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Tag: back

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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 , , , , , , , , , , , , , , , , ,

Lidocaine Patch for Pain Relief: An Overview

For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?

Lidocaine Patch

Lidocaine patches are in a drug class called local anesthetics (MedlinePlus, 2025) (Food and Drug Administration, 2022). They relieve pain in small body areas by blocking the nerves from sending pain signals. The Food and Drug Administration approved lidocaine 5% or 1.8% patches for relieving postherpetic neuralgia (PHN) pain. These lidocaine patches are prescription-only (Food and Drug Administration, 2022). They are available either by prescription or over the counter and are commonly used for back pain and other areas. Over-the-counter lidocaine, 4% patches, can be used to relieve minor aches and pains, including back pain. However, further research is needed to recommend the use of lidocaine patches as an effective method of pain relief. (Department of Veterans Affairs/Department of Defense, 2022) (North American Spine Society, 2020)

The Patch

They are available in prescription and over-the-counter forms. Over-the-counter forms come as a 4% patch in various brands, such as (MedlinePlus, 2025)

  • Aspercreme
  • Lidocare
  • Salonpas

Prescription-only patches come in 5% or 1.8% patches and are approved to relieve long-term nerve pain from shingles in adults. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically. (DailyMed, 2018) (Food and Drug Administration, 2021) The safety and effectiveness in children are unknown. (Food and Drug Administration, 2022)

Other Lidocaine Forms

As a local anesthetic, it is available in several other forms, including:

  • Spray
  • Topical cream
  • Lotion
  • Liquid
  • Ear drops
  • Eye gel
  • Injection
  • It is also available as a short-term intravenous infusion for abnormal heart rhythm. (DailyMed, 2025)

Effectiveness

Clinical trials have shown that the patches effectively relieve chronic low back pain. However, these studies were nonrandomized and did not include a control group to compare against the treatment group. (Santana J. A., Klass S., & Felix E. R. 2020) The results may be subject to potential biases. For this reason, further evidence is needed to support lidocaine patches’ effectiveness in reducing low back pain. (North American Spine Society, 2020) High-quality randomized and controlled clinical trials are necessary to study the effectiveness. (North American Spine Society, 2020) (Santana J. A., Klass S., & Felix E. R. 2020)

How to Use Safely

In general, keep the following in mind (MedlinePlus, 2025)

  • Use according to the directions on the box and the healthcare provider’s recommendations.
  • Do not use on broken or inflamed, swollen skin.
  • Do not apply heat like heating pads or electric blankets over patches.
  • Avoid getting water on or around the patch.
  • Avoid letting a patch near your eyes to limit eye irritation.
  • Fold the sticky sides of the used lidocaine patches together and safely throw them away, keeping them away from children and pets.

How to use (MedlinePlus, 2025)

  • Clean and dry the affected area before placing the patch.
  • Apply to the affected body area as directed.
  • Wash your hands after touching the patch.
  • Remove the patch after what is usually recommended after eight hours.

How Quickly Does It Work?

The amount of medication absorbed into the blood depends on how long the patch is placed on the body and how much is covered with the patch. In a study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during 24 hours. Lidocaine levels were highest at 11 hours. At the end of the 24 hours, there was still some lidocaine left in the bloodstream. (Food and Drug Administration, 2022)

Individuals with PHN may notice a difference in pain intensity after four hours of using the patch. (Rowbotham, M. C. et al., 1996) (Food and Drug Administration, 2022) Experts may suggest using patches for four weeks for those who experience pain after their shingles rash disappears. However, if there is still pain after these four weeks, it is recommended to see a pain specialist. (Gross, G. E. et al., 2020)

Side Effects

Common side effects are typically mild skin reactions where the patch is.  These reactions are usually temporary and will disappear within a few minutes or hours. Examples include: (Food and Drug Administration, 2022)

  • Irritation
  • Itchiness
  • Abnormal or burning sensation
  • Redness
  • Swelling
  • Blisters
  • Bruises
  • Skin bumps
  • Skin color changes
  • Skin peeling

Potentially serious side effects include: (Food and Drug Administration, 2022)

Serious Allergic Reaction

  • Severe allergic reactions are rare, but it is possible.
  • Symptoms include breathing problems, itchiness, and rash.

Methemoglobinemia

  • Methemoglobinemia is a condition that makes it hard for red blood cells to carry oxygen.
  • Individuals may experience symptoms of blue-looking skin, headache, lightheadedness, shortness of breath, abnormal heart rhythm, or seizures.

Using too many lidocaine patches to cover large parts of the body or using the patches longer than 12 hours within 24 hours may cause side effects that may include heart-related effects, such as a slow heart rate and low blood pressure.  Individuals may also experience the following side effects (Food and Drug Administration, 2022)

  • Hot or cold sensation
  • Numbness
  • Dizziness
  • Ringing ears
  • Lightheadedness
  • Mood changes
  • Drowsiness to unconsciousness
  • Vision changes
  • Seizures
  • Tremors
  • Vomiting

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.

Sciatica Causes and Treatments

References

National Library of Medicine. MedlinePlus. (2025). Lidocaine transdermal patch. Retrieved from https://medlineplus.gov/druginfo/meds/a603026.html

Food and Drug Administration. (2022). Lidoderm label. Retrieved from https://www.accessdata.fda.gov/spl/data/eedfe43b-1019-19a0-e053-2995a90a7696/eedfe43b-1019-19a0-e053-2995a90a7696.xml

Department of Veterans Affairs/Department of Defense. (2022). VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain. Retrieved from https://www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGFinal508.pdf

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

National Library of Medicine. DailyMed. (2018). Label: lidocaine patch. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c66f3b9-6e04-47ab-8d94-21e89ceec154

Food and Drug Administration. (2021). Ztlido label. Retrieved from https://www.ztlido.com/wp-content/uploads/2022/12/ZTlido-LABEL.pdf

National Library of Medicine. DailyMed. (2025). Lidocaine-lidocaine hydrochloride injection, solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f1b26274-a55e-4321-b96c-ce0df830f205

Santana, J. A., Klass, S., & Felix, E. R. (2020). The Efficacy, Effectiveness and Safety of 5% Transdermal Lidocaine Patch for Chronic Low Back Pain: A Narrative Review. PM & R: the journal of injury, function, and rehabilitation, 12(12), 1260–1267. https://doi.org/10.1002/pmrj.12366

Rowbotham, M. C., Davies, P. S., Verkempinck, C., & Galer, B. S. (1996). Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain, 65(1), 39–44. https://doi.org/10.1016/0304-3959(95)00146-8

Gross, G. E., Eisert, L., Doerr, H. W., Fickenscher, H., Knuf, M., Maier, P., Maschke, M., Müller, R., Pleyer, U., Schäfer, M., Sunderkötter, C., Werner, R. N., Wutzler, P., & Nast, A. (2020). S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG, 18(1), 55–78. https://doi.org/10.1111/ddg.14013

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

Back Cracking: Can It Relieve Your Back Pain?

Are there benefits to back cracking, risks, and how can it be done safely?

Back Cracking

Back cracking is intentionally applying pressure or twisting movements, producing a popping or cracking sound in the spine. Back cracking involves stretching or extending the spine. In most cases, it is considered safe when done gently as it can provide temporary relief from back pain and stiffness by:

  • Stretching the ligaments and muscles around the spine
  • Releasing gas bubbles that may be causing pressure
  • Improving joint mobility

Mechanism of Action

  • Cracking your back creates small gas bubbles in the synovial fluid (the lubricating fluid in the joints).
  • These bubbles form when the pressure in the joints is suddenly released, causing a popping or cracking sound.

It is generally safe, but there are certain conditions under which individuals should avoid cracking their backs.

Popping Sound

Research has used a new type of magnetic resonance imaging (MRI), cine MRI, to study the noise source. Cine MRI produces moving images.

  • This study using this MRI found that the formation of bubbles makes a popping sound.
  • The popping sound does not come from the popping of bubbles in the synovial fluid, as previously believed. (Kawchuk G. N. et al., 2015)
  • When someone cracks their back, the force pulls the bones of the joint apart, causing the pressure within the joint to drop and form a bubble, which eventually dissipates. (Kawchuk G. N. et al., 2015)

Crepitus

  • Crepitus is the medical term for cracking or popping noise from joints.
  • It is not a condition or disease but can be a symptom of one.
  • Other terms include clicking or crunching.

Is It Safe To Perform Daily?

Back cracking once a day is generally considered safe. But if it causes pain or swelling, then stop and contact a healthcare provider. If someone feels the need to crack their back more throughout the day, it could be a sign that they need to see a professional chiropractic healthcare provider. (AICA Orthopedics, 2022) Individuals may crack their backs to address certain conditions or to relieve various discomfort symptoms that can include: (National Center for Complementary and Integrative Health, 2025)

  • Headache
  • Neck pain
  • Lower back pain
  • Sciatica

Individuals may often experience mild side effects like headache, stiffness, or pain. These side effects tend to resolve within a day. Though back cracking can provide temporary relief for some conditions, some serious side effects like neurological problems or strokes have been reported. (National Center for Complementary and Integrative Health, 2025)

Stretches and Movements

When someone needs to crack their back, they can perform a spine stretch. Here are a couple of stretches and movements. (American Academy of Orthopedic Surgeons, 2022)

Sitting Rotation Stretch

  • Sit on the floor with both legs straight.
  • Cross the right foot over the left leg.
  • Rotate the upper body to the right side and press against the right knee with the left elbow.
  • Hold the stretch for 30 seconds and come back to the center.
  • Repeat on the other side.

Knee to Chest

  • Lie flat on the ground.
  • Lift one leg and bring the knee to the chest, pulling the knee in with your hands.
  • Hold for five seconds.
  • Repeat with the other leg.

Several back-cracking assistive devices, such as poles and wheels, are available. Talk to a healthcare provider to determine the right type and ensure it is safe for you and your condition or injury.

Individuals Who Should Avoid Back Cracking

Back cracking can cause additional stress or damage to the joints in those with back injuries or other conditions. Individuals with these conditions should avoid back cracking (AICA Orthopedics, 2022)

  • Numbness or tingling of the arms or legs.
  • Osteoporosis
  • Spinal cancer
  • Spinal abnormalities
  • Individuals who have a high stroke risk.

A Professional Back Adjustment

A chiropractor is a healthcare provider who specializes in spine and spinal adjustments. They adjust the spine and other areas of the body to correct misalignment problems, reduce and relieve pain, and allow the body to recover independently. (National Library of Medicine. MedlinePlus, 2023) The chiropractor will take a health history to learn about previous injuries and conditions. Then, they will evaluate the patient and determine the best course of action. Although a chiropractor performs spinal adjustments, they may also incorporate other treatments, including: (National Library of Medicine. MedlinePlus, 2023)

  • Stretching
  • Non-surgical decompression and traction
  • Acupuncture
  • Muscle Energy Technique (MET)
  • Exercise routines
  • Heat
  • Ice
  • Electrical stimulation
  • Dietary supplements
  • Nutrition and lifestyle counseling

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.

Chiropractic Secrets

References

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470

AICA Orthopedics. (2022). Is cracking your back bad? https://aica.com/is-cracking-your-back-bad/

National Center for Complementary and Integrative Health. (2025). Spinal manipulation: what you need to know. Retrieved from https://www.nccih.nih.gov/health/spinal-manipulation-what-you-need-to-know

American Academy of Orthopedic Surgeons. (2022). Spine conditioning program. https://orthoinfo.aaos.org/en/recovery/spine-conditioning-program/

National Library of Medicine. MedlinePlus.  (2023). Chiropractic. Retrieved from https://medlineplus.gov/chiropractic.html

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

Insights on Kyphosis & Treatment Approaches

Discover effective treatment approaches for kyphosis, its causes and symptoms while enhancing your posture today.

Introduction

How often do you catch yourself slouching after hours at a desk or scrolling through your phone? Do you experience persistent neck strain, shoulder tightness, or upper back discomfort? While many people recognize poor posture as an annoyance, few realize that long-term postural dysfunction can contribute to kyphosis—a spinal condition characterized by excessive forward curvature of the thoracic spine.

As a nurse practitioner with 20 years of experience in physical medicine and musculoskeletal health, I have seen firsthand how kyphosis affects both young and older adults, often leading to pain, mobility limitations, and even systemic complications. With a background that includes chiropractic care integration, I emphasize a multidisciplinary approach to kyphosis treatment, focusing on conservative therapies that address spinal alignment, muscle strength, and postural control.

This article explores the environmental causes of kyphosis, its impact on the musculoskeletal system, and evidence-based treatment strategies, including chiropractic adjustments, physical therapy, and postural rehabilitation.

What is Kyphosis? Understanding the Spinal Deformity

Kyphosis refers to an excessive anterior curvature of the thoracic spine, exceeding 40 degrees. While a mild thoracic curve is normal, excessive kyphosis can lead to visible postural changes, musculoskeletal pain, and even respiratory or gastrointestinal complications in severe cases.

Types of Kyphosis

There are several classifications of kyphosis, each with distinct causes:

  • Postural Kyphosis: The most common type, usually seen in adolescents and office workers, resulting from prolonged slouching and weak spinal musculature.
  • Scheuermann’s Kyphosis: A more rigid spinal deformity due to wedge-shaped vertebrae, typically diagnosed in teenagers.
  • Osteoporotic Kyphosis: Common in older adults due to vertebral compression fractures from osteoporosis.
  • Congenital Kyphosis: A rare condition present from birth due to abnormal vertebral development.

If left untreated, kyphosis can progressively worsen, leading to significant postural, neurological, and functional impairments.

Environmental Factors Contributing to Kyphosis

While genetic predisposition plays a role in kyphosis development, environmental and lifestyle factors significantly contribute to the condition. Understanding these risk factors can help with prevention and early intervention.

1. Poor Posture & Prolonged Sedentary Behavior

Chronic slouching, improper ergonomics, and excessive screen time encourage adaptive shortening of the anterior muscles (pectorals and upper abdominals) while weakening the posterior chain (erector spinae and scapular stabilizers). This imbalance reinforces thoracic kyphosis over time.

2. Sedentary Lifestyle & Weak Core Stability

A lack of functional movement and spinal stabilization exercises leads to postural instability, increasing the likelihood of kyphotic progression. A weak core and underactive back extensors contribute to poor spinal support, leading to excessive forward bending of the thoracic spine.

3. Heavy Backpacks & Improper Lifting Mechanics

In children and adolescents, carrying overweight backpacks can accelerate kyphotic posture by exerting excessive downward pressure on the spine. Similarly, incorrect lifting mechanics in adults (e.g., repetitive forward bending with poor lumbar support) increase spinal stress, contributing to degenerative kyphosis.

4. Osteoporosis & Age-Related Bone Loss

Older adults, particularly postmenopausal women, are at a higher risk of developing osteoporotic kyphosis due to decreased bone density. Compression fractures in the thoracic vertebrae can lead to irreversible spinal deformity, making early bone health management critical.

5. Spinal Injuries & Degenerative Disc Disease

Trauma, herniated discs, and chronic spinal degeneration can disrupt normal vertebral alignment, leading to structural kyphosis. Degenerative changes in the intervertebral discs contribute to spinal instability, loss of disc height, and increased forward curvature of the thoracic spine.

Symptoms & Effects of Kyphosis on the Musculoskeletal System

Kyphosis not only alters spinal alignment but also leads to cascading effects throughout the musculoskeletal system. Depending on severity, symptoms may range from mild discomfort to functional disability.

Common Symptoms of Kyphosis

–Upper Back Pain & Stiffness: Chronic discomfort, particularly between the shoulder blades and mid-thoracic region.
–Limited Mobility & Flexibility: A rigid thoracic spine reduces spinal extension, affecting overall movement.
–Neck & Shoulder Tension: Forward head posture and rounded shoulders cause excessive strain on the cervical spine, leading to cervicogenic headaches and referred pain.
–Muscle Fatigue & Weakness: Over time, kyphotic posture weakens the paraspinal muscles, reducing spinal endurance.
–Breathing & Digestive Issues: Severe kyphosis can compress the thoracic cavity, leading to restricted lung expansion and impaired digestion.

Neuromuscular Impact of Kyphosis

Cervical Involvement: Increased kyphotic curvature forces cervical hyperextension, straining the posterior neck muscles and contributing to occipital headaches, vertigo, and TMJ dysfunction.

Thoracic & Lumbar Impact: Kyphosis can trigger compensatory hyperlordosis in the lumbar spine, increasing stress on the lower back and contributing to disc degeneration and sciatic symptoms.

Biomechanical Dysfunction: Altered gait mechanics, hip instability, and reduced balance have been observed in patients with significant kyphotic curvature (Lorbergs et al., 2017).

Understanding Long-Lasting Injuries- Video

Effective Treatment Approaches for Kyphosis

1. Chiropractic Care for Kyphosis Management

Chiropractic therapy is one of the most effective non-invasive treatments for managing kyphosis-related pain and improving spinal alignment. Research has shown that chiropractic spinal manipulation can improve mobility, reduce pain, and enhance postural stability (Norton et al., 2022).

Key Benefits of Chiropractic Adjustments:

1Spinal Realignment: Chiropractic adjustments restore normal vertebral positioning and reduce excessive thoracic curvature.
–Improved Postural Control: Chiropractic care strengthens postural awareness, spinal mobility, and core stability.
–Reduced Muscle Tension & Nerve Compression: Manual therapy alleviates trigger points, myofascial restrictions, and nerve impingements contributing to kyphotic discomfort.
 –Enhanced Flexibility & Range of Motion: Stretching techniques combined with spinal mobilization restore thoracic extension and shoulder mobility.

2. Physical Therapy & Postural Rehabilitation

Physical therapy plays a crucial role in strengthening the posterior chain, improving spinal stability, and reinforcing proper movement mechanics.

–Thoracic Extension Exercises (e.g., foam rolling, wall angels)
– Core Stabilization & Strength Training (e.g., dead bugs, planks)
– Scapular Retraction & Strengthening (e.g., rows, reverse flys)
–Cervical & Lumbar Postural Corrections

3. Bracing for Kyphosis Correction

In adolescents with Scheuermann’s kyphosis, bracing can help prevent worsening curvature during growth phases.

4. Postural Ergonomics & Lifestyle Modifications

– Ergonomic Workstations: Maintaining neutral spine alignment while sitting reduces kyphotic strain.
– Daily Mobility Exercises: Incorporating yoga, Pilates, or spinal decompression exercises can improve flexibility.
– Weight Management & Bone Health Optimization: Vitamin D, calcium supplementation, and weight-bearing exercises support spinal integrity.

Final Thoughts: Addressing Kyphosis Proactively

Kyphosis is a progressive condition that requires early intervention and a multidisciplinary treatment approach. By combining chiropractic adjustments, targeted physical therapy, and ergonomic modifications, patients can significantly reduce pain, improve posture, and enhance spinal function.

Injury Medical Chiropractic & Functional Medicine Clinic

We associate with certified medical providers who implement the importance of the causes and symptoms of kyphosis. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to reduce the effects of kyphosis from affecting the cervical and thoracic areas. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

Fortner, M. O., Oakley, P. A., & Harrison, D. E. (2017). Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics((R)): a case report utilizing a multimodal mirror image((R)) rehabilitation program. Journal of Physical Therapy Science, 29(8), 1475-1480. https://doi.org/10.1589/jpts.29.1475

Jenkins, H. J., Downie, A. S., Fernandez, M., & Hancock, M. J. (2021). Decreasing thoracic hyperkyphosis – Which treatments are most effective? A systematic literature review and meta-analysis. Musculoskelet Sci Pract, 56, 102438. https://doi.org/10.1016/j.msksp.2021.102438

Lam, J. C., & Mukhdomi, T. (2025). Kyphosis. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/32644371

Lorbergs, A. L., Murabito, J. M., Jarraya, M., Guermazi, A., Allaire, B. T., Yang, L., Kiel, D. P., Cupples, L. A., Bouxsein, M. L., Travison, T. G., & Samelson, E. J. (2017). Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc, 65(10), 2257-2264. https://doi.org/10.1111/jgs.15038

Norton, T. C., Oakley, P. A., & Harrison, D. E. (2022). Improving the cervical lordosis relieves neck pain and chronic headaches in a pediatric: a Chiropractic Biophysics((R)) (CBP((R))) case report with a 17-month follow-up. Journal of Physical Therapy Science, 34(1), 71-75. https://doi.org/10.1589/jpts.34.71

Oakley, P. A., Gage, W. H., Harrison, D. E., & Mochizuki, G. (2024). Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics((R)) case report. Journal of Physical Therapy Science, 36(11), 756-764. https://doi.org/10.1589/jpts.36.756

Ogura, Y., Dimar, J. R., Djurasovic, M., & Carreon, L. Y. (2021). Etiology and treatment of cervical kyphosis: state of the art review-a narrative review. J Spine Surg, 7(3), 422-433. https://doi.org/10.21037/jss-21-54

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

Straight Leg Test: Understanding Its Purpose

Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?

Straight Leg Test

The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what’s causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they’ll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.

Purpose

The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what’s happening. It is a manual exam, and the healthcare provider will:

  • Position the patient
  • Moves the patient
  • Create pressure to see how well the patient can resist it

This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)

During the Test

Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:

  • Tight hip or back muscles
  • Back muscle spasms
  • Slipped disc
  • Spinal instability

Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:

  • The patient lies on their back with their legs straight.
  • The provider will ask the patient to turn one of the legs in.
  • This tells them what hip position affects the lower back symptoms.
  • They’ll then ask you to bring the leg toward the body’s center.
  • Then, they’ll lift the straight leg until the patient experiences symptoms.
  • Pain suggests a herniated disc.
  • If there is no pain, this also provides valuable information.
  • The procedure is repeated with the other leg.

Modifications

It’s important to let the examiner know about any limitations. The straight leg raise test has modifications if the patient cannot lift their leg while it’s straight or if they have difficulty lying on their back, which can also help avoid an injury during the test.

Variations

The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they’ll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Injury to Recovery with Chiropractic Care

References

Casiano, V. E., Sarwan, G., Dydyk, A. M., & Varacallo, M. A. (2025). Back Pain. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844200

Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-021-04649-z

Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2

Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. https://doi.org/10.1016/j.apmr.2016.06.019

Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. https://doi.org/10.5704/MOJ.1511.012

Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. https://doi.org/10.1186/1757-1146-6-46

Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. https://doi.org/10.1097/BRS.0000000000001867

Camino Willhuber, G. O., & Piuzzi, N. S. (2025). Straight Leg Raise Test. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30969539

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

A Comprehensive Guide to Facet Arthropathy

Can individuals managing facet arthropathy treat the condition with over-the-counter pain relievers, prescription muscle relaxers, exercise, and chiropractic spinal manipulation?

Facet Arthropathy

Blog Image Facet Joint Arthritis

Facet arthropathy, or facet osteoarthritis, is arthritis that affects the facet joints in the spine. It causes pain and stiffness due to cartilage degeneration within these joints, often resulting from wear and tear associated with aging. Essentially, it occurs when the small joints in the back of the spine become arthritic and rub against each other painfully.

  • It affects the bony protrusions, called facet joints, that connect the spine’s bones.
  • Symptoms include neck and back pain that can worsen with standing, bending, or twisting.
  • Facet arthropathy is diagnosed using X-rays and other imaging studies.
  • Severe cases may require surgery.

Facet Joints

Twenty-four vertebrae form the spine, with two facet joints between each. Facet joints are small joints located at the back of each vertebra in the spine. They allow movement and stability, help maintain the alignment of the spinal bones/vertebrae, and limit excessive motion. The joints and the cushioning intervertebral disc form a three-joint complex between each vertebra.

  • The three-joint complex allows the spine to move, including bending, rotating, and extending.
  • Synovial fluid lubricates the joints so they can move.
  • The intervertebral disc provides flexibility and dissipates compressive loads.
  • The facet joints stabilize the spine by constraining rotation and bending.

Symptoms

Arthropathy refers to any disease affecting a joint, including arthritis. Osteoarthritis, also known as arthrosis, is a specific type of arthropathy. It is a non-inflammatory, degenerative arthritis. Pain is the main symptom that is typically worse in the morning when awakening, and in the evening, the pain can also get worse when twisting or bending backward. The symptoms can vary based on the part of the affected spine. Low back pain is the most common, a condition referred to as lumbar facet arthropathy because it affects the lumbar spine of the lower back. (Perolat R. et al., 2018) Common Symptoms include:

  • Muscle spasms or cramps.
  • Pain that may come in periodic flare-ups
  • Pain that worsens with standing or inactivity.
  • Dull pain on both sides of the spine.
  • Aching pain on both sides of the spine.
  • Pain in the lower back, buttocks, shoulders, or back of the skull
  • Radiating pain to the buttocks and legs.
  • Pain that improves with sitting, leaning forward, or changing positions.
  • Pins-and-needles sensations in the hands or feet.
  • Clicking sounds when moving the spine.
  • Catching sensations when moving the spine.
  • Muscle weakness.

Causes

Facet arthropathy causes progressive damage to the spine. Spinal osteoarthritis, aka spondylosis, is the most common cause, but it can also occur with a severe form of spinal arthritis known as ankylosing spondylitis. It is primarily due to age-related wear and tear, but injuries or repetitive stress on the spine can also cause it. Arthritis in the facet joints can develop due to:

  • Aging-related wear and tear
  • Disc problems
  • A previous back injury
  • Torn ligaments
  • Spinal fractures

Deterioration of facet joints can also cause bony overgrowths called osteophytes or bone spurs, which can cause radiating pain and restrict the spine’s range of motion.

Degeneration

  • The facet joints and intervertebral discs degenerate due to age-related wear and tear.
  • The cartilage in the facet joints can dry out, crack, and wear down.
  • The joint capsule and synovial membrane can inflame or tear, affecting synovial fluid production.
  • The loss of cartilage can lead to hypermobility, and the joint can stiffen over time.

Diagnosis

Imaging studies are important to the diagnosis. Several types confirm the diagnosis and also characterize the nature and severity of the condition:

  • X-rays provide a plain, black-and-white image of the spinal column.
  • CT scan composites multiple X-rays to create a three-dimensional image of the spinal column.
  • MRI uses magnetic and radio waves to generate images of soft tissues like ligaments and cartilage.

To confirm the diagnosis, a diagnostic block, which is a small amount of local anesthetic, is injected into a facet joint. The needle placement is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection provides immediate relief (American Academy of Orthopaedic Surgeons, 2022). The healthcare provider will want to exclude other possible causes as part of the differential diagnosis. Conditions that mimic facet arthropathy include:

  • Herniated disc
  • Psoriatic arthritis
  • Reactive arthritis
  • Spinal gout
  • Spinal compression fracture

Treatment

The treatment varies based on its location and severity. Generally, conservative treatments are used before more invasive procedures are considered.

Lifestyle Changes

  • Initially, a healthcare provider may recommend rest and avoiding aggravating movements, including any activity that involves bending or twisting.
  • Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions, may help ease the pain.
  • Patients may also be advised to adjust their sleep positions to take the pressure off facet joints.
  • Options included curling up on your side or lying on your back with the knees supported with pillows.

Medications

If a diagnostic block is used, a patient may not need medications immediately. However, as the anesthetic starts to wear off, the patient may be prescribed over-the-counter or prescription pain relievers based on the severity of the pain. These can include:

  • Analgesics like Tylenol
  • Nonsteroidal anti-inflammatory drugs like Advil or Aleve
  • Muscle relaxants like Lloresal for acute back pain
  • Antidepressants like Cymbalta for chronic back pain

Physical Therapy

Physical therapy is a major part of the treatment of lower back pain. The treatment plan will include personalized exercises to strengthen the core muscles and avoid stress on the spine. Examples include:

  • Mechanical traction and non-surgical to decompress the spine.
  • Knee-to-chest stretches, hugging your knees for 30 to 60 seconds.
  • Walking 10 to 20 minutes per day.
  • Aquatic therapy to alleviate pressure on the spine.

Surgery

If conservative measures don’t work or provide sufficient relief, a healthcare provider may recommend specialist procedures or surgeries that include:

  • Lumbar intra-articular injections deliver an anesthetic or corticosteroid into the spine for longer-lasting pain relief.
  • Sinuvertebral nerve ablation destroys spinal nerves with a strong electrical current.
  • Extracorporeal shockwave therapy ESWT delivers low- or high-energy electrical pulses to help ease pain.
  • Spinal fusion surgery involves fusing two or more vertebrae to eliminate movement and pain in the facet joints.
  • Facet rhizotomy is a surgical procedure used to sever one of the nerves supplying the facet joint.
  • Stem cell regeneration is an experimental procedure in which stem cells are harvested and injected into damaged joints to restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Facet Syndrome Pain Treatment

References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x

American Academy of Orthopaedic Surgeons. (2022). Spinal injections. https://orthoinfo.aaos.org/en/treatment/spinal-injections/

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

Get Relief for Your Spine & Back with Simple and Effective Exercises

Can individuals incorporate these simple but effective exercise routines to reduce pain and discomfort in their spine and back?

Why It’s Important To Keep The Back Mobile

When many individuals are dealing with back pain from their upper, middle, and lower portions, it can put a halt to a person’s routine. When back pain becomes present, it causes the person to find a comfortable place like a couch or a bed and lie down. However, this can cause more issues than the original one, affecting the individual. Back pain is a common worldwide problem and is the leading issue of disability associated with a high socio-economic cost. (Chou, 2021) Additionally, when a person is dealing with back pain, they are also dealing with degenerative issues that are also affecting their spines, thus causing problems to their joints, discs, and bones. (Hauser et al., 2022) This is because back pain is a multifactorial musculoskeletal disorder that can cause referred pain to different body locations. So when a person dealing with back pain rests, it can become an issue as inflammation builds up and swelling in the affected areas. Hence, many doctors, chiropractors, physical therapists, and spine specialists recommend keeping mobile to allow blood flow and the body’s natural healing response to reduce pain and speed up recovery. Since back pain relief is challenging through visceral-somatic disturbances, it is important to find various treatment options to aid the person’s specific condition. As a person goes to get treatment for their back pain, it is important to note that the causes of their back pain can help determine which exercises can be most effective within their treatment plan. We associate with certified medical providers who inform our patients of the benefits of incorporating simple but effective exercises for their back pain. While asking important questions to our associated medical providers, we advise patients to integrate an exercise routine to reduce the chances of environmental factors causing back pain to return. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Understanding Academic Low Back Pain- Video

Effective But Simple Exercises For The Back

Many people often wonder, “If I am dealing with back pain, why should I exercise to reduce this pain?” The answer is simple: since the affected back muscles are tight and weakened, simple but effective exercises can help recover. Exercise therapy can help increase muscle-joint strength in the body while improving muscle function and increasing range of motion. This boosts a speedy recovery and allows the individual to return to their usual activities. (Hayden et al., 2021) At the same time, with a customized treatment plan, exercise therapy can incorporate other non-surgical treatments with one goal: to restore normal musculoskeletal function and reduce the pain caused by environmental factors, diseases, or injuries. (Karlsson et al., 2020) Now, depending on the severity of the back pain, there are simple but effective exercises below to help reduce the pain and restore mobility to the back.

Physical Therapy & At-Home Workouts

Physical therapy and at-home exercises can help many individuals with back pain. They can help figure out which position can help centralize the pain and correct any restricted motions. Many physical therapists incorporate the McKenzie method to strengthen and support the spine while decreasing pain and inflammation. At-home exercises can be combined with a series designed to be practical, assessable, and feasible for therapeutic gain or even to improve physical capacity to maximum effort. (Quentin et al., 2021)

Water Exercises

Water exercises are amazing exercises that can help lessen the body’s weight to take pressure and stress off the spine. This is because water is supposed to help cleanse and rejuvenate the body. When individuals are experiencing chronic back pain, aquatic physical therapy can help relieve pain intensity, relax the aching muscles, and even promote a positive workout experience for the individual. (Ma et al., 2022) After a few consecutive sessions, many individuals can see improvement in pain intensity and restored mobility function in their routines.

Tai Chi & Stabalizing Exercises

Now, another simple and effective exercise routine can help stabilize the surrounding muscles in the back and spine and become effective as part of a health and well-being routine. Tai chi and Qigong practices can help the individual emphasize stillness and controlled movements to promote calmness, resilience, body awareness, and relaxation for proper body alignment. (Yang et al., 2024) Tai chi and Qigong can also help support immune function in the body while regulating inflammation, which can help reduce and prevent diseases. (Oh et al., 2020) At the same time, yoga can help improve flexibility, mobility, and stability within the muscles and joints while also improving spinal alignment, which can help many individuals have proper posture. (Zhu et al., 2020) Depending on which exercise a person prefers for their treatment plan and to reduce their back pain; it is important to make these small changes to achieve optimal results. Making these small changes can help many individuals reduce the chances of their back pain returning and help them along with their health and wellness journey.

References

Chou, R. (2021). Low Back Pain. Ann Intern Med, 174(8), ITC113-ITC128. https://doi.org/10.7326/AITC202108170

Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. https://doi.org/10.3233/BMR-210097

Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database Syst Rev, 9(9), CD009790. https://doi.org/10.1002/14651858.CD009790.pub2

Karlsson, M., Bergenheim, A., Larsson, M. E. H., Nordeman, L., van Tulder, M., & Bernhardsson, S. (2020). Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews. Syst Rev, 9(1), 182. https://doi.org/10.1186/s13643-020-01412-8

Ma, J., Zhang, T., He, Y., Li, X., Chen, H., & Zhao, Q. (2022). Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord, 23(1), 1050. https://doi.org/10.1186/s12891-022-05981-8

Oh, B., Bae, K., Lamoury, G., Eade, T., Boyle, F., Corless, B., Clarke, S., Yeung, A., Rosenthal, D., Schapira, L., & Back, M. (2020). The Effects of Tai Chi and Qigong on Immune Responses: A Systematic Review and Meta-Analysis. Medicines (Basel), 7(7). https://doi.org/10.3390/medicines7070039

Quentin, C., Bagheri, R., Ugbolue, U. C., Coudeyre, E., Pelissier, C., Descatha, A., Menini, T., Bouillon-Minois, J. B., & Dutheil, F. (2021). Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health, 18(16). https://doi.org/10.3390/ijerph18168430

Yang, Y., McCluskey, S., Bydon, M., Singh, J. R., Sheeler, R. D., Nathani, K. R., Krieger, A. C., Mehta, N. D., Weaver, J., Jia, L., DeCelle, S., Schlagal, R. C., Ayar, J., Abduljawad, S., Stovitz, S. D., Ganesh, R., Verkuilen, J., Knapp, K. A., Yang, L., & Hartl, R. (2024). A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial. N Am Spine Soc J, 20, 100557. https://doi.org/10.1016/j.xnsj.2024.100557

Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 15(9), e0238544. https://doi.org/10.1371/journal.pone.0238544

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

Muscle Relaxers for Back Spasms: What You Need to Know

For individuals who injure their neck or back, the muscles may spasm or seize up, making it difficult to get through the day, exercises, physical activities, etc. Can skeletal muscle relaxers help relieve pain and reduce frequency?

Back Spasms Muscle Relaxers

Back muscle spasms are common back pain that feels like a sudden tightness or contraction in the back muscles. They can range from minor twinges to severe pain.

Causes

  • Poor posture: Sitting or standing with bad posture can strain the back muscles.
  • Overuse: Picking something up, bending, or lifting can cause a spasm.
  • Dehydration: Not drinking enough water can cause electrolyte imbalances, leading to spasms.
  • Underlying conditions: A herniated disc or degenerative disc disease can cause back spasms.
  • Muscle imbalances: Weak muscles or muscles that are too tight can cause spasms.

Treatments

  • Home treatments: Apply heat or ice, take over-the-counter pain medication, try gentle stretching, or massage the area.
  • Exercise: Improve your back’s strength and flexibility with exercise or physical therapy.
  • Hydration and nutrition: Drink enough water and eat foods rich in magnesium and calcium.
  • Chiropractic Adjustments: These can realign the spine to the correct position and muscles to relax.
  • Non-surgical Decompression: Decompression of the spine will allow more blood and nutrients to heal painful areas.

Skeletal Muscle Relaxers

A healthcare provider may prescribe skeletal muscle relaxers. These medications are not available over the counter and must be prescribed by a healthcare provider.

  • Skeletal muscle relaxers will probably cause drowsiness.
  • Individuals should not drive, operate heavy machinery, or engage in other physical activities when taking back spasm muscle relaxers.
  • Skeletal muscle relaxers are not recommended for 65 or older because safer, effective alternatives exist.
  • Also, women who are pregnant or breastfeeding should not take these medications.
  • Discuss these issues with your healthcare provider.

Carisoprodol 

Carisoprodol is available generically and as Soma and Vanadom brands. It works by suppressing nerve impulses located in the brain and spinal cord. Healthcare providers prescribe this medication in combination with physical therapy for the healing release of any muscle spasm and management of musculoskeletal injuries and/or pain. (Witenko C. et al., 2014) It’s not about having to continue taking the medication to feel better but more as a jump start to help with the physical therapy program.

  • Back muscle spasms are a perfect example of a condition that may benefit from carisoprodol in the short term.
  • Carisoprodol can be habit-forming.
  • Be sure to talk to a healthcare provider before suddenly going off this medication.
  • Carisoprodol can cause side effects that may impair thinking or reactions.
  • Avoid drinking alcohol as it may increase drowsiness and dizziness that are often caused by carisoprodol. (Zacny J. P., Paice J. A., & Coalson D. W. 2012)
  • Inform your healthcare provider of any drug allergies, kidney disease, or liver disease, or if you get seizures.

Cyclobenzaprine

Cyclobenzaprine is available as Amrix and in generic form. Like other muscle relaxers, cyclobenzaprine may cause dizziness or drowsiness. The sedation effects are how it works on painful, tension-filled muscles. Cyclobenzaprine is used together with physical therapy to treat skeletal muscle-related conditions and/or injuries, especially when pain or spasm is involved. When used in conjunction with physical therapy, it can help expedite recovery.

  • Cyclobenzaprine is chemically related to tricyclic antidepressants.
  • Although it is considered a derivative of the tricyclic antidepressant class, it does not pose the same risk to liver health.
  • According to the National Institutes of Health, reasons not to take this medication include having a thyroid disorder, heart block, congestive heart failure, a heart rhythm disorder, or having recently had a heart attack. (Witenko C. et al., 2014)

Metaxalone

Skelaxin is the brand name for metaxalone. As with the other muscle relaxers, metaxalone is used in combination with physical therapy and rest when muscles get too tight. (Witenko C. et al., 2014) It works by suppressing nerve impulses in the brain and spinal cord. In addition to older individuals and pregnant women, metaxalone is usually not prescribed for those with kidney disease, liver disease, seizures, or blood disorders.

Injury Medical Chiropractic and Functional Medicine Clinic

Back spasms and muscle relaxers could help individuals, along with a personalized physical therapy treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Thoracic Spine Pain

References

Witenko, C., Moorman-Li, R., Motycka, C., Duane, K., Hincapie-Castillo, J., Leonard, P., & Valaer, C. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. P & T: a peer-reviewed journal for formulary management, 39(6), 427–435.

Zacny, J. P., Paice, J. A., & Coalson, D. W. (2012). Subjective and psychomotor effects of carisoprodol in combination with oxycodone in healthy volunteers. Drug and alcohol dependence, 120(1-3), 229–232. https://doi.org/10.1016/j.drugalcdep.2011.07.006

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

Effective Back Stretching Exercises for Pain Management

Can knowing how to stretch your back help reduce pain and improve your range of motion?

Stretch Your Back

Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:

  • When stretching, don’t try to push past your pain limit.
  • Listen to your body, which leads to a calmer nervous system.
  • Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.

Warm Up

Stretching cold muscles can lead to injury. Always warm up first.

  • Do between five and 10 minutes of mild activity, such as walking.
  • Apply heat for 15 to 20 minutes before stretching.

Knees-to-Chest Back Stretch

To perform:

  • Lie on your back with your feet flat on the floor.
  • Bring your legs toward your chest With your knees bent.
  • Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
  • Pull until there is a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Do a total of 10 reps.

Supine Twist Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Prone Bridging Back Stretch

To perform:

  • Lie on your stomach.
  • Prop yourself up on your elbows.
  • Extend your back.
  • Start straightening your elbows, further extending the back.
  • Continue straightening the elbows until the stretch is felt.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Supine Butt Lift Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Push down through the feet as you slowly raise yourself off the floor.
  • Hold for 10 seconds.
  • Return to starting position.
  • Repeat for nine reps.

Seated Forward Curl Back Stretch

To perform:

  • Sit in a chair with your feet flat on the ground.
  • Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Side Stretch

To perform:

  • Stand up straight with your arms at your sides and feet shoulder-width apart.
  • Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
  • Hold for 10 seconds.
  • Repeat for nine reps.

Other Treatments to Loosen a Tight Back

Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)

Acupuncture

  • Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
  • They have an analgesic, pain-relieving effect. (Foley C., & Litscher G. 2024)

Massage Therapy

  • Various massages involve kneading soft tissue in the back with hands, fingers, elbows, or instruments/tools/devices to relieve stress or pain.

Spinal Manipulation

  • Practiced by chiropractors, this therapy involves using the hands or instruments/tools/devices to manipulate the joints in the spine to relieve pain.

Tai Chi

  • Based on martial arts, slow movements, and deep breaths help to work muscle groups in flowing motions, supporting back strength and overall health.

Yoga

  • Yoga combines physical poses, breathwork, and meditation to help build strength, be restorative, and relax the body.

Anti-inflammatory Diet

  • An anti-inflammatory diet can also benefit tight muscles. (U.S. Department of Defense, 2012)
  • Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.

Stretching Benefits

References

Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. https://doi.org/10.1089/acu.2020.1499

Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. https://doi.org/10.1089/acu.2023.0054

U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from https://media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF

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

How a Massage Gun Can Help Ease Pregnancy Pain and Fatigue

Stress on the lower back during pregnancy often leads to back (upper, middle, lower), sciatica, and leg pain. Can you use a massage gun while pregnant?

Pregnancy Massage Gun Use

Pregnant women often experience back, hip, and leg pain along with symptoms such as swelling (edema), muscle spasms, cramps, and fatigue, which interfere with daily functions and sleep. Pregnancy massage gun use is a safe and helpful form of stress and tension relief, so long as healthcare providers and safety precautions are followed and sensitive areas are avoided. Massage guns use percussion and vibration to create a form of massage that can relieve tension, stiffness, and muscle soreness, break up tissue adhesions, and reduce inflammation. Moreover, pregnancy massage can provide relaxation and pain relief for muscles and joints that are adapting to a growing, changing body. Traditional massage therapy and massage gun therapy have been shown to help reduce muscle soreness and pain. (Imtiyaz S., Veqar Z., & Shareef M. Y. 2014) The benefits of pregnancy massage gun use include:

However, it is essential to discuss massage gun use with a healthcare professional and follow safety precautions when using massage guns during pregnancy.

Benefits

While there is no specific research on the benefits of massage guns for pregnant individuals, studies have demonstrated the general benefits of massage during pregnancy, including deep tissue massage. Therapeutic massage effectively reduces pregnancy discomforts and pain and is a safe and affordable method of pain relief. (El-Hosary EA, Abbas Soliman HF, El-Homosy SM. 2016) Researchers believe this relief helps improve the health of mother and baby in ways that include. (El-Hosary EA, Abbas Soliman HF, El-Homosy SM. 2016) (Mueller S. M., & Grunwald M. 2021)

  • Improves cardiovascular health
  • Overall circulation improves
  • Increases serotonin and dopamine levels
  • Decreases chronic back pain
  • Relieves muscle aches and joint pains
  • Improves sleep patterns
  • Increases energy
  • Reduces anxiety
  • Increases immune response
  • Enhances sense of well-being and mood
  • Reduces risk of preterm delivery

Massage Gun Safety

Pregnancy massage gun use is generally safe for those who do not have preexisting conditions. (Mueller S. M., & Grunwald M. 2021) However, there are no studies on the safety of massage guns or other massage tools for pregnant individuals. It is recommended to discuss the use of massage guns with a doctor before use.

When to Avoid Massage Therapies

Pregnant individuals should avoid pregnancy massage of any kind if any of the following conditions are present (American Massage Therapy Association, 2018)

High-risk Pregnancy

  • Individuals with high-risk factors, such as bleeding, pre-term contractions, and preeclampsia, should avoid using massage guns unless a doctor clears them to do so.

Preeclampsia

  • This condition causes a rise in blood pressure that can be serious.
  • It typically develops around 20 weeks of pregnancy or later.

Deep Vein Thrombosis – DVT

  • Avoid using a massage gun if there is a history of deep vein thrombosis.
  • Blood volume increases during pregnancy, and leg circulation can be poor.
  • Certain hormones that prevent hemorrhage during delivery can cause blood to clot more easily.
  • Using a massage gun on areas with potential blood clots may release the clot, leading to a life-threatening embolism. (Sutham K. et al., 2020)
  • Compression socks are a better alternative for relieving leg pain and swelling, but follow the healthcare provider’s recommendations.

Placenta Previa, Accrete, or Abruption

  • These conditions involve the placenta, which can lead to bleeding.

Gestational Diabetes

  • High blood sugar levels do not necessarily mean individuals cannot use a massage gun during pregnancy.
  • However, speak to a doctor and monitor blood sugar before use.

How to Use

Although there are no specific expert directions for the use of massage guns during pregnancy, there are guidelines to consider while using the device. This includes:

  • Never place the massage gun directly over bones, nerves, or joints.
  • Avoid using the device around injured, swollen, or painful areas.
  • Avoid using a massage gun directly on the abdomen.

Additional Tips (Hospital for Special Surgery, 2021)

  • Start by trying a light 10- to 15-second pass over sore or tight areas.
  • Perform three to five sweeps over the location, then move on to another.
  • Be careful not to keep the gun on a single area too long, as you could overwork the muscle, leading to bruising and irritation.
  • The recommended time for leaving the massager in one area is two minutes.
  • Stop using the massage gun if there is unusual pain, sensations, or discomfort.

Injury Medical Chiropractic and Functional Medicine Clinic

Massage during pregnancy can help relieve symptoms such as anxiety, stress, pain, discomfort, tightness, and poor circulation. Regular massage can help improve sleep and can even benefit the baby. However, it is recommended to consult with a doctor about using a massage gun before trying it out. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Pregnancy and Sciatica: How Chiropractic Helped

References

Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS). Journal of clinical and diagnostic research: JCDR, 8(1), 133–136. https://doi.org/10.7860/JCDR/2014/7294.3971

American Massage Therapy Association. (2011). Pregnancy Massage. https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-pregnancy/

El-Hosary EA, Abbas Soliman HF, El-Homosy SM. (2016). Effect of Therapeutic Massage on Relieving Pregnancy Discomforts. IOSR Journal of Nursing and Health Science., 5(4), 57-64. https://doi.org/10.9790/1959-0504025764

Mueller, S. M., & Grunwald, M. (2021). Effects, Side Effects and Contraindications of Relaxation Massage during Pregnancy: A Systematic Review of Randomized Controlled Trials. Journal of Clinical Medicine, 10(16), 3485. https://doi.org/10.3390/jcm10163485

American Massage Therapy Association. (2018). Massage and pregnancy: A powerful combination. https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-pregnancy-a-powerful-combination/

Sutham, K., Na-Nan, S., Paiboonsithiwong, S., Chaksuwat, P., & Tongsong, T. (2020). Leg massage during pregnancy with unrecognized deep vein thrombosis could be life-threatening: a case report. BMC pregnancy and childbirth, 20(1), 237. https://doi.org/10.1186/s12884-020-02924-w

Hospital for Special Surgery. Surgery, H. F. S. (2021). What you should know about using a massage gun. https://www.hss.edu/article_how-to-use-massage-gun.asp