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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 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

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

Bone Density Test and Its Importance for Health

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.

Procedure

The most common bone density test is a dual-energy X-ray absorptiometry, or DEXA, scan. A DEXA scan is similar to getting an X-ray taken, but it uses two beams to produce a more detailed and sensitive reading. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2025)

  • 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.

For postmenopausal women and men aged 50 and older, bone density values are given a T score. The T-scores are then compared to a standardized bone density level of a healthy 30-year-old adult with peak bone density levels. (Kling J. M., Clarke B. L., & Sandhu N. P. 2014) Scores indicate the following: (Kling J. M., Clarke B. L., & Sandhu N. P., 2014)

  • Equal to minus 1.0 or above: Normal bone density
  • Between minus 1.0 and minus 2.5: Low bone density (osteopenia)
  • Equal to minus 2.5 or below: Osteoporosis
  1. Bone density values are reported as a Z score for women who have not undergone menopause and men under 50 years old.
  2. Z scores are compared to bone density levels of individuals of the same age and sex.
  3. 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

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

Postural Assessment for Optimal Movement Efficiency

Can postural assessments help identify problems with how a person stands or sits, which can lead to various musculoskeletal issues?

Postural Assessment

Proper posture is an exercise in which the muscles support the skeleton in a comfortable, stable, and efficient alignment. Healthy posture is present when the body is still and when moving. However, numerous factors can affect and hinder posture. These include daily wear and tear, injury, illness, or a condition. A posture assessment is a process that identifies posture issues and their root causes, often using visual and palpation techniques, and can help determine appropriate treatment or exercises. (Science Direct, 2007)

Visual Assessment

  • Observing the body’s alignment and symmetry from different angles (anterior, posterior, and lateral views).

Palpation

Movement Analysis

  • Assessing how a person moves and if there are any limitations or compensations. (Physiopedia, 2025)

Importance and Benefits

Early Identification

  • Helps identify potential problems early, before they become more serious.

Targeted Treatment

  • Allows for the development of personalized treatment plans to address specific postural issues.

Injury Prevention

  • It can help prevent injuries by addressing underlying postural imbalances.

Postural Assessment Tools

Some tools used include:

Basic Assessment

Stand Upright

  • The patient stands with their feet shoulder-width apart, arms relaxed at their sides, and looks straight ahead. (Science Direct, 2007)

Alignment Observation

  • Head: Is the head aligned over the shoulders, forward, or tilted?
  • Shoulders: Are the shoulders level, or are they rounded forward?
  • Back: Is the back straight, or is there excessive curvature (kyphosis or lordosis)?
  • Pelvis: Is the pelvis level or tilted forward or backward?
  • Knees: Are the knees straight or slightly bent?
  • Feet: Are the feet flat on the ground, or is there excessive arch or pronation?

Palpate for Muscle Imbalances

Consider the Patient’s Activity Level and History

Wall Test

  • The patient stands against a wall with their feet shoulder-width apart and heels about 6 inches from the baseboard.
  • If they have good posture, their ears will be vertically aligned with their shoulders, and their head will be no more than three finger widths from the wall. (Physiopedia, 2025)

Postural Issues Examples

Rounded Shoulders (Hyperkyphosis)

  • Forward rounding of the upper back.

Forward Head Posture

  • Head positioned too far forward.

Lordosis

  • Excessive inward curve of the lower back.

Flat Back

  • Reduced natural curve of the lower back.

Muscle Imbalances

Professionals Who Can Perform a Posture Assessment

Physiotherapists

  • Professionals trained in assessing and treating musculoskeletal problems.

Chiropractors

  • Professionals who focus on the spine and nervous system.

Fitness Professionals

  • Personal trainers or other fitness professionals can use posture assessments to help clients improve their posture and movement.

Ergonomists

  • Professionals who specialize in designing workspaces and environments to promote good posture and reduce strain.

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider to learn what interventions would help the most. 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.

Multidisciplinary Evaluation and Treatment

References

ScienceDirect. (2007). Postural Assessment – an Overview. Evidence-Based Manual Medicine, 2007. https://www.sciencedirect.com/topics/medicine-and-dentistry/postural-assessment#recommended-publications

Singla, D., & Veqar, Z. (2014). Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR, 8(4), LE01–LE4. https://doi.org/10.7860/JCDR/2014/6836.4266

Du, S. H., Zhang, Y. H., Yang, Q. H., Wang, Y. C., Fang, Y., & Wang, X. Q. (2023). Spinal posture assessment and low back pain. EFORT open reviews, 8(9), 708–718. https://doi.org/10.1530/EOR-23-0025

Physiopedia. (2025). Sports Screening: Postural Assessment. https://www.physio-pedia.com/Sports_Screening:_Postural_Assessment#:~:text=Postural%20assessment%20as%20part%20of,tone%20can%20cause%20postural%20faults.

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

Hamstring Syndrome Relief for Sciatic Nerve Pain

Individuals dealing with pain in the buttocks and in the back of the thigh, along with numbness and tingling down to the bottom of the foot, may be experiencing hamstring syndrome, a condition caused by pressure on the sciatic nerve. What is the recommended treatment?

Hamstring-Syndrome Relief

The hamstrings are three muscles in the back of the thigh, extending from the pelvis or upper thigh across the back of the knee to the leg. This muscle group is important for bending the knee, straightening the hip, and stabilizing the knee. The sciatic nerve is a large nerve that runs from the lower back down the legs. It usually passes near or through these muscles, and the pelvis then runs under these muscles in the thigh. Hamstring syndrome refers to pain in the buttock and back of the thigh, often radiating down the leg, caused by compression or irritation of the sciatic nerve at the hamstring-insertion point on the ischial tuberosity, typically due to tight or scarred tissue. (Sakari Orava, 1997)

Pain Location

The pain is primarily felt in the buttock and back of the thigh, sometimes extending down the leg. It’s characterized by pressure on the sciatic nerve, which runs through the buttock and into the back of the thigh, where it supplies the hamstring muscles. (Kaiser Permanente, 2024)

Mechanism

This pressure can occur due to: (Sakari Orava, 1997) (Kaiser Permanente, 2024)

Fibrotic Bands

  • Tight, tendon-like, or scarred bands of tissue at the hamstring’s insertion point/ischial tuberosity can irritate the sciatic nerve.

Compression

  • These bands can compress the nerve, especially when sitting or during activities that involve hip flexion and knee extension.

Traction

  • The sciatic nerve can also be stretched or irritated by the hamstring tendons.

Symptoms

  • Pain in the buttock and back of the thigh may radiate down the leg.
  • Pain that is worse when sitting, stretching the hamstrings, or during activities like running. (Puranen J. & Orava S. 1988)
  • Numbness or tingling in the back of the leg

Differential Diagnosis

It’s important to differentiate hamstring syndrome from other conditions that could be causing similar symptoms, including:

  • Piriformis syndrome
  • Ischiogluteal bursitis
  • Hamstring muscle strains

Treatment

Hamstring syndrome relief may consist of the following:

Conservative

  • Initial treatment focuses on rest, ice, stretching, and over-the-counter pain relievers.

Physical Therapy

Injections

  • In some cases, injections with cortisone and numbing medicine may be used to reduce nerve inflammation and pain. (Lower Limb Surgery, 2024)

Surgery

  • In severe cases, surgery may be necessary to release the compressing bands and free the sciatic nerve. (Lower Limb Surgery, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about what interventions would help the most. 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.

Sciatica: Causes, Symptoms and Tips

References

Orava, Sakari. (1997). Hamstring syndrome. Operative Techniques in Sports Medicine, 5(3). https://doi.org/https://doi.org/10.1016/S1060-1872(97)80035-4.

Kaiser Permanente. (2024). Hamstring Syndrome: Care Instructions. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hamstring-syndrome-care-instructions.abr3618

Puranen, J., & Orava, S. (1988). The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American Journal of Sports Medicine, 16(5), 517–521. https://doi.org/10.1177/036354658801600515

Zion Physical Therapy. (2023). Hamstring Tendinitis Vs. Hamstring Syndrome. https://www.zionpt.com/post/hamstring-tendinitis-vs-hamstring-syndrome

Lower Limb Surgery. (2024). Hamstring Syndrome. https://www.lowerlimbsurgery.com/hamstring syndrome#:~:text=General%20Treatment%20Considerations,%E2%80%8B

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

Leg Cramp Causes Explained: Your Guide

Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?

Leg Cramp Causes

A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from

  • Dehydration
  • Muscle overexertion
  • They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
  • They can also be a side effect of certain medications.

Sensation

Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)

Causes

The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:

  • Muscle fatigue from overuse
  • Electrolyte imbalances (e.g., potassium, magnesium)
  • Dehydration
  • Poor circulation
  • Nerve damage
  • Certain medications (e.g., statins, diuretics)

Lifestyle Risk Factors

Certain lifestyle factors and other physical characteristics can increase the risk of leg cramps and can include: (Harvard Health Publishing, 2024) (National Library of Medicine, 2020)

  • Age (those 60 and over are affected more often than younger individuals)
  • Exercising in a hot environment
  • Exercising for extended periods
  • Obesity
  • Pregnancy

Medical Factors

Leg cramps are also associated with certain medical conditions and treatments for illness. Examples include: (Maughan R. J. & Shirreffs S. M. 2019) (Garrison, S. R. et al., 2020)

  • Pinched nerves in the lower back
  • Decreased blood circulation in the legs
  • Spinal cord injury
  • Certain medications (such as statins and diuretics)
  • Allergies
  • Gastrointestinal disease (digestive tract disorders)
  • Cardiovascular disease
  • Liver failure
  • Cancer
  • Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
  • Respiratory diseases of the lungs and airways
  • Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)

Self-Care

Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)

Change Body Positions

  • Moving can help relieve tension and pain.
  • If the leg cramps happen at night, stand up and take a few steps.

Massage

  • Gently rubbing the cramped muscle can help it relax.

Stretch

  • Stretching the cramping muscle can help it relax.

Apply Heat

  • If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.

Treatment

There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)

Exercises and Stretches

Knowing which muscle to target when stretching the leg is important. If the cramp does not resolve after the first stretch attempt, try again.

Hamstring Muscle

Pain in the back of the thigh. Here’s how to stretch the hamstrings (American Academy of Orthopaedic Surgeons, 2018)

  • Lie on your back.
  • Bend both knees and rest your feet on the ground or mattress if the cramp occurs at night.
  • On the leg that is cramping, bring the knee toward your chest.
  • Interlock the fingers behind your knee.
  • Slowly straighten the knee and pull your leg toward your head until you feel a stretching sensation along the back of the thigh.
  • Hold for 30 to 60 seconds.

Calf Muscle

The calf muscle is the most common for leg cramps. To stretch the calf muscle (American Academy of Orthopaedic Surgeons, 2018)

  • Stand facing a wall.
  • Place palms flat against the wall at shoulder height.
  • Step the cramping leg away from the wall around 12 to 18 inches.
  • Keep your heels flat on the floor.
  • Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
  • Hold for 30 to 60 seconds.

Prevention

They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)

  • Drink plenty of water.
  • Stretch the leg muscles before you go to bed.
  • Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
  • Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
  • Properly cool down after a workout.
  • Stretch the leg muscles before and after exercising.
  • Maintain a healthy body weight.

Contact a Healthcare Provider

Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)

  • Change in skin color, including redness or a deeper tone than normal
  • Cramps that last more than a few minutes or occur frequently
  • Muscle weakness
  • Severe pain from the cramps
  • Swelling
  • Warm skin

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about leg cramps to learn what interventions would help the most. 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.

Is Motion Key to Healing?

References

Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. https://www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs

National Library of Medicine. (2020). Muscle cramps. Retrieved from https://medlineplus.gov/musclecramps.html

Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. https://doi.org/10.1007/s40279-019-01162-1

Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. https://doi.org/10.1002/14651858.CD009402.pub3

American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. https://orthoinfo.aaos.org/en/recovery/knee-conditioning-program/

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

Gua-Sha & Chiropractic Care for Wellness and Health: A Perfect Combo

Unlock the potential of gua-sha and chiropractic care. Learn how it can enhance your well-being and relieve tension.

Introduction: Rethinking Musculoskeletal Pain Through a Functional Medicine Lens

As a nurse practitioner with two decades of experience in physical and functional medicine, I’ve seen firsthand how musculoskeletal pain disrupts lives—whether it’s the desk-bound professional with chronic neck tension, the athlete recovering from overuse injuries, or the aging adult with persistent back discomfort. While pharmaceutical interventions may offer temporary relief, the key to long-term healing often lies in a more integrative approach.

Gua Sha therapy, a time-tested East Asian technique, combined with chiropractic care, offers a powerful, evidence-informed, and non-surgical strategy to alleviate musculoskeletal pain, restore function, and improve mobility. In this article, we’ll explore how these two modalities complement each other, the science behind their synergistic benefits, and how they can be integrated into a personalized treatment plan to support whole-body healing.

What Is Gua Sha Therapy? A Functional Medicine Perspective

Gua Sha (pronounced “gwah-shah”) is a traditional healing modality rooted in Traditional Chinese Medicine (TCM), involving the use of a smooth-edged instrument—often made of jade, rose quartz, or stainless steel—to gently scrape the skin in targeted areas. The goal? To release stagnation, promote microcirculation, and activate the body’s innate healing response.

The term “Gua” means “to scrape” and “Sha” refers to the reddish marks that appear on the skin, signifying the release of stagnant blood and toxins. These marks typically fade within a few days and are a normal part of the healing process.

In the modern clinical setting, Gua Sha has evolved into a sophisticated tool used by physical therapists, chiropractors, acupuncturists, and functional medicine providers. It’s particularly effective in addressing myofascial tension, trigger points, chronic inflammation, and reduced mobility due to soft tissue adhesions.

How Gua Sha Alleviates Musculoskeletal Pain

Musculoskeletal pain is often multifactorial—stemming from overuse, injury, postural imbalances, or systemic inflammation. When these factors are left unaddressed, they can lead to myofascial restrictions, scar tissue formation, and neuromuscular dysfunction, perpetuating a cycle of pain and immobility.

Gua Sha works by:

  • Disrupting fascial adhesions and encouraging tissue remodeling
  • Enhancing microvascular circulation, accelerating the delivery of oxygen and nutrients to the affected tissues
  • Activating the parasympathetic nervous system, shifting the body from “fight or flight” to “rest and repair”
  • Reducing pro-inflammatory cytokines and promoting anti-inflammatory responses (Chu et al., 2021)
  • Stimulating lymphatic flow, helping to reduce edema and clear metabolic waste
  • Releasing trigger points in hypertonic muscle groups, particularly in the neck, shoulders, lower back, and limbs

These mechanisms align well with the goals of functional medicine: identifying and treating root causes rather than masking symptoms.

Chiropractic Care: Aligning Structure and Function

Chiropractic care focuses on restoring proper spinal alignment and joint mobility through manual manipulation techniques. It is based on the principle that optimal nervous system function depends on structural integrity, particularly of the vertebral column.

Common benefits of chiropractic care include:

  • Pain reduction in the back, neck, and extremities
  • Improved range of motion and posture
  • Decompression of nerve roots, reducing radiculopathy and referred pain
  • Enhanced proprioception and neuromuscular coordination
  • Prevention of degenerative joint changes through biomechanical correction

A growing body of research supports chiropractic adjustments as an effective, evidence-based option for managing musculoskeletal conditions, especially when integrated into a multimodal treatment approach (Trager et al., 2024).

Discovering the Benefits of Chiropractic Care- Video

Gua Sha and Chiropractic Care: A Synergistic Duo

When Gua Sha is combined with chiropractic care, the result is a comprehensive therapeutic approach that targets both soft tissue restrictions and structural misalignments. This synergy accelerates healing and maximizes outcomes by preparing the body for more effective manual adjustments.

Here’s how the two modalities work together:

Gua Sha TherapyChiropractic Care
Breaks down adhesions in fascia and muscle tissueRestores joint alignment and spinal biomechanics
Stimulates lymphatic and circulatory systemsReduces nerve impingement and improves neural signaling
Releases tension in overactive muscle groupsRestores balance and mobility in underactive joints
Supports parasympathetic activationReinforces proprioceptive and neuromuscular patterns

One specific chiropractic application of Gua Sha is the Graston Technique, a modern adaptation that uses stainless steel instruments to identify and treat areas of soft tissue fibrosis. The goal is similar—restore mobility, reduce pain, and promote tissue healing (Deshmukh & Phansopkar, 2023).

Clinical Applications: When to Consider Gua Sha + Chiropractic Integration

As a nurse practitioner in functional medicine, I often incorporate both Gua Sha and chiropractic care for patients with:

  • Chronic neck pain and tension headaches
  • Myofascial pain syndrome (MPS)
  • Postural dysfunctions from prolonged desk work
  • Repetitive strain injuries (e.g., carpal tunnel, tennis elbow)
  • Lower back pain with fascial tightness
  • Post-surgical scar tissue and restricted mobility
  • TMJ dysfunction and facial tension
  • Sports-related injuries and performance recovery

These patients often report improved mobility, reduced inflammation, and greater pain relief when Gua Sha is included in their care plan—especially when timed before or after a chiropractic adjustment to reduce soft tissue guarding and enhance adjustment efficacy.

The Science: What Does the Research Say?

Numerous studies support the physiological effects of Gua Sha on circulation, inflammation, and pain modulation:

  • A 2021 study by Chu et al. found that Gua Sha therapy significantly increased microcirculation and decreased inflammatory markers in patients with chronic muscle pain.
  • Wang et al. (2020) highlighted Gua Sha’s role in stimulating the du meridian (governing vessel) and clearing blood stasis, promoting faster soft tissue recovery.
  • Knezevic et al. (2021) emphasized that musculoskeletal pain often arises from the interplay between soft tissue dysfunction, trigger points, and neural sensitization—areas where Gua Sha can provide targeted relief.
  • Trager et al. (2024) affirmed that chiropractic care continues to show promise as a cost-effective, non-pharmacological solution to chronic spinal pain and joint dysfunction.

Together, these therapies create a healing environment that supports the body’s biomechanical, neurological, and energetic systems.

Safety Considerations and Contraindications

While Gua Sha is a safe and gentle therapy, it is not suitable for everyone. Contraindications include:

  • Bleeding disorders or anticoagulant use
  • Severe varicose veins or vascular fragility
  • Active skin infections, open wounds, or dermatologic conditions
  • Recent surgeries with unhealed incisions

Always consult with a licensed provider trained in both modalities to determine appropriateness and ensure personalized, safe care.

Optimizing Results: A Functional Medicine Approach to Musculoskeletal Recovery

Incorporating Gua Sha and chiropractic care into a broader functional medicine care plan often yields the most sustainable results. Complementary strategies may include:

  • Anti-inflammatory nutrition
  • Targeted supplementation (e.g., magnesium, omega-3s, curcumin)
  • Postural training and ergonomic assessment
  • Myofascial release, cupping, or acupuncture
  • Stress management and sleep optimization

The body is a system of systems. Addressing musculoskeletal dysfunction holistically allows patients to heal not just their symptoms but the root cause of imbalance.

Conclusion: Empowering Patients With Integrative Pain Solutions

Musculoskeletal pain is one of the most common complaints in modern healthcare, yet the solution doesn’t have to be invasive, pharmaceutical, or surgical. By combining the ancient wisdom of Gua Sha with the mechanical precision of chiropractic care, we unlock a deeply therapeutic pathway toward healing, function, and resilience.

As a nurse practitioner grounded in both physical and functional medicine, I encourage patients and providers alike to explore the synergistic power of these modalities. When integrated skillfully and applied with intention, Gua Sha and chiropractic care can dramatically improve musculoskeletal health, restore balance, and empower patients to reclaim their active lives.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal pain by incorporating Gua-Sha and chiropractic care. When asking important questions to our associated medical providers, we advise patients to utilize Gua-Sha combined with chiropractic care to reduce musculoskeletal pain and restore soft tissue mobility in the extremities. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Chu, E. C., Lin, A. F. C., & Chu, V. (2023). The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus, 15(8), e43068. https://doi.org/10.7759/cureus.43068

Chu, E. C. P., Wong, A. Y. L., Sim, P., & Kruger, F. (2021). Exploring scraping therapy: Contemporary views on ancient healing – A review. J Family Med Prim Care, 10(8), 2757-2762. https://doi.org/10.4103/jfmpc.jfmpc_360_21

Deshmukh, N. S., Jr., & Phansopkar, P. (2023). Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial. Cureus, 15(11), e48246. https://doi.org/10.7759/cureus.48246

Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. https://doi.org/10.1016/s0140-6736(21)00733-9

Trager, R. J., Bejarano, G., Perfecto, R. T., Blackwood, E. R., & Goertz, C. M. (2024). Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med, 13(19). https://doi.org/10.3390/jcm13195668

Wang, Y. W., Xi, Z. W., Pu, B., Chen, G. Y., Ma, Y. F., Liu, D. L., & Xu, X. (2020). Gua sha therapy for chronic low back pain: A protocol for systematic review. Medicine (Baltimore), 99(40), e20606. https://doi.org/10.1097/MD.0000000000020606

Disclaimer

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

Back Pain When Walking: A Comprehensive Guide

For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?

Back Pain When Walking

Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.

Muscle Issues

Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)

Strains

  • Occur when the fibers in the back are overstretched or torn.
  • Pain from muscle strains is usually worse during activity and better when resting.

Sprains

  • It occurs when the ligaments that connect bone to bone become detached.
  • If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.

Fatigue

  • It can happen from overexertion and lead to lower back pain when walking.
  • It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.

Degenerative Disc Disease

  • Between each vertebra is a disc that provides cushioning between the bones.
  • As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
  • Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
  • Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)

Sciatica

Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)

  • Numbness
  • Tingling
  • Muscle cramps
  • Leg muscle weakness

Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.

Lumbar Spinal Stenosis

  • Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
  • It causes the space surrounding the spinal cord to narrow.
  • Sometimes, the narrowing can add pressure on the nerves, resulting in numbness, tingling, and weakness in the legs. (American Academy of Orthpaedic Surgeons, 2021)
  • Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
  • Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.

Hyperlordosis

Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)

Prevention Strategies

Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)

  • Wear shoes made for walking.
  • Perform gentle lower back stretches before walking.
  • Start slowly by walking for a few minutes, then gradually increase the time.
  • Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
  • Warm up and cool down by walking slowly at the beginning and end of the walk.
  • This allows the back and leg muscles to warm up before exercise and recover afterward.
  • Walk at a slow to moderate pace/speed that allows one to converse.
  • Standing up straight while walking or standing upright reduces pressure on the lower back.

Alternative Exercise

If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)

Elliptical Trainer

  • This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.

Recumbent Biking

  • will keep the back upright, which is recommended if there is more pain when bending forward.

Upright Stationary Biking

  • This is recommended if the back pain improves when bending forward.

Walking In A Pool

  • This activity provides benefits while reducing pressure on the spine.
  • To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).

Water Aerobics

  • This activity provides cardiovascular health benefits with decreased pressure on the back.

Injury Medical Chiropractic & Functional Medicine Clinic

See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your condition. 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.

Beyond Adjustments: Chiropractic and Integrative Healthcare

References

American Association of Neurological Surgeons. (2024). Low back strain and sprain. https://www.aans.org/patients/conditions-treatments/low-back-strain-and-sprain/

Hospital for Special Surgery. (2024). Degenerative disc disease. https://www.hss.edu/condition-list_degenerative-disc-disease.asp

American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica

American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

American Academy of Orthopaedic Surgeons. (2020). Spine basics. https://orthoinfo.aaos.org/en/diseases–conditions/spine-basics/

Cedars-Sinai. (2025). Swayback (lordosis). https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html

Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173

Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. https://www.health.harvard.edu/exercise-and-fitness/get-started

Hospital for Special Surgery. (2023). Best types of exercise for back pain. https://www.hss.edu/article_best-exercise-lower-back-pain.asp

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

Personal TENS Devices: A Modern Approach to Pain Relief

For individuals managing chronic pain conditions, can incorporating a personal TENS device help?

Personal TENS Device

Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.

How It Works

TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.

Uses

TENS units are used to treat a variety of conditions, including:

  • Arthritis 
  • Muscle cramps
  • Neck pain
  • Back pain
  • Pelvic pain
  • Knee pain
  • Osteoarthritis
  • Fibromyalgia
  • Tendinitis
  • Bursitis
  • Diabetes-related neuropathy
  • Pelvic pain from periods or endometriosis

Features

Portability

  • TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)

Electrodes

  • The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.

Adjustable Settings

  • Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.

Benefits

Non-Invasive

  • TENS therapy is a non-invasive method for relieving pain.

Drug-Free

  • It can provide pain relief without the need for medication.

Convenient

  • TENS units are small, portable, and relatively discrete.

Precautions

Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)

  • Head
  • Eyes
  • Mouth
  • Front of the Neck
  • Chest and upper back at the same time
  • Numb areas
  • Broken skin
  • Tumors

There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.

Effectiveness

Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)

Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. 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.

Don’t Ignore Post-Accident Pain

 

References

National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/

Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30725873

Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. https://doi.org/10.1016/j.pain.2013.07.043

Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. https://doi.org/10.2217/pmt.14.13

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

Pulled Muscle: Understanding the Healing Process

What are the recommendations for a pulled muscle injury to fully recover?

Pulled Muscle Recovery Time

A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015)  Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.

Timeline

The timeline for recovering from a pulled muscle depends on the injury’s severity.

Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)

Grade 1 (mild)

  • Heals in a few days.
  • A microscopic tear or stretch in the muscle fiber.
  • It might feel sore, but you can still use the muscle.

Grade 2 (moderate)

  • Heals in four to six weeks.
  • A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.

Grade 3 (severe)

  • Heals in several months
  • This type of muscle strain causes a complete tear, also known as a rupture.
  • It results in intense pain, significant swelling, and inability to use the muscle.
  • Surgery may be required in some cases.
  • Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.

Body Parts More Susceptible To Injury

The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)

  • Neck – levator scapulae and trapezius
  • Shoulders – rotator cuff muscles
  • Lower back – erector spinae
  • Groin – adductors
  • Front of the thigh – quadriceps
  • Behind the thigh – hamstrings
  • Calves – gastrocnemius and soleus

Healing Stages and Factors

Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).

Inflammatory Stage (zero to three days)

  • When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
  • Rest is important during this stage to prevent the injury from getting worse.

Repair Stage (three to 21 days)

  • Damaged muscle fibers are repaired and regrow during this stage.
  • Collagen fills in any tears to rebuild damaged muscle tissue.
  • Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
  • Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.

Remodeling Stage (three weeks to one year)

  • Repaired tissue gets stronger and adapts to regular movement.
  • Scar tissue may form.
  • Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

  • Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
  • Prolonged rest can slow healing, so maintain a balance between rest and exercise.

Ice

  • Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
  • Ice helps control inflammation by limiting blood flow to the injured area.

Compression

  • Use compression stockings or wrap the injured part in bandages to help reduce swelling.
  • Ensure the binding is not too tight so circulation is not cut off.

Elevation

  • Raise the injured area above heart level throughout the day.
  • This helps reduce swelling by allowing fluids to drain away from the injury site.

Heat

  • After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.

Eat Healthy

  • Get enough protein for muscle repair.

Maintain Hydration

  • Drink plenty of water to help with circulation and muscle lubrication.

Massage and Physical Therapy

  • These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.

Over-the-counter Medications

  • If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
  • Only use as directed.

These steps can help promote faster healing and expedite returning to normal daily activities.

When to Resume Normal Activity

Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)

  • Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
  • Slowly resume normal activities, avoiding overexerting the injured area.
  • Gradually increase activity levels and stop if there is any pain.
  • Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.

Contact a Healthcare Provider

While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)

  • Pain persists or worsens after seven to 10 days.
  • This can indicate a more serious injury, such as a severe torn muscle.
  • Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
  • It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
  • There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
  • There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.

A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.

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.

Say Goodbye to Pain with Chiropractic Care

References

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains