Understand the key aspects of spinal prevention from auto injuries and protect your spine while you travel.
Buckle Up for Safety: Reducing Auto Injuries with Seatbelts and Expert Care
Imagine cruising down the highway, the wind in your hair (or at least through the air vents), feeling as invincible as Herman Munster behind the wheel of the Munster Koach. But even a big, strong guy like Herman knows that one simple click of a seatbelt can make all the difference when the unexpected happens. Motor vehicle accidents (MVAs) are a leading cause of injuries worldwide, and in the United States, millions of people face the consequences of car crashes each year. From minor bumps to life-changing spinal injuries, the impact of these accidents can be profound. Fortunately, seatbelts and expert medical care, like that provided by Dr. Alexander Jimenez in El Paso, can help reduce the toll of these injuries.
In this blog post, we’ll delve into the clinical reasons why seatbelts are essential for preventing auto injuries, examine how these injuries can lead to cervical pain (that pesky neck ache), and highlight the role of chiropractic care in recovery. We’ll also shine a spotlight on Dr. Jimenez, a local hero for personal injury victims, who combines medical expertise with legal know-how to help patients get back on their feet. So, buckle up—let’s take a ride through the world of auto injury prevention and healing, with a touch of humor to keep things light!
The Impact of Auto Injuries
Car accidents happen every day—over 36,000 daily in the U.S., according to the National Safety Council. While many are minor fender-benders, more than 25% result in injuries serious enough to send someone to the emergency room. That’s nearly 3.5 million ER visits annually! Among the most common and troublesome injuries are those to the spine, which includes the cervical (neck), thoracic (mid-back), and lumbar (lower back) regions.
Spinal injuries can range from annoying to life-altering. Here’s a quick rundown of the main culprits:
Whiplash: Picture your head snapping back and forth like a bobblehead doll in a rear-end crash. That’s whiplash, a soft tissue injury that strains neck muscles and ligaments, causing pain and stiffness.
Herniated Discs: The force of a crash can displace the cushiony discs between your vertebrae, leading to pain, numbness, or weakness.
Fractures: High-impact collisions can cause vertebrae to crack or shatter, sometimes requiring surgical intervention.
Spinal Cord Injuries: The most severe injuries can cause partial or complete paralysis, depending on where and how badly the spinal cord is damaged.
These injuries don’t just hurt—they can disrupt your daily life, from missing work to struggling with simple tasks like turning your head. That’s why preventing them, or at least minimizing their severity, is so important.
Seatbelts: Your First Line of Defense
Seatbelts are like the unsung heroes of car safety, quietly saving lives every day. From 1975 to 2017, they’re estimated to have saved 374,276 lives, according to Injury Facts. In 2017 alone, seatbelts saved nearly 15,000 lives in the U.S. (The Zebra). The NHTSA reports that lap and shoulder belts cut the risk of fatal injury for front-seat passengers by 45% and moderate to critical injuries by 50%. That’s a pretty big deal for a simple strap!
But seatbelts aren’t perfect. A study by Rao et al. (2014) found that while three-point seatbelts (the kind with both lap and shoulder straps) reduce overall injury severity and death rates, they’re linked to a higher chance of thoracic and lumbar spine fractures, particularly burst fractures (Spine Journal). In their analysis of 4,572 crash victims from 1996 to 2011, 35.3% of belted occupants had thoracic or lumbar injuries compared to 11.6% of unbelted ones. However, belted folks had lower injury severity scores (25 vs. 29.7) and fatality rates (9% vs. 16.5%).
So, what’s the deal? Seatbelts work by spreading the crash force across your chest and pelvis—strong parts of your body—keeping you from flying out of the car or smashing into the dashboard. This restraint is a lifesaver, but it can put extra pressure on your spine, especially in high-speed crashes. Even so, the trade-off is clear: a possible fracture is far better than a fatal injury or severe brain trauma.
Table 1: Seatbelt Impact on Thoracic and Lumbar Spine Injuries (Rao et al., 2014)
Group
T&L Injury Incidence
Major Injuries
Minor Injuries
Mean ISS
Fatality Rate
Three-Point Belted
35.3% (365/1033)
18.4% (190/1033)
16.9% (175/1033)
25
9% (33/365)
Unbelted
11.6% (158/1360)
5.6% (76/1360)
6% (82/1360)
29.7
16.5% (26/158)
Despite the fracture risk, seatbelts protect against neurologic injuries, which can leave you paralyzed or worse. They also reduce the chance of being ejected from the vehicle, a major cause of death in crashes. So, even if Herman Munster’s neck is as sturdy as a steel beam, he’d still buckle up to avoid a bumpy ride to the hospital!
Why Seatbelts Matter: The Clinical Rationale
Why do doctors and safety experts keep harping on about seatbelts? Because the science backs them up. Seatbelts are the single most effective way to reduce the risk of death and serious injury in a car crash. Here’s why:
Lives Saved
The numbers don’t lie. Seatbelts have been saving lives for decades, with nearly 15,000 people spared in 2018 alone (The Zebra). They prevent nearly 50% of all automobile deaths, and only 1% of belted passengers are ejected during a crash, compared to 75% of those who die after being thrown from the vehicle.
How They Work
Seatbelts are like a trusty sidekick, holding you in place when chaos strikes. During a crash, they lock tight, distributing the force across your chest and hips, which are built to handle it. This keeps your head and neck from slamming into the steering wheel or windshield. Airbags help, too, but they’re designed to work with seatbelts, not replace them. Belted occupants with airbag deployment had even lower injury severity scores (22.9) and fatality rates (5.3%) in the Rao study.
Reducing Severity
Even when injuries occur, seatbelts make them less severe. A BMC Public Health study found that seatbelt use cuts the risk of spinal injuries by 44% (RR = 0.56, 95% CI = 0.37 to 0.84), along with facial and abdominal injuries. While the study noted no significant difference for neck or thoracic injuries, the overall harm reduction is undeniable.
The Catch
Seatbelts aren’t a magic shield. They can cause injuries like bruises, rib fractures, or sternal fractures, especially in high-speed crashes. The Rao study highlighted that three-point belts are linked to burst fractures in the spine, and older or heavier individuals may face extension injuries. But these risks pale in comparison to the alternative—unbelted crashes often lead to catastrophic outcomes like fracture-dislocations or severe organ damage.
So, the clinical takeaway? Seatbelts are your best bet for staying safe, even if they carry a small risk of specific injuries. It’s like choosing a helmet for a bike ride—sure, it might mess up your hair, but it’s better than a trip to the ER!
Cervical Pain: The Whiplash Woes
Now, let’s zoom in on the neck, or cervical spine, which often bears the brunt of auto injuries. If you’ve ever felt like your neck was auditioning for a horror movie after a fender-bender, you might have experienced whiplash. This injury is the poster child for MVAs, especially rear-end collisions, and it’s a major cause of cervical pain.
What Is Whiplash?
Whiplash happens when your head whips back and forth faster than a Munster family dance party. The sudden motion stretches and tears the muscles, ligaments, and tendons in your neck, leading to pain and stiffness. It’s most common in rear-end crashes, where the seat pushes your body forward, but your head lags, snapping backward before jerking forward again (Johns Hopkins Medicine).
A 2005 study cited by Grigory Goldberg, MD, found that 83% of individuals involved in collisions experience whiplash. That’s a lot of sore necks! Even low-speed crashes, as slow as five mph, can cause it, especially if you have a pre-existing neck issue or poor posture in the car (Thompsons Scotland).
Symptoms of Whiplash
Whiplash symptoms can sneak up on you, sometimes not showing up until hours or days after the crash. Common signs include:
Neck pain and stiffness
Headaches, often at the base of the skull
Dizziness or vertigo
Blurred vision
Fatigue
Trouble concentrating or remembering
Sleep problems
Tinnitus (ringing in the ears)
In severe cases, you might feel weakness in your arms or legs, indicating nerve damage. These symptoms can last a few days or, for some unlucky folks, turn into chronic pain known as whiplash-associated disorders (WAD) (Healthline).
Why Seatbelts Don’t Fully Prevent Whiplash
Here’s the tricky part: seatbelts are great at keeping your body in place, but your head is still free to move. In a rear-end crash, the seatbelt holds your torso, but your neck and head can whip around, causing that classic whiplash motion. Some sources, such as Kaizo Health, suggest that seatbelts can even increase the risk of whiplash in mild to moderate crashes by amplifying the force on the neck and chest.
However, this doesn’t mean you should skip the seatbelt. Without one, you’re far more likely to suffer severe injuries, like head trauma or ejection. The key is to pair seatbelt use with other precautions, such as a properly adjusted headrest, which can help catch your head and reduce the risk of whiplash (Consumer Reports).
Other Cervical Injuries
Whiplash isn’t the only neck injury from MVAs. More severe crashes can cause:
Cervical Fractures: Breaks in the cervical vertebrae, often from high-impact collisions, which can pinch nerves and cause pain or tingling (Spine Diagnostic).
Spinal Stenosis: Trauma can narrow the spinal canal, pressing on nerves and causing radiating pain.
Disc Herniations: The force can push cervical discs out of place, leading to arm pain or numbness.
These injuries can have long-term effects, making early diagnosis and treatment critical.
The Road To Recovery- Video
Preventing Auto Injuries: More Than Just Seatbelts
While seatbelts are the MVP of car safety, they’re not the only player on the team. Here are some practical tips to keep you safer on the road:
Wear Your Seatbelt Right
It’s not enough to just buckle up—you’ve got to do it correctly. Here’s how:
Place the lap belt low across your hips, not your stomach.
Position the shoulder belt across your chest, not under your arm or behind your back.
Make sure the belt is snug and not twisted.
For children, use car seats or booster seats until they’re big enough for adult seatbelts, typically around 8 to 12 years old (NHTSA).
A properly worn seatbelt is like Herman Munster’s favorite tie—secure, stylish, and ready for action!
Adjust Your Headrest
Your headrest isn’t just for napping on long drives—it’s a key whiplash preventer. Set it so the top is level with the top of your head and as close as possible to the back of your head (no more than 4 inches away). Newer cars may have “active” headrests that move forward in a crash to catch your head (Chiropractor at Castlebury).
Drive Smart
Safe driving habits can prevent crashes altogether:
Stick to speed limits and traffic rules.
Keep your eyes on the road—no texting or scrolling!
Maintain a safe distance from other cars.
Adjust for weather or road conditions.
Think of it like navigating the Munster mansion—slow and steady avoids the creaky traps!
Choose a Safe Vehicle
Check crash safety ratings from the Insurance Institute for Highway Safety (IIHS). Cars with well-designed headrests and advanced safety features, such as automatic emergency braking, can help lower your risk of injury.
The Role of Immediate Medical Care
Even if you feel fine after a crash, don’t skip the doctor’s visit. Injuries like whiplash or internal damage can hide for days, only to cause trouble later. A StatPearls article notes that post-crash soreness often appears 24 to 72 hours after the accident, and many patients don’t realize their injury severity until the next day.
Seeing a healthcare provider right away can:
Catch hidden injuries with exams or imaging.
Start treatment early to prevent chronic pain.
Document your injuries for insurance or legal claims.
In El Paso, Dr. Alexander Jimenez is a go-to expert for this kind of care, offering a one-stop shop for diagnosis, treatment, and recovery.
Dr. Alexander Jimenez: El Paso’s Injury Expert
When it comes to auto injuries, Dr. Alexander Jimenez is like the Herman Munster of healing—big on expertise and always ready to help. With over 30 years of experience, he’s a dual-licensed Doctor of Chiropractic (DC) and an Advanced Practice Registered Nurse (APRN), specifically a Family Nurse Practitioner-Board Certified (FNP-BC). His practice at El Paso’s Chiropractic Rehabilitation Clinic focuses on treating complex injuries, including those from MVAs.
Who Is Dr. Jimenez?
Dr. Jimenez isn’t just a chiropractor—he’s a functional medicine pioneer, certified by the Institute for Functional Medicine. His dual licensure lets him approach injuries from both a structural (bones and joints) and systemic (overall health) perspective. He’s also a community leader, working with veterans through the Tri-West Program and bringing neuropathy treatments to El Paso via the El Paso Neuropathy Center.
His accolades include being named a Top Rated El Paso Chiropractor from 2015 to 2024 by Three Best Rated® and memberships in the American and Texas Chiropractic Associations. He’s even a former bodybuilding champ, so he knows a thing or two about physical resilience!
How He Helps Auto Injury Patients
Dr. Jimenez employs a holistic, evidence-based approach to treating auto injuries, tailored to each patient’s specific needs. His methods include:
Chiropractic Adjustments: Realigning the spine to relieve pain and improve mobility.
Spinal Decompression Therapy: Gently stretching the spine to ease disc pressure.
Acupuncture and Electro-Acupuncture: Reducing pain and inflammation with targeted needle or electrical stimulation.
Nutritional Counseling: Supporting healing with diet and supplements.
Mind-Body Techniques: Managing stress to aid recovery.
He also utilizes advanced imaging techniques, such as X-rays or MRIs, and diagnostic evaluations to pinpoint injuries. For example, the Objective Spinal Motion Imaging Assessment (OSMIA) system, which measures spinal motion with low-dose fluoroscopy, can help assess damage with high accuracy (RMS error as low as 0.32° for side-bending).
Table 2: OSMIA Calibration Model 1 RMS Errors (degrees)
Condition
Side-bending Optimal
Side-bending Degraded
Flexion-extension Optimal
Flexion-extension Degraded
RMS Error (°)
0.32
0.40
0.52
1.03
This precision ensures patients get the right treatment, whether it’s for whiplash or a spinal fracture.
Personal Injury Cases in El Paso
El Paso sees its share of MVAs, and personal injury cases are common as victims seek compensation for medical bills, lost wages, and pain. Dr. Jimenez stands out in this regard, acting as a bridge between medical care and legal needs. He meticulously documents injuries using advanced diagnostics, which is crucial for insurance claims or lawsuits. His reports align clinical findings with legal standards, helping patients navigate the complex world of personal injury law.
For example, in a typical case, Dr. Jimenez might use OSMIA to measure spinal instability post-crash, then provide a detailed report linking the injury to the accident. This can make or break a claim, as insurance companies often require clear evidence of causation. His dual expertise as a chiropractor and nurse practitioner gives him a unique edge in this role.
Why El Paso Trusts Dr. Jimenez
Dr. Jimenez’s commitment to patient empowerment sets him apart. He educates his patients through webinars, podcasts, and daily blog posts on his website, covering topics such as injury recovery and chronic pain management. His work with the Health Voice 360 Podcast reaches a wide audience, spreading knowledge about health and wellness.
He’s also a community advocate, supporting veterans and bringing cutting-edge treatments to El Paso. Whether it’s helping a crash victim walk again or guiding a family through a legal battle, Dr. Jimenez is a trusted name in the city.
The Bigger Picture: Safety and Recovery
Auto injuries, especially to the spine, can turn your life upside down faster than a Munster family prank. However, with seatbelts and expert care, you can minimize the damage and return to your normal life. Seatbelts save lives—there’s no debate about that. They cut the risk of death and serious injury by nearly half, even if they come with a small chance of causing fractures. Whiplash and other cervical injuries are common, but proper headrests and safe driving can help keep them at bay.
If you’re in a crash, don’t wait to get checked out. Injuries can hide, and early care can prevent long-term pain. In El Paso, Dr. Alexander Jimenez offers the expertise and compassion you need to recover, from advanced diagnostics to personalized treatment plans. His role in personal injury cases ensures you’re covered medically and legally, giving you peace of mind.
So, next time you hop in the car, channel your inner Herman Munster and buckle up with a grin. It’s a small act that could save your life—and if the worst happens, know that experts like Dr. Jimenez are ready to help you bounce back.
Conclusion: A Serious Note
Motor vehicle accidents are no laughing matter. They cause millions of injuries and thousands of deaths each year, with spinal injuries like whiplash and fractures leading to significant pain and disability. Seatbelts are your best defense, reducing the risk of severe harm and saving countless lives. However, they don’t eliminate all risks, and injuries like whiplash can still occur. Taking preventive steps, such as wearing seatbelts correctly and adjusting headrests, is essential for your safety.
If you’re involved in a crash, seek medical attention immediately, even if you feel okay. Early diagnosis and treatment can make a huge difference in your recovery. In El Paso, Dr. Alexander Jimenez provides expert care for auto injury victims, combining advanced diagnostics with holistic treatments to help you heal. His role in personal injury cases ensures you get the support you need, both medically and legally.
Disclaimer: This blog post is for informational purposes only and should not be taken as medical advice. Always consult a qualified healthcare provider for any health concerns or injuries. Prioritize safety on the road, and don’t hesitate to seek professional help if you’re injured in an accident.
The Cobb angle is a mathematical measurement tool for assessing the curvature of the spine. Along with physical exams and other tests, how is it used to evaluate scoliosis and kyphosis of the spine?
Cobb Angle
The Cobb angle is used to quantify the curvature of the spine, particularly in conditions like scoliosis. It measures the degree of side-to-side spinal curvature, a deformity called scoliosis. The angle’s size helps determine what kind of treatment is needed. Monitoring may be all that’s necessary for mild curvature. With severe scoliosis, treatment may require spinal fusion surgery. Named for orthopedic surgery pioneer John Robert Cobb, it describes the distance a scoliotic curve may deviate from being straight. (Botterbush K. S. et al., 2023) Generally, it takes at least 10 degrees of deviation from straight before scoliosis is confirmed.
X-Ray and Interpretation
An X-ray is taken to measure the Cobb angle. Side and back views are taken. The healthcare provider or examiner then views the X-rays and locates the most affected vertebra in the curve, the apical vertebra. In a scoliotic curve, the apical vertebra is the spinal bone with the greatest degree of rotation that takes the biggest curve away from the center of a normal spine column.
Visualizing the Angle
The apical vertebra is where two lines drawn from the X-rays meet. Two lines are drawn along the edge of the top and bottom bones of the curve. The lines extend out as follows:
On the top bone, the line starts on the high side, continues along the top edge, and then slopes down according to the angle of the vertebra. (Jin, C. et al., 2022)
On the bottom vertebra, the line starts on the low side, continues along the bottom edge, and slopes upward.
The Cobb angle is found by measuring the angle of the two intersecting lines where they meet.
Then, the top and bottom vertebrae of the side-to-side curve are identified to create a number for the Cobb angle. These bones have the most tilt but the least rotation and displacement and are located above and below the apical vertebra. Computer software is commonly used to calculate the Cobb angle. (Jin, C. et al., 2022) Treatment is based on the:
Angle size
Gender: Scoliosis is more common and likely to progress in females
Scoliosis is diagnosed when the Cobb angle reaches 10 degrees or more. However, this is not generally considered a significant curvature (American Association of Neurological Surgeons, 2024). In around 80% of cases, the scoliosis is considered idiopathic or without congenital or other underlying causes.
Less Than 25 Degrees Cobb Angle
If a scoliotic curve is less than 25 degrees, individuals may only need to visit their healthcare provider periodically so long as the scoliosis is monitored. These are mild cases, often without symptoms, but there is a chance that the curvature can progress. This usually means reassessing the Cobb angle every four to six months in a growing child or adolescent. (National Scoliosis Foundation, 2015) A 5-degree or more progression can change the diagnosis and treatment. (Jin, C. et al., 2022)
Between 25 and 40 Degrees Cobb Angle
A Cobb angle of 25 to 40 degrees usually requires wearing a back brace and intensive physical therapy. The goal of these treatments is to help halt the curve’s progression. Braces are generally worn 16 to 23 hours every day. (National Scoliosis Foundation, 2015) The healthcare provider will provide a referral for physical therapy. Many report excellent results with the Schroth or other scoliosis-specific exercise methods. A study found that core stabilization exercise programs can decrease Cobb angles in adolescents with idiopathic scoliosis. (Ko K. J. & Kang S. J. 2017)
Scoliosis in Adults
Scoliosis is diagnosed in adults, usually in those who have had the condition, treated or not, that was identified in their youth. A study that followed various cases for 20 years found disease progression occurred in 40% of adults but was usually less than one degree per year. However, degenerative scoliosis can also occur in individuals aged 65 and older. (American Association of Neurological Surgeons, 2024)
40 Degrees or More Cobb Angle
Surgery may be recommended once the Cobb angle reaches 40 to 50 degrees. A spinal fusion is often used to force the curve to stop developing. In adults, surgery may be needed if the angle reaches 50 degrees and they experience complications, such as nerve damage or bowel/bladder dysfunction. Risk factors in adults include older age, a history of smoking, and a diagnosis of other conditions, including being overweight. (American Association of Neurological Surgeons, 2024)
Variations
Variations occur in measuring scoliosis, and it is important to understand the difference between a change in scoliosis and a change in the tools or measurement. Equipment errors, imaging errors, and the subjective reading of the healthcare provider can change the values. (Jin, C. et al., 2022) Scoliosis measurement software and intelligent medical devices continue to improve how scoliosis is evaluated and treated. Physical exams, symptoms, and careful monitoring of changes in posture or function are still critical to an accurate diagnosis. The healthcare provider will explain the Cobb angle and other test results.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Academic Low Back Pain: Impact and Chiropractic Solutions
References
Botterbush, K. S., Zhang, J. K., Chimakurty, P. S., Mercier, P., & Mattei, T. A. (2023). The life and legacy of John Robert Cobb: the man behind the angle. Journal of neurosurgery. Spine, 39(6), 839–846. https://doi.org/10.3171/2023.7.SPINE23146
Jin, C., Wang, S., Yang, G., Li, E., & Liang, Z. (2022). A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel, Switzerland), 22(9), 3258. https://doi.org/10.3390/s22093258
National Scoliosis Foundation. (2015). Scoliosis Media & Community Guide. https://www.scoliosis.org/nsf2/wp-content/uploads/2015/06/ScoliMediaGuide_9June3.pdf
American Association of Neurological Surgeons. (2024). Scoliosis. https://www.aans.org/patients/conditions-treatments/scoliosis/
Ko, K. J., & Kang, S. J. (2017). Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. Journal of Exercise Rehabilitation, 13(2), 244–249. https://doi.org/10.12965/jer.1734952.476
Can understanding how nociceptors function and their role in processing pain signals help individuals who are managing injuries and/or living with chronic pain conditions?
Nociceptors
Nociceptors are nerve endings that detect harmful stimuli, such as extreme temperatures, pressure, and chemicals, and signal pain. They are the body’s first defense against potentially damaging environmental inputs.
Nociceptors are in the skin, muscles, joints, bones, internal organs, deep tissues, and cornea.
They detect harmful stimuli and convert them into electrical signals.
These signals are sent to the brain’s higher centers.
The brain interprets the signals as pain, which prompts the body to avoid the harmful stimulus.
Nociceptors, often called pain receptors, are free nerve endings all over the body. They play a pivotal role in how the body feels and reacts to pain. The main purpose of a nociceptor is to respond to damage to the body by transmitting signals to the spinal cord and brain. (Purves D, Augustine GJ, Fitzpatrick D, et al., editors. 2001) If you bang your foot, the nociceptors on the skin are activated, sending a signal to the brain via the peripheral nerves to the spinal cord. Pain resulting from any cause is transmitted this way. Pain signals are complex, carrying information about the stimuli’s location and intensity. This causes the brain to fully process the pain and send communication back to block further pain signals.
Thermal nociceptors respond to extreme hot or cold temperatures.
For instance, when touching a hot stove, the nociceptors, which signal pain, are activated immediately, sometimes before you know what you’ve done.
Mechanical
Mechanical nociceptors respond to intense stretching or strain, such as pulling a hamstring or straining a tendon.
The muscles or tendons are stretched beyond their ability, stimulating nociceptors and sending pain signals to the brain.
Chemical
Chemical nociceptors respond to chemicals released from tissue damage.
For example, prostaglandins and substance P or external chemicals like topical capsaicin pain creams.
Silent
Silent nociceptors must be first activated by tissue inflammation before responding to a mechanical, thermal, or chemical stimulus.
Most visceral nociceptors are located on organs in the body.
Polymodal
Polymodal nociceptors respond to mechanical, thermal, and chemical stimuli.
Mechano-thermal
Mechano-thermal nociceptors respond to mechanical and thermal stimuli.
Pain Transmission
Nociceptors are also classified by how fast they transmit pain signals. Transmission speed is determined by the type of nerve fiber known as an axon a nociceptor has. There are two main types.
The first type is A fiber axon, fibers surrounded by a fatty, protective sheath called myelin.
Myelin allows nerve signals/action potentials to travel rapidly.
Because of the difference in transmission speed, the pain signals from the A fibers reach the spinal cord first. As a result, after an acute injury, an individual experiences pain in two phases, one from the A fibers and one from the C fibers. (Ngassapa D. N. 1996)
Pain Perception Phases
When an injury occurs, the stimulated nociceptors activate the A fibers, causing a person to experience sharp, prickling pain.
This is the first phase of pain, known as fast pain, because it is not especially intense but comes right after the stimulus.
During the second phase of pain, the C fibers are activated, causing an intense, burning pain that persists even after the stimulus has stopped.
The fact that the C fibers carry burning pain explains why there is a short delay before feeling the sensation.
The C fibers also carry aching, sore pain caused by organs within the body, such as a sore muscle or stomachache. (Ngassapa D. N. 1996)
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.
From Injury To Recovery With Chiropractic Care
References
Purves D, A. G., Fitzpatrick D, et al., editors. (2001). Nociceptors. In Neuroscience. 2nd edition. (2nd ed.). Sunderland (MA): Sinauer Associates. https://www.ncbi.nlm.nih.gov/books/NBK10965/
University of Texas McGovern Medical School. (2020). Chapter 6: Pain Principles. https://nba.uth.tmc.edu/neuroscience/m/s2/chapter06.html
Ngassapa D. N. (1996). Comparison of functional characteristics of intradental A- and C-nerve fibres in dental pain. East African medical journal, 73(3), 207–209.
Can the thoracolumbar fascia cause or contribute to lower back pain and inflammation?
Thoracolumbar Fascia
Tissue behind the spinal column, positioned at both the lower back and mid-back levels, is connected to the thoracolumbar fascia, also called the lumbodorsal fascia or LF. The fascia is a thick connective tissue that covers and supports all the body’s muscles, bones, tendons, ligaments, and organs. The fascia also contains nociceptive nerve endings, also known as free nerve endings, that arise from the central nervous system, i.e., the brain and spinal cord, which may be responsible for some forms of back pain and stiffness caused by injury or inflammation.
Anatomy
The thoracolumbar fascia is divided into three layers:
Many of the back muscles attach to the thoracolumbar fascia. The erector spinae muscle group, known as the paraspinals, runs longitudinally down the spine. They are attached to the thoracolumbar fascia and the bony spine. The lumbar part of the posterior layer of the thoracolumbar fascia extends from the lowest rib to the top of the hip bone or the iliac crest. On the same path, it connects with the transverse abdominal muscle. The thoracolumbar fascia connections help bridge the back muscles to the abdominal wall muscles. The latissimus dorsi, a large back muscle that bears and moves the body’s weight with the arms and shoulders, is also connected to the thoracolumbar fascia, with the fibers extending outward from the fascia. The front part of the thoracolumbar fascia, or anterior layer, covers a muscle called the quadratus lumborum. This muscle bends the trunk to the side, helps maintain a healthy posture, and is often focused on muscle-related lower back pain.
What the Fascia Does
The thoracolumbar fascia, examined from the back of an anatomical drawing or diagram, is diamond-shaped. Its shape, large size, and central location uniquely position it to unify and synchronize the upper body’s movements with the lower body’s. The fascia’s fibers are very strong, enabling the tissue sheath to lend support (Willard, F. H. et al., 2012) . The tissue is also flexible, enabling it to help circulate forces of movement and contralateral movements as the back muscles contract and relax. An example is walking.
Back Pain
Scientists and doctors don’t know for sure, but it’s possible that the thoracolumbar fascia may contribute to lower back pain. A study found that the fascia may generate back pain based on: (Wilke, J. et al., 2017)
Sustaining micro-injuries and/or inflammation, which are often related, may cause signal changes in the free nerve endings in the fascia. Nerve endings acquire information from the outer areas of the body, like skin and other fascia, and relay it back to the central nervous system. The theory is that when the fascia close to the skin becomes injured, damaged, and/or backed up with inflammatory chemicals and substances, it is communicated as pain and other sensations back to the brain and spinal cord.
After a back injury, tissues tighten and stiffen. Some studies of patients with back pain noted alterations in their thoracolumbar fascia.
Injuries tend to stimulate nerves, which can lead to increased sensitivity.
Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Sciatica, Causes, Symptoms, and Tips
References
Willard, F. H., Vleeming, A., Schuenke, M. D., Danneels, L., & Schleip, R. (2012). The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of anatomy, 221(6), 507–536. https://doi.org/10.1111/j.1469-7580.2012.01511.x
Wilke, J., Schleip, R., Klingler, W., & Stecco, C. (2017). The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review. BioMed research international, 2017, 5349620. https://doi.org/10.1155/2017/5349620
Individuals may discover a lump, bump, or nodule under the skin around their lower back, hips, and sacrum that can cause pain by compressing nerves and damaging the fascia. Can knowing the conditions linked to them and their symptoms help healthcare providers determine a correct diagnosis and develop an effective treatment plan for them?
Painful Bumps, Nodules Around Low Back, Hips, and Sacrum
Painful masses in and around the hips, the sacrum, and the lower back are lumps of fat or lipomas, fibrous tissue, or other types of nodules that move when pressed on. Some healthcare providers and chiropractors, in particular, use the non-medical term back mice (In 1937, the term was used to describe lumps associated with episacroiliac lipoma) to describe the bumps. Some healthcare professionals argue against calling the masses mice because it is not specific and could lead to misdiagnoses or incorrect treatment.
Most show up in the lower back and hip area.
In some cases, they protrude or herniate through the lumbodorsal fascia or the network of connective tissue that covers the deep muscles of the lower and middle back.
Other lumps can develop in the tissue under the skin.
Today, many conditions are associated with back mice lumps, including:
Iliac crest pain syndrome
Multifidus triangle syndrome
Lumbar fascial fat herniation
Lumbosacral (sacrum) fat herniation
Episacral lipoma
Related Conditions
Iliac Crest Pain Syndrome
Also known as iliolumbar syndrome, iliac crest pain syndrome develops when a tear in the ligament occurs.
The ligament band connects the fourth and fifth lumbar vertebrae with the ilium on the same side. (Dąbrowski, K. Ciszek, B. 2023)
Causes include:
Tearing the ligament from repeated bending and twisting.
Trauma or fracture of the ilium bone caused by a fall or vehicle collision accident.
Multifidus Triangle Syndrome
Multifidus triangle syndrome develops when the multifidus muscles along the spine weaken and diminish function or ability.
These muscles can atrophy, and intramuscular fatty tissue can replace the muscle.
The lumbodorsal fascia is a thin fibrous membrane covering the back’s deep muscles.
Lumbar fascial fat herniation is a painful mass of fat that protrudes or herniates through the membrane, gets trapped and inflamed, and causes pain.
The causes of this type of herniation are currently unknown.
Lumbosacral (Sacrum) Fat Herniation
Lumbosacral describes where the lumbar spine meets the sacrum.
Lumbosacral fat herniation is a painful mass like lumbar facial herniation in a different location around the sacrum.
The causes of this type of herniation are currently unknown.
Episacral Lipoma
Episacral lipoma is a small painful nodule under the skin that primarily develops over the top outer edges of the pelvic bone. These lumps occur when a portion of the dorsal fat pad protrudes through a tear in the thoracodorsal fascia, the connective tissue that helps hold the back muscles in place. (Erdem, H. R. et al., 2013) A healthcare provider may refer an individual to an orthopedist or orthopedic surgeon for this lipoma. An individual may also find pain relief from a massage therapist familiar with the condition. (Erdem, H. R. et al., 2013)
Symptoms
Back lumps can often be seen under the skin. They are typically tender to the touch and can make sitting in a chair or lying on the back difficult, as they often appear on the hip bones and sacroiliac region. (Bicket, M. C. et al., 2016) The nodules may:
Be firm or tight.
Have an elastic feel.
Move under the skin when pressed.
Cause intense, severe pain.
The pain results from pressure on the lump, which compresses the nerves.
Damage to the underlying fascia can also cause pain symptoms.
Diagnosis
Some individuals do not realize they have nodules or lumps until pressure is applied. Chiropractors and massage therapists often find them during treatments but do not diagnose the abnormal fatty growth. The chiropractor or massage therapist will refer the patient to a qualified dermatologist or medical professional who can perform imaging studies and a biopsy. Determining what the lumps are can be challenging because they are non-specific. Healthcare providers sometimes diagnose the nodules by injecting them with a local anesthetic. (Bicket, M. C. et al., 2016)
Differential Diagnosis
The fatty deposits can be any number of things, and the same applies to the sources of nerve pain. A healthcare provider may further diagnose by ruling out other causes, which can include:
Sebaceous Cysts
A benign, fluid-filled capsule between the layers of skin.
Subcutaneous Abscess
A collection of pus beneath the skin.
Usually painful.
It can become inflamed.
Sciatica
Radiating nerve pain down one or both legs that is caused by a herniated disc, bone spur, or spasming muscles in the lower back.
Liposarcoma
Malignant tumors can sometimes appear as fatty growths in the muscles.
Liposarcoma is typically diagnosed by biopsy, where some tissue is removed from the nodule and examined for cancer cells. (Johns Hopkins Medicine. 2024)
An MRI or CT scan may also be performed to determine the exact location of the nodule.
Painful lipomas are also associated with fibromyalgia.
Treatment
Back nodules are usually benign, so there’s no reason to remove them unless they’re causing pain or mobility problems (American Academy of Orthopedic Surgeons: OrthoInfo. 2023). However, they should be examined to make sure they are not cancerous. Treatment usually involves injected anesthetics, such as lidocaine or corticosteroids, as well as over-the-counter pain relievers like NSAIDs.
Surgery
If pain is severe, surgical removal may be recommended. This involves cutting out the mass and repairing the fascia for lasting relief. However, removal may not be recommended if there are many nodules, as some individuals can have hundreds. Liposuction may be effective if the lumps are smaller, more extensive, and comprise more fluid. (American Family Physician. 2002) Complications of surgical removal can include:
Scarring
Bruising
Uneven skin texture
Infection
Complementary and Alternative Treatment
Complimentary and Alternative Medicine treatments like acupuncture, dry needling, and spinal manipulation can help. Many chiropractors believe back nodules can be successfully treated with complementary and alternative therapies. A common approach uses acupuncture and spinal manipulation in combination. A case study reported that anesthetic injections followed by dry needling, which is similar to acupuncture, improved pain relief. (Bicket, M. C. et al., 2016)
Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive therapies and functional rehabilitation procedures focused on restoring normal body functions after trauma and soft tissue injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If the individual requires other treatment, they will be referred to a clinic or physician best suited for their condition, as Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers.
Beyond the Surface
References
Dąbrowski, K., & Ciszek, B. (2023). Anatomy and morphology of iliolumbar ligament. Surgical and radiologic anatomy : SRA, 45(2), 169–173. https://doi.org/10.1007/s00276-022-03070-y
Seyedhoseinpoor, T., Taghipour, M., Dadgoo, M., Sanjari, M. A., Takamjani, I. E., Kazemnejad, A., Khoshamooz, Y., & Hides, J. (2022). Alteration of lumbar muscle morphology and composition in relation to low back pain: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 22(4), 660–676. https://doi.org/10.1016/j.spinee.2021.10.018
Erdem, H. R., Nacır, B., Özeri, Z., & Karagöz, A. (2013). Episakral lipoma: Bel ağrısının tedavi edilebilir bir nedeni [Episacral lipoma: a treatable cause of low back pain]. Agri : Agri (Algoloji) Dernegi’nin Yayin organidir = The journal of the Turkish Society of Algology, 25(2), 83–86. https://doi.org/10.5505/agri.2013.63626
Bicket, M. C., Simmons, C., & Zheng, Y. (2016). The Best-Laid Plans of “Back Mice” and Men: A Case Report and Literature Review of Episacroiliac Lipoma. Pain physician, 19(3), 181–188.
American Academy of Orthopedic Surgeons: OrthoInfo. (2023). Lipoma. https://orthoinfo.aaos.org/en/diseases–conditions/lipoma
American Family Physician. (2002). Lipoma excision. American Family Physician, 65(5), 901-905. https://www.aafp.org/pubs/afp/issues/2002/0301/p901.html
When sciatica or other radiating nerve pain presents, can learning to distinguish between nerve pain and different types of pain help individuals recognize when spinal nerve roots are irritated or compressed or more serious problems that require medical attention?
Spinal Nerve Roots and Dermatomes
Spinal conditions such as herniated discs and stenosis can lead to radiating pain that travels down one arm or leg. Other symptoms include weakness, numbness, and/or shooting or burning electrical sensations. The medical term for pinched nerve symptoms is radiculopathy (National Institutes of Health: National Institute of Neurological Disorders and Stroke. 2020). Dermatomes could contribute to irritation in the spinal cord, where the nerve roots cause symptoms in the back and limbs.
Anatomy
The spinal cord has 31 segments.
Each segment has nerve roots on the right and left that supply motor and sensory functions to the limbs.
The anterior and posterior communicating branches combine to form the spinal nerves that exit the vertebral canal.
The 31 spine segments result in 31 spinal nerves.
Each one transmits sensory nerve input from a specific skin region on that side and area of the body.
These regions are called dermatomes.
Except for the first cervical spinal nerve, dermatomes exist for each spinal nerve.
The spinal nerves and their associated dermatomes form a network all over the body.
Dermatomes Purpose
Dermatomes are the body/skin areas with sensory input assigned to individual spinal nerves. Each nerve root has an associated dermatome, and various branches supply each dermatome off that single nerve root. Dermatomes are pathways through which sensational information in the skin transmits signals to and from the central nervous system. Sensations that are physically felt, like pressure and temperature, get transmitted to the central nervous system. When a spinal nerve root becomes compressed or irritated, usually because it comes into contact with another structure, it results in radiculopathy. (National Institutes of Health: National Institute of Neurological Disorders and Stroke. 2020).
Radiculopathy
Radiculopathy describes symptoms caused by a pinched nerve along the spine. Symptoms and sensations depend on where the nerve is pinched and the extent of the compression.
Cervical
This is a syndrome of pain and/or sensorimotor deficiencies when nerve roots in the neck are compressed.
It often presents with pain that goes down one arm.
Individuals may also experience electrical sensations like pins and needles, shocks, and burning sensations, as well as motor symptoms like weakness and numbness.
Lumbar
This radiculopathy results from compression, inflammation, or injury to a spinal nerve in the lower back.
Sensations of pain, numbness, tingling, electrical or burning sensations, and motor symptoms like weakness traveling down one leg are common.
Diagnosis
Part of a radiculopathy physical examination is testing the dermatomes for sensation. The practitioner will use specific manual tests to determine the spinal level from which the symptoms originate. Manual exams are often accompanied by diagnostic imaging tests like MRI, which can show abnormalities in the spinal nerve root. A complete physical examination will determine if the spinal nerve root is the source of the symptoms.
Treating Underlying Causes
Many back disorders can be treated with conservative therapies to provide effective pain relief. For a herniated disk, for example, individuals may be recommended to rest and take a nonsteroidal anti-inflammatory medication. Acupuncture, physical therapy, chiropractic, non-surgical traction, or decompression therapies may also be prescribed. For severe pain, individuals may be offered an epidural steroid injection that can provide pain relief by reducing inflammation. (American Academy of Orthopaedic Surgeons: OrthoInfo. 2022) For spinal stenosis, a provider may first focus on physical therapy to improve overall fitness, strengthen the abdominals and back muscles, and preserve motion in the spine. Pain-relieving medications, including NSAIDs and corticosteroid injections, can reduce inflammation and relieve pain. (American College of Rheumatology. 2023) Physical therapists provide various therapies to decrease symptoms, including manual and mechanical decompression and traction. Surgery may be recommended for cases of radiculopathy that don’t respond to conservative treatments.
Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on restoring normal body functions after trauma and soft tissue injuries using Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility, and mobility Fitness Training, and Rehabilitation Systems for all ages. If the individual requires other treatment, they will be referred to a clinic or physician best suited for their condition. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers to bring El Paso, the top clinical treatments, to our community.
Reclaim Your Mobility: Chiropractic Care For Sciatica Recovery
References
National Institutes of Health: National Institute of Neurological Disorders and Stroke. (2020). Low back pain fact sheet. Retrieved from https://www.ninds.nih.gov/sites/default/files/migrate-documents/low_back_pain_20-ns-5161_march_2020_508c.pdf
American Academy of Orthopaedic Surgeons: OrthoInfo. (2022). Herniated disk in the lower back. https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/
American College of Rheumatology. (2023). Spinal stenosis. https://rheumatology.org/patients/spinal-stenosis
For individuals who are dealing with back pain and problems, could knowing how to improve and maintain intervertebral disc health help alleviate symptoms?
Intervertebral Disc Health
The spinal column comprises 24 movable bones and 33 bones called vertebrae. The vertebral bones are stacked on top of each other. The intervertebral disc is the cushioning substance between the adjacent bones. (Dartmouth. 2008)
Bones
The vertebral bones are small and round in an area called the vertebral body. In the back is a bony ring from which protrusions extend and arches and pathways are formed. Each structure has one or more purposes and includes: (Waxenbaum JA, Reddy V, Williams C, et al., 2023)
Stabilizing the spine.
Providing a space for the connective tissue and back muscles to attach.
Providing a tunnel for the spinal cord to pass through cleanly.
Providing a space where nerves exit and branch out to all areas of the body.
Structure
The intervertebral disc is the cushioning that sits between the vertebrae. The design of the spine allows it to move in various directions:
Flexion or bending
Extension or arching
Tilting and rotation or twisting.
Powerful forces act upon and influence the spinal column to produce these movements. The intervertebral disc absorbs shock during movement and protects the vertebrae and spinal cord from injury and/or trauma.
Ability
On the outside, strong woven fiber tissues form an area called the annulus fibrosis. The annulus fibrosis contains and protects the softer gel substance in the center, the nucleus pulposus. (Y.S. Nosikova et al., 2012) The nucleus pulposis provides shock absorption, flexibility, and pliability, especially under pressure during spinal movement.
Mechanics
The nucleus pulposus is a soft gel substance located in the center of the disc that allows elasticity and flexibility under stress forces to absorb compression. (Nedresky D, Reddy V, Singh G. 2024) The swivel action alters the tilt and rotation of the vertebra above and below, buffering the effects of spinal motion. The discs swivel in response to the direction the spine moves. The nucleus pulposus is made mostly of water, which moves in and out through small pores, acting as byways between the vertebra and disc bone. Body positions that load the spine, like sitting and standing, push the water out of the disc. Lying down on the back or in a supine position facilitates water restoration into the disc. As the body ages, the discs lose water/dehydrate, leading to disc degeneration. The intervertebral disc has no blood supply, which means that for a disc to receive necessary nutrition and for waste removal, it must rely on water circulation to stay healthy.
Care
Some ways of maintaining intervertebral disc health include:
Paying attention to posture.
Changing positions frequently throughout the day.
Exercising and moving around.
Applying correct body mechanics to physical activities.
Sleeping on a supportive mattress.
Drinking plenty of water.
Eating healthy.
Maintaining a healthy weight.
Drinking alcohol in moderation.
Quitting smoking.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractic team, care plans, and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Acupuncture, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Beyond the Surface: Understanding the Effects of Personal Injury
References
Dartmouth Ronan O’Rahilly, MD. (2008). Basic Human Anatomy. Chapter 39: The vertebral column. In D. Rand Swenson, MD, PhD (Ed.), BASIC HUMAN ANATOMY A Regional Study of Human Structure. W.B. Saunders. https://humananatomy.host.dartmouth.edu/BHA/public_html/part_7/chapter_39.html
Waxenbaum, J. A., Reddy, V., Williams, C., & Futterman, B. (2024). Anatomy, Back, Lumbar Vertebrae. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29083618
Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. https://doi.org/10.1111/j.1469-7580.2012.01537.x
Nedresky D, Reddy V, Singh G. (2024). Anatomy, Back, Nucleus Pulposus. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30570994
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What the Fascia Does
Ability
