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Category: Therapy

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

Exercise and Dementia: Key to Cognitive Health

To what extent can regular exercise contribute to the overall health of elderly individuals and reduce the likelihood of developing dementia?

Exercise and Dementia: Improving Brain Function

Dementia Prevention and Exercise

Dementia is a term that refers to various diseases that impede memory and cognition, and it is presently the seventh most common cause of death worldwide. (World Health Organization, 2025) Approximately 10 million new cases of dementia are diagnosed annually on a global scale. (Yoon J.H. et al., 2023) A study investigating the correlation between insulin and exercise in the brain discovered that consistent physical activity may enhance brain function and reduce the likelihood of developing dementia. Researchers have discovered that factors such as.

Exercise and stretching are necessary. Muscle rigidity impairs insulin’s ability to work in those who don’t exercise. The body enhances insulin sensitivity by contracting and releasing those muscles in response to movement. Dementia prevention efforts might benefit from identifying mechanisms that lower insulin resistance.

Physical Activity and Reduced Risk

After observing 21 older individuals with prediabetes for two weeks, the researchers discovered that physical activity assists the brain in regulating insulin, directly improving cognitive function. Under supervision, they completed twelve exercise sessions that ranged from moderate to high intensity. (Malin S. K. et al., 2025)

  • The findings show a notable rise in the number of extracellular vesicles produced from the brain that contain insulin-related proteins.
  • These micro-messengers ensure that neurons can communicate with one another and play an essential part in maintaining the brain.
  • AKT (also known as protein kinase B or PKB) comprises three specific protein kinases that are important for many body functions, such as keeping cells alive, helping them grow, managing metabolism, and controlling the cell cycle.
  • The protein is considered a significant factor in insulin signaling and has ramifications for neuronal cell growth and health.
  • Inadequate insulin response may contribute to dementia. Hence, it is noteworthy that exercise could mitigate this by potentially enhancing insulin signaling.

Although further investigation is necessary, these results underscore that physical activity may be an accessible, cost-effective method to promote long-term cognitive health. In the subsequent phase of the investigation, researchers will employ an insulin spray and MRIs to gain further insight into insulin’s impact on brain activity. They will analyze cerebral blood circulation before and during the administration of the insulin spray to elucidate its effects.

Insulin, Exercise, and Brain Health

Insulin is a hormone synthesized by the pancreas that regulates blood glucose levels. Nonetheless, insulin’s significance in cerebral health is equally crucial. The brain’s abundance of insulin receptors facilitates neuronal communication, enhances synaptic connections upon insulin binding, and promotes memory and learning. (Gray, S. M., Meijer, R. I., & Barrett, E. J. 2014)

Impaired insulin signaling, as observed in situations such as type 2 diabetes, renders the brain more susceptible to cognitive deterioration. (Yoon J.H. et al., 2023) Research indicates that insulin resistance plays a role in the accumulation of amyloid-beta plaques and tau tangles, which are fundamental features of Alzheimer’s disease. (Hong, S., Han, K., & Park, C. Y. 2021) Enhancing insulin sensitivity may mitigate or avert these cerebral alterations. Aerobic exercise positively influences total brain health. Prior research has demonstrated that physical activity improves or sustains adult cognitive function and memory. (Rosenberg A. et al., 2020) Other ways to increase brain health include

  • Staying socially engaged
  • Challenging the mind
  • Getting plenty of sleep
  • Managing Stress
  • Healthy diet
  • Staying physically active
  • Diabetes management
  • Blood pressure management

The future of dementia prevention will likely entail a synthesis of lifestyle modifications, including physical activity and pharmacological treatments, to achieve the most significant impact. Consistent physical activity may substantially diminish the likelihood of dementia in adults with prediabetes or diabetes and support normal cognitive function.

Clinic for Chiropractic Care and Functional Medicine

Family Practice Nurse Practitioner Dr. Jimenez integrates sophisticated medical proficiency with chiropractic treatment to manage diverse illnesses. Our clinic combines Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to develop tailored care plans that enhance natural healing, mobility, and sustained 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 dedicate ourselves to treating individuals recovering from injuries and chronic pain disorders. We enhance your capabilities through flexibility, mobility, and agility programs customized for various age demographics and disabilities. We employ in-person and virtual health coaching and comprehensive care plans to guarantee tailored care and optimal wellness outcomes for each patient.

Is Motion Key to Healing?

References

World Health Organization. (2025). “Dementia.” World Health Organization. from https://www.who.int/news-room/fact sheets/detail/dementia#:~:text=Alzheimer%20disease%20is%20the%20most,60%E2%80%9370%25%20of%20cases.

Yoon, J. H., Hwang, J., Son, S. U., Choi, J., You, S. W., Park, H., Cha, S. Y., & Maeng, S. (2023). How Can Insulin Resistance Cause Alzheimer’s Disease?. International Journal of Molecular Sciences, 24(4), 3506. https://doi.org/10.3390/ijms24043506

Malin, S. K., Battillo, D. J., Beeri, M. S., Mustapic, M., Delgado-Peraza, F., & Kapogiannis, D. (2025). Two weeks of exercise alters neuronal extracellular vesicle insulin signaling proteins and pro-BDNF in older adults with prediabetes. Aging cell, 24(1), e14369. https://doi.org/10.1111/acel.14369

Gray, S. M., Meijer, R. I., & Barrett, E. J. (2014). Insulin regulates brain function, but how does it get there?. Diabetes, 63(12), 3992–3997. https://doi.org/10.2337/db14-0340

Hong, S., Han, K., & Park, C. Y. (2021). The insulin resistance by triglyceride glucose index and risk for dementia: population-based study. Alzheimer’s research & therapy, 13(1), 9. https://doi.org/10.1186/s13195-020-00758-4

Rosenberg, A., Mangialasche, F., Ngandu, T., Solomon, A., & Kivipelto, M. (2020). Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer’s Disease, and Dementia: From FINGER to World-Wide FINGERS. The Journal of Prevention of Alzheimer’s disease, 7(1), 29–36. https://doi.org/10.14283/jpad.2019.41

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

Bone Growth Stimulator in Post-Injury Healing

Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?

Bone Growth Stimulator

Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.

How They Work

Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)

  • They come in various shapes, sizes, and technologies depending on the location of the fracture.
  • The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
  • The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
  • Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.

Electrical Stimulation

  • Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.

Ultrasound Stimulation

  • They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.

Implantable vs. External

  • Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.

The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.

Effectiveness

Studies of bone stimulator effectiveness suggest two benefits:

  1. Less pain is associated with the bone healing process.
  2. Faster fracture healing.

However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)

  • While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
  • Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
  • It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.

When Stimulation is Necessary

Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)

Nonunion Fractures

  • When a fracture doesn’t heal within the expected timeframe.
  • Open fractures
  • Stress fractures
  • Scaphoid bone fractures
  • Talus fractures

Failed Fusions

  • When a spinal fusion hasn’t been successful.

High-Risk Patients

  • For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications

Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.

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.

From Injury to Recovery with Chiropractic Care

References

U.S. Food & Drug Administration. (2022). AccelStim Bone Growth Stimulator – P210035. Retrieved from https://www.fda.gov/medical-devices/recently-approved-devices/accelstim-bone-growth-stimulator-p210035#:~:text=What%20is%20it?,the%20transducer%20to%20the%20fracture

Childs, S. G. (2003). Stimulators of bone healing. Biologic and biomechanical. Orthopedic nursing, 22(6), 421–428. https://doi.org/10.1097/00006416-200311000-00010

Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. https://doi.org/10.1038/srep31724

Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. https://doi.org/10.4103/0019-5413.50844

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

Length of Time for Muscle Tightness Relief

For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?

Length Of Time to Loosen Tight Muscles

Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.

Factors Influencing Timeline

Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)

Severity of Tightness

  • Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.

Underlying Causes

  • If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)

Individual Factors

  • Genetics, age, and overall health can influence how quickly muscles adapt to stretching.

Consistency

  • Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)

Stretching Routine

The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.

Consistency

Hold Time

  • Hold static stretches for at least 30 seconds.
  • Longer holds (1-2 minutes) can provide deeper benefits.

Long-term Gains

  • For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)

Initial Changes

  • Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.

Influencing Factors and Results

  • Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)

What To Expect

Improvements

  • Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)

Longer-Term Changes

  • Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.

Maintenance

Treatment Options

  • Stretching, physical therapy, massage, and other therapies can help alleviate tight muscles and promote recovery. (Spine Medicine and Surgery of Long Island, 2024)
  • Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.

The length of time to see results means consistency and patience are important.

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.

Understanding Long-Lasting Injuries

References

Spine Medicine and Surgery of Long Island. (2024). How Long Do Muscle Knots Last? Spine Medicine and Surgery of Long Island. https://www.spinemedli.com/how-long-do-muscle-knots-last/#:~:text=The%20duration%20of%20a%20muscle,chronic%20pain%20if%20left%20untreated.

Peterson Physical Therapy. (2024). How Long Does It Take to Improve Flexibility? https://petersenpt.com/how-long-does-it-take-to-improve-flexibility#:~:text=Over%20the%20years%2C%20I’ve,takes%20to%20become%20more%20flexible.

Healthline. (2023). Everything You Need to Know About Muscle Stiffness. https://www.healthline.com/health/muscle-stiffness

Mayo Clinic. (2023). Stretching: Focus On Flexibility. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931#:~:text=Stretch%20in%20a%20smooth%20movement,hold%20for%20around%2060%20seconds.

Harvard Health Publishing. (2022). Everyday Stretching. https://www.health.harvard.edu/everyday-stretching#:~:text=A%20daily%20regimen%20will%20deliver,or%20three%20times%20a%20week.

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 Physio, Therapy , , , , , , , , , , , , , , , , , , ,

Pigeon Toed: Causes and Treatment Options

Children walking with their toes pointed in may be pigeon-toed. What are the causes, conditions associated with it, and treatments?

Pigeon-toed Walking

If a child walks with their feet turned inward at the toes, it is usually described as being pigeon-toed. This pointing inward of the feet occasionally occurs as a child learns to walk and may continue through toddlerhood. It is noticed more often in children than adults, but older individuals can experience it. Pigeon-toed walking is rarely a major orthopedic problem and usually disappears without treatment. However, there are times when it may impact a child’s lower extremities and hips. Bracing or surgery may be necessary in these cases to correct the problem. (Paramanandam V. et al., 2019) This condition is common and typically is caused by abnormal birth positions in utero. Sometimes, slight issues may lead to noticeable functional characteristics. Mild changes in bone shape and positioning usually cause pigeon toes. Often, it subsides in a few years as the child continues to develop.

What Does It Mean?

There is usually no need to worry, as this condition is likely not permanent and will go away in a few years. (Paramanandam V. et al., 2019) However, it is recommended that you check in with your healthcare provider to ensure the child is developing normally. Some adults walk with their toes turned in. This may be due to a birth defect, a weakness, or a rare case of pigeon-toed walking as a youth that was left untreated or did not go away.

Causes

There are various reasons for pigeon-toed walking. To determine the cause, a healthcare provider can assess the child’s condition and make a diagnosis, including:

Metatarsus Adductus

  • A condition where the front part of the foot is turned inward.
  • The metatarsals are the long bones of the forefoot.
  • This is when the bones of the foot point inward, leading to pigeon-toed walking.
  • A clinical examination and X-ray can confirm the metatarsus adducts as a cause of pigeon-toed walking.

Tibial Torsion

  • A twisted shinbone (tibia) can cause the feet to turn inward in younger children.
  • The shinbone/tibia in some children may be slightly twisted.
  • The tibia can either turn outward or inward.
  • When it twists inward, it may manifest as a pigeon-toed gait.
  • Tibial torsion may accompany femoral anteversion.
  • It is diagnosed with an X-ray.
  • Children with tibial torsion typically grow out of the problem, and the pigeon-toed disappears by age 4. (Uden H., & Kumar S. 2012)

Femoral Anteversion

  • A common cause, especially in older children, is when the thighbone/femur is twisted inward.
  • If the femur turns inward and forward unnaturally, where the femoral neck meets the body of the femur, it is called femoral anteversion.
  • An outward and backward rotation of the femur is called femoral retroversion.
  • This occurs in about 10% of children. (Scorcelletti M. et al., 2020)
  • Many children with femoral anteversion appear knock-kneed with a large gap between their feet when standing with knees together, and when they walk, they appear pigeon-toed.
  • A clinical examination and X-ray diagnose it.

Symptoms

In most cases, the child does not complain of any pain. However, if pain is felt, it can include:

  • Tightness in the calf muscles
  • Aching on the outer edges of the feet
  • Knee pain

Usually, parents will notice pigeon-toes when their child is first learning to walk. Rest assured, the child most likely is not experiencing pain. They have feet and knees that turn inward when they walk and run. (Uden H., & Kumar S., 2012)

A pediatrician or primary care provider can assess the situation and make recommendations. Most pigeon-toed children begin walking and running normally after age 3 or 4, so a watch-and-wait approach is used. Parents may have to take their child to a specialist, like an orthopedic surgeon, if they complain of pain while walking. A specialist may be referred if the child cannot walk due to the inward turn of their feet.

Risk Factors

Pigeon-toed walking is not a preventable condition but rather one that develops during pregnancy. Causes may include: (Scorcelletti M. et al., 2020)

  • A pregnancy with twins or multiple births
  • Large fetus
  • Breech position in utero when the baby is positioned feet first.
  • Not enough amniotic fluid

Muscle Weakness in Adults

Adolescents or adults who notice their knees turn in and walk pigeon-toed may have weakness in the hip and leg muscles that control the position of their legs when they walk. Strengthening those muscles can help. (Scorcelletti M. et al., 2020)

Treatment

Typically, a normal gait will appear by the age of 3 or 4. Other treatments may include:

Physical Therapy Exercises and Gait Training

  • Exercises to stretch tight lower extremity muscles and strengthen hip and leg muscles can help improve walking gait.
  • See a pediatric specialist before starting, as research shows that parental stretching of a newborn with metatarsus adductus offers little benefit. (Eamsobhana P. et al., 2017)

Bracing or Casting 

  • Braces
  • Serial casting is a procedure that helps children improve their range of movement and may be done to place their lower extremities in an optimum position as they develop. (Uden H., & Kumar S., 2012)

Surgery

  • For cases in which tibial torsion is the cause, osteotomy surgery, which involves cutting and/or removing bone, may be recommended to correct the structural deformity of the shinbone.

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.

Foot Pronation

References

Paramanandam, V., Lizarraga, K. J., Soh, D., Algarni, M., Rohani, M., & Fasano, A. (2019). Unusual gait disorders: a phenomenological approach and classification. Expert review of neurotherapeutics, 19(2), 119–132. https://doi.org/10.1080/14737175.2019.1562337

Uden, H., & Kumar, S. (2012). Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence. Journal of Multidisciplinary Healthcare, 5, 27–35. https://doi.org/10.2147/JMDH.S28669

Scorcelletti, M., Reeves, N. D., Rittweger, J., & Ireland, A. (2020). Femoral anteversion: significance and measurement. Journal of Anatomy, 237(5), 811–826. https://doi.org/10.1111/joa.13249

Eamsobhana, P., Rojjananukulpong, K., Ariyawatkul, T., Chotigavanichaya, C., & Kaewpornsawan, K. (2017). Does the parental stretching programs improve metatarsus adductus in newborns?. Journal of Orthopaedic Surgery (Hong Kong), 25(1), 2309499017690320. https://doi.org/10.1177/2309499017690320

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, 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 Acupuncture, Chiropractic Care, Therapy , , , , , , , , , , , , , , , ,

Cupping as Alternative Medicine for Pain Relief

For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?

Cupping Therapy

This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)

Increasing Blood Circulation

  • The suction draws blood to the area, which can help reduce inflammation and promote healing.

Releasing Muscle Tension

  • The suction can stretch and pull on muscles, which can help relieve pain and tightness.

Breaking Up Adhesions

  • The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.

Detoxifying the Body

  • Some practitioners believe that cupping can help remove toxins from the body.

It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)

Benefits

  • Pain relief, especially for muscle and joint pain
  • Reduced inflammation
  • Improved circulation
  • Increased range of motion
  • Detoxification

Procedure

The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:

Preparation

  • The practitioner cleans the area where the cups will be placed.
  • They may apply oil or massage cream to the skin for easier movement of the cups.

Techniques

Dry

  • The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
  • The cup is then placed on the skin, which adheres due to the negative pressure.
  • The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.

Wet

  • Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
  • This allows blood to flow into the cup, creating a more intense suction.

Aftercare

  • The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
  • The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.

The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)

It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)

Risks

The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:

Bruising

  • It can cause temporary bruising at the site of the cups.

Skin Irritation

  • Some people may experience skin irritation or burns from the suction.

Infection

  • There is a small risk of infection if the cups are not properly sterilized.

Who should avoid the therapy?

Those with skin conditions like eczema and psoriasis should avoid cupping, as it may worsen them. (National Center for Complementary and Integrative Health, 2018) 

Injury Medical Chiropractic & Functional Medicine Clinic

It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. 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 Medicine: The Power of Chiropractic Care

References

Cleveland Clinic. (2023). Cupping Therapy. https://my.clevelandclinic.org/health/treatments/16554-cupping

Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. https://doi.org/10.1016/j.jams.2018.02.001

National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from https://www.nccih.nih.gov/health/cupping