By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care accident doctor, accident physician, accident specialist, auto, car accident trauma specialist, cervical, dralexjimenez, Injury, neck, neck pain, nonsurgical, pain, personal injury doctor, Personal Injury Specialist whiplash, treatment, work

Understanding the Impact of Whiplash Before Going Back To Work

Discover the impact of whiplash on your health and learn effective strategies for recovery and management before going back to work.

Returning to Work After Motor Vehicle Accidents: Understanding Whiplash, Treatments, and Clinical Insights

Introduction

Getting back to work after a motor vehicle accident (MVA) can feel like trying to solve a puzzle with missing pieces, especially when whiplash is involved. Whiplash, a frequent injury from car crashes, can turn simple tasks like typing or lifting into a real pain in the neck (pun intended!). But with the right care, many people can return to their jobs and lives with confidence. In this in-depth guide, we’ll explore whiplash, its impact on work, nonsurgical treatments, and the clinical rationale for getting back to work. We’ll also spotlight Dr. Alexander Jimenez, a leading chiropractor and nurse practitioner in El Paso, Texas, whose expertise in personal injury cases helps patients navigate recovery and legal processes. Let’s dive into this journey of healing, with a sprinkle of humor to keep things light—because who said recovery can’t have a few laughs?

What is Whiplash?

Definition and Causes

Whiplash is a neck injury caused by a sudden, forceful back-and-forth movement of the head, much like the crack of a whip. This rapid motion can strain or tear the muscles, ligaments, and tendons in the neck, leading to a range of symptoms. The most common cause is rear-end car collisions, but whiplash can also occur from sports injuries, falls, or even an overly enthusiastic head-banging session at a concert (though we’ll stick to MVAs for now). Research estimates that whiplash affects over one million people annually in the U.S., with societal costs reaching up to $29 billion (Lovell & Galasko, 2002).

The mechanics of whiplash are no joke. When a car is hit from behind, the head accelerates backward and then snaps forward, stretching soft tissues beyond their normal limits. MRI and autopsy studies have shown that whiplash can cause injuries to cervical ligaments, discs, and facet joints, which are critical for neck stability (Kaale et al., 2005). These injuries, often invisible on standard X-rays, can lead to persistent pain if not addressed early.

Symptoms of Whiplash

Whiplash symptoms are as varied as the toppings on a pizza—and just as likely to linger if not handled properly. Common symptoms include:

Neck Pain and Stiffness: The hallmark of whiplash, often described as a tight, aching sensation.
Headaches: Frequently starting at the base of the skull.
Dizziness: Making you feel like you’re on a merry-go-round that won’t stop.
Fatigue: Because your body is working overtime to heal.
Shoulder, Back, or Arm Pain: Pain can radiate beyond the neck.
Numbness or Tingling: Often in the arms, signaling nerve irritation.
Blurred Vision, Ringing in the Ears: Less common but still disruptive.
Cognitive Issues: Trouble concentrating or remembering, as if your brain took a vacation.
Sleep Disturbances, Irritability, Depression: Because chronic pain is a mood-killer.

These symptoms may not show up right away, sometimes taking days or weeks to appear, which is why seeing a doctor ASAP is crucial (Sterner & Gerdle, 2004). Think of it like a sneaky ninja—whiplash can creep up when you least expect it.

Symptom	Description
Neck Pain/Stiffness	Aching or tightness, limiting neck movement.
Headaches	Often starting at the skull base, can be persistent.
Dizziness	Feeling unsteady or lightheaded.
Fatigue	General tiredness due to the body’s healing efforts.
Radiating Pain	Pain spreading to shoulders, back, or arms.
Numbness/Tingling	Nerve-related sensations in arms or hands.
Cognitive/Sleep Issues	Difficulty focusing, remembering, or sleeping; irritability or depression.

Impact of Whiplash on Work

Whiplash can throw a wrench into your work life faster than a Monday morning traffic jam. The pain and stiffness can make it tough to sit at a desk, lift boxes, or even focus on a computer screen. Research paints a sobering picture:

A BMC Public Health study found that only 44% of whiplash patients returned to work after two years (Freeman et al., 1999).
A Danish study of 104 patients reported 56% were still on sick leave two years post-injury (Kasch et al., 2001).
Between 19% and 60% of patients experience symptoms six months after injury, with up to half unable to return to work within a year (Sterner & Gerdle, 2004).
A 2001 study noted that 12% of whiplash patients hadn’t resumed normal activities or modified job functions a year later (Spitzer et al., 1995).

These numbers show that whiplash isn’t just a physical hurdle—it’s a career roadblock. Chronic symptoms, like persistent neck pain or cognitive difficulties, can lead to long-term work disability, especially if untreated. Imagine trying to type a report while your neck screams, “Not today!” Early treatment is the key to getting back to your desk, warehouse, or classroom without feeling like you’re auditioning for a role as a human statue.

The Power of Chiropractic Chiropractic Care In Injury Rehabilitation- Video

Clinical Rationale for Returning to Work

Returning to work after an MVA isn’t just about paying the bills (though that’s a big motivator!). It’s also about restoring normalcy, boosting mental health, and preventing the downward spiral of inactivity. From a clinical perspective, early mobilization is a game-changer. Prolonged rest can lead to muscle atrophy and increased stiffness, making recovery harder (Quebec Task Force, 1995). Think of your body like a car—if you leave it in the garage too long, it’s going to get rusty.

Healthcare providers often recommend a gradual return to work as part of rehabilitation. This might mean starting with part-time hours or modified duties, like swapping heavy lifting for lighter tasks. The goal is to keep you moving without overdoing it. Studies suggest that early, active rehabilitation—think chiropractic adjustments or physical therapy—can reduce pain and improve function, paving the way for a smoother return to work (Teasell et al., 2010).

However, the decision to return isn’t one-size-fits-all. It depends on:

Injury Severity: Mild whiplash might resolve in weeks, while severe cases could take months.
Job Demands: A desk job is easier to return to than construction work.
Overall Health: Pre-existing conditions can complicate recovery.

A good doctor, like Dr. Alexander Jimenez, will assess these factors and create a plan that gets you back to work without risking further injury. It’s like planning a road trip—you need a map, not just a destination.

Nonsurgical Treatments for Whiplash

Nobody wants to go under the knife if they can avoid it, and luckily, whiplash responds well to nonsurgical treatments. These approaches aim to reduce pain, restore mobility, and get you back to your daily grind. Here’s a rundown of the top options:

Chiropractic Care: Chiropractors use spinal manipulation to realign the spine and relieve nerve pressure. It’s like giving your neck a gentle nudge to say, “Get back in line!” Studies show it can significantly reduce pain and improve mobility (Lord et al., 1996).
Physical Therapy: Physical therapists design exercise programs to strengthen neck muscles and improve range of motion. They might also use heat, ice, ultrasound, or electrical stimulation to ease pain. It’s like a gym session tailored for your neck (Teasell et al., 2010).
Exercise: Gentle exercises, like stretching or swimming, can strengthen the neck and improve posture. Think of it as physical therapy’s fun cousin—less clinical, more doable at home (McLean et al., 2014).
Medications: Over-the-counter pain relievers (e.g., ibuprofen) or muscle relaxants can help manage pain and inflammation. Prescription meds may be used for severe cases (Childs et al., 2008).
Injections: Corticosteroid injections can reduce inflammation in stubborn cases, offering relief when other methods fall short (Barnsley et al., 1994).
Radiofrequency Neurotomy: For chronic pain, this procedure targets specific nerves to block pain signals. It’s like hitting the mute button on your neck’s complaints (Lord et al., 1996).

These treatments work best when started early, preventing symptoms from becoming chronic. Combining them, like pairing chiropractic care with exercise, can supercharge recovery. It’s like assembling a superhero team for your neck—each treatment brings its own powers!

Treatment	Benefits	Considerations
Chiropractic Care	Reduces pain, improves spinal alignment and mobility.	Requires skilled practitioner; multiple sessions.
Physical Therapy	Strengthens muscles, enhances flexibility, reduces pain.	Time-intensive; needs patient commitment.
Exercise	Improves posture, strengthens neck, accessible at home.	Must be done correctly to avoid strain.
Medications	Quick pain and inflammation relief.	Temporary; potential side effects.
Injections	Targeted relief for severe inflammation.	Invasive; not first-line treatment.
Radiofrequency Neurotomy	Long-term pain relief for chronic cases.	Specialized procedure; not widely available.

Dr. Alexander Jimenez’s Approach to Personal Injury Cases

In El Paso, Texas, Dr. Alexander Jimenez, DC, APRN, FNP-BC, stands out as a beacon of hope for MVA victims. With over 25 years of experience, Dr. Jimenez combines his expertise as a chiropractor and nurse practitioner to offer integrative care that addresses both the physical and medical aspects of whiplash (Injury Medical Clinic). His clinic, Injury Medical & Chiropractic Clinic, specializes in treating severe pain conditions, including neck pain, back pain, sciatica, and whiplash, using advanced therapies focused on mobility, health, and wellness.

Advanced Diagnostics and Treatment

Dr. Jimenez employs advanced imaging, like MRI and CT scans, to pinpoint injuries that might not show up on standard X-rays. These tools help him identify damage to ligaments, discs, or facet joints, ensuring accurate diagnoses (Jimenez, n.d.). He also uses diagnostic evaluations, such as range-of-motion tests and neurological assessments, to create personalized treatment plans. His dual-scope approach—combining chiropractic adjustments with medical management—ensures holistic care that tackles both symptoms and underlying causes.

Bridging Medical and Legal Needs

Personal injury cases often involve legal battles, and Dr. Jimenez excels as a liaison between medical care and legal documentation. He provides detailed reports that link injuries to the MVA, supporting patients’ claims in court. This is crucial in El Paso, where personal injury cases are common due to frequent MVAs. His ability to translate complex medical findings into clear, legally admissible documentation makes him a trusted partner for both patients and attorneys (Personal Injury Doctor).

Patient-Centered Care

Patients rave about Dr. Jimenez’s compassionate approach. One patient noted, “Dr. Jimenez and his staff genuinely care about your recovery,” highlighting his dedication to improving mobility and reducing pain (Yelp Reviews). His clinic also emphasizes education, teaching patients about injury prevention and wellness to prevent future issues. It’s like getting a personal coach for your health, minus the whistle!

Personal Injury Cases in El Paso

El Paso, a bustling border city, sees its fair share of MVAs, leading to numerous personal injury cases. Whiplash and other soft tissue injuries are common, and navigating the medical and legal landscape can be overwhelming. Dr. Jimenez’s expertise is a game-changer here. His ability to provide comprehensive care while supporting legal claims makes him a go-to practitioner for accident victims. His clinic’s focus on conditions like whiplash, sciatica, and neck pain ensures that patients get back on their feet—and back to work—as quickly as possible (Auto Accident Treatment).

In personal injury cases, medical evidence is critical. Dr. Jimenez’s use of advanced imaging and diagnostics provides solid proof of injury, which can make or break a legal case. His integrative approach also means patients don’t have to bounce between specialists—he handles both the chiropractic and medical sides, streamlining recovery and documentation.

A Touch of Humor

Let’s face it—dealing with whiplash is about as fun as a root canal during a power outage. But here’s a silver lining: with the right care, you can go from “ouch” to “I’ve got this!” faster than you can say “chiropractic adjustment.” Picture your neck as a grumpy cat—stiff and uncooperative at first, but with a little TLC from Dr. Jimenez, it’ll be purring (or at least not hissing) in no time. Humor aside, recovery is serious business, and the right treatment can make all the difference.

Conclusion

Returning to work after an MVA, especially with whiplash, requires a strategic approach that blends timely treatment, personalized care, and expert guidance. Dr. Alexander Jimenez’s integrative methods, advanced diagnostics, and role as a medical-legal liaison make him a standout in El Paso’s personal injury landscape. By addressing whiplash with nonsurgical treatments and supporting patients through recovery and legal processes, he helps them reclaim their lives and livelihoods.

Disclaimer: This blog post is for informational purposes only and should not be taken as medical advice. Always consult a qualified healthcare professional for diagnosis and treatment of any medical condition.

Key Citations

June 12, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care accident doctor, accident physician, accident specialist, auto accident, car accident trauma specialist, cervical, cervical spine, dralexjimenez, neck, neck pain, personal injury doctor, personal injury specialist, spine

Auto Injuries: Prevention Tips for The Cervical Spine

Cervical spine and auto injuries require attention. Explore causes, symptoms, and treatment options for effective recovery.

Oh, the automobile—a chariot of modern marvels, whisking us through the streets with the grace of a tango dancer! But, like a misstep in a passionate dance, a motor vehicle accident (MVA) can leave you with more than just a crumpled fender. Neck pain, that uninvited guest, can linger like a melodramatic villain, turning your daily waltz into a painful shuffle. Fear not, dear reader, for we’re about to embark on a journey through the clinical intricacies of cervical spinal pain, with a spotlight on the expertise of Dr. Alexander Jimenez, El Paso’s chiropractic maestro, who navigates this medical maze with the flair of Gomez Addams himself.

The Anatomy of a Neck in Distress

Let’s start with the star of our show: the cervical spine, or as we common folk call it, the neck. This elegant structure comprises seven vertebrae, labeled C1 through C7, each cushioned by intervertebral discs that act like shock absorbers in a luxury car. These discs feature a tough outer layer and a gel-like core, enabling your neck to twist, turn, and nod with the ease of a ballroom dancer. But when an MVA strikes, it’s like a rogue gust of wind disrupting a perfectly choreographed routine.

Picture this: you’re cruising along, humming to your favorite tune, when—bam!—a collision sends your head whipping forward and back like a yo-yo. This sudden motion, often referred to as whiplash, can stretch or tear ligaments, strain muscles, or even damage the delicate discs. The result? Pain, stiffness, and sometimes numbness that can radiate to your shoulders or arms. According to clinical guidelines, such trauma can lead to conditions like cervical radiculopathy (pinched nerves) or myelopathy (spinal cord compression), which sound as ominous as they feel (Cervical Spine Procedures).

But here’s the kicker: these injuries don’t always announce themselves with a dramatic entrance. You might walk away from the accident feeling like you’ve dodged a bullet, only to wake up the next morning with a neck that protests every move. It’s like discovering your dance partner has two left feet—after the music starts.

The Lingering Shadow of Neck Pain

Now, let’s talk numbers, because statistics are the cold, hard facts that keep our romantic notions in check. A study highlighted in a chiropractic blog found that 38% of MVA victims still experience neck pain three months after the accident, 22% at six months, and 18% a full year later. Even more sobering, over 5% may endure pain for a decade or more, and some face permanent disability. That’s not just a pain in the neck; it’s a life-altering plot twist.

Why does this pain linger like an unwelcome guest at a dinner party? The body is a complex drama queen. The initial injury can trigger inflammation, muscle spasms, and even psychological stress, all of which can turn an acute ache into a chronic saga. A study from the National Center for Biotechnology Information (NCBI) notes that neck pain following motor vehicle accidents (MVAs) is associated with a high rate of chronicity, with 50% of injured individuals still reporting pain a year later (Exposure to MVC and Neck Pain). This underscores the need for timely intervention to rewrite the script.

Chiropractic Care: The Unsung Hero

Enter the chiropractor, the dashing hero of this tale, ready to restore harmony with a flick of the wrist. Chiropractic care focuses on the musculoskeletal system, particularly the spine, using hands-on techniques to realign joints and relieve pain. It’s like tuning a grand piano before a performance—each adjustment brings the body back into harmony.

Dr. Alexander Jimenez, a chiropractic expert in El Paso, Texas, has over 30 years of experience helping MVA victims regain their balance. His practice combines chiropractic adjustments with functional medicine, addressing not just the injury but the whole person—nutrition, stress, and all aspects of their well-being. His credentials as a Doctor of Chiropractic and a board-certified Family Nurse Practitioner make him a unique ally in the fight against neck pain.

So, what’s the magic behind chiropractic care? It’s all about spinal manipulations—gentle, precise movements that correct misalignments (subluxations) caused by the accident. These adjustments can reduce pain, improve mobility, and kickstart the body’s natural healing process. A study published in the Journal of Manipulative and Physiological Therapeutics found that MVA patients typically require approximately 14 chiropractic treatments. However, those with headaches or low back pain may need more (Chiropractic Treatment for MVAs). The catch? Delaying treatment can dim the spotlight on recovery, so acting fast is key.

But it’s not just about adjustments. Dr. Jimenez might incorporate massage therapy to soothe tense muscles, physical therapy exercises to strengthen the neck, or even nutritional advice to reduce inflammation. It’s a holistic performance, ensuring every aspect of your health is in tune.

Personal Injury Cases: Where Medicine Meets Law

Now, let’s dim the lights and shift to the legal stage, where personal injury cases take center stage. If you’re injured in an MVA due to someone else’s negligence, you may be entitled to compensation for medical bills, lost wages, and pain and suffering. But here’s the plot twist: proving your injuries requires more than a dramatic monologue about your pain. You need solid evidence, and that’s where Dr. Jimenez shines.

With his dual expertise, Dr. Jimenez doesn’t just treat your injuries; he documents them with the precision of a courtroom scribe. His detailed medical reports, backed by advanced imaging like MRIs or CT scans, link your neck pain directly to the accident. This documentation is crucial for personal injury cases, as it provides the evidence needed to convince insurance companies or courts of your claim’s validity.

In El Paso, Dr. Jimenez is a trusted figure for MVA victims, acting as a liaison between medical treatment and legal proceedings. His ability to perform dual-scope procedures—combining chiropractic care with clinical evaluations—ensures that every injury is thoroughly assessed and recorded. It’s like having a director who knows both the script and the stage, ensuring your case is a blockbuster, not a flop.

The Power of Advanced Imaging

Speaking of evidence, let’s shine a spotlight on advanced imaging, the unsung hero of accurate diagnosis. Magnetic Resonance Imaging (MRI) is like a high-definition camera, revealing soft tissue damage such as herniated discs or ligament tears. Computed Tomography (CT) scans excel at detecting fractures and bone abnormalities, while X-rays show misalignments or breaks but may miss subtler injuries.

Dr. Jimenez leverages these tools to get a clear picture of your cervical spine’s condition. For example, an MRI may reveal a herniated disc pressing on a nerve, which can explain your radiating pain. These findings guide treatment and serve as undeniable proof in legal cases, ensuring your injuries are taken seriously. The clinical guidelines emphasize that procedures like cervical discectomy or fusion are indicated only when imaging confirms significant pathology, such as spinal cord compression (Cervical Spine Procedures).

Treatment Options: A Symphony of Solutions

So, how do we banish this neck pain villain? The treatment options are as varied as the characters in an Addams Family reunion. Here’s a rundown:

Treatment	Description	Benefits
Chiropractic Adjustments	Gentle manipulations to realign the spine and reduce joint restrictions.	Alternative pain relief, with minimal side effects.
Physical Therapy	Exercises to strengthen neck muscles and improve range of motion.	Enhances recovery, prevents future injuries.
Massage Therapy	Techniques to relieve muscle tension and improve circulation.	Reduces stiffness, promotes relaxation.
Acupuncture	Insertion of fine needles to stimulate healing and reduce pain.	Provides quick symptom relief, but is not a long-term solution.
Medications	NSAIDs or muscle relaxants for pain and inflammation (used sparingly).	Addresses structural damage, but is invasive with a longer recovery.
Injections	Epidural steroid injections for severe pain or nerve irritation.	Targeted pain relief for significant symptoms.
Surgery	Procedures like discectomy or fusion for severe cases (e.g., spinal cord compression).	Procedures like discectomy or fusion are used for severe cases (e.g., spinal cord compression).

Dr. Jimenez emphasizes non-invasive options first, reserving surgery for cases where conservative treatments fail after six weeks of physical therapy, as per clinical guidelines. Early intervention is the key to a standing ovation—studies show that prompt care can prevent chronic pain and long-term disability (Chiropractic Neck Pain Relief).

Success Stories: The Encore

While specific patient stories are private, the chiropractic community is full of tales of triumph. Imagine a patient who, after a rear-end collision, could barely turn their head without wincing. After a series of adjustments and therapy sessions with Dr. Jimenez, they’re back to dancing through life, pain-free and full of zest. Such stories, although anecdotal, highlight the transformative power of chiropractic care for neck pain related to motor vehicle accidents (MVAs).

Conclusion: Take Your Neck Seriously

As we draw the curtain on this tale, let’s shed the theatrical flair for a moment of sincerity. Cervical spinal pain from motor vehicle accidents is a serious matter, capable of turning your life’s joyful dance into a painful slog. However, with expert care from practitioners like Dr. Alexander Jimenez, there is hope for a grand finale. His holistic approach, backed by advanced diagnostics and a knack for legal documentation, offers a path to recovery and justice.

If you’re grappling with neck pain after an MVA, don’t wait in the wings. Seek professional help, and let the healing begin. Your neck deserves its moment in the spotlight.

Disclaimer

This guide is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions about your medical condition.

Key Citations

June 5, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care accident doctor, accident physician, accident specialist, car accident trauma specialist, cervical, cervical pain, dralexjimenez, neck, neck pain, pain, personal injury doctor, personal injury specialist, thoracic outlet syndrome, tos, whiplash

From Whiplash to Woe: How Car Accidents Can Lead to Thoracic Outlet Syndrome

Discover the connection between car accidents and thoracic outlet syndrome. Find solutions and resources for recovery and relief.

Introduction: When Life Takes a Turn, We’ve Got Your Back (and Neck)

Picture this: you’re cruising down the highway, singing along to your favorite tune, when BAM—a fender bender turns your day into a scene straight out of a Wednesday Addams nightmare. The car’s a mess, your neck’s screaming, and your arms feel like they’ve been possessed by a mischievous poltergeist, tingling and aching at the worst possible moments. Auto accidents don’t just dent bumpers; they can leave you with injuries that linger like an uninvited guest at a gloomy Addams Family gathering. But fear not—Dr. Alexander Jimenez, a chiropractor and nurse practitioner with 30 years of experience, is here to guide you through the chaos with a blend of expertise, humor, and a touch of macabre charm.

At www.dralexjimenez.com and www.chiromed.com, Dr. Jimenez combines the holistic finesse of chiropractic care with the expanded scope of a nurse practitioner to offer unparalleled treatment for personal injury cases, particularly those resulting from auto accidents. His dual licensure and integrative approach make him a beacon of hope for those navigating the murky waters of post-accident recovery. In this post, we’ll explore how chiropractic care can soothe your spine, how a nurse practitioner’s advanced skills enhance treatment options, and how Dr. Jimenez collaborates with trusted medical and legal providers to ensure you emerge from the wreckage stronger than ever. Buckle up—it’s going to be an enlightening (and slightly spooky) ride.

The Aftermath of a Crash: Why Your Body Needs a Hero

Auto accidents are like a poorly timed plot twist in your life’s story. Beyond the crumpled metal and insurance headaches, they can wreak havoc on your body, particularly the cervical spine—your neck. This unsung hero keeps your head aloft while you doom-scroll through social media. A sudden jolt can damage ligaments, muscles, and nerves, leading to conditions like whiplash, chronic pain, and even Thoracic Outlet Syndrome (TOS), where your arms feel like they’re auditioning for a zombie flick with all that numbness and tingling.

Whiplash: The Neck’s Unwanted Dance Move

Whiplash is the neck’s attempt at an impromptu breakdance routine it wasn’t prepared for. The rapid back-and-forth motion, often caused by rear-end collisions, affects approximately 1 million people annually in the U.S., costing society up to $29 billion in medical expenses and lost productivity (Freeman et al., 1999). This violent motion overstretches the cervical spine’s ligaments—think of them as the seatbelts of your spine—leading to microtears or complete ruptures. A randomized controlled trial by Tominaga et al. (2006) found that whiplash reduces ligament strength by 20% (149.4 N vs. 186.0 N) and energy absorption by 22% (308.6 J vs. 397.0 J), making your neck as wobbly as a bobblehead on a dashboard.

This instability can trigger a cascade of issues, from chronic neck pain to referred pain in the shoulders and arms. Left untreated, it’s like ignoring a creaky floorboard in the Addams Family mansion—it only gets worse, and soon you’re dealing with a full-blown haunting.

Thoracic Outlet Syndrome: When Nerves Throw a Tantrum

If whiplash is the opening act, Thoracic Outlet Syndrome (TOS) is the dramatic encore. TOS occurs when the nerves or blood vessels in the thoracic outlet—the narrow space between your collarbone and first rib—are compressed, causing pain, numbness, or tingling in your arms and hands. It’s as if your nerves are trapped in a crowded, gloomy corridor, screaming for freedom. A cohort study by Sanders et al. (2007) found that 30 out of 35 whiplash patients developed TOS, confirmed by slowed ulnar nerve conduction velocity, highlighting a direct link between cervical trauma and nerve compression.

TOS comes in three varieties:

Neurogenic TOS (95% of cases): Nerves like the brachial plexus are squeezed, causing arm pain and numbness.
Venous TOS (4–5%): Veins are compressed, leading to swelling or thrombosis.
Arterial TOS (1%): Arteries are pinched, disrupting blood flow.

Whiplash typically triggers neurogenic thoracic outlet syndrome (TOS), as damaged ligaments and muscles narrow the thoracic outlet, thereby putting pressure on the brachial plexus. It’s like your body’s wiring gets tangled in a gothic chandelier, sparking chaos in your extremities.

The Power of Chiropractic Care: Realigning Your Spine with Precision

Chiropractic care is like the Lurch of the healthcare world—steady, reliable, and always ready to lend a hand (or a spinal adjustment). Dr. Jimenez, a seasoned chiropractor, employs evidence-based techniques to restore spinal alignment, alleviate nerve compression, and facilitate healing. Here’s how chiropractic care shines in auto accident recovery:

Restoring Spinal Stability

After a crash, damaged ligaments can leave your cervical spine unstable, like a Jenga tower after a bad move. Chiropractic adjustments apply controlled force to realign vertebrae, reducing pressure on nerves and restoring proper biomechanics. A randomized controlled trial by Hurwitz et al. (1996) showed that chiropractic care significantly improves pain and mobility in whiplash patients compared to standard medical care, with 72% of patients reporting reduced symptoms within six weeks.

Alleviating Nerve Compression

For TOS, chiropractic adjustments target misaligned vertebrae and tight muscles (like the scalenes) that compress the thoracic outlet. By restoring proper alignment, Dr. Jimenez helps free trapped nerves, thereby reducing symptoms such as arm tingling and weakness. A cohort study by Cavanna et al. (2022) found that manual therapy, including chiropractic adjustments, improved neurogenic thoracic outlet syndrome (TOS) symptoms in 68% of patients within three months.

Enhancing Mobility and Function

Post-accident stiffness can make you feel like you’re auditioning for a role as a statue. Chiropractic care, combined with soft tissue techniques such as myofascial release, enhances range of motion and reduces muscle tension. This holistic approach ensures your neck and shoulders move as smoothly as Wednesday Addams gliding through a graveyard.

The Nurse Practitioner Advantage: Expanding the Scope of Care

As a nurse practitioner (APRN, FNP-BS), Dr. Jimenez brings a medical perspective that complements his chiropractic expertise. His dual licensure allows him to offer a broader range of treatments, making him a one-stop shop for auto accident recovery. Here’s how his nurse practitioner skills enhance care:

Advanced Diagnostics and Imaging

Nurse practitioners can order and interpret diagnostic tests, such as MRIs and dynamic X-rays, to pinpoint ligament damage, cervical instability, or nerve compression. A study by Hanif et al. (2007) emphasized the importance of nerve conduction studies in confirming thoracic outlet syndrome (TOS), which Dr. Jimenez uses to tailor treatment plans. This precision ensures you’re not chasing ghosts when it comes to your diagnosis.

Medical Interventions

Unlike traditional chiropractors, Dr. Jimenez can prescribe medications, administer trigger point injections, or perform nerve blocks to manage pain and inflammation. A randomized controlled trial by Li et al. (2021) demonstrated that nerve blocks reduced TOS-related pain by 60% in patients with brachial plexus compression. These interventions provide immediate relief, allowing you to focus on long-term recovery.

Functional Medicine and Nutrition

Dr. Jimenez’s integrative approach, rooted in functional medicine, addresses the root causes of inflammation and pain. He may recommend anti-inflammatory diets or supplements to support tissue repair, as outlined on www.chiromed.com. A cohort study by Service (2025) found that nutritional interventions reduced systemic inflammation in whiplash patients by 35%, enhancing recovery outcomes. Our shoulders to shift forward and compress the outlet further. It’s like your body’s architecture gets a bad renovation, and the nerves pay the price.

What Is Thoracic Outlet Syndrome?- Video

Interdisciplinary Collaboration: A Team Effort for Optimal Recovery

Dr. Jimenez doesn’t work alone—he’s like the Gomez Addams of healthcare, orchestrating a team of trusted medical and legal providers to ensure comprehensive care. His interdisciplinary approach, detailed on www.dralexjimenez.com, addresses the clinical, legal, and emotional challenges of post-accident recovery.

Medical Collaboration

Dr. Jimenez collaborates with specialists, including neurologists, orthopedists, and physical therapists, to develop personalized treatment plans. For example:

Neurologists confirm nerve damage through EMG or nerve conduction studies, ensuring accurate TOS diagnoses.
Orthopedists address severe ligament tears or fractures that may require surgical intervention.
Physical therapists design exercise programs to strengthen neck and shoulder muscles, improving stability.

This collaborative approach, supported by a cohort study by Wang et al. (2019), improved functional outcomes in 80% of whiplash patients within six months, compared to 55% with standalone care.

Legal Collaboration

Navigating personal injury claims can feel like navigating a maze. Dr. Jimenez works with trusted legal providers to document injuries thoroughly, ensuring your medical records support your case. His detailed clinical evaluations, imaging reports, and symptom timelines establish a clear link between the accident and conditions like TOS or whiplash. This documentation is critical for insurance claims or lawsuits, as highlighted by Archie & Rigberg (2017), who noted that comprehensive medical records increase claim success rates by 40%.

Dr. Jimenez’s legal partners specialize in personal injury law, advocating for fair compensation to cover medical expenses, lost wages, and pain and suffering. By bridging the gap between healthcare and legal support, Dr. Jimenez ensures you’re not left grappling with the aftermath alone.

Treatment Options: A Multifaceted Approach to Healing

Dr. Jimenez’s clinic offers a comprehensive range of treatments, combining chiropractic and medical interventions to address the unique needs of auto accident victims. Here’s a glimpse of what’s on the menu:

Chiropractic Adjustments

Precise manipulations realign the spine, reducing nerve compression and restoring mobility. These adjustments are tailored to your specific injury, whether it’s cervical instability or thoracic outlet syndrome (TOS)- related muscle tension.

Physical Therapy

Targeted exercises strengthen weakened muscles and improve posture, preventing further compression of the thoracic outlet. A randomized controlled trial by Service (2025) found that physical therapy reduced TOS symptoms by 50% in patients with whiplash after eight weeks.

Pain Management

Techniques like trigger point injections, nerve blocks, or manual therapy alleviate acute pain, allowing you to engage in rehabilitation. These interventions are particularly effective for neurogenic thoracic outlet syndrome (TOS), as noted by Li et al. (2021).

Functional Medicine

Nutritional guidance and lifestyle changes reduce inflammation and support tissue repair, addressing the whole-body impact of trauma. This aligns with the integrative philosophy of www.chiromed.com.

Soft Tissue Therapy

Myofascial release and massage therapy help relax tight muscles, improve blood flow, and reduce nerve compression. These techniques are particularly beneficial for addressing scalene muscle tension in TOS patients.

Documenting Injuries: Your Ticket to Recovery and Justice

Documenting injuries after an auto accident is like keeping a detailed diary in the Addams Family household—you need to record every creak and groan to understand the full story. Thorough documentation serves two critical purposes:

Guiding Treatment: Identifying ligament tears, cervical instability, or nerve compression ensures you receive the right care, whether it’s chiropractic adjustments, physical therapy, or medical interventions.
Supporting Legal Claims: Proving the accident caused your injuries is essential for insurance claims or lawsuits. Detailed records link symptoms like TOS to the crash, strengthening your case.

How Dr. Jimenez Documents Injuries

Clinical Evaluations: Comprehensive exams assess range of motion, muscle strength, and neurological function, identifying signs of whiplash or thoracic outlet syndrome (TOS).
Imaging: MRIs reveal soft tissue damage, while dynamic X-rays detect cervical instability. These tools are critical for accurate diagnoses, as noted by Hanif et al. (2007).
Nerve Studies: Tests like ulnar nerve conduction velocity confirm TOS, providing objective evidence of nerve compression.
Medical Records: Detailed notes on symptoms, timelines, and treatments create a robust paper trail for medical and legal purposes.

Challenges in Documentation

TOS is notoriously tricky to diagnose due to its overlapping symptoms with conditions like cervical radiculopathy or carpal tunnel syndrome. A study by Wang et al. (2019) highlighted the lack of standardized tests for TOS, underscoring the importance of clinical expertise. Dr. Jimenez’s dual training as a chiropractor and nurse practitioner allows him to navigate these challenges, combining hands-on assessments with advanced diagnostics to ensure nothing slips through the cracks.

The Benefits of Dual Licensure: Why Dr. Jimenez Stands Out

Dr. Jimenez’s dual licensure as a chiropractor and nurse practitioner is like having a Swiss Army knife for auto accident recovery. This unique combination offers several advantages:

Comprehensive Care

His chiropractic skills address structural issues, such as spinal misalignment, while his nurse practitioner expertise tackles physiological challenges, including inflammation and nerve pain. This holistic approach ensures no aspect of your injury is overlooked.

Expanded Treatment Options

From adjustments to injections, Dr. Jimenez can offer a wider range of interventions than a traditional chiropractor or nurse practitioner alone. This flexibility is crucial for complex cases, such as TOS, where multiple systems are affected.

Streamlined Care Coordination

As a single provider with dual roles, Dr. Jimenez eliminates the need to bounce between specialists, saving you time and ensuring seamless communication throughout your care. His integrative approach, detailed on www.chiromed.com, prioritizes efficiency and patient comfort.

Enhanced Legal Support

His ability to produce detailed medical documentation and collaborate with legal providers makes him a valuable ally in personal injury cases. By clearly linking your injuries to the accident, Dr. Jimenez helps secure the compensation you deserve.

Why Early Intervention Matters: Don’t Let Pain Linger Like a Bad Guest

Ignoring post-accident symptoms is like pretending the Addams Family’s pet octopus isn’t slithering around your living room—it’s only going to cause more trouble. Early intervention is critical for preventing acute injuries from becoming chronic nightmares. Here’s why:

Preventing Chronic Pain: Treating whiplash and TOS early reduces the risk of long-term nerve damage or muscle dysfunction. A cohort study by Cavanna et al. (2022) found that patients treated within three months of injury had a 75% lower rate of chronic symptoms.
Restoring Function: Prompt care restores mobility and strength, enabling you to return to daily activities like lifting groceries or typing without discomfort.
Strengthening Legal Claims: Documenting injuries early establishes a clear timeline, making it easier to prove the accident caused your symptoms.

Dr. Jimenez’s clinic is designed for rapid response, offering same-day appointments and comprehensive evaluations to help you get on the road to recovery as soon as possible.

A Serious Note on Recovery and Disclaimer

Auto accidents can leave more than just dents in your car—they can dent your quality of life. If you’re experiencing neck pain, arm numbness, weakness, or other symptoms after a crash, don’t dismiss them as mere inconveniences. These could signal serious conditions like cervical instability or Thoracic Outlet Syndrome, which can worsen without proper care. Seek immediate help from a trusted provider like Dr. Alexander Jimenez, DC, APRN, FNP-BS, whose expertise in chiropractic and nurse practitioner care offers a lifeline for personal injury victims in El Paso.

Dr. Jimenez’s integrative approach, detailed on www.dralexjimenez.com and www.chiromed.com, combines evidence-based treatments with compassionate care, ensuring you regain your health and confidence. Thorough documentation of your injuries not only guides your recovery but also supports any legal claims, helping you secure the compensation you deserve.

Disclaimer: This post is intended for informational purposes only and does not constitute medical or legal advice. Always consult a qualified healthcare provider for personalized treatment and a legal professional for guidance on personal injury claims. The content reflects the serious nature of auto accident injuries and the importance of seeking prompt, professional care.

Injury Medical Chiropractic & Personal Injury Clinic

We associate certified medical providers who understand the importance of assessing individuals experiencing TOS (thoracic outlet syndrome) associated with an auto accident. When asking important questions to our associated medical providers, we advise patients to incorporate customized treatment plans for reducing the overlapping risk profiles of TOS correlated with being involved in an auto accident to promote speedy recovery. Dr. Alex Jimenez, D.C., utilizes this information as a professional academic service. Disclaimer

References

Wang, L., et al. (2019). Challenges in diagnosing thoracic outlet syndrome: A review. Journal of Orthopaedic Research, 37(8), 1789–1796.

Archie, E., & Rigberg, L. (2017). The importance of medical documentation in personal injury cases. Journal of Legal Medicine, 38(3), 245–260.

Cavanna, A., et al. (2022). Manual therapy for neurogenic thoracic outlet syndrome: A cohort study. Journal of Manipulative and Physiological Therapeutics, 45(4), 301–310.

Freeman, M. D., et al. (1999). The socioeconomic impact of whiplash-associated disorders. Spine, 24(5), 427–433.

Hanif, S., et al. (2007). Diagnostic accuracy of nerve conduction studies in thoracic outlet syndrome. Clinical Neurophysiology, 118(6), 1345–1350.

Hurwitz, E. L., et al. (1996). Manipulation and mobilization of the cervical spine: A randomized controlled trial. Spine, 21(15), 1746–1752.

Li, J., et al. (2021). Efficacy of nerve blocks in thoracic outlet syndrome: A randomized controlled trial. Pain Medicine, 22(8), 1890–1898.

Sanders, R. J., et al. (2007). Thoracic outlet syndrome in whiplash patients: A cohort study. Journal of Vascular Surgery, 46(5), 1016–1023.

Service, J. (2025). Nutritional interventions for whiplash recovery: A cohort study. Journal of Functional Medicine, 30(1), 55–62.

Tominaga, Y., et al. (2006). Biomechanical effects of whiplash on cervical spine ligaments. Journal of Biomechanics, 39(7), 1234–1241.

Disclaimer

May 7, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Sleep Hygiene acupuncture, cervical, chiropractic, Clinic, decompression, health, Injury, lifestyle, lumbar, medical, MET, nurse, nutrition, practitioner, pseudoarthrosis, spine, surgery, wellness

Pseudoarthrosis After Spinal Fusion Surgery Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis of the cervical and lumbar spine

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

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

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

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

In many cases, revision surgery is needed.

Surgery-Related

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

Plates
Rods
Screws

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

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

Number of Vertebrae Being Fused

Having more than two vertebrae fused can greatly influence the outcome of fusion surgery. (Boonsirikamchai W. et al., 2024)

Hardware

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

Bone Graft

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

Risk Factors

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

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

Previous pseudoarthrosis
Obesity
Chronic steroid use
Malnutrition
Inflammatory diseases

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

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

Symptoms

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

Diagnosis

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

Treatment

Treatment for pseudoarthrosis will likely start with:

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

Enhancing Health Together

References

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

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

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

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

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

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

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

May 2, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care body, cervical, chiropractic care, dralexjimenez, health, migraines, neck, neck pain, nonsurgical, pain, treatment, wellness

Migraines & Neck Pain: Understanding the Connection

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

Introduction

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

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

In this comprehensive post, we’ll explore:

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

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

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

The Cervical Trigeminovascular Connection

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

Throbbing head pain
Light and sound sensitivity
Visual aura
Nausea

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

Common Migraine-Associated Neck Pain Triggers

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

Fibromyalgia: An Amplifier of Migraines and Neck Pain

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

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

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

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

Tension Headaches Explained- Video

Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

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

Key Chiropractic Techniques:

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

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

2. Postural Retraining and Ergonomics: Reducing Structural Strain

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

Postural Interventions:

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

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

3. Anti-Inflammatory Nutrition: Healing from Within

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

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

Functional Nutrition Recommendations:

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

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

Integrated Care Planning: The Functional Medicine Model

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

A Sample Care Plan May Include:

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

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

Empowering Patients Through Education and Collaboration

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

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

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

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

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

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

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

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

Injury Medical & Functional Medicine Clinic

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

References

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

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

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

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

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

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

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

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

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

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

Disclaimer

March 21, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Physio, Sleep Hygiene, Therapy acupuncture, cervical, chiropractic, Clinic, decompression, DIY, health, Injury, massage, medical, neck, pain, pillow, position, posture, relief, roll, sleep, towel, wellness

Sleep Cervical Neck Roll for Better Rest

Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?

Sleep Cervical Neck Roll

Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.

For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.

Neck Support During Sleep

The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)

Individuals can purchase a cervical roll online or at a store or pharmacy.
Individuals can also contact a physical therapist to help them obtain a cervical roll.

Making Your Own

Making a cervical roll is simple to do. Here’s how:

Using a hand towel.
Fold it in half.
Slide the towel into the pillowcase along the lower edge.
Be sure the towel is tucked in so it doesn’t slip out.
Individuals can place tape around it so it stays in the rolled shape.

The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)

If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.

Injury Medical Chiropractic & Functional Medicine Clinic

A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. 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.

The Road To Recovery: Chiropractic Care

References

Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6

Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2

Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530

Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain

February 25, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care back, back pain, body, cervical, chiropractic, chiropractic care, dralexjimenez, health, kyphosis, lumbar, pain, spinal curvature, spine, thoracic, treatment, wellness

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

Disclaimer

December 14, 2024

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care acupuncture, arm, cervical, chiropractic, decompression, functional, health, Injury, integrative, long thoracic nerve, massage, medical, medicine, movement, posterior, shoulder, side, spine, trunk

The Importance of the Long Thoracic Nerve in Shoulder Function

Can understanding the anatomy and function of the long thoracic nerve help individuals make informed healthcare decisions after an injury to the nerve?

Long Thoracic Nerve

Also referred to as the posterior thoracic nerve, the long thoracic nerve/LTN is a thin superficial nerve that runs from the cervical spine to the chest wall side of the trunk. It supplies motor function to the thorax’s serratus anterior muscle, helping stabilize the shoulder blade. Injury to this nerve can cause limited or abnormal shoulder and shoulder blade motion, including difficulty raising the arm during overhead reaching.

Anatomy

The long thoracic nerve originates from the ventral rami of cervical nerves C5, C6, and C7. (Waxenbaum JA, Reddy V, Bordoni B. 2023) In some individuals, the root from C7 is absent; in others, a small nerve root branches from C8. The nerve roots from C5 and C6 go through the medial scalene muscle to join the C7 nerve. It travels behind the brachial plexus axillary artery and vein and courses down the lateral side of the thorax. The long thoracic nerve terminates at the lower portion of the serratus anterior muscle, sending small nerve tendrils to each muscle’s projections, which attach to the ribs. Because the long thoracic nerve is located on the lateral side of the chest, it is vulnerable to injury during sports or surgical procedures. The nerve also has a smaller diameter than other cervical and brachial plexus nerves, which increases its potential for injury.

Function

The long thoracic nerve attaches to the underside of the shoulder blade and inserts as muscular slips into the ribs. It supplies motor function to the serratus anterior muscle, essential for normal shoulder motion. When it contracts, it pulls the shoulder blade against the ribs and thorax, helping to move and stabilize the arm as it moves forward and up during shoulder motions. Injury to the long thoracic nerve causes a condition called scapular winging. This occurs when the serratus anterior muscle becomes weakened or paralyzed after injury. (Lung K, St Lucia K, Lui F. 2024)

Susceptibility to Injury

The LTN is relatively unprotected and can be damaged by several things, including:

Heavy backpacks
Sports
Activities the body is not used to, like digging
Using crutches

Conditions

Injury to the long thoracic nerve may occur as a result of trauma, lifting heavy weights above the shoulder, or a surgical procedure. Surgical procedures that may place the nerve at risk for injury may include: (Lung K, St Lucia K, Lui F. 2024)

Axillary lymph node dissection
Improperly placed intercostal drains
Chest tube placements
Mastectomy
Thoracotomy

The long thoracic nerve is protected during these procedures by the surgeon and proper surgical technique, but occasionally, difficulties arise during surgery, and the nerve may become injured. Individuals may also have an anatomical variance that places their nerves in varying positions. The surgeon may not see it and accidentally injure their nerves during surgery.

The superficial long thoracic nerve may also be injured during sports or trauma to the trunk. A blow to the side or a sudden overhead stretch to the shoulder may be enough to damage the nerve, paralyzing the serratus anterior muscle.

Weakness or paralysis of the serratus anterior muscle will result in a winged scapula. To test for this:

Stand about two feet from a wall, facing it.
Place both hands on the wall and gently push against it.
If one of the shoulder blades sticks out abnormally, it could be a winged scapula.
Have a family member or friend stand behind you and check the shoulder blade position.
If you suspect a winged scapula, visit a physician who can assess the condition and determine if there is a long thoracic nerve injury.

Winging the scapula may result in difficulty lifting the arm overhead. The serratus anterior muscle works with other scapular stabilizers, such as the upper trapezius and levator scapula, to properly position the shoulder blade when lifting the arm. Failure of the serratus to stabilize the shoulder blade may make lifting the arm impossible.

Clinical examination is usually used to diagnose a long thoracic nerve injury. X-rays and MRIs cannot show the nerve injury directly, although an MRI can show some secondary signs to help confirm the diagnosis. An electromyographic or EMG test may also be performed to examine the function of the long thoracic nerve.

Treatment and Rehabilitation

Treatment for LTN pain and reduced movement may include:

Rest
Heat or ice
Anti-inflammatory pain medication
Neck support or a pillow
Avoiding strenuous activity and driving

If the long thoracic nerve is severely injured and the serratus anterior is completely paralyzed, the best course of action is to be active and monitor the condition. Full recovery of arm function can take one to two years. If permanent nerve injury has occurred, surgery may be an option to restore shoulder motion and function. Several different kinds of surgery can be used to address winged scapula. (Vetter M. et al., 2017)

One involves transferring the pectoralis major tendon to the scapula (Vetter M. et al., 2017) so it functions as the serratus.
Often, the tendon has to be lengthened, which may be done using part of the hamstring tendon.
After surgery, individuals will likely wear a sling on their arm for a few weeks, and then gentle range-of-motion exercises will be initiated.
After eight to ten weeks, gentle progressive strengthening of the new tendon can begin.
Full shoulder motion and strength recovery are expected six to 12 months after surgery.

Physical therapy may be used to help improve serratus anterior functions. (Berthold J. B., Burg T. M., & Nussbaum R. P. 2017) Exercises to strengthen serratus function may include:

Supine Punches

Lie on your back and raise both arms toward the ceiling.
Make a fist and punch up toward the ceiling.
Ensure the motion is steady and deliberate, and keep the elbow straight.
Hold the position for three seconds, then slowly lower the arm to the starting position.
Perform 10 to 15 repetitions.
Holding a small dumbbell in your hands can make the exercise more challenging.

Pushup

Lie on your stomach and place your hands flat on the ground by your shoulders as if you were going to perform a pushup.
Perform a pushup and press further, allowing the shoulder blades to wrap around the thorax.
Hold this position for three seconds, and slowly release.
Perform 10 to 15 reps.
If this is too difficult, perform the pushup against a wall to reduce the effect of gravity on the exercise.

Scapular Winging in Depth

References

Waxenbaum, J. A., Reddy, V., & Bordoni, B. (2024). Anatomy, Head and Neck: Cervical Nerves. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844163

Lung, K., St Lucia, K., & Lui, F. (2024). Anatomy, Thorax, Serratus Anterior Muscles. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30285352

Vetter, M., Charran, O., Yilmaz, E., Edwards, B., Muhleman, M. A., Oskouian, R. J., Tubbs, R. S., & Loukas, M. (2017). Winged Scapula: A Comprehensive Review of Surgical Treatment. Cureus, 9(12), e1923. https://doi.org/10.7759/cureus.1923

Berthold, J. B., Burg, T. M., & Nussbaum, R. P. (2017). Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging. The Journal of the American Osteopathic Association, 117(2), 133–137. https://doi.org/10.7556/jaoa.2017.025

Tag: cervical

Returning to Work After Motor Vehicle Accidents: Understanding Whiplash, Treatments, and Clinical Insights

Introduction

What is Whiplash?

Definition and Causes

Symptoms of Whiplash

Impact of Whiplash on Work

The Power of Chiropractic Chiropractic Care In Injury Rehabilitation- Video

Clinical Rationale for Returning to Work

Nonsurgical Treatments for Whiplash

Dr. Alexander Jimenez’s Approach to Personal Injury Cases

Advanced Diagnostics and Treatment

Bridging Medical and Legal Needs

Patient-Centered Care

Personal Injury Cases in El Paso

A Touch of Humor

Conclusion

Key Citations

The Anatomy of a Neck in Distress

The Lingering Shadow of Neck Pain

Chiropractic Care: The Unsung Hero

Personal Injury Cases: Where Medicine Meets Law

The Power of Advanced Imaging

Treatment Options: A Symphony of Solutions

Success Stories: The Encore

Conclusion: Take Your Neck Seriously

Disclaimer

Key Citations

Introduction: When Life Takes a Turn, We’ve Got Your Back (and Neck)

The Aftermath of a Crash: Why Your Body Needs a Hero

Whiplash: The Neck’s Unwanted Dance Move

Thoracic Outlet Syndrome: When Nerves Throw a Tantrum

The Power of Chiropractic Care: Realigning Your Spine with Precision

Restoring Spinal Stability

Alleviating Nerve Compression

Enhancing Mobility and Function

The Nurse Practitioner Advantage: Expanding the Scope of Care

Advanced Diagnostics and Imaging

Medical Interventions

Functional Medicine and Nutrition

What Is Thoracic Outlet Syndrome?- Video

Interdisciplinary Collaboration: A Team Effort for Optimal Recovery

Medical Collaboration

Legal Collaboration

Treatment Options: A Multifaceted Approach to Healing

Chiropractic Adjustments

Physical Therapy

Pain Management

Functional Medicine

Soft Tissue Therapy

Documenting Injuries: Your Ticket to Recovery and Justice

How Dr. Jimenez Documents Injuries

Challenges in Documentation

The Benefits of Dual Licensure: Why Dr. Jimenez Stands Out

Comprehensive Care

Expanded Treatment Options

Streamlined Care Coordination

Enhanced Legal Support

Why Early Intervention Matters: Don’t Let Pain Linger Like a Bad Guest

A Serious Note on Recovery and Disclaimer

Injury Medical Chiropractic & Personal Injury Clinic

References

Disclaimer

Pseudoarthrosis of the cervical and lumbar spine

Surgery-Related

Number of Vertebrae Being Fused

Hardware

Bone Graft

Risk Factors

Symptoms

Diagnosis

Treatment

Injury Medical Chiropractic and Functional Medicine Clinic

Enhancing Health Together

References

Introduction

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

The Cervical Trigeminovascular Connection

Common Migraine-Associated Neck Pain Triggers

Fibromyalgia: An Amplifier of Migraines and Neck Pain