For individuals suffering from neck pain and headaches, can craniosacral head massage therapy help provide relief?
Craniosacral Therapy
Craniosacral therapy is a gentle massage to release fascia or connective tissue network tension. The therapy is not new but has gained new attention because of the public interest in natural pain treatments and therapies. Studies are limited, but clinical research is ongoing to see if the therapy can become a mainstream treatment option. The therapy aims to alleviate the symptoms of various health ailments and conditions, including:
By relieving compression in the lower back, head, and spinal column, cerebrospinal fluid circulation is restored, and the body rhythms within the nervous system are reset. This provides pain relief, lowers stress, and improves overall well-being.
The focus areas are those along the fascia, the connective tissue that holds organs, blood vessels, bones, nerve fibers, and muscles in place. By working this tissue through gentle-pressure massage, practitioners help to calm the fight-or-flight response by relaxing the sympathetic nervous system. The symptoms will determine what areas of the body necessitate craniosacral therapy. Individuals with headaches will be given a head or neck massage. Other areas involved in craniosacral therapy include: (Heidemarie Haller, Gustav Dobos, and Holger Cramer, 2021)
Back
Around the spinal column.
Other areas like the joints or muscles.
The pressure applied during craniosacral therapy is light and not the same as a deep tissue massage.
The parasympathetic and sympathetic nervous systems control various body responses.
The parasympathetic nervous system supports proper rest and digestive functions, and the sympathetic nervous system regulates the body’s fight-or-flight response. (Cleveland Clinic. 2022)
Therapy Techniques
The massage techniques used in craniosacral therapy rely on low pressure intended to be as gentle as possible. The fingertips are often used to avoid applying too much pressure. Healthcare providers work the areas between the skull and the bottom of the spine to identify and reset imbalances within the body and the cerebrospinal fluid. If there is an imbalance in cerebrospinal fluid, the massage therapist will reposition the individual or press on the area to release and/or increase circulation. The techniques work to improve the body’s ability to regulate physiological responses. (Heidemarie Haller et al., 2019) During and after the session, individuals may experience different sensations, including: (Biodynamic Craniosacral Therapy Association of North America, 2024)
Relaxation.
Feeling like being in a meditative state.
Sleepiness.
Energized.
Feeling a sense of warmth.
Deeper breathing.
Feeling the body is straighter and taller.
Individuals Who Should Not Receive Craniosacral Therapy
Craniosacral therapy is considered safe; however, some individuals should avoid it or consult a healthcare provider before trying it. Those recommended not to receive the treatment include individuals with the following ailments or disorders:
Concussion or other traumatic brain injuries.
Blood clots.
Brain swelling.
Brain aneurysm – a blood-filled bulge in a blood vessel in or around the brain.
Conditions that cause cerebrospinal fluid buildup.
Treatment
Craniosacral therapy is offered by several healthcare providers, including:
Craniosacral therapy licensed massage therapists
Physical therapists
Occupational therapists
Osteopaths
Chiropractors
These professionals know how to perform the massage technique correctly.
Tension Headaches
References
Haller, H., Lauche, R., Sundberg, T., Dobos, G., & Cramer, H. (2019). Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC musculoskeletal disorders, 21(1), 1. https://doi.org/10.1186/s12891-019-3017-y
Haller, H., Dobos, G., & Cramer, H. (2021). The use and benefits of Craniosacral Therapy in primary health care: A prospective cohort study. Complementary therapies in medicine, 58, 102702. https://doi.org/10.1016/j.ctim.2021.102702
Biodynamic Craniosacral Therapy Association of North America. (2024). What is a session like? https://www.craniosacraltherapy.org/what-is-a-session-like-
For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?
Almond Flour
Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.
Almond Flour and Almond Meal
The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.
Carbohydrates and Calories
A half cup of commercially prepared flour contains about:
The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
The high glycemic index of whole wheat flour is 71, and rice flour is 98.
Using Almond Flour
It is recommended for making gluten-free quick bread recipes, such as gluten-free:
Muffins
Pumpkin bread
Pancakes
Some cake recipes
Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.
Almond Meal
Almond meal can be cooked as polenta or grits such as shrimp and grits.
Cookies can be made gluten-free with almond meal.
Almond meal biscuits can be made, but pay attention to the recipe.
Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.
Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.
Sensitivities
Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.
Making Your Own
It can be made in a blender or food processor.
Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
Add a little at a time and pulse until it is ground into meal.
Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.
Store Bought
Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.
Integrative Medicine
References
USDA FoodData Central. (2019). Almond Flour. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/603980/nutrients
Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. https://www.anaphylaxis.org.uk/factsheets/
Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. https://doi.org/10.1093/ajcn/nqab233
For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?
Peppermint
First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.
How It Is Used
Peppermint oil can be taken as a tea or in capsule form.
Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.
For Irritable Bowel Syndrome
Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)
Peppermint extract may increase serum levels of these medications.
It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.
Pregnancy
Peppermint is not recommended for use during pregnancy or by nursing individuals.
It is unknown if it could affect a developing fetus.
It is unknown if it can affect a nursing baby.
How To Use The Herb
It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.
Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
Supplements may contain harmful ingredients or not contain the active ingredient at all.
This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.
It has the potential to worsen certain conditions and should not be used by:
Peppermint was used to treat colic in infants but is not recommended today.
The menthol in the tea may cause infants and small children to choke.
Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. https://doi.org/10.1186/s12906-018-2409-0
Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. https://doi.org/10.3399/bjgp18X699101
Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.
National Center for Complementary and Integrative Health. (2020). Peppermint oil. Retrieved from https://www.nccih.nih.gov/health/peppermint-oil#safety
Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. https://doi.org/10.1007/s10620-015-3858-7
Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. https://doi.org/10.1097/MCG.0b013e3182a88357
For individuals dealing with eczema, can incorporating acupuncture into a treatment plan help manage and reduce symptoms?
Acupuncture for Eczema
Eczema is a chronic skin disorder that causes intense itching, dry skin, and rashes. Common treatment options for eczema include:
Moisturizers
Topical steroids
Prescription medications
Some research suggests that acupuncture may also help individuals with eczema. In recent years, researchers have looked at acupuncture as a possible treatment option and found that it can reduce symptoms.
Acupuncture
Acupuncture involves inserting thin metallic needles in specific acupoints in the body. It is believed that by stimulating specific points, the body’s central nervous system activates and releases certain chemicals designed to enable healing. Ailments that are treated using acupuncture include: (Johns Hopkins Medicine. 2024)
Headaches
Back pain
Nausea
Asthma
Osteoarthritis
Fibromyalgia
Treatment
Studies have found that acupuncture could be a treatment option depending on the severity of the condition and the intensity of the itching sensations. (Ruimin Jiao et al., 2020) The needles are placed at various points associated with relieving the condition. These points include: (Zhiwen Zeng et al., 2021)
LI4
Located at the base of the thumb and index finger.
It has been shown to help reduce inflammation and irritation.
LI11
This point is located within the elbow to reduce itchiness and dryness.
LV3
Located on the top of the foot, this point reduces stress on the nervous system.
SP6
The SP6 is on the lower calf above the ankle and can help reduce inflammation, redness, and skin irritation.
SP10
This point is located adjacent to the knee and reduces itchiness and inflammation.
ST36
This point is located below the knee on the back of the leg and is used to improve overall well-being.
Eczema flare-ups are also linked to stress and anxiety. Acupuncture has been shown to reduce anxiety and stress, which can also help relieve eczema symptoms (Beate Wild et al., 2020).
Acupuncture helps repair skin barrier damage or the outer part of the skin designed to protect the body. (Rezan Akpinar, Saliha Karatay, 2018)
Individuals with eczema tend to have a weakened skin barrier; this benefit can also improve symptoms. (National Eczema Association. 2023)
Individuals with eczema often have an overactive immune system contributing to the disorder.
According to research, acupuncture can also help in regulating the immune system. (Zhiwen Zeng et al., 2021)
Risks
Acupuncture is generally considered safe, but there are some risks to be aware of. These risks include: (Ruimin Jiao et al., 2020)
Swelling where the needles are inserted.
Red spots on the skin.
Increased itchiness.
A rash known as erythema – occurs when small blood vessels are injured.
Most studies on acupuncture for eczema show positive results that prove it can aid in relieving symptoms. (SeHyun Kang et al., 2018) (Ruimin Jiao et al., 2020) However, individuals should talk to their healthcare provider to see if it’s a safe option.
Jiao, R., Yang, Z., Wang, Y., Zhou, J., Zeng, Y., & Liu, Z. (2020). The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 38(1), 3–14. https://doi.org/10.1177/0964528419871058
Zeng, Z., Li, M., Zeng, Y., Zhang, J., Zhao, Y., Lin, Y., Qiu, R., Zhang, D. S., & Shang, H. C. (2021). Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review. Evidence-based complementary and alternative medicine : eCAM, 2021, 9994824. https://doi.org/10.1155/2021/9994824
Wild, B., Brenner, J., Joos, S., Samstag, Y., Buckert, M., & Valentini, J. (2020). Acupuncture in persons with an increased stress level-Results from a randomized-controlled pilot trial. PloS one, 15(7), e0236004. https://doi.org/10.1371/journal.pone.0236004
Akpinar R, Karatay S. (2018). Positive Effects of Acupuncture on Atopic Dermatitis. International Journal of Allergy Medications 4:030. doi.org/10.23937/2572-3308.1510030
National Eczema Association. (2023). Skin barrier basics for people with eczema. What is my skin barrier? https://nationaleczema.org/blog/what-is-my-skin-barrier/
National Eczema Association. (2021). Get the facts: acupuncture. Get the facts: acupuncture. https://nationaleczema.org/blog/get-the-facts-acupuncture/
Kang, S., Kim, Y. K., Yeom, M., Lee, H., Jang, H., Park, H. J., & Kim, K. (2018). Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: A randomized, sham-controlled preliminary trial. Complementary therapies in medicine, 41, 90–98. https://doi.org/10.1016/j.ctim.2018.08.013
Those experiencing neck pain, stiffness, headache, shoulder and back pain may suffer from a whiplash injury. Can knowing whiplash signs and symptoms help individuals recognize the injury and help healthcare providers develop an effective treatment plan?
Whiplash Signs and Symptoms
Whiplash is a neck injury that typically occurs after a motor vehicle collision or accident but can happen with any injury that rapidly whips the neck forward and backward. It is a mild to moderate injury of the neck muscles. Common whiplash signs and symptoms include:
Some individuals can develop chronic pain and headaches.
The symptoms and treatment depend on the severity of the injury. Treatment can include over-the-counter pain medicines, ice and heat therapy, chiropractic, physical therapy, and stretching exercises.
Frequent Signs and Symptoms
The sudden whipping movement of the head can affect several structures within the neck. These structures include:
Muscles
Bones
Joints
Tendons
Ligaments
Intervertebral discs
Blood vessels
Nerves.
Any or all of these can be affected by a whiplash injury. (MedlinePlus, 2017)
Statistics
Whiplash is a neck sprain that occurs from a fast neck-jerking motion. Whiplash injuries account for more than half of vehicle traffic collision injuries. (Michele Sterling, 2014) Even with a minor injury, the most frequent symptoms include: (Nobuhiro Tanaka et al., 2018)
Neck pain
Next stiffness
Neck tenderness
Limited range of motion of the neck
Individuals can develop neck discomfort and pain shortly after an injury; however, the more intense pain and stiffness typically do not occur right after the injury. Symptoms tend to worsen the next day or 24 hours later. (Nobuhiro Tanaka et al., 2018)
Beginning Symptoms
Researchers have found that approximately more than half of individuals with whiplash develop symptoms within six hours of the injury. Around 90% develop symptoms within 24 hours, and 100% develop symptoms within 72 hours. (Nobuhiro Tanaka et al., 2018)
Whiplash vs. Traumatic Cervical Spine Injury
Whiplash describes a mild to moderate neck injury without significant skeletal or neurological symptoms. Significant neck injuries can lead to fractures and dislocations of the spine that can affect the nerves and spinal cord. Once an individual develops neurological problems associated with a neck injury, the diagnosis changes from whiplash to traumatic cervical spine injury. These differences can be confusing as they are on the same spectrum. To better understand the severity of a neck sprain, the Quebec classification system divides neck injury into the following grades (Nobuhiro Tanaka et al., 2018)
Grade 0
This means there are no neck symptoms or physical examination signs.
Grade 1
There is neck pain and stiffness.
Very few findings from the physical examination.
Grade 2
Indicates neck pain and stiffness
Neck tenderness
Decreased mobility or neck range of motion on physical examination.
Grade 3
Involves muscle pain and stiffness.
Neurologic symptoms include:
Numbness
Tingling
Weakness in the arms
Decreased reflexes
Grade 4
Involves a fracture or dislocation of the bones of the spinal column.
Other Symptoms
Other whiplash signs and symptoms that can be associated with the injury but are less common or only occur with a severe injury include (Nobuhiro Tanaka et al., 2018)
Tension headache
Jaw pain
Sleep problems
Migraine headache
Difficulty concentrating
Reading difficulties
Blurred vision
Dizziness
Driving difficulties
Rare Symptoms
Individuals with severe injuries can develop rare symptoms that often indicate traumatic cervical spine injury and include: (Nobuhiro Tanaka et al., 2018)
Amnesia
Tremor
Voice changes
Torticollis – painful muscle spasms that keep the head turned to one side.
Bleeding in the brain
Complications
Most individual generally recover from their symptoms within a few weeks to a few months. (Michele Sterling, 2014) However, whiplash complications can occur, especially with severe grade 3 or grade 4 injuries. The most common complications of a whiplash injury include chronic/long-term pain and headaches. (Michele Sterling, 2014) Traumatic cervical spine injury can affect the spinal cord and be associated with chronic neurological problems, including numbness, weakness, and difficulty walking. (Luc van Den Hauwe et al., 2020)
Treatment
The pain is typically more severe the next day than after the injury. Whiplash musculoskeletal injury treatment depends on whether it is an acute injury or the individual has developed chronic neck pain and stiffness.
Acute pain can be treated with over-the-counter medicines like Tylenol and Advil, which effectively treat the pain.
Advil is a nonsteroidal anti-inflammatory that can be taken with the pain reliever Tylenol, which works in different ways.
The mainstay of treatment is encouraging regular activity with stretching and exercise. (Michele Sterling, 2014)
Physical therapy uses various range of motion exercises to strengthen the neck muscles and relieve the pain.
Chiropractic adjustments and non-surgical decompression can help realign and nourish the spine.
Acupuncture can cause the body to release natural hormones that provide pain relief, help relax the soft tissues, increase circulation, and reduce inflammation. The cervical spine can return to alignment when the soft tissues are no longer inflamed and spasming. (Tae-Woong Moon et al., 2014)
Neck Injuries
References
Medicine, J. H. (2024). Whiplash Injury. https://www.hopkinsmedicine.org/health/conditions-and-diseases/whiplash-injury
MedlinePlus. (2017). Neck Injuries and Disorders. Retrieved from https://medlineplus.gov/neckinjuriesanddisorders.html#cat_95
Sterling M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of physiotherapy, 60(1), 5–12. https://doi.org/10.1016/j.jphys.2013.12.004
Tanaka, N., Atesok, K., Nakanishi, K., Kamei, N., Nakamae, T., Kotaka, S., & Adachi, N. (2018). Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury. Advances in orthopedics, 2018, 4765050. https://doi.org/10.1155/2018/4765050
van Den Hauwe L, Sundgren PC, Flanders AE. (2020). Spinal Trauma and Spinal Cord Injury (SCI). In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554330/ doi: 10.1007/978-3-030-38490-6_19
Moon, T. W., Posadzki, P., Choi, T. Y., Park, T. Y., Kim, H. J., Lee, M. S., & Ernst, E. (2014). Acupuncture for treating whiplash associated disorder: a systematic review of randomised clinical trials. Evidence-based complementary and alternative medicine : eCAM, 2014, 870271. https://doi.org/10.1155/2014/870271
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Nutrition Fundamentals
References
University of Arizona Cooperative Extension. Hope Wilson, M. W., Patricia Zilliox. (2019). Prickly pear cactus: food of the desert. https://extension.arizona.edu/sites/extension.arizona.edu/files/pubs/az1800-2019.pdf
U.S. Department of Agriculture. FoodData Central. (2018). Nopales, cooked, without salt. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/169388/nutrients
U.S. Department of Agriculture. MyPlate. (2020-2025). Vegetables. Retrieved from https://www.myplate.gov/eat-healthy/vegetables
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. https://doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. https://doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. https://doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. https://doi.org/10.2337/dc06-2506
Centers for Disease Control and Prevention. (2022). Fiber: the carb that helps you manage diabetes. Retrieved from https://www.cdc.gov/diabetes/library/features/role-of-fiber.html
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. https://doi.org/10.1111/nmo.13986
National Institutes of Health (NIH). Office of Dietary Supplements. (2024). Calcium. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
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For athletes and sports enthusiasts, a torn triceps can be a serious injury. Can knowing their symptoms, causes, risk factors, and potential complications help healthcare providers develop an effective treatment plan?
Torn Triceps Injury
The triceps is the muscle on the back of the upper arm that allows the elbow to straighten. Fortunately, triceps tears are uncommon, but they can be serious. The injury affects men more often than women and usually occurs from trauma, sports, and/or exercise activities. Depending on the extent and severity of the injury, a torn triceps injury can require splinting, physical therapy, and possibly surgery to regain movement and strength. Recovery after a triceps tear typically lasts around six months. (The Ohio State University Wexner Medical Center. 2021)
Anatomy
The triceps brachii muscle, or triceps, runs along the back of the upper arm. It is named tri- because it has three heads – the long, medial, and lateral head. (Sendic G. 2023) The triceps originates at the shoulder and attaches to the shoulder blade/scapula and upper arm bone/humerus. At the bottom, it attaches to the point of the elbow. This is the bone on the pinky side of the forearm, known as the ulna. The triceps cause movement at the shoulder and the elbow joint. At the shoulder, it performs extension or backward movement of the arm and adduction or moving the arm toward the body. The main function of this muscle is at the elbow, where it performs extension or straightening of the elbow. The triceps work the opposite of the biceps muscle on the front of the upper arm, which conducts flexion or bending of the elbow.
Triceps Tear
Tears can occur anywhere along the length of a muscle or tendon, which is the structure that attaches the muscle to the bones. Triceps tears commonly occur in the tendon connecting the triceps to the back of the elbow. Muscle and tendon tears are graded from 1 to 3 based on severity. (Alberto Grassi et al., 2016)
Grade 1 Mild
These small tears cause pain that worsens with movement.
There is some swelling, bruising, and minimal loss of function.
Grade 2 Moderate
These tears are larger and have moderate swelling and bruising.
The fibers are partially torn and stretched.
Up to 50% loss of function.
Grade 3 Severe
This is the worst type of tear, where the muscle or tendon is completely torn.
These injuries cause severe pain and disability.
Symptoms
Triceps tears cause immediate pain in the back of the elbow and upper arm that worsens when trying to move the elbow. Individuals might also feel and/or hear a popping or tearing sensation. There will be swelling, and the skin will likely be red and/or bruised. With a partial tear, the arm will feel weak. If there is a complete tear, there will be significant weakness when straightening the elbow. Individuals may also notice a lump on the back of their arm where the muscles have contracted and knotted together.
Causes
Triceps tears usually occur during trauma, when the muscle is contracted and an external force pushes the elbow into a bent position. (Kyle Casadei et al., 2020) One of the most common causes is by falling on an outstretched arm. Triceps tears also occur during sports activities like:
Throwing a baseball
Blocking in a football game
Gymnastics
Boxing
When a player falls and lands on their arm.
Tears can also happen when using heavy weights during triceps-targeted exercises, such as the bench press.
Tears can also occur from direct trauma to the muscle, like a motor vehicle accident, but are less common.
Long-Term
Triceps tears can develop over time as a result of tendonitis. This condition usually occurs from repetitive use of the triceps muscle during activities like manual labor or exercise. Triceps tendonitis is sometimes referred to as weightlifter’s elbow. (Orthopedic & Spine Center. N.D.) The strain on tendons causes tiny tears that the body typically heals. However, if more strain is placed on the tendon than it can keep up with, the tiny tears can begin to grow.
Risk Factors
Risk factors can increase the risk of a triceps tear. Underlying medical conditions can weaken tendons, increasing the risk of injury, and can include: (Tony Mangano et al., 2015)
Diabetes
Rheumatoid arthritis
Hyperparathyroidism
Lupus
Xanthoma – fatty deposits of cholesterol under the skin.
Hemangioendothelioma – cancerous or noncancerous tumors caused by abnormal growth of blood vessel cells.
Chronic kidney failure
Chronic tendonitis or bursitis in the elbow.
Individuals who have had cortisone shots in the tendon.
Individuals using anabolic steroids.
Triceps tears tend to occur more commonly in males between 30 and 50. (Ortho Bullets. 2022) This comes from participating in activities like football, weightlifting, bodybuilding, and manual labor, which also increases the risk of injury.
Treatment
Treatment depends on which part of the triceps is affected and the extent of the damage. It may only need resting for a few weeks, physical therapy, or require surgery.
Nonsurgical
Partial tears in the triceps that involve less than 50% of the tendon can often be treated without surgery. (Mehmet Demirhan, Ali Ersen 2016) Initial treatment includes:
Splinting the elbow with a slight bend for four to six weeks allows the injured tissue to heal. (Ortho Bullets. 2022)
During this time, ice can be applied to the area for 15 to 20 minutes several times daily to help decrease pain and swelling.
Non-steroidal anti-inflammatory medications/NSAIDs – Aleve, Advil, and Bayer can help reduce inflammation.
Other over-the-counter medications like Tylenol can help decrease the pain.
Once the splint is removed, physical therapy will help restore movement and strength in the elbow.
Full movement is expected to return within 12 weeks, but full strength will not return until six to nine months after the injury. (Mehmet Demirhan, Ali Ersen 2016)
Surgery
Triceps tendon tears that involve more than 50% of the tendon require surgery. In some cases, however, surgery may still be recommended for tears smaller than 50% if the individual has a physically demanding job or plans to resume playing sports at a high level. Tears in the muscle belly or area where the muscle and tendon join are typically sewn back together. If the tendon is no longer attached to the bone, it is screwed back on. Recovery and physical therapy after surgery depend on the specific surgeon’s protocols. In general, individuals will spend a couple of weeks in a brace. Around four weeks after surgery, individuals will be able to start moving the elbow again. However, they won’t be able to start doing heavy lifting for four to six months. (Ortho Bullets. 2022) (Mehmet Demirhan, Ali Ersen 2016)
Complications
Complications can occur after triceps repair, whether there was surgery or not. For example, individuals may have problems regaining full elbow extension or straightening. They are also at a higher risk of re-rupture if they try to use the arm before it’s fully healed. (Mehmet Demirhan, Ali Ersen 2016)
Chiropractic Care for Healing After Trauma
References
The Ohio State University Wexner Medical Center. (2021). Distal triceps repair: clinical care guideline. (Medicine, Issue. https://medicine.osu.edu/-/media/files/medicine/departments/sports-medicine/medical-professionals/shoulder-and-elbow/distaltricepsrepair.pdf?
Sendic G. Kenhub. (2023). Triceps brachii muscle Kenhub. https://www.kenhub.com/en/library/anatomy/triceps-brachii-muscle
Grassi, A., Quaglia, A., Canata, G. L., & Zaffagnini, S. (2016). An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints, 4(1), 39–46. https://doi.org/10.11138/jts/2016.4.1.039
Casadei, K., Kiel, J., & Freidl, M. (2020). Triceps Tendon Injuries. Current sports medicine reports, 19(9), 367–372. https://doi.org/10.1249/JSR.0000000000000749
Mangano, T., Cerruti, P., Repetto, I., Trentini, R., Giovale, M., & Franchin, F. (2015). Chronic Tendonopathy as a Unique Cause of Non Traumatic Triceps Tendon Rupture in a (Risk Factors Free) Bodybuilder: A Case Report. Journal of orthopaedic case reports, 5(1), 58–61. https://doi.org/10.13107/jocr.2250-0685.257
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