For individuals who are getting into exercise, fitness, and physical activity, can knowing how glycogen works help in workout recovery?
Glycogen
When the body needs energy, it draws on its glycogen stores. Low-carbohydrate, ketogenic diets and intense exercise deplete glycogen stores, causing the body to metabolize fat for energy. Glycogen is supplied through carbohydrates in an individual’s diet and is used to power the brain, physical activity, and other bodily functions. The molecules made from glucose are mainly stored in the liver and muscles. What is eaten, how often, and the activity level influence how the body stores and uses glycogen. Restoring glycogen after physical activity or working out is a vital part of the recovery process. The body can quickly mobilize glycogen from these storage sites when it needs fuel. Eating enough carbohydrates to reach health goals and activity levels is essential for success.
What Is It
It is the body’s stored form of glucose or sugar.
It is stored in the liver and muscles.
It is the body’s primary and preferred energy source.
It comes from carbohydrates in foods and drinks.
It is made from several connected glucose molecules.
Production and Storage
Most carbohydrates eaten are converted to glucose, which becomes the body’s main energy source. However, when the body doesn’t need fueling, the glucose molecules become linked chains of eight to 12 glucose units, forming a glycogen molecule.
Process Triggers
Eating a carbohydrate-containing meal will raise blood glucose levels in response.
Increasing glucose signals the pancreas to produce insulin, a hormone that helps the body’s cells take up glucose from the bloodstream for energy or storage.
Insulin activation causes the liver and muscle cells to produce an enzyme called glycogen synthase, which links glucose chains together.
With enough glucose and insulin, glycogen molecules can be delivered to the liver, muscles, and fat cells for storage.
Since most glycogen is found in the muscles and liver, the amount stored in these cells varies depending on activity level, how much energy is burned at rest, and the foods eaten. The muscles primarily use glycogen stored in the muscles, while glycogen stored in the liver is distributed throughout the body, mainly to the brain and spinal cord.
Body Usage
The body converts glucose to glycogen through a process called glycogenesis. During this process, various enzymes help the body break down glycogen in glycogenolysis so the body can use it. The blood has a set amount of glucose ready to go at any given time. The insulin levels also drop when the level begins to decline, either from not eating or burning glucose during exercise. When this happens, an enzyme known as glycogen phosphorylase starts breaking the glycogen down to supply the body with glucose. Glucose from liver glycogen becomes the body’s primary energy. Short bursts of energy use glycogen, whether during sprints or heavy lifting. (Bob Murray, Christine Rosenbloom, 2018) A carbohydrate-rich pre-workout drink can provide energy to exercise longer and recover quicker. Individuals should eat a post-workout snack with a balanced amount of carbohydrates to replenish glycogen stores. The brain also uses glucose for energy, with 20 to 25% of glycogen going toward powering the brain. (Manu S. Goyal, Marcus E. Raichle, 2018) Mental sluggishness or brain fog can develop when not enough carbohydrates are consumed. When glycogen stores are depleted through exercise or insufficient carbs, the body can feel fatigued and sluggish and perhaps experience mood and sleep disturbances. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)
Diet
What foods are eaten and how much physical activity an individual does also influence glycogen production. The effects can be acute if one follows a low-carb diet, where carbohydrates, the primary source of glucose synthesis, are suddenly restricted.
Fatigue and Brain Fog
When first starting a low-carb diet, the body’s glycogen stores can be severely depleted and individuals may experience symptoms like fatigue and brain fog. (Kristen E. D’Anci et al., 2009)
The symptoms begin to subside once the body adjusts and renews its glycogen stores.
Water Weight
Any amount of weight loss can have the same effect on glycogen stores.
Initially, individuals may experience a rapid drop in weight.
Over time, weight may plateau and possibly increase.
The phenomenon is partly due to glycogen composition, which is also water. Rapid glycogen depletion at the onset of the diet triggers the loss of water weight. Over time, glycogen stores are renewed, and the water weight returns. When this happens, weight loss can stall or plateau. Fat loss can continue despite the short-term plateau effect.
Exercise
If undertaking a strenuous exercise routine, there are strategies to help avoid decreased performance that may be helpful:
Carbo-loading
Some athletes consume excessive amounts of carbohydrates before working out or competing.
Extra carbohydrates provide plenty of fuel.
The method has fallen out of favor as it can lead to excess water weight and digestive issues.
Glucose Gels
Energy gels containing glycogen can be consumed before or as needed during an event to increase blood glucose levels.
For example, energy chews are effective supplements for runners to help increase performance during extended runs.
Low-Carb Ketogenic Diet
Eating a diet high in fat and low in carbohydrates can put the body in a keto-adaptative state.
In this state, the body begins to access stored fat for energy and relies less on glucose for fuel.
At Injury Medical Chiropractic and Functional Medicine Clinic, our providers use an integrated approach to create personalized care plans for each individual, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to restore health and function to the body.
Sports Nutrition and Sports Dietician
References
Murray, B., & Rosenbloom, C. (2018). Fundamentals of glycogen metabolism for coaches and athletes. Nutrition reviews, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001
Goyal, M. S., & Raichle, M. E. (2018). Glucose Requirements of the Developing Human Brain. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875
Winwood-Smith, H. S., Franklin, C. E., & White, C. R. (2017). Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen. American journal of physiology. Regulatory, integrative and comparative physiology, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017
D’Anci, K. E., Watts, K. L., Kanarek, R. B., & Taylor, H. A. (2009). Low-carbohydrate weight-loss diets. Effects on cognition and mood. Appetite, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009
For individuals who are dealing with back pain and problems, could knowing how to improve and maintain intervertebral disc health help alleviate symptoms?
Intervertebral Disc Health
The spinal column comprises 24 movable bones and 33 bones called vertebrae. The vertebral bones are stacked on top of each other. The intervertebral disc is the cushioning substance between the adjacent bones. (Dartmouth. 2008)
Bones
The vertebral bones are small and round in an area called the vertebral body. In the back is a bony ring from which protrusions extend and arches and pathways are formed. Each structure has one or more purposes and includes: (Waxenbaum JA, Reddy V, Williams C, et al., 2023)
Stabilizing the spine.
Providing a space for the connective tissue and back muscles to attach.
Providing a tunnel for the spinal cord to pass through cleanly.
Providing a space where nerves exit and branch out to all areas of the body.
Structure
The intervertebral disc is the cushioning that sits between the vertebrae. The design of the spine allows it to move in various directions:
Flexion or bending
Extension or arching
Tilting and rotation or twisting.
Powerful forces act upon and influence the spinal column to produce these movements. The intervertebral disc absorbs shock during movement and protects the vertebrae and spinal cord from injury and/or trauma.
Ability
On the outside, strong woven fiber tissues form an area called the annulus fibrosis. The annulus fibrosis contains and protects the softer gel substance in the center, the nucleus pulposus. (Y.S. Nosikova et al., 2012) The nucleus pulposis provides shock absorption, flexibility, and pliability, especially under pressure during spinal movement.
Mechanics
The nucleus pulposus is a soft gel substance located in the center of the disc that allows elasticity and flexibility under stress forces to absorb compression. (Nedresky D, Reddy V, Singh G. 2024) The swivel action alters the tilt and rotation of the vertebra above and below, buffering the effects of spinal motion. The discs swivel in response to the direction the spine moves. The nucleus pulposus is made mostly of water, which moves in and out through small pores, acting as byways between the vertebra and disc bone. Body positions that load the spine, like sitting and standing, push the water out of the disc. Lying down on the back or in a supine position facilitates water restoration into the disc. As the body ages, the discs lose water/dehydrate, leading to disc degeneration. The intervertebral disc has no blood supply, which means that for a disc to receive necessary nutrition and for waste removal, it must rely on water circulation to stay healthy.
Care
Some ways of maintaining intervertebral disc health include:
Paying attention to posture.
Changing positions frequently throughout the day.
Exercising and moving around.
Applying correct body mechanics to physical activities.
Sleeping on a supportive mattress.
Drinking plenty of water.
Eating healthy.
Maintaining a healthy weight.
Drinking alcohol in moderation.
Quitting smoking.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractic team, care plans, and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Acupuncture, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Beyond the Surface: Understanding the Effects of Personal Injury
Waxenbaum, J. A., Reddy, V., Williams, C., & Futterman, B. (2024). Anatomy, Back, Lumbar Vertebrae. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29083618
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. doi.org/10.1111/j.1469-7580.2012.01537.x
Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?
Food Poisoning and Restoring Gut Health
Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centers for Disease Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.
Foods to Eat
After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)
Gatorade
Pedialyte
Water
Herbal tea
Chicken broth
Jello
Applesauce
Crackers
Toast
Rice
Oatmeal
Bananas
Potatoes
Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)
When Food Poisoning Is Active Foods To Avoid
During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)
Caffeinated drinks and alcohol can further dehydrate.
Greasy foods and high-fiber foods are hard to digest.
Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)
Recovery Time and Resuming Regular Diet
Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centers for Disease Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centers for Disease Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)
Recommended Gut Foods Post Stomach Virus
Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)
Beans
Onions
Tomatoes
Asparagus
Peas
Honey
Milk
Banana
Wheat, barley, rye
Garlic
Soybean
Seaweed
In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)
Pickles
Sourdough bread
Kombucha
Sauerkraut
Yogurt
Miso
Kefir
Kimchi
Tempeh
Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. doi.org/10.1371/journal.pone.0095534
Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. doi.org/10.1093/cid/cix669
Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. doi.org/10.3945/ajcn.115.114769
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. doi.org/10.1002/bab.1938
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. doi.org/10.3390/microorganisms7010014
Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. doi.org/10.1002/jev2.12172
Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. doi.org/10.3390/foods8030092
Can incorporating acupressure provide effective relief and benefits for individuals looking to try natural treatments for common health ailments?
Acupressure
Acupressure is a type of complementary medicine that is rising in popularity due to its simplicity and accessibility. It can assist in treating various diseases and conditions. (Piyush Mehta et al., 2016) Anyone can learn it, and no special equipment is required. It is an effective and safe therapeutic option with no known side effects. (Youngmi Cho et al., 2021) It is a cost-effective intervention similar to acupuncture. (Lukas Israel et al., 2021)
What Is It?
The concept of acupressure activates acupoints or pressure points across meridians or channels connected to various organs to balance energy and promote health. Practitioners believe that the quality or state of a person’s energy determines their health. (Piyush Mehta et al., 2016) Acupressure is the stimulation of acupoints using either the fingers or a tool. Massage techniques like Amma, Shiatsu, Tui Na, and Thai massage incorporate acupressure in their treatments and follow the same energy channels as acupuncture.
The Way It Works
Acupressure works similarly to acupuncture. The Gate Control Theory theorizes that pleasure impulses reach the brain four times faster than pain impulses. Continuous pleasurable impulses close the neural gates and block slower messages, like pain. According to this theory, acupressure improves the pain perception threshold. (Piyush Mehta et al., 2016) Stimulating acupoints activates functional responses, like releasing hormones. These hormones serve various functions, physical, like regulating organ function, and mental, like regulating emotions, and releasing them can help improve health and well-being. (Piyush Mehta et al., 2016)
Acupressure is a simple and effective intervention that can be self or professionally administered.
Acupoints are activated in the elbows, fingers, feet, knuckles, palms, or thumbs.
Though acupressure doesn’t require specialized tools, they are available for convenience.
Some practitioners used Bian stones to activate acupoints.
Acupressure is often used alongside modern medicine, as it treats common or coexisting symptoms, such as anxiety or stress. Some of the conditions for which acupressure may be effective include.
Stress and Fatigue Reduction
Stress and fatigue are common but often arise alongside other ailments or conditions if persistent or severe, anxiety and fatigue can significantly affect quality of life by reducing an individual’s ability to participate in daily activities. In a study looking at shift work nurses who experience stress and fatigue from the intensity of their work, acupressure significantly reduced their symptoms. (Youngmi Cho et al., 2021) In studies with breast cancer survivors, acupressure was also used to decrease fatigue levels and was shown to be an effective and low-cost option for managing persistent fatigue alongside standard care for breast cancer. (Suzanna Maria Zick et al., 2018) (Suzanna M Zick et al., 2016)
Can Help With Anxiety and Depression
Depression and anxiety can be part of a disorder or exist on their own. Acupressure may help alleviate some of the anxiety and depression that arise as part of a condition or ailment. In the shift work nurses study, acupressure helped decrease anxiety levels. (Youngmi Cho et al., 2021) In other studies, acupressure reduced anxiety scores and improved depressive symptoms in individuals with mild to moderate symptoms. (Elizabeth Monson et al., 2019) (Jingxia Lin et al., 2022) (Suzanna Maria Zick et al., 2018)
Pain Reduction
Individuals experience physical pain for a variety of reasons. Pain can come from temporary sports injuries, work, sudden awkward movements, and/or chronic illness. Acupressure can effectively reduce pain as a complementary therapy. (Elizabeth Monson et al., 2019) In a study, athletes who had a musculoskeletal sports injury reported decreased pain intensity after three minutes of acupressure therapy. (Aleksandra K Mącznik et al., 2017) In another study, breast cancer survivors showed significant improvements with acupressure. (Suzanna Maria Zick et al., 2018)
Nausea Relief
Nausea and vomiting are conditions that are common for those who are pregnant or undergoing chemotherapy. It also can be a medication side effect or arise with migraine or indigestion. There is evidence that acupressure may be effective in alleviating symptoms. Some researchers believe a particular type of acupressure known as auricular acupressure is the most effective for treating chemotherapy-induced nausea and vomiting alongside standard treatment. (Jing-Yu Tan et al., 2022) However, further research is needed to determine whether this is a viable, ongoing option for treating nausea and vomiting. (Heather Greenlee et al., 2017)
Sleep Better
Acupressure can be an effective and low-cost option for managing breast cancer symptoms. One study found relaxing acupressure techniques improved sleep quality and quality of life in breast cancer survivors. Additionally, researchers note that relaxing acupressure is more effective for improving sleep and quality of life than stimulating acupressure. (Suzanna M Zick et al., 2016)
Allergy Reduction
Allergic rhinitis is inflammation caused by an allergic reaction. Previous trials have found that acupressure could improve overall health by reducing seasonal allergic rhinitis symptoms and the need for allergy medication. (Lukas Israel et al., 2021) Researchers also noted that individuals are likely to adhere to self-applied acupressure therapy as a form of self-massage. (Lukas Israel et al., 2021)
Always consult a healthcare provider before starting acupressure treatments, especially if you have any pre-existing health conditions. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. Flexibility, mobility, and agility programs are tailored for all age groups and disabilities. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Enhance Performance with Functional Foot Orthotics
References
Mehta, P., Dhapte, V., Kadam, S., & Dhapte, V. (2016). Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. Journal of traditional and complementary medicine, 7(2), 251–263. doi.org/10.1016/j.jtcme.2016.06.004
Cho, Y., Joo, J. M., Kim, S., & Sok, S. (2021). Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. International journal of environmental research and public health, 18(8), 4199. doi.org/10.3390/ijerph18084199
Israel, L., Rotter, G., Förster-Ruhrmann, U., Hummelsberger, J., Nögel, R., Michalsen, A., Tissen-Diabaté, T., Binting, S., Reinhold, T., Ortiz, M., & Brinkhaus, B. (2021). Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chinese medicine, 16(1), 137. doi.org/10.1186/s13020-021-00536-w
Zick, S. M., Sen, A., Hassett, A. L., Schrepf, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2018). Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors. JNCI cancer spectrum, 2(4), pky064. doi.org/10.1093/jncics/pky064
Zick, S. M., Sen, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2016). Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Clinical Trial. JAMA oncology, 2(11), 1470–1476. doi.org/10.1001/jamaoncol.2016.1867
Monson, E., Arney, D., Benham, B., Bird, R., Elias, E., Linden, K., McCord, K., Miller, C., Miller, T., Ritter, L., & Waggy, D. (2019). Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. Journal of alternative and complementary medicine (New York, N.Y.), 25(5), 517–521. doi.org/10.1089/acm.2018.0422
Lin, J., Chen, T., He, J., Chung, R. C., Ma, H., & Tsang, H. (2022). Impacts of acupressure treatment on depression: A systematic review and meta-analysis. World journal of psychiatry, 12(1), 169–186. doi.org/10.5498/wjp.v12.i1.169
Mącznik, A. K., Schneiders, A. G., Athens, J., & Sullivan, S. J. (2017). Does Acupressure Hit the Mark? A Three-Arm Randomized Placebo-Controlled Trial of Acupressure for Pain and Anxiety Relief in Athletes With Acute Musculoskeletal Sports Injuries. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 27(4), 338–343. doi.org/10.1097/JSM.0000000000000378
Tan, J. Y., Molassiotis, A., Suen, L. K. P., Liu, J., Wang, T., & Huang, H. R. (2022). Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC complementary medicine and therapies, 22(1), 87. doi.org/10.1186/s12906-022-03543-y
Greenlee, H., DuPont-Reyes, M. J., Balneaves, L. G., Carlson, L. E., Cohen, M. R., Deng, G., Johnson, J. A., Mumber, M., Seely, D., Zick, S. M., Boyce, L. M., & Tripathy, D. (2017). Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: a cancer journal for clinicians, 67(3), 194–232. doi.org/10.3322/caac.21397
Ho, K. K., Kwok, A. W., Chau, W. W., Xia, S. M., Wang, Y. L., & Cheng, J. C. (2021). A randomized controlled trial on the effect of focal thermal therapy at acupressure points treating osteoarthritis of the knee. Journal of orthopaedic surgery and research, 16(1), 282. doi.org/10.1186/s13018-021-02398-2
Certain neurological disorders can cause acute episodes of peripheral neuropathy, and for individuals diagnosed with chronic peripheral neuropathy, can physical therapy help improve the ability to move around safely along with medications, procedures, and lifestyle adjustments to help control and manage symptoms?
Peripheral Neuropathy Treatments
Peripheral neuropathy treatment includes symptomatic therapies and medical management to help prevent worsening nerve damage.
For acute types of peripheral neuropathy, medical interventions and therapies can treat the underlying process, improving the condition.
For chronic types of peripheral neuropathy, medical interventions and lifestyle factors can help to prevent the condition’s progression.
Chronic peripheral neuropathy treatment focuses on controlling the pain symptoms and protecting areas of diminished sensation from damage or infection.
Self-Care and Lifestyle Adjustments
For individuals who have been diagnosed with peripheral neuropathy or are at risk of developing the condition, lifestyle factors play a significant role in managing symptoms and preventing nerve damage from worsening and can even prevent the condition from developing. (Jonathan Enders et al., 2023)
Pain Management
Individuals can try these self-care therapies and see if and which help reduce their discomfort and then develop a routine that they can work off of. Self-care for pain symptoms include:
Placing a warm heating pad on painful areas.
Placing a cooling pad (not ice) on painful areas.
Covering the area or leaving it uncovered, depending on comfort levels.
Wear loose-fitting clothes, socks, shoes, and/or gloves not made with material that can cause irritation.
Avoid using lotions or soaps that can cause irritation.
Use soothing creams or lotions.
Keeping the painful areas clean.
Injuries Prevention
Diminished sensation is one of the most common effects that can lead to problems like stumbling, difficulty getting around, and injuries. Preventing and regularly checking for injuries can help avoid complications like infected wounds. (Nadja Klafke et al., 2023) Lifestyle adjustments to manage and prevent injuries include:
Wear well-padded shoes and socks.
Inspect feet, toes, fingers, and hands regularly to look for cuts or bruises that may not have been felt.
Clean and cover cuts to avoid infections.
Use extra caution with sharp utensils like cooking and work or gardening tools.
Disease Management
Lifestyle factors can help prevent disease progression and are closely correlated with the risks and underlying causes. To help prevent peripheral neuropathy or its progression can be done by: (Jonathan Enders et al., 2023)
Maintain healthy glucose levels if you have diabetes.
Avoid alcohol for any peripheral neuropathy.
Maintain a well-balanced diet, which can include vitamin supplements, especially for vegetarians or vegans.
Over-the-Counter Therapies
A few over-the-counter therapies can help with painful symptoms and can be taken as needed. Over-the-counter pain therapies include: (Michael Überall et al., 2022)
Topical lidocaine spray, patch, or creams.
Capsaicin creams or patches.
Topical Icy Hot
Non-steroidal anti-inflammatory medications – Advil/ibuprofen or Aleve/naproxen
Tylenol/acetaminophen
These treatments can help relieve painful symptoms of peripheral neuropathy, but they do not help improve diminished sensation, weakness, or coordination problems. (Jonathan Enders et al., 2023)
Prescription Therapies
Prescription therapies for treating peripheral neuropathy include pain medications and anti-inflammatories. Chronic types of peripheral neuropathy include:
Alcoholic neuropathy
Diabetic neuropathy
Chemotherapy-induced neuropathy
The prescription treatments for chronic types differ from the treatments for acute types of peripheral neuropathy.
Pain Management
Prescription treatments can help manage the pain and discomfort. Medications include (Michael Überall et al., 2022)
Sometimes, a prescription strength supplement or vitamin B12 given through injection can help prevent progression when peripheral neuropathy is associated with a severe vitamin deficiency. Prescription treatment can help treat the underlying process in some types of acute peripheral neuropathy. Treatment for acute peripheral neuropathy, such as Miller-Fisher syndrome or Guillain-Barré syndrome, can include:
Corticosteroids
Immunoglobulins – immune system proteins
Plasmapheresis is a procedure that removes the liquid portion of blood, returning the blood cells, which modifies the overactivity of the immune system. (Sanja Horvat et al., 2022)
Researchers believe there is an association between these conditions and inflammatory nerve damage, and modifying the immune system is beneficial for treating symptoms and the underlying disease.
Surgery
In some cases, surgical procedures can benefit individuals who have certain types of peripheral neuropathy. When another condition is exacerbating the symptoms or process of peripheral neuropathy, surgery may help relieve symptoms and prevent disease progression. This has proved effective when nerve entrapment or vascular insufficiency are factors. (Wenqiang Yang et al., 2016)
Complementary and Alternative Medicine
Some complementary and alternative approaches can help individuals cope with the pain and discomfort. These treatments can serve as an ongoing option for those who have chronic peripheral neuropathy. Options can include: (Nadja Klafke et al., 2023)
Acupuncture involves the placement of needles in specific areas of the body to help reduce pain symptoms.
Acupressure involves applying pressure on specific areas of the body to help reduce pain symptoms.
Massage therapy can help relax muscle tension.
Meditation and relaxation therapies can help manage symptoms.
Physical therapy can also serve as an important component of living with chronic peripheral neuropathy and recovering from acute peripheral neuropathy.
Physical therapy can help strengthen weak muscles, improve coordination, and learn how to adapt to sensory and motor changes to get around safely.
Individuals considering complementary or alternative treatment are encouraged to speak with their primary healthcare provider to determine whether it is safe for their condition. Injury Medical Chiropractic and Functional Medicine Clinic will work with the individual’s healthcare provider and/or specialists to develop an optimal health and wellness treatment solution to provide pain relief and improve quality of life.
Peripheral Neuropathy: A Successful Recovery Story
References
Enders, J., Elliott, D., & Wright, D. E. (2023). Emerging Nonpharmacologic Interventions to Treat Diabetic Peripheral Neuropathy. Antioxidants & redox signaling, 38(13-15), 989–1000. doi.org/10.1089/ars.2022.0158
Klafke, N., Bossert, J., Kröger, B., Neuberger, P., Heyder, U., Layer, M., Winkler, M., Idler, C., Kaschdailewitsch, E., Heine, R., John, H., Zielke, T., Schmeling, B., Joy, S., Mertens, I., Babadag-Savas, B., Kohler, S., Mahler, C., Witt, C. M., Steinmann, D., … Stolz, R. (2023). Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Medical sciences (Basel, Switzerland), 11(1), 15. doi.org/10.3390/medsci11010015
Überall, M., Bösl, I., Hollanders, E., Sabatschus, I., & Eerdekens, M. (2022). Painful diabetic peripheral neuropathy: real-world comparison between topical treatment with lidocaine 700 mg medicated plaster and oral treatments. BMJ open diabetes research & care, 10(6), e003062. doi.org/10.1136/bmjdrc-2022-003062
Horvat, S., Staffhorst, B., & Cobben, J. M. G. (2022). Intravenous Lidocaine for Treatment of Chronic Pain: A Retrospective Cohort Study. Journal of pain research, 15, 3459–3467. doi.org/10.2147/JPR.S379208
Yang, W., Guo, Z., Yu, Y., Xu, J., & Zhang, L. (2016). Pain Relief and Health-Related Quality-of-Life Improvement After Microsurgical Decompression of Entrapped Peripheral Nerves in Patients With Painful Diabetic Peripheral Neuropathy. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 55(6), 1185–1189. doi.org/10.1053/j.jfas.2016.07.004
Spinal stenosis is the term used to describe a narrowing spine. Treatments vary because everybody’s case is different. Some individuals experience mild symptoms, while others experience severe symptoms. Can knowing treatment options help the patient and healthcare team customize and personalize a treatment plan to the individual’s condition?
Spinal Stenosis Treatments
Spaces within the spine can become narrower than they’re supposed to be, which can cause pressure on nerve roots and the spinal cord. Anywhere along the spine can be affected. The narrowing can cause pain, burning, and/or aching in the back and weakness in the legs and feet. Spinal stenosis has several primary treatments. When working through spinal stenosis treatments, a healthcare provider will assess symptoms and start treatment with first-line therapy, such as pain medication and/or physical therapy. These are often the first among individuals with the disease.
Medication
Chronic pain is one of the main symptoms. The first-line treatment often involves using pain-relieving medication/s. Commonly prescribed medications are nonsteroidal anti-inflammatories or NSAIDs. These medications reduce pain and inflammation. However, NSAIDs are not recommended for long-term use, and other medications may need to be used to relieve pain that includes: (Sudhir Diwan et al., 2019)
Tylenol – acetaminophen
Gabapentin
Pregabalin
Opioids for severe cases
Exercise
Exercise can reduce spinal stenosis symptoms by taking pressure off the nerves, which can reduce pain and improve mobility. (Andrée-Anne Marchand et al., 2021) Healthcare providers will recommend the most effective exercises for the individual. Examples include:
Another primary spinal stenosis treatment is physical therapy, which is often used alongside pain medications. Typically, individuals undergo six to eight weeks of physical therapy, with sessions two to three times a week. Utilizing physical therapy has been shown to (Sudhir Diwan et al., 2019)
Reduce pain
Increase mobility
Reduce pain medications.
Reduce mental health symptoms like anger, depression, and mood changes.
For severe cases, physical therapy following surgery can reduce recovery times.
Back Braces
Back braces can help reduce movement and pressure on the spine. This is helpful because even small spinal movements can lead to nerve irritation, pain, and worsening symptoms. Over time, the bracing can lead to a positive increase in mobility. (Carlo Ammendolia et al., 2019)
Injections
Epidural steroid injections may be recommended to relieve severe symptoms. Steroids act as anti-inflammatories to reduce pain and swelling caused by inflammation and irritation of the spinal nerves. They are considered nonsurgical medical procedures. According to research, injections can effectively manage pain for two weeks and up to six months, and some research has found that after a spinal injection, relief can last 24 months. (Sudhir Diwan et al., 2019)
Thickened Ligaments Decompression Procedure
Some individuals may be recommended to undergo a decompression procedure. This procedure involves using a thin needle tool inserted into the back. The thickened ligament tissue is removed to reduce the pressure on the spine and nerves. Research has found that the procedure can reduce symptoms and the need for more invasive surgery. (Nagy Mekhail et al., 2021)
Alternative Treatments
In addition to first-line treatments, individuals may be referred to alternative therapies for symptom management, including:
Acupuncture
This involves the insertion of thin-tipped needles into various acupoints to relieve symptoms.
Some research has found that acupuncture may be more effective at reducing symptoms than physical therapy alone. Both options are viable and can improve mobility and pain. (Hiroyuki Oka et al., 2018)
Chiropractic
This therapy reduces pressure on nerves, maintains spinal alignment, and helps to improve mobility.
Massage
Massage helps to increase circulation, relax the muscles, and reduce pain and stiffness.
New Treatment Options
As spinal stenosis research continues, new therapies are emerging to help relieve and manage symptoms in individuals who don’t respond to traditional medicine or cannot partake in conventional therapies for various reasons. However, some evidence presented is promising; medical insurers may consider them experimental and not offer coverage until their safety has been proven. Some new treatments include:
Acupotomy
Acupotomy is a form of acupuncture that uses thin needles with a small, flat, scalpel-type tip to relieve tension in painful areas. Research on its effects is still limited, but preliminary data shows it could be an effective complementary treatment. (Ji Hoon Han et al., 2021)
Stem Cell Therapy
Stem cells are the cells from which all other cells originate. They act as the raw material for the body to create specialized cells with specific functions. (National Institutes of Health. 2016)
Individuals with spinal stenosis can develop soft tissue damage.
Stem cell therapy uses stem cells to help repair injured or diseased tissues.
Stem cell therapy can help repair or improve the damaged areas and provide symptom relief.
Clinical studies for spinal stenosis report that it could be a viable treatment option for some.
However, more research is needed to confirm whether the therapy is effective enough to be widely used. (Hideki Sudo et al., 2023)
Dynamic Stabilization Devices
LimiFlex is a medical device undergoing research and analysis for its ability to restore mobility and stability in the spine. It is implanted into the back through a surgical procedure. According to research, individuals with spinal stenosis who receive the LimiFlex often experience a higher reduction in pain and symptoms than with other forms of treatment. (T Jansen et al., 2015)
Lumbar Interspinous Distraction Decompression
Lumbar interspinous distraction decompression is another surgical procedure for spinal stenosis. The surgery is performed with an incision above the spine and places a device between two vertebrae to create space. This reduces movement and pressure on the nerves. Preliminary results show positive short-term relief from symptoms; long-term data is not yet available as it is a relatively new spinal stenosis treatment option. (UK National Health Service, 2022)
Surgical Procedures
There are several surgical procedures are available for spinal stenosis. Some include: (NYU Langone Health. 2024) Surgery for spinal stenosis is often reserved for individuals with severe symptoms, like numbness in the arms or legs. When these symptoms develop, it indicates a more notable compression of the spinal nerves and the need for a more invasive treatment. (NYU Langone Health. 2024)
Laminectomy
A laminectomy removes part or all of the lamina, the vertebral bone covering the spinal canal.
The procedure is designed to reduce pressure on nerves and the spinal cord.
Laminotomy and Foraminotomy
Both surgeries are used if an individual’s spinal stenosis negatively affects an opening in the vertebral foramen.
Ligaments, cartilage, or other tissues that constrict the nerves are removed.
Both reduce pressure on the nerves traveling through the foramen.
Laminoplasty
A laminoplasty relieves pressure on the spinal cord by removing parts of the spinal canal’s lamina.
This surgical procedure involves removing herniated or bulging discs that are placing pressure on the spinal cord and nerves.
Spinal fusion
Spinal fusion involves joining two vertebrae using metal pieces like rods and screws.
The vertebrae are more stable because the rods and screws act as a brace.
Which Treatment Is The Right One?
Because all treatment plans differ, determining the most effective is best suited for a healthcare provider. Each approach will be personalized to the individual. To decide what therapy is best, healthcare providers will assess: (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
The severity of symptoms.
The current level of overall health.
The level of damage that’s occurring in the spine.
The level of disability and how mobility and quality of life are affected.
Injury Medical Chiropractic and Functional Medicine Clinic will work with an individual’s primary healthcare provider and/or specialists to help determine the best treatment options and concerns regarding medications or other forms of treatment.
Unlocking Wellness
References
Diwan, S., Sayed, D., Deer, T. R., Salomons, A., & Liang, K. (2019). An Algorithmic Approach to Treating Lumbar Spinal Stenosis: An Evidenced-Based Approach. Pain medicine (Malden, Mass.), 20(Suppl 2), S23–S31. doi.org/10.1093/pm/pnz133
Marchand, A. A., Houle, M., O’Shaughnessy, J., Châtillon, C. É., Cantin, V., & Descarreaux, M. (2021). Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial. Scientific reports, 11(1), 11080. doi.org/10.1038/s41598-021-90537-4
Ammendolia, C., Rampersaud, Y. R., Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C., & Côté, P. (2019). Effect of a prototype lumbar spinal stenosis belt versus a lumbar support on walking capacity in lumbar spinal stenosis: a randomized controlled trial. The spine journal : official journal of the North American Spine Society, 19(3), 386–394. doi.org/10.1016/j.spinee.2018.07.012
Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C., & Saied, O. (2021). The durability of minimally invasive lumbar decompression procedure in patients with symptomatic lumbar spinal stenosis: Long-term follow-up. Pain practice : the official journal of World Institute of Pain, 21(8), 826–835. doi.org/10.1111/papr.13020
Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study). BMC complementary and alternative medicine, 18(1), 19. doi.org/10.1186/s12906-018-2087-y
Han, J. H., Lee, H. J., Woo, S. H., Park, Y. K., Choi, G. Y., Heo, E. S., Kim, J. S., Lee, J. H., Park, C. A., Lee, W. D., Yang, C. S., Kim, A. R., & Han, C. H. (2021). Effectiveness and safety of acupotomy on lumbar spinal stenosis: A pragmatic randomized, controlled, pilot clinical trial: A study protocol. Medicine, 100(51), e28175. doi.org/10.1097/MD.0000000000028175
Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, Y. M., Kahata, K., Tha, K. K., Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N., & Isoe, T. (2023). Protocol for treating lumbar spinal canal stenosis with a combination of ultrapurified, allogenic bone marrow-derived mesenchymal stem cells and in situ-forming gel: a multicentre, prospective, double-blind randomised controlled trial. BMJ open, 13(2), e065476. doi.org/10.1136/bmjopen-2022-065476
Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D., & Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [A Comparison of Dorsal Decompression and Dorsal Decompression Combined with the Dynamic Stabilisation Device LimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. doi.org/10.1055/s-0035-1545990
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. 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. doi.org/10.1016/j.ctim.2021.102702
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