Can understanding the nucleus pulposus help in body positioning and prevention for individuals wanting to practice spinal hygiene and protect their discs from injury?
Nucleus Pulposus
The spinal discs are located between the spine’s vertebrae and are the body’s natural impact and shock absorbers. Within the disc is the nucleus pulposus, which plays a major role in providing the spine with shock absorption during movement. (Zhou Z. et al., 2014) The discs have a tough outer portion and a soft inner core. They are the:
It forms the tough circular exterior and comprises concentric sheets of collagen fibers or lamellae surrounding the inner core.
It has cartilaginous endplates that firmly attach to the vertebrae above and below.
Nucleus Pulposus
The nucleus pulposus is the inner core soft filling of the discs.
It contains a network of fibers suspended in a mucoprotein gel with a water base to maintain strength and pliability.
The near-liquid consistency makes it responsive to movement to handle the body’s axial load.
It helps maintain spinal suspension to prevent pressure on the bones and prevent bone-to-bone contact, reducing the potential for injuries and pain.
Shock Absorber
Each intervertebral disc is a shock-absorbing cushion, with the nucleus pulposus providing shock-absorbing properties (Zhou Z. et al., 2014). The intervertebral discs move as the body moves. For example, when arching the back, the disc moves forward slightly, and when twisting, the disc twists as well.
Spinal Action
The intervertebral disc supports spinal movements. When bending, twisting, arching, or tilting the spine, the nucleus pulposus swivels to accommodate these actions. These repeated spinal actions, which occur throughout the day and night, contribute to shifting positions while sitting, working, playing sports, carrying groceries, performing house chores, etc. An example is bending forward to pick something up. This action involves forward spinal flexion, which is bending the spine forward, flattening, or rounding. When bending using flexion, the spinal bones come closer together, pushing the nucleus pulposus toward the back.
Injuries
The disc can be pushed too far back with persistent or excessive spinal flexion. If the fibers of the annulus fibrosus become weak, they can tear, causing the nucleus pulposus to leak out and disc herniation. Generally, the nucleus pulposus will leak to the side and back; however, this corresponds to the location of the very sensitive nerve root/s with which it can come into contact, causing pain and other symptoms. The most common causes of disc herniation are degenerative wear and tear changes of the disc and trauma. Disc degeneration occurs as the body ages; it weakens the annulus fibers, allowing the nucleus pulposus to distend, bulge, or herniate.
Aging
Disc degeneration occurs with age but can also occur with injuries to the area. In young individuals, the nucleus pulposus is mostly water. For this age group, a herniation from trauma is more likely than in older individuals. (Ucar, D. et al., 2021) But as the body ages, the discs, especially the nucleus pulposus, begin to dry out. This dehydration leads to a significant loss of disc height. (UCLA Health, 2024) By age 60 or 70, the discs may be composed entirely of fiber, which can cause the shock absorption function not to work and disappear.
Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with more invasive treatments. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.
The Science of Functional Healing
References
Zhou, Z., Gao, M., Wei, F., Liang, J., Deng, W., Dai, X., Zhou, G., & Zou, X. (2014). Shock absorbing function study on denucleated intervertebral disc with or without hydrogel injection through static and dynamic biomechanical tests in vitro. BioMed research international, 2014, 461724. https://doi.org/10.1155/2014/461724
Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. https://doi.org/10.1111/j.1469-7580.2012.01537.x
Ucar, D., Duman, S., Bayram, Y., & Ucar, B. Y. (2021). Extruded disc herniations are experienced earlier by inactive young people in the high-tech gaming era. Journal of medicine and life, 14(3), 402–407. https://doi.org/10.25122/jml-2021-1059
Should individuals increase their intake of black pepper to help with various health issues like fighting inflammation, strengthening the immune system, and improving digestion?
Black Pepper
One of the most popular spices, black pepper offers anti-inflammatory and pain-reducing effects. Piperine is the compound that gives black pepper its flavor, helps prevent inflammation, (Gorgani Leila, et al., 2016), and helps to increase the absorption of selenium, vitamin B12, and turmeric. (Dudhatra GB, et al., 2012) Piperine has been found to be almost as effective as prednisolone – a common medication for arthritis – in reducing symptoms.
Black pepper has been used in ancient Ayurvedic medicine for thousands of years because of its concentration of beneficial plant compounds. (Johns Hopkins Medicine, 2023)
Pepper is made by grinding peppercorns, which are dried berries from the vine Piper nigrum.
The plant is a tall woody plant with small flowers that bloom a yellowish-red color.
It has a sharp and mildly spicy flavor that goes with all kinds of dishes.
Inflammation is the immune system’s response to injury, illness, or any mental or physical stressor, that triggers the body’s healing and repair process. However, long-term inflammation can lead to various health problems and, in individuals that begin to develop arthritis, joint degeneration. Damage to the body’s pain processors can exacerbate pain and other uncomfortable symptoms.
Chronic inflammation can be a cause of diabetes, arthritis, asthma, and heart disease.
While the anti-inflammatory effects have not been extensively studied in humans, there are several mouse studies that show promising results.
In one study, treatment for arthritis with piperine resulted in less joint swelling and decreased inflammation markers. (Bang JS, Oh DH, Choi HM, et al., 2009)
Antioxidants
The active compound, piperine is rich in antioxidants, which prevent or delay the free radical damaging effects from exposure to pollution, smoke, and the sun.
In one study, rats with a diet of concentrated black pepper had less free radical damage than a group that did not ingest concentrated black pepper. (Vijayakumar RS, Surya D, Nalini N. 2004)
Brain Function Improvement
Piperine has been shown to decrease symptoms associated with Parkinson’s and Alzheimer’s and improve brain function. (Ramaswamy Kannappan, et al., 2011)
Studies show piperine increased memory as well as the ability to decrease the production of amyloid plaques, which are damaging proteins associated with Alzheimer’s disease.
Blood Sugar Control Improvement
Studies suggest that piperine can improve blood sugar and improve insulin sensitivity.
In one study, individuals with insulin resistance took a piperine supplement for 8 weeks.
After 8 weeks, improvements were seen in the response to the insulin hormone to remove glucose from the blood (Rondanelli M, et al., 2013)
Improved Nutrient Absorption
Black pepper is considered to have the ability to bind and activate with other foods for improved positive health effects.
It increases the absorption of certain nutrients such as calcium, turmeric, selenium, and green tea.
It is often recommended to consume calcium or selenium with a source of black pepper and to ensure any turmeric supplement you take contains black pepper. (Shoba G, et al., 1998)
Storage
Whole peppercorns sealed in a container and stored in a cool, dry place can last up to a year.
Over time ground black pepper loses its flavor, therefore it is recommended to use within 4 to 6 months.
Allergic Reactions
If you believe you are allergic to black pepper, see a healthcare professional who can perform testing to determine the root cause of symptoms.
Allergies can present as tingling or itching in the mouth, hives, abdominal pain, and possible nausea and vomiting.
Symptoms can also include wheezing, congestion, and/or swelling of the lips, tongue, mouth, and throat.
Black pepper can be substituted with spices like chili powder, cayenne pepper, and allspice.
The Healing Diet
References
Gorgani, L., Mohammadi, M., Najafpour, G. D., & Nikzad, M. (2017). Piperine-The Bioactive Compound of Black Pepper: From Isolation to Medicinal Formulations. Comprehensive reviews in food science and food safety, 16(1), 124–140. https://doi.org/10.1111/1541-4337.12246
Dudhatra, G. B., Mody, S. K., Awale, M. M., Patel, H. B., Modi, C. M., Kumar, A., Kamani, D. R., & Chauhan, B. N. (2012). A comprehensive review on pharmacotherapeutics of herbal bio-enhancers. TheScientificWorldJournal, 2012, 637953. https://doi.org/10.1100/2012/637953
Platel, K., & Srinivasan, K. (2016). Bioavailability of Micronutrients from Plant Foods: An Update. Critical reviews in food science and nutrition, 56(10), 1608–1619. https://doi.org/10.1080/10408398.2013.781011
Kunnumakkara, A. B., Sailo, B. L., Banik, K., Harsha, C., Prasad, S., Gupta, S. C., Bharti, A. C., & Aggarwal, B. B. (2018). Chronic diseases, inflammation, and spices: how are they linked? Journal of translational medicine, 16(1), 14. https://doi.org/10.1186/s12967-018-1381-2
Bang, J. S., Oh, D. H., Choi, H. M., Sur, B. J., Lim, S. J., Kim, J. Y., Yang, H. I., Yoo, M. C., Hahm, D. H., & Kim, K. S. (2009). Anti-inflammatory and antiarthritic effects of piperine in human interleukin 1beta-stimulated fibroblast-like synoviocytes and in rat arthritis models. Arthritis research & therapy, 11(2), R49. https://doi.org/10.1186/ar2662
Lobo, V., Patil, A., Phatak, A., & Chandra, N. (2010). Free radicals, antioxidants, and functional foods: Impact on human health. Pharmacognosy reviews, 4(8), 118–126. https://doi.org/10.4103/0973-7847.70902
Vijayakumar, R. S., Surya, D., & Nalini, N. (2004). Antioxidant efficacy of black pepper (Piper nigrum L.) and piperine in rats with high-fat diet-induced oxidative stress. Redox report: communications in free radical research, 9(2), 105–110. https://doi.org/10.1179/135100004225004742
Kannappan, R., Gupta, S. C., Kim, J. H., Reuter, S., & Aggarwal, B. B. (2011). Neuroprotection by spice-derived nutraceuticals: you are what you eat! Molecular neurobiology, 44(2), 142–159. https://doi.org/10.1007/s12035-011-8168-2
Rondanelli, M., Opizzi, A., Perna, S., Faliva, M., Solerte, S. B., Fioravanti, M., Klersy, C., Cava, E., Paolini, M., Scavone, L., Ceccarelli, P., Castellaneta, E., Savina, C., & Donini, L. M. (2013). Improvement in insulin resistance and favorable changes in plasma inflammatory adipokines after weight loss associated with two months’ consumption of a combination of bioactive food ingredients in overweight subjects. Endocrine, 44(2), 391–401. https://doi.org/10.1007/s12020-012-9863-0
Shoba, G., Joy, D., Joseph, T., Majeed, M., Rajendran, R., & Srinivas, P. S. (1998). Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta medica, 64(4), 353–356. https://doi.org/10.1055/s-2006-957450
Toxin overload is the condition of having an excessive amount of toxins in the body. Harmful substances can come from water, food, cleaning products, and environmental sources that individuals are exposed to regularly. Toxins are also produced in the body by poor gut health through autointoxication. Considering the number of toxins from food additives, preservatives, and perfumes to cleaning products, cosmetic products, and plastic water bottles, much of everyday life include exposure to chemicals that are not healthy. That’s why it’s recommended to undergo regular detoxes to ensure optimal body function and disease prevention.
Toxin Overload
One of the main ways toxins damage the body is they poison the enzymes, which prevents the body from functioning correctly. The body relies on enzymes for every physiological function. When toxins damage the enzymes, the production of hemoglobin in the blood is prevented, which can accelerate aging and lead to the failure of energy production and lower protection against oxidated stress. The failure of normal body functions increases the risk of diseases that include:
Proper waste elimination is essential to optimal health.
80% of the immune system is in the gut, and with a compromised digestive system, toxins can begin to accumulate.
Fatigue
When the body efficiently delivers nutrients to the cells and eliminates waste, there should be balanced energy throughout the day.
Toxin overload can cause individuals to experience fatigue, even in individuals that eat healthily and exercise, which could be an indicator of accumulation.
Chronic fatigue and viral infections could present from a weakened immune system.
Muscle Joint Aches and Pains
When gut health is compromised, undigested food particles can cause tears in the lining of the intestinal wall leading to a leaky gut.
The food particles enter the bloodstream and can cause an inflammatory response.
They can lodge themselves in weak areas of the joints, causing pain and increased muscle soreness.
Proper digestion and detoxification help eliminate toxins from the joints and muscles and heal the damaged lining.
Insomnia
Sleep is when the body detoxes, repairs, and rejuvenates itself.
Sleep problems could be a sign that the body is struggling to detoxify.
Chronic Headaches
Chronic headaches often result from imbalances in the body resulting from toxin overload and obstructed/blocked detoxification pathways.
Fluid Retention and Congestion
The lymphatic system is part of the circulatory system. The primary function is to transport lymph, a clear fluid that contains white blood cells essential for regulating inflammation.
Diet, hormone imbalances, sedentary lifestyle, medications, and genetics can contribute to fluid retention and congestion, causing stagnation of the lymphatic system.
If the system becomes congested, it can cause pain and swelling.
Unusual Weight Loss or Gain
Increased belly/visceral fat is the fat stored within the abdominal cavity. This is the most dangerous fat because of its proximity to vital organs like the liver, pancreas, and stomach.
Visceral fat or active fat influences how hormones function in the body. Stress, lack of exercise, and an unhealthy diet contribute to excess visceral fat.
Individuals trying to lose weight unsuccessfully could be a sign of having excessive toxins in the body.
Skin Problems
The skin reveals what’s happening inside the body.
Acne, rosacea, eczema, or other chronic skin issues, could indicate toxins are traveling through the skin.
When waste is not eliminated thoroughly through sweat, urine, and feces, the body could try to expel it through the skin.
Improving the body’s digestive and detoxification processes can help heal the root problem.
Giannini, Edoardo G et al. “Liver enzyme alteration: a guide for clinicians.” CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne vol. 172,3 (2005): 367-79. doi:10.1503/cmaj.1040752
Grant, D M. “Detoxification pathways in the liver.” Journal of inherited metabolic disease vol. 14,4 (1991): 421-30. doi:10.1007/BF01797915
Lala V, Goyal A, Minter DA. Liver Function Tests. [Updated 2022 Mar 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482489/
Mattick, R P, and W Hall. “Are detoxification programmes effective?.” Lancet (London, England) vol. 347,8994 (1996): 97-100. doi:10.1016/s0140-6736(96)90215-9
Seaman, David R. “Toxins, Toxicity, and Endotoxemia: A Historical and Clinical Perspective for Chiropractors.” Journal of chiropractic humanities vol. 23,1 68-76. 3 Sep. 2016, doi:10.1016/j.echu.2016.07.003
There are certain foods that although healthy, for individuals trying to prevent osteoporosis, they could stunt healthy bone growth. There are ways to prevent osteoporosis, and eating a diet rich in calcium and vitamin D is one of them. However, not all foods are beneficial for bone health.
Some nutrients can actually damage bones when consumed in high doses. These foods do not have to be completely removed from an individual’s diet. These foods and nutrients are still important so it would not be healthy to just stop. Individuals with or trying to prevent osteoporosis just need to make adjustments and consume them in moderation.
Caffeine
Too much caffeine more than four cups of coffee a day decreases calcium absorption, that increases risk for fractures. Coffee and tea contain caffeine naturally, but sodas create even larger concerns. Experts believe that the caffeine content in sodas is not the only danger. It is the substitution of milk and other calcium-based drinks.
Protein
Protein is essential for a balanced diet. This is because it helps build healthy muscle mass. A diet too high in animal protein (beef/pork) as opposed to protein from nuts and grains could contribute to calcium loss. Animal protein/s contain sulfur, that forms acid in the body. Acidic balance is necessary and so the body will release calcium from the bones to neutralize the acid and achieve balance.
What is considered too much protein?
No general amount has been determined. Therefore just an individual’s daily requirement, determined by body weight is what is recommended. Finding out how much protein is needed, take your weight in pounds, and multiply by .37. (Weight/lbs x .37 =) This will tell an individual how many grams they should be consuming every day. There are more specific techniques to get an exact number if need be.
Spinach
Green vegetables are considered some of the best foods to eat when the aim is to strengthen the bones. But spinach can prevent the body from absorbing calcium properly. This is because it contains oxalate. Oxalate interferes with the body’s ability to absorb calcium. Fortunately, spinach can still be included but may need to be adjusted/altered as to how it is prepared. In this case, spinach is best eaten cooked, as the chemical is destroyed through the process.
Salt
Too much salt makes it difficult for the body to keep the calcium, which can cause bone loss. Many processed foods are extremely high in sodium. Therefore, try to eat fresh foods and try sea, Himalayan, or healthy form of salt when seasoning meals.
Pure Wheat Bran
Pure wheat bran is the only food that can lower the absorption of calcium in other foods when eaten together. If taking a calcium supplement the effects of this process can be lessened by taking the supplement a few hours before or after eating foods with pure wheat bran.
These foods don’t have to be eliminated from your diet but should be consumed in moderation. The focus should be on a balanced diet. Building strong bones and maintaining them can be a delicious endeavor. Osteoporosis prevention is not the only benefit of healthy eating habits. A proper diet will promote and generate the optimal function of the body.
Learning About Food Substitutions
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The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Injuries to the muscles and ligaments around the hip affect both competitive and recreational athletes. These injuries can interfere significantly with sports enjoyment and performance levels, and they occasionally will end participation completely. Excessive pronation and poor shock absorption have been found to be an underlying cause or a contributing factor for many leg injuries. Functional orthotics which have been custom-fitted to improve the biomechanics of the feet and reduce the extent of pronation can help to prevent many sport-related leg injuries.
Lower Extremity Problems in Athletes
One study looked at the foot biomechanics of athletes who reported a recent foot or leg injury and compared them to an uninjured control group. The researchers determined that those athletes with more foot pronation had a much greater statistical probability of sustaining one of five leg injuries, including iliotibial band syndrome (which is due to excessive tightness of the hip abductor muscles).
This study helps us understand how providing appropriate functional foot orthotic support to patients who are involved in sports or recreational activities lowers their likelihood of developing both traumatic and overuse hip injuries.
In this paper, sixty-six injured athletes who ran at least once a week, and who had no history of traumatic or metabolic factors, were the study group. Another control group of 216 athletes were matched who did not have any symptoms of lower extremity injuries. The amount of pronation during standing and while running at �regular speed� was determined by measuring the angles of their footprints. The investigators found a significant correlation: Those athletes with more pronation had a much greater likelihood of having sustained one of the overuse athletic injuries.
Hip and Thigh Injuries
Many injuries experienced at the hip develop from poor biomechanics and gait asymmetry, especially when running. Smooth coordination of the muscles that provide balance and support for the pelvis is needed for optimum bipedal sports performance. This includes the hamstring muscles and the hip abductor muscles, especially the tensor fascia lata (the iliotibial band). When there is a biomechanical deficit from the feet and ankles, abnormal motions (such as excessive internal rotation of the entire leg) will predispose to pulls and strains of these important support muscles. The hamstrings (comprised of the biceps femoris, semimembranosus, and semitendinosus muscles) are a good example.
During running, the hamstrings are most active during the last 25% of the swing phase, and the first 50% of the stance phase. This initial 50% of stance phase consists of heel strike and maximum pronation. The hamstring muscles function to control the knee and ankle at heel strike and to help absorb some of the impact. A recent study has shown a significant decrease in electromyographic activity in the hamstrings when wearing orthotics. In fact, these investigators found that the biceps femoris (which is the most frequently injured of the three hamstring muscles) had the greatest decrease in activity of all muscles tested, including the tibialis anterior, the medial gastrocnemius, and the medial and lateral vastus muscles. The scientists in this study theorized that the additional support from the orthotics helped the hamstrings to control the position of the calcaneus and knee, so there was much less stress into the hip joint and pelvis.
Excessive Pronation and Hip Injuries
Using functional orthotics to correct excessive pronation and to treat hip problems requires an awareness of the various problems that can develop. The following is a list of the pathologies that are seen in the hip and pelvis secondary to pronation and foot hypermobility:
Iliotibial band syndrome����������������� Tensor fascia lata strain
Trochanteric bursitis����������������������� Hip flexor muscle strain
Piriformis muscle strain������������������ Hip adductor muscle strain
Hip joint capsulitis��������������������������� Anterior pelvic tilt
These conditions will develop much more easily in athletes, who push their musculoskeletal systems, and who seek more efficient and effective functional performances.
In 2002, researchers at Logan College of Chiropractic recruited a total of 40 male subjects that demonstrated bilateral pes planus or hyperpronation syndrome. Subjects were cast for custom made orthotics; their right and left Q-angles were measured with and without the orthotic in place. Thirty-nine of 40 test subjects showed reduced Q-angle, which was in the direction of correction, suggesting that wearing orthotics can improve stability and levelness of the pelvis, thus protecting the body to some degree from hip injury.
Conclusion
Excessive pronation and/or poor shock absorption have been shown to be an associated or causative factor in many leg injuries � from the foot itself, up the lower leg to the knee, thigh, and into the hip joint. The good news is that many of these conditions can be prevented with custom-fitted functional orthotics. Evaluation of foot biomechanics is a good idea in all patients, but is especially necessary for those who are recreationally active, or for anyone who has experienced hip problems.
To avoid potentially disabling hip injuries, competitive athletes must have regular evaluations of the alignment and function of their feet. Additional preventive measures include wearing well-designed and solidly-constructed shoes. When athletes are provided with custom-fitted functional orthotics, it can help prevent arch breakdown and biomechanical foot problems, and also treat numerous injuries of the lower extremities, including the hip joints.
Many injuries experienced at the hip develop from poor biomechanics and gait asymmetry, especially when running. Smooth coordination of the muscles that provide balance and support for the pelvis is needed for optimum bipedal sports performance. For Answers to any questions you may have please call Dr. Jimenez at 915-850-0900
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