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Managing Hinge Joint Pain and Conditions

Managing Hinge Joint Pain and Conditions

 Can understanding the body’s hinge joints and how they operate help with mobility and flexibility problems and manage conditions for individuals with difficulty fully bending or extending their fingers, toes, elbows, ankles, or knees?

Managing Hinge Joint Pain and Conditions

Hinge Joints

A joint forms where one bone connects to another, allowing motion. Different types of joints differ in structure and movement depending on their location. These include hinge, ball and socket, planar, pivot, saddle, and ellipsoid joints. (Boundless. General Biology, N.D.) Hinge joints are synovial joints that move through one plane of motion: flexion and extension. Hinge joints are found in the fingers, elbows, knees, ankles, and toes and control movement for various functions. Injuries, osteoarthritis, and autoimmune conditions can affect hinge joints. Rest, medication, ice, and physical therapy can help alleviate pain, improve strength and range of motion, and help manage conditions.

Anatomy

A joint is formed by the joining of two or more bones. The human body has three main classifications of joints, categorized by the degree to which they can move. These include: (Boundless. General Biology, N.D.)

Synarthroses

  • These are fixed, immovable joints.
  • Formed by two or more bones.

Amphiarthroses

  • Also known as cartilaginous joints.
  • A fibrocartilage disc separates the bones that form the joints.
  • These movable joints allow for a slight degree of movement.

Diarthroses

  • Also known as synovial joints.
  • These are the most common freely mobile joints that allow movement in multiple directions.
  • The bones that form the joints are lined with articular cartilage and enclosed in a joint capsule filled with synovial fluid that allows for smooth motion.

Synovial joints are classified into different types depending on differences in structure and the number of motion planes they allow. A hinge joint is a synovial joint that allows movement in one plane of motion, similar to a door hinge that moves forward and backward. Within the joint, the end of one bone is typically convex/pointed outward, with the other concave/rounded inward to allow the ends to fit smoothly. Because hinge joints only move through one plane of movement, they tend to be more stable than other synovial joints. (Boundless. General Biology, N.D.) Hinge joints include:

  • The finger and toe joints – allow the fingers and toes to bend and extend.
  • The elbow joint – allows the elbow to bend and extend.
  • The knee joint – allows the knee to bend and extend.
  • The talocrural joint of the ankle – allows the ankle to move up/dorsiflexion and down/plantarflexion.

Hinge joints allow the limbs, fingers, and toes to extend away and bend toward the body. This movement is essential for activities of daily living, such as showering, getting dressed, eating, walking, standing up, and sitting down.

Conditions

Osteoarthritis and inflammatory forms of arthritis can affect any joint (Arthritis Foundation. N.D.) Autoimmune inflammatory forms of arthritis, including rheumatoid and psoriatic arthritis, can cause the body to attack its own joints. These commonly affect the knees and fingers, resulting in swelling, stiffness, and pain. (Kamata, M., Tada, Y. 2020) Gout is an inflammatory form of arthritis that develops from elevated levels of uric acid in the blood and most commonly affects the hinge joint of the big toe. Other conditions that affect hinge joints include:

  • Injuries to the cartilage within the joints or ligaments that stabilize the outside of the joints.
  • Ligament sprains or tears can result from jammed fingers or toes, rolled ankles, twisting injuries, and direct impact on the knee.
  • These injuries can also affect the meniscus, the tough cartilage within the knee joint that helps cushion and absorb shock.

Rehabilitation

Conditions that affect hinge joints often cause inflammation and swelling, resulting in pain and limited mobility.

  • After an injury or during an inflammatory condition flare-up, limiting active movement and resting the affected joint can reduce increased stress and pain.
  • Applying ice can decrease inflammation and swelling.
  • Pain-relieving medications like NSAIDs can also help reduce pain. (Arthritis Foundation. N.D.)
  • Once the pain and swelling start to subside, physical and/or occupational therapy can help rehabilitate the affected areas.
  • A therapist will provide stretches and exercises to help improve the joint range of motion and strengthen the supporting muscles.
  • For individuals experiencing hinge joint pain from an autoimmune condition, biologic medications to decrease the body’s autoimmune activity are administered through infusions delivered every several weeks or months. (Kamata, M., Tada, Y. 2020)
  • Cortisone injections may also be used to decrease inflammation.

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes and improving ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. Our goal is to relieve pain naturally by restoring health and function to the body. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments.


Chiropractic Solutions


References

Boundless. General Biology. (N.D.). 38.12: Joints and Skeletal Movement – Types of Synovial Joints. In. LibreTexts Biology. https://bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Book%3A_General_Biology_%28Boundless%29/38%3A_The_Musculoskeletal_System/38.12%3A_Joints_and_Skeletal_Movement_-_Types_of_Synovial_Joints

Arthritis Foundation. (N.D.). Osteoarthritis. Arthritis Foundation. https://www.arthritis.org/diseases/osteoarthritis

Kamata, M., & Tada, Y. (2020). Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review. International journal of molecular sciences, 21(5), 1690. https://doi.org/10.3390/ijms21051690

Effective Non-Surgical Treatments for Sciatica

Effective Non-Surgical Treatments for Sciatica

For individuals dealing with sciatica, can non-surgical treatments like chiropractic care and acupuncture reduce pain and restore function?

Introduction

The human body is a complex machine that allows the host to be mobile and stable when resting. With various muscle groups in the upper and lower body portions, the surrounding muscles, tendons, nerves, and ligaments serve a purpose for the body as they all have specific jobs in keeping the host functional. However, many individuals have developed various habits that cause strenuous activities that cause repetitive motions to their muscles and nerves and affect their musculoskeletal system. One of the nerves that many individuals have been dealing with pain is the sciatic nerve, which causes many issues in the lower body extremities and, when not treated right away, leads to pain and disability. Luckily, many individuals have sought non-surgical treatments to reduce sciatica and restore body function to the individual. Today’s article focuses on understanding sciatica and how non-surgical therapies like chiropractic care and acupuncture can help reduce the sciatic pain-like effects that are causing overlapping risk profiles in the lower body extremities. We discuss with certified medical providers who consolidate with our patients’ information to assess how sciatica is often correlated with environmental factors that cause dysfunction in the body. We also inform and guide patients on how various non-surgical treatments can help reduce sciatica and its correlating symptoms. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to reduce the chances and effects of sciatica from returning. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

Understanding Sciatica

Do you often feel radiating pain that travels down one or both legs when sitting down for a long period? How often have you experienced tingling sensations that cause you to shake your leg to reduce the effect? Or have you noticed that stretching your legs causes temporary relief? While these overlapping pain symptoms can affect the lower extremities, many individuals may think it is low back pain, but in actuality, it is sciatica. Sciatica is a common musculoskeletal condition that affects many people worldwide by causing pain to the sciatic nerve and radiating down to the legs. The sciatic nerve is pivotal in providing direct and indirect motor function to the leg muscles. (Davis et al., 2024) When the sciatic nerve is compressed, many people state that the pain can vary in intensity, accompanied by symptoms like tingling, numbness, and muscle weakness that can affect a person’s ability to walk and function. 

 

 

However, some of the root causes that lead to the development of sciatica can play into the factor that causes the pain in the lower extremities. Several inherent and environmental factors are often associated with sciatica, causing lumbar nerve root compression on the sciatic nerve. Factors like poor health status, physical stress, and occupational work are correlated with the development of sciatica and can impact a person’s routine. (Gimenez-Campos et al., 2022) Additionally, some of the root causes of sciatica can include musculoskeletal conditions like herniated discs, bone spurs, or spinal stenosis, which can correlate with these inherent and environmental factors that can reduce many individuals’ motility and life quality. (Zhou et al., 2021) This causes many individuals to seek out treatments to relieve sciatica pain and its correlating symptoms. While the pain caused by sciatica can vary, many individuals often seek non-surgical treatments to alleviate their discomfort and pain from sciatica. This allows them to incorporate effective solutions to managing sciatica. 

 


Beyond Adjustments: Chiropractic & Integrative Healthcare- Video


Chiropractic Care For Sciatica

When it comes to seeking non-surgical treatments to reduce sciatica, non-surgical treatments can reduce the pain-like effects while helping restore body function and mobility. At the same time, non-surgical treatments are customized to the individual’s pain and can be incorporated into a person’s routine. Some non-surgical treatments like chiropractic care are excellent in reducing sciatica and its associated pain symptoms. Chiropractic care is a form of non-surgical therapy that focuses on restoring the body’s spinal movement while improving body function. Chiropractic care utilizes mechanical and manual techniques for sciatica to realign the spine and help the body heal naturally without surgery or medication. Chiropractic care can help decrease intradiscal pressure, increase intervertebral disc space height, and improve the range of motion in the lower extremities. (Gudavalli et al., 2016) When dealing with sciatica, chiropractic care can alleviate the unnecessary pressure on the sciatic nerve and help reduce the risk of reoccurrence through consecutive treatments. 

 

The Effects of Chiropractic Care For Sciatica

Some of the effects of chiropractic care for reducing sciatica can provide insight to the person as chiropractors work with associated medical providers to devise a personalized plan to relieve the pain-like symptoms. Many people who utilize chiropractic care to reduce the effects of sciatica can incorporate physical therapy to strengthen the weak muscles that surround the lower back, stretch to improve flexibility and be more mindful of what factors are causing sciatic pain in their lower extremities. Chiropractic care may guide many people on proper poster ergonomics, and various exercises to reduce the chances of sciatica returning while offering positive effects to the lower body.

 

Acupuncture For Sciatica

Another form of non-surgical treatment that can help reduce the pain-like effects of sciatica is acupuncture. As a key component in traditional Chinese medicine, acupuncture therapy involves professionals placing thin, solid needles at specific points on the body. When it comes to reducing sciatica, acupuncture therapy can exert analgesic effects on the body’s acupoints, regulate the microglia, and modulate certain receptors along the pain pathway to the nervous system. (Zhang et al., 2023) Acupuncture therapy focuses on restoring the body’s natural energy flow or Qi to promote healing.

 

The Effects of Acupuncture For Sciatica

 Regarding the effects of acupuncture therapy on reducing sciatica, acupuncture therapy can help reduce the pain signals that sciatica produces by changing the brain signal and rerouting the corresponding motor or sensory disturbance of the affected area. (Yu et al., 2022) Additionally, acupuncture therapy can help provide pain relief by releasing endorphins, the body’s natural pain reliever, to the specific acupoint that correlates with the sciatic nerve, reducing inflammation around the sciatic nerve, thus alleviating pressure and pain and helping improve nerve function. Both chiropractic care and acupuncture offer valuable non-surgical treatment options that can provide aid in the healing process and reduce pain caused by sciatica. When many people are dealing with sciatica and looking for numerous solutions to reduce the pain-like effects, these two non-surgical treatments can help many people address the underlying causes of sciatica, enhance the body’s natural healing process, and help provide significant relief from the pain.

 


References

Davis, D., Maini, K., Taqi, M., & Vasudevan, A. (2024). Sciatica. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939685

Gimenez-Campos, M. S., Pimenta-Fermisson-Ramos, P., Diaz-Cambronero, J. I., Carbonell-Sanchis, R., Lopez-Briz, E., & Ruiz-Garcia, V. (2022). A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Aten Primaria, 54(1), 102144. https://doi.org/10.1016/j.aprim.2021.102144

Gudavalli, M. R., Olding, K., Joachim, G., & Cox, J. M. (2016). Chiropractic Distraction Spinal Manipulation on Postsurgical Continued Low Back and Radicular Pain Patients: A Retrospective Case Series. J Chiropr Med, 15(2), 121-128. https://doi.org/10.1016/j.jcm.2016.04.004

Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., . . . Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ Open, 12(5), e054566. https://doi.org/10.1136/bmjopen-2021-054566

Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Front Neurosci, 17, 1097830. https://doi.org/10.3389/fnins.2023.1097830

Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. https://doi.org/10.3389/fendo.2021.740200

Disclaimer

Pudendal Neuropathy: Unraveling Chronic Pelvic Pain

Pudendal Neuropathy: Unraveling Chronic Pelvic Pain

For individuals experiencing pelvic pain, it could be a disorder of the pudendal nerve known as pudendal neuropathy or neuralgia that leads to chronic pain. The condition can be caused by pudendal nerve entrapment, where the nerve becomes compressed or damaged. Can knowing the symptoms help healthcare providers correctly diagnose the condition and develop an effective treatment plan?

Pudendal Neuropathy: Unraveling Chronic Pelvic Pain

Pudendal Neuropathy

The pudendal nerve is the main nerve that serves the perineum, which is the area between the anus and the genitalia – the scrotum in men and the vulva in women. The pudendal nerve runs through the gluteus muscles/buttocks and into the perineum. It carries sensory information from the external genitalia and the skin around the anus and perineum and transmits motor/movement signals to various pelvic muscles. (Origoni, M. et al., 2014) Pudendal neuralgia, also referred to as pudendal neuropathy, is a disorder of the pudendal nerve that can lead to chronic pelvic pain.

Causes

Chronic pelvic pain from pudendal neuropathy can be caused by any of the following (Kaur J. et al., 2024)

  • Excessive sitting on hard surfaces, chairs, bicycle seats, etc. Bicyclists tend to develop pudendal nerve entrapment.
  • Trauma to the buttocks or pelvis.
  • Childbirth.
  • Diabetic neuropathy.
  • Bony formations that push against the pudendal nerve.
  • Thickening of ligaments around the pudendal nerve.

Symptoms

Pudendal nerve pain can be described as stabbing, cramping, burning, numbness, or pins and needles and can present (Kaur J. et al., 2024)

  • In the perineum.
  • In the anal region.
  • In men, pain in the scrotum or penis.
  • In women, pain in the labia or vulva.
  • During intercourse.
  • When urinating.
  • During a bowel movement.
  • When sitting and goes away after standing up.

Because the symptoms are often hard to distinguish, pudendal neuropathy can often be hard to differentiate from other types of chronic pelvic pain.

Cyclist’s Syndrome

Prolonged sitting on a bicycle seat can cause pelvic nerve compression, which can lead to chronic pelvic pain. The frequency of pudendal neuropathy (chronic pelvic pain caused by entrapment or compression of the pudendal nerve) is often referred to as Cyclist’s Syndrome. Sitting on certain bicycle seats for long periods places significant pressure on the pudendal nerve. The pressure can cause swelling around the nerve, which causes pain and, over time, can lead to nerve trauma. Nerve compression and swelling can cause pain described as burning, stinging, or pins and needles. (Durante, J. A., and Macintyre, I. G. 2010) For individuals with pudendal neuropathy caused by bicycling, symptoms can appear after prolonged biking and sometimes months or years later.

Cyclist’s Syndrome Prevention

A review of studies provided the following recommendations for preventing Cyclist’s Syndrome (Chiaramonte, R., Pavone, P., Vecchio, M. 2021)

Rest

  • Take breaks at least 20–30 seconds after each 20 minutes of riding.
  • While riding, change positions frequently.
  • Stand up to pedal periodically.
  • Take time off between riding sessions and races to rest and relax the pelvic nerves. 3–10 day breaks can help in recovery. (Durante, J. A., and Macintyre, I. G. 2010)
  • If pelvic pain symptoms are barely starting to develop, rest and see a healthcare provider or specialist for an examination.

Seat

  • Use a soft, wide seat with a short nose.
  • Have the seat level or tilted slightly forward.
  • Seats with cutout holes place more pressure on the perineum.
  • If numbness or pain is present, try a seat without holes.

Bike Fitting

  • Adjust the seat height so the knee is slightly bent at the bottom of the pedal stroke.
  • The body’s weight should rest on the sitting bones/ischial tuberosities.
  • Keeping the handlebar height below the seat can reduce pressure.
  • The Triathlon bike’s extreme-forward position should be avoided.
  • A more upright posture is better.
  • Mountain bikes have been associated with an increased risk of erectile dysfunction than road bikes.

Shorts

  • Wear padded bike shorts.

Treatments

A healthcare provider may use a combination of treatments.

  • The neuropathy can be treated with rest if the cause is excessive sitting or cycling.
  • Pelvic floor physical therapy can help relax and lengthen the muscles.
  • Physical rehabilitation programs, including stretches and targeted exercises, can release nerve entrapment.
  • Chiropractic adjustments can realign the spine and pelvis.
  • The active release technique/ART involves applying pressure to muscles in the area while stretching and tensing. (Chiaramonte, R., Pavone, P., Vecchio, M. 2021)
  • Nerve blocks may help relieve pain caused by nerve entrapment. (Kaur J. et al., 2024)
  • Certain muscle relaxers, antidepressants, and anticonvulsants may be prescribed, sometimes in combination.
  • Nerve decompression surgery may be recommended if all conservative therapies have been exhausted. (Durante, J. A., and Macintyre, I. G. 2010)

Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness and nutrition, 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, and Functional Medicine Treatments. If the individual requires other treatment, they will be referred to a clinic or physician best suited for their condition, as Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers.


Pregnancy and Sciatica


References

Origoni, M., Leone Roberti Maggiore, U., Salvatore, S., & Candiani, M. (2014). Neurobiological mechanisms of pelvic pain. BioMed research international, 2014, 903848. https://doi.org/10.1155/2014/903848

Kaur, J., Leslie, S. W., & Singh, P. (2024). Pudendal Nerve Entrapment Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31334992

Durante, J. A., & Macintyre, I. G. (2010). Pudendal nerve entrapment in an Ironman athlete: a case report. The Journal of the Canadian Chiropractic Association, 54(4), 276–281.

Chiaramonte, R., Pavone, P., & Vecchio, M. (2021). Diagnosis, Rehabilitation and Preventive Strategies for Pudendal Neuropathy in Cyclists, A Systematic Review. Journal of functional morphology and kinesiology, 6(2), 42. https://doi.org/10.3390/jfmk6020042

Migraine Physical Therapy: Relieving Pain and Restoring Mobility

Migraine Physical Therapy: Relieving Pain and Restoring Mobility

For individuals who suffer from migraine headaches, can incorporating physical therapy help decrease pain, improve mobility, and manage future attacks?

Migraine Physical Therapy: Relieving Pain and Restoring Mobility

Migraine Physical Therapy

Cervicogenic migraine headaches can cause pain, limited motion, or confusing symptoms like dizziness or nausea. They may originate from the neck or cervical spine and be called cervicogenic headaches. A chiropractic physical therapy team can assess the spine and offer treatments that help improve mobility and decrease pain. Individuals may benefit from working with a migraine physical therapy team to perform treatments for specific conditions, quickly and safely relieving pain and returning to their previous level of activity.

Cervical Spine Anatomy

The neck is comprised of seven stacked cervical vertebrae. The cervical vertebrae protect the spinal cord and allow the neck to move through:

  • Flexion
  • Extension
  • Rotation
  • Side bending

The upper cervical vertebrae help support the skull. There are joints on either side of the cervical level. One connects to the back of the skull and allows motion. This suboccipital area is home to several muscles that support and move the head, with nerves that travel from the neck through the suboccipital area into the head. The nerves and muscles in this area may be a source of neck pain and/or headaches.

Symptoms

Sudden motions can trigger symptoms of cervicogenic migraine, or they may come on during sustained neck postures. (Page P. 2011) The symptoms are often dull and non-throbbing and may last several hours to days. Symptoms of cervicogenic migraine headache may include:

  • Pain on both sides of the back of the head.
  • Pain in the back of the head that radiates to one shoulder.
  • Pain on one side of the upper neck that radiates to the temple, forehead, or eye.
  • Pain in one side of the face or cheek.
  • Reduced range of motion in the neck.
  • Sensitivity to light or sound
  • Nausea
  • Dizziness or vertigo

Diagnosis

Tools a physician may use may include:

  • X-ray
  • MRI
  • CT scan
  • Physical examination includes neck range of motion and palpation of the neck and skull.
  • Diagnostic nerve blocks and injections.
  • Neck imaging studies may also show:
  • Lesion
  • Bulging or herniated disc
  • Disc degeneration
  • Arthritic changes

Cervicogenic headache diagnosis is usually made with one-sided, non-throbbing headache pain and a loss of neck range of motion. (Headache Classification Committee of the International Headache Society. 2013) A healthcare provider may refer the individual to physical therapy to treat cervicogenic headaches once diagnosed. (Rana M. V. 2013)

Physical Therapy

When first visiting a physical therapist, they will go through medical history and conditions, and questions will be asked about the onset of pain, symptom behavior, medications, and diagnostic studies. The therapist will also ask about previous treatments and review medical and surgical history. Components of the evaluation may include:

  • Palpation of the neck and skull
  • Measures of neck range of motion
  • Strength measurements
  • Postural assessment

Once the evaluation is completed, the therapist will work with the individual to develop a personalized treatment program and rehabilitation goals. Various treatments are available.

Exercise

Exercises to improve neck motion and decrease pressure on cervical nerves may be prescribed and may include. (Park, S. K. et al., 2017)

  • Cervical rotation
  • Cervical flexion
  • Cervical side bending
  • Cervical retraction

The therapist will train the individual to move slowly and steadily and avoid sudden or jerky movements.

Postural Correction

If forward head posture is present, the upper cervical spine and the suboccipital area could compress the nerves that travel up the back of the skull. Correcting posture may be an effective strategy for treatment and can include:

  • Performing targeted postural exercises.
  • Utilizing a supportive neck pillow for sleep.
  • Using a lumbar support when sitting.
  • Kinesiology taping may help increase tactile awareness of back and neck position and improve overall postural awareness.

Heat/Ice

  • Heat or ice may be applied to the neck and skull to help decrease pain and inflammation.
  • Heat can help relax tight muscles and improve circulation and may be used before performing neck stretches.

Massage

  • If tight muscles are limiting neck motion and causing head pain, a massage can help improve mobility.
  • A special technique called suboccipital release loosens the muscles that attach the skull to the neck for improved motion and decreased nerve irritation.

Manual and Mechanical Traction

  • Part of the migraine physical therapy plan may involve mechanical or manual traction to decompress the neck’s discs and joints, improve motion in the neck, and decrease pain.
  • Joint mobilizations may be used to improve neck motion and manage pain. (Paquin, J. P. 2021)

Electrical Stimulation

  • Electrical stimulation, like electro-acupuncture or transcutaneous neuromuscular electrical stimulation, may be used on the neck muscles to decrease pain and improve headache symptoms.

Therapy Duration

Most migraine physical therapy sessions for cervicogenic headaches last about four to six weeks. Individuals may experience relief within a few days of starting therapy, or symptoms may come and go in different phases for weeks. Some experience continued migraine headache pain for months after starting treatment and use techniques they learned to help control symptoms.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive therapies and functional rehabilitation procedures focused on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our natural programs use the body’s ability to achieve specific measured goals. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.


Chiropractic Care For Migraines


References

Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.

Headache Classification Committee of the International Headache Society (IHS) (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia : an international journal of headache, 33(9), 629–808. https://doi.org/10.1177/0333102413485658

Rana M. V. (2013). Managing and treating headache of cervicogenic origin. The Medical clinics of North America, 97(2), 267–280. https://doi.org/10.1016/j.mcna.2012.11.003

Park, S. K., Yang, D. J., Kim, J. H., Kang, D. H., Park, S. H., & Yoon, J. H. (2017). Effects of cervical stretching and cranio-cervical flexion exercises on cervical muscle characteristics and posture of patients with cervicogenic headache. Journal of physical therapy science, 29(10), 1836–1840. https://doi.org/10.1589/jpts.29.1836

Paquin, J. P., Tousignant-Laflamme, Y., & Dumas, J. P. (2021). Effects of SNAG mobilization combined with a self-SNAG home-exercise for the treatment of cervicogenic headache: a pilot study. The Journal of manual & manipulative therapy, 29(4), 244–254. https://doi.org/10.1080/10669817.2020.1864960

Dried Fruit: A Healthy and Delicious Source of Fiber and Nutrients

Dried Fruit: A Healthy and Delicious Source of Fiber and Nutrients

Can knowing the serving size help lower sugar and calories for individuals who enjoy eating dried fruits?

Dried Fruit: A Healthy and Delicious Source of Fiber and Nutrients

Dried Fruits

Dried fruits, like cranberries, dates, raisins, and prunes, are great because they last a long time and are healthy sources of fiber, minerals, and vitamins. However, dried fruits contain more sugar and calories per serving because they lose volume when dehydrated, allowing more to be consumed. This is why the serving size matters to ensure one does not overeat.

Serving Size

Fruits are dried in dehydrators or left in the sun to dehydrate naturally. They are ready once most of the water has disappeared. The loss of water decreases their physical size, which allows individuals to eat more, increasing sugar and calorie intake. For example, around 30 grapes fit in a single measuring cup, but 250 raisins can fill one cup once dehydrated. Nutritional information for fresh and dried fruit.

Sugar

  • Ten grapes have 34 calories and about 7.5 grams of sugar. (FoodData Central. U.S. Department of Agriculture. 2018)
  • Thirty raisins have 47 calories and under 10 grams of sugar.
  • Grapes’ natural sugar content varies, so different types can be subject to nutritional value assessments.
  • Some fruits, like cranberries, can be very tart, so sugar or fruit juices are added during drying.

Ways to Use

Fresh fruit may be higher in certain vitamins, but mineral and fiber content are retained during drying. Dried fruits are versatile and can be made part of a healthy, balanced diet that can include:

Trail Mix

  • Mix dried fruits, nuts, and seeds.
  • Monitor portion size.

Oatmeal

  • Lightly sweeten oatmeal with a small serving of dried fruits for a hearty and healthy breakfast.

Salads

  • Toss dark, leafy greens, fresh apple slices, dried cranberries or raisins, and cheeses.

Main Course

  • Use dried fruit as an ingredient in savory entrees.

Protein Bar Substitutes

  • Raisins, dried blueberries, apple chips, and dried apricots are convenient and last longer than fresh fruit, making them perfect when protein bars are unavailable.

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, 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. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs.


Functional Medicine’s Influence Beyond Joints


References

FoodData Central. U.S. Department of Agriculture. (2017). Raisins. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/530717/nutrients

FoodData Central. U.S. Department of Agriculture. (2018). Grapes, American type (slip skin), raw. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/174682/nutrients

FoodData Central. U.S. Department of Agriculture. (2018). Grapes, red or green (European type, such as Thompson seedles), raw. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/174683/nutrients

Choosing the Right Exercise Ball for an Optimal Workout

Choosing the Right Exercise Ball for an Optimal Workout

For individuals wanting to improve core stability, can using the right size exercise or stability ball help improve workouts and achieve goals?

Get Fit and Improve Your Posture with an Exercise Stability Ball

Exercise Stability Ball

An exercise ball, stability ball, or Swiss ball is a piece of fitness equipment used in gyms, Pilates and yoga studios, and HIIT classes. (American Council on Exercise. 2014) It is inflated with air to supplement bodyweight workouts or improve posture and balance. It can also be used as a chair. They add a core stability challenge to almost any exercise (American Council on Exercise, N.D.) Getting the appropriate exercise ball size and firmness for your body and purpose will ensure an optimal workout.

Size

  • The exercise ball size should be proportional to individual height.
  • Individuals should be able to sit on the ball with their legs at a 90-degree angle or slightly more, but not less.
  • The thighs should be parallel to the ground or angled slightly down.
  • With the feet flat on the floor and the spine straight, not leaning forward, backward, or sideways, the knees should be even with or slightly lower than the hips.

Here is the American Council on Exercise guide when choosing. (American Council on Exercise. 2001)

Height – Ball Size

  • Under 4’6”/137 cm – 30 cm/12 inches
  • 4’6” – 5’0”/137-152 cm – 45 cm/18 inches
  • 5’1”-5’7”/155-170 cm –  55 cm/22 inches
  • 5’8”-6’2”/173-188 cm – 65 cm/26 inches
  • Over 6’2”/188 cm – 75 cm/30 inches

Getting the right exercise ball for weight is also important. Individuals who are heavy for their height may need a larger ball to keep the knees and legs at the correct angle. It is recommended to check the weight rating of the ball, its durability, and its high burst resistance before buying.

Inflation

Individuals want a little give on the ball’s surface for exercise. When sitting on the exercise stability ball, body weight should create a little seat and provide more stability. More importantly, it allows sitting evenly on the ball, which is essential for exercising with proper spinal alignment. (Rafael F. Escamilla et al., 2016) Inflation is a matter of preference, but the more inflated the ball is, the more difficult it will be to balance the body, whether sitting or in other positions. It is recommended not to over-inflate the ball at the risk of bursting. The ball may require reinflation occasionally, so many are sold with a small pump for this purpose.

Exercises and Stretches

Exercise balls are highly versatile, inexpensive, and easy-to-use workout tools. They are beneficial for improving core strength and stability. Ways to be used include:

  • Active sitting in place of a chair.
  • Stretching on the ball.
  • Balance and stability exercises.
  • Pilates or yoga.
  • Strength workout.
  • Target exercises for core activation and strengthening.

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.


Home Exercises For Pain Relief


References

American Council on Exercise. Sabrena Jo. (2014). Core-strengthening Stability Ball Workout. ACE Fitness® & Healthy Lifestyle Blog. https://www.acefitness.org/resources/pros/expert-articles/5123/core-strengthening-stability-ball-workout/

American Council on Exercise. (N.D.). Exercise Database & Library. Featured Exercises from ACE. Stability Ball. Healthy Living Blog. https://www.acefitness.org/resources/everyone/exercise-library/equipment/stability-ball/

American Council on Exercise. (2001). Strengthen your abdominals with stability balls. Healthy Living Blog. https://acewebcontent.azureedge.net/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_129.pdf

Escamilla, R. F., Lewis, C., Pecson, A., Imamura, R., & Andrews, J. R. (2016). Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball. Sports health, 8(4), 372–379. https://doi.org/10.1177/1941738116653931

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear can cause lower back pain and problems for some individuals. Can understanding the connection between footwear and back problems help individuals find the right shoes to maintain back health and relieve pain?

Footwear for Back Pain Relief: Choosing the Right Shoes

Footwear Back Pain

The back provides the strength for physical activities. Back pain affects daily life and can have various causes. Unhealthy posture, walking, twisting, turning, bending, and reaching can contribute to back problems that result in pain. According to the CDC, 39% of adults report living with back pain (Centers for Disease Control and Prevention, 2019). Improper footwear can also contribute to back pain. Selecting footwear carefully can help bring pain relief and help maintain spinal health. Individuals can enjoy less pain and manage symptoms by choosing shoes that maintain spinal alignment and protect the feet from blunt impact.

Understanding the Back Pain-Footwear Connection

Improper footwear could be the cause of lower back pain. What impacts the bones at the bottom of the neuromusculoskeletal system radiates upward and affects the spine and back muscles. What footwear is used travels upward, impacting gait, posture, spinal alignment, and more. When back problems originate from the feet, these are biomechanical issues. Biomechanics means how the bones, joints, and muscles work together and how changes in external forces impact the body.

Movement

When the feet impact the ground, they are the first extremities to absorb shock for the rest of the body. Individuals will start to walk differently if they have a problem or change in their feet. Wearing shoes with improper support can increase the wear and tear on the muscles and joints, leading to awkward and unnatural movement. For example, consider the difference between standing on tiptoes in high heels and the natural flat-footed state. Well-cushioned shoes help absorb impact and lessen pain sensations. The pressures on each of the joints shift balance, which causes instability problems with less pressure on some and more on others. This creates an imbalance that leads to pain and joint conditions.

Posture

Maintaining a healthy posture is another factor in preventing or alleviating back pain. With the right footwear, the body can maintain a healthier stance and the right curvature throughout the spine, and it helps distribute the weight evenly. This results in decreased stress on ligaments, muscles, and joints. (Harvard Health Publishing. 2014) It’s recommended to see an orthopedist to get to the root of an individual’s condition. For some, a herniated disc, sciatica, automobile collision, fall, unhealthy ergonomics, or a combination, as well as other underlying issues, may be contributing to their back pain.

Shoe Types and Their Impact on The Back

How various shoes impact posture, potentially causing or relieving back pain.

High Heels

High heels can definitely contribute to back pain. They change body posture, causing a domino effect on the spine. The body’s weight is shifted to increase pressure on the balls of the feet, and the spine’s alignment becomes altered. High heels also affect how the ankles, knees, and hips move when walking, balance, and how the back muscles operate, all of which can worsen back pain.

Flat Shoes

Flat shoes may not be the best choice for spinal health. If they lack arch support, they can cause the foot to roll inward, known as pronation. This can contribute to misalignment, which can strain the knees, hips, and lower back. However, they can be a decent choice if they provide arch support. When wearing flat shoes with healthy support, the weight is distributed evenly on the feet and the spine. This helps maintain correct posture, which can help prevent and/or alleviate back pain.

Sneakers, Tennis, and Athletic Shoes

Sneakers, tennis, and athletic shoes can relieve back pain with thorough cushioning and support. Choosing the right ones involves determining the activity that will be done in them. There are tennis, running, basketball, pickleball, skating shoes, and more. Research what features will be needed for the sport or activity. This could include:

  • Heel cups
  • Insole cushioning
  • Wide base
  • Other features to meet individual foot needs.

It is recommended that athletic shoes be changed every 300 to 500 miles of walking or running or with any signs of unevenness when placed on a flat surface, as worn-out soles and degraded materials can increase the risk of injury and back pain. (American Academy of Podiatric Sports Medicine, 2024).  If a certain pair puts the legs, hips, or ankles into an unnatural position or impedes regular movement, it may be time to replace them.

Choosing the Right Shoes

The ideal solution for choosing shoe wear is to get a gait analysis and a review of how you walk and run. Various healthcare professionals may offer this service to tailor each individual’s search for the right shoes for back pain. In gait analysis, individuals are asked to run and walk, sometimes on camera, while a professional notes physical tendencies, like when the foot hits the ground and whether it rolls inward or outward. This provides data on affected posture, movement, pain levels, how much arch support is needed, and what type to wear to help prevent back pain. Once the analysis is complete, it will guide you on what to look for, such as what level of arch support, heel height, or material is best for you.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our programs are natural and use the body’s ability to achieve specific measured goals rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.


Benefits of Using Custom Foot Orthotics


References

Centers for Disease Control and Prevention. (2019). Back, lower limb, and upper limb pain among U.S. adults, 2019. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db415.htm

Harvard Health Publishing. (2014). Posture and back health. Harvard Health Education. https://www.health.harvard.edu/pain/posture-and-back-health

American Academy of Podiatric Sports Medicine. Ayne Furman, D. F., AAPSM. (2024). How do I know when it is time to replace my athletic shoes?

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