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.
For individuals with chronic pain conditions, what are the risks of developing peptic ulcers?
NSAIDs and Peptic Ulcers
A peptic ulcer is a sore in the lining of the stomach or duodenum, the first area of the small intestine. The most common symptom is a burning stomach pain that may come and go for several days or weeks. Other symptoms include:
Feeling full
Feeling bloated
Belching
Heartburn
Nausea
Stress and spicy foods can worsen ulcers but do not cause them.
A peptic ulcer is a sore that occurs in the mucosal lining of the stomach, small intestine, or esophagus. It is caused by stomach acids or other digestive juices damaging the stomach or duodenum lining. When the ulcer is in the stomach, it might also be called a gastric ulcer. The acid can create a painful open sore that may bleed. The most common cause of a peptic ulcer is a type of bacteria called Helicobacter pylori (H. pylori). A second, less common cause of peptic ulcers is the use of non-steroidal anti-inflammatory medications or NSAIDs like aspirin, ibuprofen, and naproxen. (Fashner J. & Gitu A. C. 2015) Using over-the-counter NSAIDs for the occasional headache or achy back won’t cause a peptic ulcer. Rather, peptic ulcer disease is something that can occur with longer-term use, especially at high doses, such as for chronic pain associated with arthritis or other inflammatory conditions. (National Institute of Diabetes and Digestive and Kidney Diseases, 2022)
NSAIDs and Ulcer Development
NSAIDs can cause ulcers because they can interfere with the stomach’s ability to protect itself from gastric acids as they slow the production of protective mucus in the stomach and change its structure. (National Institute of Diabetes and Digestive and Kidney Diseases, 2022) While these acids are vital to the digestive process, they can compromise the stomach’s protective barriers. The stomach has three protections against gastric acid:
Foveolar cells that line the stomach produce a protective mucus.
Bicarbonate is produced by the foveolar cells, which help neutralize stomach acid.
Blood circulation aids in repairing and renewing cells in the stomach’s mucosal layer.
Specific lipids called prostaglandins, which the body makes, affect pain receptors. NSAIDs work to reduce pain by blocking enzymes involved in the production of certain prostaglandins. Prostaglandins also protect the stomach’s mucosal layer, which can be broken when depleted. Suppressing the body’s natural defenses against gastric acids can lead to inflammation in the stomach lining. Over time, this can cause a capillary blood vessel to rupture, causing bleeding and the development of an open, ulcerative sore. (Bjarnason I. et al., 2018)
Symptoms
A peptic ulcer may cause symptoms in the digestive tract, but some individuals may have no symptoms. The most common symptom is upper abdominal pain, which can feel dull or burning. The pain can range in severity, with some experiencing mild discomfort and others having severe pain. Most of the time, the pain will occur after a meal, but it might also happen at night for some. It could go on from a few minutes to a few hours. (National Institute of Diabetes and Digestive and Kidney Diseases, 2022) Other symptoms are less common but can include:
Bloating
Burping
Gas
Nausea
Vomiting
Loss of appetite
Weight loss
Feeling sick in the stomach.
Feeling full after even a small meal.
In rare cases, individuals with peptic ulcers may see blood in their stool or have black stools because blood is present. Blood coming from one or more peptic ulcers could also be visible in vomit. Call a healthcare provider right away if there is blood in stool or vomit, as this can be a sign of excessive bleeding or other serious problems. (National Institute of Diabetes and Digestive and Kidney Diseases, 2022)
Diagnosis
When peptic ulcer symptoms occur, a healthcare provider may order several tests to determine the cause. For individuals who are receiving NSAIDs for chronic pain, a healthcare provider may already have a high suspicion that the medication is the cause or is contributing to peptic ulcer disease. Because infection with H. pylori is the most common cause, it is normally ruled out through a breath, blood, or stool test. (National Institute of Diabetes and Digestive and Kidney Diseases, 2022) Tests to look for ulcers inside the upper digestive tract can include:
Upper GI Series
Patients drink a barium substance to help the internal organs appear on imaging.
A series of X-rays are taken.
Upper Endoscopy
A flexible tube with a camera is used to look inside the esophagus, the stomach, and the duodenum.
All NSAIDs have the potential to cause indigestion, gastric bleeding, and ulcers. However, some individuals are more susceptible to developing peptic ulcer disease than others. Peptic ulcers caused by NSAIDs are more likely to occur in individuals who: (National Institute of Diabetes and Digestive and Kidney Diseases, 2022)
Are 70 or older
Have a history of ulcers
Take corticosteroids
Take high-dose NSAIDs
Take NSAIDs regularly for a long time
Take more than two types of NSAIDs
Use aspirin daily, including low-dose aspirin, for cardioprotective purposes.
Take blood thinners
Drink alcohol regularly
Smoke
Studies suggest that 25% of those who use NSAIDs long-term will develop an ulcer, but only a small percentage will go on to develop serious complications. (Lanza F. L. et al., 2009)
Treatment
NSAID-induced ulcers usually heal once the NSAID is stopped. Certain treatments may be recommended to expedite the healing process depending on the severity of the peptic ulcer. In severe cases, surgery may be recommended to repair the damage.
Medications
A healthcare provider may recommend taking one or more medications. Over-the-counter options may include:
Antacids help neutralize stomach acid.
A proton pump inhibitor or PPI, such as omeprazole, lowers acid levels in the stomach. (Begg M. et al., 2023)
The bigger problem for individuals is how to manage pain when the medications are discontinued. For individuals with chronic pain, this may require the help of a physical therapy team, including a pain management healthcare provider. Certain medications called COX inhibitors could be used to control pain for some. COX inhibitors have been shown to work for pain relief and are associated with fewer digestive side effects than other types of NSAIDs. These meds have also been shown to have cardiovascular side effects, however, so it’s usually recommended they be used at the lowest dosage. (Scarpignato C. et al., 2015)
Lifestyle Adjustments
Lifestyle adjustments may be recommended to heal peptic ulcers, including:
Avoiding foods that worsen symptoms.
Avoiding caffeine
Avoiding alcohol
Quitting smoking
Surgery
In some cases, surgery may be recommended, but this is more often the case when there are complications as a result of the ulcer, such as:
Avoiding long-term and high-dose use of NSAIDs or not using these medications can help protect and prevent peptic ulcers. For individuals who have to take an NSAID due to a condition they are trying to manage, a healthcare provider may prescribe one of the meds used to treat peptic ulcers to prevent them from occurring. Some believe that spicy food and stress cause ulcers, but that has been discredited. (Cleveland Clinic, 2022) Most individuals who take NSAIDs will not experience peptic ulcer disease. (Drini M. 2017) However, those who have chronic pain and who are receiving high doses should be aware of the potential.
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals who have any concerns about the use of NSAIDs and how the digestive system will be affected should ask a healthcare provider if there are ways to prevent ulcers and if those measures should be implemented while receiving high doses of NSAIDs. Left untreated, ulcers can lead to complications, which is why it is important to get a diagnosis and receive treatment. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign naturally.
Root Causes of Gut Dysfunction
References
Fashner, J., & Gitu, A. C. (2015). Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection. American family physician, 91(4), 236–242.
Bjarnason, I., Scarpignato, C., Holmgren, E., Olszewski, M., Rainsford, K. D., & Lanas, A. (2018). Mechanisms of Damage to the Gastrointestinal Tract From Nonsteroidal Anti-Inflammatory Drugs. Gastroenterology, 154(3), 500–514. doi.org/10.1053/j.gastro.2017.10.049
Lanza, F. L., Chan, F. K., Quigley, E. M., & Practice Parameters Committee of the American College of Gastroenterology (2009). Guidelines for prevention of NSAID-related ulcer complications. The American journal of gastroenterology, 104(3), 728–738. doi.org/10.1038/ajg.2009.115
Begg, M., Tarhuni, M., N Fotso, M., Gonzalez, N. A., Sanivarapu, R. R., Osman, U., Latha Kumar, A., Sadagopan, A., Mahmoud, A., & Khan, S. (2023). Comparing the Safety and Efficacy of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in the Management of Patients With Peptic Ulcer Disease: A Systematic Review. Cureus, 15(8), e44341. doi.org/10.7759/cureus.44341
Scarpignato, C., Lanas, A., Blandizzi, C., Lems, W. F., Hermann, M., Hunt, R. H., & International NSAID Consensus Group (2015). Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis–an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC medicine, 13, 55. doi.org/10.1186/s12916-015-0285-8
Lee, C. W., & Sarosi, G. A., Jr (2011). Emergency ulcer surgery. The Surgical clinics of North America, 91(5), 1001–1013. doi.org/10.1016/j.suc.2011.06.008
Drini M. (2017). Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Australian prescriber, 40(3), 91–93. doi.org/10.18773/austprescr.2017.037
For pregnant individuals, dehydration during pregnancy increases the risk of health problems for the individual and the fetus. Is it possible to prevent dehydration by drinking more water and managing morning sickness?
Pregnancy Dehydration
Maintaining proper hydration is an important part of a healthy pregnancy. Dehydration during pregnancy can occur for several reasons. A pregnant body needs more water to support the increased physical demands. Pregnant individuals need more water than non-pregnant ones and risk losing more water throughout the day. (American College of Obstetricians and Gynecologists, 2023) Pregnant individuals need eight to 12 glasses of water daily to prevent dehydration. Risks of dehydration during pregnancy include:
Low amniotic fluid levels and preterm contractions.
Early symptoms can include decreased urination, increased thirst, and dry mouth.
Serious symptoms can include dizziness, confusion, fainting, and low blood pressure.
In severe cases, intravenous/IV intervention may be required to replenish fluids.
The body’s physiological changes during pregnancy cause it to require more water. Pregnant individuals need more water and lose more water throughout the day. Dehydration happens when the body loses more water than it takes in. Factors that contribute to dehydration during pregnancy include: (Song, Y. et al., 2023)
Increased Blood Volume
A pregnant body requires increased blood circulation.
Blood volume increases as much as 30% to 45%.
The body needs more water to keep up with the increased volume.
Changes In The Urinary System
The kidneys often increase slightly in size during pregnancy.
This causes changes in the urinary system, causing the body to lose more water.
Changes In The Respiratory System
The increased demands on the body cause increased breathing.
Each time the body exhales, it loses water through the breath.
Increased Metabolism
Pregnancy causes the adrenal and thyroid functions to become slightly hyperactive.
This leads to increased metabolism and sweating.
When the body loses water through sweat, dehydration risks increase.
Increased Nutrition
A pregnant individual requires 300 extra daily calories, which increases to 450 additional daily calories in late pregnancy.
Eating more means the individual needs added hydration to support digestion and prevent constipation.
Morning Sickness
Nausea and vomiting are common.
Morning sickness causes fluid loss, increasing the risk of dehydration.
If the body does not acquire enough water when mildly dehydrated further symptoms can present and include fatigue, dizziness, feeling overheated, and having Braxton Hicks contractions or tightening and release of the uterus that are not from labor contractions. (Mulyani E. Y. et al., 2021)
Emergency Symptoms
Severe dehydration can lead to serious pregnancy complications and require immediate medical care. Emergency signs and symptoms include: (National Library of Medicine, 2023)
Irritability
Confusion
Sunken eyes
Fainting
Low or no urine
Low blood pressure
Rapid heart and breathing rate
Shock
Risks
Staying hydrated is essential, and hydration status affects health and pregnancy outcomes. When pregnant, the body needs extra water to produce enough amniotic fluid, which fills the amniotic sac with the fetus. When amniotic levels are low, the fetus has little room to grow and move. This can lead to delayed growth and development and potential umbilical cord issues. If the umbilical cord becomes compressed, the baby cannot receive oxygen and nutrients, which can quickly lead to an emergency. (Song, Y. et al., 2023) Chronic, untreated dehydration during pregnancy increases the risk of complications and can include (Aziz M. M. et al., 2018) (Song Y. et al., 2023)
Preterm contractions
Decreased birth weight and length
Reduced head circumference and chest circumference
Neural tube defects – malformations in early development of the brain and spine.
Low milk production
Rehydrating and Adding Electrolytes
Individuals must drink eight to 12 glasses of water daily to prevent dehydration (American College of Obstetricians and Gynecologists, 2020). Rehydration with water and electrolytes, essential minerals the body needs for normal function, may also be recommended. Ask a healthcare provider if they recommend consuming electrolytes through sports drinks, Pedialyte, coconut water, or electrolyte powders.
Drink between meals if drinking water is difficult because of nausea or feeling full.
Always have a water bottle, and drink what is possible when nausea is not manifesting.
Other recommended sources can include milk, natural fruit juices, and broth.
To reduce water loss, avoid high-caffeine or sugar drinks.
Take frequent breaks and drink more water when in the heat.
Minor Dehydration Treatment
Most pregnant individuals can safely treat mild dehydration at home. Call a healthcare provider if there are any concerns about symptoms. To treat minor dehydration, rest in a cool area and replenish fluids. Drink water, a sports drink, or a rehydration solution like Pedialyte. If symptoms do not improve, contact a healthcare provider. (Song Y. et al., 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
Fortunately, treating and preventing dehydration is possible by drinking plenty of water throughout the day, avoiding drinks with caffeine or sugar, and taking frequent breaks. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate a treatment plan to improve the body’s flexibility and mobility and resolve musculoskeletal issues.
Mulyani, E. Y., Hardinsyah, Briawan, D., Santoso, B. I., & Jus’at, I. (2021). Effect of dehydration during pregnancy on birth weight and length in West Jakarta. Journal of nutritional science, 10, e70. doi.org/10.1017/jns.2021.59
Song, Y., Zhang, F., Lin, G., Wang, X., He, L., Li, Y., Zhai, Y., Zhang, N., & Ma, G. (2023). A Study of the Fluid Intake, Hydration Status, and Health Effects among Pregnant Women in Their Second Trimester in China: A Cross-Sectional Study. Nutrients, 15(7), 1739. doi.org/10.3390/nu15071739
Aziz, M. M., Kulkarni, A., Tunde-Agbede, O., Benito, C. W., & Oyelese, Y. (2018). Are Women With Threatened Preterm Labor More Dehydrated Than Women Without It? Journal of obstetric, gynecologic, and neonatal nursing: JOGNN, 47(5), 602–607. doi.org/10.1016/j.jogn.2018.05.006
For individuals that are trying to change up their daily routine, can incorporating the beneficial properties of a HIIT workout reduce pain?
Introduction
When it comes to a person’s health and wellness, they need to exercise for at least 30 minutes. However, many individuals have hectic lifestyles, which correlates to a lack of time to work out, leading to various health conditions that can develop over time and lead to pain and discomfort. Around the world, many adults should get 150 to 300 minutes of exercise to reduce pain in their body system. This can include doing chores, exercising at home, or going to the gym. But people who want to get in a quick workout within their busy schedules can opt for a HIIT workout or high-intensity interval training. In today’s article, we will look at what HIIT is, its beneficial effects on the body, and how important it is to incorporate a HIIT workout as part of a daily routine. We talk with certified associated medical providers who inform our patients to include a HIIT workout in their daily routine. While asking their associated medical provider intricate questions, we advise patients to formulate a customized treatment plan to help with chronic pain affecting their bodies through various exercise routines. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
What is HIIT?
Do you experience any weight changes that cause difficulty maintaining your ideal weight? How often do you feel stressed and tired after a hectic day that you don’t have time for yourself? Or do you feel unusual aches and pains in your body that make you feel fatigued throughout the day? When it comes to individuals making small changes in their health and well-being, try to work out with the minimum time they have but also achieve the benefits of a full workout, can try HIIT. HIIT, or high-intensity interval training, is defined by exercise activities that target 80% of the individual’s max heart rate with alternative explosive bursts of full-throttle efforts with rest periods. (Coates et al., 2023)
Additionally, a HIIT workout usually involves cardio and resistance training as part of its sub-categories. This is generally incorporated into gyms and fitness centers and still requires both a warm-up, recovery intervals, and cool-down to ensure that the body is getting the full beneficial properties and effects from a HIIT workout. This is because a HIIT workout involves an active, high-intensity training session that is less than 15 minutes long and helps improve cardiometabolic health and cardiovascular endurance. (Atakan et al., 2021)
Optimize Your Wellness- Video
The Beneficial Properties of HIIT
Since HIIT has beneficial properties, many individuals experiencing low back pain from stress, excessive sitting or standing, or lifting heavy objects can utilize HIIT workouts as part of their exercise routine. HIIT workouts for lower back pain can help through general resistance and core strength training, which helps improve muscle strength and decrease the pain and deconditioning of the trunk muscles. (Verbrugghe et al., 2020) The other beneficial properties of HIIT are that it can help improve a person’s cardiorespiratory system or stamina. This helps maintain healthy endurance levels and causes them to increase the length or intensity of a HIIT workout while enjoying the health benefits it can provide. (Martin-Smith et al., 2020)
Since HIIT has beneficial properties, many individuals experiencing low back pain from stress, excessive sitting or standing, or lifting heavy objects can utilize HIIT workouts as part of their exercise routine. HIIT workouts for lower back pain can help through general resistance and core strength training, which helps improve muscle strength and decrease the pain and deconditioning of the trunk muscles. (Verbrugghe et al., 2020) The other beneficial properties of HIIT are that it can help improve a person’s cardiorespiratory system or stamina. This helps maintain healthy endurance levels and causes them to increase the length or intensity of a HIIT workout while enjoying the health benefits it can provide. (Martin-Smith et al., 2020)
Incorporating HIIT As Part of A Routine
Additionally, anyone who wants to do a HIIT workout routine can do it since it is perfect for a quick workout in a short amount of time. Individuals with busy schedules can complete a workout with alternating bursts of exercises and rest periods that can build up a person’s endurance. With a HIIT workout, many individuals will begin to notice that they have more energy throughout the day and start making changes to improve their lives.
References
Atakan, M. M., Li, Y., Kosar, S. N., Turnagol, H. H., & Yan, X. (2021). Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective. Int J Environ Res Public Health, 18(13). doi.org/10.3390/ijerph18137201
Coates, A. M., Joyner, M. J., Little, J. P., Jones, A. M., & Gibala, M. J. (2023). A Perspective on High-Intensity Interval Training for Performance and Health. Sports Med, 53(Suppl 1), 85-96. doi.org/10.1007/s40279-023-01938-6
Gjellesvik, T. I., Becker, F., Tjonna, A. E., Indredavik, B., Lundgaard, E., Solbakken, H., Brurok, B., Torhaug, T., Lydersen, S., & Askim, T. (2021). Effects of High-Intensity Interval Training After Stroke (The HIIT Stroke Study) on Physical and Cognitive Function: A Multicenter Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 102(9), 1683-1691. doi.org/10.1016/j.apmr.2021.05.008
Guimaraes, G. V., Ciolac, E. G., Carvalho, V. O., D’Avila, V. M., Bortolotto, L. A., & Bocchi, E. A. (2010). Effects of continuous vs. interval exercise training on blood pressure and arterial stiffness in treated hypertension. Hypertens Res, 33(6), 627-632. doi.org/10.1038/hr.2010.42
Martin-Smith, R., Cox, A., Buchan, D. S., Baker, J. S., Grace, F., & Sculthorpe, N. (2020). High Intensity Interval Training (HIIT) Improves Cardiorespiratory Fitness (CRF) in Healthy, Overweight and Obese Adolescents: A Systematic Review and Meta-Analysis of Controlled Studies. Int J Environ Res Public Health, 17(8). doi.org/10.3390/ijerph17082955
Verbrugghe, J., Agten, A., Stevens, S., Hansen, D., Demoulin, C., Eijnde, B. O., Vandenabeele, F., & Timmermans, A. (2020). High Intensity Training to Treat Chronic Nonspecific Low Back Pain: Effectiveness of Various Exercise Modes. J Clin Med, 9(8). doi.org/10.3390/jcm9082401
For individuals who may need to take pain medications to manage an injury or condition, can knowing the potential side effects help in treatment?
Medications For Pain Side Effects
Over-the-counter and prescription pain medications can help relieve physical discomfort and distress but can also cause side effects. Patients may not manifest side effects when using certain meds or experience mild, limited, severe, or intolerable effects. Pain medication side effects can include:
Allergic reactions
Upset stomach
Bruising
Dizziness
However, medication side effects don’t affect everyone in the same way.
Pain Relief
The patient and their healthcare provider can decide whether they risk developing side effects and which effects they are more predisposed to. Individuals may be susceptible to side effects from certain medications but are likely to tolerate others. For example, individuals with a history of ulcers may be recommended to avoid anti-inflammatories. For those who have trouble sleeping, it is recommended to avoid pain meds that are known to interfere with sleep.
Reading Labels and Asking Questions
When taking over-the-counter medications, read the label for side effects, then weigh the possible risks against the medicine’s benefits for pain relief. Ask a pharmacist or healthcare provider about anything that is not understood. Some side effects are medical emergencies, such as allergic reactions. Recognizing the signs of an allergic reaction and being prepared to call for emergency help if symptoms present. (American Academy of Allergy, Asthma & Immunology, 2024) These can include:
Itching
Hives
Rash
Mouth or facial swelling
Shortness of breath
If a healthcare provider prescribes medication, discuss the anticipated risks and benefits. The prescription will come with a label that lists the side effects associated with the drug.
Opioid Risks
Opioids are powerful prescription meds, usually used for severe, short-term use, like post-surgery pain or after a severe traumatic injury. Some effects of opioids include: (Plein L. M. and Rittner H. L. 2018) Common side effects include sedation, constipation, and nausea. Chronic use can lead to depression and/or sexual dysfunction. With narcotics, there is the risk of addiction that can change an individual’s life, as addiction can be difficult to overcome. One of the reasons the CDC published a guideline on opioid prescriptions was because of the number of overdoses and deaths.
The CDC recommends that practitioners not prescribe opioids as a first-line treatment for chronic back pain.
The CDC recommends that healthcare providers initially treat patients with chronic back or neck pain using non-pharmacological therapies or medications other than opioids.
Opioids should only be used if the expected benefits for pain and function are anticipated to outweigh the risks to the patient.
With more than half of regular opioid users experiencing back pain, they aren’t proven to help return individuals to work or normal life faster, nor did they improve functioning when used for the treatment of an acute episode. (Deyo R. A. Von Korff M. and Duhrkoop D. 2015) The effectiveness of opioids is about 30% for short-term relief and did not improve physical functioning.
Examples and Comparisons
Examples of common medications used to treat back pain.
Advil
Active Ingredient – Ibuprofen
Drug Class – NSAID
Over-the-counter or Prescribed – Available over-the-counter
Side Effects – GI-related symptoms and Reye’s Syndrome in children
Aleve and Other Generic Brands
Active Ingredient – Naproxen
Drug Class – NSAID
Over-the-counter or Prescribed – Available as both depending on strength.
Side Effects – GI-related symptoms, headaches
Tylenol and Other Generic Brands
Active Ingredient – Acetaminophen
Drug Class Analgesic – pain reliever
Over-the-counter or Prescribed – Available as both and can be prescribed with codeine.
Side Effects – Potential liver damage
Lyrica
Active Ingredient – Pregabalin
Drug Class – Anticonvulsant
Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain and neuropathy in diabetes. Other uses off-label.
Side Effects – Dizziness, drowsiness, swelling, weight gain.
Neurontin
Active Ingredient – Gabapentin
Drug Class – Anticonvulsant
Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain
Side Effects – Dizziness, drowsiness, allergic reaction, withdrawal, and seizures.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself.
Plein, L. M., & Rittner, H. L. (2018). Opioids and the immune system – friend or foe. British journal of pharmacology, 175(14), 2717–2725. doi.org/10.1111/bph.13750
Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. BMJ (Clinical research ed.), 350, g6380. doi.org/10.1136/bmj.g6380
Can individuals dealing with pain and inflammation in their bodies can incorporate a ketogenic diet and have beneficial results?
Introduction
When it comes to a person’s health and wellness journey, many people often wonder where to start making changes in their bodies. Many people begin exercising not only to reduce stress levels in the musculoskeletal system but also to help clear their minds. This is a great cause, as any form of physical activity can help reduce muscle fatigue and weakness and strengthen the extremities and quadrants in the musculoskeletal system. However, even though exercising is part of the health and wellness journey, another component plays a crucial part in the health and wellness journey: eating nutritional foods and dieting. Now, dieting can be scary for some newcomers who are just entering their health and wellness journey, but when people start making small changes to their eating habits, like incorporating more vegetables and fruits in their meals, making more meals at home, and doing portion control to eat enough till they are full can provide beneficial results. These small changes can empower individuals to take control of their health and wellness journey. Dieting and changing eating habits can give useful results for people dealing with chronic issues correlated with environmental factors. In today’s article, we will look at a particular diet known as the ketogenic diet, its beneficial properties, and how to incorporate it to reduce chronic conditions affecting the body. We talk with certified associated medical providers who provide our patients’ information to assess how incorporating the ketogenic diet can help reduce chronic conditions. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to help with chronic conditions by incorporating the ketogenic diet along with physical activities. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is the Ketogenic Diet?
Do you often feel extremely thirsty throughout the day, and do you chug at least a couple of gallons of water daily? Do you feel heat or see redness in various locations around your body that seem tender when touched? Or do your joints become stiff in the mornings when you wake up and feel better throughout the entire day? Often, people have a love-hate relationship with food. However, it all depends on what the person is eating and what environmental factors correlate with their food. So, when a person has chronic conditions that cause pain and inflammation in their joints, muscles, and organs, the negative side effects are that the food they consume can induce the inflammatory effects. In contrast, the positive impact of food can help individuals dampen the pain and inflammation in the body. (Fifi & Holton, 2020) Many individuals dealing with inflammation and pain in their bodies can incorporate a ketogenic diet to reduce the inflammatory effects.
Now, what is the ketogenic diet? The ketogenic diet is where carbohydrates are low, and various levels of lean proteins and healthy fats induce ketosis. (McGaugh & Barthel, 2022) This, in turn, helps with alternating the metabolic pathways to induce weight loss, improve health conditions like lipid profile improvements, and reduce hyperglycemia. When environmental factors like obesity, sedentary lifestyles, or physical inactivity can cause chronic issues like lipedema, the body will cause overlapping risk profiles to induce inflammation. When the body is dealing with lipedema, it can cause the body to be in a constant inflammatory state that induces cell damage and cell death through apoptosis. Hence, when a person is going to do a ketogenic diet, it can help reduce the inflammatory effects while alleviating pain symptoms. (Verde et al., 2023)
Eating Right To Feel Better-Video
The Beneficial Properties Of A Ketogenic Diet
One of the beneficial properties that a person can take with a ketogenic diet is that it can help reduce cardiovascular diseases with its anti-inflammatory properties. Since a ketogenic diet helps place the body in a state of nutritional ketosis, incorporating omega-3 fatty acids can help the body exert systemic anti-inflammatory effects and begin healing. (Dynka et al., 2023) At the same time, the ketogenic diet can help individuals who are suffering from chronic conditions like epilepsy, diabetes, or obesity to not only induce weight loss but also help improve body composition. (Sjodin et al., 2020) This is because when individuals get a customized treatment plan incorporating the ketogenic diet, it must include physical activities that help strengthen muscles in the body’s quadrants. In contrast, the ketogenic diet helps slow down muscle glycogen depletion. Additionally, the ketogenic diet is beneficial by:
Reducing glucose levels so individuals with diabetes don’t need insulin.
When it comes to the ketogenic diet, many individuals have dealt with chronic conditions like epilepsy, diabetes, or cardiovascular conditions. Understand that incorporating a healthy diet filled with healthy fats, lean protein, plenty of fruits and vegetables, and physical activity can benefit many individuals in the long run. The ketogenic diet can help the liver by producing more ketone bodies to help with the production of ATPs and reduce ROS (reactive oxygen species); this, in turn, helps improve a person’s quality of life. (Abboud et al., 2021) Informing individuals who are dealing with chronic conditions that they must make small changes to their routines. This can be incorporated into their customized treatment plan and help reduce the pain-like effects from the person’s chronic conditions correlating to the inflammatory effects. The ketogenic diet can be a stepping stone to a person’s health and wellness and help them be motivated to see positive results.
References
Abboud, M., AlAnouti, F., Georgaki, E., & Papandreou, D. (2021). Effect of Ketogenic Diet on Quality of Life in Adults with Chronic Disease: A Systematic Review of Randomized Controlled Trials. Nutrients, 13(12). doi.org/10.3390/nu13124463
Dowis, K., & Banga, S. (2021). The Potential Health Benefits of the Ketogenic Diet: A Narrative Review. Nutrients, 13(5), 1654. doi.org/10.3390/nu13051654
Dynka, D., Kowalcze, K., Charuta, A., & Paziewska, A. (2023). The Ketogenic Diet and Cardiovascular Diseases. Nutrients, 15(15). doi.org/10.3390/nu15153368
Fifi, A. C., & Holton, K. F. (2020). Food in Chronic Pain: Friend or Foe? Nutrients, 12(8). doi.org/10.3390/nu12082473
Sjodin, A., Hellstrom, F., Sehlstedt, E., Svensson, M., & Buren, J. (2020). Effects of a Ketogenic Diet on Muscle Fatigue in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients, 12(4). doi.org/10.3390/nu12040955
Verde, L., Camajani, E., Annunziata, G., Sojat, A., Marina, L. V., Colao, A., Caprio, M., Muscogiuri, G., & Barrea, L. (2023). Ketogenic Diet: A Nutritional Therapeutic Tool for Lipedema? Curr Obes Rep, 12(4), 529-543. doi.org/10.1007/s13679-023-00536-x
Can individuals support their parasympathetic nervous system to maintain a relaxed state and avoid excessive agitation, stress, anxiety, and dysregulation?
Parasympathetic Nervous System
The parasympathetic nervous system (PSNS) involves organs and cells that release neurotransmitters that help the body maintain essential functions like heart rate, breathing, digestion, relaxation, thinking, and sleep. It is part of the autonomic nervous system, which includes the nerves and neurotransmitters that control the body’s internal organs to maintain reliable function. The autonomic nervous system regulates a continual balance between the parasympathetic nervous system’s rest-and-digest functions and the sympathetic nervous system’s fight-or-flight responses.
Functions and Responses
The parasympathetic nervous system includes nerves and neurotransmitters (chemical messengers) distributed throughout the body and is often described as promoting the body’s rest-and-digest state. The body’s needs regulate the control and effects of the system. Certain medications and health issues can modify or alter the function of the autonomic nervous system, including sympathetic and parasympathetic areas. The parasympathetic and sympathetic nervous systems collaborate to control cells, tissues, and organs. The body requires constant functioning and adjustment of both systems. (McQuade J. D. et al., 2017) Functions include: (Valenti V. E. et al., 2024)
Saliva secretion to break down food.
Maintaining blood pressure, resting heart, and breathing rate.
Producing enzymes in the stomach and intestines to break down food further and absorb nutrients.
Kidney balancing of fluid and mineral levels by producing urine.
Constricting pupils (making the dark circle in the eye smaller) to see details up close.
Maintaining focus and concentration to think, remember, and make decisions.
Releasing hormones to fall asleep and stay asleep.
Providing consistent muscle stimulation to maintain endurance for muscle activity.
All functions are adjusted based on the body’s needs.
Activation
The parasympathetic response constantly works to keep the body active, engaged, and healthy and can be stimulated simply by relaxing and resting. Individuals can sometimes focus on promoting their body’s parasympathetic activity through stretching, slow movements, relaxing sounds or music, meditation, and similar activities. Individuals who frequently feel anxious or stressed and have difficulty relaxing could benefit from guidance from a therapist or coach on learning to engage the parasympathetic nervous system. (Goren O. et al., 2024) This can involve activities such as guided meditation or talk therapy, which can help individuals work through fears and anxieties.
Dysregulation
Some medical conditions are associated with dysregulation. Heart disease, respiratory disease, sleep disorders, mental health conditions, and behavioral conditions can be associated with overactive or underactive parasympathetic or sympathetic nervous system regulation. (Veerakumar A. et al., 2022) Various mental health and physical health disorders can involve symptom fluctuations that affect the autonomic nervous system. For example, anxiety disorders can cause periods of overeating as well as loss of appetite and episodic indigestion, nausea, and vomiting. Symptoms of dysregulation can include: (McQuade J. D. et al., 2017)
Excessive sleepiness
Insomnia
Difficulty concentrating
Confusion
Anxiety – nervousness or agitation
A feeling of a rapid heart rate
Shortness of breath
Dry mouth
Throat tightness
Indigestion
Stomachaches
Nausea
Vomiting
Cold hands and feet
Sweating or clammy hands
Sadness
Depression
Dizziness or feeling physically off-balance
Any of these symptoms can develop and resolve quickly. Most individuals experience symptoms or parasympathetic nervous system dysfunction when an unexpected stressful event occurs, and the response is considered normal in traumatic, shocking, sad, or high-stress circumstances. (Veerakumar A. et al., 2022)
Medications may induce parasympathetic overactivity or underactivity until the medicine is broken down and removed from the body. (Valenti V. E. et al., 2024)
Nerves
The system comprises nerves that release hormones and neurotransmitters and nerves that respond to the hormones and neurotransmitters. Parasympathetic activation and response include: (Valenti V. E. et al., 2024)
The nerves that activate the parasympathetic nervous system run throughout the body, primarily in the brain, heart, lungs, stomach, and intestines.
The brain, heart, lungs, stomach, intestines, muscles, liver, kidneys, reproductive organs, eyes, and mouth are among the areas of the body that respond to stimulation.
The vagus nerve, one of the cranial nerves, is closely associated with parasympathetic nervous system activity. It runs from the brainstem down into the throat, heart, lungs, and digestive system. (Valenti V. E. et al., 2024) Surgical, medical, and alternative interventions are used to regulate the activity of the parasympathetic nervous system and are targeted toward regulating and controlling the activity of the vagus nerve. (Hernández-Domínguez R. A. et al., 2024)
PSNS Support
Living with any parasympathetic nervous system dysfunction can be challenging. For individuals with heart or lung disease, healthcare providers will evaluate the medical condition and recommend surgery or medication to control symptoms and avoid complications. (Hernández-Domínguez R. A. et al., 2024) Individuals who are living with a mental health disorder or behavioral disorder that is associated with any dysregulation of the parasympathetic nervous system activity may benefit from a combination of behavioral interventions and medication to help control symptoms long term. (Goren O. et al., 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
The spinal cord has multiple functions in restoring, rejuvenating, and strengthening the nervous system. Chiropractic care has a highly responsive therapeutic effect on the nervous system because of its focus on the spine. Spinal decompression, traction, soft tissue manipulation, and other treatments help regulate and restore the function of the nervous system. Chiropractic benefits:
Reduce and/or eliminate pain.
Improves the quality of sleep.
Increases energy.
Improves cognition and clarity.
Reduces or eliminates headaches and migraines.
Improves digestive function.
Improves balance and coordination.
Increases flexibility and mobility.
Regulates respiration.
Regulates lower heart rate.
At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for every patient to restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, or ailment.
Chiropractic Secrets Exposed
References
McQuade, J. D., Penzel, T. E., Silk, J. S., & Lee, K. H. (2017). Parasympathetic Nervous System Reactivity Moderates Associations Between Children’s Executive Functioning and Social and Academic Competence. Journal of abnormal child psychology, 45(7), 1355–1367. doi.org/10.1007/s10802-016-0246-5
Valenti, V. E., Vanderlei, L. C. M., & Godoy, M. F. (2024). Editorial: Understanding the role of the autonomic nervous system in health and disease. Frontiers in neuroscience, 18, 1446832. doi.org/10.3389/fnins.2024.1446832
Goren, O., Paz, A., Bar-Kalifa, E., Gilboa-Schectman, E., Wolff, M., & Atzil-Slonim, D. (2024). Clients’ and therapists’ parasympathetic interpersonal and intrapersonal regulation dynamics during psychotherapy for depression. Psychotherapy research : journal of the Society for Psychotherapy Research, 1–15. Advance online publication. doi.org/10.1080/10503307.2024.2378038
Veerakumar, A., Yung, A. R., Liu, Y., & Krasnow, M. A. (2022). Molecularly defined circuits for cardiovascular and cardiopulmonary control. Nature, 606(7915), 739–746. doi.org/10.1038/s41586-022-04760-8
Hernández-Domínguez, R. A., Herrera-Orozco, J. F., Salazar-Calderón, G. E., Chávez-Canales, M., Márquez, M. F., González-Álvarez, F., Totomoch-Serra, A., Reyes-Cruz, T., Lip, F., & Aceves-Buendía, J. J. (2024). Optogenetic modulation of cardiac autonomic nervous system. Autonomic neuroscience : basic & clinical, 255, 103199. doi.org/10.1016/j.autneu.2024.103199
Can incorporating selenium-rich foods into one’s diet improve overall health?
Selenium
Selenium is a chemical element and a micronutrient with antioxidant properties that protect cells from damage and increase immune function (University of Florida Health, 2023). It has also been linked to heart health and longevity. Most individuals in the U.S. can acquire a healthy amount of selenium through a balanced diet. Research has shown that selenium supports healthy aging and reduces the risk of heart disease. (Alehagen U. et al., 2021) (Zhang Y. et al., 2024) A recent study found a region in China where residents have sustained longevity with soil that is rich with selenium. (Li B. et al., 2024) The body does not produce the chemical, so it must be obtained through food or supplements. (National Institutes of Health Office of Dietary Supplements, 2024) However, excessive amounts can build up in the body and be toxic, causing gastrointestinal problems, hair loss, kidney failure, neurological issues, and death. (National Institutes of Health Office of Dietary Supplements, 2024)
Only A Small Amount Is Needed
The body only needs small amounts of selenium to support bodily functions, including thyroid hormone metabolism and antioxidant defense. Most adults need 55 micrograms daily, and pregnant and lactating adults require an additional 5–15 micrograms daily (National Institutes of Health Office of Dietary Supplements, 2024). Individuals can get selenium from many food sources, including Brazilian nuts, meat, seafood, vegetables, and grains. A large hard-boiled egg comprises 15 micrograms, a cup of cooked spaghetti provides 33 micrograms, and 3 ounces of cooked shrimp offer 42 micrograms of selenium. (National Institutes of Health Office of Dietary Supplements, 2024)
Individuals who eat healthy and eat various foods will meet their selenium needs. However, in some parts of the world, poor selenium soil may not provide enough of this mineral for individuals through their diet. (National Institutes of Health Office of Dietary Supplements, 2024) Low selenium intake is linked to a heart condition called Keshan disease, which may weaken the heart’s ability to pump blood. (National Library of Medicine, 2023) However, individuals are recommended not to take more than 400 micrograms daily.
Longevity
Various researchers are trying to understand the link between selenium and aging. A study associated dietary intake with increased telomere length (protein structures at the ends of chromosomes that protect DNA and help control cell division), a biological marker that may indicate aging and other health conditions. (Liang C. et al., 2024) Shorter telomeres generally indicate aging and disease progression. Another study suggests moderate amounts of dietary selenium may protect against cardiovascular disease and death. However, the observational study included data from over 25,000 adults but did not prove a cause-and-effect relationship between selenium and improved longevity. (Zhang Y. et al., 2024) Further research is needed before experts recommend selenium as an anti-aging dietary component.
Injury Medical Chiropractic and Functional Medicine Clinic
Selenium helps with cell growth and thyroid function and is known to increase immune system function. However, avoiding excessive intake is important, as high levels can be harmful. Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and various medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician, as Dr. Jimenez has teamed with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Alehagen, U., Opstad, T. B., Alexander, J., Larsson, A., & Aaseth, J. (2021). Impact of Selenium on Biomarkers and Clinical Aspects Related to Ageing. A Review. Biomolecules, 11(10), 1478. doi.org/10.3390/biom11101478
Zhang, Y., Meng, S., Yu, Y., Bi, L., Tian, J., & Zhang, L. (2024). Associations of dietary selenium intake with the risk of chronic diseases and mortality in US adults. Frontiers in nutrition, 11, 1363299. doi.org/10.3389/fnut.2024.1363299
Li, B., Liu, X., Yu, T., Lin, K., Ma, X., Li, C., Yang, Z., Tang, Q., Zheng, G., Qin, J., & Wang, Y. (2024). Environmental selenium and human longevity: An ecogeochemical perspective. Chemosphere, 347, 140691. doi.org/10.1016/j.chemosphere.2023.140691
Liang, C., Zhao, R., Du, J., Zhao, G., & Zhang, Y. (2024). The association between dietary selenium intake and telomere length in hypertension. Journal of clinical hypertension (Greenwich, Conn.), 26(8), 990–996. doi.org/10.1111/jch.14861
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