ClickCease
+1-915-850-0900 spinedoctors@gmail.com
Select Page
Peroneal Nerve Injury: El Paso Back Clinic

Peroneal Nerve Injury: El Paso Back Clinic

A peroneal nerve injury/peroneal neuropathy can be caused by direct trauma to the outer knee with symptoms and sensations of numbness, tingling, pins-and-needles sensations, pain, or weakness in the foot that can cause a condition known as foot drop. Chiropractic can perform spinal manipulation, realignment, and decompression to restore the nerve’s function. They can also help with walking and mobility by providing muscle strengthening and stretching exercises to correct abnormal gait caused by foot drop and increase the range of motion in the ankle.

Peroneal Nerve Injury: EP's Chiropractic Team

Peroneal Nerve Injury

The peroneal nerve begins near the sciatic nerve at the glutes/hip and buttocks. It travels down the back of the thigh to the knee, which wraps around the front of the leg and extends into the feet to the toes. It provides sensory input from the lateral aspect of the lower leg and the top of the foot. It also provides motor input to the muscles responsible for lifting the foot off the ground lifting the toes and ankles and turning the foot outwards.

Causes

Structural problems in the spine or misalignment can affect the functionality of the nervous system and lead to peroneal neuropathy. Traumatic nerve injury causes include musculoskeletal injury, peroneal nerve paralysis, compression, or laceration. Injuries by trauma and nerve compression include:

  • Compression of the nerve in the leg.
  • Knee dislocation.
  • Knee or hip replacement surgery.
  • Knee or leg fracture. Fractures of the tibia or fibula, especially in the areas closer to the knee, can injure the nerve.
  • Ankle fracture.
  • Blood clot.
  • Compression by a nerve sheath tumor or cyst.

Certain underlying medical conditions can cause symptoms of peroneal nerve injury. It is recommended to be evaluated by a medical professional who can diagnose and offer appropriate treatment options. Neurologic disorders that can cause similar symptoms:

  • Herniated lumbar disc
  • Multiple sclerosis
  • Parkinson’s disease
  • Amyotrophic lateral sclerosis – ALS or Lou Gehrig’s disease.
  • Metabolic syndromes – diabetes, alcohol abuse, exposure to toxins.

Symptoms

Nerve injury symptoms include:

  • Numbness, tingling, or loss of sensation in the top of the foot or outer part of the lower leg.
  • Inability to flex toes or ankles upward/dorsiflexion.
  • Inability to flex the ankle to take a step forward.
  • Inability to move the foot.
  • Weakness in foot eversion/rotating outward.
  • Flopping or slapping sounds when walking.
  • Gait changes – dragging the toes or lifting the knee higher than the other to raise the foot off the ground.
  • Tripping often.
  • Pain in the foot or lower leg.

Diagnosis

In diagnosing a peroneal nerve injury, a healthcare provider examines the leg and analyzes symptoms. Tests can include:

  • Imaging tests – CT scan, ultrasound, or MRI.
  • Magnetic resonance – MR – neurography is a specialized high-resolution MRI of the nerves.
  • An electromyogram measures how muscles react to nerve stimulation.
  • Nerve conduction studies measure how electrical impulses run through the nerves.

Treatment

Treatment for a peroneal nerve injury depends on the severity and can be surgical or non-surgical. Non-surgical options include orthotic footwear, chiropractic care, and physical therapy. A physical therapy program could consist of the following:

  • Icing
  • Massage
  • Manual manipulation
  • Stretching
  • Strengthening exercises
  • Mobilization exercises
  • Balancing exercises
  • Ankle bracing
  • Ankle taping
  • Shoe inserts – splints, braces, or orthotics can improve gait.
  • Gait training to walk without the drop.

Ankle Sprain Chiropractor


References

Longo, Diego, et al. “The Muscle Shortening Maneuver: a noninvasive approach to treating peroneal nerve injury. A case report.” Physiotherapy theory and practice, 1-8. 31 Jul. 2022, doi:10.1080/09593985.2022.2106915

Milenković, S S, and M M Mitković. “Common peroneal nerve schwannoma.” Hippokratia vol. 22,2 (2018): 91.

Radić, Borislav et al. “PERIPHERAL NERVE INJURY IN SPORTS.” Acta clinica Croatica vol. 57,3 (2018): 561-569. doi:10.20471/acc.2018.57.03.20

Thatte H et al. (2022). Electrodiagnostic evaluation of peroneal neuropathy. ncbi.nlm.nih.gov/books/NBK563251/

T Francio, Vinicius. “Chiropractic care for foot drop due to peroneal nerve neuropathy.” Journal of bodywork and movement therapies vol. 18,2 (2014): 200-3. doi:10.1016/j.jbmt.2013.08.004

Hydrating Foods, Intense Heat, Health

Hydrating Foods, Intense Heat, Health

Medical experts advise that maintaining body hydration is one of the most important things to do in extreme heat. Individuals out in the heat lose electrolytes like sodium, potassium, and chloride and need added electrolytes to prevent cramping and excessive sweating that can strain the body. Dehydration can be dangerous, leading to heat exhaustion and possible heat stroke. If gulping water all day seems like a lot, remember that not all hydration must come from drinking water; there are hydrating foods that contain enough water that can be incorporated.

Hydrating Foods, Intense Heat, Body Health

H2O

The body needs H20 to:

  • Deliver nutrients to the cells
  • Regulate body temperature
  • Prevent infection
  • Lubricate the joints
  • Maintain organ function
  • Help with mood
  • Help with Sleep
  • Help with Cognition

Electrolytes

Sweating is vital for maintaining body temperature, and electrolytes are essential in maintaining the body’s homeostasis. Electrolytes help coordinate muscle contractions, heart function, and the conductivity of electric signals transmitting to and from the nervous system. The kidneys regulate fluid absorption and excretion to maintain electrolyte balance, but an imbalance can occur when electrolyte levels spike or drop. An electrolyte imbalance is caused by a change in the number of electrolytes in the body. Sodium, potassium, and calcium are the common elements most likely to be affected by an electrolyte imbalance. Other reasons why electrolyte levels can change include:

  • Unhealthy diet
  • Medications
  • Kidney problems

It is recommended that instead of focusing on how many glasses of water have been drunk, concentrate on two biomarkers:

  • How often do you urinate?
  • What color is the urine?

When the body is thoroughly hydrated, an individual should go to the bathroom every two to three hours, and the urine should be a pale yellow. If it looks orange, it indicates that the body is trying to conserve water and needs further hydration.

Hydrating Foods

Consulting a doctor or nutritionist is recommended to help determine what foods are safe for the individual if there are underlying conditions or other health concerns. Here are a few hydrating foods that contain at least 80 percent water that can be eaten throughout the hot day to maintain body hydration.

Apples

  • Best known for their fiber content  (up to 5 grams), they are also more than 80 percent water.
  • A quick crunchy snack with potassium, vitamin B6, C, and magnesium.

Watermelon

  • These can be up to 92 percent water.
  • Contain vitamin A, B6, and C, plus lycopene and antioxidants.
  • Watermelon can be cubed by itself or with feta cheese, olive oil, salt, pepper, and basil for a sweet-savory salad.

Peaches

  • These can contain up to 88 percent water, fiber, protein, and vitamin C.
  • Peaches can be added to salsas or incorporated into a salad.

Carrots

  • Carrots are around 90 percent water.
  • Rich in beta carotene, which the body uses to make vitamin A.
  • Vitamin A helps the eyes convert light into a signal sent to the brain, allowing for better sight in dim to dark light.
  • Vitamin K
  • Potassium
  • Fiber

Cucumbers

  • Cucumbers have more than 96 percent water.
  • They also contain potassium, phosphorus, magnesium, and some calcium.
  • They contain nutrients known as cucurbitacins, which can have an anti-diabetic effect.
  • Fisetin is an anti-inflammatory substance that helps brain health.

Potatoes

  • The waxy variety contains more water, as much as 80 percent.
  • They contain potassium, vitamin C, fiber, and minerals.
  • Have them baked or roasted with skins to keep as much potassium as possible.

Tomatoes

  • Tomatoes are almost 95 percent water.
  • They contain cancer-fighting carotenoid lycopene, vitamin A and C, and potassium.
  • Sliced onto sandwiches, sauteed into pasta, or blended into a gazpacho.

Cantaloupe

  • 90 percent water.
  • Contains beta-carotene, fiber, and vitamin C.
  • It can be eaten by itself, chopped into salads or smoothies.

Plain yogurt

  • One cup of plain yogurt is around 88 percent water.
  • It contains protein, gut probiotics, calcium, zinc, magnesium, potassium, and phosphorus.
  • Top with some berries for extra hydration.

These are a few hydrating foods that can help with the intense heat. Others include zucchini, iceberg lettuce, strawberries, blueberries, celery, broccoli, and cauliflower. Healthy H2O levels benefits include:

  • Decreased appetite.
  • Improved physical performance during exercise.
  • Increased energy levels.
  • Optimal brain function.

What Are The Most Hydrating Foods?


References

Bergeron, Michael F. “Hydration and thermal strain during tennis in the heat.” British journal of sports medicine vol. 48 Suppl 1, Suppl 1 (2014): i12-7. doi:10.1136/bjsports-2013-093256

Gauer, Robert, and Bryce K Meyers. “Heat-Related Illnesses.” American family physician vol. 99,8 (2019): 482-489.

Karppanen, H et al. “Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets?.” Journal of human hypertension vol. 19 Suppl 3 (2005): S10-9. doi:10.1038/sj.jhh.1001955

Schiefermeier-Mach, Natalia, et al. “Electrolyte Intake and Major Food Sources of Sodium, Potassium, Calcium, and Magnesium among a Population in Western Austria.” Nutrients vol. 12,7 1956. 30 Jun. 2020, doi:10.3390/nu12071956

Strimbu, Kyle, and Jorge A Tavel. “What are biomarkers?.” Current opinion in HIV and AIDS vol. 5,6 (2010): 463-6. doi:10.1097/COH.0b013e32833ed177

Summer Activities For Back Pain That Are Easy On The Spine

Summer Activities For Back Pain That Are Easy On The Spine

It is time for outdoor summer activities. Summer is iconic in its association with a wide range of outdoor activities. However, many can be physically strenuous and require a great deal of body movement. Summer gets individuals thinking of:

  • Hiking
  • Bicycling
  • Swimming
  • Water sports
  • Tennis
  • Golf
  • Gardening

This is when individuals have to figure out which activities will be easy on their backs. For those dealing with regular and/or chronic back or neck pain, athletic/movement-based activities can be done with:

  • Proper planning
  • Strain prevention/reduction
  • Activity modification/s
  • Most activities can be manageable.
  • Preventing/avoiding worsening the pain is the most recommended solution.

Individuals can still enjoy favorite outdoor activities for those who do have back pain, whether from an injury, herniated disc, muscle strain, arthritis, osteoporosis, or another cause.

Summer Activities For Back Pain That Are Easy On The Spine

Safe Summer Activities Safe For The Spine

Swimming

The best summer activity for the spine/back is swimming or any movement in the water. It is recommended and utilized in physical therapy for those with injuries and pain conditions and is shown to prove that it brings relief and exercise. Hot weather makes it easy to get in the water, whether a pool, river, or lake. Doing basic water stretches, exercises, or walking movements can bring significant pain relief. This is because the body’s weight is lessened, which lessens the spine’s pressure.

Walking

Getting outside every day and running can cause a great deal of strain. However, walking is extremely safe and effective, especially on the spine. The key is to take it slow and build up the ability to walk longer and further. However, those with spinal stenosis, which is the narrowing of the spinal canal, might find that walking increases pain. It is recommended to start with light walking sessions and modify them as much as needed. An example could be walking half a block; if pain presents, perform some other movement/s that does not cause pain, and then walk another half block. Taking it slow.

Hiking

It is not out of the question for individuals who like to hike, but caution should be taken. This is because hiking adds factors that can increase the risk for injuries or conditions if the activity is not modified. Most hikes involve hills, elevation changes, climbing, and uneven surfaces. This requires planning and preparation. It is recommended to choose hiking paths that will not exhaust an individual, and that can be easily backtracked if pain or issues arise. This is especially important for those that are flexion-intolerant.  This is when individuals feel pain when bending or leaning forward over the hips. This could be hiking up and down hills that are likely to cause flare-ups.

Fishing

Fishing is a favorite summer activity and is recommended because of the relaxed atmosphere and ability to be modified easily. Individuals can sit in a supportive chair and fish, or they can stand and fish. There is not a lot of quick bending or rotating and totally open to modifications.

Activity Moderation and/or Modification

Figuring out movement modifications or mix up the time. Activities can be enjoyed; it just requires making the right adjustment/s that will make the activity manageable. For those with back pain usually know what movements will cause pain. This can help make it easier to modify specific movements/motions. Activities that more than likely will cause inflammation flare-ups are about finding a way to do it so that the result is not as extreme.

  • One way to modify summer activities is by altering/changing the amount of time engaged. For example, instead of spending 4-6 hours fixing up the yard/gardening, break it up by doing the activity for an hour, stop, stretch, relax, rehydrate, and then continue, respectively.
  • Modification can also be done by changing the functional components of the activity/s. Rather than bending and picking up tools, pulling weeds, etc., get a work stool/bench and perform the activity sitting. This goes for any activity.

Body Composition Health


Can more fat be burned by exercising in the heat?

Individuals wonder if exercising when it’s hot out causes the body to burn more fat. After all, the body is hotter and sweating much more. However, it’s more complicated. Studies show that when exercise is done in high temperatures, the heat can affect the body’s hormonal and metabolic response. The same studies show a consistent shift from breaking down fat cells for energy and breaking down carbohydrates for energy. When exercising in extreme heat, the energy demand becomes too high to break down more fat.  Instead, it uses carbohydrates. So the extra sweat is just water, salt, and not fat. But heat can still play a positive role in improving body composition. Two ways include:

  • Heat shock proteins – HSP – Without exercise, exposure to heat can cause heat shock proteins to activate. Heat shock proteins live inside cells and aid in muscle protein synthesis and repair. When exposed to temperature/thermal stress, they increase to meet the demand.
  •  Human Growth Hormone – HGH – Synthetic Human Growth Hormone increases lean mass, reduces body fat, and improves performance. However, it is naturally produced by the body and can be enhanced through exercise.
References

American Journal of Physical Medicine & Rehabilitation. (February 2018) “Aquatic Exercises in the Treatment of Low Back Pain: A Systematic Review of the Literature and Meta-Analysis of Eight Studies”

Gobbo, Stefano et al. “Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace.” Journal of Functional morphology and kinesiology vol. 4,3 43. 5 Jul. 2019, doi:10.3390/jfmk4030043

Grabovac, Igor, and Thomas Ernst Dorner. “Association between low back pain and various everyday performances: Activities of daily living, ability to work and sexual function.” Wiener klinische Wochenschrift vol. 131,21-22 (2019): 541-549. doi:10.1007/s00508-019-01542-7

Preventive Medicine Reports. (2017.)“Gardening is beneficial for health: A meta-analysis.” ncbi.nlm.nih.gov/pmc/articles/PMC5153451/pdf/main.pdf

Selby, Sasha et al. “Facilitators and barriers to green exercise in chronic pain.” Irish Journal of medical science vol. 188,3 (2019): 973-978. doi:10.1007/s11845-018-1923-x

Yard Work and Gardening With a Bad Back

Yard Work and Gardening With a Bad Back

Dr. Alexander Jimenez takes a look at how to keep your back healthy while doing yard work and gardening. We�re looking for ways to find mental and physical engagement without socializing. Many individuals are breaking up isolation and monotony by doing some home projects out in the yard and garden.

Doctors may tell patients that yard work and gardening should be avoided if they have a bad back. Individuals with a history of back pain/issues or have had spinal surgery might think that gardening is out of the question.�None of this is true. Yard work and gardening can be therapeutic physically and mentally for individuals with compromised backs as long as they follow some common-sense safety concepts.

 

11860 Vista Del Sol, Ste. 128 Yard Work and Gardening With a Bad Back El Paso Texas
 

Gardening with an ergonomic approach can make yard work and gardening very back/spine-friendly. If possible try to get tools for gardeners with neck and back problems or modify your own. Modified tools can highly reduce the chances of injuring your back. Try to set up the yard or garden in a way where there is minimal bending and reaching.

If this cannot be achieved set up the work to be done in an order where any bending/reaching tasks are spaced out so as not to be doing them all at once. Here are some ways for back-preservation when doing yard work and gardening. They will make your work more productive and reduce fatigue, discomfort, and minimize the risk of exacerbating any back injuries/problems.

Environment

Working in the right environment is an important step for those with a bad back. If possible garden on a raised platform or a raised garden that is at a comfortable height to be able to stand and garden without bending and reaching. Structures can be purchased, or make them yourself with old broken used furniture like tables, shelves, etc. Garden beds can be worked using the square foot technique to minimize bending, reaching and squatting.

 

 

The Square Foot gardening technique was invented in 1976 by Mel Bartholomew, a civil engineer, and efficiency expert that took up gardening after retiring. These types of gardens are made to be waist level using old furniture, self-made or store-bought frames that are back-friendly. Gardening like this means less time weeding, bending and reaching with more time enjoying the therapeutic benefits.

Preparation with the Spine in Mind

Here are some tips on modifying your methods and tools for safe yard work and gardening. One example is using a golf bag with wheels for carrying and select long tools. Also using a two-wheeled garden cart/wheel-barrow. It is more balanced than a standard wheelbarrow and is better for the spine.

 

 

Practice Safe Posture/Position

Never use the back muscles to lift. Lift with the legs. Bend the knees, hinge at your hips and keep the back straight. If needed practice bending in front of a mirror to see your form and make sure the technique is being done properly. Check out this YouTube video on raking and hoeing. Plant containers while standing using a potting bench, or an old table. Have a stool, chair or heavy-duty bucket to sit down easily when a break is needed.

Containers

One back-friendly gardening technique is to plant in containers. Plant them where they will sit, which minimizes having to lift or carrying to a location. Styrofoam peanuts can be placed at the bottom third of the container instead of gravel to make the containers lighter. If using large containers, invest in a wheeled pot dolly to move the containers easily.

 

11860 Vista Del Sol, Ste. 128 Yard Work and Gardening With a Bad Back El Paso Texas

 

Focus on the Time and Not the Task

With big projects, break them down into smaller more manageable tasks. Dividing the bed/s into halves or thirds makes the work more pleasant. Underestimating how long a project might take can be a major set back. So set time limits and follow through. When recovering from surgery or a back injury, set a limit of 15 minutes of work and see how it feels. If your back is not irritated or sore then expand to 30 minutes and so on.

Work smarter not harder. Under no circumstances should you shovel or pull up heavy, deep-rooted plant/s. This type of movement could put an end to yard work and gardening for some time. Do not forget that pain is our body’s way of telling us to stop. Be sure to talk with a spine specialist or chiropractor before starting yard work or gardening.

 

Gardening Benefits

Activity and fresh air can make us feel healthy and happy. Gardening can provide this along with healthy exercise. Therapeutic benefits of yard work and gardening have been well documented. Gardeners that did daily work were found to experience significant reductions in stress and improvement in overall health and quality of life compared to non-gardeners.

Gardening can significantly raise levels of energy, optimism, zest for life, self-esteem, openness and other factors relevant to self-image. Even a little gardening goes a long way. Just being outside and the physicality of yard work and gardening contributes to stress reduction. Another benefit from gardening is if planting herbs, and veggies you can cook even healthier. Much like a farm to table restaurant.


 

Low Back Pain Care


 

NCBI Resources