in the summer, as stress and anxiety can significantly affect sleep quality. Avoid eating close to bedtime, avoid alcohol, and add some time to relax and unwind before going to bed. Sleep experts suggest general sleep hygiene habits like keeping a consistent bedtime and turning off screens an hour before bed can help improve sleep, even in hot weather. (Baranwal, N., Yu, P. K., and Siegel, N. S. 2023)
Chiropractic Treatment
Chiropractic care, massage, and decompression therapy can help improve sleep. Treatment retrains the body to relax; stretching and pulling the muscles increases blood circulation and advanced and improved brain signals telling the body to relax. A chiropractor will evaluate the individual’s sleeping patterns and recommend various strategies. Benefits include:
Muscle tension relief.
Stimulates nerve and blood circulation.
Relaxes the whole body.
Enhances central nervous system function.
Relieves pain and discomfort.
A chiropractor will also provide:
Sleeping position recommendations.
Postural stretches and exercises.
Recommendations on supportive mattresses.
Ergonomics for work, home, and bed.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Beyond Adjustments: Chiropractic and Integrative Healthcare
Zheng, G., Li, K., & Wang, Y. (2019). The Effects of High-Temperature Weather on Human Sleep Quality and Appetite. International journal of environmental research and public health, 16(2), 270. doi.org/10.3390/ijerph16020270
Obradovich, N., Migliorini, R., Mednick, S. C., & Fowler, J. H. (2017). Nighttime temperature and human sleep loss in a changing climate. Science advances, 3(5), e1601555. doi.org/10.1126/sciadv.1601555
Tai, Y., Obayashi, K., Yamagami, Y., Yoshimoto, K., Kurumatani, N., Nishio, K., & Saeki, K. (2021). Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(6), 1257–1266. doi.org/10.5664/jcsm.9180
Baranwal, N., Yu, P. K., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in cardiovascular diseases, 77, 59–69. doi.org/10.1016/j.pcad.2023.02.005
Emotional challenges like anxiety and depression or digestive disorders can cause individuals to experience a nervous stomach. Can knowing common symptoms, what causes them, and when to see a healthcare provider help manage the disorder?
Nervous Stomach
A nervous stomach is usually nothing to worry about, but it can happen occasionally as a reaction to a new environment, groups of people, foods, stress, and anxiety. Symptoms include indigestion, fluttering stomach/butterflies, or a gut-wrenching feeling. (Anxiety and Depression Association of America. 2023) Causes include underlying psychological and physical health conditions, certain medications, and lifestyle factors. Individuals experiencing chronic or ongoing symptoms should speak with a healthcare provider about their full range of symptoms. Treatments include medication, therapy, and lifestyle changes.
Symptoms
Nervous stomach symptoms can vary. Stress and anxiety can lead to physical symptoms, and physical symptoms may also lead to stress and anxiety. This is because the brain and gut connection communicates which hormones and neurotransmitters will be released and when. Common symptoms include: (Anxiety and Depression Association of America. 2023)
Loss of appetite
Butterflies or fluttering feeling in the stomach
Upset stomach
Indigestion
Bloating
Flatulence
Gut-wrenching feeling
Cramping
Nausea, dry heaving
Increased need to urinate or have bowel movements
Constipation
Diarrhea
Out-of-sync hunger cues
Causes
In most cases, a nervous stomach will come and go. However, it can also be caused by disorders such as anxiety disorder, depression, or gastrointestinal and digestive disorders. Brain health contributes to gut health, and vice versa. The brain is always communicating with the digestive system, and the digestive system is always sending information back to the brain. (Foster, J. A., and McVey Neufeld, K. A. 2013) (University of Chicago Medical Center, 2024) Common causes of a nervous stomach include: (Anxiety and Depression Association of America. 2023)
Over-the-counter and prescription medications can cause a nervous stomach as a side effect. This can happen when taking a single medication or more than one simultaneously. It can also occur in those with food sensitivities or other medical conditions. (Johns Hopkins Medicine, 2024) This is why consulting and updating a healthcare provider on the current list of prescribed and over-the-counter medications is important. Some meds can irritate the stomach, while others can cause constipation or diarrhea, leading to discomfort and nervous stomach symptoms. Common medications that may cause stomach side effect symptoms include: (Johns Hopkins Medicine, 2024)
NSAIDs – non-steroidal anti-inflammatory drugs such as ibuprofen can weaken the stomach lining.
Iron, antacids, and pain meds can cause constipation.
Antibiotics can cause diarrhea.
Home Treatment
Treatment depends on the severity and cause/s. An infrequently nervous stomach may benefit from over-the-counter therapies to calm it and/or lifestyle changes to reduce stress. Tips for reducing stress and anxiety include (Anxiety and Depression Association of America. 2023)
More frequent short breaks during the day
Practicing slow and deep breathing
Listening to guided meditations for stress-relief
Adding exercise to the daily routine
Realizing that stomach problems are part of anxiety and worrying about symptoms may make them worse.
Medical Treatment
Individuals may benefit from additional support treatment options with a healthcare provider (Johns Hopkins Medicine, 2024)
Antidepressant treatment for nervous stomach and/or irritable bowel syndrome.
Cognitive behavioral therapy for stress relief and learning how to manage anxiety.
Medical hypnotherapy
If symptoms are a side effect of medication or certain foods, a healthcare provider can develop an effective treatment plan that includes using another medication that is easier on the stomach or seeing a dietician.
Complications
Left untreated, a nervous stomach can contribute to further symptoms and other health problems. One study looked at the relationship between irritable bowel syndrome and certain psychiatric disorders. (Fadgyas-Stanculete, M. et al., 2014) This does not mean that a psychiatric disorder causes a nervous stomach or that a nervous stomach causes a psychiatric disorder. It is more likely that a combination of chemicals released when stressed can hurt gut health. This creates imbalances known to be risk factors for digestive disorders and conditions. (Anxiety and Depression Association of America. 2023)
Seeing a Healthcare Provider
Most nervous stomach symptoms resolve on their own. However, certain signs and symptoms can indicate that it is time to see a healthcare provider. Discuss symptoms with a healthcare provider who will order lab tests to check for underlying causes like anemia. See a healthcare provider immediately if you notice the following (University of Chicago Medical Center, 2024)
Symptoms are making work and/or normal life challenging.
Chronic or unresolved gastrointestinal issues like heartburn.
Unexplained weight reduction – losing weight without exercising or diet changes.
Blood in stool or blackish, tarry stools.
Vomiting
If there is a medical history of digestive disorders or cancers such as stomach cancer or colon cancer, this will help a healthcare provider. Depending on overall symptoms and family medical history, individuals may be referred to a gastroenterologist and/or a mental healthcare provider, like a counselor or psychiatrist. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. We work with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal health. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Foster, J. A., & McVey Neufeld, K. A. (2013). Gut-brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences, 36(5), 305–312. doi.org/10.1016/j.tins.2013.01.005
Fadgyas-Stanculete, M., Buga, A. M., Popa-Wagner, A., & Dumitrascu, D. L. (2014). The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. Journal of molecular psychiatry, 2(1), 4. doi.org/10.1186/2049-9256-2-4
Ness-Jensen, E., & Lagergren, J. (2017). Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best practice & research. Clinical gastroenterology, 31(5), 501–508. doi.org/10.1016/j.bpg.2017.09.004
Can knowing the difference between butter and margarine help Individuals looking to improve cholesterol levels?
Butter and Margarine
Individuals watching their cholesterol levels and switching from butter to margarine may have heard that it may be worse for heart health. What research has to say about the healthiest spread and the butter and margarine debate?
History
Butter was shown to be associated with an increased risk of heart disease because of its saturated fat content when margarine was developed as a substitute. Margarine is made from plant-based oils like canola, palm fruit, and soybeans. Nutritionists and researchers saw it as a healthier alternative. It is lower in saturated fat and has no cholesterol but contains high levels of trans fats, which raise unhealthy LDL cholesterol levels and lower healthy HDL cholesterol levels. (Ginter, E., and Simko, V. 2016)
Margarine Trans Fat and Butter Saturated Fat
Most of margarine’s unsaturated fats undergo hydrogenation, creating harmful trans fats. Trans fat raises unhealthy LDL cholesterol levels more than saturated fat. The trans-fatty acids solidify and maintain margarine consistency at room temperature. Stick margarines, the hardest type, contain the most trans fats and are still sold despite what is known about the damage they can do. (Brouwer, I. A. et al., 2010) Clinical studies showed these trans fats are associated with a 28% increased risk of death from heart disease and a 34% increased risk of death. (de Souza, R. J. et al., 2015)
Margarine Types
Some softer and liquid margarine products contain less trans fat than stick versions. They are low in saturated fat and high in unsaturated fat. Individuals can determine how much trans fat the margarine has by its softness. Those that are more solid at room temperature contain more trans fats than those in a tub, which are softer. However, some soft options can contain trans fats. If the label has partially hydrogenated oil, it’s recommended to avoid it. (Garsetti, M. et al., 2016) Some newer margarines are enriched with plant sterols, which block cholesterol absorption and help lower LDL levels. These are healthy choices if trying to lower LDL. (Ras, R. T. et al., 2014)
Butter
Butter is primarily made up of saturated fat and cholesterol and comes in a stick and spread. One tablespoon of butter contains around 30 milligrams of cholesterol and 7 grams of saturated fat. The maximum amount allowed daily is 200 milligrams and 10 milligrams, respectively. Both types of fat are linked to rising cholesterol levels and the risk of heart disease. Butter from grass-fed cows is higher in omega-3 fatty acids, essential for heart health, making it far more nutritional than the more widely used butter from conventionally-fed cows. (Hebeisen, D. F. et al., 1993)
Other Options
Butter or margarine are not the healthiest options. Olive, avocado, and other vegetable-based spreads are the most heart-healthy options. (Yubero-Serrano, E. M. et al., 2019) Use avocado oil as a cooking oil when sautéing or roasting vegetables. Consider substituting applesauce, nut butters, or squash purees in baked goods. Look for soft versions of margarine as a bread spread that contain plant sterols and no hydrogenated oils.
Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to create personalized care plans for each patient to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Enhancing Health Together: Multidisciplinary Evaluation and Treatment
References
Ginter, E., & Simko, V. (2016). New data on harmful effects of trans-fatty acids. Bratislavske lekarske listy, 117(5), 251–253. doi.org/10.4149/bll_2016_048
Brouwer, I. A., Wanders, A. J., & Katan, M. B. (2010). Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans–a quantitative review. PloS one, 5(3), e9434. doi.org/10.1371/journal.pone.0009434
de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., & Anand, S. S. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed.), 351, h3978. doi.org/10.1136/bmj.h3978
Garsetti, M., Balentine, D. A., Zock, P. L., Blom, W. A., & Wanders, A. J. (2016). Fat composition of vegetable oil spreads and margarines in the USA in 2013: a national marketplace analysis. International journal of food sciences and nutrition, 67(4), 372–382. doi.org/10.3109/09637486.2016.1161012
Ras, R. T., Geleijnse, J. M., & Trautwein, E. A. (2014). LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. The British journal of nutrition, 112(2), 214–219. doi.org/10.1017/S0007114514000750
Hebeisen, D. F., Hoeflin, F., Reusch, H. P., Junker, E., & Lauterburg, B. H. (1993). Increased concentrations of omega-3 fatty acids in milk and platelet rich plasma of grass-fed cows. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 63(3), 229–233.
Yubero-Serrano, E. M., Lopez-Moreno, J., Gomez-Delgado, F., & Lopez-Miranda, J. (2019). Extra virgin olive oil: More than a healthy fat. European journal of clinical nutrition, 72(Suppl 1), 8–17. doi.org/10.1038/s41430-018-0304-x
How can healthcare professionals recognize and establish protocols for individuals who are being trafficked and provide a safe place?
Introduction
Today, we will look at part two of this series, which is about recognizing trafficking in a clinical setting. Today’s article in this two-part series of recognizing trafficking helps inform many healthcare professionals to understand the roles and protocols for identifying trafficking that is affecting their patients and help provide a safe, positive space for them. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic while taking the proper protocols to ensure patient safety. We also inform and guide patients while asking their associated medical provider intricate questions to integrate and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Health Care Professional’s Role in Identifying Trafficking
Even though they may come across victims of human trafficking and have the chance to step in, many healthcare professionals believe they lack the knowledge and self-assurance needed to recognize these victims and offer them the kind of aid they need. As an illustration:
Just 37% of social workers and medical professionals surveyed again had any training in recognizing and supporting victims of human trafficking (Beck et al., 2015).
It is extremely hard for processors to identify and aid victims because traffickers move their victims around a lot and employ various strategies to evade discovery. Frequently, it could be your final interaction with the victim (Macy & Graham, 2012).
There can be a companion who comes across as very domineering, who won’t let the patient spend time alone with you, or who insists on filling out paperwork or talking on the patient’s behalf.
It’s possible that neither the victim nor their friend will have identification or insurance paperwork and will just pay in cash.
The victim or their companion may refuse to answer questions.
The victim may decline additional testing and follow-up care.
The victim may have physical injuries, sexually transmitted diseases, and signs of psychosocial stress.
The victim may not know the city and state that they are in.
The victim may appear fearful when asked questions or in the presence of their companion.
The victim may exhibit feelings of shame, guilt, helplessness, or humiliation.
You may notice inconsistencies in basic information, such as age, name, address, work history, or information regarding living status and daily activities.
If the patient does not speak English, where are they from, and how did they arrive?
If the patient is a minor, who and where is the guardian?
The victim may have unusual tattoos to indicate that they are the “property” of their trafficker.
Recognizing the Signs of Trafficking
You can more easily spot possible victims and offer the right help if you are aware of the typical warning indicators of human trafficking. The following are typical signs that someone is being trafficked. Naturally, not all victims or forms of trafficking will exhibit all of the indicators. Work and Living Conditions (National Human Trafficking Hotline, n.d.):
The victim may not be able to come and go on their own or leave their current home or work situation.
Human trafficking victims are often minors who are forced to engage in commercial sex acts.
The individual may work in the commercial sex industry and be under the control of a pimp or manager.
The victim may be required to work unusual or excessively long hours.
The victim may receive little, if any, pay or may only receive tips.
The victim may be subjected to unusual or extreme restrictions at work or may not be allowed to take breaks.
The victim may owe a large debt to their “employer.”
The victim may have been lured to their current work or living situation through false promises about the nature of their work or living environment.
The victim’s home or work location may have unusually high security, such as opaque or boarded-up windows, bars on windows, high fences, and security cameras.
The victim may be required to live at their work location.
The victim may experience various signs of abuse at the hands of their employer.
The victim may not be paid directly. Instead, the money is directed to the supervisor or manager, who deducts a large percentage for living expenses and other debts.
The victim may be forced to meet unreasonable daily quotas.
The victim may be forced to work in unsafe work environments without the proper safety equipment.
Chiropractic Care for Healing After Trauma-Video
Best Practice Guidelines for Interviewing Trafficking Individuals
As a healthcare provider, you must continuously weigh the different courses of action at every interview process step. To establish trust and ensure safety, practitioners must, above all, put aside preconceived notions and assumptions about the victims and their behavior (Hodge, 2014; DeBoise, 2014; Hemmings, Jakobowitz, & Abas, 2016). Zimmerman and Watts (2003) suggest that the World Health Organization has produced rules for every phase of the interview process, which include the following recommendations:
It’s critical to keep in mind that every trafficking scenario and survivor is distinct, making it crucial to pay attention to and accept each person’s account.
It could take some time for victims to open up and be willing to talk about their experiences because it can be hard for them to build rapport and trust.
You should take precautions to protect both you and the victim because you should anticipate that the victim is at risk of psychological, bodily, social, and legal harm.
To prevent further upsetting the victim, you should consider the risks and advantages before beginning the interview process, as it can be a traumatic experience in itself.
While you should direct victims to available resources when necessary, you should avoid making unfulfilled promises or pledges.
The amount of time it takes for victims of human trafficking to be prepared to embrace change might vary greatly. Some victims can be eager to look for new possibilities and to improve their circumstances. Some people can be less likely to accept assistance because they haven’t developed enough trust issues or because they fear retaliation from their trafficker.
Depending on the situation, many service providers or interpreters must be present during the interview. Everyone taking part in the interview process ought to be reasonably knowledgeable about human trafficking, including how traffickers manipulate their victims and how to interact with them in a way that respects their cultural differences. To maintain anonymity and ensure the victim can communicate freely and honestly, you should refrain from using interpreters who are acquainted with the victim or who live in the same neighborhood.
Having an emergency safety plan in place is crucial to shielding the victim from harm—both from others and self-harm.
Consent must always be obtained voluntarily for all interventions, including interviews. For many victims who have never known autonomy or self-determination, this may be a foreign idea.
Avoid using legal or technical jargon.
Furthermore, it’s critical to remember that trauma survivors may suffer after treatment can have a lasting effect on all facets of their lives, making psychological, emotional, and physical safety a top priority. It is reasonable to presume that the person provides the most accurate account of their experience at that time. A person’s guarded, defensive, and belligerent behavior may be only their coping mechanism for their trauma. (V. Greenbaum, 2017)
How to Report Known or Suspected Trafficking
The best way to report suspected trafficking is by calling the National Human Trafficking Hotline or texting the number 711 if the patient responds affirmatively to the evaluation questions if your findings imply that they might be victims of human trafficking. Additionally, you can text 233733. Basic details about the case will be requested from you, such as (National Human Trafficking Hotline, n.d.):
the location of the suspected trafficking
the name of the alleged trafficker, if possible
your city and state
how you learned about the hotline
Health care providers who know or believe that a youngster is being abused, neglected, or abandoned should report their concerns to law enforcement or the relevant child welfare agency right away, as they are required reporters under child abuse and neglect statutes. You can report abuse online or by calling the Department of Children and Families Abuse Hotline in the state you are residing in.
Documenting Physical Findings
Physical findings should be meticulously and precisely recorded using written descriptions, freehand sketches that have been identified and annotated, and digital or film photos with the patient’s consent. Regarding photography, the picture should show the patient’s face and the lesion or injury measured using a coin, ruler, or other common object. The photo should include a piece of paper bearing the date the picture was taken. More photos can capture up close shots of every pertinent lesion or injury. Serial follow-up photos over seven to ten days can be used to record the healing or advancement of ecchymoses and other injury-related symptoms. A statement identifying the photographer and attesting to the accuracy and integrity of the images ought to be incorporated into the chart. Before any photos are taken, consent for the photographic documentation should be sought and recorded. Patients should be aware of their rights, which include the ability to decline all photographic documentation or limit it to a limited number of specified locations.
In addition to providing essential medical care, the healthcare professional should work to establish an environment where each patient feels respected, comfortable, cared for, validated, and empowered to reveal if they so choose. If the patient does not feel “ready” to demonstrate in the clinical environment, disclosure may happen later. As a result, for at-risk patients, every single clinical interaction should be seen as a step toward their eventual safety.
Laws & Policies for Human Trafficking
The United States has enacted a variety of laws and policies designed to prevent human trafficking, punish the perpetrators, and protect the survivors. One of these laws and policies is the Trafficking Victims Protection Act law or the TVPA (U.S. Congress).
This is the centerpiece of federal human trafficking legislation. The act focuses on three primary areas:
The TVPA seeks to prevent human trafficking through increased training and awareness.
The act seeks to protect trafficking victims by providing them access to services using federal funds similar to other refugees.
The act establishes trafficking and related crimes as federal offenses subject to stiff penalties.
One way that the legislation protects victims of human trafficking is that it absolves them of consequences for engaging in criminal activities that arise from their trafficking experience, such as entering the nation using fraudulent documents or working without the proper authorization. In addition, families of trafficking victims are qualified for T visas, which let them stay in the nation to support federal law enforcement in their pursuit of the offenders. After three years, victims can then apply to become permanent residents. Depending on the specific circumstances, many individuals may be entitled to assistance and benefits, such as access to the Witness Security Program and reparations. In addition, individuals between 16 and 24 could qualify for the Job Corp program and work permits.
Others criticize the TVPA. Usually, the onus is on the victim to prove their innocence or compulsion first. Second, the act emphasizes sex trafficking more than other types of human trafficking, which ignores how intricate human trafficking is. Only victims and survivors of “severe” types of trafficking who are prepared to cooperate with the investigation and prosecution of their offenders are eligible for the services provided under the act. This ignores the severity of the abuse the victims endured and the degree of mistrust and terror they might harbor toward both the abuser and others in positions of power.
Preventing Trafficking Through Awareness, Interventions, & Resources
In the shadows, human trafficking flourishes. We eradicate the shadows where human traffickers lurk by increasing public and health practitioner awareness of the problem (Hodge, 2008; Gozdziak & MacDonnell, 2007). For instance, putting up signs and pamphlets on human trafficking can not only help to enhance public awareness but also boost the chance that victims may come forward on their own. Brochures and posters are free from the Campaign to Rescue and Restore Victims of Trafficking.
When assisting victims of human trafficking, practitioners and service providers need to be able to engage with a variety of governmental, legal, medical, and social service organizations and institutions. Generally speaking, there are three main categories into which the care and services that a victim falls (Dell et al., 2019; Johnson, 2012; Oram & Domoney, 2018):
Immediate Services
Services Related to Recovery
Services About Reintegration
Resources for Providers
The National Human Trafficking Resource Center’s referral database can be consulted by providers looking to connect with local programs that assist victims of human trafficking or who need assistance for a victim or survivor. Many healthcare providers can check out the website to provide helpful resources in their local area.
Conclusion
Any human trafficking violates fundamental rights. Since human trafficking has many underlying roots, eradicating the issue would need different approaches on various fronts. When it comes to addressing racism, poverty, oppression, prejudice, and other factors that lead to human trafficking, healthcare professionals need to be dedicated to facing this issue both within their patient population and in partnership with colleagues from different disciplines. Physicians, social workers, counselors, and other health care professionals are required by their code of ethics to lead in addressing power abuses and advancing social justice. Practitioners can accomplish this, among other things, by teaching others and themselves about the intricate dynamics and international scope of human trafficking.
References
Beck, M. E., Lineer, M. M., Melzer-Lange, M., Simpson, P., Nugent, M., & Rabbitt, A. (2015). Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics, 135(4), e895-902. doi.org/10.1542/peds.2014-2814
DeBoise, C. (2014). Human Trafficking and Sex Work: Foundational Social-Work Principles. Meridians: Feminism, Race, Transnationalism, 12(1), 227–233. muse.jhu.edu/article/541879/pdf
Dell, N. A., Maynard, B. R., Born, K. R., Wagner, E., Atkins, B., & House, W. (2019). Helping Survivors of Human Trafficking: A Systematic Review of Exit and Postexit Interventions. Trauma Violence Abuse, 20(2), 183-196. doi.org/10.1177/1524838017692553
Gozdziak, E., & MacDonnell, M. (2013, March 4). Closing the Gaps: the Need to Improve Identification and Services to Child Victims of Trafficking by School of Foreign Service – Georgetown University – Issuu. Issuu.com. issuu.com/georgetownsfs/docs/gozdziak-closing-the-gaps
Greenbaum, V. J. (2017). Child sex trafficking in the United States: Challenges for the healthcare provider. PLoS Med, 14(11), e1002439. doi.org/10.1371/journal.pmed.1002439
Hemmings, S., Jakobowitz, S., Abas, M., Bick, D., Howard, L. M., Stanley, N., Zimmerman, C., & Oram, S. (2016). Responding to the health needs of survivors of human trafficking: a systematic review. BMC Health Serv Res, 16, 320. doi.org/10.1186/s12913-016-1538-8
Hodge, D. R. (2008). Sexual trafficking in the United States: a domestic problem with transnational dimensions. Soc Work, 53(2), 143-152. doi.org/10.1093/sw/53.2.143
Macy, R. J., & Graham, L. M. (2012). Identifying domestic and international sex-trafficking victims during human service provision. Trauma Violence Abuse, 13(2), 59-76. doi.org/10.1177/1524838012440340
Oram, S. (2021). Responding to the mental health needs of trafficked women. European Psychiatry, 64(S1), S12-S12. doi.org/10.1192/j.eurpsy.2021.55
Zimmerman, C., & Watts, C. (2003). Ethical and safety recommendations for intervention research on violence against women. Www.who.int. www.who.int/publications/i/item/9789241510189
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