What type of concussion tests are there to help establish the extent of head injuries and help assess improvement during recovery?
Concussion Tests
A concussion is a temporary change in brain function that occurs from a traumatic brain injury or TBI. It can cause problems with thinking and mood and can take weeks to years to heal. Concussion tests are done after a suspected head injury and are also used after diagnosis to assess healing progress. They are noninvasive tests that measure brain functions. Several tests vary in how they are given and what they measure.
Tests
A mild or moderate traumatic brain injury can cause damage to the brain that is not detectable with brain imaging tests. However, the damage can cause serious symptoms, including headaches, emotional changes, difficulty concentrating, and memory problems. (Haider M. N. et al., 2021) The effects of a concussion can be hard to describe, but concussion testing can help identify and quantify these changes. For individuals who don’t have time to heal or experience further brain injuries while recovering, the effects can be prolonged and worsen. This is one reason why concussion testing is vital to get a diagnosis and follow medical recommendations to avoid further injury to the brain. Diagnosis can help set goals, adjust, and assess how the effects improve over time. With improvement, individuals can participate in rehabilitation and follow their doctor’s instructions for gradually returning to work, school, and other activities.
Measurements
Concussion tests can measure subtle aspects of brain function, like visual or auditory perception and response speed (Joyce A. S. et al., 2015). The damage sustained can impair these abilities, like slow decision-making. A traumatic brain injury can be associated with serious injuries, like a skull fracture, swelling, bruise, or bleeding in the brain. These injuries can be detected with imaging tests and often require surgery or other interventions. Brain damage from bleeding or swelling would cause focal neurological symptoms and signs, including partial vision loss, numbness, and weakness. Individuals can have a concussion along with detectable brain injuries or in the absence of detectable brain injuries.
Types of Tests
There are several types of concussion tests. Individuals may have one or more of these, depending on the standard test that is used in their school, sports league, or by their doctor. These can include:
Online Checklists
Several different online checklists are available for concussion screening.
These tests may include questions about symptoms and are often used as self-tests but are not intended to replace an evaluation by a medical professional.
Baseline and Post-Injury Tests
Many schools and sports leagues conduct preseason skill measurements, including memory tests or tests of speed and accuracy, either in an interview form or with computer testing.
Individuals might be asked to retake the test that is used as a comparison if they have experienced a traumatic brain injury.
Standardized Assessment of Concussion – SAC
This five-minute test can be done on the sidelines after a sports injury or later.
It evaluates orientation, immediate memory, neurologic function, concentration, and delayed recall. (Kaufman M. W. et al., 2021)
King-Devick Concussion Test
This two-minute test can be performed on the sidelines after a sports injury or later to assess language, eye movement, and attention. (Krause D. A. et al., 2022)
Post-Concussion Symptom Scale
This test includes 22 questions involving neurocognitive factors, including difficulty concentrating or remembering, physical symptoms like headaches and dizziness, and emotional symptoms like sadness or irritability. (Langevin P. et al., 2022)
Sport Concussion Assessment Tool – SCAT
This test includes an on-field assessment noting concussion symptoms, memory assessment using Maddocks questions (a short list of specific questions), Glasgow Coma Scale (GCS), and cervical spine assessment.
An off-field assessment involves the evaluation of cognitive, neurological, balance, and delayed recall. (Kaufman M. W. et al., 2021)
Buffalo Concussion Physical Examination – BCPE
A modified physical examination that assesses neck tenderness and range of motion, head, jaw, and face abnormalities, eye movements examination, and coordination. (Haider M. N. et al., 2021)
After a concussion, individuals will also have a physical examination, including a full neurological examination, in a doctor’s office.
Results
A doctor will diagnose based on symptoms, physical examination, and concussion test results. For example, for individuals who have broken several bones and are taking powerful pain medications, concussion test results can be abnormal even if they did not experience a concussion. The results of concussion testing can be compared with results before the head injury. Often, baseline testing is required for participation in certain sports leagues at professional and amateur levels. A low score can indicate that head injury has impaired brain function. Sometimes, testing can be done within a few hours of the head trauma and then again a few days later. Responses of individuals who did not have measurements taken before a head injury can be compared with the average results of people their age.
Injury Medical Chiropractic and Functional Medicine Clinic
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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Lumbar Spine Injuries in Sports: Chiropractic Healing
References
Haider, M. N., Cunningham, A., Darling, S., Suffoletto, H. N., Freitas, M. S., Jain, R. K., Willer, B., & Leddy, J. J. (2021). Derivation of the Buffalo Concussion Physical Examination risk of delayed recovery (RDR) score to identify children at risk for persistent postconcussive symptoms. British journal of sports medicine, 55(24), 1427–1433. https://doi.org/10.1136/bjsports-2020-103690
Joyce, A. S., Labella, C. R., Carl, R. L., Lai, J. S., & Zelko, F. A. (2015). The Postconcussion Symptom Scale: utility of a three-factor structure. Medicine and science in sports and exercise, 47(6), 1119–1123. https://doi.org/10.1249/MSS.0000000000000534
Kaufman, M. W., Su, C. A., Trivedi, N. N., Lee, M. K., Nelson, G. B., Cupp, S. A., & Voos, J. E. (2021). The Current Status of Concussion Assessment Scales: A Critical Analysis Review. JBJS reviews, 9(6), e20.00108. https://doi.org/10.2106/JBJS.RVW.20.00108
Krause, D. A., Hollman, J. H., Breuer, L. T., & Stuart, M. J. (2022). Validity Indices of the King-Devick Concussion Test in Hockey Players. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 32(3), e313–e315. https://doi.org/10.1097/JSM.0000000000000938
Langevin, P., Frémont, P., Fait, P., & Roy, J. S. (2022). Responsiveness of the Post-Concussion Symptom Scale to Monitor Clinical Recovery After Concussion or Mild Traumatic Brain Injury. Orthopaedic journal of sports medicine, 10(10), 23259671221127049. https://doi.org/10.1177/23259671221127049
For pregnant individuals, dehydration during pregnancy increases the risk of health problems for the individual and the fetus. Is it possible to prevent dehydration by drinking more water and managing morning sickness?
Pregnancy Dehydration
Maintaining proper hydration is an important part of a healthy pregnancy. Dehydration during pregnancy can occur for several reasons. A pregnant body needs more water to support the increased physical demands. Pregnant individuals need more water than non-pregnant ones and risk losing more water throughout the day. (American College of Obstetricians and Gynecologists, 2023) Pregnant individuals need eight to 12 glasses of water daily to prevent dehydration. Risks of dehydration during pregnancy include:
Low amniotic fluid levels and preterm contractions.
Early symptoms can include decreased urination, increased thirst, and dry mouth.
Serious symptoms can include dizziness, confusion, fainting, and low blood pressure.
In severe cases, intravenous/IV intervention may be required to replenish fluids.
The body’s physiological changes during pregnancy cause it to require more water. Pregnant individuals need more water and lose more water throughout the day. Dehydration happens when the body loses more water than it takes in. Factors that contribute to dehydration during pregnancy include: (Song, Y. et al., 2023)
Increased Blood Volume
A pregnant body requires increased blood circulation.
Blood volume increases as much as 30% to 45%.
The body needs more water to keep up with the increased volume.
Changes In The Urinary System
The kidneys often increase slightly in size during pregnancy.
This causes changes in the urinary system, causing the body to lose more water.
Changes In The Respiratory System
The increased demands on the body cause increased breathing.
Each time the body exhales, it loses water through the breath.
Increased Metabolism
Pregnancy causes the adrenal and thyroid functions to become slightly hyperactive.
This leads to increased metabolism and sweating.
When the body loses water through sweat, dehydration risks increase.
Increased Nutrition
A pregnant individual requires 300 extra daily calories, which increases to 450 additional daily calories in late pregnancy.
Eating more means the individual needs added hydration to support digestion and prevent constipation.
Morning Sickness
Nausea and vomiting are common.
Morning sickness causes fluid loss, increasing the risk of dehydration.
If the body does not acquire enough water when mildly dehydrated further symptoms can present and include fatigue, dizziness, feeling overheated, and having Braxton Hicks contractions or tightening and release of the uterus that are not from labor contractions. (Mulyani E. Y. et al., 2021)
Emergency Symptoms
Severe dehydration can lead to serious pregnancy complications and require immediate medical care. Emergency signs and symptoms include: (National Library of Medicine, 2023)
Irritability
Confusion
Sunken eyes
Fainting
Low or no urine
Low blood pressure
Rapid heart and breathing rate
Shock
Risks
Staying hydrated is essential, and hydration status affects health and pregnancy outcomes. When pregnant, the body needs extra water to produce enough amniotic fluid, which fills the amniotic sac with the fetus. When amniotic levels are low, the fetus has little room to grow and move. This can lead to delayed growth and development and potential umbilical cord issues. If the umbilical cord becomes compressed, the baby cannot receive oxygen and nutrients, which can quickly lead to an emergency. (Song, Y. et al., 2023) Chronic, untreated dehydration during pregnancy increases the risk of complications and can include (Aziz M. M. et al., 2018) (Song Y. et al., 2023)
Preterm contractions
Decreased birth weight and length
Reduced head circumference and chest circumference
Neural tube defects – malformations in early development of the brain and spine.
Low milk production
Rehydrating and Adding Electrolytes
Individuals must drink eight to 12 glasses of water daily to prevent dehydration (American College of Obstetricians and Gynecologists, 2020). Rehydration with water and electrolytes, essential minerals the body needs for normal function, may also be recommended. Ask a healthcare provider if they recommend consuming electrolytes through sports drinks, Pedialyte, coconut water, or electrolyte powders.
Drink between meals if drinking water is difficult because of nausea or feeling full.
Always have a water bottle, and drink what is possible when nausea is not manifesting.
Other recommended sources can include milk, natural fruit juices, and broth.
To reduce water loss, avoid high-caffeine or sugar drinks.
Take frequent breaks and drink more water when in the heat.
Minor Dehydration Treatment
Most pregnant individuals can safely treat mild dehydration at home. Call a healthcare provider if there are any concerns about symptoms. To treat minor dehydration, rest in a cool area and replenish fluids. Drink water, a sports drink, or a rehydration solution like Pedialyte. If symptoms do not improve, contact a healthcare provider. (Song Y. et al., 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
Fortunately, treating and preventing dehydration is possible by drinking plenty of water throughout the day, avoiding drinks with caffeine or sugar, and taking frequent breaks. 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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate a treatment plan to improve the body’s flexibility and mobility and resolve musculoskeletal issues.
Pregnancy and Sciatica: How Chiropractic Can Help
References
American College of Obstetricians and Gynecologists. (2023). Nutrition during pregnancy. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
Mulyani, E. Y., Hardinsyah, Briawan, D., Santoso, B. I., & Jus’at, I. (2021). Effect of dehydration during pregnancy on birth weight and length in West Jakarta. Journal of nutritional science, 10, e70. https://doi.org/10.1017/jns.2021.59
Song, Y., Zhang, F., Lin, G., Wang, X., He, L., Li, Y., Zhai, Y., Zhang, N., & Ma, G. (2023). A Study of the Fluid Intake, Hydration Status, and Health Effects among Pregnant Women in Their Second Trimester in China: A Cross-Sectional Study. Nutrients, 15(7), 1739. https://doi.org/10.3390/nu15071739
American College of Obstetricians and Gynecologists. (2023). Morning sickness: nausea and vomiting. https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy
National Library of Medicine. MedlinePlus. (2023). Dehydration. Retrieved from https://medlineplus.gov/dehydration.html
Aziz, M. M., Kulkarni, A., Tunde-Agbede, O., Benito, C. W., & Oyelese, Y. (2018). Are Women With Threatened Preterm Labor More Dehydrated Than Women Without It? Journal of obstetric, gynecologic, and neonatal nursing: JOGNN, 47(5), 602–607. https://doi.org/10.1016/j.jogn.2018.05.006
American College of Obstetricians and Gynecologists. (2020). How much water should I drink during pregnancy? https://www.acog.org/womens-health/experts-and-stories/ask-acog/how-much-water-should-i-drink-during-pregnancy
For individuals who may need to take pain medications to manage an injury or condition, can knowing the potential side effects help in treatment?
Medications For Pain Side Effects
Over-the-counter and prescription pain medications can help relieve physical discomfort and distress but can also cause side effects. Patients may not manifest side effects when using certain meds or experience mild, limited, severe, or intolerable effects. Pain medication side effects can include:
Allergic reactions
Upset stomach
Bruising
Dizziness
However, medication side effects don’t affect everyone in the same way.
Pain Relief
The patient and their healthcare provider can decide whether they risk developing side effects and which effects they are more predisposed to. Individuals may be susceptible to side effects from certain medications but are likely to tolerate others. For example, individuals with a history of ulcers may be recommended to avoid anti-inflammatories. For those who have trouble sleeping, it is recommended to avoid pain meds that are known to interfere with sleep.
Reading Labels and Asking Questions
When taking over-the-counter medications, read the label for side effects, then weigh the possible risks against the medicine’s benefits for pain relief. Ask a pharmacist or healthcare provider about anything that is not understood. Some side effects are medical emergencies, such as allergic reactions. Recognizing the signs of an allergic reaction and being prepared to call for emergency help if symptoms present. (American Academy of Allergy, Asthma & Immunology, 2024) These can include:
Itching
Hives
Rash
Mouth or facial swelling
Shortness of breath
If a healthcare provider prescribes medication, discuss the anticipated risks and benefits. The prescription will come with a label that lists the side effects associated with the drug.
Opioid Risks
Opioids are powerful prescription meds, usually used for severe, short-term use, like post-surgery pain or after a severe traumatic injury. Some effects of opioids include: (Plein L. M. and Rittner H. L. 2018) Common side effects include sedation, constipation, and nausea. Chronic use can lead to depression and/or sexual dysfunction. With narcotics, there is the risk of addiction that can change an individual’s life, as addiction can be difficult to overcome. One of the reasons the CDC published a guideline on opioid prescriptions was because of the number of overdoses and deaths.
The CDC recommends that practitioners not prescribe opioids as a first-line treatment for chronic back pain.
The CDC recommends that healthcare providers initially treat patients with chronic back or neck pain using non-pharmacological therapies or medications other than opioids.
Opioids should only be used if the expected benefits for pain and function are anticipated to outweigh the risks to the patient.
With more than half of regular opioid users experiencing back pain, they aren’t proven to help return individuals to work or normal life faster, nor did they improve functioning when used for the treatment of an acute episode. (Deyo R. A. Von Korff M. and Duhrkoop D. 2015) The effectiveness of opioids is about 30% for short-term relief and did not improve physical functioning.
Examples and Comparisons
Examples of common medications used to treat back pain.
Advil
Active Ingredient – Ibuprofen
Drug Class – NSAID
Over-the-counter or Prescribed – Available over-the-counter
Side Effects – GI-related symptoms and Reye’s Syndrome in children
Aleve and Other Generic Brands
Active Ingredient – Naproxen
Drug Class – NSAID
Over-the-counter or Prescribed – Available as both depending on strength.
Side Effects – GI-related symptoms, headaches
Tylenol and Other Generic Brands
Active Ingredient – Acetaminophen
Drug Class Analgesic – pain reliever
Over-the-counter or Prescribed – Available as both and can be prescribed with codeine.
Side Effects – Potential liver damage
Lyrica
Active Ingredient – Pregabalin
Drug Class – Anticonvulsant
Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain and neuropathy in diabetes. Other uses off-label.
Side Effects – Dizziness, drowsiness, swelling, weight gain.
Neurontin
Active Ingredient – Gabapentin
Drug Class – Anticonvulsant
Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain
Side Effects – Dizziness, drowsiness, allergic reaction, withdrawal, and seizures.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first. 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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself.
Chronic Body Pain Recovery
References
American Academy of Allergy, Asthma & Immunology. (2024). Anaphylaxis Symptoms & Diagnosis. https://www.aaaai.org/conditions-treatments/allergies/anaphylaxis
Plein, L. M., & Rittner, H. L. (2018). Opioids and the immune system – friend or foe. British journal of pharmacology, 175(14), 2717–2725. https://doi.org/10.1111/bph.13750
Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. BMJ (Clinical research ed.), 350, g6380. https://doi.org/10.1136/bmj.g6380
Can physical therapies help individuals with a Colles’ or wrist fracture?
Colles’ Fracture
A broken wrist or Colles fracture can be a painful and stressful experience. Individuals may be unable to perform their jobs or engage in recreational activities. A Colles fracture is a break in the radius bone of the forearm that occurs near the wrist, usually about an inch from the end of the bone. It’s a common type of broken wrist often caused by falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2022) As the individual lands on their hand, the end of the radius bone breaks off and gets pushed toward the inner wrist. If the wrist is flexed when falling on the hand, the radius may break and move toward the front of the wrist. This is called a Smith’s fracture. (Matsuura, Y. et al., 2017) A physical therapy team can help improve functional mobility to quickly and safely return to normal activity.
Symptoms
Individuals who have suffered trauma to their wrist or have fallen onto their hand or wrist may have a Colles fracture. Common signs and symptoms of a wrist or Colles fracture include: (American Academy of Orthopaedic Surgeons, 2022)
Bruising
Loss of mobility in the wrist.
Swelling in the arm, wrist, or hand.
Pain
Visible deformity or a lump on the backside of the forearm near the wrist.
Initial Treatment
Individuals who have fallen and injured their wrist and hand and suspect a Colles fracture seek immediate medical attention. Call a healthcare provider or report to a local emergency clinic. Left untreated, it can result in complications and permanent loss of arm and hand function. (American Academy of Orthopaedic Surgeons, 2022)
An X-ray will show a wrist fracture.
Because of the pain and swelling, it is recommended that individuals put an ice pack on their wrists and hands until they can get to a healthcare provider or emergency room. The R.I.C.E. principle can help control swelling and lessen pain until a medical professional can provide treatment. The initial treatment is to reduce the fracture. This is where a healthcare provider situates the broken bone or bones back into the correct position to ensure proper healing. This is done manually if the fractured bone is not too far out. If the fracture is severe, a surgical procedure known as an open reduction internal fixation or ORIF may be required to reduce the fracture. (American Academy of Orthopaedic Surgeons, 2022)
Once the fracture has been reduced, it must be immobilized. This is done with a cast or a brace. Individuals may also be required to wear a sling. They may need to visit a physical therapist to learn how to wear the sling properly. It is essential to keep the bones immobilized for proper healing. Consult a healthcare provider for questions about cast, sling, or brace.
Physical Therapy
After four to six weeks of immobilization, a healthcare provider may remove the cast and refer a physical therapist or team. (American Academy of Orthopaedic Surgeons, 2022) A physical therapist may measure and evaluate pain, swelling, range of motion, and strengthening. The physical therapist may assess the surgical scar tissue and analyze the hand, wrist, and arm function of individuals who underwent an ORIF procedure to reduce the fracture. After the initial evaluation, a physical therapist will work with the patient to develop an appropriate plan of care to help improve the impairments and functional limitations. The therapist may prescribe a specific exercise program as well.
Pain and Swelling
Individuals may experience pain and swelling around their wrists and hands.
A physical therapist can provide individuals with various treatments and modalities to help decrease swelling and pain.
Range of Motion
After a Colles’ fracture, individuals may lose hand, wrist, and elbow mobility.
The shoulder may also be tight, especially after wearing a sling.
Range of motion exercises for the hand, wrist, and elbow can be prescribed.
Strength
Loss of strength is common after a Colles’ fracture.
Exercises focusing on hand, wrist, and elbow strength may be prescribed.
At-home exercises and stretches will get the best results from physical therapy.
Scar Tissue
Individuals who have had an ORIF procedure will likely have scar tissue that has developed around the surgical site.
A physical therapist may perform scar tissue massage and mobilization to help improve mobility and can train patients how to self-massage.
Injury Medical Chiropractic and Functional Medicine Clinic
After a few weeks of physical therapy, individuals should notice their mobility and strength improve while pain and swelling decrease. Individuals will find it easier to use their arms and hands to perform functional activities. While the fracture should be fully healed six to eight weeks after injury, individuals may still be limited for potentially 12 to 16 weeks. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for every patient to restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, or ailment.
Personal Injury Rehabilitation
References
American Academy of Orthopaedic Surgeons. (2022). Distal radius fractures (broken wrist). https://orthoinfo.aaos.org/en/diseases–conditions/distal-radius-fractures-broken-wrist/
Matsuura, Y., Rokkaku, T., Kuniyoshi, K., Takahashi, K., Suzuki, T., Kanazuka, A., Akasaka, T., Hirosawa, N., Iwase, M., Yamazaki, A., Orita, S., & Ohtori, S. (2017). Smith’s fracture generally occurs after falling on the palm of the hand. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 35(11), 2435–2441. https://doi.org/10.1002/jor.23556
For individuals with cervical arthritis, can physical therapies help manage symptoms and bring pain relief?
Cervical Arthritis
Cervical spondylosis, more commonly known as cervical arthritis or arthritis of the neck, refers to the wearing down of neck bones, discs, tendons, ligaments, and joints. The primary symptoms are neck pain and stiffness. However, it is also possible to have cervical spondylosis and not have any symptoms. The condition affects over 85% of individuals over age 65. (American Academy of Orthopaedic Surgeons, 2021) Treatment can consist of conservative therapies and includes physical therapies, alternative medicine therapies, at-home self care, and over-the-counter and prescription medications. Severe cases of cervical spondylosis are treated with surgery to repair damaged parts of the spine.
Symptoms
Neck pain and headaches at the back of the head are usually the first symptoms. (Kazeminasab S. et al., 2022) The neck can also feel stiff, with worse morning symptoms that improve throughout the day. (Johns Hopkins Medicine, 2024) Symptoms can range from mild discomfort to severe pain. As cervical spondylosis progresses, individuals can experience:
Inability to turn the head or bend the neck.
A clicking or grinding noise when turning the neck.
Tenderness with pressure on the neck.
Pain that radiates to the shoulders or shoulder blades.
Pain and symptoms that disrupt sleep, sometimes causing waking up throughout the night.
Symptoms that decrease with rest.
More severe symptoms include:
Cervical Bone Spurs – Osteophytes
Some with cervical spondylosis have bony growths that can place pressure on the spinal nerves (a pinched nerve) (Bon Secours, 2024). Compression of spinal nerve roots produces cervical radiculopathy, which leads to pain, tingling, and weakness that radiates into the shoulders, arms, and hands.
Cervical Myelopathy
This refers to spinal impingement that leads to spinal cord dysfunction. (Spinal cord dysfunction is a nervous system disorder with interruptions in the spinal cord’s motor, sensory, and autonomic functions.) Symptoms include pain, tingling, numbness, muscle spasms, and weakness in areas below the neck. Spinal cord dysfunction can affect mobility, hand use, and bladder or bowel function control.
Causes
Where degenerative changes are commonly associated with cervical spondylosis, other conditions, and factors can lead to it and include:
Autoimmune Diseases
Rheumatoid arthritis and psoriatic arthritis can cause chronic inflammation in the cervical spine.
Trauma
Neck trauma, including injury and repetitive stress on the neck.
Cervical spondylosis is commonly seen in occupations that involve neck-stressing activities, such as sports.
Age
Wearing down of the spinal discs cartilage between the vertebrae.
Genetic components have been identified in connection with cervical spondylosis, meaning that some types of arthritis that lead to spinal damage are hereditary. (Kazeminasab S. et al., 2022)
Treatment
Treatment begins conservatively, using protocols to preserve function and avoid surgery. Nonsurgical treatments include medications, physical therapy, at-home exercises, and alternative medicine. The treatment method a healthcare provider chooses will depend on how severe the spondylosis is and other factors like age, how much pain is being experienced, the cause, and overall health. The main objectives are to relieve pain, prevent long-term damage to the spinal cord and nerves, and help maintain performing daily activities. (Bon Secours, 2024)
Medications
Medicines used to treat cervical spondylosis include:
Nonsteroidal Anti-inflammatory Drugs NSAIDs
NSAIDs, including ibuprofen and naproxen sodium, are available without a prescription to relieve pain and inflammation.
A healthcare provider can prescribe a more powerful NSAID to help manage severe symptoms.
Corticosteroids
A corticosteroid injection or a short course of an oral corticosteroid, like prednisone, can ease pain and reduce inflammation.
Muscle Relaxants
If cervical spondylosis causes muscle spasms, a healthcare provider can prescribe cyclobenzaprine, a muscle relaxant, to manage symptoms.
Antidepressants
Some types of antidepressants can ease neck pain from cervical spondylosis.
Anti-seizure Meds
Some anti-seizure drugs can cause nerve pain resulting from damaged nerves.
Physical Therapies
Physical therapy will help manage pain and stiffness and keep muscles loose and relaxed.
A physical therapist will teach the patient exercises to stretch and strengthen neck and shoulder muscles.
At-Home Self Care
At-home exercises can help relieve pain, stiffness, and swelling. Some can include:
Reducing inflammation and stress on the neck through posture training.
At-home targeted stretches and exercises will help bring pain relief.
Ice treatment reduces swelling.
Heat will increase circulation.
A neck brace may be recommended briefly to avoid muscle weakness and stiffness.
Alternative Medicine
Chiropractic adjustments and massage therapy are alternative treatments that will help manage cervical spondylosis.
Acupuncture can also be beneficial in reducing neck pain and increasing energy circulation. (Gu C. L. et al., 2019)
Various therapeutic massage therapies will help relieve neck pain and stiffness. Talk to a healthcare provider before starting treatment so they can advise on whether neck massages are safe.
Surgery
A healthcare provider may recommend surgical treatment when all other treatments have failed, if neurological symptoms are severe, or if neck arthritis causes extreme pain or disability. Surgery to treat cervical spondylosis can involve removing bone spurs, part of the cervical vertebra, or a herniated disc. The removed portions of the cervical spine are fused with hardware and bone grafts.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first before proceeding with surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.
Arthritis Explained
References
American Academy of Orthopaedic Surgeons. (2021). Cervical spondylosis (arthritis of the neck). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-spondylosis-arthritis-of-the-neck/
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC musculoskeletal disorders, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4
Johns Hopkins Medicine. (2024). Spinal arthritis (arthritis in the back or neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
Bon Secours. (2024). Cervical osteoarthritis (arthritis in the neck). https://www.bonsecours.com/health-care-services/spine-care/conditions/cervical-osteoarthritis
American Chiropractic Association. (2024). Neck pain. https://www.acatoday.org/patients/neck-pain-and-chiropractic/
Jenkins, H. J., Downie, A. S., Moore, C. S., & French, S. D. (2018). Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropractic & manual therapies, 26, 48. https://doi.org/10.1186/s12998-018-0217-8
Gu, C. L., Yan, Y., Zhang, D., & Li, P. (2019). An evaluation of the effectiveness of acupuncture with seven acupoint-penetrating needles on cervical spondylosis. Journal of pain research, 12, 1441–1445. https://doi.org/10.2147/JPR.S199798
Individuals with hip bursitis often experience discomfort during physical activity, walking, and pain when lying on the affected side. What treatment options are available to control and manage the condition?
Hip Bursitis
Hip bursitis, also known as trochanteric bursitis, is a common condition that causes pain and discomfort in the hip and upper thigh along the outside of the hip joint. It occurs when one of the hip’s bursae, or fluid-filled sacs cushion joints, becomes inflamed. Treatment for hip bursitis is to control the inflammation caused by this condition.
Causes
Hip bursitis can be caused by injury or overuse of the hip, such as repetitive activities, twisting, or rapid joint movement. It can also be caused by a direct blow or fall to the side of the hip.
Symptoms
Pain from hip bursitis can be sharp at first and may feel dull and achy later.
It may be worse when standing up after sitting, moving, or using the hip.
Individuals may also notice pain when lying on the affected side or sitting for a long time.
Rest
This means a period of not participating in physical, exercise, and sports activities that aggravate symptoms. Any activity that causes hip pain should be avoided as this only contributes to inflammation of the bursa. (American Academy of Orthopaedic Surgeons, 2022) Modifying how particular activities are performed can help alleviate pressure on the inflamed bursa. Working with a physical therapist can also be recommended. They are experts in movement and alignment, and if certain muscles are overused compared to others, this can lead to unhealthy movement patterns, causing bursa irritation.
Anti-Inflammatory Medications
Nonsteroidal anti-inflammatory drugs, such as Motrin, Aleve, Naprosyn, etc., will help control inflammation (American Academy of Orthopaedic Surgeons, 2022). Anti-inflammatory medications can be extremely effective but should be taken cautiously. The instructions on the label need to be followed unless directed otherwise by a healthcare provider. Be aware of side effects and inform the healthcare provider if side effects present.
Cold Therapy
Applying ice to the hip area often helps alleviate the symptoms (National Library of Medicine, 2022). Ice can control inflammation by decreasing blood circulation to the area, especially after physical activity and exercise.
Aspiration
A needle is placed into the bursa to drain the fluid for those with a significant amount of fluid collected within the bursa. (National Library of Medicine, 2022) This is rarely needed in cases of hip bursitis, but when it is done, it can be combined with a cortisone injection.
Cortisone Injections
A cortisone injection may also be given into the bursa to alleviate pain. (American Academy of Orthopaedic Surgeons, 2022) The cortisone injection is helpful because it can be a diagnostic and therapeutic tool. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if it helps alleviate symptoms. Cortisone is a powerful anti-inflammatory medication that can be administered directly to the problem area. These injections are well-tolerated, but there can be possible side effects. Once the initial symptoms are under control, physical therapy strengthening and stretching exercises may be recommended.
Stretching
Most find relief by stretching the muscles and tendons over the outside of the hip, specifically the iliotibial band. The goal is for a better-conditioned muscle and tendon to glide more easily and not cause inflammation. Proper stretching techniques and posture are important in re-injury prevention.
Physical Therapy
Working with a physical therapist is an effective adjunct treatment for bursitis (American Academy of Orthopaedic Surgeons, 2022). Physical therapists correct muscle imbalances through stretching and exercise and improve alignment to prevent bursa irritation from reoccurring.
Surgery
Most patients get better with conservative treatment within about six weeks. Surgical treatment for hip bursitis is rarely needed (UCSF Health, 2024). Those who do not rest from their activities until the inflammation subsides often have a return of bursitis symptoms, and those who return too aggressively to activities and do not gradually build up also find that their symptoms return. In cases where surgery is needed, the healthcare provider may recommend an arthroscopic bursectomy. (American Academy of Orthopaedic Surgeons, 2022) The surgery is an outpatient minimally invasive procedure in which the bursa is removed through a small incision. After a short healing period, the individual can return to normal activity. Crutches may be used for a few days. Common complications are anesthetic-related complications and infection.
Injury Medical Chiropractic and Functional Medicine Clinic
As with any treatment program, always talk with your healthcare provider before initiating specific treatments. Fortunately, treatment of hip bursitis is generally accomplished with conservative therapies. Efforts to limit pressure directly on the bursa, alleviate inflammation, and restore normal movement to the hip joint will typically resolve symptoms. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate into a treatment plan to improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.
The Chiropractic Approach for Pain Relief
References
American Academy of Orthopaedic Surgeons. (2022). Hip bursitis. https://orthoinfo.aaos.org/en/diseases–conditions/hip-bursitis
National Library of Medicine. (2022). Bursitis: Learn More – How can bursitis be treated? InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK525763/
Fans of almonds may have noticed that they can go stale and taste awful. Can knowing how to store almonds help extend their shelf life?
Almonds
Almonds are a healthy, satisfying snack rich in nutrients, including fiber and protein. However, they can go stale and should not be eaten. Whole almonds stay fresh the longest because chopped, roasted, or ground almonds release their oils, which are exposed to more oxygen and go rancid more quickly.
Storage
They should be stored in an airtight container in the refrigerator or freezer for extended life. They are not recommended to be stored at room temperature for long periods, so storing them in the pantry is not recommended. However, enough for a snack can be taken from storage for a day or two while keeping the rest safe and fresh.
Natural almonds can be stored in the refrigerator or freezer for two years or more.
Roasted almonds can stay fresh for up to a year in an airtight container in the refrigerator or freezer.
Almond paste is recommended to be refrigerated and can stay fresh for 2 to 2 1/2 years.
Rancidity
Almonds are rich in omega-3 and monounsaturated fats, so they are recommended for heart health. (Cleveland Clinic, 2023) However, the fats become rancid if the almonds are exposed to oxygen, especially at room temperature. Rancid oil gives the stale almonds a bad taste. Spoiled almonds are not poisonous, but the fats no longer benefit health. It is possible that rancid fat could contribute to chronic health problems if consumed regularly. (Estévez M. et al., 2017) Almonds last longer than other nuts because they contain some phytochemical antioxidants that protect the nuts. So, if they taste bad, it’s time to throw them out. (University of California Agriculture and Natural Resources, 2010)
Salmonella
Salmonella is a bacteria that causes symptoms of food-borne illness, including upset stomach, vomiting, diarrhea, and fever. Almonds are generally safe from salmonella. However, raw almonds were responsible for two salmonella outbreaks in the United States and Canada. Salmonella outbreaks have also been reported in Australia. In response to those cases, the nuts now must be roasted, blanched, processed, steamed, or treated with a gas called propylene oxide. And none of these treatments remove the nutritional benefits.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Functional Nutrition
References
Almond Board of California. (2024). Shelf Stability and Shelf Life. https://www.almonds.com/tools-and-resources/food-safety-and-quality/shelf-stability-and-shelf-life
Estévez, M., Li, Z., Soladoye, O. P., & Van-Hecke, T. (2017). Health Risks of Food Oxidation. Advances in food and nutrition research, 82, 45–81. https://doi.org/10.1016/bs.afnr.2016.12.005
University of California Agriculture and Natural Resources. (2010). Nuts: Safe Methods for Consumers to Handle, Store, and Enjoy. https://ucfoodsafety.ucdavis.edu/sites/g/files/dgvnsk7366/files/inline-files/44384_0.pdf
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