By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Physio, Therapy attorneys, car crashes, chiropractic care, compression, indirect damage, medical, motor vehicle accidents, MVA's, nerve injuries, nurse practitioner, personal injury, physical therapy, spinal decompression

Treatment of Nerve Injuries Resulting from Automobile Accidents

Nerve Injuries from Car Accidents: Causes, Treatment, and Dr. Alexander Jimenez’s Expertise

Introduction

Car accidents happen in an instant, but their effects can last a lifetime. Among the many injuries sustained in motor vehicle accidents (MVAs), nerve injuries are particularly common and can significantly impact daily life. Research suggests that over 25% of nerve injury cases result from car and truck accidents, with motorcycle crashes contributing to 32.5% of peripheral nerve injuries (Miller & Zois, 2024). These injuries often lead to peripheral neuropathy, a condition where nerves outside the brain and spinal cord are damaged, causing symptoms like pain, numbness, and weakness. In El Paso, TX, Dr. Alexander Jimenez, a chiropractor and board-certified nurse practitioner, stands out as a leading clinician helping victims recover from such injuries while supporting their personal injury cases. This comprehensive guide explores the medical causes of nerve injuries, their role in peripheral neuropathy, and how Dr. Jimenez’s unique approach aids recovery and legal processes.

References

Miller & Zois. (2024). Nerve injuries in auto accident lawsuits. Retrieved from Miller & Zois

Understanding Nerve Injuries

Nerves are the body’s communication network, transmitting signals between the brain, spinal cord, and other parts. Injuries to the nerves can disrupt this communication, leading to a range of symptoms. Nerve injuries from MVAs typically fall into three categories:

Compression: Nerves are pinched or pressed, often by swollen tissues or misaligned bones.
Stretching: Nerves are overstretched, as seen in whiplash injuries.
Severing: Nerves are partially or completely cut, often from severe trauma.

Peripheral neuropathy occurs when peripheral nerves—those outside the brain and spinal cord—are damaged. This condition can affect motor nerves (controlling movement), sensory nerves (responsible for sensation), or autonomic nerves (managing involuntary functions like heart rate). Symptoms vary depending on the nerve type affected, but common signs include pain, tingling, numbness, and weakness (Mayo Clinic, 2024).

Types of Nerve Injuries

Type	Description	Common Symptoms
Compression	The nerve is overstretched without tearing	The nerve is pinched by surrounding tissues
Stretching	Nerve is overstretched without tearing	Burning sensation, weakness
Severing	Numbness, tingling, and sharp pain	Loss of function, severe pain, paralysis

References

Mayo Clinic. (2024). Peripheral nerve injuries: Symptoms and causes. Retrieved from Mayo Clinic

Causes of Nerve Injuries in MVAs

Car accidents subject the body to sudden, violent forces that can damage nerves in various ways. The following are the primary causes of nerve injuries in MVAs:

Whiplash

Whiplash, one of the most common MVA injuries, occurs when the head and neck are jerked forward and backward rapidly. This motion can overstretch nerves in the neck and shoulders, leading to inflammation and compression. Whiplash is a significant contributor to nerve injuries, often causing symptoms like neck pain, tingling in the arms, and headaches (AICA Orthopedics, 2021).

Direct Trauma

The impact of a car accident can cause direct trauma to nerves. For example, hitting a steering wheel or being struck by debris can crush or sever nerves. Blunt force trauma is a leading cause of nerve damage, particularly in high-impact collisions (Singleton Schreiber).

Secondary Injuries

After an accident, swelling, inflammation, or scar tissue can compress nerves, leading to delayed symptoms. Herniated discs or spinal misalignments can also exert pressure on nerve roots, leading to radiculopathy, a related condition characterized by nerve root irritation (Fletcher Law Office, 2023).

Common MVA Scenarios Leading to Nerve Injuries

Scenario	Mechanism of Injury	Potential Nerve Damage
Rear-end collision	Whiplash from sudden neck movement	Cervical nerve stretching
Head-on collision	Blunt force trauma to chest or limbs	Peripheral nerve compression
Rollover accident	Blunt force trauma to the chest or limbs	Severe nerve severing or compression

References

AICA Orthopedics. (2021). Can you get nerve damage from a car accident? Retrieved from AICA Orthopedics
Singleton Schreiber. (n.d.). Nerve damage from car accidents in California. Retrieved from Singleton Schreiber
Fletcher Law Office. (2023). What is radiculopathy vs. neuropathy from a Texas car accident? Retrieved from Fletcher Law Office

Symptoms of Nerve Injuries

Nerve injuries present a wide range of symptoms, depending on the type and severity of the damage. Recognizing these signs early is crucial for seeking timely treatment.

Motor Nerve Damage

Motor nerves control muscle movement. Damage can lead to:

Muscle weakness or difficulty with tasks like gripping or walking.
Loss of coordination or balance.
In severe cases, paralysis (HM Attorneys, 2022).

Sensory Nerve Damage

Sensory nerves are responsible for detecting sensations such as touch, temperature, and pain. Symptoms include:

Numbness or tingling, often described as “pins and needles.”
Sharp, burning, or shooting pain radiating along nerve pathways.
Hypersensitivity to touch or temperature changes (Bensinger Legal).

Autonomic Nerve Damage

Autonomic nerves regulate involuntary functions. Damage may cause:

Irregular heart rate or blood pressure.
Digestive issues, such as nausea or constipation.
Excessive sweating or inability to sweat (The Russo Firm).

Common Symptoms by Nerve Type

Nerve Type	Symptoms
Motor	Weakness, coordination loss, paralysis
Sensory	Numbness, tingling, burning pain, hypersensitivity
Autonomic	Heart rate changes, digestive issues, sweating abnormalities

Delayed Symptoms

Some nerve injuries may not be immediately apparent. Swelling or scar tissue can develop days or weeks after an accident, leading to symptoms that worsen over time. This underscores the importance of medical evaluation even if you feel fine initially (Houston Pain Specialists).

References

HM Attorneys. (2022). Can a car accident cause nerve damage? Retrieved from HM Attorneys
Bensinger Legal. (n.d.). Signs of nerve damage after a car accident. Retrieved from Bensinger Legal
The Russo Firm. (n.d.). Neurological issues caused by car accidents. Retrieved from The Russo Firm
Houston Pain Specialists. (n.d.). Why some auto accident injuries lead to chronic nerve pain. Retrieved from Houston Pain Specialists

Diagnosis of Nerve Injuries

Accurate diagnosis is essential for effective treatment. Doctors use a combination of physical examinations, imaging techniques, and specialized tests to diagnose nerve injuries.

Physical Examination

A doctor will:

Test reflexes using a reflex hammer to check for hyporeflexia (reduced reflexes) or hyperreflexia (overactive reflexes).
Assess sensation using tools such as a pinprick or cotton swab to detect sensory abnormalities.
Evaluate muscle strength and coordination (Spine Universe, 2018).

Diagnostic Imaging

Imaging helps identify structural issues causing nerve compression.

X-rays: Detect bone fractures or misalignments.
MRI: Shows soft tissue damage, such as herniated discs or nerve compression.
CT Scans: Provide detailed views of bones and tissues (Dr. Alex Jimenez, 2018).

Nerve Conduction Studies

These tests measure how well nerves transmit electrical signals, helping pinpoint the location and extent of damage. Electromyography (EMG) may be used alongside to assess muscle response.

Diagnostic Methods

Method	Purpose
Physical Exam	Assess reflexes, sensation, and strength
X-ray	Identify bone fractures or misalignments
MRI	Detect soft tissue and nerve compression
Nerve Conduction Study	Measure nerve signal transmission

References

Spine Universe. (2018). Neurological exams: Sensory nerves and deep tendon reflexes. Retrieved from Spine Universe
Dr. Alex Jimenez. (2018). The abdomen: Diagnostic imaging approach. Retrieved from Dr. Alex Jimenez

Treatment Options

Treatment for nerve injuries aims to alleviate symptoms, promote healing, and prevent the development of chronic conditions. Options range from non-invasive therapies to surgical interventions.

Chiropractic Care

Chiropractic adjustments realign the spine and joints, reducing nerve compression. This approach is effective for whiplash, pinched nerves, and herniated discs. Chiropractors also provide soft tissue therapy to reduce inflammation (PrimeCare Chiropractic).

Physical Therapy

Targeted exercises and stretches improve mobility, strengthen muscles, and reduce nerve pressure. For optimal results, Houston Pain Specialists often combine physical therapy with chiropractic care.

Medication

Medications may include:

Anti-inflammatory drugs are used to reduce swelling.
Nerve pain medications, such as gabapentin.
Muscle relaxants are used to alleviate spasms.

Surgery

Surgery may be necessary in severe cases to repair severed nerves or relieve compression from herniated discs or fractures. Surgery is typically considered a last resort (Dolman Law, 2022).

Treatment Options Overview

Treatment	Description	Best For
Chiropractic Care	Spinal adjustments, soft tissue therapy	Whiplash, pinched nerves
Physical Therapy	Exercises to improve mobility and strength	Muscle weakness, mobility issues
Medication	Pain relief and inflammation reduction	Acute pain, inflammation
Surgery	Repair severe nerve damage or compression	Severed nerves, severe compression

References

PrimeCare Chiropractic. (n.d.). Chiropractic care for personal injury recovery. Retrieved from PrimeCare Chiropractic
Houston Pain Specialists. (n.d.). Why some auto accident injuries lead to chronic nerve pain. Retrieved from Houston Pain Specialists
Dolman Law. (2022). Neurological issues from a car accident. Retrieved from Dolman Law

The Role of Chiropractic Care in Recovery

Chiropractic care plays a vital role in recovering from MVA-related nerve injuries. By addressing spinal misalignments and reducing nerve pressure, chiropractors help restore function and alleviate pain.

Benefits of Chiropractic Care

Pain Relief: Adjustments reduce nerve compression, easing pain without relying heavily on medications.
Improved Mobility: Realigning the spine enhances range of motion, aiding daily activities.
Non-Invasive: Chiropractic care avoids surgery, making it a safer option for many patients (Aventura Wellness, 2023).

Supporting Personal Injury Claims

Chiropractors provide detailed documentation of injuries, treatment plans, and progress, which is crucial for personal injury lawsuits. This evidence links the accident to the injury, supporting compensation claims. Chiropractors may also testify in court to explain the extent of injuries (Comfort Rehab, 2024).

Early Intervention

Seeking chiropractic care soon after an accident can prevent chronic conditions. Delayed treatment may allow scar tissue or inflammation to worsen nerve damage, leading to persistent pain (Hensley Legal, 2024).

References

Aventura Wellness. (2023). The role of chiropractic care in personal injury recovery. Retrieved from Aventura Wellness
Comfort Rehab. (2024). Role of chiropractic in personal injury lawsuits. Retrieved from Comfort Rehab
Hensley Legal. (2024). Can a personal injury chiropractor help your case? Retrieved from Hensley Legal

Dr. Alexander Jimenez: A Leading Expert in El Paso

In El Paso, TX, Dr. Alexander Jimenez is a prominent clinician for MVA victims, offering a unique blend of chiropractic and medical expertise. With over 25 years of experience, he leads Injury Medical & Chiropractic Clinic, specializing in injury rehabilitation, functional medicine, and personal injury care (A4M, n.d.).

Background and Credentials

Dr. Jimenez holds dual licensure as a Doctor of Chiropractic (DC) and a board-certified Family Nurse Practitioner (FNP-BC). He is also certified in functional medicine, allowing him to address both biomechanical and systemic health issues. His education includes training from the National University of Health Sciences, and he has been recognized as a top-rated chiropractor in El Paso from 2015 to 2024 (Healthgrades).

Clinical Approach

Dr. Jimenez employs a comprehensive approach to treat nerve injuries:

Advanced Diagnostics: He utilizes imaging techniques (X-rays, MRIs) and the Living Matrix Functional Medicine Assessment to pinpoint the underlying causes of nerve damage (Dr. Alex Jimenez, 2025).
Dual-Scope Interventions: Combining chiropractic adjustments with medical management, he addresses both structural and physiological aspects of injuries.
Each patient receives a personalized treatment plan that prioritizes pain relief, mobility recovery, and long-term wellness.

Role in Personal Injury Cases

Dr. Jimenez acts as an intermediary between medical care and legal processes. His clinic provides detailed medical records, diagnostic imaging results, and treatment summaries that support personal injury claims. These documents help establish the link between the accident and the injury, which is crucial for securing compensation. His expertise also allows him to collaborate with attorneys, providing expert testimony when needed (Dr. Alex Jimenez, 2017).

Community Impact

Dr. Jimenez’s commitment to El Paso extends beyond his clinic. He engages in community outreach, such as the “Tell A Veteran” program, offering chiropractic care to disabled veterans. His Health Voice 360 Podcast educates the public on various health issues, including nerve injuries and recovery, as well as other related topics (LinkedIn).

Why Choose Dr. Jimenez?

Feature	Benefit
Dual Licensure	Combines chiropractic and medical expertise
Advanced Diagnostics	Pinpoints injury causes with precision
Legal Support	Provides documentation for personal injury claims
Holistic Approach	Addresses physical, nutritional, and emotional health

References

A4M. (n.d.). Dr. Alex Jimenez: Injury Medical & Chiropractic Clinic. Retrieved from A4M
Healthgrades. (n.d.). Dr. Alexander Jimenez, DC. Retrieved from Healthgrades
Dr. Alex Jimenez. (2025). Why choose Dr. Jimenez and clinical team. Retrieved from Dr. Alex Jimenez
Dr. Alex Jimenez. (2017). Personal injury doctor. Retrieved from Dr. Alex Jimenez
LinkedIn. (n.d.). Dr. Alexander Jimenez’s profile. Retrieved from LinkedIn

Conclusion

Nerve injuries from car accidents, including compression injuries and whiplash, can lead to peripheral neuropathy, causing significant physical and emotional challenges. Early diagnosis and treatment are critical to prevent chronic pain and restore quality of life. Dr. Alexander Jimenez, located in El Paso, TX, provides MVA victims with hope by integrating advanced diagnostics, chiropractic care, and functional medicine to facilitate their recovery. His role in personal injury cases ensures patients receive both medical care and legal support, helping them navigate the aftermath of an accident. If you’ve been in a car accident, don’t wait for symptoms to worsen—seek expert care to start your journey to healing.

References

June 2, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Athletes, Chiropractic Care, El Paso TX, Sporting acupuncture, bunion, chiropractic, Clinic, condition, decompression, foot, health, Injury, massage, medical, MET, misalignment, nutrition, pain, swelling, wellness

Bunions Management: Relief and Care Strategies

What is the most effective method for managing the initial symptoms of bunions?

Bunions

A bunion, which is also known as hallux valgus, is a bony bump that is frequently excruciating and located on the side of the big toe. A misalignment of the big toe is the most prevalent cause of bunions. Redness, edema, tenderness, and thickened skin around the big toe joint are early indications of bunions. Although it is impossible to halt the progression of a bunion, it is possible to alleviate its symptoms as it progresses. Pain management strategies and various treatment options are among the early indications of bunions. (MedlinePlus, 2024)

Visual Signs of Early Symptoms

Bunions initially develop slowly and do not cause significant discomfort right away. When a bunion first begins to form, you can notice the following symptoms around your metatarsophalangeal (MTP) joint, which joins the base of your big toe to the remainder of your foot. (American Academy of Orthopaedic Surgeons, 2022)

Erythema
Edema Hyperpigmentation
Hyperkeratotic skin
A bony protrusion exists
Prominence where the hallux deviates towards the second digit or even beneath it
Calluses and corns

Initial Somatic Indicators

Although bunions may not be immediately apparent, they can still cause discomfort in the early stages. The following are some of the initial physical indicators of a developing bunion: (MedlinePlus, 2024)

Pain in the foot and big toe
This discomfort is especially evident during ambulation or when donning constrictive, pointed footwear.
Decreased movement of the big toe
Tenderness
Inflammation
Swelling
Stiffness
Heat

Stages

Bunions are typically progressive, meaning they tend to deteriorate over time. Failure to implement preventive measures for your bunions may result in consequences. Subsequent symptoms often accompany advanced-stage bunions. (American Academy of Orthopaedic Surgeons, 2022)

Persistent, intense pain in and around the metatarsophalangeal joint and the lateral and plantar aspects of the foot
Bursitis results in the formation of a fluid-filled cyst near the base of the big toe.
Hallux adducting and maybe overlapping the second toe
Excessive osseous proliferation along the lateral aspect of the hallux
Inability to accommodate your standard footwear
Impediment in ambulation
Hammertoe abnormalities occur when the second, third, or fourth toes exhibit an upward bend at the middle joint, like a hammer or claw.
Hallux rigidus, a kind of arthritis affecting the big toe

Halt the Advancement

Once bunions have begun to form, they will become irreversible. Nevertheless, some methods exist to prevent their exacerbation or the onset of additional issues. These encompass (American Academy of Orthopaedic Surgeons, 2022)

Refraining from wearing improperly fitting footwear and elevated heels
Utilizing orthopedic footwear and/or broad, comfy, soft-soled, and low-heeled shoes
Inserting spacers between the toes to avert friction and irritation
Applying over-the-counter (OTC) pads composed of felt, silicone, or foam to the bunion
Extending your calf muscles to enhance joint alignment

Analgesic Administration

Ice packs and non-steroidal anti-inflammatory medicines (NSAIDs), such as Advil or Motrin (ibuprofen), may alleviate bunion discomfort. Research indicates that Botox injections into the forefoot muscles may offer analgesic benefits. (Hurn, S. E., et al., 2022)

Non-invasive Therapy in Initial Phases

If your bunions continue to deteriorate despite using the aforementioned self-care measures, you may need to seek intervention from a podiatrist or another healthcare professional. A healthcare professional may advise

Foot orthoses, commonly referred to as orthotics

Orthoses, also known as foot orthoses, are specially designed implants that alleviate bunion-associated pain and prevent chafing.

Splints

Bunion splints, commonly used at night, are orthotic devices designed to help realign the toes. (Aebischer, A. S., & Duff, S. 2020)

Physical Therapy

A physical therapist can assist you by offering exercises to enhance the alignment of your feet and joints. They may further administer manual treatment to alleviate pain. (Hurn, S. E., et al., 2022)

Podiatrist

A podiatrist is a medical doctor (M.D.) specializing in the treatment of health issues affecting the foot, ankles, and lower legs. Request a referral to a podiatrist from your healthcare physician if you seek assistance in managing your bunion problems. (American Podiatric Medical Association, 2025)

Chiropractic Perspective

Chiropractors focus on biomechanical alignment and musculoskeletal health, viewing bunions as part of a broader kinetic chain dysfunction. Their approach emphasizes manual therapies and functional restoration.

Biomechanical Assessment:
- Evaluate foot, ankle, knee, hip, and spinal alignment to identify compensatory patterns contributing to bunion formation (e.g., overpronation, pelvic misalignment).
- Assess gait and foot mechanics to identify areas of abnormal stress on the big toe joint.
Chiropractic Interventions:
- Adjustments: Perform gentle manipulations to the foot and ankle (e.g., metatarsal or tarsal adjustments) to improve joint mobility and reduce stress on the bunion. Spinal or pelvic adjustments may address upstream biomechanical issues.
- Soft Tissue Therapy: Utilize techniques such as myofascial release or instrument-assisted soft tissue mobilization to reduce tension in the foot’s muscles and fascia, thereby improving circulation and flexibility.
- Taping: Apply kinesiology tape to support the big toe and reduce strain during movement.
Corrective Exercises:
- Prescribe exercises to strengthen intrinsic foot muscles and improve toe alignment, such as:
  - Toe spreading: Actively spread toes apart to strengthen the abductor hallucis.
  - Arch strengthening: Perform short foot exercises to support the medial longitudinal arch.
  - Calf stretches: Address tight Achilles tendons that contribute to foot strain.
- Recommend balance and proprioception exercises (e.g., standing on one leg) to improve overall foot stability.
Orthotic and Footwear Guidance:
- Fit patients with custom orthotics to correct overpronation or supination, which can exacerbate bunions.
- Advise on minimalist or wide-toe-box shoes to promote natural foot mechanics, aligning with chiropractic principles of functional movement.
Holistic Approach:
- Address lifestyle factors, such as posture and ergonomics, that affect lower extremity alignment.
- Educate on anti-inflammatory diets (e.g., rich in omega-3 fatty acids, low in processed sugars) to help reduce joint inflammation.

Nurse Practitioner Perspective

NPs focus on holistic patient care, symptom management, and coordinating multidisciplinary treatment. Their approach to bunions focuses on pain relief, slowing the progression, and providing patient education.

Assessment and Diagnosis:
- Conduct a thorough history and physical exam to evaluate bunion severity, pain level, and contributing factors (e.g., footwear, family history, arthritis).
- Order imaging (X-rays) if needed to assess joint alignment and rule out complications like osteoarthritis or bone spurs.
- Screen for systemic conditions (e.g., rheumatoid arthritis, gout) that may worsen bunions.
Conservative Management:
- Footwear Education: Recommend wide-toe-box shoes with low heels to reduce pressure on the bunion. Avoid high heels and narrow shoes.
- Orthotics: Prescribe custom or over-the-counter orthotic inserts to support the arch, redistribute pressure, and correct foot mechanics.
- Padding and Splinting: Suggest bunion pads or spacers to cushion the area and reduce friction. Night splints may help align the toe, though evidence for their effectiveness is mixed.
- Pain Relief: Advise over-the-counter NSAIDs (e.g., ibuprofen) for pain and inflammation, ensuring proper dosing and monitoring for side effects. For severe cases, refer to a specialist for corticosteroid injections.
- Physical Therapy: Refer to a physical therapist for exercises to strengthen foot muscles, improve flexibility, and enhance gait. Examples include toe stretches, towel curls, and marble pickups.
Patient Education:
- Educate on weight management to reduce stress on the feet.
- Discuss lifestyle changes, such as avoiding prolonged standing or high-impact activities that worsen symptoms.
- Highlight the progressive nature of bunions and the importance of early intervention.
Referral and Coordination:
- Refer to a podiatrist or orthopedic surgeon if conservative measures fail or if the bunion causes significant pain, deformity, or functional impairment.
- Collaborate with chiropractors, physical therapists, or other specialists for a comprehensive care plan.

Both NPs and chiropractors emphasize:

Early Intervention: Addressing bunions early can prevent the worsening of deformity.
Footwear Modification: Wearing wide, supportive shoes is critical to reducing pressure.
Exercise and Mobility: Strengthening and stretching exercises improve foot function.
Pain Management: Non-invasive methods, such as padding, icing, or non-steroidal anti-inflammatory drugs (NSAIDs), are the first-line approach.
Referral for Surgery: If conservative measures prove ineffective, a specialist may be consulted for surgical options, such as bunionectomy, although this is typically considered a last resort.

Limitations and Considerations

Evidence Gaps: While orthotics and exercises are widely recommended, studies on their efficacy for bunions are limited. Splints may not correct severe deformities.
Individual Variation: Treatment must be tailored to the patient’s bunion severity, lifestyle, and comorbidities.
Surgical Indications: Severe pain, joint damage, or inability to walk may necessitate surgical consultation, which neither NPs nor chiropractors are qualified to perform.

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a nurse practitioner, integrates medical expertise with chiropractic care to address a wide range of conditions. The clinic provides individualized care programs that incorporate functional medicine, acupuncture, electroacupuncture, and sports medicine. The clinic addresses chronic pain syndromes and injuries by prioritizing strength, agility, and flexibility. Comprehensive care programs, combined with in-person and virtual health coaching, ensure personalized treatment and wellness outcomes for patients of all ages and abilities.

Enhance Your Performance with Functional Foot Orthotics

References

MedlinePlus (2024). Bunions. U.S. Department of Health and Human Services.

American Academy of Orthopaedic Surgeons. (2022). “Bunions.” OrthoInfo. from https://orthoinfo.aaos.org/en/diseases–conditions/bunions/.

Hurn, S. E., Matthews, B. G., Munteanu, S. E., & Menz, H. B. (2022). Effectiveness of Nonsurgical Interventions for Hallux Valgus: A Systematic Review and Meta-Analysis. Arthritis care & research, 74(10), 1676–1688. https://doi.org/10.1002/acr.24603

Aebischer, A. S., & Duff, S. (2020). Bunions: A review of management. Australian Journal of General Practice, 49(11), 720–723. https://doi.org/10.31128/AJGP-07-20-5541

American Podiatric Medical Association. (2025). “What is a podiatrist?” Advancing foot and ankle medicine and surgery. from https://www.apma.org/patients-and-the-public/what-is-a-podiatrist/.

May 21, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Exercises, Therapy acupuncture, chiropractic, Clinic, coaching, decompression, dementia, exercise, health, Injury, massage, medical, nutrition, regular, rehabilitation, wellness, workouts

Exercise and Dementia: Key to Cognitive Health

To what extent can regular exercise contribute to the overall health of elderly individuals and reduce the likelihood of developing dementia?

Exercise and Dementia: Improving Brain Function

Dementia Prevention and Exercise

Dementia is a term that refers to various diseases that impede memory and cognition, and it is presently the seventh most common cause of death worldwide. (World Health Organization, 2025) Approximately 10 million new cases of dementia are diagnosed annually on a global scale. (Yoon J.H. et al., 2023) A study investigating the correlation between insulin and exercise in the brain discovered that consistent physical activity may enhance brain function and reduce the likelihood of developing dementia. Researchers have discovered that factors such as.

High blood pressure
High blood sugar
Age
The risk of developing dementia is increased. (World Health Organization, 2025)

Exercise and stretching are necessary. Muscle rigidity impairs insulin’s ability to work in those who don’t exercise. The body enhances insulin sensitivity by contracting and releasing those muscles in response to movement. Dementia prevention efforts might benefit from identifying mechanisms that lower insulin resistance.

Physical Activity and Reduced Risk

After observing 21 older individuals with prediabetes for two weeks, the researchers discovered that physical activity assists the brain in regulating insulin, directly improving cognitive function. Under supervision, they completed twelve exercise sessions that ranged from moderate to high intensity. (Malin S. K. et al., 2025)

The findings show a notable rise in the number of extracellular vesicles produced from the brain that contain insulin-related proteins.
These micro-messengers ensure that neurons can communicate with one another and play an essential part in maintaining the brain.
AKT (also known as protein kinase B or PKB) comprises three specific protein kinases that are important for many body functions, such as keeping cells alive, helping them grow, managing metabolism, and controlling the cell cycle.
The protein is considered a significant factor in insulin signaling and has ramifications for neuronal cell growth and health.
Inadequate insulin response may contribute to dementia. Hence, it is noteworthy that exercise could mitigate this by potentially enhancing insulin signaling.

Although further investigation is necessary, these results underscore that physical activity may be an accessible, cost-effective method to promote long-term cognitive health. In the subsequent phase of the investigation, researchers will employ an insulin spray and MRIs to gain further insight into insulin’s impact on brain activity. They will analyze cerebral blood circulation before and during the administration of the insulin spray to elucidate its effects.

Insulin, Exercise, and Brain Health

Insulin is a hormone synthesized by the pancreas that regulates blood glucose levels. Nonetheless, insulin’s significance in cerebral health is equally crucial. The brain’s abundance of insulin receptors facilitates neuronal communication, enhances synaptic connections upon insulin binding, and promotes memory and learning. (Gray, S. M., Meijer, R. I., & Barrett, E. J. 2014)

Impaired insulin signaling, as observed in situations such as type 2 diabetes, renders the brain more susceptible to cognitive deterioration. (Yoon J.H. et al., 2023) Research indicates that insulin resistance plays a role in the accumulation of amyloid-beta plaques and tau tangles, which are fundamental features of Alzheimer’s disease. (Hong, S., Han, K., & Park, C. Y. 2021) Enhancing insulin sensitivity may mitigate or avert these cerebral alterations. Aerobic exercise positively influences total brain health. Prior research has demonstrated that physical activity improves or sustains adult cognitive function and memory. (Rosenberg A. et al., 2020) Other ways to increase brain health include

Staying socially engaged
Challenging the mind
Getting plenty of sleep
Managing Stress
Healthy diet
Staying physically active
Diabetes management
Blood pressure management

The future of dementia prevention will likely entail a synthesis of lifestyle modifications, including physical activity and pharmacological treatments, to achieve the most significant impact. Consistent physical activity may substantially diminish the likelihood of dementia in adults with prediabetes or diabetes and support normal cognitive function.

Clinic for Chiropractic Care and Functional Medicine

Family Practice Nurse Practitioner Dr. Jimenez integrates sophisticated medical proficiency with chiropractic treatment to manage diverse illnesses. Our clinic combines Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to develop tailored care plans that enhance natural healing, mobility, and sustained wellness. By emphasizing flexibility, agility, and strength, we enable patients to flourish, irrespective of age or health obstacles. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we dedicate ourselves to treating individuals recovering from injuries and chronic pain disorders. We enhance your capabilities through flexibility, mobility, and agility programs customized for various age demographics and disabilities. We employ in-person and virtual health coaching and comprehensive care plans to guarantee tailored care and optimal wellness outcomes for each patient.

Is Motion Key to Healing?

References

World Health Organization. (2025). “Dementia.” World Health Organization. from https://www.who.int/news-room/fact sheets/detail/dementia#:~:text=Alzheimer%20disease%20is%20the%20most,60%E2%80%9370%25%20of%20cases.

Yoon, J. H., Hwang, J., Son, S. U., Choi, J., You, S. W., Park, H., Cha, S. Y., & Maeng, S. (2023). How Can Insulin Resistance Cause Alzheimer’s Disease?. International Journal of Molecular Sciences, 24(4), 3506. https://doi.org/10.3390/ijms24043506

Malin, S. K., Battillo, D. J., Beeri, M. S., Mustapic, M., Delgado-Peraza, F., & Kapogiannis, D. (2025). Two weeks of exercise alters neuronal extracellular vesicle insulin signaling proteins and pro-BDNF in older adults with prediabetes. Aging cell, 24(1), e14369. https://doi.org/10.1111/acel.14369

Gray, S. M., Meijer, R. I., & Barrett, E. J. (2014). Insulin regulates brain function, but how does it get there?. Diabetes, 63(12), 3992–3997. https://doi.org/10.2337/db14-0340

Hong, S., Han, K., & Park, C. Y. (2021). The insulin resistance by triglyceride glucose index and risk for dementia: population-based study. Alzheimer’s research & therapy, 13(1), 9. https://doi.org/10.1186/s13195-020-00758-4

Rosenberg, A., Mangialasche, F., Ngandu, T., Solomon, A., & Kivipelto, M. (2020). Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer’s Disease, and Dementia: From FINGER to World-Wide FINGERS. The Journal of Prevention of Alzheimer’s disease, 7(1), 29–36. https://doi.org/10.14283/jpad.2019.41

May 21, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, El Paso TX, Work Injury accident doctor, accident physician, accident specialist, car accident trauma specialist, chiropractic, Clinic, functional, health, Injury, integrative, medical, personal injury doctor, personal injury specialist, wellness

Chiropractic and Nurse Practitioner for Injury Recovery

What advantages does possessing dual licensure as a chiropractor and nurse practitioner confer in personal injury lawsuits and automobile accidents?

Chiropractic and Nurse Practitioner On Auto Accidents

Following a motor vehicle collision, chiropractors and nurse practitioners are essential in injury management and recovery facilitation. Chiropractors emphasize manual therapies, including adjustments and manipulations, to resolve musculoskeletal problems and enhance mobility, whereas nurse practitioners deliver comprehensive care encompassing assessments, diagnoses, treatment plans, and education, frequently collaborating with specialists to maximize patient outcomes. (Physicians Group, LLC. 2024)

Chiropractors

Chiropractors address musculoskeletal problems, including back and neck discomfort, frequently resulting from automobile accidents. They employ tactile methods to alleviate discomfort and enhance mobility, frequently without pharmaceuticals. Comprehensive data and expert testimony can substantiate personal injury claims, demonstrating the severity of injuries. (Dies, S., & Strapp, J. W., 1992)

Assessment and Management of Musculoskeletal Disorders

Chiropractors can diagnose and treat spinal misalignments, muscle spasms, and soft tissue injuries that may occur following an accident.

Analgesic Relief

Manual therapy, such as spine adjustments and soft tissue mobilization, can mitigate pain and diminish inflammation.

Enhanced Mobility

Chiropractors can restore range of motion and enhance overall function by correcting joint and muscle limitations.

Comprehensive Care

Chiropractors typically emphasize holistic body care and guide sustaining proper posture, ergonomics, and general wellness to avert future injuries.

Cooperation with Additional Healthcare Practitioners

Chiropractors can collaborate with physicians, physical therapists, and other professionals to develop a holistic treatment plan for the patient. (Physicians Group, LLC, 2024)

Nurse Practitioners

Nurse practitioners are capable of delivering comprehensive care for injuries resulting from motor vehicle accidents, encompassing (Integrity Spine & Orthopedics, 2024)

Evaluation and Identification

Nurse practitioners are capable of performing physical examinations, interpreting diagnostic tests, and diagnosing conditions such as whiplash, soft tissue injuries, and concussions.

Therapeutic Protocols

They can develop individualized treatment regimens, encompassing pharmacological therapies, physical rehabilitation, and additional interventions, to meet the patient’s distinct requirements.

Patient Instruction

Nurse practitioners can instruct patients regarding their injuries, the recuperation process, and self-care techniques to facilitate healing and avert complications.

Care Coordination

They can collaborate with other professionals, including surgeons, neurologists, and physical therapists, to guarantee a comprehensive approach to treatment.

Post-Treatment Care

Nurse practitioners can assess the patient’s progress, modify treatment plans as necessary, and offer continuous care during the healing process.

Personal injury cases, especially those resulting from automobile collisions, frequently entail intricate medical and legal requirements. Chiropractors and nurse practitioners, each with unique scopes of practice, are essential in diagnosis, treatment, and documentation.

Chiropractors and nurse practitioners both contribute distinct advantages to personal injury cases. Chiropractors concentrate on musculoskeletal disorders, providing non-invasive therapies, whereas nurse practitioners address a wider range of medical requirements, including the prescription of drugs and the coordination of care. Their collaboration can improve patient results, as demonstrated in environments such as the Accident Treatment and Treatment Center, where nurse practitioners and physicians oversee treatment, augmenting chiropractic interventions. (Accident Care, 2025)

Legal resources indicate that the documentation of both professions is essential for insurance claims and settlements. Chiropractors’ meticulous reports on spinal injuries and nurse practitioners’ extensive medical records on overall health can collectively establish a compelling case for compensation. This synergy is especially apparent in automobile accident situations, where patients may necessitate both physical changes and medical supervision for complete recovery. (Chiropractic Economics, 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Dr. Jimenez, a family practice nurse practitioner, integrates advanced medical knowledge with chiropractic treatment to manage diverse illnesses. Our clinic amalgamates functional medicine, acupuncture, electro-acupuncture, and sports medicine to design tailored care regimens that foster natural healing, enhance mobility, and ensure long-term wellness. By emphasizing flexibility, agility, and strength, we enable patients to flourish, irrespective of age or health obstacles. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are dedicated to treating individuals following injuries and chronic pain disorders. We concentrate on enhancing your capabilities through customized flexibility, mobility, and agility training designed for various age demographics and disabilities. We employ both in-person and virtual health coaching, together with comprehensive care plans, to guarantee tailored care and wellness outcomes for each patient.

Don’t Ignore Your Post-Accident Pain

References

Physicians Group, LLC. (2024). The Role of Nurse Practitioners in Managing Auto Injuries. Physicians Group, LLC. https://physiciansgroupllc.com/the-role-of-nurse-practitioners-in-managing-auto-injuries/#:~:text=Nurse%20Practitioners%20are%20vital%20in,improved%20outcomes%20and%20patient%20satisfaction.

Dies, S., & Strapp, J. W. (1992). Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis. The Journal of the Canadian Chiropractic Association, 36(3), 139–145.

The Neck and Back Clinics. (2025). Why Seeing a Chiropractor After a Car Accident Is Crucial for Long-Term Recovery. https://theneckandbackclinics.com/long-term-recovery/#:~:text=Reducing%20Inflammation%20and%20Pain,each%20patient%20for%20optimal%20recovery.

Integrity Spine & Orthopedics. (2024). The 9 Steps to Recovery After an Auto Accident. https://www.integrityspineortho.com/post/the-9-steps-to-recovery-after-an-auto-accident/#:~:text=CONTACT%20INTEGRITY%20SPINE%20AND%20ORTHOPEDICS%20AFTER%20A,concussions%2C%20soft%20tissue%20damage%20and%20spine%20damage.

Accident Care and Treatment Center, Inc. (2025). Comprehensive Therapies and Treatments in One Location. https://accidentcare.com/treatment/

Chiropractic Economics. (2023). Evidence-based chiropractic: the key to personal-injury cases. https://www.chiroeco.com/evidence-based-chiropractic-the-key-to-personal-injury-cases/

May 16, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Therapy, Work Injury accelerate, acupuncture, body, bone, chiropractic, Clinic, coach, fracture, growth, healing, Injury, massage, medical, nurse, physical, problems, stimulator, Therapy, wellness

Bone Growth Stimulator in Post-Injury Healing

Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?

Bone Growth Stimulator

Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.

How They Work

Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)

They come in various shapes, sizes, and technologies depending on the location of the fracture.
The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.

Electrical Stimulation

Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.

Ultrasound Stimulation

They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.

Implantable vs. External

Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.

The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.

Effectiveness

Studies of bone stimulator effectiveness suggest two benefits:

Less pain is associated with the bone healing process.
Faster fracture healing.

However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)

While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.

When Stimulation is Necessary

Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)

Nonunion Fractures

When a fracture doesn’t heal within the expected timeframe.
Open fractures
Stress fractures
Scaphoid bone fractures
Talus fractures

Failed Fusions

When a spinal fusion hasn’t been successful.

High-Risk Patients

For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications

Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.

Injury Medical Chiropractic and Functional Medicine Clinic

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

From Injury to Recovery with Chiropractic Care

References

U.S. Food & Drug Administration. (2022). AccelStim Bone Growth Stimulator – P210035. Retrieved from https://www.fda.gov/medical-devices/recently-approved-devices/accelstim-bone-growth-stimulator-p210035#:~:text=What%20is%20it?,the%20transducer%20to%20the%20fracture

Childs, S. G. (2003). Stimulators of bone healing. Biologic and biomechanical. Orthopedic nursing, 22(6), 421–428. https://doi.org/10.1097/00006416-200311000-00010

Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. https://doi.org/10.1038/srep31724

Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. https://doi.org/10.4103/0019-5413.50844

May 13, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Athletes, Exercises breathing, chiropractic, Clinic, coach, decompression, exercise, health, Injury, massage, medical, mental, MET, nutrition, pace running, pacer, prevention, run, techniques, training, wellness

Pace Running: How to Work with Pacers

Can pace running help runners concentrate on other things, like breathing, form, or mental toughness?

Pace Running

Running is a sport many participate in and doesn’t require any equipment—only quality running shoes. Running in races comes with various physical and mental challenges. Some runners enjoy running in races and marathons but want to perfect their abilities and techniques, become more consistent, finish in a certain time, or pass a personal record. This is where pace running or working with a pace runner can help achieve those goals.

What is a Pace Runner?

A pace runner, or pacer, is an experienced runner who can run at a set pace for a long time. The pacer sets the speed so the runner can focus on running. Pacers run in races or marathons to help set the pace for a runner or runners. There are different reasons why professional and amateur runners work with a pace runner. Professional runners often use pace runners to work on techniques and help reach new levels in their running, while amateur runners can work on improving their overall running abilities. There are three typical types of pacers.

Race Pacer

Pacers wear or carry signs to make it easier for the runners and can often run split times.
A split time is the time it takes to run a certain distance.
Typically, these pacers will run at an even pace.
Many marathons will have pace groups that run at a specific speed or pace throughout the race.
The pace groups will have runners running a set time so other runners can key off these runners.
There are typically set paces for a 3-hour marathon time up to a 6-hour marathon time.
Runners can use pacers to help them reach their goals without relying on technology, such as a smartwatch or GPS, to determine if they maintain the correct speed throughout the race.

Distance Pacer

Professional and non-professional runners who run long distances or ultramarathons may also use a pace runner to set a specific tempo.
Ultramarathons are any race with a distance longer than the standard marathon of 26.2 miles.
Because some ultramarathons can be as long as 50 to 100 miles, runners who choose to have a pacer often have several pacers at different sections to motivate them and help set the rhythm.

Record Pacer or Rabbit

A record pacer, also known as a rabbit, is a pacer who helps a professional runner set a new record.
A rabbit often leads the race for a predetermined distance at a predetermined pace.
Some races have multiple pacers at various distances.

How Are Pacers Used?

There are different reasons for having a pacer, but they are based on the runner’s goals.

A runner being paced runs directly behind a pacer or pacers.
A pacer can run any pace requested, but typically, the pace groups run at an even pace or with a slight negative split.
A negative split is when a runner runs the race’s second half faster than the first half.

How Do They Help?

A pacer can be helpful because it takes more energy to lead a race than to sit back and follow another runner.
The pacer is responsible for timing and establishing the tempo so runners only have to focus on running.
A pacer does more work setting the pace, which allows the runner being paced to relax and not stress about hitting the pace.

A study focused on elite athletes who used pacers. It found that running together at a realistic speed helped optimize and achieve finishing time goals. (Casado A. et al., 2021) However, not all elite events allow pacers to participate. Some championship events, like the Olympics and NCAA Championships, do not allow pacer runners.

Benefits

Benefits of running with a pacer.

Prevent Running Too Fast

When a race begins, runners can take off and start too fast.
Starting too quickly can negatively impact the runners, like losing energy and stamina.
A pacer can help start the race with a steady pace, keeping them from going out too fast or expending too much energy.

Maintain an Even Pace

Maintaining an even pace can be difficult throughout a long race or a marathon.
Having a pacer can relieve some stress and pressure.
A pacer can keep the runners on an even pace or negative splits versus going out too fast and losing energy.

Focus on the Race

Pacers help the runners stay focused on the race without worrying about how they are running or maintaining the right speed.
A pacer can help keep runners relaxed.

Motivating

Pacers can help motivate runners.
The pace runners may encourage individuals along the way and help them stay motivated to keep working toward their goal, especially when the hard parts come.

Disadvantages

Running with a pacer can sometimes be more stressful than beneficial, especially for amateur runners. A pacer or pace group can be helpful, but it also can create more stress for some amateur runners.

Sometimes, individuals realize the pacer is running too quickly for what they can handle.
Anxiety can present as not being able to keep up.
Other times, runners underestimate their abilities and run more slowly than their bodies can handle.
However, runners don’t have to stay with a pace group just because they started with them.
Individuals can run ahead.
Or if the group is too fast, the runner can slow down and join the slower-paced group behind them.
The key is to listen to your body and do what feels right.

Becoming a Pacer

An experienced runner who wants to be a pacer for a race can contact a running organization about becoming a pace runner.

Individuals need to be able to have consistent racing times.
Be able to run at a set speed for a long duration.
Most pacers will contact the race organization to apply for a certain pace.
Some pacers enjoy the thrill of running in a race and helping other runners meet their goals.
The runner’s goals and the type of event also influence who the pacer is.

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals can talk to local running experts or a running coach. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. We can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

The Difference of Using Custom Foot Orthotics

References

Casado, A., Hanley, B., Jiménez-Reyes, P., & Renfree, A. (2021). Pacing profiles and tactical behaviors of elite runners. Journal of Sport and Health Science, 10(5), 537–549. https://doi.org/10.1016/j.jshs.2020.06.011

May 8, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Acupuncture, Chiropractic Care, Electroacupuncture acupuncture, back, chain, chiropractic, decompression, entrapment, health, Injury, lower, massage, medical, MET, muscle, paraspinal, piriformis, reaction, sciatica, spasm, symptoms, wellness

Paraspinal Muscle Tension: Understanding the Impacts

Can a paraspinal muscle spasm in the lower back create a chain reaction leading to hamstring spasms and potential sciatic nerve entrapment?

Paraspinal Muscle Spasm Chain Reaction

A paraspinal muscle spasm in the lower back can cause a cascade of events, including: (Cedars-Sinai, 2025)

Spasms in other lower back muscles
Hamstring spasms
Potential entrapment of the sciatic nerve

Leading to symptoms similar to sciatica:

Pain
Sore, achy muscles
Weak muscles
Numbness
Tingling along the back of the leg

Possible Mechanisms

Triggering Muscle Spasms in the Lower Back

Paraspinal muscles are located along the spine and help to stabilize and support the lower back.
When these muscles spasm, they can become tense and painful, causing a chain reaction.
This tension can radiate down and affect other muscles in the lower back. (Noonan A. M., & Brown S. H. M., 2021)

Can Affect Lower Back Muscles and Cause Hamstring Spasms

Lower back muscles, including those like the quadratus lumborum, can be affected by paraspinal spasms. (Hospital for Special Surgery, 2024)
The spasms can cause these muscles to tighten or spasm, potentially pulling on the hamstring muscles.
This can lead to hamstring spasms and tightness, further contributing to pain and potential nerve irritation.

Entrapment of the Sciatic Nerve

Piriformis syndrome is a common condition where the piriformis muscle (located in the buttock) spasms and compresses the sciatic nerve. (Cedars-Sinai, 2025)
The sciatic nerve runs from the lower back down the back of the thigh and into the leg, making it vulnerable to compression by surrounding muscles.
If the paraspinal and hamstring spasms create enough tension on the piriformis muscle or surrounding tissues, it can lead to sciatic nerve entrapment. (Hospital for Special Surgery, 2024)

How acupuncture helps relieve sciatica

Acupuncture can help relieve sciatica pain by stimulating specific points on the body, which can trigger the release of endorphins, reduce inflammation, improve blood flow, and relax tight muscles that could be compressing the sciatic nerve. By modulating the nervous system and promoting the body’s natural healing processes, acupuncture can help alleviate pain and improve overall function. (Qin, Z. et al., 2015)

Releases endorphins

Acupuncture stimulates the nervous system, triggering the release of endorphins, the body’s natural painkillers.

Reduces inflammation

Acupuncture can help reduce inflammation in the area surrounding the sciatic nerve, which can contribute to pain and nerve irritation. (Natural Care Chiropractic, 2022)

Improves circulation

By increasing blood flow to the affected area, acupuncture can help deliver nutrients and oxygen to the sciatic nerve and surrounding tissues, promoting faster healing.

Relaxes tight muscles

Sciatica pain can be exacerbated by tight muscles compressing the nerve. Acupuncture can help relax these muscles, reducing pressure on the sciatic nerve and alleviating pain.

Regulates the nervous system

Acupuncture can help regulate the nervous system, positively impacting pain perception and overall well-being. (Qin, Z. et al., 2015)

Promotes regeneration

Some evidence suggests that acupuncture can promote sciatic nerve regeneration, potentially leading to long-term pain relief. (Natural Care Chiropractic, 2022)

Needling Types

Distal needling

Acupuncture can also involve using points that are further away from the site of pain, which can also help to reduce pain and inflammation.

Local needling

Points are also selected on or near the sciatic nerve’s path, which can help directly address the source of pain and inflammation. (Qin, Z. et al., 2015)

Holistic approach

Acupuncture is often viewed as a holistic approach to pain management, addressing the symptoms of sciatica and the underlying causes and imbalances in the body.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Chiropractic and Integrative Healthcare

References

Cedars Sinai. (2025). Piriformis Syndrome. https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/piriformis-syndrome.html#:~:text=Overview,can%20run%20through%20the%20muscle)

Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR spine, 4(3), e1171. https://doi.org/10.1002/jsp2.1171

Hospital for Special Surgery. (2024). Sciatica. https://www.hss.edu/condition-list_sciatica.asp

Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine: eCAM, 2015, 425108. https://doi.org/10.1155/2015/425108

Natural Care Chiropractic, D. M. F. (2022). Acupuncture for Sciatica Pain Relief. https://www.naturalcarechiropractic.com/post/acupuncture-for-sciatica-pain-relief

May 7, 2025

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

Pseudoarthrosis After Spinal Fusion Surgery Explained

What is pseudoarthrosis of the cervical and lumbar spine?

Pseudoarthrosis of the cervical and lumbar spine

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

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

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

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

In many cases, revision surgery is needed.

Surgery-Related

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

Plates
Rods
Screws

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

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

Number of Vertebrae Being Fused

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

Hardware

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

Bone Graft

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

Risk Factors

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

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

Previous pseudoarthrosis
Obesity
Chronic steroid use
Malnutrition
Inflammatory diseases

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

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

Symptoms

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

Diagnosis

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

Treatment

Treatment for pseudoarthrosis will likely start with:

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

Enhancing Health Together

References

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

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

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

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

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

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

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

May 6, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Physio, Therapy acupuncture, chiropractic, Clinic, coach, decompression, flexibility, health, improvement, Injury, length of time, medical, MET, muscles, rehabilitation, sessions, tightness, treatment, wellness

Length of Time for Muscle Tightness Relief

For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?

Length Of Time to Loosen Tight Muscles

Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.

Factors Influencing Timeline

Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)

Severity of Tightness

Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.

Underlying Causes

If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)

Individual Factors

Genetics, age, and overall health can influence how quickly muscles adapt to stretching.

Consistency

Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)

Stretching Routine

The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.

Consistency

Aim for at least 3-4 weekly stretching sessions, each lasting 20-30 minutes. (Harvard Health Publishing, 2022)

Hold Time

Hold static stretches for at least 30 seconds.
Longer holds (1-2 minutes) can provide deeper benefits.

Long-term Gains

For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)

Initial Changes

Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.

Influencing Factors and Results

Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)

What To Expect

Improvements

Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)

Longer-Term Changes

Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.

Maintenance

Once flexibility improves, ongoing stretching is needed to maintain those gains. (Harvard Health Publishing, 2022)

Treatment Options

Stretching, physical therapy, massage, and other therapies can help alleviate tight muscles and promote recovery. (Spine Medicine and Surgery of Long Island, 2024)
Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.

The length of time to see results means consistency and patience are important.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Understanding Long-Lasting Injuries

References

Spine Medicine and Surgery of Long Island. (2024). How Long Do Muscle Knots Last? Spine Medicine and Surgery of Long Island. https://www.spinemedli.com/how-long-do-muscle-knots-last/#:~:text=The%20duration%20of%20a%20muscle,chronic%20pain%20if%20left%20untreated.

Peterson Physical Therapy. (2024). How Long Does It Take to Improve Flexibility? https://petersenpt.com/how-long-does-it-take-to-improve-flexibility#:~:text=Over%20the%20years%2C%20I’ve,takes%20to%20become%20more%20flexible.

Healthline. (2023). Everything You Need to Know About Muscle Stiffness. https://www.healthline.com/health/muscle-stiffness

Mayo Clinic. (2023). Stretching: Focus On Flexibility. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931#:~:text=Stretch%20in%20a%20smooth%20movement,hold%20for%20around%2060%20seconds.

Harvard Health Publishing. (2022). Everyday Stretching. https://www.health.harvard.edu/everyday-stretching#:~:text=A%20daily%20regimen%20will%20deliver,or%20three%20times%20a%20week.

May 3, 2025

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet, El Paso TX, Exercises acupuncture, before and after, chiropractic, Clinic, coach, decompression, diet, exercise, fitness, health, Injury, massage, medical, MET, nutrition, Pilates, wellness, workout

Pilates Nutrition for Enhanced Performance and Recovery

Many ask, what and when should you eat before, during, and after engaging in Pilates exercises?

Pilates Nutrition Plan

Pilates involves a lot of core work on the mat. However, it does not require a special diet. To fully utilize Pilates nutrition, individuals should consider what foods keep their bodies feeling the most balanced. A balanced nutrition plan can enhance Pilates practice by:

Providing sustained energy
Supporting muscle recovery
Promoting overall well-being

Pre-Pilates

Timing

Eat a light meal or snack 2-3 hours before a class or a smaller snack 30 minutes before.

Food Options

Eat complex carbohydrates like whole grains, fruits, and vegetables for sustained energy.

Avoid

Heavy, greasy, or spicy foods may cause discomfort during exercise.
Foods that will make you gassy or cause queasiness.

During the Workout

Complex carbohydrates and lean proteins, with a little healthy fat, are good pre-Pilates meals, as they sustain energy better than simple carbs or sugary snacks. (American Heart Association, 2024) Suggestions for a pre-Pilates meal.

Individuals can adjust the portion size.
A protein shake that uses fruit can be convenient.
Peanut butter on whole-grain bread offers a quick source of complex carbohydrates and protein.
Yogurt with fruit.
Small portion of oatmeal.

Because Pilates emphasizes using the abdominal muscles, individuals will want to ensure that any food they’ve eaten before their session is fully digested. Try to eat light before, like snacking on a banana or sipping on a smoothie for some carbohydrates for energy. Regardless of what is eaten, nutrition experts recommend waiting two to three hours after eating before exercising.

Maintain Hydration

Drink water and/or eat hydrating fruits throughout the day, especially before and during the workout or class.

After Working Out

Individuals want to ensure their bodies have enough nutrients to strengthen their muscles and replenish their energy. Try a protein green smoothie afterward or a light snack with lean protein like fish or chicken and carbohydrates like whole grains. The diet between workouts will depend on weight loss goals.

Timing

Consume a protein-rich snack or meal within 30-60 minutes after your class to aid muscle recovery.

Food Choices

Focus on protein for muscle repair and carbohydrates to replenish energy stores.

Hydration

Continue to hydrate to replenish fluids lost through perspiration.

While Pilates can complement cardiovascular exercise as part of a fat-burning workout program, health experts advise that losing weight will not come from exercise alone. Individuals will need to work on reducing their calorie intake overall. (Centers for Disease Control and Prevention, 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions.

Wellness & Nutrition: Personalized plans to optimize health and prevent disease.
Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
Chronic Pain Management: Non-invasive solutions for fibromyalgia, sciatica, and low back pain.
Personal Injury & Auto Accident Care: Tailored rehabilitation for whiplash, soft tissue injuries, and more.
Functional Medicine: Root-cause analysis for chronic disorders, incorporating nutrition, lifestyle, and environmental factors.
Neuromusculoskeletal Health: Care for neck pain, migraines, herniated discs, and scoliosis.

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

Home Exercises for Pain Relief

References

American Heart Association. (2024). Food as fuel before, during, and after workouts. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/food-as-fuel-before-during-and-after-workouts

Centers for Disease Control and Prevention. (2023). Tips for Maintaining Healthy Weight. Retrieved from https://www.cdc.gov/healthy-weight-growth/about/tips-for-balancing-food-activity.html?CDC_AAref_Val=https://www.cdc.gov/healthyweight/calories/index.html

Tag: medical

Nerve Injuries from Car Accidents: Causes, Treatment, and Dr. Alexander Jimenez’s Expertise

Introduction

References

Understanding Nerve Injuries

Types of Nerve Injuries

References

Causes of Nerve Injuries in MVAs

Whiplash

Direct Trauma

Secondary Injuries

Common MVA Scenarios Leading to Nerve Injuries

References

Symptoms of Nerve Injuries

Motor Nerve Damage

Sensory Nerve Damage

Autonomic Nerve Damage

Common Symptoms by Nerve Type

Delayed Symptoms

References

Diagnosis of Nerve Injuries

Physical Examination

Diagnostic Imaging

Nerve Conduction Studies

Diagnostic Methods

References

Treatment Options

Chiropractic Care

Physical Therapy

Medication

Surgery

Treatment Options Overview

References

The Role of Chiropractic Care in Recovery

Benefits of Chiropractic Care

Supporting Personal Injury Claims

Early Intervention

References

Dr. Alexander Jimenez: A Leading Expert in El Paso

Background and Credentials

Clinical Approach

Role in Personal Injury Cases

Community Impact

Why Choose Dr. Jimenez?

References

Conclusion

References

Bunions

Visual Signs of Early Symptoms

Initial Somatic Indicators

Stages

Halt the Advancement

Analgesic Administration

Non-invasive Therapy in Initial Phases

Foot orthoses, commonly referred to as orthotics

Splints

Physical Therapy

Podiatrist

Chiropractic Perspective

Nurse Practitioner Perspective

Limitations and Considerations

Injury Medical Chiropractic and Functional Medicine Clinic

Enhance Your Performance with Functional Foot Orthotics

References

Dementia Prevention and Exercise

Physical Activity and Reduced Risk

Insulin, Exercise, and Brain Health

Clinic for Chiropractic Care and Functional Medicine

Is Motion Key to Healing?

References

Chiropractic and Nurse Practitioner On Auto Accidents

Chiropractors

Assessment and Management of Musculoskeletal Disorders

Analgesic Relief

Enhanced Mobility

Comprehensive Care

Cooperation with Additional Healthcare Practitioners

Nurse Practitioners

Evaluation and Identification

Therapeutic Protocols