Traditional medical treatment for sciatica can sometimes be not as effective or ineffective for individuals, but nerve flossing is an option that could help. Flossing is not something individuals expect to hear from a medical professional treating their sciatica. However, when sciatica does not respond to common treatment methods like light physical activity or medications, a physician, chiropractor, or physical therapist might suggest combining traditional treatment with nerve flossing to alleviate sciatic nerve pain.
Nerve Flossing
The nerves can get jammed/stuck between the tissues and are not able to move, flex as they should. Nerve flossing involves performing gentle exercises to mobilize and stretch the nerves that help reduce irritation, inflammation, and improve mobility, especially in the hips. Nerve flossing is also known as:
The exercises can be done at home with no equipment and simple instructions. When used in combination with other treatments, like chiropractic and physical therapy the effectiveness is increased. Consult with a doctor or doctor of chiropractic for an accurate diagnosis, because what is causing sciatica helps significantly to determine the best treatment plan.
Guidelines
These are simple exercises but they are still exercises that require following safety guidelines to prevent injury or pain. These include:
The body will need time to adjust to new exercises so individuals should start slow
Only a few repetitions should be done at a time
Gradually increase
Stop if pain presents with any of the exercises and report the pain to a doctor or chiropractic physical therapist to see if there is a problem with how the exercises are being performed or if the exercises should be done later on after further treatment.
Focus on staying relaxed, as tensing up the muscles decreases the effectiveness
Breathing properly is key. Individuals unknowingly stop breathing when doing exercises, which is not healthy. Breathe deep in and out.
Nerve Exercises
True nerve flossing is an active movement with motion otherwise, it is just stretching.
Mobilizing floss
Lie on the floor with both knees bent, feet flat on the floor, and with space at hip-width
A flat pillow can be used for the head if it makes it more comfortable
Tuck the chin in and be sure to keep the upper body relaxed throughout the exercise
Pull the right leg in towards the chest
Keep holding behind the right knee
Slowly straighten the leg until there is a comfortable stretch
Slowly return the knee to the starting position
Breathe deeply, slowly, and try not to press the lower back into the floor
Lower the leg back towards the chest then lower it back to the starting position
Perform with the left leg
Complete five repetitions on each side
Seated nerve floss
Sitting upright in a chair, knees spaced hip-width, feet flat on the floor, and face forward
Extend the left leg
Flex the foot toward the body
Extend the head up and back looking up at the ceiling
Gently lower head and leg down, tucking the chin into the chest while bending the leg slightly backward
Extend and lower head at the same time when extending and lowering the leg
Perform 10 repetitions
Switch legs and repeat the exercise
Perform exercise 2–3 times every day
Hamstring floss
Stand up straight, raise the right leg onto a step or other stable surface while keeping the leg straight and toes pointed up
Keeping the back straight, tilt the head and neck forward until there is a slight pull/stretch in the back
Point the toe and bring the chin to the chest
Flex the foot and return
Repeat five times
Return to starting position
Switch legs
Repeat three sets on each leg
Exercise for Piriformis Syndrome
The piriformis muscle joins the base of the spine to the upper leg. Because this muscle is so close to the sciatic nerve, any type of irritation or compression of the sciatic nerve can also cause piriformis syndrome. Piriformis syndrome can cause radiating pain to the:
Hips
Buttocks
Hamstrings
Pain when sitting down or walking upstairs
Nerve flossing can also help relieve the symptoms increasing flexibility and range of motion.
Mobilizing stretch
Lie flat on the floor on the back
Extend both legs
Bend the right leg and bring it up
Hold the right knee and foot
While holding, gently pull the leg across the right side of the body and up toward the right shoulder
Return to the original position
Repeat five times
Gently lower the right leg
Switch legs
Complete five repetitions on each side two to three times a day
Risks
These exercises are not about pushing the body to its limits or in a way that causes pain. They are designed to rehabilitate, stretch, and strengthen the sciatic nerve making risks for further injury minimal. If there are still concerns about the safety of nerve flossing exercises, check with a doctor, doctor of chiropractic, or physical therapist. If there is severe nerve damage or undiagnosed acute pain, nerve flossing could worsen symptoms.Nerve flossing for acute cases of nerve irritation is not recommended as this can cause nerve root aggravation with the stretching/pulling.
There is a difference between being tired after a long day working, playing, etc, and being tired on a regular daily basis. This can be referred to as Chronic Fatigue Syndrome, a clinical condition where fatigue lasts longer than 6 months. With acute, non-clinical fatigue, it is typical to experience many of the symptoms that hamper an individual’s ability to function. Symptoms can include:
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
References
Anikwe EE, Tella BA, Aiyegbusi AI, Chukwu SC: Influence of Nerve Flossing Technique on acute sciatica and hip range of motion, International Journal of Medicine and Biomedical Research, 4(2) May – August 2015, www.ijmbr.com
Jeong UC, Kim CY, Park YH, Hwang-Bo G, Nam CW. The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain. J Phys Ther Sci. 2016;28(1):46-50. doi:10.1589/jpts.28.46
The body’s muscles function to produce force and motion. The trapezius muscle is one of the largest, which makes it highly susceptible to injury/s and spasms. A trapezius muscle spasm is when the muscle starts to contract. This muscle group is based around the neck and shoulders and is used to move the scapula shoulder bone.
Causes of Trapezius Muscle Spasms
A few causes for this muscle to become inflamed/irritated include:
Poor posture
Injury
Stress
Tension
Improper lifting
Symptoms
The effects feel similar to a pulled shoulder muscle. Common symptoms include:
Upper body stiffness
Shoulder pain
Neck pain
Arm numbness/tingling
Lack of shoulder flexibility
Spasm and Pinched Nerve Difference
A muscle spasm and pinched nerve might seem or feel similar, but they are different. A muscle spasm makes the area tight and can cause muscle twitching. They vary in intensity with some spasms being mild and others excruciating. In some cases, a spasm can cause a nerve to get pinched if the knot contorts tightly around a nerve and if it is big enough. Conversely, a pinched nerve can also cause twitching, but it typically results in severe pain. Pinched nerves can also cause tingling sensations and numbness depending on the severity it could cause muscle spasms.
Treating The Spasms
There are a few ways to treat this naturally.
Heat and Ice Therapy
One way to calm a muscle spasm is using heat and ice. The heat will increase nerve and blood circulation keeping the muscles flexible, and the warmth will soothe the injury. This helps prevent the muscles from spazzing and generating pain. Ice therapy also increases blood circulation but the focus is on reducing inflammation. The nerves become slightly frozen which stops the tingling, significantly reducing the pain.
If pain presents around the trapezius, immediately put an ice pack on.It should be applied every few hours in 15-minute sessions. Once the pain subsides, heat therapy can be applied. A heating pad placed around the area, a warm/hot bath, or standing in the shower if possible with a massage setting letting the warm/hot water hit the muscle. But it must be consistent, doing it for about 20-minute sessions three times a day.
Stretches and Exercises
Stretches and exercises can help keep the muscle flexible and prevent any tightening.
Upper Trapezius Stretch
This stretch will move the upper trapezius area, promoting flexibility and preventing the muscle from becoming stiff.
Sit in a chair with proper posture
Holding onto the chair with the left hand, wrap the right arm over the top of the head so that the hand touches the left ear.
Gently pull the head toward the right and hold.
Slowly move the head back and repeat with the other hand.
Shoulder Shrugs
Moving the shoulders up and down throughout the day stretches the trapezius.
It releases tension and strengthens the muscle to protect it.
This exercise should be done every few hours for about a minute or two.
Also occasionally rolling the shoulders will help stretch the smaller components of the trapezius.
Cobra Pose
This yoga pose is for relieving tension.
It can be very helpful for those suffering from severe spasms or from a pinched nerve.
The first thing is to lie face-down on the floor.
Keeping the feet straight behind, use the hands to gently push the upper body up so that the spine slightly curves.
Make sure that the hands are situated in front of the body and firm on the ground.
Hold for a few seconds and then release.
Repeat the process three more times.
Therapeutic Massage
The soothing motions from a massage will calm irritated areas and encourage them to heal quicker.
At first, because of the tenderness around the area, a massage could present with pain.
The massage therapist needs to press on the area to increase blood circulation so that toxins get flushed out.
While it might hurt the individual soon notices that the swelling and pain are reducing.
Chiropractors specialize in the musculoskeletal system and understand how the muscles, bones, and joints all work together. For muscle spasms, they investigate the problem and look at other areas of the body that could be contributing to or worsening the condition. For some, muscle spasms could be brought on by a misplaced joint pressing on the area. A chiropractor will palpate the areas to ensure this is not the case. And if there is a problem, they will perform a joint manipulation. This realigns the joint back in place and reduces muscle spasm symptoms. Over time the muscles become healthier because chiropractic releases toxins and improves the range of motion.
Body Composition
Anti-Inflammatory Diet
Often, muscle spasms are the result of inflammation. When a muscle swells, it can place pressure on surrounding nerves. The more intense the inflammation the more pressure/stress on the nerves. This can make moving and functioning very difficult because of the pain. To naturally reduce inflammation consider an anti-inflammatory diet. This type of diet is filled with antioxidants, vitamins, and minerals that will work to reduce swelling. Although it might not completely repair the muscle injury, it can reduce symptoms and stop oxidative stress. Foods to eat more of are:
Cherries
Tomatoes
Almonds
Blueberries
Oranges
Salmon
Kale
Turmeric
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Back pain combined with sciatica is the number one cause of temporary disability all over the world. The spine is a complex interconnected system that supports the entire body. Being overweight does not help. Losing weight can help relieve sciatica and prevent future episodes. It can be done through chiropractic health coaching. According to research, overweight individuals have a higher risk of developing sciatica. The more weight the body carries the more stress is placed on the spine and joints, which can irritate/inflame the sciatic nerve.
Causes and Symptoms
To understand how sciatica is affected by the weight of the body one needs to understand how it works. A breakdown of the causes and symptoms.
The sciatic nerve runs from the lower spine, through the glutes, down the back of the thigh, and is attached under the foot.
The nerve becomes compressed or irritated where it exits the lower spine. This can be caused by a bulging or herniated disc, narrowing of the spinal canal, or bone spurs.
Symptoms include a sharp pain that spreads out from the low back and down the back of the leg. It also causes tingling, numbness, and weakness.
Indirect Cause Being Overweight
Being overweight can indirectly cause sciatica. When the body has to support added/extra weight it can cause problems. That extra weight also places tremendous stress on the joints, especially those in the spine. The lower back takes most of the force from this stress, which is how sciatica develops. The stress slowly pulls the spine out of alignment and compresses the discs between the vertebrae, which then compresses the sciatic nerve, causing pain and discomfort.
Sciatica and Weight Loss
Keep in mind that weight loss is not a cure for sciatica. Weight loss will surely help relieve sciatica pain but there are other issues at work that are combined with excess weight and are causing sciatica. Weight loss is only a step in the right direction. The most recommended and effective ways to lose weight and relieve sciatica pain is having a healthy diet, exercise, and chiropractic health coaching. Other things that can be done to relieve sciatic nerve pain include:
Regular exercise will help reduce the symptoms and strengthen the body’s core and leg muscles. There are a variety of things that make sciatica worse like:
Sitting too much
Sedentary lifestyle
Wearing shoes with no support
Lifting, bending, twisting, reaching, overuse
Exercise is the best antidote to sitting too much and living a sedentary. Exercising with sciatica does not mean a full gym routine but doing the right exercises that will not worsen the condition. The important thing is staying active. Avoiding exercise will only make sciatica worse. For example, yoga is great for sciatica and health in general. A 30-minute session of yoga 3 times a week combined with another form of exercise twice a week can produce optimal results.
Weight Training
Weight training will work with sciatica with certain adjustments and avoiding specific exercises that can cause pain and should be discussed with a doctor, chiropractor, physical therapist depending on the individual’s sciatic condition.
Form and Posture
Weight training form is essential. Practice slow repetitions with special attention to physical form. Proper posture, maintaining a neutral spine, and avoiding rounding the lower back will help avoid worsening sciatica, and prevent further injury/s.
Avoid Overhead and Straight Leg Exercises
Not until the sciatica pain reduces avoid overhead lifting exercises and straight leg exercises, as these can cause flare-ups. Also, avoid intensive abdominal exercises that require doing crunches.
Know The Limits
When sciatica is present, the body is in healing mode, the key is to not overdo it. This exercise is minimal, to help in the recovery process, and strengthen the muscles. Too much exercise can prolong the recovery.
Losing Belly Fat
Losing belly fat with sciatica is possible. But it will take a sustained effort that will be well worth it when sciatica. Losing the fat needs concentration on three things:
Nutrition
Eating whole nutritious foods with plenty of vegetables, and staying away from processed and sugary foods. This is where a health coach and nutritionist can offer the greatest recommendations and develop a customized diet/health plan.
Exercise
Weight training, yoga, cardio, or a combination of all is probably best. Whatever regimen is chosen the objective to stick with it.
Lifestyle adjustments
This includes improving posture, workstation set up, adjusting sitting routines, and limiting activities that cause back pain/sciatica.
Chiropractic Health Coaching
The full-body approach outlined is how chiropractic treats sciatica. Chiropractic can relieve the pain quickly with massage, spinal adjustments, and physical therapies. This is why chiropractic health coaching is ideal for those who have a hard time making nutrition, exercise, and lifestyle changes on their own. Numerous studies show that chiropractic promotes weight loss, reduced pain, improved posture, and increased well being. And it is done in a safe, non-invasive, medication-free way.
Body Composition
Eating Out A Significant Contributor For Weight Gain
When eating out, there is a tendency to consume excess empty calories and increase fat storage. This is why preparing food is so important. It gives the individual direct control over what is being consumed and allows trying out different dietary approaches to see which one works best for improving body composition and gut health. Even for those that don�t enjoy cooking, consult a chiropractic health coach to see what options are available.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Trying to understand what is causing back pain that comes out of nowhere, whether a spinal issue or a kidney issue can be quite challenging. Doing a self-examination, retracing steps, and constantly thinking about it is exhausting. The right healthcare professional that has experience in spinal issues, as well as, understanding various health conditions that can contribute to spine pain, and making the correct diagnosis can help in developing the proper treatment plan or refer the individual to the proper specialist.
The Kidneys
The organs are located below the ribs, close to the middle/thoracic back. Healthy kidneys support and help with:
These can easily be mistaken for mid and upper back pain. However, if there is persistent soreness or irritation it could mean a more significant health issue associated with the kidneys could be present.
Spine Problem or Stone/s
If there is a feeling of kidney pain it is possible to come from one of two places and/or both. This could be distension/ballooning of the capsule called the ureter that surrounds the kidneys. The ureters are the tubes that are attached to each kidney and transport urine from the kidneys to the bladder. Urine contains salts and minerals. These minerals can clump together creating a kidney stone and block the ureters. The ureter contracts from the stone that is creating the blockage.
When there is a blockage from a stone, the urine can back up and cause the capsule to expand causing pain. The pain location is usually on one side and is categorized as a dull ache – meaning the pain is constantly present and causing discomfort. Chronic back pain caused by nerve compression is typically on one side like sciatica.
The pain from a stone can be only slight unless the stone is trying to move. Then the pain can be severe and last for several minutes before it passes. However, if the pain is excruciating and a kidney stone is suspected, go to the hospital and get an examination. Collecting the stone is crucial when it passes in order to be analyzed. A stone analysis will help in figuring the proper treatment to prevent another kidney stone/s from developing.
Spine Problem or Infection
A kidney infection could be another cause of back pain. Kidney infection/s are typically caused by bacteria. A dull throbbing could be sensed in the middle and/or upper back.
Symptoms
Signs and symptoms associated with infection often include back, side, and groin pain as well as a combination of symptoms like:
Chills
Fever
Burning sensation when urinating
Constant sensation of needing to use the bathroom
Nausea
Vomiting
Causes
Causes that can increase the chances of developing an infection.
Kidney stone/s
Nerve damage that affects the bladder
Spinal damage that does not allow the bladder to be emptied
Urinary tract infection
Older individuals can develop kidney infections without any underlying conditions. There are rare genetic diseases like polycystic kidney disease and Fabry disease that can cause kidney pain and be mistaken for back pain.
Telling the Difference
There is no quick and easy way to figure out if it is back or kidney pain. Especially, if a constant aching is present. Seeing an experienced doctor or chiropractor is the recommended option for getting a formal and accurate diagnosis. A physical exam, family, and personal medical history will be collected along with various tests. Tests can include:
Urine analysis
Culture
Abdominal X-ray
CT scan
MRI
Pain medications and specific fluids are usually prescribed along with time to pass the stone. Antibiotics can be prescribed for kidney infections, chiropractic treatment can be suggested for spinal alignment/myofascial tense muscle release, and home remedies can help treat any discomfort. These can include:
Using ice/heat on the area where there is discomfort
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Tozzi, P et al. �Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility.��Journal of bodywork and movement therapies�vol. 16,3 (2012): 381-391. doi:10.1016/j.jbmt.2012.02.001
Arachnoiditis arach�?noid�?itis (?- rak-n?id-??t-?s) is a condition that is characterized by stinging, burning pain and neurological problems.
A common symptom is chronic and persistent�low back pain, lower limb pain.
It is inflammation of the arachnoidlining. This is one of three linings that surround the brain and spinal cord.
This inflammation causes:
Constant irritation
Scarring
Binding of nerve roots
Binding blood vessels
In the intradural space 3 meninges or protective membranes that surround the brain and spinal cord.
Dura mater
Arachnoid
Pia Mater
Symptoms of Arachnoiditis
Predominant symptoms are chronic pain in the:
Low back
Lower limbs
In severe cases the entire body
Other symptoms can include:
Leg tingling, numbness, and weakness
Weird sensations like the feeling of insects crawling on the skin or water running down the leg
Shooting pain like an electric shock sensation
Muscle cramps, spasms, and twitching
The bladder, bowel, and possible sexual dysfunction
Progression of the disease can make symptoms more severe and possibly permanent.
The pain is constant and incurable, which makes the disorder very debilitating. Those with arachnoiditis usually cannot work and have a disability.
Causes
Three main causes of arachnoiditis are:
Trauma/surgery
Arachnoiditis has been recognized as a rare complication of spinal surgery usually after multiple or complex surgeries.
It can also be caused by trauma to the spine.
Similar causes include:
Multiple lumbar punctures
Advanced spinal stenosis
Chronic degenerative disc disease
Chemical
Myelograms have come under scrutiny as being a possible cause of the condition.
A myelogram is a test where a radiographic contrast dye is injected into the area around the spinal cord and nerves.
The dye becomes visible on:
X-rays
CT
MRI scans
Used by physicians to diagnose spinal conditions.
Now there is a concern that repeated exposure to some of these dyes may cause arachnoiditis.
There is also a concern of the preservatives found in epidural steroid injections, that they may cause the condition, especially if the steroid medicine accidentally enters the cerebral spinal fluid.
Infection
The disorder can also be caused by certain infections that affect the spine like:
Viral and fungal meningitis
Tuberculosis
Treatment
Currently, there is no cure for arachnoiditis.
Therefore, treatment is aimed at pain relief and is similar to how other chronic pain conditions are treated.
Examples include:
Spinal cord stimulation: is one of the best treatment options. Spinal cord stimulation runs on a device that transmits electrical signals to the spinal cord for relief.
Lidocaine intravenous infusions: Lidocaine is a powerful anti-inflammatory.
Ketamine infusions: Ketamine is an anesthetic, that also helps with pain relief.
Low-dose naltrexone is an anti-inflammatory for chronic pain management.
Surgery is not recommended because it causes more scar tissue to develop and makes the irritated spine susceptible to more trauma.
Living with the Arachnoiditis
This condition can be extremely disabling.
Living with chronic pain is not an easy thing to do.
It affects the body and also causes mental stress.
People with the condition are encouraged to join support groups or find therapeutic outlets for stress.
Treatment plans are focused on pain relief and keeping a high quality of life.
Research is ongoing to find a cure.
*CHRONIC* pain Chiropractic Relief | El Paso, Tx
Patients with chronic pain discuss how their symptoms have affected their overall health and wellness. With chiropractic care, patients describe how Dr. Jimenez, a doctor of chiropractic or chiropractor in El Paso, Texas, has helped them recover their original quality of life.
Chiropractic care is an alternative treatment option that focuses on the diagnosis, treatment, and prevention of a variety of health issues, including chronic pain and personal injuries. Patients highly recommend Dr. Jimenez and his staff as the non-surgical choice for auto accident injuries and slip-and-fall accidents.
NCBI Resources
Those who continue to deal with the pain after a few weeks� time may choose to look for other solutions. This is also true for people who experience repeated flare-ups, or chronic lower back pain. One of the best and most popular options is chiropractic care. Chiropractic care doesn�t focus solely on the pain but helps the body heal itself. Chiropractors understand the bones, muscles, discs, and nerves in the back, and can figure out the reason for the pain.
From there, they can create a customized treatment plan from compresses to�spinal manipulation�to exercises that help heal the area and reduces the pain.
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