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By admin 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/#

By admin 0 Comments Gut Health , , , , , , , , , , , , , , , , , ,

Chamomile Manzanilla Tea: A Natural Remedy for Health Issues

For individuals looking to improve their gut and overall health, can drinking chamomile manzanilla tea help?

Chamomile Manzanilla Tea

Chamomile (Manzanilla is Spanish for chamomile) is a herb that belongs to the Asteraceae family. Chamomile tea is made from the dried flowers of the chamomile plant steeped in hot water and is used as a natural remedy for various health issues. The tea can calm upset stomach, relieve anxiety, improve sleep, and reduce muscle spasms or flatulence. (Srivastava J. K., Shankar E., & Gupta S. 2010) It is caffeine-free and often drunk before bed because it can calm the brain and help with sleep. It also contains natural plant compounds that promote antioxidant activity, which may help reduce the risk of certain diseases. The nutrients it contains, vitamins A and B, magnesium, manganese, potassium, calcium, iron, copper, and zinc, can help manage diabetes, menstrual pain, and sleep problems.

Types

There are two kinds of chamomile: German, also known as wild or Hungarian chamomile and Roman chamomile. Each type is believed to provide various benefits.

German Chamomile

  • This type is believed to provide help with a wide range of conditions, including travel sickness, flatulence, diarrhea, ADHD, stomach upset, restlessness, and insomnia.
  • It is sometimes also used in cosmetics and soaps.

Roman Chamomile

  • This type may relieve heartburn, loss of appetite, menstrual discomfort, and other conditions.
  • Roman chamomile is also used as a fragrance in perfumes and tobacco products.

The tea can be made with either type. However, many medical sources that report the health benefits of manzanilla tea focus on German chamomile. (Srivastava J. K., Shankar E., & Gupta S. 2010)

Preparation

Chamomile Manzanilla tea is sold in tea bags and loose-leaf varieties. It is prepared like most traditional teas.

  1. Place a tea bag or infuser containing about one tablespoon of loose tea leaves in a teacup. Or place loose tea leaves at the bottom of a cup.
  2. Heat water to 194-205 F.
  3. Bring water to a boil and let it sit for a minute to reduce the temperature slightly.
  4. Pour water over the tea bag, infuser, or tea leaves.
  5. Let the tea leaves steep for as long as desired, up to four or five minutes.
  6. Remove the tea bag or infuser or strain loose leaves from the cup before drinking.
  7. Optional: add a small amount of milk, honey, or sugar to sweeten the drink.

Benefits

  • Chamomile tea is believed to have calming properties, and individuals consume the beverage in times of stress to reduce anxiety or before bed to induce sleep. (Srivastava J. K., Shankar E., & Gupta S. 2010)
  • A study in the Journal of Advanced Nursing found that drinking chamomile tea helped postpartum women alleviate depression and sleep better. (Chang S. M. & Chen C. H. 2016)
  • Other reports say that chamomile helps to relieve gastrointestinal conditions such as upset stomach, gas, and diarrhea. However, the National Institutes of Health National Center for Complementary and Integrative Health explains that insufficient research has been conducted to ensure these health benefits are certain. (National Center for Complementary and Integrative Health, 2024)

Side Effects

Individuals allergic to ragweed, chrysanthemums, marigolds, or daisies may experience an allergic reaction to chamomile manzanilla tea. They should also avoid drinking the tea if they are on warfarin or any blood thinners or if they are taking a sedative. Chamomile may increase the risk of side effects if taking cyclosporine or cytochrome P450 substrate meds. (Colombo D., Lunardon L., & Bellia G. 2014) If unsure if drinking chamomile manzanilla tea may interfere with medication, speak to a healthcare provider.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

From Inflammation to Healing

References

Srivastava, J. K., Shankar, E., & Gupta, S. (2010). Chamomile: A herbal medicine of the past with bright future. Molecular medicine reports, 3(6), 895–901. https://doi.org/10.3892/mmr.2010.377

Chang, S. M., & Chen, C. H. (2016). Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial. Journal of advanced nursing, 72(2), 306–315. https://doi.org/10.1111/jan.12836

National Center for Complementary and Integrative Health. (2024). Chamomile. Retrieved from https://www.nccih.nih.gov/health/chamomile

Colombo, D., Lunardon, L., & Bellia, G. (2014). Cyclosporine and herbal supplement interactions. Journal of toxicology, 2014, 145325. https://doi.org/10.1155/2014/145325

By admin 0 Comments Chiropractic Care, Therapy , , , , , , , , , , , , , , , , , ,

How a Massage Gun Can Help Ease Pregnancy Pain and Fatigue

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

Pregnancy Massage Gun Use

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

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

Benefits

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

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

Massage Gun Safety

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

When to Avoid Massage Therapies

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

High-risk Pregnancy

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

Preeclampsia

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

Deep Vein Thrombosis – DVT

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

Placenta Previa, Accrete, or Abruption

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

Gestational Diabetes

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

How to Use

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

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

Additional Tips (Hospital for Special Surgery, 2021)

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

Pregnancy and Sciatica: How Chiropractic Helped

References

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

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

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

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

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

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

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

By admin 0 Comments Chiropractic Care, Sleep Hygiene , , , , , , , , ,

The Role of Melatonin in Enhancing Sleep

Can melatonin help many individuals dealing with sleep issues and help them stay asleep longer and feel refreshed in the morning?

What Is Melatonin?

How often do you have trouble sleeping at night? Do you constantly toss and turn at night, which makes you stay awake even longer? Or do you feel continually stressed, and you feel more tired than before, and that is affecting your routine? Many people can fall asleep instantly when it comes to getting a good night’s sleep. However, when environmental factors like stress and insomnia start to affect the body, while causing many people to deal with restless sleep and symptoms of fatigue that affect their routine. Hence, why are many people taking a supplement known as melatonin to get a full night’s sleep? But what is melatonin, and how can it help improve sleep quality? Located and secreted in the pineal gland, melatonin is a hormone primarily synthesized to regulate the body’s sleep and wake cycle. (Savage et al., 2024) This hormone helps many people fall asleep, stay asleep, and wake up refreshed. At the same time, it is an antioxidant that dampens chronic inflammation and helps with the immune system. We associate with certified medical providers who inform our patients of the effects of melatonin as a supplement to reduce overlapping risk profiles affecting sleep quality. While asking important questions to our associated medical providers, we advise patients to incorporate various techniques to stay asleep longer and utilize melatonin when needed. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Its Benefits

Melatonin is a hormone that is produced from the body’s pineal gland, and it can naturally command the circannual rhythm as its synthesis and exert its effect on the body’s biological rhythm and sleep initiation. (Boutin et al., 2023) There are many benefits that melatonin provides as it can:

  • Lengthen total sleep time
  • Reduce seasonal depression
  • Increase human growth hormone levels
  • Help with eye health
  • Treat GERD

However, many people have noticed that melatonin has hypnotic “effects” that are exerted through thermoregulatory mechanisms. Melatonin helps the body lower its core temperature, reduce arousal, and increase sleep propensity (Dawson & Encel, 1993). This allows many people dealing with sleep disorders to have a good night’s rest and feel better when waking up.  

Eating Right To Feel Better- Video

How Melatonin Improves Sleep

When it comes to melatonin and improving sleep quality, many people with sleep disorders like insomnia, CRSD (Circadian Rhythm Sleep Disorder, and DSPD (Delayed Sleep Phase Disorder) use melatonin in pill and gummy form to administer the beneficial properties of improving sleep initiation and maintenance. (Cruz-Sanabria et al., 2023) At the same time, melatonin, especially exogenous melatonin, can be prescribed by a doctor or taken as a supplement in pill, tablet, or gummy form and has been the most frequently requested as a non-prescription sleep pain to promote total sleep time. (Costello et al., 2014) However, even though melatonin is used as a dietary supplement, it has to be regulated to what dosage the individual takes to reduce adverse effects. (Tuft et al., 2023) This is because taking too much melatonin can lead to the development of chronic conditions. If a person is taking medication, it can cause overlapping risk profiles for the individuals. Luckily, when it comes to reducing sleep disorders, taking melatonin for at least 30 minutes to an hour before bed can allow the body to relax and help kickstart the sleep-wake cycle for individuals to get that full night’s rest they deserve.

References

Boutin, J. A., Kennaway, D. J., & Jockers, R. (2023). Melatonin: Facts, Extrapolations and Clinical Trials. Biomolecules, 13(6). https://doi.org/10.3390/biom13060943

Costello, R. B., Lentino, C. V., Boyd, C. C., O’Connell, M. L., Crawford, C. C., Sprengel, M. L., & Deuster, P. A. (2014). The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature. Nutr J, 13, 106. https://doi.org/10.1186/1475-2891-13-106

Cruz-Sanabria, F., Carmassi, C., Bruno, S., Bazzani, A., Carli, M., Scarselli, M., & Faraguna, U. (2023). Melatonin as a Chronobiotic with Sleep-promoting Properties. Curr Neuropharmacol, 21(4), 951-987. https://doi.org/10.2174/1570159X20666220217152617

Dawson, D., & Encel, N. (1993). Melatonin and sleep in humans. Journal of Pineal Research, 15(1), 1-12. https://doi.org/10.1111/j.1600-079x.1993.tb00503.x

Savage, R. A., Zafar, N., Yohannan, S., & Miller, J. M. M. (2024). Melatonin. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30521244

Tuft, C., Matar, E., Menczel Schrire, Z., Grunstein, R. R., Yee, B. J., & Hoyos, C. M. (2023). Current Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults. Clin Interv Aging, 18, 49-59. https://doi.org/10.2147/CIA.S361519

Disclaimer

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Enhance Your Fitness Journey: Kettlebell Training for All Ages

For older individuals looking for a workout that can help improve overall fitness, can kettlebell training help achieve health goals?

Kettlebell Training At Any Age

Previous research found that training with a kettlebell can improve aerobic capacity, balance, and core strength. New research suggests that kettlebell training is beneficial at any age (American Physiological Society, 2024). Compared to dumbbells or barbells, the kettlebell’s specific shape—a sphere on the bottom and a handle that can be grabbed by one or both hands—better emulates how the body moves through daily tasks and activities. When isolating a muscle, like a bicep, only that muscle is getting worked out. But in everyday life, a lot of what the body does is lifting and moving things. A kettlebell allows those muscle groups to connect in a stronger and more efficient movement.

Benefits At Any Age

A research study examined how using kettlebells impacted the health of individuals from different backgrounds without prior exposure to resistance training between the ages of 60 and 80. The participants enrolled in a twice-a-week exercise program using kettlebells to improve fitness. At the end of six months, the researchers found the participants had increased muscle mass and grip strength. At the end of the year, the participants had lower inflammation markers in their blood and had met other fitness goals, including climbing stairs faster and making multiple chair stands/standing from a seated position. The researchers say the findings show how effective kettlebells can be for all ages and demonstrate that the kettlebell training program leads to benefits even in older individuals just starting. (American Physiological Society, 2024) The kettlebell’s unique shape allows for an offset center of gravity from the handle, encouraging increased engagement of stabilizing muscles. This combination of strength and functional movement patterns helps to improve the following:

  • Balance
  • Coordination
  • Core stability

This makes it a versatile tool for older adults.

Getting Started

For individuals just starting kettlebell training, it is recommended that they work with a certified instructor or find a beginner’s class. Guided training ensures proper technique and form and reduces the risk of injury. To avoid common kettlebell mistakes when lifting weights for the first time, start with lighter kettlebells to master form and focus on slow, controlled movements. When lifting weight from the ground to the chest, don’t pull with the shoulder muscles. Instead, start in the legs and let the energy move up through the body, known as the kinetic chain. When exercising, spend only 20 to 30 seconds on a rep before resting for 30 seconds, and don’t spend more than five minutes on a single exercise. (American Council on Exercise, 2015)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who want to start an exercise routine should consider kettlebell training. Following basic tips and training slowly, kettlebells can be an option for anyone looking to improve their fitness and overall health. Consider working with a personal trainer to ensure safety and get the most out of workouts. 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.

Transform Your Body

References

American Physiological Society. (2024). Kettlebell training may help maintain muscle strength in older adults. https://www.physiology.org/detail/news/2024/11/21/kettlebell-training-may-help-maintain-muscle-strength-in-older-adults?SSO=Y

American Council on Exercise. Wall, A. J. (2015). How to get started with kettlebells. https://www.acefitness.org/resources/pros/expert-articles/5269/how-to-get-started-with-kettlebells/?srsltid=AfmBOor4x0yZwrHzGRccSA2uYMQtS3PX-vRC03eVwQoGX6_6B5wryAAi

By admin 0 Comments Chiropractic Care, Sleep Hygiene , , , , , , , , , , ,

Sleep Easy: Choosing The Right Pillow For Neck Pain

Can choosing the right pillow help many individuals with neck pain get a full night’s sleep and reduce pain-like symptoms?

The Effects Of Neck Pain

How often do you feel stiffness in your neck and shoulders after being hunched for an extended period? Does it hurt when turning your neck from side to side? Or have you been suffering from constant headaches or migraines that are making you have a hard time falling asleep? As the second most common musculoskeletal condition, neck pain is a multifactorial disease developed through various risk factors that can impact a person. (Kazeminasab et al., 2022) The multiple muscles surrounding the neck are constantly overstretched and tight, which can cause pain and discomfort to the upper extremities due to environmental factors. Some environmental factors can range from improper posture to injuries that can affect the neck. When many people are experiencing neck pain associated with environmental factors, it can cause considerable personal pain and discomfort, disability, impaired quality of life, and, for adults, loss of time from work. (Ben Ayed et al., 2019) At the same time, when people experience neck pain, they can develop disruptive sleeping habits. We associate with certified medical providers who inform our patients of the effects of neck pain and how it can disrupt their sleeping habits. While asking important questions to our associated medical providers, we advise patients to incorporate various techniques to reduce neck pain and find ways to stay asleep longer. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

How Neck Pain Disrupts Sleep

Now, many people wonder how neck pain is associated with sleep. Environmental stressors like chronic stress from the workplace or natural disasters can cause a person to have tense neck muscles and can increase sleep disturbances. (Yabe et al., 2022) When environmental stressors impact the body, the musculoskeletal system becomes tight and tense in different body areas. In the neck, the muscles that surround the cervical can become tense and develop trigger points in muscle tissue, causing referred pain and discomfort. When neck pain causes disruptive sleep problems, it can cause impairment to the multifunctional protective role of sleep via physiological homeostasis and restoration. (Van Looveren et al., 2021) At the same time, some of the pain-like symptoms that can be increased with neck pain associated with disruptive sleep include: (Chin et al., 2021)

  • Soreness
  • Pain
  • Numbness
  • Difficulty in movement

However, there are ways to reduce the effects of neck pain and get a full night’s sleep, starting with the bedroom.

Low Back & Neck Pain Rehabilitation-Video

Choosing The Right Pillow For Neck Pain

 Now, when it comes to getting a full night’s sleep, it is important to find the right mattress to stay asleep as well as feel refreshed. However, as important as it is to sleep in the right mattress when dealing with neck pain, finding the right pillow can do wonders for the neck and help people get enough sleep. When it comes to finding the right pillow, the individual needs to find a pillow with an appropriate height that can provide adequate support for the head and neck to reduce cervical spinal stress and relax the surrounding neck and shoulder muscles. (Lei et al., 2021) This is because when it comes to quality sleep, many people prefer sleeping positions, pillows, and mattresses aimed at comfort. Many pillows have a variety of materials that can help aid in comfort and help reduce neck pain. Some of the types of pillows include:

  • Memory foam
  • Polyfilled pillows
  • Down Pillow
  • Latex
  • Combo style

Finding the right pillow for neck pain allows the individual to have their neck fully supported while having the pillow in a lateral position to reduce neck fatigue and improve sleep quality (Son et al., 2020). By doing so, many people can finally get a good night’s sleep and wake up feeling better. By choosing the right pillow, many people will begin to be more mindful of their bodies and make small changes to their routine while getting the sleep they deserve.

References

Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. https://www.ncbi.nlm.nih.gov/pubmed/31133629

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6941626/pdf/jrhs-19-e00440.pdf

Chin, W. S., Chen, Y. C., Lin, T. T., Guo, Y. L., & Shiao, J. S. C. (2021). Short sleep and chronic neck and shoulder discomfort in nurses. J Occup Health, 63(1), e12236. https://doi.org/10.1002/1348-9585.12236

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4

Lei, J. X., Yang, P. F., Yang, A. L., Gong, Y. F., Shang, P., & Yuan, X. C. (2021). Ergonomic Consideration in Pillow Height Determinants and Evaluation. Healthcare (Basel), 9(10). https://doi.org/10.3390/healthcare9101333

Son, J., Jung, S., Song, H., Kim, J., Bang, S., & Bahn, S. (2020). A Survey of Koreans on Sleep Habits and Sleeping Symptoms Relating to Pillow Comfort and Support. Int J Environ Res Public Health, 17(1). https://doi.org/10.3390/ijerph17010302

Van Looveren, E., Bilterys, T., Munneke, W., Cagnie, B., Ickmans, K., Mairesse, O., Malfliet, A., De Baets, L., Nijs, J., Goubert, D., Danneels, L., Moens, M., & Meeus, M. (2021). The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade. J Clin Med, 10(17). https://doi.org/10.3390/jcm10173836

Yabe, Y., Hagiwara, Y., Sekiguchi, T., Sugawara, Y., Tsuchiya, M., Yoshida, S., & Tsuji, I. (2022). Sleep disturbance is associated with neck pain: a 3-year longitudinal study after the Great East Japan Earthquake. BMC Musculoskelet Disord, 23(1), 459. https://doi.org/10.1186/s12891-022-05410-w

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Say Goodbye to Back Pain: Selecting the Perfect Mattress

What is the recommended way to choose a mattress for individuals with back pain?

Back Pain Mattress

When choosing a back pain mattress, one size does not fit all in selecting one for those with spine pain. Several other factors play a role, as well. However, whether a firm or soft mattress is the best option for individuals whose back pain keeps them up at night, most health experts say the choice is yours and that the mattress that makes you feel most comfortable is likely the best option. The research says that medium firmness seems to provide the most painless sleep. A review gathered information from 24 controlled trials where participants used soft, medium-firm, firm, or custom-inflated mattresses. The results showed that medium-firm and self-adjusted mattresses were best for sleep comfort, quality, and spinal alignment. (Radwan A. et al., 2015)

Medical Status

Selecting the back pain mattress best suited to your spinal condition is more than just how hard or soft the mattress is. Individuals and their healthcare providers should thoroughly review their medical history to tailor the mattress to their needs. Before purchasing a mattress, check the following:

  • Age
  • Medical history
  • Injuries current and past
  • Current diagnosis or diagnoses
  • Disease and/or Conditions
  • Sleeping preferences

For example, symptoms of spinal stenosis tend to present themselves when one is standing and walking but not when lying down. For this reason, mattress firmness is not a big issue only for people with spinal stenosis. However, it must be taken into consideration for those who have degeneration along with spinal stenosis.

Individuals with spinal arthritis without stenosis, disc problems, or non-specific back pain need to consider the relative firmness or softness of the back pain mattress. People with these conditions do better with more support, i.e., a firmer mattress. While everyone needs some back support when they sleep, those who have undergone multiple back surgeries often need less. The tissues have been altered and may be stiffer after several surgeries. In this case, a softer mattress may be more suitable and comfortable.

Mattress Age

Mattress springs break down over time, which makes the bed softer. This can aggravate the spine and back muscles. Based on this, investing in a new mattress makes sense, or pain and stiffness can worsen with the current one. While this will vary among individuals, medical research may help shed some light: A study measured the comfort and quality of sleep for 27 participants with low back pain and stiffness. The participants recorded their sleep comfort and quality in their beds for 21 days and then with a new prescribed mattress and bedding system, which they used for 12 weeks. The study found that the participants showed significant and progressive improvement in back pain and stiffness on the new mattresses and improved sleep quality significantly. (Jacobson B. H. et al., 2010)

Sleeping Position

The position usually slept in makes a difference in the support needed for the back pain mattress. Some recommendations for back sleepers, side and fetal position sleepers, and stomach sleepers:

Side Sleepers

  • Most people are side sleepers.
  • They sleep in the fetal position with their knees drawn up toward their chest.
  • This position tends to place pressure on the hips and shoulders.
  • For side and fetal sleepers, a slightly softer mattress is recommended.
  • The foam the mattress is made of conforms to the body, especially in the thoracic and lumbar regions of the spine.

Stomach Sleepers

  • For the stomach sleeper, soft mattresses can irritate the back.
  • A soft mattress encourages the abdomen to sink into the bed.
  • The resulting position is known to increase the arch in the lower back and cause pain.
  • A medium-firm surface is good for stomach sleepers.
  • The idea is to derive support from the chosen mattress without the abdominal sinking.
  • The sinking effect is amplified if you have a large abdomen.
  • For thin individuals, sinking may not be as much of an issue.

Back Sleepers

  • For support, place a thin, rolled towel or pillow under the knees and lower back of those who sleep on their backs.
  • A pillow/s under these areas will help support them and provide more comfort.

Researchers divided the participants according to their usual sleep position. They were assigned to a medium-firm mattress with foam and latex layering based on their preferred sleep position. The participants rated their sleep comfort and quality daily for three months. The researchers found that the new mattresses improved back pain and stiffness. For this reason, they concluded that sleep surfaces relate to sleep discomfort and that replacing a mattress with one uniquely suitable to your spinal condition can reduce and relieve pain. (Jacobson B. H. et al., 2010)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right back pain mattress ultimately comes down to personal preference. Individuals should try various mattresses and see which one they like best. 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. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Chiropractic Care Can Transform Pain Into Relief

References

Radwan, A., Fess, P., James, D., Murphy, J., Myers, J., Rooney, M., Taylor, J., & Torii, A. (2015). Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep health, 1(4), 257–267. https://doi.org/10.1016/j.sleh.2015.08.001

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. https://doi.org/10.1016/j.apergo.2010.05.004

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Deep Sleep Guaranteed: Discover the Benefits of Sleep Sounds

Can listening to sleep sounds help achieve and maintain healthy sleep patterns for individuals having trouble sleeping?

Sleep Sounds

Sleep sounds include white, pink, green, or brown noise, binaural beats, ASMR, nature, and ambient sounds. Each has different benefits and can potentially improve sleep. (Ebben M. R., Yan P., & Krieger A. C. 2021) Sound has no color, but it follows a spectrum. The color of a sound refers to the power spectrum of a particular noise signal. Each color has different qualities.

  • White noise, such as an untuned radio or television, is the most well-known background noise and is often used as a sleep aid.
  • Green noise features more powerful mid-range frequencies.
  • Brown noise is a more low-frequency rumble deeper than green and white noise.
  • Pink noise combines white noise softened by brown and could be the most effective option for improving sleep.

White noise is a sound that includes all the audible frequencies at equal volume, like a continuous hiss. One study found that adults fell asleep faster while listening to white noise. (Messineo L. et al., 2017)

Green noise, which features more powerful mid-range frequencies, is similar to natural sounds like ocean waves, rainfall, and rustling leaves. It’s more soothing than white noise and can help individuals with anxiety sleep better.

Brown noise, also known as red noise, has a deeper tone than white noise and is similar to the hum of an airplane. It can help mask lower-pitched sounds and may be especially helpful for individuals with ADHD, as it aids in productivity and concentration. Brown noise mimics sounds found in nature but with a low-frequency rumble. Examples include heavy rainfall, thunder, or loud waves.

Pink Noise

While further scientific research on sleep noise is needed, evidence has begun to suggest that pink noise may be the most effective option for improving sleep. (Ong J. L. et al., 2016) Pink noise is softer and more soothing than the other colored sleep sounds. It combines white noise softened by brown noise and is considered more relaxing because of its lower pitch. It has a pleasant-sounding, balanced volume across frequencies, making it calming to the human ear. Pink noise includes digital recreations of natural sounds such as a gently flowing stream, soft rain falling, wind rustling through trees, or calm waves lapping at the shore.

In a study, adults over 60 were given intermittent bursts of pink noise while sleeping, similar to rushing water. (Papalambros N. A. et al., 2017) The following morning, participants were given memory tests, which indicated that retention levels were approximately three times greater than those of the control group not exposed to the pink noise. Another study found that steady pink noise significantly reduced brain wave complexity during sleep while improving stable sleep time with less fragmentation and fewer wake periods. (Zhou, J. et al., 2012)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right sound for you ultimately comes down to personal preference. Individuals can try each color and see which one they like best. 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.

Beyond Medicine: The Power of Chiropractic Care

References

Ebben, M. R., Yan, P., & Krieger, A. C. (2021). The effects of white noise on sleep and duration in individuals living in a high noise environment in New York City. Sleep medicine, 83, 256–259. https://doi.org/10.1016/j.sleep.2021.03.031

Messineo, L., Taranto-Montemurro, L., Sands, S. A., Oliveira Marques, M. D., Azabarzin, A., & Wellman, D. A. (2017). Broadband Sound Administration Improves Sleep Onset Latency in Healthy Subjects in a Model of Transient Insomnia. Frontiers in neurology, 8, 718. https://doi.org/10.3389/fneur.2017.00718

Ong, J. L., Lo, J. C., Chee, N. I., Santostasi, G., Paller, K. A., Zee, P. C., & Chee, M. W. (2016). Effects of phase-locked acoustic stimulation during a nap on EEG spectra and declarative memory consolidation. Sleep medicine, 20, 88–97. https://doi.org/10.1016/j.sleep.2015.10.016

Papalambros, N. A., Santostasi, G., Malkani, R. G., Braun, R., Weintraub, S., Paller, K. A., & Zee, P. C. (2017). Acoustic Enhancement of Sleep Slow Oscillations and Concomitant Memory Improvement in Older Adults. Frontiers in human neuroscience, 11, 109. https://doi.org/10.3389/fnhum.2017.00109

Zhou, J., Liu, D., Li, X., Ma, J., Zhang, J., & Fang, J. (2012). Pink noise: effect on complexity synchronization of brain activity and sleep consolidation. Journal of theoretical biology, 306, 68–72. https://doi.org/10.1016/j.jtbi.2012.04.006

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Understanding the Relationship Between Eating Habits and Insomnia

Insomnia is a condition with causes that vary from person to person and can be a result of stress, caffeine, and excessive screen time. Can modifying eating habits help reduce episodes and improve sleep patterns?

Eating Habits and Insomnia

Insomnia is a common sleep disorder characterized by persistent difficulty falling asleep, staying asleep, and/or both. Individuals often experience daytime sleepiness, mood disturbances, or cognitive impairments. There are two types:

  • Primary insomnia, which is not linked to other health conditions.
  • Secondary insomnia is associated with other health issues like asthma, depression, or heartburn. (National Library of Medicine, 2024)

While there are various causes of insomnia, researchers have recently learned more about its impact on eating habits. New data has found that an individual’s dietary pattern may impact sleep habits. (Gan Z. H. et al., 2024)

Risk Factors

Chronic insomnia is linked to negative health outcomes, including an increased risk of high blood pressure, diabetes, obesity, depression, heart attack, and stroke. (Chalet F. X. et al., 2023) (Marie-Pierre St-Onge et al., 2016) Researchers recruited over five thousand participants who did not have insomnia and evaluated their eating habits and insomnia incidence. (Gan Z. H. et al., 2024) Results showed that 464 of the participants developed insomnia, and of those, the risk was lower in vegetarians than those who ate more meat. Males who followed a more plant-based diet had a reduced incidence of insomnia; however, this relationship was not seen among females. The research suggests that a diet with more vegetables may positively affect sleep. Many plant-based foods are rich sources of sleep-supporting compounds, such as melatonin. Treating and preventing insomnia is important for restoring health and daily functioning.

Past nutritional data highlights the relationship between healthy sleep and a diet rich in fruits, vegetables, legumes, and other sources of tryptophan and melatonin. (Zuraikat F. M. et al., 2021) Prior research also shows how vegetarian diets can help reduce chronic inflammation, positively impacting sleep. (Dzierzewski J. M. et al., 2020) Specifically, the Mediterranean diet, known for its anti-inflammatory effects, is linked to improved sleep and reduced insomnia. (Zaidalkilani A. T. et al., 2021) Also, data links a vegetarian diet to improved mood, which might enhance the quality of sleep by moderating mental health, including depression condition. (Wang X. et al., 2023)

Support Quality Sleep

According to dieticians, looking at an individual’s eating habits during the day is crucial in determining why they can’t sleep at night. Often, making a few small dietary adjustments is enough to help with better sleep. Some steps to try include:

  • Increase magnesium by adding more leafy greens, nuts, and seeds.
  • Incorporating melatonin-rich foods like walnuts rather than relying on melatonin supplements.
  • Easing off caffeine, alcohol, and refined carbohydrates can help improve sleep quality.

Dietary changes should not be the only way to combat insomnia. Cognitive behavioral therapy (CBT-I) is a recommended first-line treatment rather than sleeping medications, along with learning healthy sleep habits and using the right mattress. This therapy can help improve sleep habits and behaviors by rethinking sleep and current practices that could affect an individual’s ability to sleep well. Combining CBT-I with a healthy diet and regular physical activity can significantly impact overall health and sleep patterns.

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 avoid deprivation side effects and restore health. 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 heal.

Revolutionizing Healthcare

References

National Library of Medicine: MedlinePlus. (2024). Insomnia. Retrieved from https://medlineplus.gov/insomnia.html

Gan, Z. H., Chiu, T. H. T., Lin, C. L., Lin, M. N., & Kuo, P. H. (2024). Plant-based dietary patterns and risk of insomnia: a prospective study. European journal of clinical nutrition, 78(3), 228–235. https://doi.org/10.1038/s41430-023-01380-x

Chalet, F. X., Saskin, P., Ahuja, A., Thompson, J., Olopoenia, A., Modi, K., Morin, C. M., & Wickwire, E. M. (2023). The Associations between Insomnia Severity and Health Outcomes in the United States. Journal of clinical medicine, 12(6), 2438. https://doi.org/10.3390/jcm12062438

St-Onge, M. P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., Bhatt, D. L., & American Heart Association Obesity, Behavior Change, Diabetes, and Nutrition Committees of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council (2016). Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation, 134(18), e367–e386. https://doi.org/10.1161/CIR.0000000000000444

Zuraikat, F. M., Wood, R. A., Barragán, R., & St-Onge, M. P. (2021). Sleep and Diet: Mounting Evidence of a Cyclical Relationship. Annual review of nutrition, 41, 309–332. https://doi.org/10.1146/annurev-nutr-120420-021719

Dzierzewski, J. M., Donovan, E. K., Kay, D. B., Sannes, T. S., & Bradbrook, K. E. (2020). Sleep Inconsistency and Markers of Inflammation. Frontiers in neurology, 11, 1042. https://doi.org/10.3389/fneur.2020.01042

Zaidalkilani, A. T., Alhaj, O. A., Serag El-Dine, M. F., Fekih-Romdhane, F., AlRasheed, M. M., Jahrami, H. A., & Bragazzi, N. L. (2021). Arab Women Adherence to the Mediterranean Diet and Insomnia. Medicina (Kaunas, Lithuania), 58(1), 17. https://doi.org/10.3390/medicina58010017

Wang, X., Song, F., Wang, B., Qu, L., Yu, Z., & Shen, X. (2023). Vegetarians have an indirect positive effect on sleep quality through depression condition. Scientific reports, 13(1), 7210. https://doi.org/10.1038/s41598-023-33912-7

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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