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
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.
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.
Chiropractors focus on spinal alignment and joint mobility.
Nurse practitioners provide broader medical oversight and patient education.
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
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/
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.
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
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
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.
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
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
The bone graft promotes growth between the two bones.
The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
The hardware goes inside, or internal fixation.
Although rare, a severe spinal fracture or deformity may need external fixation.
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:
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 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
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
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
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
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
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
It’s also used for various procedures, such as lumbar punctures and injections. (Steris Healthcare, 2025)
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
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
What is a bone density test, how is it performed, and what do the results mean?
Bone Density Test
A bone density test examines bone mass, which indicates overall bone strength. Assessing bone density or mass is necessary for diagnosing osteopenia or osteoporosis, conditions that increase the risk of broken bones. The scan is performed through dual-energy X-ray absorptiometry (DEXA), which examines the thickness of the bones. Results from DEXA scans are compared to standardized values to determine whether bone density is lower than normal and whether osteopenia or osteoporosis is present.
Examination
The procedure examines bone density, or bone mass. The bones’ density, or mass, is an overall indicator of bone strength. The greater the bone density, the thicker and stronger the bones are. The test is used to diagnose osteoporosis, a condition characterized by brittle bones at risk of breaking due to significantly low bone density. A bone density test can also diagnose osteopenia, a condition characterized by lower than normal bone mass that can lead to osteoporosis. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2025) It is recommended that all women aged 65 and older and all men aged 70 and older have a bone density scan to screen for bone loss to help prevent fractures. (Kling J. M., Clarke B. L., & Sandhu N. P. 2014)
Bone density scans can establish a baseline level of bone density and track changes over time.
For individuals with osteoporosis or osteopenia, a bone density scan can help track how well their bones respond to treatment.
During a DEXA scan, the patient will lie on their back on a table with their legs elevated on a padded platform.
An X-ray scanner will pass over the spine and hips while another scans beneath.
While the scan takes place, the patient will be asked to hold very still to obtain an accurate image.
The scan will obtain bone density readings from the spine and hip, the two most commonly fractured bones, and generally takes less than 30 minutes.
Results
A DEXA scan measures bone density in grams per centimeter squared (g/cm²). This number indicates how densely bone cells are packed together in a specific area of bone. This bone density reading is then compared to a standardized value to determine if bone density is within a normal range or lower than average.
Between minus 1.0 and minus 2.5: Low bone density (osteopenia)
Equal to minus 2.5 or below: Osteoporosis
Bone density values are reported as a Z score for women who have not undergone menopause and men under 50 years old.
Z scores are compared to bone density levels of individuals of the same age and sex.
A Z score of minus 2.0 or lower indicates low bone density, which can be caused by factors other than aging, such as medication side effects, nutritional deficiencies, or thyroid problems.
Arthritis Diagnosis
Because a DEXA scan only measures the thickness of bones, it doesn’t work to diagnose arthritis. An X-ray of the affected joint is currently the most accurate way to diagnose arthritis. The Kellgren-Lawrence classification system categorizes the extent of arthritis based on the severity of joint damage seen on an X-ray. According to this system, arthritis can be classified as: (Kohn M. D., Sassoon A. A., & Fernando N. D. 2016)
Grade 1 (minor)
Minimal or no joint space narrowing, with possible bone spur formation.
Grade 2 (mild)
Possible joint space narrowing, with definite bone spur formation.
Grade 3 (moderate)
Definite joint space narrowing, moderate bone spur formation, mild sclerosis (abnormal thickening of bone), and possible deformation of bone ends.
Grade 4 (severe)
Severe joint space narrowing, large bone spur formation, marked sclerosis, and definite deformation of bone ends.
Injury Medical Chiropractic & Functional Medicine Clinic
Exercise can be incredibly beneficial for improving bone density, joint mobility, and the strength of surrounding muscles, which support and protect joints and bones. Talk to a healthcare provider to learn what interventions and available treatment options would be the most effective. 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.
Osteoporosis
References
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2025). Bone mineral density tests: what the numbers mean. Retrieved from https://www.niams.nih.gov/health-topics/bone-mineral-density-tests-what-numbers-mean
Kling, J. M., Clarke, B. L., & Sandhu, N. P. (2014). Osteoporosis prevention, screening, and treatment: a review. Journal of women’s health (2002), 23(7), 563–572. https://doi.org/10.1089/jwh.2013.4611
Kohn, M. D., Sassoon, A. A., & Fernando, N. D. (2016). Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clinical orthopaedics and related research, 474(8), 1886–1893. https://doi.org/10.1007/s11999-016-4732-4
