The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.
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Anatomy
The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:
Nerves
Arteries
Veins
Muscles
Tendons
Ligaments
Joint cartilage
Fingernails
Get injured or damaged in some way; there is increased potential for various injuries.
Causes
The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:
Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:
Lacerations
Tenderness
Pain
Bleeding
Numbness
Decreased range of motion
Difficulty moving
Weakness
Pale appearance
Fractures and Dislocations
Swelling
Discoloration
Tenderness
Deformity
Reduced range of motion
Numbness
Weakness
Bleeding
Soft Tissue Injuries and Amputations
Swelling
Discoloration
Tenderness
Deformity with or without tissue loss/bone loss
Bleeding
Weakness
Numbness
Infection
Tenderness
Swelling
Warmth/Heat around the area
Redness
Deformity
Reduced range of motion
Fever is rare in hand infections
Burns
Redness
Tenderness
Blistering
Complete numbness
Discoloration
Loss of tissue
The texture of the skin change
Areas of tissue blackened
Deformity
High-pressure Injection Injury
Pain
Swelling
Bleeding
Skin discoloration
Muscle, tendon, ligament tears
Cracked/Broken bones
Medical Care
Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.
Severe bleeding
Severe pain
Numbness
Loss of motion
Loss of strength
Deformity
Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
Exposure of structures – tendons, bones, joints, arteries, veins, or nerves
Diagnosis
A medical examination can include a medical history and physical examination.
Medical History
Past medical history
Does the patient have diabetes or arthritis?
Is the patient right or left-handed?
Occupation
Extracurricular activities and hobbies
How does the patient use their hands?
How did the injury occur, mechanism of injury?
Does the patient smoke?
Physical Exam
Visual inspection look at the injury
Sensory nerve exam feeling
Vascular exam circulation of blood supply
Muscular and tendon exam movement and strength
Bone exam broken bones or dislocated joints
Tests
A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly
Body Composition
Artificial Sweeteners And Muscle Gain
Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:
Greek yogurt
Fruit with nuts or nut butter
Hummus with whole-grain crackers
Tuna
Hard-boiled eggs
References
Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.
Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177
Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5
MedscapeReference.com. High-Pressure Hand Injury.
MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.
Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016
Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:
In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining
These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.
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Spinal Infection Types
They are classified according to the type of tissue they infect. The most common include:
Vertebral Osteomyelitis
This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:
Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site
Treatment includes:
Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.
Discitis
This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.
Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:
Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving
Treatment options include:
Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility
Epidural Abscess
This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:
Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems
Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.
Risk Factors
Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:
Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery
Risk factors include:
Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.
Surgical risk factors:
Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area
Diagnosis
Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:
Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI
Outcome
These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.
Body Composition
Practice Mindfulness
Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.
Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.
References
American Association of Neurological Surgeons. Spinal Infections. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.
Stat Pearls. (2021). Diskitis. https://www.ncbi.nlm.nih.gov/books/NBK541047/
Stat Pearls. (2021). Spinal Epidural Abscess. https://www.ncbi.nlm.nih.gov/books/NBK441890/
Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. https://www.frontiersin.org/articles/10.3389/fmed.2014.00007/full
Microorganisms. (2020). Spinal Infections: An Update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/
The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” https://www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext
The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:
Repetitive overuse in a job or doing a task/chore that requires constant
Bending
Pulling
Pushing
Reaching
Twisting
Kneeling
A result of poor technique in sports or similar physical activities.
Chiropractic treatment, along with exercises, can help prevent and relieve this pain.
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Symptoms of lat pain
The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:
Lower, middle, and upper back
Back of the shoulders
The base of the shoulder blade
Lower arms
Inside of the arms, extending down to the fingers
In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:
Extends their hands forward and out in front
Raises their hands above their head
Tosses or throws an object
Damage or injury to the latissimus dorsi
Tissue damage or injury can cause other symptoms to present. These include:
If the source of the back pain cannot be identified, or if it is accompanied by:
Fever
Breathing problems
Abdominal pain
Consult a doctor as these could be symptoms of a more serious condition.
Uses and Causes
The lat muscles are used in everyday activities. These include:
Picking up objects like grocery bags
Opening heavy doors
Chest expansion for breathing
Pushing against the armrests of a chair to stand up
Using handrails to climb stairs
For sports or working out, the lats are used in:
Weightlifting exercises using the upper body
Bench-presses
Rowing
Swimming
Throwing
Common causes of pain include:
Overusing the muscles
Using poor techniques
Exercising without warming up
Risk of injury
Individuals that are at risk of developing this injury include those that:
Are continually reaching overhead
Regularly chop wood
Perform regular shoveling
Move furniture or other heavy objects
Regularly practice poor posture
Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:
Golfers
Baseball pitchers
Gymnasts
Swimmers
Tennis players
Exercises that can help bring relief
Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.
Back bow
This pose is known as the superman pose. To perform:
Lay facedown on the floor
Extend the legs so they are straight
Stretch arms away from the body, so they are in front of the head
Bend the knees like for a sit-up with the heels close to the buttocks
Keeping the hands and feet in place
Lift the pelvis upward
Slowly lower back to the floor
Prevention
Individuals can prevent lat pain with lifestyle adjustments. These include:
Using proper technique and posture during work, sports, and exercise
Staying aware to not overuse the muscles
Staying hydrated
Warming up and cooling down thoroughly before and after a workout, sports, physical activities
Regular stretching
Applying ice and heat before and after work, sports, and physical activities
Chiropractic care
Physical therapy massage
Body Composition
Nutrition and Recovery Advantage
Two important steps to achieve optimal health include:
Nutrition
Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesisafter exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.
Recovery
For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.
References
Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
https://www.ajronline.org/doi/abs/10.2214/AJR.04.1247
Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb
Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
http://www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20
George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581
Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4
Muscle cramp and muscle spasm: Three types of muscles make up the body.
Cardiac muscle makes up the heart.
Smooth muscle cells line the blood vessels, gastrointestinal tract, and organs.
Skeletal muscles attach to the bones and are used for voluntary movements.
A muscle spasm happens when skeletal muscle contracts and does not go back to its relaxed state. Spasms are forceful and involuntary. A muscle spasm that sustains/continues is a muscle cramp. The leg muscles, especially the quadriceps/thigh, hamstrings/back of the thigh, and gastrocnemius/calves, are prone to cramping, but any skeletal muscle can cramp. Charley horse is another name for a muscle cramp.
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Causes
There can be a variety of causes for muscle cramps. This includes:
Physical exertion in hot weather
Overexertion
Dehydration
Electrolyte imbalance
Physical deconditioning
Certain medications and supplements could contribute to muscle cramping.
They can interfere with electrolyte levels, contribute to the breakdown of muscle tissue, and/or interfere with blood circulation. Any medication-related muscle cramping should be reported to a doctor.
Night Cramping
Night cramping, especially in the calves, is common and affects up to 60% of adults. Women are more prone to night-leg cramps than men. They are also common with age and a common contributor to insomnia. Muscle fatigue and nerve dysfunction are believed to be a factor. Management remedies include:
Stretching
Self-Massage
Topical muscle pain ointments/creams
Ice therapy
Remedies and Treatment
The majority of cramps resolve on their own within a few minutes without treatment.
It is recommended that as soon as a cramp begins, stop the activity.
Stretch and massage the area,
Hydrate with water and, if necessary healthy sports drink to replenish sodium, vitamins, electrolytes, and more.
Apply heat to help relax the muscle.
Apply an ice pack.
Nonsteroidal anti-inflammatory medications (NSAIDs) can help if the pain is substantial.
Consult a doctor if cramps are severe or are recurring often.
Prevention
Strategies for reducing the risk include:
To vary exercise routines
Maintain proper hydration
Maintain proper levels of electrolytes. Sodium and potassium are lost during physical activity, especially in the heat and with consistent sweating.
Regular Stretching
Warm-up with a quick jog or quick walk before stretching the body.
Body Composition
Insulin and the body
Insulin assists the transport and storage of energy glucose to cells, tissues, and organs. These include the body’s glucose storage like the skeletal muscles and liver. Once the blood sugar returns to a base level as the glucose is absorbed, the pancreas begins producing glucagon instead of insulin. Glucagontells the liver to release the stored sugar, which typically happens between meals. What happens to the body when eating too much sugar and carbohydrates than the glucose-storing organs can handle?
Individuals with Type 1 diabetes have a pancreas that does not produce insulin. Type 1 diabetics need to control their glucose levels with lifelong insulin therapy.
With Type 2 diabetes, the pancreas ends up producing insulin through frequent outbursts. When this starts to happen more than normal, the cells eventually lessen their insulin sensitivity. The body becomes numb to the signaling that there is excess blood sugar in the body. This is what happens in individuals with insulin resistance or Type 2 diabetes. This type of diabetes can be managed or prevented with diet adjustments.
References
AAOS: “Muscle Cramps.” Jun. 2017.
American Academy of Orthopedic Surgeons: “Muscle Cramp.”
American Academy Physician: “AAN Recommendations on Symptomatic Treatment for Muscle Cramps.”
American Family Physician: “Nocturnal Leg Cramps.”
American Osteopathic Association: “Muscle Cramp – A Common Pain.”
Journal of the American Academy of Orthopedic Surgeons: “The Athlete With Muscular Cramps: Clinical Approach.”
National Cancer Institute: “Muscle Types.”
National Institute of Mental Health: “What Is Generalized Anxiety Disorder?”
Getting dizzy can happen, usually after standing up too fast or staring at an optical illusion then looking away. The unsteadiness can be troubling but is minimal when compared to vertigo symptoms. Vertigo is a symptom rather than a condition that causes dizziness combined with a spinning sensation, even when an individual stands completely still. Vertigo can make everyday life a debilitating nightmare:
It causes individuals to feel nauseous.
It makes it difficult to walk.
It interrupts vision and hearing.
Vertigo symptoms usually begin with a communication issue with the inner ear and brain. This neurological connection involves the spinal cord, which chiropractic can treat and cure. A chiropractor will implement the necessary techniques to help alleviate vertigo symptoms.
Contents
Causes
The most common signs and symptoms are dizziness accompanied by a spinning sensation. Vertigo symptoms can also include:
Vertigo is a common symptom in individuals that have gone through trauma to the neck and/or head. A disturbance/interruption occurs in the nerve pathways in the spinal column. Disruption, injury, or damage to the vestibular system/inner ear also causes vertigo symptoms. Other causes include:
Ear infections
Pressure changes
Movement of particles within the inner ear
Chiropractic Treatment
Chiropractic treatment can cure vertigo symptoms through various exercises and spinal adjustments. When nerve signals don’t transmit correctly, it can cause a feeling of dizziness along with the other symptoms. Adjustments or manipulations help alleviate the symptoms by allowing nerve energy to circulate properly. Spinal adjustments realign the joints and vertebrae in the cervical spine. This opens the nerves pathways and allows for clear communication.
A common type of vertigo is known as benign paroxysmal positional vertigo or BPPV. This is the movement of particles around the inner ear. These particles come from otolith organs. The particles break loose and fall into other parts of the vestibular labyrinth. This alters the center of balance and can cause dizziness. A chiropractor may use the Epley maneuver, which maneuvers the head into different positions. A chiropractor will recommend specific exercises at home to benefit the vestibular system and its communication with the brain.
Body Composition
A Common Cold
The common cold, aka upper respiratory tract inflammation. It is the most common infectious respiratory disease. It is called this because of the effects on the nose and throat. According to the Center for Disease Control and Prevention, an adult will catch 2–3 colds a year. A cold-causing virus enters the respiratory tract directly when an individual inhales droplets or direct skin contact from an infected person. Cold symptoms include:
Runny nose
Stuffy nose
Sneezing
Coughing
Headaches
Body aches
The duration of a cold differs, but most individuals with a healthy immune system recover in 7–10 days. However, individuals with compromised immune systems, asthma, or COPD have an increased risk of developing serious illnesses like bronchitis or pneumonia. Quickly recovering from a cold requires boosting the immune system with proper rest, a nutritious diet, and drinking plenty of water.
References
Collins, Matthew E, and Tom M Misukanis. “Chiropractic management of a patient with post-traumatic vertigo of complex origin.” Journal of chiropractic medicine vol. 4,1 (2005): 32-8. doi:10.1016/S0899-3467(07)60110-4
Dalby, B J. “Chiropractic diagnosis and treatment of closed head trauma.” Journal of manipulative and physiological therapeutics vol. 16,6 (1993): 392-400.
Sajko, Sandy S et al. “Chiropractic management of benign paroxysmal positional vertigo using the Epley maneuver: a case series.” Journal of manipulative and physiological therapeutics vol. 36,2 (2013): 119-26. doi:10.1016/j.jmpt.2012.12.011
Chiropractors and spine specialists utilize spinal imaging through X-rays, MRIs, or CT scans to figure out what is causing back problems and pain. Imaging is common. Whether chiropractic or spinal surgery, they help immensely discover back issues and allow the individual to see what is happening. Types of cases include back pain that:
X-rays for back pain can be quite helpful. An X-ray is radiation-based and is used to examine the conditions of the bone structures. X-rays are optimal for bone tissue or tissues that are ossified or calcified. They work the best with hard tissues, specifically bones. Soft tissues like muscles, ligaments, or intravertebral discs do not present as well.
Individuals undergoing a back X-ray will be scanned by a machine that generates a beam. A receiver picks registers the beam after it passes through the body and generates an image. It takes around five minutes to complete but could be longer depending on the doctor’s number of images. X-rays are helpful for insurance purposes and rule out bone conditions like compression fractures and/or bone spurs. X-rays are ordered for specific reasons and are often part of a whole-body diagnostic study. This includes MRI and/or CT scan.
CT Scan
CT stands for computed tomography. It is a series of X-rays that are digitized into images using a computer. The advantage of a CT scan to standard X-rays is that it offers different views/angles of the body and can be in 3D. CT scans are most often used in trauma cases or individuals who have had surgery. They take around five minutes. For X-rays, individuals stand up or lay under the X-ray machine as it scans the body. A CT scan has the individual lie down in a circular donut-looking machine that scans while rotating during the imaging. Individuals are recommended to wear casual loose, comfortable clothing. Sometimes a dye, or intravenous contrast, is used to get the vascular tissues to stand out, generating clearer images.
MRI
MRI is short for magnetic resonance imaging. MRIs use magnets to generate images. MRI imaging is often used in individuals that have undergone surgery. They take longer, usually around 30 to 45 minutes. No metallic objects are allowed in the MRI. Patients are asked to remove items like belts, jewelry, etc. Contrast dye can be a part of an MRI. The machine is like a tunnel. This can become challenging for individuals that have claustrophobia. Consult with a doctor and find out how to get comfortable during the process.
Other Forms of Spinal Imaging
Other forms of imaging include:
CT navigation
CT navigation shows real-time CT scans during the procedure.
Fluoroscopy
Fluoroscopy involves an X-ray beam that passes directly through the body that shows live, moving images.
Both of these types of spinal imaging are utilized during surgeries. For some cases, intraoperative imaging is used. This type of imaging uses high-tech robotics to help surgeons navigate through tight spaces during the procedure. This increases the surgeon’s accuracy and reduces the size of the incision.
Ultrasound
Ultrasound can be used for spinal conditions. This is an imaging test that uses sound waves to generate images. However, the imaging tests which are used in spinal imaging are primarily X-rays and MRIs.
Imaging Appointment
Talk with your doctor or chiropractor ahead of time to understand what to expect during the imaging process. They will let you know how to prepare and any special instructions before the appointment. Along with medical history and a physical examination, spinal imaging is an important part of the diagnostic process to find what is causing the pain and to develop the best treatment plan.
Body Composition
Short-term Effects of Coffee and Blood Pressure
The caffeine in coffee is a stimulant or substance that excites the body’s systems. When caffeine is ingested, individuals experience an increase in excitement, specifically in the cardiovascular system. This excitement causes the heart rate and blood pressure to rise and then lower back to a baseline level for healthy individuals. Coffee slightly increases short-term blood pressure. Moderate coffee consumption is safe for individuals that do not have pre-existing cardiovascular conditions.
References
United States Nuclear Regulatory Commission. (May 2021) “Doses in Our Daily Lives” https://www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html
X-Ray for Back Pain: Current Reviews in Musculoskeletal Medicine. (April 2009) “What is the role of imaging in acute low back pain?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/
When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.
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Back muscles development
With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:
Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.
Guidelines while using weights
When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:
Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s
Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.
Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.
Smaller weights build strength progressively
Effective ways to strengthen the spine.
Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches
Exercise machines can be recommended instead of free weights.
Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.
It is recommended to combine regular walking activity with a weight training program.
Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.
Training program and benefits
Gaining the most benefits from strength training, tips to keep in mind:
Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.
Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.
Body Composition
Carbohydrates and Muscle Growth
Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.
Carbs prevent muscle weakness.
Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.
Carbs help muscles recover after exercise.
Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.
References
Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325
Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.
Contents
Importance of Pillows
Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.
Shape
The shape of the pillow has a definitive role in the cervical/neck’s curvature.
Posture
Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.
Sleep quality
Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.
Height
Cervical alignment can become significantly impacted by the shape and height of the pillow.
Pillow Comfort Importance
Trying to find the right pillow will require trial and error. The basics to consider include:
One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed. Make it as comfortable as possible.
Body Health
Sleep Body Composition Importance
Not getting enough sleep makes it difficult to gain muscle.
Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.
Not getting enough sleep makes it difficult to lose fat.
Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
Tiredness reduces spontaneous movements.
References
“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017. https://pubmed.ncbi.nlm.nih.gov/28626314/
“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. https://pubmed.ncbi.nlm.nih.gov/27635354/
“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA. https://www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows
“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. https://pubmed.ncbi.nlm.nih.gov/25008402/
“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. https://pubmed.ncbi.nlm.nih.gov/33895703/
Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14
Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.
At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, a health coach, and a nutritionist to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.
Contents
Salt, Sugar, and Fat Affects the Body
A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.
Changing unhealthy eating habits is up to the individual.
Individuals can be advised to cut back or cut out unhealthy diet choices; however, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.
Nutrition Discussion
Chronic pain associated with inflammation linked to a poor diet is the first step in the diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.
The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen instages. An example could be:
Having one cheeseburger and not two.
Having a burger without cheese.
Eating a burger without the buns.
Switching to a plant-based burger.
There are many options to be explored to improve eating habits in small steps.
Willpower also has to be addressed in a controlled and supportive setting. This is where the whole team comes in. Many individuals’ eating habits are part of who they and adjusting them can be an uphill challenge. To educate on:
Having the family or friends eat healthy with them
These are techniques and methods to increase willpower to make healthy changes.
Body Composition
Foods Can Support Body Detoxing
The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:
Neutralize oxidative stress
Lower inflammation
Increase immunity
Strengthen the musculoskeletal system
Foods and nutrients that detoxify can be a part of a healthy lifestyle.
References
Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015
Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346
Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421
More individuals are reporting extreme levels of stress. Studies indicate that an increasing number of individuals are feeling worried, anxious, or depressed regularly from various stressors. Maintaining the body’s health includes:
Following a balanced diet
Getting enough exercise
Taking vitamins or supplements to ensure the body gets what it needs for optimal function.
However, research has found that a sudden increase in stress, specifically stress associated with anger, can trigger:
This type of stress can affect individuals that did not know they had heart disease. Intense short-term stress can have dangerous effects on the body’s health, leading to chronic stress. Chronic stress continues at a low level for weeks, months, or years. It can significantly change the way the body functions. Stress management is very important for overall well-being. Learning how to handle stress properly is the goal.
Contents
Poor Stress Management
When stress hits it triggers the brain to release various hormones. These hormones increase heart rate and raise blood pressure. This comes from evolution that helped early humans escape from predators and stay safe from different types of physical danger. This same stress reaction is what we go through, however, it is not to escape danger but to deal with work, family, school, commuting, and social issues, etc. And when the stress response happens on a regular basis it can have serious and long-term effects on the body’s ability to function properly. Stress includes mental, behavioral, and physical symptoms. The effects of stress that are most familiar are related to mood. Mood changes that can result from chronic low-level stress include:
These mood changes can be tied to changes in behavior. The following behaviors are associated with increased stress levels:
Alcohol and/or drug abuse
Starting or increasing tobacco use
Eating changes – undereating or overeating
Withdrawing from friends and family
Avoiding social interaction
Little to no physical activity
Physical effects that are associated with long-term stress.
Chronic stress that lasts for a long period can affect the whole body. The immune system, digestive system, sleep cycles, etc. Physical symptoms include:
Tension in the neck and back
Persistent headaches
Stomach aches
Constant fatigue, even after waking up
Sleeping pattern changes
Insomnia
Muscle pain
Changes in libido
Being more prone to infections because of a weakened immune system
Chest pain
Learning Healthy Stress Management
Mental health is now an important part of living a healthy life. Stress comes from all kinds of different places. We can’t always change these moments, but we can change our reactions to reduce the negative effects and results. To manage stress, it is important to know what is causing it.
It could be an argument with a boss, co-worker, family member, or significant other.
Work deadlines
School grades, teachers, kids, etc
Bills
Repairs
Clearly identifying the main stressors will help individuals anticipate them and form a plan. There are different ways of dealing with it. The different strategies need to be researched and tried by individuals to see what works for them. Think about what helps the mind and body relax and unwind. A few recommended ways include:
These are strategies that can be incorporated into regular daily life. Be sure to set time aside to focus on mental wellbeing. Learn to recognize the signs when getting overwhelmed. Don’t hesitate to ask for help when needed. This can be a support system or mental health professional. This is to empower individuals to take better care of themselves in both body and mind.
Body Composition
Setting Attainable Goals
Individuals that have trouble achieving health goals might want to look at the goals themselves. Individuals typically have a general idea of their fitness journey. However, it is hard to reach those goals without a map. Losing weight or getting healthy is the goal but these goals are not measurable. This is too broad that can be different things to different people. Trying to accomplish a vague goal makes it hard to plan, making it happen, or seeing progress. A recommended strategy for goal setting is to use the SMART system. The acronym stands for:
Specific
Measurable
Attainable
Realistic
Timed
When goals fall into these parameters, it provides a clear picture of what is trying to get accomplished and the ability to plan accordingly. An example could be: An individual will work out at home or the gym for one hour, five days a week for one month. This is a specific and measurable goal when compared to I’m going to work out more. This provides clear guidelines of what needs to happen to achieve success.
References
Bailey, Ryan R. “Goal Setting and Action Planning for Health Behavior Change.” American journal of lifestyle medicine vol. 13,6 615-618. 13 Sep. 2017, doi:10.1177/1559827617729634
Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395
Jamison, J R. “Stress management: an exploratory study of chiropractic patients.” Journal of manipulative and physiological therapeutics vol. 23,1 (2000): 32-6. doi:10.1016/s0161-4754(00)90111-8
Jamison, J. “Stress: the chiropractic patients’ self-perceptions.” Journal of manipulative and physiological therapeutics vol. 22,6 (1999): 395-8. doi:10.1016/s0161-4754(99)70085-0
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