How can one effectively manage the early signs of bunions?
Bunions
A bunion, also known as hallux valgus, is a bony, often painful protrusion on the side of the big toe. The most common cause of bunions is a misalignment of the big toe. Early symptoms of a bunion include redness, thicker skin, edema, and discomfort around the big toe joint. While you can’t stop a bunion from growing, you can manage the symptoms along the way. Early indicators of bunions include pain management measures and treatment choices. (MedlinePlus, 2024)
Early Visual Signs
Bunions are initially minor and don’t result in many noticeable issues. The following symptoms may be present in the early stages of a bunion around the metatarsophalangeal (MTP) joint, which joins the base of your big toe to the rest of your foot. (American Academy of Orthopaedic Surgeons, 2022)
Redness
Skin that is darker and swollen
Skin that has gotten thicker and harder
There is a bony bump
A bump where the big toe goes toward the second toe or even under it
Corns and calluses
Early Physical Signs
While bunions may not be visible immediately, they can cause discomfort even in the early stages. Here are some early physical indicators of a developing bunion. (MedlinePlus, 2024)
Pain in the foot and big toe
This pain is especially noticeable when walking or wearing tight, narrow-toed shoes.
Decreased movement of the big toe
Tenderness
Inflammation
Swelling
Stiffness
Heat
Stages
Bunions often worsen over time, a condition known as progressive. You could have problems if you don’t do anything to stop your bunions from getting bigger. Bunions in later stages might cause the following symptoms: (American Academy of Orthopaedic Surgeons, 2022)
Long-lasting, intense pain in and around the MTP joint and the sides and bottom of your foot
Bursitis causes a sac full of fluid to form at the bottom of your big toe.
The big toe bends toward and even crosses over the second toe.
Too much bone development on the side of your big toe
Not being able to wear your regular shoes
Hard to walk
Abnormalities known as “hammer toe” occur when your second, third, or fourth toes bend upward in the middle, resembling a hammer or claw.
Hallux rigidus is a form of arthritis affecting the big toe.
Manage the Progression
Bunions tend to remain in place once they start to develop. However, there are several steps you can take to prevent them from worsening or causing additional problems. These are some of them: (American Academy of Orthopaedic Surgeons, 2022)
Place spacers between your toes to prevent friction and chafing.
Use over-the-counter (OTC) pads made of felt, silicone, or foam to cover the bunion.
You should also stretch your calf muscles to improve joint alignment.
Managing Pain
Advil and Motrin (ibuprofen) are two examples of non-steroidal anti-inflammatory medicines (NSAIDs) that can aid with bunion pain. Studies also show that injecting Botox into the muscles in the forefoot can help with pain. (Hurn, S. E., et al., 2022)
Nonsurgical Early Stage Treatment
If your bunions continue to worsen despite using the self-care procedures listed above, you may need to consult a podiatrist (a foot expert) or another healthcare provider. A healthcare provider may recommend.
Orthotics, or foot orthoses
Foot orthoses, also known as orthotics, are customized inserts that help alleviate bunion pain and prevent chafing.
Splints
Bunion splints are orthotic devices that can help straighten out your toes. People typically use them at night. (Aebischer, A. S., & Duff, S. 2020)
Physical Therapy
A physical therapist can help you by giving you exercises that will help your feet and joints line up better. They might also do manual therapy to help with pain. (Hurn, S. E., et al., 2022)
Podiatrist
A podiatrist is a medical doctor (M.D.) who specializes in treating health problems that affect the feet, ankles, and lower legs. If you want help with your bunion issues, ask your doctor for a referral to a podiatrist. (American Podiatric Medical Association, 2025)
Chiropractic Treatment
Chiropractors and nurse practitioners (NPs) have distinct roles in managing bunions, which are bony bumps at the base of the big toe caused by joint misalignment, often resulting in pain, swelling, and restricted movement. Here’s how each can help:
Chiropractors:
Focus: Chiropractors primarily address musculoskeletal issues through manual adjustments and manipulations.
Bunion Support:
Foot Adjustments: They may perform adjustments to improve foot alignment and joint mobility, which can potentially reduce bunion-related discomfort.
Soft Tissue Therapy: Techniques such as massage or myofascial release can help alleviate tension in surrounding muscles and tissues.
Orthotics or Taping: Some chiropractors recommend custom orthotics or use taping to support proper foot mechanics.
Exercise Guidance: They may suggest stretches or exercises to strengthen foot muscles and improve alignment.
Limitations: Chiropractors don’t prescribe medications or perform surgeries, so severe cases requiring these interventions would need referral to a podiatrist or orthopedic specialist.
Evidence: While some patients report relief from chiropractic care for foot issues, evidence specifically for bunions is limited, and results vary.
Nurse Practitioners:
Focus: NPs are advanced practice registered nurses with broad medical training, able to diagnose, treat, and prescribe medications within their scope of practice.
Bunion Support:
Diagnosis and Assessment: NPs can evaluate bunion severity, often using physical examinations or ordering imaging, such as X-rays, to assess joint damage.
Pain Management: They may prescribe anti-inflammatory medications (e.g., ibuprofen) or corticosteroid injections for pain and swelling.
Conservative Treatments: NPs can recommend padding, splints, or orthotic devices to reduce pressure and improve alignment.
Lifestyle Advice: They provide guidance on footwear (such as wide-toed shoes) and weight management to reduce stress on the bunion.
Referrals: For severe cases, NPs can refer patients to podiatrists or orthopedic surgeons for surgical options, such as bunionectomies.
Scope: NPs offer a medical approach, bridging conservative care and coordination with specialists.
Key Differences:
Chiropractors focus on non-invasive, manual techniques and alignment, while NPs can incorporate medications and broader medical management.
NPs are more likely to coordinate with other healthcare providers for comprehensive care, whereas chiropractors tend to work more independently.
General Notes:
Both can assist in managing mild to moderate bunion symptoms, but neither can “cure” bunions, particularly if the structural deformity has progressed.
Consult a podiatrist or an orthopedic specialist for persistent or worsening symptoms, as severe cases may require surgical intervention.
Always verify the provider’s credentials and experience in treating bunions.
Injury Medical Chiropractic and Functional Medicine Clinic
Dr. Jimenez, a nurse practitioner, treats a wide range of conditions using a combination of medical knowledge and chiropractic care. The clinic offers personalized care plans that incorporate functional medicine, acupuncture, electroacupuncture, and sports medicine. The clinic treats chronic pain syndromes and injuries, focusing on strength, agility, and flexibility. Comprehensive care plans, when paired with in-person and virtual health coaching, offer personalized treatment and wellness outcomes for patients of all ages and abilities.
Enhance Your Performance with Functional Foot Orthotics
References
MedlinePlus (2024). Bunions. U.S. Department of Health and Human Services.
Hurn, S. E., Matthews, B. G., Munteanu, S. E., & Menz, H. B. (2022). Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta-Analysis. Arthritis care & research, 74(10), 1676–1688. doi.org/10.1002/acr.24603
Aebischer, A. S., & Duff, S. (2020). Bunions: A review of management. Australian Journal of General Practice, 49(11), 720–723. doi.org/10.31128/AJGP-07-20-5541
Can older people who exercise regularly lessen their risk of dementia and enhance their overall health?
Exercise and the Prevention of Dementia
Dementia, a term used to cover several conditions that impact memory and cognition, is currently the seventh leading cause of mortality worldwide. (World Health Organization, 2025) More than 10 million new cases of dementia are found around the world each year. (J.H. Yoon et al., 2023) Research investigating the relationship between exercise and insulin in the brain suggests that regular exercise may improve brain function and decrease the prevalence of dementia. Scientists have discovered that variables, such as.
Muscles must be exercised and mobilized. People who do not engage in physical activity have rigid muscles, which impede the effectiveness of insulin. The body’s sensitivity to insulin is improved by the contraction and relaxation of the muscles during movement. Dementia can be prevented by understanding how to decrease the body’s insulin resistance.
Physical Activity and Lower Risk
Over two weeks, researchers examined 21 older adults with prediabetes and found that exercise enhances cognitive performance by aiding the brain in insulin regulation. They conducted twelve supervised training sessions of moderate to extreme intensity. (Malin S. K. et al., 2025)
The results indicated that brain-derived extracellular vesicles containing insulin-related proteins had significantly increased.
These microscopic messengers are essential for brain maintenance and aid in neuronal communication.
Three serine/threonine-specific protein kinases known as AKT (protein kinase B, or PKB) are essential for several cellular functions, such as cell growth, survival, metabolism, and cell cycle control.
The protein affects the development and health of neuronal cells and is thought to play a significant role in insulin signaling.
The notion that exercise might help prevent dementia by potentially enhancing insulin signaling is important since poor insulin response can result in dementia.
Even while further research is needed, these findings prove that physical activity could be a cost-effective and easily accessible way to improve long-term brain health. To better understand how insulin affects brain activity, researchers will use MRIs and an insulin spray in the study’s next phase. To learn more about the effects of the insulin spray, they will compare the blood flow in the brain before and after it is administered.
Insulin and Exercise Are Essential for Brain Health
Insulin is a hormone that the pancreas makes. It controls blood sugar levels. But it’s just as vital for the health of the brain. Insulin binds to many receptors in the brain, which makes synaptic connections stronger and makes it easier for neurons to talk to each other. Both of these things help with memory and learning. (Gray, S. M., Meijer, R. I., & Barrett, E. J. 2014)
Type 2 diabetes, which impairs insulin transmission, increases the risk of cognitive impairment. (Yoon J.H. et al., 2023) Research has demonstrated that insulin resistance exacerbates tau tangles and amyloid-beta plaques, which are two critical characteristics of Alzheimer’s disease. (Hong, S., Han, K., & Park, C. Y. 2021) Increasing insulin sensitivity may slow down or even stop these changes in the brain. Working out, especially aerobic exercise, is good for the brain. According to earlier research, exercise can help people maintain or enhance their memory and brain function. (Rosenberg A. et al., 2020) Other ways to increase brain health include:
Maintaining social interaction
Challenging the mind
Getting a good night’s sleep
Controlling stress
A nutritious diet
Maintaining an active lifestyle
Controlling diabetes
Controlling blood pressure
To achieve the greatest possible effect, dementia prevention in the future will likely involve integrating lifestyle modifications, such as exercise, with medications. In individuals with diabetes or prediabetes, the risk of dementia is significantly reduced, and frequent exercise can assist in the preservation of optimal brain function.
Chiropractic and Functional Medicine Clinic
As a family nurse practitioner, Dr. Jimenez uses the latest medical expertise and chiropractic therapy to address many problems. Our clinic uses functional medicine, acupuncture, electro-acupuncture, and sports medicine to create individualized care plans that improve movement, encourage long-term health, and speed up the body’s natural healing process. We focus on strength, agility, and flexibility to help our patients thrive, regardless of age or health problems. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we want to help people with chronic pain syndromes and injuries. We focus on improving flexibility, mobility, and agility through programs suitable for people of all ages and abilities. We ensure that each patient gets personalized care and reaches their health objectives through detailed care plans and health coaching in person and online.
Is Movement Essential to Recovery?
References
World Health Organization. (2025). “Dementia.” World Health Organization. from www.who.int/news-room/fact sheets/detail/dementia#:~:text=Alzheimer%20disease%20is%20the%20most,60%E2%80%9370%25%20of%20cases.
Yoon, J. H., Hwang, J., Son, S. U., Choi, J., You, S. W., Park, H., Cha, S. Y., & Maeng, S. (2023). How Can Insulin Resistance Cause Alzheimer’s Disease?. International Journal of Molecular Sciences, 24(4), 3506. doi.org/10.3390/ijms24043506
Malin, S. K., Battillo, D. J., Beeri, M. S., Mustapic, M., Delgado-Peraza, F., & Kapogiannis, D. (2025). Two weeks of exercise alters neuronal extracellular vesicle insulin signaling proteins and pro-BDNF in older adults with prediabetes. Aging cell, 24(1), e14369. doi.org/10.1111/acel.14369
Gray, S. M., Meijer, R. I., & Barrett, E. J. (2014). Insulin regulates brain function, but how does it get there?. Diabetes, 63(12), 3992–3997. doi.org/10.2337/db14-0340
Hong, S., Han, K., & Park, C. Y. (2021). The insulin resistance by triglyceride glucose index and risk for dementia: population-based study. Alzheimer’s research & therapy, 13(1), 9. doi.org/10.1186/s13195-020-00758-4
Rosenberg, A., Mangialasche, F., Ngandu, T., Solomon, A., & Kivipelto, M. (2020). Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer’s Disease, and Dementia: From FINGER to World-Wide FINGERS. The Journal of Prevention of Alzheimer’s disease, 7(1), 29–36. doi.org/10.14283/jpad.2019.41
What are the benefits of both a chiropractor and a nurse practitioner in cases of personal injury and car accidents?
Chiropractic and Nurse Practitioner On Auto Accidents
Following a car accident, both nurse practitioners and chiropractors are essential in treating injuries and accelerating healing. To treat musculoskeletal problems and restore mobility, chiropractors concentrate on manual therapies like adjustments and manipulations. In contrast, nurse practitioners offer comprehensive care that includes evaluations, diagnoses, treatment plans, and education, frequently working with specialists to maximize patient outcomes. (Physicians Group, LLC. 2024)
Chiropractors
Musculoskeletal injuries, such as neck and back discomfort, are frequently sustained in traffic accidents and are treated by chiropractors. Frequently, without the use of drugs, they employ manual methods to reduce pain and increase mobility. Their thorough documentation and professional opinions can also bolster personal injury lawsuits by demonstrating the severity of injuries. (Dies, S., & Strapp, J. W., 1992)
Identification and Management of Musculoskeletal Conditions
After an accident, chiropractors can detect and treat soft tissue injuries, muscle spasms, and spinal misalignments. (The Neck and Back Clinics, 2025)
Pain Management
Soft tissue mobilization and spinal adjustments are examples of manual therapies that can help lower inflammation and relieve pain.
Enhanced Mobility
Chiropractors can assist in restoring range of motion and enhancing general function by addressing joint and muscle limitations.
Holistic Medical Treatment
In order to prevent further injuries, chiropractors can offer advice on maintaining proper posture, ergonomics, and general well-being.
Cooperation with Other Medical Experts
To develop a thorough treatment plan for a patient, chiropractors might collaborate closely with doctors, physical therapists, and other professionals. (Physicians Group, LLC, 2024)
Nurse Practitioners
For injuries sustained in auto accidents, nurse practitioners can offer comprehensive care, including: (Integrity Spine & Orthopedics, 2024)
Evaluation and Diagnosis
Nurse practitioners are qualified to perform physical examinations, interpret test results, and diagnose illnesses such as concussions, soft tissue injuries, and whiplash.
Plans for Treatment
To meet the patient’s unique needs, they can create individualized treatment programs that include prescription drugs, physical therapy, and other therapies.
Education of Patients
To encourage healing and avoid problems, nurse practitioners can instruct patients on their injuries, the healing process, and self-care techniques.
Care Coordination
To guarantee a comprehensive approach to treatment, they can coordinate care with other professionals like neurologists, physical therapists, and surgeons.
Aftercare
Throughout the healing process, nurse practitioners can keep an eye on the patient’s progress, modify treatment plans as necessary, and offer continuous support.
Complex medical and legal requirements are frequently present in personal injury cases, especially those resulting from traffic accidents. With their different areas of expertise, chiropractors and nurse practitioners are essential to diagnosis, care, and record-keeping.
When it comes to personal injury claims, NPs and chiropractors both have special advantages. While NPs handle more general medical needs, such as writing prescriptions and organizing care, chiropractors concentrate on musculoskeletal problems and provide non-invasive treatments. As seen in places like the Accident Care and Treatment Center, where NPs and doctors oversee care in addition to chiropractic interventions, their cooperation can improve patient results. (Accident Care, 2025)
According to legal resources, the documentation of both experts is essential for insurance settlements and claims. Together, the thorough medical records of NPs regarding general health and the detailed reports of chiropractors on spinal injuries can make a strong case for compensation. In situations involving auto accidents, when patients would need both medical supervision and physical adaptations for a proper recovery, this synergy is especially noticeable. (Chiropractic Economics, 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
Dr. Jimenez, a family practice nurse practitioner, combines advanced medical skills with chiropractic care to treat a variety of problems. Our clinic combines functional medicine, acupuncture, electro-acupuncture, and sports medicine to provide personalized care regimens for natural healing, mobility, and long-term wellness. By emphasizing flexibility, agility, and strength, we enable patients to thrive regardless of age or health challenges. El Paso Chiropractic Rehabilitation Clinic & Integrated Medicine Center specializes in treating injuries and chronic pain conditions. We focus on enhancing your ability through flexibility, mobility, and agility training that is adapted to all age groups and disabilities. We offer personalized care through in-person and virtual health coaching, as well as comprehensive care plans.
Dies, S., & Strapp, J. W. (1992). Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis. The Journal of the Canadian Chiropractic Association, 36(3), 139–145.
Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?
Bone Growth Stimulator
Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.
How They Work
Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)
They come in various shapes, sizes, and technologies depending on the location of the fracture.
The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.
Electrical Stimulation
Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.
Ultrasound Stimulation
They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.
Implantable vs. External
Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.
The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.
Effectiveness
Studies of bone stimulator effectiveness suggest two benefits:
Less pain is associated with the bone healing process.
Faster fracture healing.
However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)
While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.
When Stimulation is Necessary
Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)
Nonunion Fractures
When a fracture doesn’t heal within the expected timeframe.
Open fractures
Stress fractures
Scaphoid bone fractures
Talus fractures
Failed Fusions
When a spinal fusion hasn’t been successful.
High-Risk Patients
For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications
Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. doi.org/10.1038/srep31724
Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. doi.org/10.4103/0019-5413.50844
Can pace running help runners concentrate on other things, like breathing, form, or mental toughness?
Pace Running
Running is a sport many participate in and doesn’t require any equipment—only quality running shoes. Running in races comes with various physical and mental challenges. Some runners enjoy running in races and marathons but want to perfect their abilities and techniques, become more consistent, finish in a certain time, or pass a personal record. This is where pace running or working with a pace runner can help achieve those goals.
What is a Pace Runner?
A pace runner, or pacer, is an experienced runner who can run at a set pace for a long time. The pacer sets the speed so the runner can focus on running. Pacers run in races or marathons to help set the pace for a runner or runners. There are different reasons why professional and amateur runners work with a pace runner. Professional runners often use pace runners to work on techniques and help reach new levels in their running, while amateur runners can work on improving their overall running abilities. There are three typical types of pacers.
Race Pacer
Pacers wear or carry signs to make it easier for the runners and can often run split times.
A split time is the time it takes to run a certain distance.
Typically, these pacers will run at an even pace.
Many marathons will have pace groups that run at a specific speed or pace throughout the race.
The pace groups will have runners running a set time so other runners can key off these runners.
There are typically set paces for a 3-hour marathon time up to a 6-hour marathon time.
Runners can use pacers to help them reach their goals without relying on technology, such as a smartwatch or GPS, to determine if they maintain the correct speed throughout the race.
Distance Pacer
Professional and non-professional runners who run long distances or ultramarathons may also use a pace runner to set a specific tempo.
Ultramarathons are any race with a distance longer than the standard marathon of 26.2 miles.
Because some ultramarathons can be as long as 50 to 100 miles, runners who choose to have a pacer often have several pacers at different sections to motivate them and help set the rhythm.
Record Pacer or Rabbit
A record pacer, also known as a rabbit, is a pacer who helps a professional runner set a new record.
A rabbit often leads the race for a predetermined distance at a predetermined pace.
Some races have multiple pacers at various distances.
How Are Pacers Used?
There are different reasons for having a pacer, but they are based on the runner’s goals.
A runner being paced runs directly behind a pacer or pacers.
A pacer can run any pace requested, but typically, the pace groups run at an even pace or with a slight negative split.
A negative split is when a runner runs the race’s second half faster than the first half.
How Do They Help?
A pacer can be helpful because it takes more energy to lead a race than to sit back and follow another runner.
The pacer is responsible for timing and establishing the tempo so runners only have to focus on running.
A pacer does more work setting the pace, which allows the runner being paced to relax and not stress about hitting the pace.
A study focused on elite athletes who used pacers. It found that running together at a realistic speed helped optimize and achieve finishing time goals. (Casado A. et al., 2021) However, not all elite events allow pacers to participate. Some championship events, like the Olympics and NCAA Championships, do not allow pacer runners.
Benefits
Benefits of running with a pacer.
Prevent Running Too Fast
When a race begins, runners can take off and start too fast.
Starting too quickly can negatively impact the runners, like losing energy and stamina.
A pacer can help start the race with a steady pace, keeping them from going out too fast or expending too much energy.
Maintain an Even Pace
Maintaining an even pace can be difficult throughout a long race or a marathon.
Having a pacer can relieve some stress and pressure.
A pacer can keep the runners on an even pace or negative splits versus going out too fast and losing energy.
Focus on the Race
Pacers help the runners stay focused on the race without worrying about how they are running or maintaining the right speed.
A pacer can help keep runners relaxed.
Motivating
Pacers can help motivate runners.
The pace runners may encourage individuals along the way and help them stay motivated to keep working toward their goal, especially when the hard parts come.
Disadvantages
Running with a pacer can sometimes be more stressful than beneficial, especially for amateur runners. A pacer or pace group can be helpful, but it also can create more stress for some amateur runners.
Sometimes, individuals realize the pacer is running too quickly for what they can handle.
Anxiety can present as not being able to keep up.
Other times, runners underestimate their abilities and run more slowly than their bodies can handle.
However, runners don’t have to stay with a pace group just because they started with them.
Individuals can run ahead.
Or if the group is too fast, the runner can slow down and join the slower-paced group behind them.
The key is to listen to your body and do what feels right.
Becoming a Pacer
An experienced runner who wants to be a pacer for a race can contact a running organization about becoming a pace runner.
Individuals need to be able to have consistent racing times.
Be able to run at a set speed for a long duration.
Most pacers will contact the race organization to apply for a certain pace.
Some pacers enjoy the thrill of running in a race and helping other runners meet their goals.
The runner’s goals and the type of event also influence who the pacer is.
Injury Medical Chiropractic & Functional Medicine Clinic
Individuals can talk to local running experts or a running coach. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. We can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Difference of Using Custom Foot Orthotics
References
Casado, A., Hanley, B., Jiménez-Reyes, P., & Renfree, A. (2021). Pacing profiles and tactical behaviors of elite runners. Journal of Sport and Health Science, 10(5), 537–549. doi.org/10.1016/j.jshs.2020.06.011
Can Affect Lower Back Muscles and Cause Hamstring Spasms
Lower back muscles, including those like the quadratus lumborum, can be affected by paraspinal spasms. (Hospital for Special Surgery, 2024)
The spasms can cause these muscles to tighten or spasm, potentially pulling on the hamstring muscles.
This can lead to hamstring spasms and tightness, further contributing to pain and potential nerve irritation.
Entrapment of the Sciatic Nerve
Piriformis syndrome is a common condition where the piriformis muscle (located in the buttock) spasms and compresses the sciatic nerve. (Cedars-Sinai, 2025)
The sciatic nerve runs from the lower back down the back of the thigh and into the leg, making it vulnerable to compression by surrounding muscles.
If the paraspinal and hamstring spasms create enough tension on the piriformis muscle or surrounding tissues, it can lead to sciatic nerve entrapment. (Hospital for Special Surgery, 2024)
How acupuncture helps relieve sciatica
Acupuncture can help relieve sciatica pain by stimulating specific points on the body, which can trigger the release of endorphins, reduce inflammation, improve blood flow, and relax tight muscles that could be compressing the sciatic nerve. By modulating the nervous system and promoting the body’s natural healing processes, acupuncture can help alleviate pain and improve overall function. (Qin, Z. et al., 2015)
Releases endorphins
Acupuncture stimulates the nervous system, triggering the release of endorphins, the body’s natural painkillers.
Reduces inflammation
Acupuncture can help reduce inflammation in the area surrounding the sciatic nerve, which can contribute to pain and nerve irritation. (Natural Care Chiropractic, 2022)
Improves circulation
By increasing blood flow to the affected area, acupuncture can help deliver nutrients and oxygen to the sciatic nerve and surrounding tissues, promoting faster healing.
Relaxes tight muscles
Sciatica pain can be exacerbated by tight muscles compressing the nerve. Acupuncture can help relax these muscles, reducing pressure on the sciatic nerve and alleviating pain.
Regulates the nervous system
Acupuncture can help regulate the nervous system, positively impacting pain perception and overall well-being. (Qin, Z. et al., 2015)
Promotes regeneration
Some evidence suggests that acupuncture can promote sciatic nerve regeneration, potentially leading to long-term pain relief. (Natural Care Chiropractic, 2022)
Needling Types
Distal needling
Acupuncture can also involve using points that are further away from the site of pain, which can also help to reduce pain and inflammation.
Local needling
Points are also selected on or near the sciatic nerve’s path, which can help directly address the source of pain and inflammation. (Qin, Z. et al., 2015)
Holistic approach
Acupuncture is often viewed as a holistic approach to pain management, addressing the symptoms of sciatica and the underlying causes and imbalances in the body.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR spine, 4(3), e1171. doi.org/10.1002/jsp2.1171
Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine: eCAM, 2015, 425108. doi.org/10.1155/2015/425108
What is pseudoarthrosis of the cervical and lumbar spine?
Pseudoarthrosis of the cervical and lumbar spine
Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:
Issues with the instruments used to stabilize the bone
Lack of bone growth
The number of vertebrae being fused.
The patient’s health and lifestyle play a role in failed fusions, which can include
Diabetes
Inflammatory health conditions increase the risk
Smoking
Long-term steroid use
In many cases, revision surgery is needed.
Surgery-Related
During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:
Plates
Rods
Screws
The bone graft promotes growth between the two bones.
The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
The hardware goes inside, or internal fixation.
Although rare, a severe spinal fracture or deformity may need external fixation.
A rigid frame secured outside the body helps to stabilize the bones.
If the fusion fails, it could be caused by one or more of the following surgical issues:
The surgeon must carefully plan and use the right hardware.
The type of hardware used during a spinal fusion may influence bone healing.
The instruments can come loose or break, interfering with the fusion process.
Spinal osteoporosis, having thin, weak bones, can affect fixation.
Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.
Bone Graft
The type of bone graft used may affect the fusion.
For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.
Risk Factors
The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)
The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
Rarely does a pinched nerve affect both arms.
The pain may return shortly after the procedure.
The pain may develop gradually or not appear for many months.
However, it’s more likely to appear after several months when the individual returns to their usual activities.
Diagnosis
The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
They’ll assess mobility and the type of movement that causes pain.
Then, they order diagnostic imaging to see the spine and identify the cause of pain.
Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.
Treatment
Treatment for pseudoarthrosis will likely start with:
Physical therapy
Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
Medication
Injections
If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Enhancing Health Together
References
Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. doi.org/10.1186/s12891-024-07531-w
Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. doi.org/10.1055/s-0041-1722853
Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. doi.org/10.14444/4029
Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1
Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. doi.org/10.1007/s11914-023-00824-4
Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. doi.org/10.1007/s11914-015-0286-8
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