Certain neurological disorders can cause acute episodes of peripheral neuropathy, and for individuals diagnosed with chronic peripheral neuropathy, can physical therapy help improve the ability to move around safely along with medications, procedures, and lifestyle adjustments to help control and manage symptoms?
Peripheral Neuropathy Treatments
Peripheral neuropathy treatment includes symptomatic therapies and medical management to help prevent worsening nerve damage.
For acute types of peripheral neuropathy, medical interventions and therapies can treat the underlying process, improving the condition.
For chronic types of peripheral neuropathy, medical interventions and lifestyle factors can help to prevent the condition’s progression.
Chronic peripheral neuropathy treatment focuses on controlling the pain symptoms and protecting areas of diminished sensation from damage or infection.
Self-Care and Lifestyle Adjustments
For individuals who have been diagnosed with peripheral neuropathy or are at risk of developing the condition, lifestyle factors play a significant role in managing symptoms and preventing nerve damage from worsening and can even prevent the condition from developing. (Jonathan Enders et al., 2023)
Pain Management
Individuals can try these self-care therapies and see if and which help reduce their discomfort and then develop a routine that they can work off of. Self-care for pain symptoms include:
Placing a warm heating pad on painful areas.
Placing a cooling pad (not ice) on painful areas.
Covering the area or leaving it uncovered, depending on comfort levels.
Wear loose-fitting clothes, socks, shoes, and/or gloves not made with material that can cause irritation.
Avoid using lotions or soaps that can cause irritation.
Use soothing creams or lotions.
Keeping the painful areas clean.
Injuries Prevention
Diminished sensation is one of the most common effects that can lead to problems like stumbling, difficulty getting around, and injuries. Preventing and regularly checking for injuries can help avoid complications like infected wounds. (Nadja Klafke et al., 2023) Lifestyle adjustments to manage and prevent injuries include:
Wear well-padded shoes and socks.
Inspect feet, toes, fingers, and hands regularly to look for cuts or bruises that may not have been felt.
Clean and cover cuts to avoid infections.
Use extra caution with sharp utensils like cooking and work or gardening tools.
Disease Management
Lifestyle factors can help prevent disease progression and are closely correlated with the risks and underlying causes. To help prevent peripheral neuropathy or its progression can be done by: (Jonathan Enders et al., 2023)
Maintain healthy glucose levels if you have diabetes.
Avoid alcohol for any peripheral neuropathy.
Maintain a well-balanced diet, which can include vitamin supplements, especially for vegetarians or vegans.
Over-the-Counter Therapies
A few over-the-counter therapies can help with painful symptoms and can be taken as needed. Over-the-counter pain therapies include: (Michael Überall et al., 2022)
Topical lidocaine spray, patch, or creams.
Capsaicin creams or patches.
Topical Icy Hot
Non-steroidal anti-inflammatory medications – Advil/ibuprofen or Aleve/naproxen
Tylenol/acetaminophen
These treatments can help relieve painful symptoms of peripheral neuropathy, but they do not help improve diminished sensation, weakness, or coordination problems. (Jonathan Enders et al., 2023)
Prescription Therapies
Prescription therapies for treating peripheral neuropathy include pain medications and anti-inflammatories. Chronic types of peripheral neuropathy include:
Alcoholic neuropathy
Diabetic neuropathy
Chemotherapy-induced neuropathy
The prescription treatments for chronic types differ from the treatments for acute types of peripheral neuropathy.
Pain Management
Prescription treatments can help manage the pain and discomfort. Medications include (Michael Überall et al., 2022)
Sometimes, a prescription strength supplement or vitamin B12 given through injection can help prevent progression when peripheral neuropathy is associated with a severe vitamin deficiency. Prescription treatment can help treat the underlying process in some types of acute peripheral neuropathy. Treatment for acute peripheral neuropathy, such as Miller-Fisher syndrome or Guillain-Barré syndrome, can include:
Corticosteroids
Immunoglobulins – immune system proteins
Plasmapheresis is a procedure that removes the liquid portion of blood, returning the blood cells, which modifies the overactivity of the immune system. (Sanja Horvat et al., 2022)
Researchers believe there is an association between these conditions and inflammatory nerve damage, and modifying the immune system is beneficial for treating symptoms and the underlying disease.
Surgery
In some cases, surgical procedures can benefit individuals who have certain types of peripheral neuropathy. When another condition is exacerbating the symptoms or process of peripheral neuropathy, surgery may help relieve symptoms and prevent disease progression. This has proved effective when nerve entrapment or vascular insufficiency are factors. (Wenqiang Yang et al., 2016)
Complementary and Alternative Medicine
Some complementary and alternative approaches can help individuals cope with the pain and discomfort. These treatments can serve as an ongoing option for those who have chronic peripheral neuropathy. Options can include: (Nadja Klafke et al., 2023)
Acupuncture involves the placement of needles in specific areas of the body to help reduce pain symptoms.
Acupressure involves applying pressure on specific areas of the body to help reduce pain symptoms.
Massage therapy can help relax muscle tension.
Meditation and relaxation therapies can help manage symptoms.
Physical therapy can also serve as an important component of living with chronic peripheral neuropathy and recovering from acute peripheral neuropathy.
Physical therapy can help strengthen weak muscles, improve coordination, and learn how to adapt to sensory and motor changes to get around safely.
Individuals considering complementary or alternative treatment are encouraged to speak with their primary healthcare provider to determine whether it is safe for their condition. Injury Medical Chiropractic and Functional Medicine Clinic will work with the individual’s healthcare provider and/or specialists to develop an optimal health and wellness treatment solution to provide pain relief and improve quality of life.
Peripheral Neuropathy: A Successful Recovery Story
References
Enders, J., Elliott, D., & Wright, D. E. (2023). Emerging Nonpharmacologic Interventions to Treat Diabetic Peripheral Neuropathy. Antioxidants & redox signaling, 38(13-15), 989–1000. https://doi.org/10.1089/ars.2022.0158
Klafke, N., Bossert, J., Kröger, B., Neuberger, P., Heyder, U., Layer, M., Winkler, M., Idler, C., Kaschdailewitsch, E., Heine, R., John, H., Zielke, T., Schmeling, B., Joy, S., Mertens, I., Babadag-Savas, B., Kohler, S., Mahler, C., Witt, C. M., Steinmann, D., … Stolz, R. (2023). Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Medical sciences (Basel, Switzerland), 11(1), 15. https://doi.org/10.3390/medsci11010015
Überall, M., Bösl, I., Hollanders, E., Sabatschus, I., & Eerdekens, M. (2022). Painful diabetic peripheral neuropathy: real-world comparison between topical treatment with lidocaine 700 mg medicated plaster and oral treatments. BMJ open diabetes research & care, 10(6), e003062. https://doi.org/10.1136/bmjdrc-2022-003062
Horvat, S., Staffhorst, B., & Cobben, J. M. G. (2022). Intravenous Lidocaine for Treatment of Chronic Pain: A Retrospective Cohort Study. Journal of pain research, 15, 3459–3467. https://doi.org/10.2147/JPR.S379208
Yang, W., Guo, Z., Yu, Y., Xu, J., & Zhang, L. (2016). Pain Relief and Health-Related Quality-of-Life Improvement After Microsurgical Decompression of Entrapped Peripheral Nerves in Patients With Painful Diabetic Peripheral Neuropathy. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 55(6), 1185–1189. https://doi.org/10.1053/j.jfas.2016.07.004
For individuals experiencing back pain from a herniated disc, can understanding the difference between surgery and chiropractic help individuals find the right treatment plan?
Surgery or Chiropractic
Living with back pain can be a nightmare, and yet many struggle without seeking care. Today, there are a vast number of surgeries and noninvasive techniques that are better at treating spine and back problems and managing symptoms. For individuals who may have a herniated disc or are curious about ways to relieve their back pain, a health care provider, physical therapist, spine specialist, and chiropractor can inform them of treatment options. Surgery and chiropractic therapy are popular treatments for a herniated, bulging, or slipped disc.
A herniated disc is when the cartilage discs that cushion the vertebrae shift out of position and leak out.
Surgery for a herniated disc involves removing or repairing the disc.
Chiropractic nonsurgically repositions the disc and realigns the spine.
Both treatments have the same goals with key differences.
Chiropractic Care
Chiropractic is a system of therapy that focuses on adjusting and maintaining spinal alignment to help with back and posture problems. Chiropractors are trained and licensed medical professionals who take a nonsurgical approach, a proven therapy for chronic pain, flexibility, and mobility issues.
The Way It Works
Chiropractic treatment encourages and supports the body’s natural healing processes. It is considered for joint pain in the back, neck, legs, arms, feet, and hands. It typically involves sessions in which the chiropractor physically and carefully adjusts the vertebrae by hand, also known as spinal manipulation or chiropractic adjustments. (MedlinePlus. 2023). A chiropractor performs a thorough medical evaluation and runs tests to establish a diagnosis. A chiropractor will develop a treatment plan that may involve a team of massage and physical therapists, acupuncturists, health coaches, and nutritionists to treat affected areas with various techniques, recommend targeted exercises, adjust lifestyle and nutrition to support the treatment, and monitor progress. Combined with stretching and sustained pressure, the multiple methods can increase joint mobility and relieve pain symptoms. (National Center for Complimentary and Integrative Health. 2019) Added protocols to support or enhance chiropractic therapy include:
Heating and ice therapies to reduce inflammation and increase blood circulation.
Using devices to stimulate muscles and nerves electrically.
Developing relaxation and deep breathing techniques.
Incorporating exercises to promote rehabilitation.
Establishing a regular fitness routine.
Making adjustments to diet and lifestyle.
Taking certain dietary supplements.
Spinal manipulation and chiropractic adjustments have been shown to improve symptoms and restore mobility in cases of chronic back pain. One review found that individuals with chronic lumbar/low back pain reported significant improvement after six weeks of chiropractic treatment. (Ian D. Coulter et al., 2018)
Prices
The out-of-pocket expenses of chiropractic treatment depend on a variety of factors.
Insurance may or may not cover the treatment, and the amount an individual has to pay can vary based on the severity of their case, what their plan covers, and where they live. One review found the cost can range between $264 and $6,171. (Simon Dagenais et al., 2015)
Surgery
There is a range of minimally invasive surgical procedures to treat herniated discs. These work to ease nerve compression by removing or replacing damaged discs or stabilizing the vertebrae, relieving pain and inflammation.
The Way It Works
A herniated disc can happen in any part of the spine but is more common in the lower back/lumbar spine and in the neck/cervical spine. Surgery is recommended when: (American Academy of Orthopaedic Surgeons. 2022)
More conservative treatments, like medications and physical therapy, are unable to manage symptoms.
The pain and symptoms impact daily life and functioning.
Standing or walking becomes difficult or impossible.
The herniated disc causes difficulty walking, muscle weakness, and bladder or bowel control loss.
The individual is reasonably healthy, without infection, osteoporosis, or arthritis.
Specific surgical procedures used include:
Fusion Surgery
Spinal fusion is the most common procedure for a lower back herniated disc.
It involves using artificial bone material to fuse vertebrae to increase stability and release and prevent nerve irritation and compression. (American Academy of Neurological Surgeons. 2024)
Laminotomy and Laminectomy
Herniated disc symptoms appear from compression placed on the nerves.
Laminotomy involves making a small cut in the lamina, or the arch of the spinal vertebrae, to release the pressure.
Another approach involves implanting an artificial disc.
This is most often used for hernia in the lower spine; the worn or damaged disc is removed, and a specialized prosthetic replaces the removed disc. (American Academy of Orthopaedic Surgeons. 2022)
This allows for more mobility.
The success of herniated disc surgery depends on different factors. Advances in minimally invasive techniques have significantly improved long-term outcomes, with one review finding that around 80% reported good—excellent results at a six-year follow-up. (George J. Dohrmann, Nassir Mansour 2015) However, there is the possibility of recurrence. About 20% to 25% of individuals with herniated lumbar discs experience re-herniation at some point. (American Academy of Neurological Surgeons. 2024)
Prices
Surgery for a herniated disc is specialized, and the costs depend on the scope and scale of the treatment.
The individual’s specific insurance plan also determines the expenses.
When choosing between chiropractic and surgery for a herniated disc, a number of factors can determine the decision, including:
Chiropractic is the less invasive nonsurgical option.
Chiropractic adjustments cannot help certain severe cases of herniated discs.
Chiropractic adjustments prevent the herniated disc from getting worse and ease symptoms.
Surgery provides pain and symptom relief faster than chiropractic or conservative treatment but requires significant recovery time and is expensive. (Anna N A Tosteson et al., 2008)
Surgery may not be appropriate for individuals with osteoarthritis or osteoporosis.
Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with surgery. Generally, surgery is only recommended when noninvasive methods haven’t been able to stop or manage the pain and symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.
Quick Patient Process
References
MedlinePlus.MedlinePlus. (2023). Chiropractic. Retrieved from https://medlineplus.gov/chiropractic.html
National Center for Complimentary and Integrative Health. (2019). Chiropractic: in depth. Retrieved from https://www.nccih.nih.gov/health/chiropractic-in-depth
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 18(5), 866–879. https://doi.org/10.1016/j.spinee.2018.01.013
Dagenais, S., Brady, O., Haldeman, S., & Manga, P. (2015). A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC health services research, 15, 474. https://doi.org/10.1186/s12913-015-1140-5
American Academy of Orthopaedic Surgeons. (2022). Herniated disk in the lower back. https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/
American Academy of Neurological Surgeons. Surgeons, A. A. o. N. (2024). Herniated disc. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc
Dohrmann, G. J., & Mansour, N. (2015). Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 24(3), 285–290. https://doi.org/10.1159/000375499
Tosteson, A. N., Skinner, J. S., Tosteson, T. D., Lurie, J. D., Andersson, G. B., Berven, S., Grove, M. R., Hanscom, B., Blood, E. A., & Weinstein, J. N. (2008). The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 33(19), 2108–2115. https://doi.org/10.1097/brs.0b013e318182e390
Spinal stenosis is the term used to describe a narrowing spine. Treatments vary because everybody’s case is different. Some individuals experience mild symptoms, while others experience severe symptoms. Can knowing treatment options help the patient and healthcare team customize and personalize a treatment plan to the individual’s condition?
Spinal Stenosis Treatments
Spaces within the spine can become narrower than they’re supposed to be, which can cause pressure on nerve roots and the spinal cord. Anywhere along the spine can be affected. The narrowing can cause pain, burning, and/or aching in the back and weakness in the legs and feet. Spinal stenosis has several primary treatments. When working through spinal stenosis treatments, a healthcare provider will assess symptoms and start treatment with first-line therapy, such as pain medication and/or physical therapy. These are often the first among individuals with the disease.
Medication
Chronic pain is one of the main symptoms. The first-line treatment often involves using pain-relieving medication/s. Commonly prescribed medications are nonsteroidal anti-inflammatories or NSAIDs. These medications reduce pain and inflammation. However, NSAIDs are not recommended for long-term use, and other medications may need to be used to relieve pain that includes: (Sudhir Diwan et al., 2019)
Tylenol – acetaminophen
Gabapentin
Pregabalin
Opioids for severe cases
Exercise
Exercise can reduce spinal stenosis symptoms by taking pressure off the nerves, which can reduce pain and improve mobility. (Andrée-Anne Marchand et al., 2021) Healthcare providers will recommend the most effective exercises for the individual. Examples include:
Another primary spinal stenosis treatment is physical therapy, which is often used alongside pain medications. Typically, individuals undergo six to eight weeks of physical therapy, with sessions two to three times a week. Utilizing physical therapy has been shown to (Sudhir Diwan et al., 2019)
Reduce pain
Increase mobility
Reduce pain medications.
Reduce mental health symptoms like anger, depression, and mood changes.
For severe cases, physical therapy following surgery can reduce recovery times.
Back Braces
Back braces can help reduce movement and pressure on the spine. This is helpful because even small spinal movements can lead to nerve irritation, pain, and worsening symptoms. Over time, the bracing can lead to a positive increase in mobility. (Carlo Ammendolia et al., 2019)
Injections
Epidural steroid injections may be recommended to relieve severe symptoms. Steroids act as anti-inflammatories to reduce pain and swelling caused by inflammation and irritation of the spinal nerves. They are considered nonsurgical medical procedures. According to research, injections can effectively manage pain for two weeks and up to six months, and some research has found that after a spinal injection, relief can last 24 months. (Sudhir Diwan et al., 2019)
Thickened Ligaments Decompression Procedure
Some individuals may be recommended to undergo a decompression procedure. This procedure involves using a thin needle tool inserted into the back. The thickened ligament tissue is removed to reduce the pressure on the spine and nerves. Research has found that the procedure can reduce symptoms and the need for more invasive surgery. (Nagy Mekhail et al., 2021)
Alternative Treatments
In addition to first-line treatments, individuals may be referred to alternative therapies for symptom management, including:
Acupuncture
This involves the insertion of thin-tipped needles into various acupoints to relieve symptoms.
Some research has found that acupuncture may be more effective at reducing symptoms than physical therapy alone. Both options are viable and can improve mobility and pain. (Hiroyuki Oka et al., 2018)
Chiropractic
This therapy reduces pressure on nerves, maintains spinal alignment, and helps to improve mobility.
Massage
Massage helps to increase circulation, relax the muscles, and reduce pain and stiffness.
New Treatment Options
As spinal stenosis research continues, new therapies are emerging to help relieve and manage symptoms in individuals who don’t respond to traditional medicine or cannot partake in conventional therapies for various reasons. However, some evidence presented is promising; medical insurers may consider them experimental and not offer coverage until their safety has been proven. Some new treatments include:
Acupotomy
Acupotomy is a form of acupuncture that uses thin needles with a small, flat, scalpel-type tip to relieve tension in painful areas. Research on its effects is still limited, but preliminary data shows it could be an effective complementary treatment. (Ji Hoon Han et al., 2021)
Stem Cell Therapy
Stem cells are the cells from which all other cells originate. They act as the raw material for the body to create specialized cells with specific functions. (National Institutes of Health. 2016)
Individuals with spinal stenosis can develop soft tissue damage.
Stem cell therapy uses stem cells to help repair injured or diseased tissues.
Stem cell therapy can help repair or improve the damaged areas and provide symptom relief.
Clinical studies for spinal stenosis report that it could be a viable treatment option for some.
However, more research is needed to confirm whether the therapy is effective enough to be widely used. (Hideki Sudo et al., 2023)
Dynamic Stabilization Devices
LimiFlex is a medical device undergoing research and analysis for its ability to restore mobility and stability in the spine. It is implanted into the back through a surgical procedure. According to research, individuals with spinal stenosis who receive the LimiFlex often experience a higher reduction in pain and symptoms than with other forms of treatment. (T Jansen et al., 2015)
Lumbar Interspinous Distraction Decompression
Lumbar interspinous distraction decompression is another surgical procedure for spinal stenosis. The surgery is performed with an incision above the spine and places a device between two vertebrae to create space. This reduces movement and pressure on the nerves. Preliminary results show positive short-term relief from symptoms; long-term data is not yet available as it is a relatively new spinal stenosis treatment option. (UK National Health Service, 2022)
Surgical Procedures
There are several surgical procedures are available for spinal stenosis. Some include: (NYU Langone Health. 2024) Surgery for spinal stenosis is often reserved for individuals with severe symptoms, like numbness in the arms or legs. When these symptoms develop, it indicates a more notable compression of the spinal nerves and the need for a more invasive treatment. (NYU Langone Health. 2024)
Laminectomy
A laminectomy removes part or all of the lamina, the vertebral bone covering the spinal canal.
The procedure is designed to reduce pressure on nerves and the spinal cord.
Laminotomy and Foraminotomy
Both surgeries are used if an individual’s spinal stenosis negatively affects an opening in the vertebral foramen.
Ligaments, cartilage, or other tissues that constrict the nerves are removed.
Both reduce pressure on the nerves traveling through the foramen.
Laminoplasty
A laminoplasty relieves pressure on the spinal cord by removing parts of the spinal canal’s lamina.
This surgical procedure involves removing herniated or bulging discs that are placing pressure on the spinal cord and nerves.
Spinal fusion
Spinal fusion involves joining two vertebrae using metal pieces like rods and screws.
The vertebrae are more stable because the rods and screws act as a brace.
Which Treatment Is The Right One?
Because all treatment plans differ, determining the most effective is best suited for a healthcare provider. Each approach will be personalized to the individual. To decide what therapy is best, healthcare providers will assess: (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
The severity of symptoms.
The current level of overall health.
The level of damage that’s occurring in the spine.
The level of disability and how mobility and quality of life are affected.
Injury Medical Chiropractic and Functional Medicine Clinic will work with an individual’s primary healthcare provider and/or specialists to help determine the best treatment options and concerns regarding medications or other forms of treatment.
Unlocking Wellness
References
Diwan, S., Sayed, D., Deer, T. R., Salomons, A., & Liang, K. (2019). An Algorithmic Approach to Treating Lumbar Spinal Stenosis: An Evidenced-Based Approach. Pain medicine (Malden, Mass.), 20(Suppl 2), S23–S31. https://doi.org/10.1093/pm/pnz133
Marchand, A. A., Houle, M., O’Shaughnessy, J., Châtillon, C. É., Cantin, V., & Descarreaux, M. (2021). Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial. Scientific reports, 11(1), 11080. https://doi.org/10.1038/s41598-021-90537-4
Ammendolia, C., Rampersaud, Y. R., Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C., & Côté, P. (2019). Effect of a prototype lumbar spinal stenosis belt versus a lumbar support on walking capacity in lumbar spinal stenosis: a randomized controlled trial. The spine journal : official journal of the North American Spine Society, 19(3), 386–394. https://doi.org/10.1016/j.spinee.2018.07.012
Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C., & Saied, O. (2021). The durability of minimally invasive lumbar decompression procedure in patients with symptomatic lumbar spinal stenosis: Long-term follow-up. Pain practice : the official journal of World Institute of Pain, 21(8), 826–835. https://doi.org/10.1111/papr.13020
Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study). BMC complementary and alternative medicine, 18(1), 19. https://doi.org/10.1186/s12906-018-2087-y
Han, J. H., Lee, H. J., Woo, S. H., Park, Y. K., Choi, G. Y., Heo, E. S., Kim, J. S., Lee, J. H., Park, C. A., Lee, W. D., Yang, C. S., Kim, A. R., & Han, C. H. (2021). Effectiveness and safety of acupotomy on lumbar spinal stenosis: A pragmatic randomized, controlled, pilot clinical trial: A study protocol. Medicine, 100(51), e28175. https://doi.org/10.1097/MD.0000000000028175
Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, Y. M., Kahata, K., Tha, K. K., Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N., & Isoe, T. (2023). Protocol for treating lumbar spinal canal stenosis with a combination of ultrapurified, allogenic bone marrow-derived mesenchymal stem cells and in situ-forming gel: a multicentre, prospective, double-blind randomised controlled trial. BMJ open, 13(2), e065476. https://doi.org/10.1136/bmjopen-2022-065476
National Institutes of Health. (2016). Stem cell basics. U.S. Department of Health and Human Services. Retrieved from https://stemcells.nih.gov/info/basics/stc-basics
Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D., & Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [A Comparison of Dorsal Decompression and Dorsal Decompression Combined with the Dynamic Stabilisation Device LimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. https://doi.org/10.1055/s-0035-1545990
UK National Health Service. (2022). Lumbar decompression surgery: How It’s performed. https://www.nhs.uk/conditions/lumbar-decompression-surgery/what-happens/
NYU Langone Health. (2024). Surgery for spinal stenosis. https://nyulangone.org/conditions/spinal-stenosis/treatments/surgery-for-spinal-stenosis
Columbia Neurosurgery. (2024). Cervical laminoplasty procedure. https://www.neurosurgery.columbia.edu/patient-care/treatments/cervical-laminoplasty
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Spinal stenosis: Diagnosis, treatment and steps to take. Retrieved from https://www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take
Functional medicine is about taking the human body and treating it as a whole. The human body has many systems but they all work together to maintain homeostasis. In many cases with traditional medicine, a patient with headaches, joint pain, inflammation, and fatigue will be referred to many specialists to treat each individual symptom.� However, by looking at the entire body as a whole and digging into the root cause of the issue and not just the symptom itself, a lot can be revealed.
With functional medicine, often times a series of labs are run that look deeper than the typical basic blood panel. In traditional medicine, a glucose and AHb1c test will be done to assess diabetes. In functional medicine, a deeper test is ordered to rule out other possibilities and practitioners are able to view all components of diabetes including , Adiponectin, Insulin.� This allows a deeper understanding of what is happening inside the body and how to best treat it.�
With this being said, there are many labs that functional and integrative medicine practitioners utilize, each specializing in their own unique panels. The average integrative practice uses an average of 5-10 different lab companies for their patients to have the best care. Eight of the most utilized lab companies are:
Diagnostic Solutions offer many tests but their specialty lies within their GI Map. This test measures the gastrointestinal microbiota DNA from a stool sample. This allows practitioners to see and detect the exact microbes that may be causing a disturbance in the gut or a factor contributing to illness.
Vibrant Wellness has a wide variety of tests but one of the most frequently used is the food sensitivity panel. This allows practitioners to see what foods their patients are consuming that are creating havoc for their gut health.
SpectraCellstarted as a nutritional testing company but has since evolved into a lab that tests cellular nutrition, cardiometabolic health, hormone balances, and genetic predisposition.
Precision Analytical (the D.U.T.C.H test) the D.U.T.C.H test stands for Dried Urine Test for Comprehensive Hormones and takes a look at adrenal and hormone imbalances.
Genova Diagnostics has a wide variety of tests but one of the most common is the GI Effects Comprehensive Profile. This test takes a patient’s stool and detects an organism’s DNA as part of a comprehensive assessment.
Doctors Data provides a wide array of functional testing to provide patients with the best outcomes. Some tests include Environmental Exposure and Detoxification, Toxic and Essential Elements, and Allergy and Immunity.
Cyrex categories their tests as “arrays”. These arrays test for things like diabetes autoimmune reactivity,� The blood-brain barrier, Mucosal Immune Reactivity and more.
Dunwoody Labs offers food sensitivity testing, adrenal, neurotransmitters and many more. Dunwoody can test for specific IgE and IgG4 molecules.
The patient’s health comes first, and getting down to the underlying issues sometimes requires one than one lab company. These companies use the top of the line technology to ensure their patients and physicians obtain the most accurate results for optimal healing.
It is important to make sure the patient gets the best possible care available. This usually means ordering different labs from different companies to obtain the best results. Each lab is great in its own way, but they often specialize in a certain area. This is key because it often allows the patient and the practitioner to get the highest quality of results. A practitioner who uses multiple labs is educated on the subject and truly cares for their patients. – Kenna Vaughn, Senior Health Coach�
*The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. 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.�
Health coaches are becoming more and more crucial as modern medicine continues to improve. Now more than ever, the health care field is progressing at high speeds and professionals do not always have the available time some patients desire. Here is where health coaches become involved. Basically, the position of a health coach was produced to fill the emptiness in several doctor offices. Many physicians contribute but do not have the time or resources to assist each individual and aid in constructing healthy habits on a day to day basis. However, health coaches are available to be a supportive mentor that assists and guides patients in making healthy lifestyle changes. Many patients who seek help to change their lifestyle are those suffering from some kind of chronic pain, headaches, or joint inflammation.
In the previous weeks, we have defined and explained what a health coach is and what they really do, as well as the first two steps a health coach might take with a patient. Throughout this article, the third and fourth steps will be broken down and analyzed.
Need a refresher? No problem!
Health Coaching in El Paso: Part 1 can be found by clicking here.�
Health Coaching in El Paso: Part 2 can be found by clicking here.�
Step 3: Building A Plan For Action
Once the health coach understands the values and goals of the patient, a plan for change can get mapped out. One thing that is unique about building a plan, is that the health coach encourages the patient to have a say in it and contribute to building the plan. The ways of medicine have changed, and this aspect is one of them. Before, many patients would sit silently as doctors instructed them on their new protocol. However, it has been shown that patients who build a plan of action with the practitioner, are more likely to comply and complete a program.
In addition to this, the perspective of the patient can help maintain expectations and keep the plan of action at a realistic timeline. The health coach will offer their suggestions during this process as well as their perspective. Often times, this will help the patient break down their overall goal, into smaller more specific goals or tasks.
As soon as the overall goals are broken down into specific tasks, the health coach will then map out the process to complete these tasks. It can be simple to overlook small steps when thinking of a bigger picture, so the health coach will provide tools to better help the patient understand.
An example of this would be for a patient who wants to lose weight. Mapping out these tasks will have an end result that looks similar to these:
� I will try a new fruit and vegetable every day this week and identify what I enjoy
� I will think of different, creative ways to work movement into my day, such as finding a walking trail in my neighborhood
� I will always keep a water bottle with me and refill it every two hours
� I will cook dinner two nights this week
� I will go for a walk after dinner every day this week
By providing the patients with these smaller tangible tasks, the patient now has “homework” in a sense to complete these throughout the week. The health coach will set a deadline with these tasks and check-in with the patient regularly to ensure they are on track.
Step 4: Tracking Progress And Results
Before progress can be tracked, the health coach will take into consideration the patient’s goal and determine how often the patient will need to come in for follow-ups. For many patients, a combination of follow up techniques are used. Health coaches understand that in-person is not always the most convenient and does not always fit into the patient’s schedule. If this is the scenario, health coaches work around that to create follow-ups by using some in-person visits, some phone conversations, or other virtual check-in meetings that are HIPAA compliant.
Often times, during a lifestyle change patients may become confused or discouraged. It is important to remember that this is normal and progress is not always a straight line up, but rather includes bumps along the way. In order to better help the patient, the health coach will provide them with a helpful “where to turn” guide.
As humans, at different times we require different types of support. The where to turn guide will be a supporting reminder of things to do to counteract these feelings when they arise. Items included in this guide will be ideas such as:
� Pursuing a hobby, like dancing or playing an instrument
� Getting out in nature
� Starting a mindfulness practice
� Making art, like drawing or writing
� Joining a community, religious, or spiritual group
In addition to these activities, the health coach will determine with the patient what kind of support (internal or external) is appropriate depending on the situation.
Lastly,� progress does not always look like a dip in the number on the scale. Progress can come in many different forms. In order to help the patient appreciate and realize all the progress they are making, a health coach will ask questions like:
1. How can you appreciate your progress?
2. How would you describe the benefits of your experience?
3. What�s been good about this experience?
4. How have you grown?
As mentioned earlier, a health coach is important to have as they help one realize all the steps it truly takes to be successful and reach their health goals. There are many critical steps that are easily overlooked when the big picture is on their minds. The final two steps that a health coach will work on with a patient is to help them visualize their best self and to create a plan for resiliency. These two topics will be discussed in the next article.
�Using a health coach to complete a lifestyle change is similar to the work of going to therapy. One must be willing to accept the tools and resources they are givien, and actually do the work provided or it will not produce results. If a patient is truly serious about completing a lifestyle change, using a health coach is an extremly beneifical resource! As one can see, they work with the patients to hammer down tasks and ideas that a patient might not have orignally thought of. By utilizing a health coach, the patient has a higher chance of reaching their goals. – Kenna Vaughn, Senior Health Coach
All information and resources for this post came from an Integrative Practioner article titled, “A Six-Step Approach To Health And Wellness Coaching: A Toolkit for Practice Implementation” and can be found by clicking here; as well as listed below in the proper bibliography.
*The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. 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. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Bibliography:
American Psychological Association (2019). The Road to Resilience. Retrieved from: https://www.apa.org/helpcenter/road-resilience
Jonas, W. (2019). Empowering patients with chronic diseases to live healthier through health coaching: Integrative primary care case study. Samueli Integrative Health Programs.�Retrieved from: https://www.health.harvard.edu/staying-healthy/give-yourself-a-health-self-assessment
Miller, W. and Rose, G. (1991). Motivational Interviewing: Preparing People to Change Addictive Behavior. Guilford Publications.
Pecoraro, Wendy. �A Six-Step Approach to Health and Wellness Coaching: A Toolkit for Practice Implementation.� Official Media Integrative Practitioner, 17 Oct. 2019, www.integrativepractitioner.com/resources/e-books/a-six-step-approach-to-health-and-wellness-coaching-a-toolkit-for-practice-implementation.
Trzeciak, S. and Mazzarelli, A. (2019). Compassionomics. Studer Group. Virginia Polytechnic Institute and State University. The Stages of Change.Retrieved from: http://www.cpe.vt.edu/gttc/presentations/8eStagesofChange.pdf
Your Coach (2009). SMART goals.Retrieved from: https://www.yourcoach.be/en/coaching-tools/
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