Individuals who engage in a regular fitness regimen can begin to lose interest and motivation. Can knowing the signs of exercise burnout help individuals rediscover their motivation?
Exercise Burnout
When maintaining fitness and health becomes a chore and doing anything else is better than working out, individuals could be experiencing exercise burnout. Here are a few signs an individual is getting burned out.
Procrastination
One sign is constantly putting things off.
An individual may put on workout clothes, set up the equipment, etc.
However, the workout never happens as the individual continues to find other things to do.
At some point, they decide it’s too late and they’ll work out tomorrow.
Solution
Simplify the workout. Make some small goals or adjustments and keep the workout light. (Nemanja Lakicevic, et al., 2020) An example could be:
Focus only on stretching.
Take a walk around the block.
Go up and down some stairs equivalent to a few laps.
Do 10 pushups, 10 squats, and 10 lunges, or other exercises and that’s it.
No Longer Interesting
When burned out, exercise is not interesting and disenchanting. (Franklin Velasco, Rafael Jorda. 2020) Trainers will suggest finding something positive about the workouts.
When the interest and passion are nowhere to be found don’t engage in the usual workouts, as this can further decrease motivation.
This is the time to change up the routine and go for a leisurely bicycle or rollerblade, skateboard, etc., session.
Go to a park, just walk around, and forget about exercise just taking in everything.
Play a game with a friend or toss a ball around.
Exhaustion
Not just physical, but mental fatigue could be a sign of exercise burnout.
Solution
Rest.
Individuals may think they have to work out every day and stick to the regimen or else they’ve failed.
This type of mindset can lead to burnout and added stress.
The body and mind require adequate recovery time.
Forget about structured exercise for a day, and see how the mind and body feel the next day.
Two or three days off in a row can make a significant difference in motivation and offer a new perspective on the workout routine.
Low Energy Levels After Exercise
Workouts, although tiring in a good way, should energize the individual. Most workouts should leave the body feeling better than before. When the body feels worse or energy levels are low, this could be a sign of overtraining that could lead to exercise burnout.
Solution
This could be the time to ease off of the fitness regimen.
This is a form of active recovery, allowing the mind and body to rest from the overwork.
Mood Changes and/or Irritability
When the mind and body are overworked and over-trained, it can cause moodiness, irritability, and frustration that leads to burnout.
Solution
Do something that feels good. This could include:
A therapeutic massage.
A spa session.
Taking a long nap.
Soaking the feet.
Taking a therapeutic bath.
Meditation
Burnout can happen, the objective is to keep the solutions simple like taking a few days off or trying something new to come back feeling refreshed and energized.
Multidisciplinary Evaluation and Treatment
References
Lakicevic, N., Gentile, A., Mehrabi, S., Cassar, S., Parker, K., Roklicer, R., Bianco, A., & Drid, P. (2020). Make Fitness Fun: Could Novelty Be the Key Determinant for Physical Activity Adherence?. Frontiers in psychology, 11, 577522. https://doi.org/10.3389/fpsyg.2020.577522
Velasco, F., & Jorda, R. (2020). Portrait of Boredom Among Athletes and Its Implications in Sports Management: A Multi-Method Approach. Frontiers in psychology, 11, 831. https://doi.org/10.3389/fpsyg.2020.00831
Individuals diagnosed with peripheral neuropathy, or with small fiber neuropathy, can understanding symptoms and causes help with potential treatments?
Small Fiber Neuropathy
Small fiber neuropathy is a specific classification of neuropathy, as there are different types, which are nerve injury, damage, disease, and/or dysfunction. Symptoms can result in pain, loss of sensation, and digestive and urinary symptoms. Most cases of neuropathy like peripheral neuropathy involve small and large fibers. Common causes include long-term diabetes, nutritional deficiencies, alcohol consumption, and chemotherapy.
Small fiber neuropathy is diagnosed after diagnostic testing showing it is clear that the small nerve fibers are involved.
The small nerve fibers detect sensation, temperature, and pain and help regulate involuntary functions.
Isolated small-fiber neuropathy is rare, but research is ongoing on the type of nerve damage and potential treatments. (Stephen A. Johnson, et al., 2021)
Small fiber neuropathy is not specifically dangerous but is a sign/symptom of an underlying cause/condition that is damaging the body’s nerves.
Pain – symptoms can range from mild or moderate discomfort to severe distress and can happen at any time.
Loss of sensation.
Because the small nerve fibers help with digestion, blood pressure, and bladder control – symptoms of autonomic dysfunction can vary and can include:
Constipation, diarrhea, incontinence, urinary retention – the inability to completely drain the bladder.
If there is progressing nerve damage, the intensity of the pain can decrease, but the loss of normal sensation and autonomic symptoms can worsen. (Josef Finsterer, Fulvio A. Scorza. 2022)
Hypersensitivity to touch and pain sensations can cause pain without a trigger.
The loss of sensation can make individuals unable to accurately detect sensations of touch, temperature, and pain in affected areas, which can lead to various types of injuries.
Although more research is needed, certain disorders that were not considered neuropathies may have small fiber neuropathy components involved.
A study suggested that neurogenic rosacea, a skin condition, could have some elements of small fiber neuropathy. (Min Li, et al., 2023)
These small nerve fibers are distributed throughout the body including the tops of the fingers and toes, trunk, and internal organs.
These fibers are usually located in the superficial areas of the body, such as close to the skin’s surface. (Mohammad A. Khoshnoodi, et al., 2016)
The small nerve fibers that get damaged are involved in transmitting pain and temperature sensations.
Most nerves have a special type of insulation called myelin that protects them and increases the speed of nerve impulses.
Small nerve fibers may have a thin sheath, making them more susceptible to injury and damage at earlier stages of conditions and diseases. (Heidrun H. Krämer, et al., 2023)
Individuals At Risk
Most types of peripheral neuropathy cause damage to the small and large peripheral nerve fibers. Because of this, most neuropathies are a mix of small-fiber and large-fiber neuropathy. Common risk factors for mixed fiber neuropathy include: (Stephen A. Johnson, et al., 2021)
Diabetes
Nutritional deficiencies
Overconsumption of alcohol
Autoimmune disorders
Medication toxicity
Isolated small-fiber neuropathy is rare, but there are conditions that are known to contribute to the cause and include: (Stephen A. Johnson, et al., 2021)
Sjogren Syndrome
This autoimmune disorder causes dry eyes and mouth, dental problems, and joint pain.
It can also cause nerve damage throughout the body.
Fabry Disease
This condition causes a buildup of certain fats/lipids in the body that can lead to neurological effects.
Amyloidosis
This is a rare disorder that causes a buildup of proteins in the body.
The proteins can damage tissues like the heart or nerves.
Lewy Body Disease
This is a neurological disorder that causes dementia and impaired movement and can lead to nerve damage.
Lupus
This is an autoimmune disease that affects joints, skin, and sometimes nerve tissue.
Viral Infection
These infections typically cause a cold or gastrointestinal/GI upsetness.
Less often they can cause other effects like small fiber neuropathy.
These conditions have been seen to cause isolated small-fiber neuropathy or begin as small-fiber neuropathy before progressing to the large nerve fibers. They can also begin as a mixed neuropathy, with small and large fibers.
Progression
Often the damage progresses at a relatively moderate rate, leading to added symptoms within months or years. The fiber nerves that are affected by the underlying condition usually progressively deteriorate, regardless of where they are located. (Mohammad A. Khoshnoodi, et al., 2016) Medications can help alleviate damage to the peripheral nerves. For individuals that are diagnosed in the early stage, it is possible to stop the progression, and potentially prevent involvement of the large fibers.
Treatments
Treatment toward preventing the progression requires controlling the underlying medical condition with treatment options depending on the cause. Treatments that can help prevent the progression include:
Blood sugar control for individuals with diabetes.
Immune suppression for control of autoimmune diseases.
Plasmapheresis – blood is taken and the plasma is treated and returned or exchanged for the treatment of autoimmune diseases.
Symptom Treatment
Individuals can get treatment for the symptoms that will not reverse or cure the condition but can help with temporary relief. Symptomatic treatment can include: (Josef Finsterer, Fulvio A. Scorza. 2022)
Pain management can include medications and/or topical analgesics.
Physical therapy – stretching, massage, decompression, and adjustments to keep the body relaxed and flexible.
Rehabilitation to help improve coordination, which can be impaired by loss of sensation.
Medications to relieve GI symptoms.
Wearing specialized clothes such as neuropathy socks to help with foot pain symptoms.
Treatment and medical management of neuropathies usually involve a neurologist. A neurologist may prescribe medication to help alleviate pain symptoms and provide medical interventions like immunotherapy if there is concern that an autoimmune process could be the cause. Additionally, treatment could include the care of a physical medicine and rehabilitation physician or a physical therapy team to provide stretches and exercises to help strengthen the body and maintain mobility and flexibility.
Peripheral Neuropathy Myths & Facts
References
Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. https://doi.org/10.1212/WNL.0000000000012894
Finsterer, J., & Scorza, F. A. (2022). Small fiber neuropathy. Acta neurologica Scandinavica, 145(5), 493–503. https://doi.org/10.1111/ane.13591
Krämer, H. H., Bücker, P., Jeibmann, A., Richter, H., Rosenbohm, A., Jeske, J., Baka, P., Geber, C., Wassenberg, M., Fangerau, T., Karst, U., Schänzer, A., & van Thriel, C. (2023). Gadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers. Journal of neurology, 270(8), 3981–3991. https://doi.org/10.1007/s00415-023-11740-z
Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., & Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Frontiers in pain research (Lausanne, Switzerland), 4, 1122134. https://doi.org/10.3389/fpain.2023.1122134
Khoshnoodi, M. A., Truelove, S., Burakgazi, A., Hoke, A., Mammen, A. L., & Polydefkis, M. (2016). Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA neurology, 73(6), 684–690. https://doi.org/10.1001/jamaneurol.2016.0057
Osteoid osteoma refers to a benign tumor/s that can grow on the spine as well as other areas of the body. They are not cancerous, but they can cause pain and abnormal curvature of the spine. It can begin as a small benign spinal tumor that can cause pain, especially at night. They do respond well to over-the-counter pain relievers and can go away on its own. However, if symptoms are unmanageable, other treatments are available.
Osteoid Osteoma
Osteoid means a type of tissue that eventually turns to bone. Osteoma means a type of tumor unique to bones. They are small typical size is less than one inch across. These growths represent around ten percent of all benign bone tumors, with one percent representing spinal tumors.
They can appear and also affect the bones of the arms, hands, fingers, ankles, or feet. They are discovered on the spine around fifteen percent of the time. Osteoid osteomas of the spine affect the posterior, or back area of the vertebrae rather than the anterior, or front region. However, any area of the spine could be affected. But they are most common in the low back.
60% affect the lumbar spine lower back
27% affect the cervical spine or neck region
12% affects the thoracic spine or middle back
Risks
Osteoid osteoma is not cancerous and will not spread out to the various organ systems the way malignant cancer does. It can be discomforting, painful, and could have to be removed. There are some risks associated with osteoid osteomas including:
Scoliosis
It could provoke muscle spasms of the erector spinae. These are the muscles that support the spine and could lead to scoliosis. The spine has a natural curvature. Scoliosis generates an S or C shaped curve to the left, right, or both ways affecting function and mobility. This type is more likely to contribute to the left or right curve of the spine affecting the lower back.
Incorrect diagnosis
Because osteoid osteoma can cause scoliosis, sometimes a doctor will focus on treating the abnormal curve instead of the osteoma.
Nerve root compression
Most individuals do not pose a risk for nerve root compression. But there is a risk if the growth begins to press against the spinal cord, as it can interfere with nerve function. This can lead to spreading/radiating pain and sciatica.
Causes
The causes of osteoid osteoma are not completely understood. What is known is that men are three times more likely to be diagnosed than women. Young people also pose a risk at development. It can develop at any age, but around eighty percent are diagnosed in individuals under 30 years of age. The core of an osteoma is a growth called a nidus. Inside are growing tumor cells, blood vessels, along with cells that progress to bone. A bony shell encapsulates the whole thing.
Signs and Symptoms
Osteoid osteomas usually cause a dull ache at the site of the tumor along with muscle spasms. The pain often gets worse at night. It can be relieved with non-steroidal anti-inflammatory medications like ibuprofen and aspirin. The pain can also be sharp, and occur during the day, worsening with activity and sometimes progressing to severe pain over time. In some cases, however, there are no symptoms.
Diagnosis
Doctors usually notice painful or swollen soft tissue around the tumor during a physical examination. There could be a lump, but this is rare. Imaging tests like an X-ray or a CT scan will be ordered. An x-ray can show the bone thickening, but a CT scan will show the nidus clearly as a dark center surrounded by white cortical bone. Sometimes a CT and MRI imaging scan is used in conjunction to diagnose osteoid osteomas. In some cases, a biopsy could be needed. This is taking a tissue sample and sending it to a lab to be examined under a microscope. However, this is rarely needed.
Treatment
Nonsurgical
Non-steroidal anti-inflammatory medications can be effective relieving symptoms. If it can be controlled with just medication, then this could be the only treatment necessary. Some patients do well trying a different painkiller if the preferred medication no longer works. This needs to be discussed with your doctor, as chronic medication use is associated with issues like ulcers, kidney damage, and concerns about opioid addiction. When this approach is taken, the pain lasts for about three years with the lesion breaking down in five to seven years.
Surgical
If the pain cannot be controlled or the osteoma develops to scoliosis, surgery could be the next step. Most spinal osteomas are surgically removed with open curettage. It is a small incision. The nidus is scooped/scraped out and the cavity walls are removed with a motorized burr. Often a small amount of bone graft material is used to fill in the area. Unfortunately, surgical resection means having to stay at the hospital. Recovery time can be painful.
Radiofrequency ablation
For osteomas that affect the bones other than the spine, radiofrequency ablation. It is a minimally invasive outpatient procedure with a short recovery time. During the procedure, radiofrequency waves generate heat within the nidus around six minutes destroying the tumor. Surgeons use CT scans to precisely target the tumor. The procedure takes one to two hours and afterward, the patient waits in a recovery room for up to four hours.
However, radiofrequency ablation is not as commonly used to treat spinal osteomas. This comes from the risk of thermal nerve damage. The needle tip can reach 194 degrees Fahrenheit, which is more than enough to damage the nerves. Candidates for radiofrequency ablation are usually young patients with no history of neurological problems. Osteoid osteoma is not as scary as it sounds, remember the best defense is a knowledgeable doctor and chiropractor. If back pain is presenting, do not wait to get treatment. There is a spine specialist who can help.
Chronic Pain Chiropractic Relief
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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*
There is a small muscle deep in the buttocks, known, as the,�piriformis muscle.� This small muscle performs an essential function of rotating the leg outwards. Piriformis Syndrome is a condition that occurs when the muscle becomes tight and intrudes on the sciatic nerve. This causes pain, tenderness and sometimes numbness in the buttocks, which can also radiate down the leg and into the calf.
Potential causes for piriformis syndrome�are sitting for prolonged periods, which can tighten the muscle and an injury to the buttocks. This can come from a fall, accident, or sports injury. Trauma causes the small muscle to swell and irritate the sciatic nerve.
Muscle spasms can also cause piriformis syndrome, however, the cause of the spasms is still unknown.
Once an individual has piriformis syndrome, the condition can comeback periodically.
Piriformis Syndrome Small Muscle Treatment
Treatment options frequently used:
Medication
Over-the-counter or prescribed pain medicines, anti-inflammatory drugs, or muscle relaxers frequently serve to reduce the pain from piriformis syndrome. A doctor may also inject medicine directly into the piriformis muscle to improve the condition.
Heat
A common way to relax tight muscles is to apply heat. Piriformis syndrome sufferers may find relief from painful symptoms by periodically applying heat directly to the tender area.
Heat therapy�can relieve tightness of the muscle and promote healing of the area. Avoid treating the muscle with heat if the muscle may be torn.
Exercise
A proper exercise schedule will loosen the muscle and alleviate the symptoms. A chiropractor can prescribe the correct exercises to stretch and strengthen the muscle.
Manual�Therapy
Combined with other treatments or on their own. Massage is used for piriformis syndrome. This helps increase blood flow to the area. The massage therapist can manipulate the area to relieve tightness.
Chiropractic Care
Chiropractors view the entire body. They may treat other parts of the body, such as a foot or leg, in order to improve the condition of the piriformis muscle. They may also utilize pelvic and spinal adjustments, along with joint manipulation to stretch and loosen up the muscle.
It’s vital to take precautions to avoid re-aggravating the muscle. Proper stretching before exercise, periodic breaks when sitting. Spinal and pelvic maintenance will increase an individual’s chances of living pain free.
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