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

How Outcome Measurement Tests Can Guide Treatment

Can individuals experiencing difficulty with functional mobility benefit from physical therapy to help them return to normal activities?

Outcome Measurement Tests

Outcome measurement tests assess the effects of a treatment plan on a patient. They can be used to determine a patient’s baseline function, monitor their progress, and evaluate the effectiveness of treatment. They also give the therapy team an effective way to measure mobility, flexibility, and range of motion.

Function and Purpose

Outcome measurement tests serve various purposes. These include: (American Physical Therapy Association, N.D.)

  • To assist in goal-setting
  • Provide motivation
  • To guide treatment
  • To give a prognosis for the specific condition
  • To justify the treatment

The physical therapist may use other functional outcome measurements to help assess physical therapy progress.

  • They may measure your strength and range of motion.
  • Balance and posture may be evaluated.

Effective functional outcome measurement tests must meet certain criteria to be useful in a physical therapy clinic. First, they must be reliable, meaning the results must be consistent with each patient and within groups of patients. They must also be valid to measure exactly what they are intended to measure. An effective measurement test must also be easy to administer, so it must be practical and simple. Outcome measurement tests must also be purposeful. For example, a balance test must reflect a patient’s current function and be related to their balance ability.

Common Outcome Measurement Tests Used

Common functional outcome measurement tools that a physical therapist may use include:

  • The timed up-and-go or TUG test is a simple assessment used to evaluate a person’s mobility and balance by measuring how long it takes them to stand up from a chair, walk a short distance, turn around, walk back, and sit down again; it’s often used to identify potential fall risks in older adults, particularly those with mobility concerns, as a longer time to complete the task may indicate increased fall risk. (Centers for Disease Control and Prevention, 2017)
  • The Tinetti balance and gait evaluation, also known as the Performance-Oriented Mobility Assessment (POMA), is a clinical test used to assess balance and gait abilities, particularly in older adults. It evaluates stability during various standing and walking tests and provides a score that indicates a person’s fall risk potential.
  • The Berg Balance Scale (BBS) is a standardized test for adults that measures balance and the risk of falling. It’s widely used and can be performed in various settings.
  • The six-minute walk test (6MWT) is a medical assessment in which a person walks as far as they can in a designated area for exactly six minutes. This allows healthcare providers to evaluate their functional exercise capacity. It is particularly useful for assessing patients with lung or heart conditions where walking ability might be compromised. The distance covered during the six minutes is the key measurement used to interpret the test results. (Ferreira M. B. et al., 2022)
  • The functional reach test (FRT) is a clinical assessment that measures an individual’s dynamic balance by determining the maximum distance they can reach forward while standing in a fixed position. It assesses their risk of falling by evaluating how far they can extend their arm before losing stability. The FRT is often used to assess older adults or individuals with potential balance issues. 
  • The Oswestry low back pain disability questionnaire is a self-administered questionnaire used to measure the level of disability a person experiences due to low back pain. It assesses how the pain impacts their daily activities in various aspects of life, such as personal care, work, and social life; a higher score indicates greater disability. 
  • The functional independence measure (FIM) assesses a patient’s ability to perform daily activities independently. It also measures the patient’s disability level and how much assistance is needed.

Functional outcome measurement tests provide a starting point for developing physical therapy goals. For example, if the TUG test takes 19 seconds, individuals may aim for 10 seconds. A TUG score that falls at or over 10 seconds indicates reduced physical capacity (Kear B. M., Guck T. P., & McGaha A. L. 2017). This can be the motivation needed to reach physical therapy goals.

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.

Understanding The Effects of Personal Injury

References

American Physical Therapy Association. (N.D.). Outcome Measures in Patient Care. https://www.apta.org/your-practice/outcomes-measurement

Centers for Disease Control and Prevention. (2017). Timed Up & Go Assessment. Retrieved from https://www.cdc.gov/steadi/media/pdfs/steadi-assessment-tug-508.pdf

Ferreira, M. B., Saraiva, F. A., Fonseca, T., Costa, R., Marinho, A., Oliveira, J. C., Carvalho, H. C., Rodrigues, P., & Ferreira, J. P. (2022). Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis. Scientific reports, 12(1), 18672. https://doi.org/10.1038/s41598-022-21547-z

Kear, B. M., Guck, T. P., & McGaha, A. L. (2017). Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. Journal of primary care & community health, 8(1), 9–13. https://doi.org/10.1177/2150131916659282

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 Exercises, Sporting , , , , , , , , , , , , , , , , , , ,

How to Properly Warm Up Before Running

Should individuals wanting to engage in the exercise start with a warm-up and end with a cooldown to prepare the muscles for optimal performance and post-workout recovery?

Warming Up, Cooling Down

Warming up 5 to 10 minutes before exercise is beneficial for pumping blood to the muscles and preparing them for a run. Dynamic or active stretching and light aerobic activity are a few ways to warm up. This could be active stretching, such as walking lunges, brisk walking, or riding a stationary bike for a few minutes before running. However, individuals should avoid static stretches before running, as they can increase the risk of injury. The minimum length of time for an effective cooldown session is five minutes. Depending on the intensity of the workout, individuals may choose to extend that to 10 minutes.

Steps for a Running Warmup

  • Do five to 10 minutes of light aerobic exercise to loosen up muscles.
  • Walk briskly, march, jog slowly, or cycle on a stationary bike.
  • Don’t rush.
  • Perform dynamic stretches and movements during the warmup, including walking lunges, jumping jacks, or toe touches.
  • Begin the run with a slow jog and gradually increase speed.
  • Slow down if you run out of breath.
  • This is part of knowing how fast you should run; starting too fast is a common mistake.
  • Pay attention to posture and form.
  • Ensure you are using the best technique before speeding up.

Warm Up Benefits

When warming up, the blood vessels dilate. The increased blood flow primes the muscles with oxygen and prepares them to perform at their best. Blood flow also increases the temperature in the muscles for enhanced flexibility. Allowing the heart rate to increase gradually is beneficial, instead of going full max heart output by jumping full speed into the running. (The American Heart Association, 2024)

Properly Cooling Down

At the end of the run:

  • Cool down by walking or slowly jogging for five to 10 minutes.
  • Breathing and heart rate should gradually return to normal.
  • Drink water or an electrolyte-infused drink to rehydrate the body.

Benefits of a Cooldown

The cool-down keeps blood flowing throughout the body at a consistent level. Stopping immediately can cause light-headedness because heart rate and blood pressure can drop rapidly. Winding down slowly allows heart rate and blood pressure to fall gradually. The cooldown is also a good mental transition from the intensity and accomplishing the workout.

Before or After Stretching 

Stretching evidence shows it doesn’t have the benefits once thought. Static stretching before, during, or after exercise has not been shown to prevent injury or delayed onset muscle soreness. (Herbert R. D., de Noronha M., & Kamper S. J. 2011) Stretching cold muscles is not recommended. However, there is some evidence that dynamic or active stretching after a warmup can benefit performance. Active stretching is done with exercises that take the muscles through their full range of motion and mimic the actions that will be done during the workout. (Van Hooren B., & Peake J. M. 2018)

Stretching After Running

Standard stretching includes the hamstring stretch, quad stretch, calf stretch, low lunge stretch, IT band stretch, butterfly stretch, hip and backstretch, arms and abs stretch, and triceps stretch. Tips for proper stretching:

Don’t Bounce

  • Avoid bouncing, as this mimics pulling a rubber band back and forth. You want the muscle to stay stretched.
  • Hold the stretch for 15 to 30 seconds.

Don’t Stretch Through Pain

  • Don’t stretch beyond the point where tightness is felt in the muscle.
  • Do not push through muscle resistance.
  • Never stretch to the point of pain.

Stretch Whole Body

  • Don’t just stretch the areas with tightness and/or soreness.
  • Stretch the whole body equally to prevent injury.

Don’t Hold Your Breath

  • Take deep breaths during the stretch.
  • Stay relaxed and breathe in and out slowly.

If starting a new fitness routine, consult your healthcare provider to determine the optimal running warmups and stretching exercises. 

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.

The Science of Motion

References

The American Heart Association. (2024). Warm up, cool down. https://www.heart.org/en/healthy-living/fitness/fitness-basics/warm-up-cool-down

Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane database of systematic reviews, (7), CD004577. https://doi.org/10.1002/14651858.CD004577.pub3

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. https://doi.org/10.1007/s40279-018-0916-2

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

Exploring the Different Types of Knee Braces and Their Uses

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

  • Sprain
  • Ligament injury
  • Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

  • Tendonitis
  • Patellar tendinopathy
  • Chondromalacia patellae
  • Patellofemoral stress syndrome
  • Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

Unloader

  • This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
  • A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

  • This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

  • This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
  • A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

  • A knee immobilizer keeps the knee in one position.
  • It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

  • Sitting
  • Walking
  • Driving
  • Sleeping
  • Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

  • Poor circulation
  • Superficial wounds on the knee
  • Psoriasis
  • Eczema
  • Arterial insufficiency
  • Severe varicose veins
  • A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. 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.

Best Knee Injury Chiropractor

References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? https://familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. https://doi.org/10.1136/bmjopen-2020-048196

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 Acupuncture, Electroacupuncture , , , , , , , , , , , , , , , , ,

Healing with Needles: Acupuncture for Anxiety and Panic Disorders

Can acupuncture be an effective treatment for anxiety and panic disorders in addition to other treatments, like therapy and/or medication?

Acupuncture For Anxiety and Panic Disorders

Considered one of the most popular types of alternative medicine, acupuncture has grown in popularity as a way to treat a variety of mental health conditions, including depression, post-traumatic stress disorder (PTSD), and other anxiety disorders. With the growth in popularity, more research has been focused on treatment for panic and anxiety symptoms. (Pilkington K. 2010)

  • Acupuncture can enhance personal wellness.
  • Acupuncture is generally safe and has few side effects.
  • It can help reduce physical and mental symptoms like tension, pain, and rapid heart rate.

Other alternative medicine practices include yoga, therapeutic massage, herbal medicines, and aromatherapy.

Traditional Chinese Medicine

Acupuncture is a healing technique originating from traditional Chinese medicine (TCM). The practice is based on the concept that medical conditions and mental health disorders are caused by an imbalance in the energy and circulation of the body’s vital life energy, known as chi or qi (National Institute for Complementary and Integrative Health, 2022). When the body and mind function properly, energy flows optimally through the channels/meridians at certain points throughout the body. Like tight or spasming muscles, energy or circulation becomes congested in different meridian pathways, leading to disease or disorders. The goal of acupuncture is to restore the health and balance of these channels.

How It Works

During acupuncture treatment sessions, small needles are placed along specific body areas, known as acupuncture points. These areas are thought to be where energy blockage occurs. The needles, which come in various thicknesses and lengths, stimulate and open blocked energy channels. Experts have conceptualized acupuncture from a neuroscience perspective, where nerves, muscles, and connective tissues are stimulated, and neurochemicals are released.

  • Acupuncture can help regulate the nervous system.
  • It can stimulate the body’s feel-good hormones and reduce stress hormones.
  • It can help deactivate the analytical brain, which is responsible for anxiety and worries.

Acupuncture is recognized by the National Institutes of Health (NIH) for treating pain management and other medical conditions. (National Institute for Complementary and Integrative Health, 2022)

Effectiveness

Clinical trials examining acupuncture for anxiety and panic disorders have shown some positive results. (Pilkington K. 2010) Acupuncturists and medical professionals are still not clear exactly why it may help with anxiety, but some research has noted that acupuncture appears to have a calming effect. More research studies are needed to prove the effectiveness of acupuncture for anxiety disorders. (Kim Y. K. 2019)

Getting Treated

What it can help with:

  • Agoraphobia
  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Phobias
  • Selective mutism
  • Separation anxiety disorder
  • Social anxiety disorder

If you are interested in treating your anxiety and panic symptoms through acupuncture, the first step is to consult your main healthcare provider. Professional acupuncture practitioners are on websites, including the National Certification Commission for Acupuncture and Oriental Medicine and the American Academy of Medical Acupuncture. The use of acupuncture continues to rise, making it more readily available. Since it has been evaluated for effectiveness and is available through many hospitals, some insurance policies may cover some acupuncture treatments.

Injury Medical Chiropractic and Functional Medicine Clinic

Acupuncture can help relieve symptoms of anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and 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.

Discovering The Benefits of Chiropractic Care

References

Pilkington K. (2010). Anxiety, depression, and acupuncture: A review of the clinical research. Autonomic neuroscience : basic & clinical, 157(1-2), 91–95. https://doi.org/10.1016/j.autneu.2010.04.002

National Institute for Complementary and Integrative Health. (2022). Acupuncture: Effectiveness and Safety. Retrieved from https://www.nccih.nih.gov/health/acupuncture-effectiveness-and-safety

Kim Y. K. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry investigation, 16(1), 1–3. https://doi.org/10.30773/pi.2019.01.08

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

Exploring Nociceptors: Detecting and Reacting to Pain

Can understanding how nociceptors function and their role in processing pain signals help individuals who are managing injuries and/or living with chronic pain conditions?

Nociceptors

Nociceptors are nerve endings that detect harmful stimuli, such as extreme temperatures, pressure, and chemicals, and signal pain. They are the body’s first defense against potentially damaging environmental inputs.

  • Nociceptors are in the skin, muscles, joints, bones, internal organs, deep tissues, and cornea.
  • They detect harmful stimuli and convert them into electrical signals.
  • These signals are sent to the brain’s higher centers.
  • The brain interprets the signals as pain, which prompts the body to avoid the harmful stimulus.

Nociceptors, often called pain receptors, are free nerve endings all over the body. They play a pivotal role in how the body feels and reacts to pain. The main purpose of a nociceptor is to respond to damage to the body by transmitting signals to the spinal cord and brain. (Purves D, Augustine GJ, Fitzpatrick D, et al., editors. 2001) If you bang your foot, the nociceptors on the skin are activated, sending a signal to the brain via the peripheral nerves to the spinal cord. Pain resulting from any cause is transmitted this way. Pain signals are complex, carrying information about the stimuli’s location and intensity. This causes the brain to fully process the pain and send communication back to block further pain signals.

Classification

There are different classes of nociceptors, which are based on which type of stimuli they respond to (University of Texas McGovern Medical School, 2020)

Thermal

  • Thermal nociceptors respond to extreme hot or cold temperatures.
  • For instance, when touching a hot stove, the nociceptors, which signal pain, are activated immediately, sometimes before you know what you’ve done.

Mechanical

  • Mechanical nociceptors respond to intense stretching or strain, such as pulling a hamstring or straining a tendon.
  • The muscles or tendons are stretched beyond their ability, stimulating nociceptors and sending pain signals to the brain.

Chemical

  • Chemical nociceptors respond to chemicals released from tissue damage.
  • For example, prostaglandins and substance P or external chemicals like topical capsaicin pain creams.

Silent

  • Silent nociceptors must be first activated by tissue inflammation before responding to a mechanical, thermal, or chemical stimulus.
  • Most visceral nociceptors are located on organs in the body.

Polymodal

  • Polymodal nociceptors respond to mechanical, thermal, and chemical stimuli.

Mechano-thermal

  • Mechano-thermal nociceptors respond to mechanical and thermal stimuli.

Pain Transmission

Nociceptors are also classified by how fast they transmit pain signals. Transmission speed is determined by the type of nerve fiber known as an axon a nociceptor has. There are two main types.

  • The first type is A fiber axon, fibers surrounded by a fatty, protective sheath called myelin.
  • Myelin allows nerve signals/action potentials to travel rapidly.
  • The second type is C fiber axons, which are not surrounded by myelin and transmit slower. (University of Texas McGovern Medical School, 2020)

Because of the difference in transmission speed, the pain signals from the A fibers reach the spinal cord first. As a result, after an acute injury, an individual experiences pain in two phases, one from the A fibers and one from the C fibers. (Ngassapa D. N. 1996)

Pain Perception Phases

When an injury occurs, the stimulated nociceptors activate the A fibers, causing a person to experience sharp, prickling pain.

  1. This is the first phase of pain, known as fast pain, because it is not especially intense but comes right after the stimulus.
  2. During the second phase of pain, the C fibers are activated, causing an intense, burning pain that persists even after the stimulus has stopped.
  3. The fact that the C fibers carry burning pain explains why there is a short delay before feeling the sensation.
  4. The C fibers also carry aching, sore pain caused by organs within the body, such as a sore muscle or stomachache. (Ngassapa D. N. 1996)

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.

From Injury To Recovery With Chiropractic Care

References

Purves D, A. G., Fitzpatrick D, et al., editors. (2001). Nociceptors. In Neuroscience. 2nd edition. (2nd ed.). Sunderland (MA): Sinauer Associates. https://www.ncbi.nlm.nih.gov/books/NBK10965/

University of Texas McGovern Medical School. (2020). Chapter 6: Pain Principles. https://nba.uth.tmc.edu/neuroscience/m/s2/chapter06.html

Ngassapa D. N. (1996). Comparison of functional characteristics of intradental A- and C-nerve fibres in dental pain. East African medical journal, 73(3), 207–209.

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 Exercises , , , , , , , , , , , , , , , , , , ,

Lower Your Blood Pressure with Walking: Simple and Affordable

For individuals who are looking to lower blood pressure, can walking help?

Walking To Lower Blood Pressure

A walking regimen is an accessible workout that can be done almost anywhere at no cost, effectively lowering blood pressure and improving overall health. Studies show that individuals who use walking as a workout for three months have improved systolic blood pressure, which is the top number that measures the pressure in the arteries as the heart beats. (McMullan S., Nguyen C., & Smith D. K. 2022)

How It Works

Walking is an excellent way to get active. It can be done almost anywhere, including on a treadmill, outdoors, or around the house. Exercising lowers blood pressure by strengthening the heart, leading to the heart pumping blood more effectively when it is stronger. This causes less resistance to the blood vessels, which lowers overall blood pressure. (Hegde S. M., & Solomon S. D. 2015) The benefits of walking include: (American Heart Association, 2024)

  • Weight loss and management
  • Lowers stress
  • Improves mental health by reducing anxiety.
  • Improves sleep quality
  • Improves cognition
  • Strengthens the heart
  • Promotes bone health and reduces the risk of osteoporosis.

Knowing When to Take A Blood Pressure Reading

Various factors can affect blood pressure readings and can include:

  • Nervousness
  • Eating a meal
  • Drinking caffeine
  • Exercise can affect blood pressure readings.

Knowing how and when to take a blood pressure reading after walking can help prevent false elevated numbers. According to the CDC, individuals should wait at least 30 minutes after exercise before taking a reading (Centers for Disease Control and Prevention, 2024). Exercise and walking have been shown to cause an immediate reduction in systolic blood pressure. This is known as post-exercise hypotension and is normal. The reduction lasts around 24 hours after exercising and is more noticeable in those with high blood pressure. Consistent exercise and walking will cause a longer, more sustained blood pressure reduction. (Hegde S. M., & Solomon S. D. 2015)

Taking Blood Pressure at Home

Correctly taking blood pressure can help improve accuracy and reduce inaccurate readings. To do: (Centers for Disease Control and Prevention, 2024)

  • It is recommended not to talk while the blood pressure is being taken.
  • Apply the blood pressure cuff snugly around the arm.
  • Place your arm on a table, level with your heart.
  • Sit in a chair, keep your feet flat on the floor, and do not cross your legs or lean back on the chair.
  • It is recommended not to eat or drink 30 minutes before and to have an empty bladder.

Pace and Intensity

A study found that walking three to five times weekly for 20 to 40 minutes at a moderate pace for three months can lower systolic blood pressure. However, various groups determined BP rates differently by measuring heart rate, VO2 max/the maximum volume of oxygen you can use simultaneously, and walking speed. (McMullan S., Nguyen C., & Smith D. K. 2022)

Increasing Workout Intensity

Individuals with hypertension who walk may want to increase workout intensity to challenge themselves for added fitness. This can include:

  • Walk faster
  • Use intervals – walk as fast as you can for a minute or two at a time.
  • Add inclines
  • Use ankle or wrist weights or a weighted vest.
  • Walking with someone to challenge each other to push a little harder.
  • Try other places to walk.

Always talk to a healthcare provider if you are starting a walking workout for the first time, want to increase walking intensity, and take medications prescribed by a healthcare provider.

Hypertensive Crisis

A hypertensive crisis is when a person’s blood pressure is extremely high, can cause life-threatening conditions like stroke, and is a medical emergency. It is a blood pressure of 180/120 mm Hg or higher. (American Heart Association, 2024) If you get a blood pressure reading of 180/120 mm Hg or higher at home, wait five minutes and take another reading. If the blood pressure is still high, immediately contact a healthcare provider. (American Heart Association, 2024) If the individual is experiencing the below symptoms, call 911 (American Heart Association, 2024)

  • Chest pain
  • Shortness of breath
  • Vision changes
  • Difficulty speaking
  • Weakness
  • Numbness
  • Back pain

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.

Hypertension Explained

References

McMullan, S., Nguyen, C., & Smith, D. K. (2022). Can Walking Lower Blood Pressure in Patients With Hypertension?. American family physician, 105(1), 22–23.

Hegde, S. M., & Solomon, S. D. (2015). Influence of Physical Activity on Hypertension and Cardiac Structure and Function. Current hypertension reports, 17(10), 77. https://doi.org/10.1007/s11906-015-0588-3

American Heart Association. (2024). Getting active to control high blood pressure. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/getting-active-to-control-high-blood-pressure

Centers for Disease Control and Prevention. (2024). Measure your blood pressure. Retrieved from https://www.cdc.gov/high-blood-pressure/measure/

American Heart Association. (2024). Understanding blood pressure readings. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings

American Heart Association. Association, A. H. (2024). When to call 911 about high blood pressure. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Acupuncture, Electroacupuncture , , , , , , , , , , , , , , , , , ,

Pain-Free Acupuncture: Debunking the Misconceptions

Is acupuncture painful for individuals wanting to try acupuncture for various health conditions but aren’t sure?

Is Acupuncture Painful?

Acupuncture is a procedure where extremely fine needles are inserted into pressure points in the body. A traditional Chinese medicine technique used to alleviate pain and enhance physical and emotional well-being. (Harvard Health, 2023) It can be beneficial for anyone dealing with persistent painful conditions, such as back pain, sciatica, arthritis-related discomfort, headaches, and post-surgery pain. It’s also a supportive option for individuals experiencing hot flashes and generalized inflammation, making it a versatile choice for holistic health. People undergoing acupuncture experience minimal pain, usually mild pressure or soreness during or after. However, choosing an experienced practitioner and communicating with them during the treatment is the best way to avoid increased pain.

When Performed Correctly, It Should Not Hurt

Many fear that acupuncture will be painful. However, this is not the case because the procedure uses extremely fine needles. One study of pediatric patients found that 87% reported minimal to no pain while having the treatment (Gold J. I. et al., 2023). Improper needle placement is one of the most common reasons that patients experience pain during or after treatment (Johns Hopkins Medicine, 2025). This is why it is important to be treated by a licensed practitioner who is well-versed in treating specific conditions.

Soreness After Treatment

It is relatively uncommon to experience pain after receiving acupuncture. About 10% of individuals experience minor soreness after the treatment (Kelly R. B. & Willis J. 2019). The soreness is typically felt in the areas where the needles were inserted.

Situations When Pain Can Present

A small group of those who undergo acupuncture may experience some pain. It is most frequently seen in the following: (Harvard Health, 2023)

  • The acupuncturist is inexperienced and inserts the needle incorrectly or not in the right area.
  • The needles are inserted more deeply than normal or with too much pressure.
  • The patient has a lower pain threshold and/or is more sensitive to needles.
  • The practitioner uses higher gauge/thicker needles.

It is important for individuals who have not had acupuncture before to discuss the procedure and any concerns with their provider beforehand. The acupuncturist may be able to perform a trial needle insertion to provide a preview of the treatment. During the initial session, they may use fewer needles or target a smaller area. Constantly communicate with the acupuncturist during the treatment. This allows them to adjust the needles causing soreness or discontinue the procedure if there is increased pain.

Acupuncture Process

Modern medicine explains acupuncture’s benefits. When the needles are inserted, they stimulate the release of endorphins, opioids, immune system cells, and neurohormones. These chemicals help reduce and relieve pain and modify how the body perceives it. They may also impact blood pressure, body temperature, and central nervous system function. (Harvard Health, 2023)

Pressure Points: Is Acupuncture Painful On Certain Body Parts?

Acupuncture can cause some increased soreness in certain body areas. This is especially true when needles are inserted into less muscle or fat regions. For example, hand or foot acupuncture can occasionally cause increased pain (Kaiser Permanente, 2021). Thin individuals with less soft tissue may also experience a stinging sensation as needles are inserted. Communication with the provider is the key to making the acupuncture sessions as comfortable as possible.

During A Session

The first acupuncture session may consist of the following:

  • The practitioner goes over medical history and current symptoms.
  • The practitioner examines the body and may also examine the tongue to assess for any present imbalances.
  • The patient will lie or sit on a table.
  • Sterilized needles are inserted into the affected areas one at a time.
  • In some situations, heat or electrical stimulation may also be used to enhance its effects. (Johns Hopkins Medicine, 2025)
  • A typical acupuncture session is about 20 to 30 minutes. (Kaiser Permanente, 2021)

Self-Care After Treatment

Most cases of soreness after treatment will resolve in one to three days. During this time, here are a few recommendations to alleviate any soreness symptoms:

  • Apply ice to the areas of soreness.
  • Gently stretch the sore areas.
  • Increase fluid intake.
  • Soak in a warm bath with Epsom salts or magnesium oil.
  • Perform light aerobic exercise.
  • Take over-the-counter anti-inflammatory medication if recommended by a physician. (University of Georgia, N.D.)

Find a Licensed Acupuncturist

Most states have an online directory of licensed acupuncturists that can help find a local provider. Some national acupuncture associations also maintain lists of members who are board-certified. For example, this directory searches for certified acupuncturists through the National Certification Commission for Acupuncture and Oriental Medicine. (National Certification Commission for Acupuncture and Oriental Medicine, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Therefore, acupuncture is not painful and can help relieve symptoms such as anxiety, stress, pain, discomfort, tightness, and poor circulation. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and 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.

Beyond Adjustments: Chiropractic and Integrative Healthcare

References

Harvard Health Publishing. (2023). Acupuncture. https://www.health.harvard.edu/a_to_z/acupuncture-a-to-z

Gold, J. I., Kobylecka, M., Ngo, N. H., Lin, C. T., & Hurray, C. N. (2023). Does Acupuncture Hurt? A Retrospective Study on Pain and Satisfaction during Pediatric Acupuncture. Children (Basel, Switzerland), 10(11), 1774. https://doi.org/10.3390/children10111774

Johns Hopkins Medicine. (2025). Acupuncture. https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Kelly, R. B., & Willis, J. (2019). Acupuncture for Pain. American family physician, 100(2), 89–96.

Kaiser Permanente. (2021). Acupuncture 101: here’s what you can expect. https://healthy.kaiserpermanente.org/health-wellness/healtharticle.acupuncture-101

University of Georgia. (N.D.). Dry needling. https://healthcenter.uga.edu/healthtopics/dryneedling/

National Certification Commission for Acupuncture and Oriental Medicine. (2024). Directory: Feel Confident About Finding a Qualified Practitioner. https://directory.nccaom.org/#