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Managing Alcoholic Peripheral Neuropathy: Treatment Options

Managing Alcoholic Peripheral Neuropathy: Treatment Options

Excessive alcohol consumption: what is alcoholic peripheral neuropathy?

Managing Alcoholic Peripheral Neuropathy: Treatment Options

Alcoholic Peripheral Neuropathy

Alcoholic peripheral neuropathy (ALN) is a condition that damages the nerves in the body due to chronic alcohol consumption. It can cause sensory, motor, and autonomic dysfunction, which can lead to disability. This damage prevents the nerves from communicating information. Most symptoms generally start as mild but typically worsen over time as the neuropathy progresses. The most common symptoms are: (National Library of Medicine, 2023)

  • Numbness or tingling sensation in the extremities
  • Pain or a burning sensation in the extremities
  • Difficulty walking
  • Difficulty urinating
  • Difficulty talking or swallowing

Affected nerves include the peripheral and autonomic nerves, which help regulate internal body functions. Around 46% of chronic alcohol users will eventually develop the condition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Causes

The exact cause of alcoholic neuropathy is unclear. But it is directly related to heavy and long-term alcohol consumption. (Julian T., Glascow N., Syeed R., & Zis P. 2019) It is believed overconsumption of alcohol can directly harm and hinder the nerves’ ability to communicate information. Unhealthy nutritional habits are often associated with it as well. Research shows that decreased thiamine/B vitamin plays a role, while others suggest an overall dietary deficiency may play a role. (Julian T., Glascow N., Syeed R., & Zis P. 2019) However, alcoholic neuropathy can also occur without the presence of malnutrition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Neuropathy Development and Progression

Alcoholic peripheral neuropathy develops depending on many factors, including the amount of daily/nightly alcohol consumed, age and overall health, nutritional intake, and other individual factors. In most cases, the neuropathy takes several years or decades to develop, depending on the amount of alcohol consumed.

Symptoms

Symptoms are usually related to nerve dysfunction and include: (National Library of Medicine, 2023)

  • A tingling or pins-and-needles sensation in the extremities.
  • Numbness of the extremities, most commonly in the legs or feet. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
  • Pain or burning sensation in the arms, legs, or feet.
  • Symptoms that occur in the arms and legs typically affect both sides.
  • Cramps, aches, or weakness of the muscles.
  • Constipation or diarrhea.
  • Nausea and vomiting.
  • Difficulty urinating or incontinence.
  • Difficulty walking.
  • Difficulty talking or swallowing.
  • Heat intolerance.
  • Erection difficulties.

Most symptoms begin as mild and usually worsen over time as the neuropathy progresses. Alcoholic neuropathy affects individuals who consume excessive amounts of alcohol over a long time. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Diagnosis

Symptoms can vary significantly so that a diagnosis may take time. It usually involves a combination of the following (National Institute of Neurological Disorders and Stroke, 2024)

Medical History

  • Healthcare providers will collect data involving past medical history and all current symptoms.

Physical Exam

  • This exam looks at other medical conditions contributing to symptoms, like diabetes or high blood pressure.

Neurological Exam

  • This is a noninvasive exam to determine the location and extent of neurological damage.
  • Healthcare providers may ask patients several questions and have them complete a series of small movements to check neurological function.

Blood and Urine Tests

  • These tests can detect diabetes, liver and kidney problems, infections, vitamin deficiencies, and other conditions that can cause neuropathic conditions.

Chronic alcohol use can also affect how the body stores and uses vitamins necessary for healthy nerve function. Vitamin levels that a healthcare provider may check include: (National Library of Medicine, 2023)

  • Vitamin A
  • Biotin
  • Folic acid
  • Niacin, or vitamin B3
  • Pyridoxine, or vitamin B6
  • Pantothenic acid

Liver Disease

Individuals with chronic liver disease often have neuropathy. The severity and stage are associated with a higher incidence of neuropathy. (Pasha MB, Ather MM, Tanveer MA, et al. 2019)

Treatment

Alcoholic neuropathy is not reversible, even when quitting drinking. However, individuals with the condition can make healthy changes to minimize symptoms and receive help for chronic alcohol use. The first step is stopping alcohol consumption. (Chopra K., & Tiwari V. 2012) Talk to a healthcare provider about what options are available. Treatment can include:

  • In-patient or outpatient rehab
  • Therapy
  • Medication
  • Social support from groups like Alcoholics Anonymous

A combination of treatments will likely be utilized. Other treatment options involve symptom management and preventing further injuries and may include:

  • Physical therapy
  • Keeping the head elevated while sleeping.
  • Orthopedic splints to maintain limb function and positioning.
  • Wearing compression stockings.
  • Adding vitamins and supplements.
  • Eating extra salt for those without hypertension
  • Medications to reduce pain and discomfort.
  • Intermittent catheterization or manual expression of urine for those with difficulty urinating.

Individuals with neuropathy may have reduced sensitivity in the arms and legs. If this occurs, additional steps need to be taken to prevent other injuries, that include (National Library of Medicine, 2023)

  • Wear special footwear to prevent foot injuries.
  • Checking feet daily for wounds.
  • Prevent burns by ensuring that bath and shower water is not too hot.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Peripheral Neuropathy Myths and Facts


References

National Library of Medicine. (2023). Alcoholic neuropathy. Retrieved from https://medlineplus.gov/ency/article/000714.htm

Julian, T., Glascow, N., Syeed, R., & Zis, P. (2019). Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. Journal of Neurology, 266(12), 2907–2919. https://doi.org/10.1007/s00415-018-9123-1

National Institute of Neurological Disorders and Stroke. (2024). Peripheral neuropathy. Retrieved from https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy

Pasha MB, A. M., Tanveer MA, et al. (2019). Frequency of peripheral neuropathy in chronic liver disease. Med Forum Monthly, 30(8), 23-26. https://medicalforummonthly.com/index.php/mfm/article/view/3761

Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362. https://doi.org/10.1111/j.1365-2125.2011.04111.x

All About Facet Arthropathy: Causes, Symptoms, and Remedies

All About Facet Arthropathy: Causes, Symptoms, and Remedies

Can individuals managing facet arthropathy treat the condition with over-the-counter pain relievers, prescription muscle relaxers, exercise, and chiropractic spinal manipulation?

All About Facet Arthropathy: Causes, Symptoms, and Remedies

Facet Arthropathy

Blog Image  Facet Joint Arthritis

Facet arthropathy, or facet osteoarthritis, is arthritis that affects the facet joints in the spine. It causes pain and stiffness due to cartilage degeneration within these joints, often resulting from wear and tear associated with aging. Essentially, it occurs when the small joints in the back of the spine become arthritic and rub against each other painfully.

  • It affects the bony protrusions, called facet joints, that connect the spine’s bones.
  • Symptoms include neck and back pain that can worsen with standing, bending, or twisting.
  • Facet arthropathy is diagnosed using X-rays and other imaging studies.
  • Severe cases may require surgery.

Facet Joints

Twenty-four vertebrae form the spine, with two facet joints between each. Facet joints are small joints located at the back of each vertebra in the spine. They allow movement and stability, help maintain the alignment of the spinal bones/vertebrae, and limit excessive motion. The joints and the cushioning intervertebral disc form a three-joint complex between each vertebra.

  • The three-joint complex allows the spine to move, including bending, rotating, and extending.
  • Synovial fluid lubricates the joints so they can move.
  • The intervertebral disc provides flexibility and dissipates compressive loads.
  • The facet joints stabilize the spine by constraining rotation and bending.

Symptoms

Arthropathy refers to any disease affecting a joint, including arthritis. Osteoarthritis, also known as arthrosis, is a specific type of arthropathy. It is a non-inflammatory, degenerative arthritis. Pain is the main symptom that is typically worse in the morning when awakening, and in the evening, the pain can also get worse when twisting or bending backward. The symptoms can vary based on the part of the affected spine. Low back pain is the most common, a condition referred to as lumbar facet arthropathy because it affects the lumbar spine of the lower back. (Perolat R. et al., 2018) Common Symptoms include:

  • Muscle spasms or cramps.
  • Pain that may come in periodic flare-ups
  • Pain that worsens with standing or inactivity.
  • Dull pain on both sides of the spine.
  • Aching pain on both sides of the spine.
  • Pain in the lower back, buttocks, shoulders, or back of the skull
  • Radiating pain to the buttocks and legs.
  • Pain that improves with sitting, leaning forward, or changing positions.
  • Pins-and-needles sensations in the hands or feet.
  • Clicking sounds when moving the spine.
  • Catching sensations when moving the spine.
  • Muscle weakness.

Causes

Facet arthropathy causes progressive damage to the spine. Spinal osteoarthritis, aka spondylosis, is the most common cause, but it can also occur with a severe form of spinal arthritis known as ankylosing spondylitis. It is primarily due to age-related wear and tear, but injuries or repetitive stress on the spine can also cause it. Arthritis in the facet joints can develop due to:

  • Aging-related wear and tear
  • Disc problems
  • A previous back injury
  • Torn ligaments
  • Spinal fractures

Deterioration of facet joints can also cause bony overgrowths called osteophytes or bone spurs, which can cause radiating pain and restrict the spine’s range of motion.

Degeneration

  • The facet joints and intervertebral discs degenerate due to age-related wear and tear.
  • The cartilage in the facet joints can dry out, crack, and wear down.
  • The joint capsule and synovial membrane can inflame or tear, affecting synovial fluid production.
  • The loss of cartilage can lead to hypermobility, and the joint can stiffen over time.

Diagnosis

Imaging studies are important to the diagnosis. Several types confirm the diagnosis and also characterize the nature and severity of the condition:

  • X-rays provide a plain, black-and-white image of the spinal column.
  • CT scan composites multiple X-rays to create a three-dimensional image of the spinal column.
  • MRI uses magnetic and radio waves to generate images of soft tissues like ligaments and cartilage.

To confirm the diagnosis, a diagnostic block, which is a small amount of local anesthetic, is injected into a facet joint. The needle placement is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection provides immediate relief (American Academy of Orthopaedic Surgeons, 2022). The healthcare provider will want to exclude other possible causes as part of the differential diagnosis. Conditions that mimic facet arthropathy include:

  • Herniated disc
  • Psoriatic arthritis
  • Reactive arthritis
  • Spinal gout
  • Spinal compression fracture

Treatment

The treatment varies depending on the location and severity of the condition. Generally, conservative treatments are used before more invasive procedures are considered.

Lifestyle Changes

  • Initially, a healthcare provider may recommend rest and avoiding aggravating movements, including any activity that involves bending or twisting.
  • Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions, may help ease the pain.
  • Patients may also be advised to adjust their sleep positions to take the pressure off facet joints.
  • Options included curling up on your side or lying on your back with the knees supported with pillows.

Medications

If a diagnostic block is used, a patient may not need medications immediately. However, as the anesthetic starts to wear off, the patient may be prescribed over-the-counter or prescription pain relievers based on the severity of the pain. These can include:

  • Analgesics like Tylenol
  • Nonsteroidal anti-inflammatory drugs like Advil or Aleve
  • Muscle relaxants like Lloresal for acute back pain
  • Antidepressants like Cymbalta for chronic back pain

Physical Therapy

Physical therapy is a major part of the treatment of lower back pain. The treatment plan will include personalized exercises to strengthen the core muscles and avoid stress on the spine. Examples include:

  • Mechanical traction and non-surgical spinal decompression.
  • Knee-to-chest stretches, hugging your knees for 30 to 60 seconds.
  • Walking 10 to 20 minutes per day.
  • Aquatic therapy to alleviate pressure on the spine.

Surgery

If conservative measures don’t work or provide sufficient relief, a healthcare provider may recommend specialist procedures or surgeries that include:

  • Lumbar intra-articular injections deliver an anesthetic or corticosteroid into the spine for longer-lasting pain relief.
  • Sinuvertebral nerve ablation destroys spinal nerves with a strong electrical current.
  • Extracorporeal shockwave therapy ESWT delivers low- or high-energy electrical pulses to help ease pain.
  • Spinal fusion surgery involves fusing two or more vertebrae to eliminate movement and pain in the facet joints.
  • Facet rhizotomy is a surgical procedure used to sever one of the nerves supplying the facet joint.
  • Stem cell regeneration is an experimental procedure in which stem cells are harvested and injected into damaged joints to restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Facet Syndrome Pain Treatment


References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x

American Academy of Orthopaedic Surgeons. (2022). Spinal injections. https://orthoinfo.aaos.org/en/treatment/spinal-injections/

Choosing the Right Knee Brace for Pain Relief and Recovery

Choosing the Right Knee Brace for Pain Relief and Recovery

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Choosing the Right Knee Brace for Pain Relief and Recovery

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

  • Sprain
  • Ligament injury
  • Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

  • Tendonitis
  • Patellar tendinopathy
  • Chondromalacia patellae
  • Patellofemoral stress syndrome
  • Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

Unloader

  • This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
  • A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

  • This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

  • This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
  • A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

  • A knee immobilizer keeps the knee in one position.
  • It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

  • Sitting
  • Walking
  • Driving
  • Sleeping
  • Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

  • Poor circulation
  • Superficial wounds on the knee
  • Psoriasis
  • Eczema
  • Arterial insufficiency
  • Severe varicose veins
  • A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Best Knee Injury Chiropractor


References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? https://familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. https://doi.org/10.1136/bmjopen-2020-048196

Managing Back Spasms: A Guide to Muscle Relaxers

Managing Back Spasms: A Guide to Muscle Relaxers

For individuals who injure their neck or back, the muscles may spasm or seize up, making it difficult to get through the day, exercises, physical activities, etc. Can skeletal muscle relaxers help relieve pain and reduce frequency?

Managing Back Spasms: A Guide to Muscle Relaxers

Back Spasms Muscle Relaxers

Back muscle spasms are common back pain that feels like a sudden tightness or contraction in the back muscles. They can range from minor twinges to severe pain.

Causes

  • Poor posture: Sitting or standing with bad posture can strain the back muscles.
  • Overuse: Picking something up, bending, or lifting can cause a spasm.
  • Dehydration: Not drinking enough water can cause electrolyte imbalances, leading to spasms.
  • Underlying conditions: A herniated disc or degenerative disc disease can cause back spasms.
  • Muscle imbalances: Weak muscles or muscles that are too tight can cause spasms.

Treatments

  • Home treatments: You can apply heat or ice, take over-the-counter pain medication, try gentle stretching, or massage the area.
  • Exercise: Improve your back’s strength and flexibility with exercise or physical therapy.
  • Hydration and nutrition: Drink enough water and eat foods rich in magnesium and calcium.
  • Chiropractic Adjustments: These can realign the spine to the correct position and muscles to relax.
  • Non-surgical Decompression: Decompression of the spine will allow more blood and nutrients to heal painful areas.

Skeletal Muscle Relaxers

A healthcare provider may prescribe skeletal muscle relaxers. These medications are not available over the counter and must be prescribed by a healthcare provider.

  • Skeletal muscle relaxers will probably cause drowsiness.
  • Individuals should not drive, operate heavy machinery, or engage in other physical activities while taking back spasm muscle relaxers.
  • Skeletal muscle relaxers are not recommended for 65 or older because safer, effective alternatives exist.
  • Also, women who are pregnant or breastfeeding should not take these medications.
  • Discuss these issues with your healthcare provider.

Carisoprodol

Carisoprodol is available generically and as Soma and Vanadom brands. It works by suppressing nerve impulses located in the brain and spinal cord. Healthcare providers prescribe this medication in combination with physical therapy for the healing release of any muscle spasm and management of musculoskeletal injuries and/or pain. (Witenko C. et al., 2014) It’s not about having to continue taking the medication to feel better but more as a jump start to help with the physical therapy program.

  • Back muscle spasms are a perfect example of a condition that may benefit from carisoprodol in the short term.
  • Carisoprodol can be habit-forming.
  • Be sure to talk to a healthcare provider before suddenly going off this medication.
  • Carisoprodol can cause side effects that may impair thinking or reactions.
  • Avoid drinking alcohol as it may increase drowsiness and dizziness that are often caused by carisoprodol. (Zacny J. P., Paice J. A., & Coalson D. W. 2012)
  • Inform your healthcare provider of any drug allergies, kidney disease, or liver disease, or if you get seizures.

Cyclobenzaprine

Cyclobenzaprine is available as Amrix and in generic form. Like other muscle relaxers, cyclobenzaprine may cause dizziness or drowsiness. The sedation effects are how it works on painful, tension-filled muscles. Cyclobenzaprine is used together with physical therapy to treat skeletal muscle-related conditions and/or injuries, especially when pain or spasm is involved. When used in conjunction with physical therapy, it can help expedite recovery.

  • Cyclobenzaprine is chemically related to tricyclic antidepressants.
  • Although it is considered a derivative of the tricyclic antidepressant class, it does not pose the same risk to liver health.
  • According to the National Institutes of Health, reasons not to take this medication include having a thyroid disorder, heart block, congestive heart failure, a heart rhythm disorder, or having recently had a heart attack. (Witenko C. et al., 2014)

Metaxalone

Skelaxin is the brand name for metaxalone. As with the other muscle relaxers, metaxalone is used in combination with physical therapy and rest when muscles get too tight. (Witenko C. et al., 2014) It works by suppressing nerve impulses in the brain and spinal cord. In addition to older individuals and pregnant women, metaxalone is usually not prescribed for those with kidney disease, liver disease, seizures, or blood disorders.

Injury Medical Chiropractic and Functional Medicine Clinic

Back spasms: Muscle relaxers could help individuals, along with a personalized physical therapy treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Thoracic Spine Pain


References

Witenko, C., Moorman-Li, R., Motycka, C., Duane, K., Hincapie-Castillo, J., Leonard, P., & Valaer, C. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P & T: a peer-reviewed journal for formulary management, 39(6), 427–435.

Zacny, J. P., Paice, J. A., & Coalson, D. W. (2012). Subjective and psychomotor effects of carisoprodol in combination with oxycodone in healthy volunteers. Drug and alcohol dependence, 120(1-3), 229–232. https://doi.org/10.1016/j.drugalcdep.2011.07.006

How Acupuncture Can Help with Anxiety and Panic Disorders

How Acupuncture Can Help with Anxiety and Panic Disorders

Can acupuncture be an effective treatment for anxiety and panic disorders in addition to other treatments, like therapy and/or medication?

How Acupuncture Can Help with Anxiety and Panic Disorders

Acupuncture For Anxiety and Panic Disorders

Considered one of the most popular types of alternative medicine, acupuncture has grown in popularity as a way to treat a variety of mental health conditions, including depression, post-traumatic stress disorder (PTSD), and other anxiety disorders. With the growth in popularity, more research has been focused on treatment for panic and anxiety symptoms. (Pilkington K. 2010)

  • Acupuncture can enhance personal wellness.
  • Acupuncture is generally safe and has few side effects.
  • It can help reduce physical and mental symptoms like tension, pain, and rapid heart rate.

Other alternative medicine practices include yoga, therapeutic massage, herbal medicines, and aromatherapy.

Traditional Chinese Medicine

Acupuncture is a healing technique originating from traditional Chinese medicine (TCM). The practice is based on the concept that medical conditions and mental health disorders are caused by an imbalance in the energy and circulation of the body’s vital life energy, known as chi or qi (National Institute for Complementary and Integrative Health, 2022). When the body and mind function properly, energy flows optimally through the channels/meridians at certain points throughout the body. Like tight or spasming muscles, energy or circulation becomes congested in different meridian pathways, leading to disease or disorders. The goal of acupuncture is to restore the health and balance of these channels.

How It Works

During acupuncture treatment sessions, small needles are placed along specific body areas, known as acupuncture points. These areas are thought to be where energy blockage occurs. The needles, which come in various thicknesses and lengths, stimulate and open blocked energy channels. Experts have conceptualized acupuncture from a neuroscience perspective, where nerves, muscles, and connective tissues are stimulated, and neurochemicals are released.

  • Acupuncture can help regulate the nervous system.
  • It can stimulate the body’s feel-good hormones and reduce stress hormones.
  • It can help deactivate the analytical brain, which is responsible for anxiety and worries.

Acupuncture is recognized by the National Institutes of Health (NIH) for treating pain management and other medical conditions. (National Institute for Complementary and Integrative Health, 2022)

Effectiveness

Clinical trials examining acupuncture for anxiety and panic disorders have shown some positive results. (Pilkington K. 2010) Acupuncturists and medical professionals are still not clear exactly why it may help with anxiety, but some research has noted that acupuncture appears to have a calming effect. More research studies are needed to prove the effectiveness of acupuncture for anxiety disorders. (Kim Y. K. 2019)

Getting Treated

What it can help with:

  • Agoraphobia
  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Phobias
  • Selective mutism
  • Separation anxiety disorder
  • Social anxiety disorder

If you are interested in treating your anxiety and panic symptoms through acupuncture, the first step is to consult your main healthcare provider. Professional acupuncture practitioners are on websites, including the National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncture. The use of acupuncture continues to rise, making it more readily available. Since it has been evaluated for effectiveness and is available through many hospitals, some insurance policies may cover some acupuncture treatments.

Injury Medical Chiropractic and Functional Medicine Clinic

Acupuncture can help relieve symptoms of anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Discovering The Benefits of Chiropractic Care


References

Pilkington K. (2010). Anxiety, depression, and acupuncture: A review of the clinical research. Autonomic neuroscience : basic & clinical, 157(1-2), 91–95. https://doi.org/10.1016/j.autneu.2010.04.002

National Institute for Complementary and Integrative Health. (2022). Acupuncture: Effectiveness and Safety. Retrieved from https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety

Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3. https://doi.org/10.30773/pi.2019.01.08

Wrist Sprain: What You Need to Know for a Speedy Recovery

Wrist Sprain: What You Need to Know for a Speedy Recovery

Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program?

Wrist Sprain: What You Need to Know for a Speedy Recovery

Wrist Sprain

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include:

  • Pain
  • Swelling
  • Bruising
  • Decreased range of motion
  • Weakness
  • Tingling

The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully.

Grades and Types

The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024)

Grade 1

  • Ligaments are stretched; this is considered a mild sprain.
  • The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)

Grade 2

  • Ligaments are partially torn; this is considered a moderate sprain.
  • It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)

Grade 3

  • Ligaments are torn completely or have pulled away from the bone.
  • Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
  • This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)

The wrist is made up of three joints (American Society for Surgery of the Hand, 2017)

Distal radioulnar

  • This joint is between the two forearm bones.
  • The radius on the thumb side.
  • The ulna on the pinky side.

Radiocarpal

  • This joint is between the radius and three small bones in the base of the hand.
  • The scaphoid
  • The triquetrum
  • The lunate

Ulnocarpal

  • This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.

Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist.

Symptoms

The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024)

  • Decreased range of motion
  • Swelling
  • Bruising
  • Feeling instability in the wrist
  • Weakness
  • Numbness/tingling
  • Popping sensation
  • Warm skin

Causes

The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include:

  • Repetitive overuse work injuries.
  • Housework and tasks.
  • Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.

Diagnosis

A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include:

  • Magnetic resonance imaging – MRI
  • Computed tomography – CT scan
  • Arthrogram -X-rays with contrast dye

Treatment

Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024)

Rest

  • Minimize using the injured wrist for at least two days.
  • Wear a splint for support.
  • Avoid sudden movements.
  • Avoid placing too much pressure on the wrist.

Ice

  • Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.

Compression

  • Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.

Elevation

  • To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.
  1. Grade 1 sprains usually heal with basic care within a week or two.
  2. Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
  3. The removable brace or splint should be worn when using the arm.
  4. It can be taken off at rest at night and when bathing. (National Health Service, 2020)
  5. Individuals may need the brace for a week or more.

A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength.

Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020)

Healing Time

Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Path to Healing Personal Injury


References

National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf

American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases–conditions/wrist-sprains

Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain

American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints

National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html

American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist

Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050

American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament

The Importance of Back Stretching for Pain Relief

The Importance of Back Stretching for Pain Relief

Can knowing how to stretch your back help reduce pain and improve your range of motion?

The Importance of Back Stretching for Pain Relief

Stretch Your Back

Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:

  • When stretching, don’t try to push past your pain limit.
  • Listen to your body, which leads to a calmer nervous system.
  • Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.

Warm Up

Stretching cold muscles can lead to injury. Always warm up first.

  • Do between five and 10 minutes of mild activity, such as walking.
  • Apply heat for 15 to 20 minutes before stretching.

Knees-to-Chest Back Stretch

To perform:

  • Lie on your back with your feet flat on the floor.
  • Bring your legs toward your chest With your knees bent.
  • Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
  • Pull until there is a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Do a total of 10 reps.

Supine Twist Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Prone Bridging Back Stretch

To perform:

  • Lie on your stomach.
  • Prop yourself up on your elbows.
  • Extend your back.
  • Start straightening your elbows, further extending the back.
  • Continue straightening the elbows until the stretch is felt.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Supine Butt Lift Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Push down through the feet as you slowly raise yourself off the floor.
  • Hold for 10 seconds.
  • Return to starting position.
  • Repeat for nine reps.

Seated Forward Curl Back Stretch

To perform:

  • Sit in a chair with your feet flat on the ground.
  • Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Side Stretch

To perform:

  • Stand up straight with your arms at your sides and feet shoulder-width apart.
  • Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
  • Hold for 10 seconds.
  • Repeat for nine reps.

Other Treatments to Loosen a Tight Back

Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)

Acupuncture

  • Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
  • They have an analgesic, pain-relieving effect. (Foley C., & Litscher G. 2024)

Massage Therapy

  • Various massages involve kneading soft tissue in the back with hands, fingers, elbows, or instruments/tools/devices to relieve stress or pain.

Spinal Manipulation

  • Practiced by chiropractors, this therapy involves using the hands or instruments/tools/devices to manipulate the joints in the spine to relieve pain.

Tai Chi

  • Based on martial arts, slow movements, and deep breaths help to work muscle groups in flowing motions, supporting back strength and overall health.

Yoga

  • Yoga combines physical poses, breathwork, and meditation to help build strength, be restorative, and relax the body.

Anti-inflammatory Diet

  • An anti-inflammatory diet can also benefit tight muscles. (U.S. Department of Defense, 2012)
  • Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.


Stretching Benefits


References

Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. https://doi.org/10.1089/acu.2020.1499

Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. https://doi.org/10.1089/acu.2023.0054

U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from https://media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF

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