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

GI Disorders Treatment: Seeking the Best Solutions

Discover key insights into GI disorders treatment to help manage symptoms and improve gastrointestinal health.

Introduction

Do you often feel bloated after meals? Experience persistent constipation or digestive discomfort? Or perhaps you suffer from joint stiffness and muscle pain with no clear cause? Many people are unaware that their gut health can significantly impact their musculoskeletal system. Emerging research highlights the intricate connection between gastrointestinal (GI) health and musculoskeletal function, showing that poor gut health can contribute to systemic inflammation, nutrient deficiencies, and chronic pain.

As a nurse practitioner specializing in physical and functional medicine, I have seen firsthand how addressing gut health can lead to profound improvements in musculoskeletal function and overall well-being. This article explores the gut-musculoskeletal connection and evidence-based, non-surgical strategies to alleviate pain and restore balance.

The Gut-Musculoskeletal Connection: How GI Disorders Impact the Body

1. Systemic Inflammation and Musculoskeletal Pain

Inflammation is a key player in both GI disorders and musculoskeletal conditions. When gut health is compromised—due to factors such as poor diet, stress, or dysbiosis—the body mounts an immune response, leading to chronic inflammation.

GI disorders like irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and small intestinal bacterial overgrowth (SIBO) are commonly associated with systemic inflammation. Research has shown that inflammatory mediators released from the gut can trigger widespread pain and contribute to conditions like fibromyalgia, arthritis, and chronic fatigue syndrome (Casini et al., 2024).

2. Nutrient Malabsorption and Musculoskeletal Dysfunction

The gut is responsible for absorbing essential nutrients that support musculoskeletal health. Celiac disease, inflammatory bowel disease (IBD), and chronic diarrhea can impair nutrient absorption, leading to deficiencies in:

  • Vitamin D (essential for bone health and immune regulation)
  • Magnesium (necessary for muscle relaxation and nerve function)
  • B Vitamins (important for energy metabolism and nervous system function)
  • Omega-3 Fatty Acids (anti-inflammatory properties)

Deficiencies in these nutrients can manifest as muscle cramps, weakness, joint pain, and fatigue, often mimicking other musculoskeletal disorders.

3. Gut Dysbiosis and the Nervous System

The gut, often referred to as the “second brain,” has a profound relationship with the nervous system. Gut dysbiosis, or an imbalance in gut bacteria, can lead to increased intestinal permeability (leaky gut), allowing toxins and inflammatory molecules to enter the bloodstream. This, in turn, can trigger immune responses that contribute to chronic pain, joint stiffness, and muscle dysfunction (Casini et al., 2024).

Additionally, the gut-brain axis plays a significant role in pain perception. When gut health is compromised, it can disrupt neurotransmitter production (such as serotonin and dopamine), leading to increased pain sensitivity and mood disorders like anxiety and depression.

4. Visceral-Somatic Reflex and Referred Pain

GI disorders often create referred pain patterns, where discomfort originating in the gut is perceived as musculoskeletal pain.

  • GERD may cause chest and upper back pain.
  • IBS can lead to lower back and pelvic discomfort.
  • Chronic constipation can contribute to hip and sacroiliac joint pain.

This phenomenon, known as the visceral-somatic reflex, occurs when irritation in the internal organs triggers nerve responses that are felt in corresponding musculoskeletal structures (Farmer & Aziz, 2009).

Fighting Inflammation Naturally: Video

Functional and Non-Surgical Approaches to Restoring Gut and Musculoskeletal Health

1. Dietary Modifications for Gut Health

Optimizing gut health begins with nutrient-dense, anti-inflammatory dietary choices. Some effective dietary approaches include:

  • Anti-Inflammatory Diet: Emphasizes whole foods, omega-3s, and antioxidants.
  • Elimination Diet: Identifies and removes food sensitivities that trigger inflammation.
  • Low FODMAP Diet: Reduces fermentable carbohydrates that can cause bloating and gut distress.

A well-balanced diet supports gut microbiome diversity, reduces systemic inflammation, and promotes nutrient absorption (El-Salhy, 2019).

2. Probiotics and Prebiotics for Gut Microbiome Support

Restoring gut microbiome balance is crucial for reducing inflammation and improving digestion.

  • Probiotics: Contain beneficial bacteria that support gut integrity and immune function.
  • Prebiotics: Fiber-rich foods that nourish beneficial gut bacteria.

Studies show that probiotics and prebiotics help modulate the immune system, restore gut barrier function, and reduce pain associated with GI disorders (Roy & Dhaneshwar, 2023).

3. Stress Management for Gut-Musculoskeletal Health

Chronic stress exacerbates GI dysfunction and musculoskeletal pain. Incorporating stress-reducing techniques can significantly improve both systems:

  • Mindfulness & Meditation: Reduces gut sensitivity and pain perception.
  • Cognitive Behavioral Therapy (CBT): Helps manage stress-induced GI symptoms.
  • Breathwork & Yoga: Improves vagal nerve function, aiding digestion and relaxation.

4. Manual Therapies for Musculoskeletal and Gut Health

Various hands-on therapies can alleviate both GI and musculoskeletal symptoms:

  • Osteopathic Manipulative Therapy (OMT): Improves gut motility and reduces referred pain.
  • Visceral Manipulation: Releases abdominal restrictions to improve digestion.
  • Massage Therapy: Alleviates stress-related gut dysfunction and musculoskeletal tension.

5. Acupuncture for Gut and Pain Management

Acupuncture is an evidence-based approach that can modulate the autonomic nervous system, reduce inflammation, and improve gut motility. Studies show that acupuncture helps relieve IBS-related pain, bloating, and constipation(Li et al., 2023)

Conclusion: A Holistic Approach to Gut and Musculoskeletal Health

The connection between GI health and musculoskeletal function is undeniable. Chronic pain, joint stiffness, and muscle dysfunction often stem from underlying gut issues, making an integrative approach essential for effective treatment.

By incorporating functional medicine strategies such as dietary modifications, gut microbiome support, stress reduction, manual therapies, and acupuncture, individuals can address the root causes of dysfunction rather than just treating symptoms. These holistic, non-surgical interventions empower patients to take control of their health, reduce chronic pain, and achieve lasting well-being.

As a nurse practitioner specializing in physical and functional medicine, my goal is to help individuals restore balance to their gut and musculoskeletal systems. If you’re experiencing persistent pain, digestive issues, or unexplained musculoskeletal discomfort, it’s time to explore a functional medicine approach tailored to your needs.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the effects of GI disorders on not only the gut system but also the musculoskeletal system. While asking important questions to our associated medical providers, we advise patients to implement small changes like physical activities and small dietary changes to their diet to reduce the chances of GI disorders from returning. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

Casini, I., Massai, L., Solomita, E., Ortenzi, K., Pieretti, S., & Aloisi, A. M. (2024). Gastrointestinal Conditions Affect Chronic Pain and Quality of Life in Women. Int J Environ Res Public Health, 21(11). https://doi.org/10.3390/ijerph21111435

El-Salhy, M. (2019). Nutritional Management of Gastrointestinal Diseases and Disorders. Nutrients, 11(12). https://doi.org/10.3390/nu11123013

Farmer, A. D., & Aziz, Q. (2009). Visceral pain hypersensitivity in functional gastrointestinal disorders. Br Med Bull, 91, 123-136. https://doi.org/10.1093/bmb/ldp026

Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol, 62(6), 591-599. https://www.ncbi.nlm.nih.gov/pubmed/22314561

Li, X., Liu, S., Liu, H., & Zhu, J. J. (2023). Acupuncture for gastrointestinal diseases. Anat Rec (Hoboken), 306(12), 2997-3005. https://doi.org/10.1002/ar.24871

Malone, M., Waheed, A., & Samiullah, S. (2018). Functional Gastrointestinal Disorders: Functional Lower Gastrointestinal Disorders in Adults. FP Essent, 466, 21-28. https://www.ncbi.nlm.nih.gov/pubmed/29528206

Roy, S., & Dhaneshwar, S. (2023). Role of prebiotics, probiotics, and synbiotics in management of inflammatory bowel disease: Current perspectives. World J Gastroenterol, 29(14), 2078-2100. https://doi.org/10.3748/wjg.v29.i14.2078

Disclaimer

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

Managing Periodic Limb Movements of Sleep for Better Rest

For individuals experiencing periodic limb movements of sleep, can understanding how movements at night may relate to other sleep disorders help bring healthy sleep?

Periodic Limb Movements of Sleep

Periodic limb movements of sleep (PLMS) are involuntary, repetitive leg and sometimes arm movements during sleep. PLMS is one of the sleep disorders that may cause disruptive movement of the legs, like restless legs syndrome (RLS). It can lead to sleep disruption, insomnia, and daytime sleepiness.

Causes

The exact cause of PLMS is unknown, but it is thought to be related to:

  • Underlying medical conditions (e.g., restless legs syndrome, sleep apnea)
  • Nerve dysfunction
  • Neurochemical imbalances (e.g., dopamine, iron)

Symptoms

  • Repetitive leg and/or arm movements during sleep, typically lasting 0.5-5 seconds.
  • It may be accompanied by sensations of tingling, crawling, or pulling in the legs.
  • It can cause sleep disturbances, leading to daytime fatigue.

Type of Movements

Periodic limb movements during sleep (PLMS) consist of sudden jerking movements of the legs that occur involuntarily during sleep, which the affected individual may not realize is happening. It can be kicking, twitching, or extension of the legs.

  • Restless legs syndrome (RLS) symptoms are noted when awake.
  • PLMS occurs during sleep. (Walters A. S., & Rye D. B. 2009)
  • The movements associated often consist of flexion or extension at the ankle.
  • In some cases, this can also occur at the knee.
  • It may occur on one side or alternate back and forth between the left and right sides. (Cleveland Clinic, 2023)
  • It tends to increase with age and often but is not always accompanied by restless leg symptoms.

If PLMS causes daytime impairment, such as significant sleep disruption, excessive daytime sleepiness, and insomnia, it may be diagnosed as periodic limb movement disorder (PLMD). (Sleep Foundation, 2024)

Diagnosis

PLMS is diagnosed through a sleep study (polysomnography), which records brain waves, eye movements, muscle activity, and breathing patterns during sleep. As part of the study, superficial electrodes are placed on the legs and sometimes the arms to detect muscle contractions or movements.

  • In individuals with PLMS, repetitive movements at least four in a row may last from 1/2 second to 5 seconds. 
  • The movements may be more significant if they are associated with arousal or awakenings from sleep.
  • They also may be deemed important if they become disruptive to a bed partner.
  • No further treatment may be necessary when noted in isolation on a sleep study without associated symptoms or impacts.
  • If another disorder cannot explain the movements, PLMS may be the likely diagnosis.
  • Again, if the movements lead to sleep disruption, insomnia, and excessive daytime sleepiness, it is called PLMD.
  • Isolated PLMS noted on a sleep study, without consequence, are insignificant and do not require treatment with medication.

Restless leg syndrome is diagnosed based on clinical criteria of having an uncomfortable feeling in the legs associated with an urge to move that occurs in the evening when lying down and is relieved by movement. (Stefani, A., & Högl, B. 2019)

Treatment

Treatment for PLMS depends on the underlying cause and severity of symptoms. Options include:

  • Medications (e.g., dopamine agonists, iron supplements)
  • Lifestyle changes (e.g., exercise, avoiding caffeine before bed)
  • Treating the underlying medical condition

In general, it is unnecessary to treat PLMS if the individual affected has no complaints of sleep disruption. Treatment can be considered if it causes:

  • Partial or total arousal from sleep
  • Contributes to insomnia
  • Undermines sleep quality
  • Also, if the movements are disruptive to a bed partner, getting them under control may be desirable.

Prescription medications can be effective in treating PLMS. (Cleveland Clinic, 2023) Many of the meds used to treat RLS can be helpful. These may include benzodiazepines (clonazepam), Mirapex (generic name pramipexole), and ropinirole. Movements may also occur with obstructive sleep apnea events, and then the treatment would target the breathing disorder.

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to restore health. Individuals can recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. 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.

Revitalize and Rebuild with Chiropractic Care

References

Walters, A. S., & Rye, D. B. (2009). Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep, 32(5), 589–597. https://doi.org/10.1093/sleep/32.5.589

Cleveland Clinic. (2023). Periodic limb movement disorder (PLMD). https://my.clevelandclinic.org/health/diseases/14177-periodic-limb-movements-of-sleep-plms

Sleep Foundation. (2024). Periodic Limb Movement Disorder What it is, what it feels like, its possible causes, and how it’s addressed. https://www.sleepfoundation.org/periodic-limb-movement-disorder

Stefani, A., & Högl, B. (2019). Diagnostic Criteria, Differential Diagnosis, and Treatment of Minor Motor Activity and Less Well-Known Movement Disorders of Sleep. Current treatment options in neurology, 21(1), 1. https://doi.org/10.1007/s11940-019-0543-8

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

The Dangers of Sleep Debt: Health Consequences

Individuals who don’t get enough sleep at night can feel it in many ways. Can sleep deprivation or other sleep disorders contribute to an accumulated sleep debt?

Sleep Debt

Sleep debt is the difference between the amount of sleep an individual needs and the amount they get. It can accumulate over time and can negatively impact physical and mental health.

What Is It?

Regardless of the cause, sleep debt, also called a sleep deficit, is the accumulated amount of sleep loss from insufficient sleep. (Harvard Health Publishing, 2019) For example, if the body needs eight hours of sleep a night but only gets six, it has accumulated two hours of sleep debt for that particular night. This can occur due to sleep restriction, in which too few hours are spent sleeping, which can have significant consequences, especially if the debt builds.

The Effects

Sleep deprivation is linked to various mental and physical health problems, including:

  • Poor concentration or short-term memory
  • Depression and anxiety
  • High blood pressure
  • Heart disease
  • Diabetes
  • Kidney disease

Sleep deprivation can also contribute to other long-term health consequences. Individuals can have hallucinations and even a potentially increased risk of death. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Symptoms of discomfort and pain are also worsened by poor sleep.

Other Causes

Other possible causes of poor sleep quality can include individuals who have a sleep disorder such as insomnia, sleep apnea, or circadian rhythm disorders, which could lead to symptoms that are similar to those that occur with a sleep debt. (Columbia University Department of Neurology, 2022) Even though enough sleep hours were obtained, it could be fragmented, resulting in daytime sleepiness and other health issues. Some signs of sleep debt include:

  • Feeling tired throughout the day.
  • Having trouble focusing and reacting.
  • Feeling frustrated, cranky, or worried in social situations.
  • Having difficulty judging others’ emotions.

Even after sufficient sleep hours, individuals who wake up feeling unrefreshed may need to see a sleep physician or specialist for sleep testing.

Getting Out of Sleep Debt

Fortunately, the short-term effects of sleep deprivation can be reversed with sufficient rest. To recover from sleep debt, individuals can try: (Harvard Health Publishing, 2019)

  • Getting into a normal bedtime routine.
  • Using afternoon naps in moderation.
  • Avoiding stimulants, especially in the afternoon or evening.
  • Going to bed earlier.
  • Catching up by sleeping in on the weekends.
  • Keeping a sleep diary.
  • Changing their mattress.
  • Talking with a doctor.

Although sleep deprivation affects everyone, older adults seem to rebound quicker than young adults. Individuals may initially require sleeping longer than average to compensate for the recent losses. That’s why meeting daily sleep needs and following better sleep guidelines to preserve health and well-being are important. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to sleep well, avoid deprivation side effects, and restore health. Through healthy sleep practices and lifestyle accommodations, individuals can recover from sleep debt and regain the benefits of quality rest. A chiropractic therapy team can assess your condition and develop a customized treatment plan. 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.

Move Better, Live Better, Chiropractic Care

References

Harvard Health Publishing. (2019). Weekend catch-up sleep won’t fix the effects of sleep deprivation on your waistline. Harvard Health Blog. https://www.health.harvard.edu/blog/weekend-catch-up-sleep-wont-fix-the-effects-of-sleep-deprivation-on-your-waistline-2019092417861

Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US).

Columbia University Department of Neurology. (2024). Sleep Disorders. https://www.neurology.columbia.edu/patient-care/specialties/sleep-disorders?id=42069