Are treatments more successful when patients know key terms that describe their back pain and associated conditions?
Nerve Pain Types
When individuals need to better understand their spine diagnosis, being able to distinguish between key terms can make a significant difference in understanding the development of a personalized treatment plan. Terms that describe back pain and various associated conditions can include:
Sciatica
Radiating and Referred pain
Radiculopathy
Radiculitis
Neuropathy
Neuritis
Causes of Back Pain
Back pain symptoms are most commonly caused by the continued practice of unhealthy/poor posture and overcompensated and weakened muscles. Even for individuals that exercise regularly, the movement choices that are made throughout the day can disrupt the way the muscles, tendons, ligaments, and fascia function to maintain proper body alignment.
Injuries to, and conditions of, the structures of the spinal column like the bones, discs, and nerves, are generally more serious than posture problems and soft tissue-related pain.
Depending on the diagnosis, structural problems can cause symptoms related to nerve compression, irritation, and/or inflammation. (Michigan Medicine, 2022)
Spine and Nervous System
The peripheral nerves extend out to the extremities with sensation and movement capabilities.
Nerve roots exit the spinal canal which is part of the peripheral nervous system.
The branching of nerves from the spinal cord and exit out of the foramina occurs at every level of the spine.
Terms
There are different medical terms when getting a spine diagnosis or going through the treatment process.
Radiculopathy
Radiculopathy is an umbrella term, describing any disease process that affects a spinal nerve root and is something that’s happening to the body.
When a healthcare provider informs you that your pain is due to radiculopathy, a number of more specific diagnoses, clinical signs, and symptoms may be included as part of the description.
Common causes of radiculopathy include herniated disc/s and spinal stenosis.
Less common causes can include a synovial cyst or tumor that presses on the nerve root. (Johns Hopkins Medicine, 2023)
Radiculopathy can occur in the neck, low back, or in the thoracic area.
Often, radiculopathy is brought on by some form of compression of the nerve root.
For example, extruded material from a herniated disc can land on a nerve root, causing pressure to build.
This can cause symptoms associated with radiculopathy, including numbness, weakness, pain, or electrical sensations. (Johns Hopkins Medicine, 2023)
Even though there’s a spinal nerve root on either side of the spinal column, injury, trauma, or issues stemming from degeneration affect the nerves in an asymmetric fashion. Degenerative changes, known as normal wear and tear, typically occur in this fashion. Using the previous herniated disc example, the material that leaks from the disc structure tends to travel in one direction. When this is the case, the symptoms tend to be experienced on the side where the nerve root makes contact with the disc material, but not the other side. (American Association of Neurological Surgeons, 2023)
Radiculitis
Radiculitis is a form of radiculopathy but it is about inflammation and not compression. (Johns Hopkins Medicine, 2023)
Radicu– refers to the spinal nerve root.
The suffix – itis refers to inflammation.
The word refers to a spinal nerve root that is inflamed and/or irritated rather than compressed.
In disc herniations, it is the gel substance that contains various chemicals that is inflammatory.
When the gel substance makes contact with nerve roots, an inflammatory response is triggered. (Rothman SM, Winkelstein BA 2007)
Radiating or Referred Pain
Radiating pain follows the path of one of the peripheral nerves that transmit sensory information like heat, cold, pins and needles, and pain.
Referred pain is experienced in a different area of the body that is away from the pain source which tends to be an organ. (Murray GM., 2009)
It can be brought on by myofascial trigger points or visceral activity.
An example of referred pain is symptoms in the jaw or arm when an individual is having a heart attack. (Murray GM., 2009)
Radicular
The terms radicular pain and radiculopathy tend to get confused.
Radicular pain is a symptom of radiculopathy.
Radicular pain radiates from the spinal nerve root to either part or all the way down the limb/extremity.
However, radicular pain does not represent the complete symptoms of radiculopathy.
Radiculopathy symptoms also include numbness, weakness, or electrical sensations like pins and needles, burning, or shock that travels down the extremity. (Johns Hopkins Medicine, 2023)
Neuropathy
Neuropathy is another umbrella term that refers to any dysfunction or disease that affects the nerves.
It’s usually classified according to the cause, like diabetic neuropathy, or the location.
Neuropathy can occur anywhere in the body – including the peripheral nerves, the autonomic nerves/organ nerves, or nerves that are located inside the skull and innervate the eyes, ears, nose, etc.
Peripheral nerves are the long, thin strands that supply sensation, feeling, and movement impulses to all areas of the body located outside the central nervous system.
Piriformis syndrome is where a tight buttock/piriformis muscle constricts the sciatic nerve, which runs underneath. (Cass SP. 2015)
Chiropractic
Chiropractic adjustments, non-surgical decompression, MET, and various massage therapies can relieve symptoms, release stuck or trapped nerves and restore function. Through the treatments, the chiropractor and therapists will explain what is happening and why they are using a specific technique. Knowing a little about how the neuromusculoskeletal system operates can help the healthcare provider and the patient in developing and adjusting effective treatment strategies.
Sciatica During Pregnancy
References
Michigan Medicine. Upper and Middle Back Pain.
American Academy of Neurological Surgeons. Anatomy of the Spine and Peripheral Nervous System.
Johns Hopkins Medicine. Health Conditions. Radiculopathy.
American Association of Neurological Surgeons. Herniated Disc.
American Academy of Orthopaedic Surgeons. OrthoInfo. Cervical Radiculopathy (Pinched Nerve).
Rothman, S. M., & Winkelstein, B. A. (2007). Chemical and mechanical nerve root insults induce differential behavioral sensitivity and glial activation that are enhanced in combination. Brain Research, 1181, 30–43. https://doi.org/10.1016/j.brainres.2007.08.064
Murray G. M. (2009). Guest Editorial: referred pain. Journal of applied oral science: Revista FOB, 17(6), i. https://doi.org/10.1590/s1678-77572009000600001
American Academy of Orthopaedic Surgeons. OrthoInfo. Carpal Tunnel Syndrome.
Bostelmann, R., Zella, S., Steiger, H. J., & Petridis, A. K. (2016). Could Spinal Canal Compression be a Cause of Polyneuropathy? Clinics and practice, 6(1), 816. https://doi.org/10.4081/cp.2016.816
Cleveland Clinic. Mononeuropathy.
American Association of Neurological Surgeons. Glossary of Neurosurgical Terminology.
National Institutes of Health. U.S. National Library of Medicine. Medline Plus. Peripheral Nerve Disorders.
Cleveland Clinic. Spinal Stenosis.
Cass S. P. (2015). Piriformis syndrome: a cause of non-discogenic sciatica. Current sports medicine reports 14(1), 41–44. https://doi.org/10.1249/JSR.0000000000000110
Can chiropractic treatment protocols diagnose what’s causing head pressure in individuals, and provide effective treatment?
Head Pressure
Head pressure can have various causes and symptoms that affect different areas depending on whether the cause is a headache, allergies, injury, illness, or disease. The location of the pressure or pain can help a doctor of chiropractic determine the cause.
The underlying factor is usually not life-threatening, but the pressure that has built can be the result of serious conditions like a head injury or brain tumor.
Chiropractic care, which includes a combination of spinal manipulation, active and passive exercises, and massage, is often used for headache management and prevention. (Moore Craig, et al., 2018)
Chiropractic therapy is often sought out for tension and cervicogenic headaches, migraines, and each responds differently to the treatment.
The Head
The head is made up of a complex system of lobes, sinuses/channels, blood vessels, nerves, and ventricles. (Thau L, et al., 2022)
The pressure of these systems is regulated and any disruption to this balance can be noticeable.
Diagnosis can be difficult to figure out what is causing discomfort or head pressure.
Pain, pressure, irritability, and nausea are all symptoms that can occur with headaches. (Rizzoli P, Mullally W. 2017)
Head pressure can also occur only at times when standing up, bending down to pick up an object, or otherwise changing posture in some way that blood pressure is affected.
Chiropractic Treatment
The Injury Medical team will develop a personalized treatment plan to help relieve pressure symptoms through a multidisciplinary approach that can include. (Moore Craig, et al., 2018)
Moore, C., Leaver, A., Sibbritt, D., & Adams, J. (2018). The management of common recurrent headaches by chiropractors: a descriptive analysis of a nationally representative survey. BMC neurology, 18(1), 171. https://doi.org/10.1186/s12883-018-1173-6
Schizodimos, T., Soulountsi, V., Iasonidou, C., & Kapravelos, N. (2020). An overview of the management of intracranial hypertension in the intensive care unit. Journal of Anesthesia, 34(5), 741–757. https://doi.org/10.1007/s00540-020-02795-7
Wall M. (2017). Update on Idiopathic Intracranial Hypertension. Neurologic Clinics, 35(1), 45–57. https://doi.org/10.1016/j.ncl.2016.08.004
Should individuals increase their intake of black pepper to help with various health issues like fighting inflammation, strengthening the immune system, and improving digestion?
Black Pepper
One of the most popular spices, black pepper offers anti-inflammatory and pain-reducing effects. Piperine is the compound that gives black pepper its flavor, helps prevent inflammation, (Gorgani Leila, et al., 2016), and helps to increase the absorption of selenium, vitamin B12, and turmeric. (Dudhatra GB, et al., 2012) Piperine has been found to be almost as effective as prednisolone – a common medication for arthritis – in reducing symptoms.
Black pepper has been used in ancient Ayurvedic medicine for thousands of years because of its concentration of beneficial plant compounds. (Johns Hopkins Medicine, 2023)
Pepper is made by grinding peppercorns, which are dried berries from the vine Piper nigrum.
The plant is a tall woody plant with small flowers that bloom a yellowish-red color.
It has a sharp and mildly spicy flavor that goes with all kinds of dishes.
Inflammation is the immune system’s response to injury, illness, or any mental or physical stressor, that triggers the body’s healing and repair process. However, long-term inflammation can lead to various health problems and, in individuals that begin to develop arthritis, joint degeneration. Damage to the body’s pain processors can exacerbate pain and other uncomfortable symptoms.
Chronic inflammation can be a cause of diabetes, arthritis, asthma, and heart disease.
While the anti-inflammatory effects have not been extensively studied in humans, there are several mouse studies that show promising results.
In one study, treatment for arthritis with piperine resulted in less joint swelling and decreased inflammation markers. (Bang JS, Oh DH, Choi HM, et al., 2009)
Antioxidants
The active compound, piperine is rich in antioxidants, which prevent or delay the free radical damaging effects from exposure to pollution, smoke, and the sun.
In one study, rats with a diet of concentrated black pepper had less free radical damage than a group that did not ingest concentrated black pepper. (Vijayakumar RS, Surya D, Nalini N. 2004)
Brain Function Improvement
Piperine has been shown to decrease symptoms associated with Parkinson’s and Alzheimer’s and improve brain function. (Ramaswamy Kannappan, et al., 2011)
Studies show piperine increased memory as well as the ability to decrease the production of amyloid plaques, which are damaging proteins associated with Alzheimer’s disease.
Blood Sugar Control Improvement
Studies suggest that piperine can improve blood sugar and improve insulin sensitivity.
In one study, individuals with insulin resistance took a piperine supplement for 8 weeks.
After 8 weeks, improvements were seen in the response to the insulin hormone to remove glucose from the blood (Rondanelli M, et al., 2013)
Improved Nutrient Absorption
Black pepper is considered to have the ability to bind and activate with other foods for improved positive health effects.
It increases the absorption of certain nutrients such as calcium, turmeric, selenium, and green tea.
It is often recommended to consume calcium or selenium with a source of black pepper and to ensure any turmeric supplement you take contains black pepper. (Shoba G, et al., 1998)
Storage
Whole peppercorns sealed in a container and stored in a cool, dry place can last up to a year.
Over time ground black pepper loses its flavor, therefore it is recommended to use within 4 to 6 months.
Allergic Reactions
If you believe you are allergic to black pepper, see a healthcare professional who can perform testing to determine the root cause of symptoms.
Allergies can present as tingling or itching in the mouth, hives, abdominal pain, and possible nausea and vomiting.
Symptoms can also include wheezing, congestion, and/or swelling of the lips, tongue, mouth, and throat.
Black pepper can be substituted with spices like chili powder, cayenne pepper, and allspice.
The Healing Diet
References
Gorgani, L., Mohammadi, M., Najafpour, G. D., & Nikzad, M. (2017). Piperine-The Bioactive Compound of Black Pepper: From Isolation to Medicinal Formulations. Comprehensive reviews in food science and food safety, 16(1), 124–140. https://doi.org/10.1111/1541-4337.12246
Dudhatra, G. B., Mody, S. K., Awale, M. M., Patel, H. B., Modi, C. M., Kumar, A., Kamani, D. R., & Chauhan, B. N. (2012). A comprehensive review on pharmacotherapeutics of herbal bio-enhancers. TheScientificWorldJournal, 2012, 637953. https://doi.org/10.1100/2012/637953
Platel, K., & Srinivasan, K. (2016). Bioavailability of Micronutrients from Plant Foods: An Update. Critical reviews in food science and nutrition, 56(10), 1608–1619. https://doi.org/10.1080/10408398.2013.781011
Kunnumakkara, A. B., Sailo, B. L., Banik, K., Harsha, C., Prasad, S., Gupta, S. C., Bharti, A. C., & Aggarwal, B. B. (2018). Chronic diseases, inflammation, and spices: how are they linked? Journal of translational medicine, 16(1), 14. https://doi.org/10.1186/s12967-018-1381-2
Bang, J. S., Oh, D. H., Choi, H. M., Sur, B. J., Lim, S. J., Kim, J. Y., Yang, H. I., Yoo, M. C., Hahm, D. H., & Kim, K. S. (2009). Anti-inflammatory and antiarthritic effects of piperine in human interleukin 1beta-stimulated fibroblast-like synoviocytes and in rat arthritis models. Arthritis research & therapy, 11(2), R49. https://doi.org/10.1186/ar2662
Lobo, V., Patil, A., Phatak, A., & Chandra, N. (2010). Free radicals, antioxidants, and functional foods: Impact on human health. Pharmacognosy reviews, 4(8), 118–126. https://doi.org/10.4103/0973-7847.70902
Vijayakumar, R. S., Surya, D., & Nalini, N. (2004). Antioxidant efficacy of black pepper (Piper nigrum L.) and piperine in rats with high-fat diet-induced oxidative stress. Redox report: communications in free radical research, 9(2), 105–110. https://doi.org/10.1179/135100004225004742
Kannappan, R., Gupta, S. C., Kim, J. H., Reuter, S., & Aggarwal, B. B. (2011). Neuroprotection by spice-derived nutraceuticals: you are what you eat! Molecular neurobiology, 44(2), 142–159. https://doi.org/10.1007/s12035-011-8168-2
Rondanelli, M., Opizzi, A., Perna, S., Faliva, M., Solerte, S. B., Fioravanti, M., Klersy, C., Cava, E., Paolini, M., Scavone, L., Ceccarelli, P., Castellaneta, E., Savina, C., & Donini, L. M. (2013). Improvement in insulin resistance and favorable changes in plasma inflammatory adipokines after weight loss associated with two months’ consumption of a combination of bioactive food ingredients in overweight subjects. Endocrine, 44(2), 391–401. https://doi.org/10.1007/s12020-012-9863-0
Shoba, G., Joy, D., Joseph, T., Majeed, M., Rajendran, R., & Srinivas, P. S. (1998). Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta medica, 64(4), 353–356. https://doi.org/10.1055/s-2006-957450
Golfing wrist injuries are common with treatment requiring 1-3 months of rest and immobilization and if tears are present surgery. Can chiropractic treatment help avoid surgery, expedite recovery, and rehabilitation?
Golfing Wrist Injuries
Golfing Wrist Injuries: According to a study, there are over 30,000 golf-related injuries treated in American emergency rooms every year. (Walsh, B. A. et al, 2017) Nearly a third are related to a strain, sprain, or stress fracture.
This causes pain and inflammation and is usually accompanied by a grinding sensation when moving the thumb and wrist.
Chiropractic Treatment
Given the nature of these injuries, medical attention should be sought out for image scans to look at any damage and properly immobilize the wrist. Once a fracture has been ruled out or healed, golfing wrist injuries can benefit from chiropractic and physical therapy. (Hulbert, J. R. et al, 2005) A typical treatment may involve a multifaceted approach involving various therapies including:
Active release therapy, myofascial release, athletic taping, corrective exercise, and stretching.
A chiropractor will examine the wrist and its functioning to determine the nature of the injury.
A chiropractor may recommend using a splint to immobilize the wrist, particularly in cases of overuse.
They will relieve pain and swelling first, then focus on strengthening the joint.
They may recommend a regimen of icing the hand.
Adjustments and manipulations will relieve pressure on the nerves to reduce swelling and restore mobility.
Peripheral Neuropathy Successful Recovery
References
Walsh, B. A., Chounthirath, T., Friedenberg, L., & Smith, G. A. (2017). Golf-related injuries treated in United States emergency departments. The American journal of emergency medicine, 35(11), 1666–1671. https://doi.org/10.1016/j.ajem.2017.05.035
Moon, H. W., & Kim, J. S. (2023). Golf-related sports injuries of the musculoskeletal system. Journal of exercise rehabilitation, 19(2), 134–138. https://doi.org/10.12965/jer.2346128.064
Ray, G., Sandean, D. P., & Tall, M. A. (2023). Tenosynovitis. In StatPearls. StatPearls Publishing.
Zouzias, I. C., Hendra, J., Stodelle, J., & Limpisvasti, O. (2018). Golf Injuries: Epidemiology, Pathophysiology, and Treatment. The Journal of the American Academy of Orthopaedic Surgeons, 26(4), 116–123. https://doi.org/10.5435/JAAOS-D-15-00433
Tan, H. K., Chew, N., Chew, K. T., & Peh, W. C. (2014). Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Singapore medical journal, 55(10), 517–521. https://doi.org/10.11622/smedj.2014133
Hulbert, J. R., Printon, R., Osterbauer, P., Davis, P. T., & Lamaack, R. (2005). Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews. Journal of chiropractic medicine, 4(3), 144–151. https://doi.org/10.1016/S0899-3467(07)60123-2
Individuals dealing with health problems, UTIs, and skin issues can become chronic, what are the effects and benefits of drinking cranberry juice?
Cranberry Juice
Cranberries are a healthy source of nutrients and antioxidants. Cranberry juice is a recommended source of vitamin C, with the added benefits of promoting digestive, heart, immune, and skin health. Most individuals can safely drink cranberry juice to their diet with no issues, but women who are pregnant or individuals that take blood thinners, or medications should discuss adding cranberry intake with a doctor or specialist first.
One cup of unsweetened cranberry juice provides 23.5 milligrams or 26% of the daily value for vitamin C. (USDA 2018)
To avoid excess consumption of added sugars and maximize the benefits, it is recommended to drink unsweetened cranberry juice.
Digestive Health
Cranberries contain antioxidant compounds/polyphenolsthat have been shown to help with digestive health.
A study found that drinking cranberry juice was associated with increased beneficial gut bacteria and decreased constipation.
Research funded by a cranberry juice company found participants who consumed cranberry juice twice daily had lower levels of several risk factors for heart disease, stroke, and diabetes than those who received a placebo. (USDA 2016)
A systematic review and meta-analysis found that cranberry supplementation may improve body weight and blood pressure levels.
Cranberries may also help improve high-density lipoprotein (HDL) cholesterol—considered “good” cholesterol—in younger adults.
Cranberry juice contains vitamin C, which is important for immune system function.
Research suggests that inadequate vitamin C consumption can lead to decreased immunity and an increased risk of infections. (Carr A, Maggini S, 2017)
Skin Health
Thanks to its high antioxidant content, cranberry juice may help protect your skin against damage caused by free radicals that contributes to premature aging.
The vitamin C in cranberry juice is also needed for collagen production.
Collagen is a type of protein that provides strength, elasticity, and structural support to the skin, helping to keep it firm and smooth.(Pullar JM, et al., 2017)
Infection Prevention
A study found that cranberry components known as proanthocyanidins, can promote oral health.
Cranberries activate antibacterial processes that can prevent bacteria from binding together, reducing periodontitis/gum disease and the formation of dental plaque. (Chen H, et al., 2022)
Urinary Tract Infection Prevention
Cranberries have gone through many studies for home treatment of UTIs.
It is believed the chemical compounds/proanthocyanidins can help prevent certain bacteria from sticking to the lining of the urinary tract, thus reducing the risk of UTIs. (Das S. 2020)
A study found cranberry products in the form of juice or tablets may lower the risk of UTIs in at-risk groups by approximately 30%.
At-risk groups include those with recurrent UTIs, pregnant women, older adults, and individuals with chronic indwelling catheters (devices used for short-term bladder drainage) and neurogenic bladder (conditions in which people lack bladder control due to problems in the brain, spine, or spinal cord). (Xia J Yue, et al., 2021)
Daily Amount
There is no official recommendation on the optimal amount of juice an individual should consume for health benefits. Most studies examining the benefits have used amounts ranging from 8 to 16 ounces, or around 1 to 2 cups per day. (The Cranberry Institute) However, cranberry juice with large amounts of added sugar can contribute to increased calories, leading to weight gain and other health concerns. Therefore, it is important to read the product label and look for pure, 100% cranberry juice.
If the pure juice is too tart, dilute it with some ice or water.
Avoid cranberry cocktails that are often mixed with other juices, like grape or apple juice, and contain added sugars that can decrease the benefits.
Chicas MC, Talcott S, Talcott S, Sirven M. Effect of cranberry juice supplementation on the gut microbiome and inflammatory markers: a randomized, double-blind, placebo-controlled study in overweight individuals. Curr Dev Nutr. 2022;6(Suppl 1):272. doi:10.1093/cdn/nzac053.013
Chen H, Wang W, Yu S, Wang H, Tian Z, Zhu S. Procyanidins and their therapeutic potential against oral diseases. Molecules. 2022;27(9):2932. doi:10.3390/molecules27092932
Pourmasoumi M, Hadi A, Najafgholizadeh A, Joukar F, Mansour-Ghanaei F. The effects of cranberry on cardiovascular metabolic risk factors: A systematic review and meta-analysis. Clinical Nutrition. 2020;39(3):774-788. doi:10.1016/j.clnu.2019.04.003
Pullar JM, Carr AC, Vissers MCM. The roles of vitamin C in skin health. Nutrients. 2017;9(8):866. doi:10.3390/nu9080866
Xia J Yue, Yang C, Xu D Feng, Xia H, Yang L Gang, Sun G ju. Consumption of cranberry as adjuvant therapy for urinary tract infections in susceptible populations: A systematic review and meta-analysis with trial sequential analysis. PLoS One. 2021;16(9):e0256992. doi:10.1371/journal.pone.0256992
Individuals at work, school, etc, perform all kinds of repetitive physical tasks that put their bodies through a great deal of musculoskeletal stress, what are the effects and benefits of joint manipulation therapy for pain relief?
Joint Manipulation Health Benefits
Joint manipulation is a form of manual therapy that involves applying force to the spinal or peripheral joints to:
Relieve pain symptoms.
Realign the joints to their proper position.
Restore flexibility.
Improve mobility.
Increase range of motion.
Chiropractors, massage, and physical therapists use various manipulation techniques to help move and feel better after an injury or illness that causes loss of functional mobility. Here we explain joint manipulation, its applications, and if the technique is safe for you and your condition.
Joint Popping
The joints in the body are places where two or more bones come together to allow movement.
The cartilage allows the joint surfaces to glide/slide smoothly.
If the cartilage is injured or damaged, pain and limited motion can present.
When a joint doesn’t move properly, the muscles surrounding that joint don’t contract properly.
If a joint is dysfunctional for some time, significant muscle wasting and atrophy can occur around the joint, leading to difficulty with mobility like standing, walking, or reaching. (Hurley MV.1997)
The body is made up of cells that breathe by converting energy and releasing waste materials. One type of waste material from cell respiration is carbon dioxide. The gas is transported through the blood and delivered out of the body while breathing. Small pockets of gas can get trapped in the joints that expand and contract as pressure around the joint changes during movement, known as cavitation. When the gas is released through joint manipulation, there can be a popping or snapping sound as the joint is moved. Once the gas is released, joint pressure is decreased and mobility is increased. (Kawchuk, et al., 2015)
Causes
Non-medical
There are non-medical and medical causes of joint dysfunction and derangement that include:
Overuse and repetitive strain.
Unhealthy sitting and/or standing posture.
Lack of physical activity.
Over-stretching or stretching incorrectly.
In these situations, the joints can be temporarily placed in a dysfunctional/compromised position. When moving to the correct position, a popping sound can present as built-up pressure is released.
Medical
Joint problems can occur from medical conditions that can include:
Herniated cervical or lumbar discs.
Spinal arthritis.
Rheumatoid arthritis.
Osteoarthritis.
Joint contracture after being immobilized for some time.
In these cases, a medical problem can be causing a limitation in the joint’s position and movement. (Gessl, et al., 20220)
Benefits
If a chiropractic practitioner determines there is joint dysfunction then manipulation may be a treatment option. The benefits include:
Pain Relief
When a chiropractor or therapist gets an injured joint moving properly, the receptors in and around the area get reset allowing for pain relief.
Improved Muscle Activation
As a chiropractor manipulates a joint into its correct anatomical position, the surrounding muscles can flex and contract properly.
Improved Range of Motion
The joint is repositioned for proper movement.
This improves the range of motion and relieves tightness and stiffness.
Improved Functional Mobility
Once a joint is manipulated, the improved range of motion and muscle activation around the joint can lead to improved overall functional mobility. (Puentedura, et al., 2012)
Candidates
Joint manipulation is a safe manual therapy technique for certain individuals. (Puentedura, et al., 2016) This includes:
Individuals with acute neck, back, or peripheral joint pain.
Adults aged 25 to 65 with no serious medical conditions.
Athletes who have been injured from their sport.
Individuals who have been immobilized after injury or surgery.
Joint manipulation is not recommended for everyone and can be dangerous or lead to injury in individuals with certain conditions. (Puentedura, et al., 2016) These include individuals with:
Osteoporosis
Weakened bones may fracture if a high-velocity force is applied to a joint via manipulation
Joint fractures
Individuals with a joint fracture, should not have that specific joint manipulated.
Post Spinal Fusion Surgery
Individuals that have had spinal fusion in the neck or lower back should avoid spinal joint manipulations or adjustments for at least one year after the procedure.
The bones need time to heal thoroughly.
Manipulation can cause a failure of the fusion.
Individuals with Arterial Insufficiency In Their Neck
A rare but dangerous side effect of a neck adjustment is the risk of tearing an artery in the neck known as the vertebrobasilar artery. (Moser, et al., 2019)
If there is pain, loss of movement, or decreased mobility after an injury or surgery, a chiropractic adjustment with joint manipulation can be beneficial to help regain movement. Manual techniques can help improve joint mobility, alleviate pain, and increase strength and stability around the joints. Joint manipulation isn’t for everyone and is recommended to consult with a healthcare professional to see if it is safe for your specific condition.
Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment, and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Annals of the rheumatic diseases, 80(7), 884–890. https://doi.org/10.1136/annrheumdis-2020-218744
Hurley M. V. (1997). The effects of joint damage on muscle function, proprioception, and rehabilitation. Manual therapy, 2(1), 11–17. https://doi.org/10.1054/math.1997.0281
Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470
Moser, N., Mior, S., Noseworthy, M., Côté, P., Wells, G., Behr, M., & Triano, J. (2019). Effect of cervical manipulation on the vertebral artery and cerebral hemodynamics in patients with chronic neck pain: a crossover randomized controlled trial. BMJ open, 9(5), e025219. https://doi.org/10.1136/bmjopen-2018-025219
Puentedura, E. J., Cleland, J. A., Landers, M. R., Mintken, P. E., Louw, A., & Fernández-de-Las-Peñas, C. (2012). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. The Journal of orthopedic and sports physical therapy, 42(7), 577–592. https://doi.org/10.2519/jospt.2012.4243
Puentedura, E. J., Slaughter, R., Reilly, S., Ventura, E., & Young, D. (2017). Thrust joint manipulation utilization by U.S. physical therapists. The Journal of manual & manipulative therapy, 25(2), 74–82. https://doi.org/10.1080/10669817.2016.1187902
The digestive system breaks down the foods eaten so the body can absorb the nutrients. During digestion, the unnecessary parts of these foods are turned into waste/stool, which is evacuated during a bowel movement. When the digestive system stops functioning properly due to factors such as diet change, eating unhealthy foods, lack of physical activity/exercise, medications, and certain health conditions, can cause constipation. Constipation occurs when the body cannot have a regular bowel movement. The distention, gas, bloating and not being able to have a bowel movement cause irritability and stress, which can worsen constipation. Incorporating recommended nutrition can help restore regular bowel movements and gut function.
Recommended Nutrition For Constipation
Symptoms like abdominal pain, bloating, and difficult bowel movements are common. Diet and proper hydration have a significant role in digestive health, especially in relieving and preventing constipation. High-fiber foods, prebiotics, and adequate hydration from foods and beverages are essential for healthy bowel movements.
Fiber is found in whole grains, starches, fruits, and vegetables.
Soluble and insoluble fiber are important for digestive health.
Focusing on incorporating high-fiber fruits, vegetables, and whole grains.
Foods rich in prebiotics like fermented foods are recommended when constipated.
The recommended nutrition for constipation, according to a dietitian includes.
Avocados
Avocados can be paired with just about anything and are full of nutrients and fiber.
One avocado contains around 13.5 grams of fiber.
One avocado will provide almost half daily fiber needs.
Other high-fiber fruits: pomegranates, guava, raspberries, blackberries, and passionfruit.
Figs
Figs can be eaten fresh and dried.
Figs are considered a laxative and have been shown to treat and reduce constipation.
They contain antioxidants, polyphenols, polyunsaturated fatty acids, and vitamins.
Other fruits similar to a fig: dried apricots, prunes, and plums.
Plums
Plums, prunes dried plums are packed with fiber and prebiotics that have a natural laxative effect.
The added H2O makes the stools softer and easier to pass.
Natural fruit juices, like pear, apple, or prune are often prescribed for constipation.
Other fruits that aid in bowel movements: peaches, pears, and apples.
Kefir
Fermented foods like kefir are rich in beneficial bacteria that work to maintain digestive system health.
It can be consumed on its own or used in smoothies, cooking, and baking recipes.
Other fermented foods: kombucha, yogurt, sauerkraut, kimchi, miso, and tempeh.
Oat Bran
Oat bran is oatmeal that has not had the bran removed.
The bran contains beneficial nutrients including fiber, antioxidants, vitamins, and minerals.
Oat bran contains soluble and insoluble fiber, as well as beta-glucan/non-starchy polysaccharides.
All improve the composition of gut bacteria and promote healthy bowel movements.
Other beneficial grains: oatmeal, wheat bran, rye, and barley.
Incorporating Gut-Beneficial Foods
How to incorporate recommended nutrition gut-beneficial foods into a regular menu:
Smoothie
Use kefir or yogurt as a base then balance it out with fiber-rich fruits like mango, blueberries, and kiwi.
Snacks
Diversify snacks with a plate of fiber and prebiotics.
Nuts, cheese, crackers, fruit, and a yogurt or avocado dip.
Oatmeal
Try oat bran to increase fiber.
Sprinkle a serving of flaxseeds, chia seeds, or hemp seeds for added fiber and healthy fats.
Parfait
Yogurt parfaits can maximize nutrients, flavor, and textures in a bowl.
Layer up on a favorite yogurt with granola, nuts, fruit, and seeds.
Grain Bowl
Fiber found in whole grains and seeds like barley, farro, and quinoa, helps promote healthy digestion.
Make a bowl with a grain base, then top with a protein, fresh or grilled veggies, avocado, and dressing.
Talk with a registered nutritionist or other healthcare provider to discuss recommended nutrition plan options.
Balancing Body and Metabolism
References
Arce, Daisy A et al. “Evaluation of constipation.” American family physician vol. 65,11 (2002): 2283-90.
Bharucha, Adil E. “Constipation.” Best practice & research. Clinical gastroenterology vol. 21,4 (2007): 709-31. doi:10.1016/j.bpg.2007.07.001
Gray, James R. “What is chronic constipation? Definition and diagnosis.” Canadian Journal of Gastroenterology = Journal Canadien de Gastroenterology vol. 25 Suppl B, Suppl B (2011): 7B-10B.
Jani, Bhairvi, and Elizabeth Marsicano. “Constipation: Evaluation and Management.” Missouri medicine vol. 115,3 (2018): 236-240.
Naseer, Maliha, et al. “Therapeutic Effects of Prebiotics on Constipation: A Schematic Review.” Current clinical pharmacology vol. 15,3 (2020): 207-215. doi:10.2174/1574884715666200212125035
National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Constipation.
National Institute of Diabetes and Digestive and Kidney Disease. Your Digestive System and How It Works.
Sinclair, Marybetts. “The use of abdominal massage to treat chronic constipation.” Journal of bodywork and movement therapies vol. 15,4 (2011): 436-45. doi:10.1016/j.jbmt.2010.07.007
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