ClickCease
+1-915-850-0900 spinedoctors@gmail.com
Select Page
The Sciatic Nerve

The Sciatic Nerve

The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve’s path. This could be the:

  • Low back
  • Buttocks
  • Thighs
  • Calves
  • Feet
  • Or it could be a combination of all the areas

 

The Sciatic Nerve

Neurological Symptoms

When the nerve is compressed,  neurological symptoms can accompany the pain. These include:

Thigh muscle weakness

If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.

Leg and foot muscle weakness

Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.

Numbness

Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:

  • Side of the calf
  • Side of the heel
  • Bottom of the foot
  • Top of the foot

Paresthesia

This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:

  • Tingling
  • Tightness
  • Pins-and-needles
  • Crawling feeling along the back of the thigh and/or leg

The Sciatic Nerve Gets Affected

The sciatic nerve can become:

  • Irritated
  • Compressed
  • Inflamed
  • This lumbar/low back radiculopathy means that the pain originates in and around the lumbar and/or sacral/sacrum nerve roots.

Compression

Physical forces could affect the nerve following common conditions:

Disc Herniation

A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.

Stenosis

Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.

Instability

Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.

Inflammatory Response

The body’s own chemicals can irritate the nerve causing inflammation. These chemical irritants include:

  • Hyaluronic acid
  • Fibronectin protein fragments leak out of degenerated or herniated discs onto and around the sciatic nerve roots.
  • There are times when degenerated discs can cause nerve tissues to grow into a disc. The tissue penetrates the outer and inner layers of the disc, causing inflammation and pain.
  • Some studies have shown how an immune system response can contribute to sciatic pain when there is exposure to the disc material from herniated disc/s.

Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.

Body Composition

The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:

  • Overweight individuals
  • Obese individuals
  • Older individuals
  • Tall individuals

Work Injuries

Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:

  • Semi-Truck operators
  • Machine operators
  • Construction workers
  • Hairstylists
  • Office workers
  • Athletes that lift weights

This comes from:

  • Sitting for long amounts of time
  • Poor posture
  • Constant bending forward or sideways
  • Regularly lifting the arms above shoulder level
  • All are risk factors.

Vitamin B12 deficiency

Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.


Body Analysis


Alleviating Nerve Pain Through Clinical Nutrition

Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:

  • Sometimes, sciatica can be triggered by constipation from an unhealthy diet
  • Incorporate fiber-rich foods
  • Fruits and vegetables will prevent constipation
  • Oily fish like salmon and halibut are rich in omega 3 fatty acids
  • Fresh pineapples and berries are anti-inflammatories that support healing and boost the immune system
  • 2-3 cups of green tea
  • Add turmeric, ginger, and garlic to meals
  • B-Vitamins are important to take in when going through sciatica and are found in green peas, spinach, navy beans, nuts, bananas
  • Foods that are rich in A-Vitamins like dairy products, dark leafy vegetables, orange-colored fruits, eggs, and oily fish
  • Foods rich in C-Vitamins, like citrus and tomatoes
  • K-Vitamins like  broccoli and spinach
  • Drink plenty of water, between 6 to 8 glasses a day

Foods to Avoid

  • Nutritionists recommend cutting out meat products except for oily fish for the first two weeks.
  • Foods that contain sunflower oil, corn oil, sesame oil, margarine, and partially hydrogenated oil.
  • Stressor foods like caffeine, processed food, soda, refined sugars, and chocolate.
  • Alcohol
References

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/.

Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-Trøndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.

Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.

Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.

Cauda Equina Syndrome Nerve Compression

Cauda Equina Syndrome Nerve Compression

Cauda equina syndrome is an emergency that needs to be treated as soon as possible. It is a form of spinal nerve compression, but if left untreated, it can lead to permanent paralysis of one or both legs and permanent loss of bowel/bladder control. Lower back pain after sitting for too long or improperly lifting something heavy happens to most if not all of us.
However, sometimes pain in the lower back can be an indicator of something more serious. Especially, for individuals that are dealing with or managing back pain. One condition is cauda equina syndrome. It�s not like sciatica or arthritis, but it does have specific symptoms that individuals should be aware of.

Cauda Equina Syndrome

The term comes from Latin that means horse�s tail. The cauda equina forms the group of nerves that run through the lumbar spinal canal. Generally, the condition means two things:
  • There is nerve compression of most of the lumbar spinal canal
  • Compression symptoms like numbness or weakness in the leg/s
How cauda equina syndrome differs from typical compression of the lumbar spinal canal is that it can be caused by different issues, from fractures, tumors, and infections. More commonly, it is disc herniations that cause the problems. The key difference is the degree of nerve compression, and the number of nerves compressed. For example, compression of a single nerve will not cause loss of bladder function. But compression of multiple nerves, especially the sacral nerves can cause loss of function. Nerve compression that leads to pain or numbness can be treated differently. Surgery is reserved for severe cases and for individuals that are not improving with non-invasive treatment.
11860 Vista Del Sol, Ste. 128 Cauda Equina Syndrome Nerve Compression Chiropractic Diagnosis

Sneaky Presentation

One of the major factors is long-term compression that individuals do not realize they have. Individuals are more likely to be aware of symptoms from another spinal condition before cauda equina syndrome presents. However, the condition presents quickly but often other overlapping back problems mask cauda equina syndrome.

Causes

The syndrome can be brought on from anything that compresses the nerves. Most commonly, it is a root compression from degenerative processes, specifically lumbar disc herniations. Other causes include:
  • Bleeding like an epidural hematoma
  • Trauma like fractures or penetrating trauma
  • Tumors growing in the canal or the collapse of a tumor-affected bone
  • Disc herniations can progressively grow in size, which leads to a slowly-evolving cauda equina syndrome.
  • An enlarging disc herniation or synovial cyst can further compromise the already compressed nerves.
  • Overgrowth of arthritic joints or bone spurs into the spinal canal can lead to long-term compression.

Symptoms

The symptoms vary based on the degree that the spinal canal has been affected:
  • Back pain
  • Leg pain
  • Sciatica
  • Saddle numbness that extends into other areas of the legs
  • Neurogenic bladder dysfunction. This can range from difficulty starting to urinate or limited and/or non-voluntary control urinating.
  • Bowel dysfunction
  • Sexual dysfunction

Diagnosis

A doctor will examine any significant changes in bladder, bowel, or leg function that are considered red flags prompting an early and complete assessment. A physician will ask for a complete/detailed history of the onset and progression of symptoms. The second is a close physical examination which includes testing sensation and strength along with a rectal exam to assess voluntary contraction. Also checking the body’s reflexes, assess walking gait and alignment. If most or all of the symptoms are presenting this will set in motion spinal imaging or an MRI. If the symptoms, exam, and imaging match, it will lead to an emergency admission to the hospital.
11860 Vista Del Sol, Ste. 128 Cauda Equina Syndrome Nerve Compression Chiropractic Diagnosis

Body Composition Spotlight


 

Obesity and Osteoarthritis Connection

A variety of factors contribute to the development of osteoarthritis, including genetic factors and lifestyle choices. Research supports obesity is a significant risk factor in the development of osteoarthritis. It is pretty straightforward as body weight increases this equals increased load on the spine, and joints, especially the weight-bearing ones like the hips and knees. Increased pressure leads to early wearing, tearing, and eventual development of osteoarthritis. Added weight affects the body’s biomechanics and gait patterns. However, obesity has also been shown to be a risk factor even on the non-weight-bearing joints. This is based on adipose tissue, which is more than just insulation. Adipose tissue is metabolically active and is involved in the secreting adipokines and cytokines which promote an inflammatory response. Pro-inflammatory adipokines and cytokines can have detrimental effects on joint tissue including damage to cartilage, synovial joints, and subchondral bone. The effect of inflammation on the joints in the body can contribute to the development of osteoarthritis.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Causes of Cauda Equina:�Neurosurgical Focus.�(June 2004) �Spinal epidural hematoma causing acute cauda equina syndrome��https://pubmed.ncbi.nlm.nih.gov/15202871/ Arriving at a Diagnosis:�British Journal of Neurosurgery. (August 2010) �Reliability of clinical assessment in diagnosing cauda equina syndrome��https://www.tandfonline.com/doi/abs/10.3109/02688697.2010.505987
What is Functional Neurology?

What is Functional Neurology?

Functional neurology primarily focuses on the fundamentals of neuron health and it is mainly based on neuroplasticity theories. It’s believed that the brain and the nervous system are capable of changing, and can become malleable, due to a reaction to certain stimulation. The brain can be shaped by sensory, motor, cognitive, or emotional experiences. �

The creation of synapses in the nervous system depends on the stimulation they receive. Neurons which receive too much stimulation are the ones which become stronger and those which don’t receive stimulation become weaker and eventually diminish. It is believed that it is possible to create new neurons even after there has been damage to the nervous system. �

 

The Role of Functional Neurology

 

Functional neurology evaluates changes in the nervous system before these become severe health issues. The practice of functional neurology has been adopted by several modalities of practice, such as chiropractic, psychology, occupational therapy and even by conventional healthcare professionals. Functional neurology is commonly practiced by chiropractors. �

 

The practice of neurology involves applying neuroscience research from laboratory studies to determine how it can be practically applied in health care. The brain is protected by supporting the nervous system. The ultimate goal of functional neurology is to treat brain and nervous system health issues without the utilization of drugs or together with conventional treatment approaches. Functional neurologists can help treat a wide variety of neurological health issues, including:

 

  • Neurodegenerative disorders: Alzheimer�s disease, Parkinson�s disease, dementia, and multiple system atrophy.
  • Demyelinating conditions: Multiple sclerosis, transverse myelitis, and leukodystrophies.
  • Trauma and brain injuries: Concussions and whiplash-associated disorders.
  • Vestibular conditions: Motion sickness, dizziness/disequilibrium, labyrinthitis, vertigo, and Meniere’s disease.
  • Movement disorders: Tics, restless leg syndrome, myoclonus, and dystonia.
  • Neuro-developmental conditions: Autism spectrum disorders, ADHD, Asperger’s syndrome, Tourette syndrome, dyslexia, processing disorders, and global developmental delay.
  • Nerve disorders: Carpal tunnel syndrome, trigeminal neuralgia, Bell�s palsy, and polyneuropathy.
  • Cerebro-vascular disorders: Stroke, and TIA.
  • Chronic musculoskeletal pain: Arm, leg, back, hip, knee, and foot pain.
  • Headaches and pain syndromes: Cluster headaches, complex regional pain syndrome, migraines, and fibromyalgia
  • Functional neurological disorders which are best referred to as a group of physical, sensory and cognitive symptoms which do not seem to have an identifiable organic etiology.

 

Functional Neurology Treatment

 

The primary goal of functional neurology is to promote, support, and restore the optimal function of the brain and the nervous system, as opposed to the absence of pathology. Sometimes it’s not always possible to determine the natural source of a person’s neurological disease and its symptoms. Functional neurology can be particularly beneficial in these instances. �

 

The patient’s medical history and a non-invasive evaluation are required for diagnosis. Treatment is determined based on the patient’s current and targeted well-being. Any blood tests, x-rays, MRIs and/or other tests are also evaluated. During the evaluation, the healthcare professional will observe all aspects of the patient, including eye movements and posture, which can demonstrate the function of the brain and the nervous system. Blood pressure, pulse, and reflexes are also evaluated. �

 

Neuro-developmental conditions and behavioral disorders are generally treated with functional neurology. Anxiety is commonly increased in patients with these type of health issues, therefore, it is recommended that the non-invasive evaluation is performed in a way which does not trigger anxiety in the patient. Functional neurology treatment is individualized and every part of the treatment approach is customized to the individual’s treatment requirements. �

 

Functional neurology emphasizes on encouraging patients to practice self-care so that face-to-face treatment with a healthcare professional does not continue for months or years without end. Home exercise programs are developed to treat the associated health issues, meaning that functional neurology treatment is incorporated into the patient’s daily activities. �

 

Biochemistry and Nutrition in Functional Neurology

 

Functional neurology treatment focuses on retraining the brain. Neurons need energy and stimulation to survive and thrive, therefore, functional neurology treatment may involve exercises, such as eye exercises, cognitive activities, balancing activities, and joint adjustments. Different stimulation can affect different regions and pathways in the human brain. �

 

Moreover, functional neurology treatment may also involve a nutritional and biochemical approach by eliminating several factors which may potentially affect neurons. These can ultimately include toxins, chemicals, and infection, among other factors. Dietary modifications and supplementation may also be included to provide optimal energy for neurons. �

 

An individualized treatment approach is applied to each individual otherwise there exists the risk of over-stimulating and exceeding the capacity of a patient’s nervous system. The goal of functional neurology treatment is to improve brain and nervous system health, neural processing, communication, and all signaling involving the brain and the entire human body. �

 

Functional neurology focuses on the diagnosis and treatment of the human brain and the nervous system utilizing sensory and cognitive based treatment methods and techniques to promote, support, and restore neuroplasticity, integrity, and functional optimization. Functional neurology can be utilized to help improve a variety of neurological diseases and health issues, including Alzheimer’s disease. Functional neurology is frequently practiced by chiropractors. – Dr. Alex Jimenez D.C., C.C.S.T. Insight

 

The purpose of the article above is to discuss the purpose of functional neurology in the treatment of neurological disease. Neurological diseases are associated with the brain, the spine, and the nerves. The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �

 

Curated by Dr. Alex Jimenez �

 


 

Additional Topic Discussion: Chronic Pain

 

Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.

 

 


 

Formulas for Methylation Support

 

Xymogen Formulas - El Paso, TX

 

XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.

 

Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.

 

Please call our office in order for us to assign a doctor consultation for immediate access.

 

If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.

xymogen el paso, tx

 

For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download

 

* All of the above XYMOGEN policies remain strictly in force.

 


 

Difference Between AMPA and NMDA Receptors

Difference Between AMPA and NMDA Receptors

Glutamate is the main excitatory neurotransmitter in the central nervous system, or CNS, of mammals and it primarily interacts with both metabotropic and ionotropic receptors to activate and regulate postsynaptic responses. Both AMPA and NMDA receptors are fundamental mediators of synaptic plasticity, the ability of synapses to strengthen or weaken, where dysregulation of those receptors leads to neurodegeneration in a variety of disorders, including Alzheimer’s disease. �

 

The main difference between AMPA and NMDA receptors is that sodium and potassium increases in AMPA receptors where calcium increases along with sodium and potassium influx in NMDA receptors. Moreover, AMPA receptors do not have a magnesium ion block while NMDA receptors do have a calcium ion block. AMPA and NMDA are two types of ionotropic, glutamate receptors. They are non-selective, ligand-gated ion channels, which mainly enable the passage of sodium and potassium ions. Furthermore, glutamate is a neurotransmitter which creates excitatory postsynaptic signals in the CNS. �

 

Difference Between AMPA and NMDA Receptors Diagram | El Paso, TX Chiropractor

What are AMPA Receptors?

 

AMPA, also known as ?-amino-3-hydroxy-5-methyl-4-isoxazole-propionate, receptors are glutamate receptors which are in charge of maintaining the rapid, synaptic transmission in the central nervous system. AMPA receptors have four subunits, GluA1-4. Moreover, the GluA2 subunit is not permeable to calcium ions because it contains arginine from the TMII region. �

 

Furthermore, AMPA receptors are involved in the transmission of the majority of the rapid, excitatory synaptic signals. The increase of the post-synaptic response depends on the amount of receptors in the post-synaptic surface. The type of agonist which activates the AMPA receptors is ?-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid. The activation of the AMPA receptors leads to the non-selective transportation of cations, such as sodium and potassium ions, into the cell. This generates an action potential in the postsynaptic membrane. Figure 1 below demonstrates a diagram of AMPA receptors. �

 

AMPA Receptors Figure 1 | El Paso, TX Chiropractor

 

What are NMDA Receptors?

 

NMDA, also known as N-methyl-d-aspartate, receptors are glutamate receptors which are found in the postsynaptic membrane. The NMDA receptors are made up of two varieties of subunits: GluN1 and GluN2. The GluN1 subunit is fundamental for the role of the receptor. This subunit can associate with one of the four types of GluN2 subunits, GluN2A-D. �

 

Furthermore, the main utilization of the NMDA receptors is to maintain the synaptic response. In the resting membrane potential, these receptors are inactive due to the creation of a magnesium block. The agonist of the NMDA receptor is N-methyl-d-aspartic acid. L-glutamate, including glycine, can connect to the receptor to activate it. Upon stimulation, NMDA receptors activate the calcium influx along with the potassium and sodium influx. Figure 2 demonstrates NMDA receptors. �

 

NMDA Receptors Figure 2 | El Paso, TX Chiropractor

 

Similarities Between AMPA and NMDA Receptors

 

  • AMPA, NMDA, and kainate receptors are the three main types of glutamate receptors.
  • These are ligand-gated ion channels which activate and regulate sodium and potassium ions.
  • These are known due to the type of agonist which activates the receptor.
  • Moreover, the activation of these receptors produces excitatory postsynaptic responses or ESPSs.
  • Furthermore, several protein subunits connect together to form these receptors.

 

Difference Between AMPA and NMDA Receptors

 

AMPA receptors are best known as a type of glutamate receptor which activates in excitatory neurotransmission and connects ?-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid which additionally works as a cation channel. Where the NMDA receptors are best known as a type of glutamate receptor which helps in excitatory neurotransmission and also connects N-methyl-D-aspartate. This is the most fundamental difference between AMPA and NMDA receptors. �

 

AMPA receptors have four subunits, GluA1-4 while NMDA receptors have a GluN1 subunit associated with one of the four GluN2 receptors, GluN2A-D. Activation can also be a difference between AMPA and NMDA receptors. AMPA receptors are only activated by glutamate while NMDA receptors are activated by different agonists. The agonist for AMPA receptors is ?-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid where the agonist for NMDA receptors is N-methyl-d-aspartic acid. �

 

Ion influx is a fundamental difference between AMPA and NMDA receptors. Activation of AMPA receptors results in the sodium and potassium influx while the activation of NMDA receptors leads to an increase in potassium, sodium, and calcium. Another distinction between AMPA and NMDA receptors is that AMPA receptors do not contain a calcium ion where NMDA receptors contain magnesium receptors. Also, AMPA receptors are responsible for the transmission of the majority of the rapid, excitatory synaptic signals while NMDA receptors are responsible for the modulation of the synaptic response. �

 

AMPA receptors are glutamate receptors which lead to the influx of sodium and potassium ions. NMDA receptors are another type of glutamate receptors which result in the influx of calcium ions with potassium and sodium ions. The main difference between AMPA and NMDA receptors is the type of ion influx associated with their activation and regulation. �

 

Several varieties of ionotropic glutamate receptors have been demonstrated in the following article. Three of these main excitatory neurotransmitter in the central nervous system, or CNS, are ligand-gated ion channels best known as AMPA receptors, NMDA receptors, and kainate receptors. These ionotropic glutamate receptors are best referred to after the agonists which activate and regulate them: AMPA or ?-amino-3-hydroxy-5-methyl-4-isoxazole-propionate, NMDA or N-methyl-d-aspartate, and kainic acid. – Dr. Alex Jimenez D.C., C.C.S.T. Insight

 

The purpose of the article above is to demonstrate the difference between AMPA and NMDA receptors for brain health. Neurological diseases are associated with the brain, the spine, and the nerves. The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �

 

Curated by Dr. Alex Jimenez �

 


 

Additional Topic Discussion: Chronic Pain

 

Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.

 

 


 

Formulas for Methylation Support

 

Xymogen Formulas - El Paso, TX

 

XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.

 

Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.

 

Please call our office in order for us to assign a doctor consultation for immediate access.

 

If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.

xymogen el paso, tx

 

For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download

 

* All of the above XYMOGEN policies remain strictly in force.

 


 

Neurological Health Issues After Auto Injuries

Neurological Health Issues After Auto Injuries

I’m definitely able to do day-to-day stuff a lot easier. It’s just like a much happier life with less pain. Just doing anything like working out or any type of activity that a person would take for granted if you don’t have pain, it’s different when you have pain, and so to get pain relief is amazing.

Gale Grijalva

Head and neck injuries are health issues commonly caused by�automobile accidents. Due to the force of the impact, a�moderate fender bender can sometimes even jerk a victim enough to make them hit their head inside the vehicle. The brain�can be very susceptible to suffering damage�after an auto accident, leading to neurological issues which can have lasting effects.

Nerve damage is a prevalent consequence after a car crash, and it can�cause debilitating symptoms, such as pain, headaches, and mental health issues, among others, ultimately making it difficult for anyone to go about their everyday activities.�When it comes to nerve damage, the most common types of automobile accident injuries include:

  • Whiplash, an intense jerking motion of the head and neck which can cause the nerves to stretch or be pinched;
  • Blunt-force trauma, hitting your head, arms, or legs on a hard surface inside or outside the vehicle, compressing the nerves; and
  • Lacerations, deep cuts into the skin sustained during an automobile accident that can sever the nerves in the affected region.

Several signs and symptoms can help indicate when nerves are damaged. These include�pain; partial or full paralysis of limbs and appendages like fingers and/or toes; muscular fatigue; twitching or uncontrolled movements of muscles; a prickling sensation; tingling or numbness on the skin or in limbs; or increased sensitivity to cold and hot temperatures on the surface. Below, we will discuss the effects of nerve damage after an auto accident.

Neuropathy After Auto Injuries

Neuropathy, or nerve damage, may be brought on by sports injuries, work-related injuries, automobile accident injuries, or repetitive motion injuries. These scenarios may cause the nerves to be completely or partially compressed, stretched or even severed. Dislocated or broken, fractured, bones may also place an unnecessary quantity of pressure on the nerves, where slipped intervertebral discs can compress the nerve fibers.

Neuropathy,�a term used to describe nerve damage, usually involves�the peripheral nerves instead of the central nervous system, or the brain and spinal cord. This health issue may not only develop due to the causes�explained above,�but nerve damage can also occur for many other reasons. The most prevalent nerves to be affected by neuropathy include the motor nerves, the autonomic nerves, and the sensory nerves.

  • The motor nerves enable movement and power;
  • The autonomic nerves control the systems of the body; and
  • The sensory nerves control feeling.

Diagnosing neuropathy to determine the best treatment options can help a victim regain a healthy lifestyle. The healthcare professional will begin their evaluation by reviewing the patient’s medical history, including general health, signs and symptoms, any other�type of neuropathy in the family, current or recent prescriptions used, any exposure to poisons or toxins, alcohol consumption, and sexual history.

They will then diagnose the cause of the neuropathy by checking the skin, taking their pulse in different places, examining for feeling, such as analyzing vibration sensations with a tuning fork and evaluating tendon reflexes. The healthcare professional may determine your precise treatment options once the source of the neuropathy is narrowed down. The proper treatment approach can help manage the symptoms.

Radiculopathy After Auto Injuries

Radiculopathy is the medical term used to describe compression or irritation of a nerve in the spine. It is not a specific condition, but instead, a description of a general health issue in which or more nerves are affected, causing symptoms. Radiculopathy may cause pain, tingling sensations, numbness, or fatigue. This condition can occur in any portion of the spine, although it may be more common in some areas than others.

  • It is most common in the lower back (lumbar radiculopathy);
  • And in the neck (cervical radiculopathy);
  • It is�less common in the middle portion of the spine (thoracic radiculopathy), but it’s still tremendously debilitating.

Cervical radiculopathy is pain and other symptoms resulting from any condition which affects the nerves in the cervical, thoracic, or lumbar spine. Degeneration of the cervical region of the spine may lead to a myriad of conditions that might result in problems. These are usually divided between problems that come from health issues originating from pinched or irritated nerves as well as other underlying problems in the neck.

Lumbar radiculopathy causes pain which occurs in the lower back. Damage or injuries to the lumbar spine and compression or impingement of the nerve roots can cause pain, tingling sensations, and numbness. Automobile accident injuries can result in very significant pathologies including damage to the intervertebral discs, muscles, tendons, and ligaments as well as to the nerves traveling down the length of the spine.

Like neuropathy, a diagnosis for radiculopathy begins with a review of a patient’s medical history and a physical evaluation by the healthcare professional. The doctor might be able to determine the source of the symptoms by evaluating the patient’s muscle strength, sensation, and reflexes. These tests often comprise of a CT scan, an MRI or X-rays. The exam may also include an electromyogram or a nerve conduction study which analyzes the current threshold of sensibility in patients.

Dr-Jimenez_White-Coat_01.png

Millions of people are involved in automobile accidents every year, many of which result in long-term injuries and disability. Chiropractic care is one of the most frequently considered forms of treatment after an auto accident. Through the use of spinal adjustments and manual manipulations, a doctor of chiropractic can help restore normal function to the nervous system in order to allow the body to naturally heal itself.

Dr. Alex Jimenez D.C., C.C.S.T.

Treatment After Auto Injuries

The force that’s often placed on the�neck and the spine during an auto accident can cause nerve damage.�If you experience any signs and symptoms after being involved in a car crash, it’s essential to seek immediate medical attention from a healthcare professional, such as a chiropractor, to receive the proper diagnosis and treatment. Chiropractic care is a popular treatment for automobile accident injuries.

Chiropractic care is an alternative treatment approach which focuses on the diagnosis, treatment, and prevention of a variety of injuries and/or conditions associated with the musculoskeletal and nervous system. Through the use of spinal adjustments and manual manipulations, a chiropractor can carefully correct any spinal misalignments�which may be placing unnecessary amounts of stress on the nerves.�

By naturally restoring the original integrity of the spine, chiropractic care has become one of the most common treatments for a variety of injuries and conditions, including nerve damage associated with automobile accident injuries. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.

Curated by Dr. Alex Jimenez

Green Call Now Button H .png

Additional Topics: Central Sensitization After Auto Injuries

Central sensitization is a health issue affecting the nervous system which is commonly associated with the development of chronic pain. With central sensitization, the nervous system experiences a “wind-up” process that causes it to become regulated in a constant state of high reactivity. This constant, or persistent, state of high reactivity lowers the threshold for what should be causing pain in the human body, ultimately maintaining pain even after the initial injury has healed. Central sensitization is identified by two main characteristics, both of which involve a heightened sensitivity to pain and the sensation of touch, known as allodynia and hyperalgesia.

 

blog picture of cartoon paper boy

 

EXTRA IMPORTANT TOPIC: Neck Pain Chiropractic Treatment

 

Neurological Advanced Studies

Neurological Advanced Studies

After a neurological exam, physical exam, patient history, x-rays and any previous screening tests, a doctor may order one or more of the following diagnostic tests to determine the root of a possible/suspected neurological disorder or injury. These diagnostics generally involve neuroradiology, which uses small amounts of radioactive material to study organ function and structure and ordiagnostic imaging, which use magnets and electrical charges to study organ function.

Neurological Studies

Neuroradiology

  • MRI
  • MRA
  • MRS
  • fMRI
  • CT scans
  • Myelograms
  • PET scans
  • Many others

Magnetic Resonance Imaging (MRI)

Shows organs or soft tissue well
  • No ionizing radiation
Variations on MRI
  • Magnetic resonance angiography (MRA)
  • Evaluate blood flow through arteries
  • Detect intracranial aneurysms and vascular malformations
Magnetic resonance spectroscopy (MRS)
  • Assess chemical abnormalities in HIV, stroke, head injury, coma, Alzheimer’s disease, tumors, and multiple sclerosis
Functional magnetic resonance imaging (fMRI)
  • Determine the specific location of the brain where activity occurs

Computed Tomography (CT or CAT Scan)

  • Uses a combination of X-rays and computer technology to produce horizontal, or axial, images
  • Shows bones especially well
  • Used when assessment of the brain needed quickly such as in suspected bleeds and fractures

Myelogram

Contrast dye combined with CT or Xray
Most useful in assessing spinal cord
  • Stenosis
  • Tumors
  • Nerve root injury

Positron Emission Tomography (PET Scan)

Radiotracer is used to evaluate the metabolism of tissue to detect biochemical changes earlier than other study types
Used to assess
  • Alzheimer’s disease
  • Parkinson’s disease
  • Huntington’s disease
  • Epilepsy
  • Cerebrovascular accident

Electrodiagnostic Studies

  • Electromyography (EMG)
  • Nerve Conduction Velocity (NCV) Studies
  • Evoked Potential Studies

Electromyography (EMG)

Detection of signals arising from the depolarization of skeletal muscle
May be measured via:
  • Skin surface electrodes
  • Not used for diagnostic purposes, more for rehab and biofeedback
Needles placed directly within the muscle
  • Common for clinical/diagnostic EMG

neurological studies el paso tx.Diagnostic Needle EMG

Recorded depolarizations may be:
  • Spontaneous
  • Insertional activity
  • Result of voluntary muscle contraction
Muscles should be electrically silent at rest, except at the motor end-plate
  • Practitioner must avoid insertion in motor end-plate
At least 10 different points in the muscle are measured for proper interpretation

Procedure

Needle is inserted into the muscle
  • Insertional activity recorded
  • Electrical silence recorded
  • Voluntary muscle contraction recorded
  • Electrical silence recorded
  • Maximal contraction effort recorded

Samples Collected

Muscles
  • Innervated by the same nerve but different nerve roots
  • Innervated by the same nerve root but different nerves
  • Different locations along the course of the nerves
Helps to distinguish the level of the lesion

Motor Unit Potential (MUP)

Amplitude
  • Density of the muscle fibers attached to that one motor neuron
  • Proximity of the MUP
Recruitment pattern can also be assessed
  • Delayed recruitment can indicated loss of motor units within the muscle
  • Early recruitment is seen in myopathy, where the MUPs tend to be of low amplitude short duration

neurological studies el paso tx.Polyphasic MUPS

  • Increased amplitude and duration can be the result of reinnervation after chronic denervation

neurological studies el paso tx.Complete Potential Blocks

  • Demyelination of multiple segments in a row can result in a complete block of nerve conduction and therefore no resulting MUP reading, however generally changes in MUPs are only seen with damage to the axons, not the myelin
  • Damage to the central nervous system above the level of the motor neuron (such as by cervical spinal cord trauma or stroke) can result in complete paralysis little abnormality on needle EMG

Denervated Muscle Fibers

Detected as abnormal electrical signals
  • Increased insertional activity will be read in the first couple of weeks, as it becomes more mechanically irritable
As muscle fibers become more chemically sensitive they will begin to produce spontaneous depolarization activity
  • Fibrillation potentials

Fibrillation Potentials

  • DO NOT occur in normal muscle fibers
  • Fibrillations cannot be seen with the naked eye but are detectable on EMG
  • Often caused by nerve disease, but can be produced by severe muscle diseases if there is damage to the motor axons

neurological studies el paso tx.Positive Sharp Waves

  • DO NOT occur in normally functioning fibers
  • Spontaneous depolarization due to increased resting membrane potential

neurological studies el paso tx.Abnormal Findings

  • Findings of fibrillations and positive sharp waves are the most reliable indicator of damage to motor axons to the muscle after one week up to 12 months after the damage
  • Often termed �acute� in reports, despite possibly being visible months after onset
  • Will disappear if there is complete degeneration or denervation of nerve fibers

Nerve Conduction Velocity (NCV) Studies

Motor
  • Measures compound muscle action potentials (CMAP)
Sensory
  • Measures sensory nerve action potentials (SNAP)

Nerve Conduction Studies

  • Velocity (Speed)
  • Terminal latency
  • Amplitude
  • Tables of normal, adjusted for age, height and other factors are available for practitioners to make comparison

Terminal Latency

  • Time between stimulus and the appearance of a response
  • Distal entrapment neuropathies
  • Increased terminal latency along a specific nerve pathway

Velocity

Calculated based on latency and variables such as distance
Dependent on diameter of axon
Also dependent on thickness of myelin sheath
  • Focal neuropathies thin myelin sheaths, slowing conduction velocity
  • Conditions such as Charcot Marie Tooth Disease or Guillian Barre Syndrome damage myelin in large diameter, fast conducting fibers

Amplitude

  • Axonal health
  • Toxic neuropathies
  • CMAP and SNAP amplitude affected

Diabetic Neuropathy

Most common neuropathy
  • Distal, symmetric
  • Demyelination and axonal damage therefore speed and amplitude of conduction are both affected

Evoked Potential Studies

Somatosensory evoked potentials (SSEPs)
  • Used to test sensory nerves in the limbs
Visual evoked potentials (VEPs)
  • Used to test sensory nerves of the visual system
Brainstem auditory evoked potentials (AEPs)
  • Used to test sensory nerves of the auditory system
Potentials recorded via low-impedance surface electrodes
Recordings averaged after repeated exposure to sensory stimulus
  • Eliminates background �noise�
  • Refines results since potentials are small and difficult to detect apart from normal activity
  • According to Dr. Swenson, in the case of SSEPs, at least 256 stimuli are usually needed in order to obtain reliable, reproducible responses

Somatosensory Evoked Potentials (SSEPs)

Sensation from muscles
  • Touch and pressure receptors in the skin and deeper tissues
Little if any pain contribution
  • Limits ability to use testing for pain disorders
Velocity and/or amplitude changes can indicate pathology
  • Only large changes are significant since SSEPs are normally highly variable
Useful for intraoperative monitoring and to assess the prognosis of patients suffering severe anoxic brain injury
  • Not useful in assessing radiculopathy as individual nerve roots cannot be easily identified

Late Potentials

Occur more than 10-20 milliseconds after stimulation of motor nerves
Two types
  • H-Reflex
  • F-Response

H-Reflex

Named for Dr. Hoffman
  • First described this reflex in 1918
Electrodiagnostic manifestation of myotatic stretch reflex
  • Motor response recorded after electrical or physical stretch stimulation of the associated muscle
Only clinically useful in assessing S1 radiculopathy, as the reflex from the tibial nerve to triceps surae can be assessed for velocity and amplitude
  • More quantifiable that Achilles reflex testing
  • Fails to return with after damage and therefore not as clinically useful in recurrent radiculopathy cases

F-Response

So named because it was first recorded in the foot
Occurs 25 -55 milliseconds after initial stimulus
Due to antidromic depolarization of the motor nerve, resulting in a orthodromic electrical signal
  • Not a true reflex
  • Results in a small muscle contraction
  • Amplitude can be highly variable, so not as important as velocity
  • Reduced velocity indicates slowed conduction
Useful in assessing proximal nerve pathology
  • Radiculopathy
  • Guillian Barre Syndrome
  • Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP)
Useful in assessing demyelinative peripheral neuropathies

Sources

  1. Alexander G. Reeves, A. & Swenson, R. Disorders of the Nervous System. Dartmouth, 2004.
  2. Day, Jo Ann. �Neuroradiology | Johns Hopkins Radiology.� Johns Hopkins Medicine Health Library, 13 Oct. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology/index.html.
  3. Swenson, Rand. Electrodiagnosis.

Share Ebook