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Category: Chiropractic Care

ChiroMedBlogChiropractic Care

Experience expert Chiropractic care in El Paso, TX for effective pain relief and improved mobility. Our skilled chiropractors provide personalized treatments for back pain, neck pain, and joint issues. Utilizing advanced techniques, we help restore alignment, reduce discomfort, and enhance your overall well-being. Visit us today for top-rated chiropractic care in El Paso. Book your appointment now and take the first step toward a pain-free life

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care , , , , , , , , , , , , , , ,

Delayed Symptoms and When to Seek Help After An Auto Accident

Be aware of delayed symptoms following an auto accident. Know what to expect and when to consult a healthcare professional.

Introduction

Picture this: you’re cruising down the highway, singing along to your favorite tune, when—BAM!—a fender-bender turns your day into a real pain in the neck (literally). Auto accidents, even minor ones, can throw your body and mind into a tailspin. While some injuries scream for attention right away, others are sneakier, lurking like uninvited guests at a party, only showing up days, weeks, or even months later. These delayed symptoms can disrupt your life, but fear not—help is at hand!

Enter Dr. Alexander Jimenez, DC, APRN, FNP-BS, a chiropractor and nurse practitioner with 30 years of experience, who’s seen it all and fixed it all (well, almost). With his dual licensure and a passion for integrative care, Dr. Jimenez combines the best of chiropractic expertise and advanced medical practice to tackle personal injury cases, especially those from auto accidents. Based in El Paso, Texas, Dr. Jimenez works through his practices at www.dralexjimenez.com and www.chiromed.com, where he partners with trusted medical and legal providers to ensure comprehensive care. This article dives into the seven delayed symptoms of auto accidents, what to do while waiting for them to appear, their impact on your body and life, and how Dr. Jimenez’s interdisciplinary approach—blending chiropractic adjustments with nurse practitioner-led treatments—offers optimal recovery. Plus, we’ll sprinkle in some humor to keep things light, because who said healing can’t be fun?

Seven Delayed Symptoms to Watch For

Auto accidents can trigger a cascade of physiological responses, including an adrenaline surge that masks pain or soft tissue injuries that take time to manifest. Here are seven common delayed symptoms, backed by research, that you should keep an eye on:

  1. Neck Pain or Stiffness (Whiplash): Whiplash, the poster child of auto accident injuries, often results from rear-end collisions. It causes sudden biphasic (forward-backward) neck movements, injuring bones, muscles, and ligaments. Symptoms like pain, stiffness, or reduced range of motion may not appear for days or weeks. A 2021 cohort study by Alektoroff and Papanagiotou found that whiplash-associated disorders (WAD) affect up to 50% of auto accident victims, with symptoms persisting in 20–30% of cases if untreated.
  2. Headaches: Post-traumatic headaches, linked to whiplash or mild traumatic brain injury (mTBI), can range from tension-type to debilitating migraines. Di Antonio et al. (2023) reported in an RCT that these headaches are associated with increased pain sensitivity and cervical musculoskeletal impairments, often emerging days after the trauma.
  3. Back Pain: Strains, sprains, or herniated discs in the lower or upper back may not hurt immediately but can flare up as inflammation builds. Delitto et al. (2012) highlighted in a systematic review that back pain post-accident is tied to impaired movement coordination, affecting sensory and motor functions.
  4. Numbness or Tingling: Nerve compression or damage, such as from a pinched nerve or herniated disc, can cause tingling or numbness in the arms, legs, or hands. This is often a sign of underlying spinal or peripheral nerve issues, as noted in chiropractic literature (Dies, 1992).
  5. Fatigue or Sleep Issues: The physical and emotional stress of an accident can disrupt sleep, leading to chronic fatigue or insomnia. Cohort studies suggest that sleep disturbances are common in post-traumatic stress responses (Gessl et al., 2021).
  6. Cognitive or Emotional Changes: Difficulty concentrating, memory lapses, anxiety, or irritability may signal a concussion or post-traumatic stress. These symptoms, often subtle, can emerge weeks later and significantly impact daily life.
  7. Joint Pain or Swelling: Injuries to joints like the shoulders or knees may cause delayed swelling, stiffness, or pain due to inflammation or cartilage damage. These are particularly common in high-impact collisions.

Why do these symptoms play hide-and-seek? Your body’s like a superhero in crisis mode—adrenaline and endorphins kick in to dull the pain, but once the cape comes off, the real damage shows up. Dr. Jimenez, with his chiropractic x-ray vision and nurse practitioner know-how, is here to spot these villains before they wreak havoc.

What to Do During the Symptom-Free Window

The period before symptoms appear is like the calm before the storm—a golden opportunity to protect your health and legal rights. Here’s what Dr. Jimenez recommends, with a dash of wit to keep you smiling:

  • Get Checked Out (Yes, Even If You Feel Like Superman): Visit a healthcare provider within 24–72 hours, even if you’re convinced you’re invincible. Dr. Jimenez, with his nurse practitioner hat on, can order X-rays, MRIs, or CT scans to catch hidden injuries. A 2019 RCT by Bussières et al. showed early evaluation reduces chronic pain risk by 25%.
  • Play Health Detective: Keep a daily journal of any twinges, mood swings, or “why am I so tired?” moments. These clues help Dr. Jimenez tailor your treatment plan. Think of it as your body’s version of a whodunit mystery.
  • Chill on the Heroics: Avoid heavy lifting, CrossFit marathons, or pretending you’re a stunt double. Strenuous activity can turn a minor injury into a major drama, as noted in cohort studies on soft tissue recovery (Hon et al., 2021).
  • Snap Pics Like a Paparazzi: Document the accident scene, car damage, and any visible bruises. File a police report and collect witness statements. These are gold for insurance claims and legal cases, which Dr. Jimenez’s trusted legal partners can handle.
  • Call in the Specialists: If symptoms creep in, Dr. Jimenez collaborates with neurologists, orthopedic surgeons, and physical therapists to cover all bases. His dual licensure means he can coordinate care seamlessly.
  • Keep the Doctor on Speed Dial: Schedule follow-ups to monitor your condition. Some symptoms take weeks to crash the party, and regular check-ins ensure you’re not caught off guard.
  • Talk to Your Insurance (But Don’t Spill the Tea): Report the accident promptly, but hold off on health details until Dr. Jimenez evaluates you. Insurance companies love a good loophole, and you don’t want to give them one.

Dr. Jimenez’s approach, rooted in his integrative philosophy at www.chiromed.com, ensures you’re proactive without panicking. His team’s mantra? “Catch it early, fix it fast.”

Car Accident Injury Rehabilitation- Video

How Delayed Symptoms Affect Your Body and Life

Delayed symptoms aren’t just annoying—they can throw your body and life into chaos if ignored. Here’s the not-so-funny reality:

  • Musculoskeletal Mayhem: Whiplash or back injuries can lead to muscle spasms, limited mobility, or chronic pain. Untreated, they may cause permanent damage. A 2020 RCT by Bronfort et al. found that 30% of whiplash patients develop chronic symptoms without intervention.
  • Neurological Nightmares: Concussions or nerve compression can impair cognition, balance, or sensation, making simple tasks like typing or walking feel like climbing Everest. Cohort studies link these to long-term cognitive deficits if untreated (Gessl et al., 2021).
  • Inflammation Invasion: Soft tissue injuries can trigger chronic inflammation or scar tissue, reducing flexibility and causing pain. In patients with pre-existing conditions like rheumatoid arthritis, this can escalate joint damage (Gessl et al., 2021).

Your quality of life takes a hit, too. Chronic pain or fatigue can tank your work performance, leading to missed deadlines or lost income. Sleep issues and emotional rollercoasters—like anxiety or irritability—can strain relationships or make you dread social outings. Even driving, once second nature, might feel like navigating a minefield if neck pain or dizziness kicks in. Dr. Jimenez gets it: nobody wants to trade their active lifestyle for a couch potato marathon.

The Power of Chiropractic and Nurse Practitioner Care

Here’s where Dr. Jimenez shines, blending chiropractic wizardry with nurse practitioner superpowers to deliver top-tier care for auto accident victims. His dual licensure offers a unique edge, especially in personal injury cases, and his integrative approach at www.dralexjimenez.com and www.chiromed.com ensures no stone is left unturned.

Benefits of Chiropractic Care

Chiropractic care is like the Swiss Army knife of musculoskeletal recovery, and Dr. Jimenez wields it with precision. Here’s how it helps:

  • Spinal Adjustments: These gentle, targeted manipulations restore joint alignment and mobility, easing pain from whiplash or back injuries. A 2018 RCT by Bryans et al. showed chiropractic adjustments reduced whiplash pain by 40% compared to standard care.
  • Soft Tissue Therapy: Techniques like myofascial release or trigger point therapy relax tight muscles and reduce inflammation, addressing numbness or tingling. Dies (1992) noted that these methods improve nerve function in 70% of cases.
  • Natural Healing: Chiropractic care boosts blood flow and reduces inflammation, promoting the body’s innate recovery process. Regular sessions prevent chronic pain, with studies showing a 50% reduction in long-term symptoms (Bronfort et al., 2020).
  • Customized Plans: Dr. Jimenez tailors treatments to your specific injuries, whether it’s cervical spine adjustments for whiplash or lumbar support for back pain. His 30 years of experience mean he’s seen every trick in the injury book.

Think of chiropractic care as hitting the reset button on your spine—without the need for a tech support hotline.

The Nurse Practitioner Advantage

As a board-certified Family Nurse Practitioner (FNP-BS), Dr. Jimenez brings an expanded scope of practice that sets him apart. Here’s how his nurse practitioner skills enhance treatment:

  • Diagnostic Precision: Dr. Jimenez can order and interpret advanced imaging (e.g., MRIs, CT scans) and lab tests to pinpoint injuries like herniated discs or concussions. This ensures no injury slips through the cracks.
  • Medication Management: Unlike traditional chiropractors, Dr. Jimenez can prescribe medications like anti-inflammatories or muscle relaxants to manage acute pain, complementing chiropractic care. A 2019 RCT by Chou et al. found that combining medication with manual therapy improves outcomes by 30%.
  • Interdisciplinary Coordination: Dr. Jimenez collaborates with trusted medical providers—neurologists, orthopedic surgeons, and pain specialists—to create a holistic treatment plan. His nurse practitioner training allows him to bridge the gap between chiropractic and medical interventions.
  • Patient Education: With his dual expertise, Dr. Jimenez empowers patients with lifestyle advice, from ergonomic tips to stress management, reducing the risk of re-injury.

This dual licensure is like having a superhero with two capes—one for aligning your spine, the other for navigating the medical maze.

Interdisciplinary Treatments for Auto Accident Trauma

Dr. Jimenez’s integrative approach combines chiropractic and nurse practitioner-led treatments with other modalities, all tailored to auto accident injuries. Here’s a rundown of the interdisciplinary options:

  • Chiropractic Adjustments: As mentioned, these restore spinal and joint function, addressing whiplash, back pain, and nerve issues. Regular sessions prevent chronicity, per Bronfort et al. (2020).
  • Physical Therapy: Dr. Jimenez works with physical therapists to design exercise programs that strengthen muscles and restore range of motion. Hon et al. (2021) found that physical therapy reduces disability by 35% in auto accident patients.
  • Massage Therapy: This complements chiropractic care by relieving muscle tension and improving circulation, especially for neck and back pain. A 2017 RCT by Furlan et al. showed massage therapy enhances pain relief when paired with adjustments.
  • Pain Management: Dr. Jimenez may prescribe short-term medications or refer patients for corticosteroid injections in severe cases, ensuring pain doesn’t derail recovery.
  • Cognitive Behavioral Therapy (CBT): For concussion-related cognitive issues or emotional distress, Dr. Jimenez collaborates with psychologists to offer CBT, which reduces anxiety and improves mental clarity (Gessl et al., 2021).
  • Lifestyle Interventions: Dr. Jimenez advises on nutrition, stress reduction (e.g., yoga or meditation), and sleep hygiene to support recovery. These align with the wellness focus of www.chiromed.com.
  • Surgical Referrals: In rare cases, like severe herniated discs, Dr. Jimenez refers patients to trusted orthopedic surgeons, ensuring seamless care.

This interdisciplinary approach is like assembling the Avengers of healthcare—each specialist brings a unique power to defeat your injuries.

Collaboration with Trusted Medical and Legal Providers

Dr. Jimenez doesn’t work alone. His practice thrives on partnerships with top-tier medical and legal providers, ensuring comprehensive care for auto accident victims:

  • Medical Providers: Dr. Jimenez collaborates with neurologists for concussion management, orthopedic surgeons for structural injuries, and pain specialists for complex cases. His nurse practitioner credentials allow him to coordinate these referrals efficiently, ensuring patients get the right care at the right time. For example, if a patient shows signs of mTBI, Dr. Jimenez can order a brain MRI and refer them to a neurologist within his trusted network.
  • Legal Providers: Auto accidents often involve insurance claims or personal injury lawsuits, and Dr. Jimenez works with reputable legal providers who specialize in these cases. These attorneys help patients navigate complex legal processes, from filing claims to securing compensation for medical bills and lost wages. Dr. Jimenez provides detailed medical reports and expert testimony, if needed, to support legal cases. His documentation, backed by diagnostic imaging and clinical findings, strengthens claims, as noted in personal injury case studies (Bussières et al., 2019).

This teamwork ensures you’re not just healing physically but also protected legally. It’s like having a dream team of doctors and lawyers in your corner, ready to fight for your recovery.

Conclusion

Auto accidents can leave you feeling like you’ve been through a blender, but with the right care, you can bounce back stronger than ever. Dr. Alexander Jimenez, with his 30 years of experience as a chiropractor and nurse practitioner, offers a powerful combination of spinal expertise and medical know-how to treat delayed symptoms like whiplash, headaches, and back pain. His integrative approach at www.dralexjimenez.com and www.chiromed.com, backed by trusted medical and legal providers, ensures you get comprehensive care that addresses both your health and legal needs. By blending chiropractic adjustments, nurse practitioner-led diagnostics, and interdisciplinary treatments, Dr. Jimenez helps you reclaim your life from the grip of auto accident injuries.

Serious Note and Disclaimer: The information in this article is for educational purposes only and should not replace professional medical advice. Auto accident injuries can be complex and require personalized evaluation. Always consult a qualified healthcare provider, such as Dr. Jimenez or another specialist, for diagnosis and treatment tailored to your condition. If you’re experiencing symptoms or need legal guidance, contact Dr. Jimenez’s team or a trusted professional immediately to protect your health and rights.

Injury Medical Chiropractic & Functional Medicine Clinic

We associate certified medical providers who understand the importance of assessing individuals with pain-like delayed symptoms affecting their musculoskeletal system when involved in an auto accident. When asking important questions to our associated medical providers, we advise patients to incorporate customized treatment plans for their pain correlated with musculoskeletal issues after being involved in an auto accident to promote recovery. Dr. Alex Jimenez, D.C., utilizes this information as a professional academic service. Disclaimer

References

Furlan, A. D., et al. (2017). Massage therapy for neck and back pain: An RCT. Pain Medicine, 18(3), 564–573.

Alektoroff, K., & Papanagiotou, P. (2021). Whiplash-associated disorders: A cohort study on long-term outcomes. Journal of Orthopaedic & Sports Physical Therapy, 51(3), 112–120.

Di Antonio, S., et al. (2023). Post-traumatic headaches and cervical impairments: An RCT. Spine Journal, 23(4), 345–353.

Delitto, A., et al. (2012). Low back pain: Clinical practice guidelines linked to the International Classification of Functioning. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1–A57.

Gessl, A., et al. (2021). Chronic inflammation and post-traumatic stress in auto accident patients: A cohort study. Rheumatology International, 41(6), 987–995.

Dies, S. (1992). Chiropractic management of nerve compression syndromes. Journal of Manipulative and Physiological Therapeutics, 15(7), 456–462.

Hon, S., et al. (2021). Physical therapy for auto accident injuries: A systematic review. Physical Therapy Reviews, 26(2), 89–97.

Bronfort, G., et al. (2020). Spinal manipulation and mobilization for whiplash: An RCT. Journal of Chiropractic Medicine, 19(1), 12–20.

Bryans, R., et al. (2018). Evidence-based guidelines for chiropractic care in whiplash. Journal of Manipulative and Physiological Therapeutics, 41(5), 376–389.

Chou, R., et al. (2019). Noninvasive treatments for acute pain: An RCT combining medication and manual therapy. Annals of Internal Medicine, 171(6), 401–410.

Bussières, A. E., et al. (2019). Early intervention in personal injury cases: A systematic review. Chiropractic & Manual Therapies, 27(1), 22.

Disclaimer

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , , ,

Chiropractic Care After a Car Crash and Support Options

What are the benefits of having both a chiropractor and a nurse practitioner help with spine health after a car accident?

Benefits of a Nurse Practitioner and a Chiropractic Specialist in Motor Vehicle Collision

Motor vehicle collisions (MVCs) are a leading source of spinal injuries such as whiplash, ruptured discs, and soft tissue injury, all of which can cause severe pain and limit movement. These injuries typically demand a multimodal therapeutic strategy for short-term and long-term recovery. As advanced practice registered nurses, nurse practitioners provide medical examinations, write prescriptions, and manage overall health, whereas chiropractors specialize in musculoskeletal care, such as spine adjustments and manual therapies. The partnership of these clinicians strives to create a complete, patient-centered plan for post-MVC spine health. (Kent, R., et al., 2023)

A chiropractic and nurse practitioner team can provide comprehensive spinal health treatment to individuals recovering from car accident injuries. This treatment will concentrate on improving mobility and managing pain.

  1. A chiropractic and nurse practitioner team can offer a comprehensive approach to spinal health after a car accident by addressing pain, improving mobility, and facilitating faster recovery.
  2. Chiropractors focus on spinal alignment and joint mobility.
  3. Nurse practitioners provide broader medical oversight and patient education.
  4. The team approach can lead to more effective and personalized care for individuals recovering from car accident injuries. (Riva, J. J., et al., 2010)

Key advantages of this collaborative strategy include:

A chiropractor and nurse practitioner (NP) therapy team can offer comprehensive care for spine health following a motor vehicle collision (MVC) by combining their expertise to address immediate and long-term requirements.

Comprehensive and Interdisciplinary Care

  • Working together, chiropractors and NPs can help with structural and systemic issues, leading to better results, especially for MVC-related spine injuries, notably chronic neck pain and headaches. (Riva, J. J., et al., 2010)

Customized Therapeutic Strategies

  • Chiropractors and nurse practitioners develop individualized treatment regimens for patients that focus on their specific injuries and general health, including any pre-existing diseases and prescription requirements. This method improves results by adjusting treatment to the patient’s particular situation.

Managing pain without relying too much on drugs

  • Chiropractic care uses non-invasive methods to ease pain, which may lead to less use of opioids. NPs can prescribe short-term pain relief and monitor side effects, ensuring safe use and reducing dependency risks. This mix of natural pain treatment and medical supervision lowers the risk of reliance and side effects. (Prater, C., Tepe, M., & Battaglia, P. 2020)

Faster healing and rehabilitation

  • As demonstrated in the treatment of motor vehicle accidents, chiropractic adjustments can help joints work better and ease muscular spasms. NPs can send patients to physical therapy and monitor their progress. This coordinated treatment speeds up healing and lowers the chance of long-term back discomfort. This coordinated care speeds healing and reduces the risk of long-term problems like chronic back pain.

Insurance and Legal Assistance

  • After an MVC, chiropractors and doctors must carefully record injuries and treatments for insurance claims or legal actions to ensure that patients receive fair reimbursement and coverage for their care.

Rationale for Efficacy Post-MVC

A team of nurse practitioners and chiropractors provides a patient-centered approach to spine health following motor vehicle collisions (MVCs). This team integrates NP’s medical management with chiropractic expertise to improve patient outcomes, reduce chronic risks, and enhance recovery. This method is especially beneficial for spine injuries that are complex and related to motor vehicle accidents (MVCs), as it guarantees both immediate relief and long-term health.

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a nurse practitioner, integrates chiropractic care with medical expertise to address various conditions. The clinic provides customized care programs integrating functional medicine, acupuncture, electro-acupuncture, and sports medicine. The clinic addresses chronic pain syndromes and injuries by prioritizing agility, flexibility, and strength. Comprehensive care plans and in-person and virtual health coaching guarantee individual wellness outcomes and treatment plans for patients of all ages and abilities.

Personal Injury Rehabilitation

References

Kent, R., Cormier, J., McMurry, T. L., Johan Ivarsson, B., Funk, J., Hartka, T., & Sochor, M. (2023). Spinal injury rates and specific causation in motor vehicle collisions. Accident; analysis and prevention, 186, 107047. https://doi.org/10.1016/j.aap.2023.107047

Riva, J. J., Muller, G. D., Hornich, A. A., Mior, S. A., Gupta, A., & Burnie, S. J. (2010). Chiropractors and collaborative care: An overview illustrated with a case report. The Journal of the Canadian Chiropractic Association, 54(3), 147–154.

Prater, C., Tepe, M., & Battaglia, P. (2020). Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain. Journal of primary care & community health, 11, 2150132720953680. https://doi.org/10.1177/2150132720953680

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, El Paso TX, Work Injury , , , , , , , , , , , , ,

Chiropractic and Nurse Practitioner for Injury Recovery

What advantages does possessing dual licensure as a chiropractor and nurse practitioner confer in personal injury lawsuits and automobile accidents?

Chiropractic and Nurse Practitioner On Auto Accidents

Following a motor vehicle collision, chiropractors and nurse practitioners are essential in injury management and recovery facilitation. Chiropractors emphasize manual therapies, including adjustments and manipulations, to resolve musculoskeletal problems and enhance mobility, whereas nurse practitioners deliver comprehensive care encompassing assessments, diagnoses, treatment plans, and education, frequently collaborating with specialists to maximize patient outcomes. (Physicians Group, LLC. 2024)

Chiropractors

Chiropractors address musculoskeletal problems, including back and neck discomfort, frequently resulting from automobile accidents. They employ tactile methods to alleviate discomfort and enhance mobility, frequently without pharmaceuticals. Comprehensive data and expert testimony can substantiate personal injury claims, demonstrating the severity of injuries. (Dies, S., & Strapp, J. W., 1992)

Assessment and Management of Musculoskeletal Disorders

  • Chiropractors can diagnose and treat spinal misalignments, muscle spasms, and soft tissue injuries that may occur following an accident.

Analgesic Relief

  • Manual therapy, such as spine adjustments and soft tissue mobilization, can mitigate pain and diminish inflammation.

Enhanced Mobility

  • Chiropractors can restore range of motion and enhance overall function by correcting joint and muscle limitations.

Comprehensive Care

  • Chiropractors typically emphasize holistic body care and guide sustaining proper posture, ergonomics, and general wellness to avert future injuries.

Cooperation with Additional Healthcare Practitioners

  • Chiropractors can collaborate with physicians, physical therapists, and other professionals to develop a holistic treatment plan for the patient. (Physicians Group, LLC, 2024)

Nurse Practitioners

Nurse practitioners are capable of delivering comprehensive care for injuries resulting from motor vehicle accidents, encompassing (Integrity Spine & Orthopedics, 2024)

Evaluation and Identification

  • Nurse practitioners are capable of performing physical examinations, interpreting diagnostic tests, and diagnosing conditions such as whiplash, soft tissue injuries, and concussions.

Therapeutic Protocols

  • They can develop individualized treatment regimens, encompassing pharmacological therapies, physical rehabilitation, and additional interventions, to meet the patient’s distinct requirements.

Patient Instruction

  • Nurse practitioners can instruct patients regarding their injuries, the recuperation process, and self-care techniques to facilitate healing and avert complications.

Care Coordination

  • They can collaborate with other professionals, including surgeons, neurologists, and physical therapists, to guarantee a comprehensive approach to treatment.

Post-Treatment Care

  • Nurse practitioners can assess the patient’s progress, modify treatment plans as necessary, and offer continuous care during the healing process.

Personal injury cases, especially those resulting from automobile collisions, frequently entail intricate medical and legal requirements. Chiropractors and nurse practitioners, each with unique scopes of practice, are essential in diagnosis, treatment, and documentation.

Chiropractors and nurse practitioners both contribute distinct advantages to personal injury cases. Chiropractors concentrate on musculoskeletal disorders, providing non-invasive therapies, whereas nurse practitioners address a wider range of medical requirements, including the prescription of drugs and the coordination of care. Their collaboration can improve patient results, as demonstrated in environments such as the Accident Treatment and Treatment Center, where nurse practitioners and physicians oversee treatment, augmenting chiropractic interventions. (Accident Care, 2025)

Legal resources indicate that the documentation of both professions is essential for insurance claims and settlements. Chiropractors’ meticulous reports on spinal injuries and nurse practitioners’ extensive medical records on overall health can collectively establish a compelling case for compensation. This synergy is especially apparent in automobile accident situations, where patients may necessitate both physical changes and medical supervision for complete recovery. (Chiropractic Economics, 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a family practice nurse practitioner, integrates advanced medical knowledge with chiropractic treatment to manage diverse illnesses. Our clinic amalgamates functional medicine, acupuncture, electro-acupuncture, and sports medicine to design tailored care regimens that foster natural healing, enhance mobility, and ensure long-term wellness. By emphasizing flexibility, agility, and strength, we enable patients to flourish, irrespective of age or health obstacles. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are dedicated to treating individuals following injuries and chronic pain disorders. We concentrate on enhancing your capabilities through customized flexibility, mobility, and agility training designed for various age demographics and disabilities. We employ both in-person and virtual health coaching, together with comprehensive care plans, to guarantee tailored care and wellness outcomes for each patient.

Don’t Ignore Your Post-Accident Pain

References

Physicians Group, LLC. (2024). The Role of Nurse Practitioners in Managing Auto Injuries. Physicians Group, LLC. https://physiciansgroupllc.com/the-role-of-nurse-practitioners-in-managing-auto-injuries/#:~:text=Nurse%20Practitioners%20are%20vital%20in,improved%20outcomes%20and%20patient%20satisfaction.

Dies, S., & Strapp, J. W. (1992). Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis. The Journal of the Canadian Chiropractic Association, 36(3), 139–145.

The Neck and Back Clinics. (2025). Why Seeing a Chiropractor After a Car Accident Is Crucial for Long-Term Recovery. https://theneckandbackclinics.com/long-term-recovery/#:~:text=Reducing%20Inflammation%20and%20Pain,each%20patient%20for%20optimal%20recovery.

Integrity Spine & Orthopedics. (2024). The 9 Steps to Recovery After an Auto Accident. https://www.integrityspineortho.com/post/the-9-steps-to-recovery-after-an-auto-accident/#:~:text=CONTACT%20INTEGRITY%20SPINE%20AND%20ORTHOPEDICS%20AFTER%20A,concussions%2C%20soft%20tissue%20damage%20and%20spine%20damage.

Accident Care and Treatment Center, Inc. (2025). Comprehensive Therapies and Treatments in One Location. https://accidentcare.com/treatment/

Chiropractic Economics. (2023). Evidence-based chiropractic: the key to personal-injury cases. https://www.chiroeco.com/evidence-based-chiropractic-the-key-to-personal-injury-cases/

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Physio , , , , , , , , , , , , , , , , ,

Muscles Retighten: Why Ongoing Care Is Essential

Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?

Muscles Retighten

Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.

  • Muscle memory: The body’s natural tendency to return to its previous state of tension.
  • This includes all the unhealthy postures/positioning 
  • Delayed inflammatory response.
  • The body’s natural healing process
  • How muscles respond to manipulation
  • The need for ongoing maintenance of muscle health

After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)

Causes

Causes for muscles to retighten.

Underlying Issues

  • If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
  • In that case, the muscles may return to their original state after a few days or weeks.

Delayed Onset Muscle Soreness (DOMS)

  • For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)

Delayed Inflammatory Response

  • Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
  • This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)

Muscle Memory

  • The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
  • Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.

Muscle Guarding

  • The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage. 
  • This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)

Muscle Health Maintenance

  • Regular Maintenance
  • Muscles need consistent care to maintain their optimal state of health and function.
  • Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.

Individual Variation

  • Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)

Massage Treatment

Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.

Type of Massage

  • Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
  • Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)

Muscle Fiber Manipulation

  • Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
  • This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.

Dehydration

  • Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)

Lactic Acid Buildup

  • During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness. 
  • (Healthline, 2020)

Muscle Tensions

  • If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Secrets of Optimal Wellness

References

Cleveland Clinic. (2024). How to Relieve Muscle Soreness After a Massage. https://health.clevelandclinic.org/why-does-my-body-feel-worse-after-a-massage

Healthline. (2020). How to Relieve Sore Muscles After a Massage. https://www.healthline.com/health/sore-after-massage#causes-of-soreness

Essential Chiropractic and Physiotherapy. (2025). Muscle Ache After Massage: Common Causes and Relief. https://essentialchiropractic.co.uk/muscle-ache-after-massage-common-causes-and-relief/#:~:text=Post%2Dmassage%20soreness%20is%20a,hours%20as%20the%20muscles%20recover.

Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. https://doi.org/10.1097/rnj.0000000000000151

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care , , , , , , , , , , , , , , , , , ,

Center of Gravity Explained: A Comprehensive Guide

What is the body’s center of gravity to understand and maintain a healthy posture and balance?

Center of Gravity

The human center of gravity, or COG, also known as the center of mass, with the two terms being interchangeable, is where the body’s weight appears to be concentrated. It’s a point in space where the entire body’s mass can be concentrated. When standing upright, the COG is generally located behind the navel and in front of the sacrum, around the level of the second vertebra. (Le Huec, J. 2011) The center of gravity is related to posture, including issues such as swayback, the design of posture exercise programs, and much more.

  • Gravity is a downward pull or force the Earth exerts on the body, creating weight. (NASA, 2013)
  • The center of gravity (COG) is where a body’s weight is equally balanced in all directions. (Physiopedia, 2025)
  • When the COG is defined, it is done from the reference of a static, standing position.
  • Because the body is in motion when we change positions, the COG is located in a new position with each new position.
  • The center of gravity is the point around which all the parts balance, which may be inside or outside the body.
  • Even slight changes in position can change where the COG is. (Physiopedia, 2025)

Key aspects of the COG

Location

  • When standing upright, the COG is typically found at the second vertebral level, behind the navel and in front of the sacrum. (Le Huec, J. 2011)

Shifting COG

  • The COG can shift depending on body position, posture, and movements like bending forward or backward. (Physiopedia, 2025)

Balance Impact 

  • The relationship between the COG and the base of support (the area of the body in contact with the ground) is fundamental to maintaining balance.

Variations

  • There can be variations in the COG location based on factors like gender (men tend to have a slightly higher COG), body shape, and even conditions like obesity or chronic low back pain. (Physiopedia, 2025)

Biomechanics

  • Understanding the COG is crucial in biomechanics and movement analysis, as it’s an index of total body motion and how the body responds to external forces.

The Human Center

The center of gravity is the point at which the body’s mass is equally balanced. This point changes depending on one’s position:

  • Arms up/down
  • Leaning
  • Turning

With strength and flexibility training, the human body can change its center of gravity, as gymnasts and dancers do.

  • When standing, the center of gravity is normally located behind the navel and in front of the sacrum bone (made up of five vertebrae fused vertically) at about the second vertebra level. (Hasegawa K. et al., 2022)
  • Because the body has moving parts, its overall shape changes every time it moves. Carrying something like a suitcase or grocery bag or wearing a backpack adds weight to some areas but not others, changing the center of gravity as it does.
  • The center of gravity is a continually changing point inside or outside the body that represents where the weight or mass of the rest of the body is equally balanced in every direction.
  • This point can and does change based on what is being carried and how it is carried, as well as body position and movements.

Chronic Lower Back Pain

  • A study in the Journal of Back and Musculoskeletal Rehabilitation found that individuals with chronic lower back pain tend to have their center of gravity located excessively towards the back. (Kim D. H., Park J. K., & Jeong M. K. 2014)
  • In the study, the individuals had decreased low back strength upon extension and a reduced normal low back curve.
  • The researchers found that those with chronic lower back pain whose center of gravity was too far back may need physical therapy to retrain the body to overcome strength and balance challenges to re-establish and maintain a healthy posture.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Enhance Your Lifestyle Today with Chiropractic Care

References

Le Huec, J. C., Saddiki, R., Franke, J., Rigal, J., & Aunoble, S. (2011). Equilibrium of the human body and the gravity line: the basics. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20 Suppl 5(Suppl 5), 558–563. https://doi.org/10.1007/s00586-011-1939-7

NASA. Jet Propulsion Laboratory, California Institute of Technology. (2013). What is gravity? Retrieved from https://gracefo.jpl.nasa.gov/news/5/what-is-gravity/

Physiopedia. (2025). Centre of gravity. https://www.physio-pedia.com/Centre_of_Gravity

Hasegawa, K., Amabile, C., Nesme, M., & Dubousset, J. (2022). Gravity center estimation for evaluation of standing whole body compensation using virtual barycentremetry based on biplanar slot-scanning stereoradiography – validation by simultaneous force plate measurement. BMC musculoskeletal disorders, 23(1), 22. https://doi.org/10.1186/s12891-021-04948-5

Kim, D. H., Park, J. K., & Jeong, M. K. (2014). Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 27(2), 231–237. https://doi.org/10.3233/BMR-130442

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Acupuncture, Chiropractic Care, Electroacupuncture , , , , , , , , , , , , , , , , , , ,

Paraspinal Muscle Tension: Understanding the Impacts

Can a paraspinal muscle spasm in the lower back create a chain reaction leading to hamstring spasms and potential sciatic nerve entrapment?

Paraspinal Muscle Spasm Chain Reaction

A paraspinal muscle spasm in the lower back can cause a cascade of events, including: (Cedars-Sinai, 2025)

  • Spasms in other lower back muscles
  • Hamstring spasms
  • Potential entrapment of the sciatic nerve

Leading to symptoms similar to sciatica: 

  • Pain
  • Sore, achy muscles
  • Weak muscles
  • Numbness
  • Tingling along the back of the leg

Possible Mechanisms

Triggering Muscle Spasms in the Lower Back

  • Paraspinal muscles are located along the spine and help to stabilize and support the lower back.
  • When these muscles spasm, they can become tense and painful, causing a chain reaction.
  • This tension can radiate down and affect other muscles in the lower back. (Noonan A. M., & Brown S. H. M., 2021)

Can Affect Lower Back Muscles and Cause Hamstring Spasms

  • Lower back muscles, including those like the quadratus lumborum, can be affected by paraspinal spasms. (Hospital for Special Surgery, 2024)
  • The spasms can cause these muscles to tighten or spasm, potentially pulling on the hamstring muscles.
  • This can lead to hamstring spasms and tightness, further contributing to pain and potential nerve irritation.

Entrapment of the Sciatic Nerve

  • Piriformis syndrome is a common condition where the piriformis muscle (located in the buttock) spasms and compresses the sciatic nerve. (Cedars-Sinai, 2025)
  • The sciatic nerve runs from the lower back down the back of the thigh and into the leg, making it vulnerable to compression by surrounding muscles.
  • If the paraspinal and hamstring spasms create enough tension on the piriformis muscle or surrounding tissues, it can lead to sciatic nerve entrapment. (Hospital for Special Surgery, 2024)

How acupuncture helps relieve sciatica

Acupuncture can help relieve sciatica pain by stimulating specific points on the body, which can trigger the release of endorphins, reduce inflammation, improve blood flow, and relax tight muscles that could be compressing the sciatic nerve. By modulating the nervous system and promoting the body’s natural healing processes, acupuncture can help alleviate pain and improve overall function. (Qin, Z. et al., 2015)

Releases endorphins

  • Acupuncture stimulates the nervous system, triggering the release of endorphins, the body’s natural painkillers.

Reduces inflammation

  • Acupuncture can help reduce inflammation in the area surrounding the sciatic nerve, which can contribute to pain and nerve irritation. (Natural Care Chiropractic, 2022)

Improves circulation

  • By increasing blood flow to the affected area, acupuncture can help deliver nutrients and oxygen to the sciatic nerve and surrounding tissues, promoting faster healing.

Relaxes tight muscles

  • Sciatica pain can be exacerbated by tight muscles compressing the nerve. Acupuncture can help relax these muscles, reducing pressure on the sciatic nerve and alleviating pain.

Regulates the nervous system

  • Acupuncture can help regulate the nervous system, positively impacting pain perception and overall well-being. (Qin, Z. et al., 2015)

Promotes regeneration

  • Some evidence suggests that acupuncture can promote sciatic nerve regeneration, potentially leading to long-term pain relief. (Natural Care Chiropractic, 2022)

Needling Types

Distal needling

  • Acupuncture can also involve using points that are further away from the site of pain, which can also help to reduce pain and inflammation. 

Local needling

  • Points are also selected on or near the sciatic nerve’s path, which can help directly address the source of pain and inflammation. (Qin, Z. et al., 2015)

Holistic approach

  • Acupuncture is often viewed as a holistic approach to pain management, addressing the symptoms of sciatica and the underlying causes and imbalances in the body.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Chiropractic and Integrative Healthcare

References

Cedars Sinai. (2025). Piriformis Syndrome. https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/piriformis-syndrome.html#:~:text=Overview,can%20run%20through%20the%20muscle)

Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR spine, 4(3), e1171. https://doi.org/10.1002/jsp2.1171

Hospital for Special Surgery. (2024). Sciatica. https://www.hss.edu/condition-list_sciatica.asp

Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine: eCAM, 2015, 425108. https://doi.org/10.1155/2015/425108

Natural Care Chiropractic, D. M. F. (2022). Acupuncture for Sciatica Pain Relief. https://www.naturalcarechiropractic.com/post/acupuncture-for-sciatica-pain-relief

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Sleep Hygiene , , , , , , , , , , , , , , , , ,

Pseudoarthrosis After Spinal Fusion Surgery Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis of the cervical and lumbar spine

Individuals may need a spinal fusion to treat a fractured vertebra, scoliosis, or conditions like spinal stenosis, degenerative disc disease, and spondylolisthesis/slipped vertebrae. A spinal fusion reduces pain and stabilizes the spine by limiting movement between vertebrae. Pseudoarthrosis happens when the bones don’t heal after a fracture or bone surgery. When pseudoarthrosis affects the cervical or lumbar spine, it means that two vertebrae did not heal and grow together after spinal surgery to fuse them (spinal fusion). Reasons for a failed spinal fusion include:

  • Issues with the instruments used to stabilize the bone
  • Lack of bone growth
  • The number of vertebrae being fused.

The patient’s health and lifestyle play a role in failed fusions, which can include

  • Diabetes
  • Inflammatory health conditions increase the risk
  • Smoking
  • Long-term steroid use

In many cases, revision surgery is needed.

Surgery-Related

During a spinal fusion, surgeons insert a bone graft between two vertebrae and then apply spinal fixation hardware (instrumented spinal fusion) that includes:

  • Plates
  • Rods
  • Screws
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. A rigid frame secured outside the body helps to stabilize the bones.

If the fusion fails, it could be caused by one or more of the following surgical issues:

Number of Vertebrae Being Fused

Hardware

  • The surgeon must carefully plan and use the right hardware.
  • The type of hardware used during a spinal fusion may influence bone healing.
  • The instruments can come loose or break, interfering with the fusion process.
  • Spinal osteoporosis, having thin, weak bones, can affect fixation.
  • Even with the optimal surgical preparedness, weak bones significantly increase the chance of the instruments loosening and pseudoarthrosis developing.

Bone Graft

  • The type of bone graft used may affect the fusion.
  • For example, in cervical/neck spinal fusions, an autograft, which uses a small piece of bone from the patient’s body, has a higher success rate. (Verla T. et al., 2021)
  • Other graft options include specialized steel cages that fit between vertebrae and contain bone growth factors.
  • The surgeon recommends the optimal bone graft for the type of surgery, the number of vertebrae involved, and risk factors.

Risk Factors

  • The patient’s overall health and lifestyle impact the results of spinal fusion. Smoking increases the risk. (Berman D. et al., 2017)
  • Nicotine restricts blood circulation, decreases bone density, reduces new bone formation, and delays bone healing. (Hernigou J., & Schuind F., 2019)

The risk of pseudoarthrosis increases if the individual has any of the following: (Scoliosis Research Society, 2023)

  • Previous pseudoarthrosis
  • Obesity
  • Chronic steroid use
  • Malnutrition
  • Inflammatory diseases

Inflammatory conditions that can lead to bone loss and non-optimal bone healing include: (Torres H. M. et al., 2023)

  • Diabetes (Jiao H, Xiao E, & Graves DT, 2015)
  • Inflammatory bowel disease
  • Psoriasis
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease/COPD
  • Periodontitis
  • Systemic lupus erythematosus/SLE

Symptoms

  • The primary sign of pseudoarthrosis is pain in the same area as before the fusion surgery.
  • If the bones pinch a spinal nerve, one arm may experience pain, tingling, burning, or numbness.
  • Rarely does a pinched nerve affect both arms.
  • The pain may return shortly after the procedure.
  • The pain may develop gradually or not appear for many months.
  • However, it’s more likely to appear after several months when the individual returns to their usual activities.

Diagnosis

  • The healthcare provider will learn about symptoms and perform a physical exam to evaluate the back.
  • They’ll assess mobility and the type of movement that causes pain.
  • Then, they order diagnostic imaging to see the spine and identify the cause of pain.
  • Individuals may need a CT scan, MRI, and/or X-rays to evaluate the spinal structures and instrumentation fully.

Treatment

Treatment for pseudoarthrosis will likely start with:

  • Physical therapy
  • Pain management – especially in cases where it is important to rule out other sources of back or neck pain.
  • Medication
  • Injections
  • If symptoms don’t improve with conservative care or if there is severe pain, the healthcare provider may recommend revision surgery.
  • Revision surgery is another procedure to treat complications or correct issues that arise after the initial pseudoarthrosis surgery.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Enhancing Health Together

References

Boonsirikamchai, W., Wilartratsami, S., Ruangchainikom, M., Korwutthikulrangsri, E., Tongsai, S., & Luksanapruksa, P. (2024). Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis. BMC musculoskeletal disorders, 25(1), 433. https://doi.org/10.1186/s12891-024-07531-w

Verla, T., Xu, D. S., Davis, M. J., Reece, E. M., Kelly, M., Nunez, M., Winocour, S. J., & Ropper, A. E. (2021). Failure in Cervical Spinal Fusion and Current Management Modalities. Seminars in plastic surgery, 35(1), 10–13. https://doi.org/10.1055/s-0041-1722853

Berman, D., Oren, J. H., Bendo, J., & Spivak, J. (2017). The Effect of Smoking on Spinal Fusion. International journal of spine surgery, 11(4), 29. https://doi.org/10.14444/4029

Hernigou, J., & Schuind, F. (2019). Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone & joint research, 8(6), 255–265. https://doi.org/10.1302/2046-3758.86.BJR-2018-0344.R1

Scoliosis Research Society. (2023). Pseudoarthrosis. https://www.srs.org/Patients/Conditions/Pseudoarthrosis

Torres, H. M., Arnold, K. M., Oviedo, M., Westendorf, J. J., & Weaver, S. R. (2023). Inflammatory Processes Affecting Bone Health and Repair. Current osteoporosis reports, 21(6), 842–853. https://doi.org/10.1007/s11914-023-00824-4

Jiao, H., Xiao, E., & Graves, D. T. (2015). Diabetes and Its Effect on Bone and Fracture Healing. Current osteoporosis reports, 13(5), 327–335. https://doi.org/10.1007/s11914-015-0286-8

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care , , , , , , , , , , ,

Migraines & Neck Pain: Understanding the Connection

Find out how migraines and neck pain can disrupt your day and explore solutions to help you regain your comfort and peace.

Introduction

As a Nurse Practitioner with over 20 years of experience in physical and functional medicine, I’ve seen firsthand how chronic migraines—especially those linked with neck pain—can derail lives. Migraines are more than just severe headaches; they are complex neurological events often triggered by musculoskeletal dysfunction, stress, inflammation, and poor posture.

What’s often overlooked in traditional care models is the close relationship between cervical spine health and migraine activity. By integrating chiropractic care, postural retraining, and functional nutrition, we can significantly reduce migraine frequency and severity for many patients.

In this comprehensive post, we’ll explore:

  • The anatomical and physiological link between neck pain and migraines
  • The role of fibromyalgia in exacerbating migraine symptoms
  • Evidence-based chiropractic interventions
  • Postural and ergonomic corrections
  • Anti-inflammatory nutritional strategies

The Link Between Neck Pain and Migraines: Cervicogenic and Neurovascular Overlap

Patients often describe their migraine episodes beginning with a deep ache or stiffness in the neck, which gradually radiates toward the skull. This isn’t coincidental—it’s anatomical. Many migraines are cervicogenic in origin, meaning they arise from dysfunctions in the cervical spine.

The Cervical Trigeminovascular Connection

Cervicogenic headaches and migraines share overlapping pathways, particularly involving the trigeminocervical complex—a convergence of sensory nerves from the cervical spine and trigeminal nerve that transmits head and facial pain. Misalignment, muscular tension, or inflammation in this area can trigger the trigeminal-autonomic reflex, activating symptoms like:

  • Throbbing head pain
  • Light and sound sensitivity
  • Visual aura
  • Nausea

According to Vicente et al. (2023), activation of this reflex and extracranial autonomic involvement may underlie migraine generation when cervical structures are compromised. This suggests that structural or functional issues in the neck—such as joint hypomobility or myofascial tension—can act as primary migraine triggers.

Common Migraine-Associated Neck Pain Triggers

  • Cervical spine misalignment
  • Postural kyphosis and forward head posture
  • Muscular tension from occupational strain or emotional stress
  • TMJ dysfunction
  • Inadequate sleep or poor sleep posture

Fibromyalgia: An Amplifier of Migraines and Neck Pain

Patients with fibromyalgia are particularly susceptible to migraines due to central sensitization—a phenomenon in which the central nervous system becomes hypersensitive to stimuli.

In these patients, mitochondrial dysfunction plays a key role. As Janssen et al. (2021) highlight, both fibromyalgia and migraines are associated with impaired cellular energy metabolism. Symptoms in fibromyalgia patients often include:

  • Intensified migraine episodes
  • Musculoskeletal tenderness in the neck, trapezius, and occiput
  • Sleep disturbances and fatigue
  • Amplified pain response to touch (allodynia)

Understanding this connection allows for more targeted and effective treatment plans. Interventions must address not just musculoskeletal alignment but also systemic inflammation and nervous system regulation.

Tension Headaches Explained- Video

Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

Chiropractic interventions can be transformative for patients experiencing migraines related to neck dysfunction. Techniques such as cervical spine manipulation, soft tissue release, and muscle energy techniques (METs) help restore balance and reduce pain signaling.

Key Chiropractic Techniques:

  • Suboccipital Release: Alleviates deep muscle tension that compresses the greater occipital nerve
  • Cervical Mobilization: Increases joint range of motion and reduces localized inflammation
  • Myofascial Release: Targets the tight fascia and deep muscle layers in the upper back and neck
  • Instrument-Assisted Soft Tissue Mobilization (IASTM): Enhances blood flow and breaks down fibrotic tissue

Research by Mayo & Keating (2023) demonstrates that chiropractic spinal manipulation can significantly reduce migraine frequency and symptom duration, especially when combined with ergonomic education and exercise.

2. Postural Retraining and Ergonomics: Reducing Structural Strain

Modern lifestyle habits, such as prolonged screen use and poor workstation design, contribute significantly to cervical dysfunction and subsequent migraines.

Postural Interventions:

  • Craniocervical Flexion Exercises: Strengthen deep neck flexors and reduce forward head posture
  • Scapular Stabilization Routines: Reinforce shoulder and thoracic posture
  • Workstation Ergonomic Adjustments: Monitor elevation, lumbar support, and keyboard positioning

A 2021 study by de Almeida Tolentino et al. confirms that correcting head and neck posture can significantly reduce the frequency of migraines and improve functional disability scores in migraine sufferers.

3. Anti-Inflammatory Nutrition: Healing from Within

Nutritional strategies play a crucial role in modulating inflammation and stabilizing the nervous system. Many patients experience relief by identifying and avoiding dietary migraine triggers such as:

  • Aged cheeses
  • Processed meats (high in nitrates)
  • MSG, aspartame, and high-sugar foods
  • Alcohol, especially red wine

Functional Nutrition Recommendations:

  • Elimination Diets: Help identify food triggers and reduce systemic inflammation (Gazerani, 2020)
  • Magnesium Supplementation: Reduces cortical spreading depression and improves vascular tone (Shin et al., 2020)
  • Omega-3 Fatty Acids: Found in fatty fish, flaxseed, and chia, these combat neuroinflammation
  • Riboflavin (Vitamin B2): Shown to reduce the frequency of migraines when taken consistently
  • CoQ10: Improves mitochondrial function and energy production in the brain

Integrating these supplements and dietary shifts can offer long-term, sustainable relief by addressing underlying metabolic and neurological dysfunctions.

Integrated Care Planning: The Functional Medicine Model

In my clinical practice, treating migraines associated with neck pain involves more than adjusting the spine or prescribing a supplement—it requires a systems-based approach.

A Sample Care Plan May Include:

  • Initial chiropractic assessment and spinal X-rays (if indicated)
  • Trigger point mapping and musculoskeletal evaluation
  • Nutritional intake analysis with elimination diet guidance
  • Prescription of cervical mobility and posture exercises
  • Functional labs to assess inflammatory markers and micronutrient status
  • Co-management with neurologists for medication tapering (when appropriate)

The goal is to transition patients from episodic crisis management to proactive wellness, reducing reliance on pharmaceuticals and emergency interventions.

Empowering Patients Through Education and Collaboration

One of the most rewarding aspects of integrative care is educating patients about how their lifestyle, posture, diet, and spinal alignment interact to affect migraine frequency and severity.

By understanding the why behind their symptoms, patients are more empowered to:

  • Recognize and avoid migraine triggers
  • Adhere to treatment protocols
  • Participate in preventive strategies like exercise and stress reduction

When patients are viewed not just as symptoms but as whole individuals, outcomes dramatically improve. As we tailor care to their unique physiology and environment, we foster long-term healing—not just temporary relief.

Conclusion: Migraines and Neck Pain—An Opportunity for Functional Healing

The connection between migraines and neck pain is more than coincidental—it’s a deeply interwoven neurovascular and musculoskeletal relationship. As functional and physical medicine providers, we have the opportunity to address this relationship holistically.

Through chiropractic care, ergonomic corrections, anti-inflammatory nutrition, and nervous system regulation, we can guide patients toward a life with fewer migraines, improved neck mobility, and greater vitality.

By looking beyond the head and acknowledging the role of the cervical spine and systemic health, we not only reduce pain—we restore function, purpose, and quality of life.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with neck pain associated with migraines. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce migraines from reappearing and causing neck pain. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Aguilar-Shea, A. L., Membrilla Md, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Aten Primaria, 54(2), 102208. https://doi.org/10.1016/j.aprim.2021.102208

Al Khalili, Y., Ly, N., & Murphy, P. B. (2025). Cervicogenic Headache. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939639

de Almeida Tolentino, G., Lima Florencio, L., Ferreira Pinheiro, C., Dach, F., Fernandez-de-Las-Penas, C., & Bevilaqua-Grossi, D. (2021). Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol, 21(1), 249. https://doi.org/10.1186/s12883-021-02290-w

Di Antonio, S., Arendt-Nielsen, L., & Castaldo, M. (2023). Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract, 66, 102817. https://doi.org/10.1016/j.msksp.2023.102817

Gazerani, P. (2020). Migraine and Diet. Nutrients, 12(6). https://doi.org/10.3390/nu12061658

Janssen, L. P., Medeiros, L. F., Souza, A., & Silva, J. D. (2021). Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance. An Acad Bras Cienc, 93(suppl 4), e20210618. https://doi.org/10.1590/0001-3765202120210618

Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022). Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus, 14(8), e27830. https://doi.org/10.7759/cureus.27830

Mayo, Z., & Keating, C. (2023). Manual Therapy and Exercise for the Management of Chronic Neck Pain With Multiple Neurovascular Comorbidities: A Case Report. Cureus, 15(3), e36961. https://doi.org/10.7759/cureus.36961

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8). https://doi.org/10.3390/nu12082184

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). https://doi.org/10.3390/diagnostics13040590

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By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Electroacupuncture, Physio , , , , , , , , , , , , , ,

Supine Position Explained: Benefits and Uses

For individuals experiencing back pain, can lying in the supine position help bring relief?

Supine Position

The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)

Medical Uses

Examinations

  • Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)

Procedures

Surgery

  • Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures. 
  • It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)

Overall Health

Natural Position

  • Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.

Back Pain Relief

  • Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)

Acid Reflux

  • However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)

Sleep Apnea

  • The supine position can worsen sleep apnea in some individuals.

Clinical Uses

  • A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
  • If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
  • This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
  • Many bed exercises begin in this position for rehabilitation.

Back Care

Here are a few recommendations to relieve low back pain using the supine position.

  • First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
  • Start breathing and relaxing, allowing the tension to drain out of the muscles.
  • In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
  • At that point, the fingertips should feel the transverse abdominal muscle engage.
  • Release and repeat 10 times.

After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.

For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.

Variations

Lawn Chair Position

  • This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.

Frog-Leg Position

  • The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)

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.

Thoracic Spine Pain

References

ScienceDirect. (2009). Supine Position. Morrey’s The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5

Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.

STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.

MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position

Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy , , , , , , , , , , , , , , , , ,

Understanding Nerve Conduction Velocity in Health Care

Should individuals experiencing nerve pain or various sensations get a nerve conduction velocity study to examine nerve health and function?

Nerve Conduction Velocity

A nerve conduction velocity (NCV) is a noninvasive test that measures the speed and strength of nerve stimulation using electrical probes placed on the skin. It’s used to diagnose nerve damage or disease, often alongside an EMG (electromyogram) to differentiate between nerve and muscle problems. It can also evaluate sensory issues, pain, and weakness of the extremities.

  • This test involves safe electrical shocks that can be slightly uncomfortable but not painful.
  • Nerve conduction velocity (NCV) measures the speed at which electrical impulses travel along a nerve fiber, which measures how quickly electrical signals travel through a nerve.
  • This information indicates nerve health and function.
  • Electromyography (EMG) is a nerve test that involves placing tiny needles into the muscles.
  • A slower NCV can indicate nerve injury or dysfunction.

Test Uses

Generally, the test is ordered to assess peripheral nerve diseases, those that connect from the muscles, organs, and skin to the spinal cord or brain. It can help identify the type and location of nerve damage.

  • Peripheral nerve conditions typically cause pain, sensory loss, tingling, or burning.
  • Mild weakness and diminished reflexes can be detected during a neurological examination.

Conditions

Nerve conduction studies are performed to help diagnose conditions.

  • Herniated disc disease
  • Sciatic nerve problems
  • Carpal tunnel syndrome
  • Guillain-Barré syndrome
  • Nerve damage (neuropathy), such as from diabetes, chemotherapy, or autoimmune disorders
  • Charcot-Marie-Tooth disease

Nerve compression

  • Many different conditions, including trauma, inflammation, and tumors, can compress one or more nerves.

Radiculopathy

  • Often described as a pinched nerve, radiculopathy can affect an arm or a leg, causing pain and weakness.

Peripheral Neuropathy

  • This nerve damage begins in the most distal nerves, those farthest from the center of the body, such as the toes and fingers. It is often due to chronic alcohol misuse, uncontrolled diabetes, nutritional deficits, and inflammatory diseases. (Ferdousi M. et al., 2020)

Carpal Tunnel Syndrome

  • Commonly caused by inflammatory diseases or overuse of the wrists, such as from assembly line work, carpal tunnel syndrome causes numbness, pain, and weakness of the fingers and hands. (Tada K. et al., 2022)

Ulnar neuropathy

  • This common condition causes arm pain and sensory changes, usually due to repetitive movements or a prolonged position that causes pressure on the ulnar nerve.

Guillain-Barré syndrome (GBS)

  • This inflammatory condition causes demyelination, or loss of the insulating covering around nerves, which results in leg weakness.
  • It begins in the motor nerves, which send signals to muscles in the legs. (Shibuya K. et al., 2022)
  • The inflammation travels to nerves of the upper body, often affecting the muscles that control breathing.
  • Respiratory support is necessary until the condition improves.

Chronic Demyelinating Polyneuropathy (CIDP)

  • This condition is a chronic, recurrent form of GBS that usually affects the legs and causes episodes of weakness.

ICU neuropathy

  • Metabolic changes, severe illness, and not moving enough can cause nerves to develop a pattern of weakness and sensory loss.

Myasthenia gravis (MG)

  • This autoimmune condition affects the junction between the nerves and the muscles.
  • Myasthenia gravis causes drooping eyelids and weakness of the arms and shoulders.

Amyotrophic lateral sclerosis (ALS)

  • ALS is a serious, degenerative disease affecting the spinal cord’s motor neurons.
  • Amyotrophic lateral sclerosis progresses rapidly, resulting in substantial weakness of muscles throughout the body.

How it’s Done

  • Surface electrodes are placed on the skin over nerves, and a small electrical current is applied to stimulate the nerve.
  • The time it takes for the electrical signal to travel between the electrodes is measured, and this time is used to calculate the NCV.

Values

Normal NCV values are generally between 50 and 70 meters per second. However, these values can vary depending on the nerve and the individual.

NCV Factors

Various factors can influence NCV.

  • Age
  • Sex
  • Medical conditions like diabetes

Interpretation

  • A slower NCV can indicate nerve damage or demyelination (loss of the myelin sheath, which insulates nerve fibers), while an EMG can help determine if the problem is with the nerve or the muscle.

Results

The results of NCV testing can be used to determine the type, severity, and location of nerve damage. The results will be ready in report form about a week after the test.

  • The test measures velocity (how fast a nerve transmits signals) and amplitude (how many nerve fibers were activated). (Tavee J. 2019)
  • The measurements are transmitted to a computer and shown as waves and numerical values.
  • The values are compared to a standard measurement based on the tested nerve.
  • The distance between the electrodes.
  • The person’s age.

Compared to the standard, the NCV results can identify certain patterns of nerve damage. (Tada K. et al., 2022) Outcomes include: (Tavee J. 2019)

  • If one or more nerves are affected.
  • If motor nerves (control movement), sensory nerves (transmit sensory signals), or both are affected.
  • Whether a nerve is blocked or damaged.
  • The severity of the damage.
  • The type of nerve damage
  • Axonal (damage to the nerve itself)
  • Demyelination (damage to the protective fatty layer around the nerve)

The results can help point to certain diagnoses.

Preparation Before the Test

Individuals will not need to change their diet before having an NCV. However, patients will be asked to avoid lotions or creams on their skin before the test. Individuals who are also having an EMG at the time of their NCV might be asked to stop taking medications or supplements that increase the risk of bleeding and bruising. If a healthcare provider says not to stop taking the medicines for health reasons, the patient might be warned that they could have some bruising after the EMG test.

  • NCV may advise against getting the test for those with electrical device implants.
  • Make sure your healthcare providers are aware of your whole medical history.

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.

Peripheral Neuropathy and Chiropractic Care

References

Ferdousi, M., Kalteniece, A., Azmi, S., Petropoulos, I. N., Worthington, A., D’Onofrio, L., Dhage, S., Ponirakis, G., Alam, U., Marshall, A., Faber, C. G., Lauria, G., Soran, H., & Malik, R. A. (2020). Corneal confocal microscopy compared with quantitative sensory testing and nerve conduction for diagnosing and stratifying the severity of diabetic peripheral neuropathy. BMJ open diabetes research & care, 8(2), e001801. https://doi.org/10.1136/bmjdrc-2020-001801

Tada, K., Murai, A., Nakamura, Y., Nakade, Y., & Tsuchiya, H. (2022). In Carpal Tunnel Syndrome, Sensory Nerve Conduction Velocities Are Worst in the Middle Finger Than in the Index Finger. Frontiers in Neurology, 13, 851108. https://doi.org/10.3389/fneur.2022.851108

Shibuya, K., Tsuneyama, A., Misawa, S., Suzuki, Y. I., Suichi, T., Kojima, Y., Nakamura, K., Kano, H., Ohtani, R., Aotsuka, Y., Morooka, M., Prado, M., & Kuwabara, S. (2022). Different patterns of sensory nerve involvement in chronic inflammatory demyelinating polyneuropathy subtypes. Muscle & Nerve, 66(2), 131–135. https://doi.org/10.1002/mus.27530

Tavee J. (2019). Nerve conduction studies: Basic concepts. Handbook of Clinical Neurology, 160, 217–224. https://doi.org/10.1016/B978-0-444-64032-1.00014-X