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Straight Leg Test: Understanding Its Purpose

Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?

Straight Leg Test

The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what’s causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they’ll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.

Purpose

The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what’s happening. It is a manual exam, and the healthcare provider will:

  • Position the patient
  • Moves the patient
  • Create pressure to see how well the patient can resist it

This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)

During the Test

Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:

  • Tight hip or back muscles
  • Back muscle spasms
  • Slipped disc
  • Spinal instability

Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:

  • The patient lies on their back with their legs straight.
  • The provider will ask the patient to turn one of the legs in.
  • This tells them what hip position affects the lower back symptoms.
  • They’ll then ask you to bring the leg toward the body’s center.
  • Then, they’ll lift the straight leg until the patient experiences symptoms.
  • Pain suggests a herniated disc.
  • If there is no pain, this also provides valuable information.
  • The procedure is repeated with the other leg.

Modifications

It’s important to let the examiner know about any limitations. The straight leg raise test has modifications if the patient cannot lift their leg while it’s straight or if they have difficulty lying on their back, which can also help avoid an injury during the test.

Variations

The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they’ll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Injury to Recovery with Chiropractic Care

References

Casiano, V. E., Sarwan, G., Dydyk, A. M., & Varacallo, M. A. (2025). Back Pain. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844200

Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-021-04649-z

Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2

Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. https://doi.org/10.1016/j.apmr.2016.06.019

Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. https://doi.org/10.5704/MOJ.1511.012

Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. https://doi.org/10.1186/1757-1146-6-46

Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. https://doi.org/10.1097/BRS.0000000000001867

Camino Willhuber, G. O., & Piuzzi, N. S. (2025). Straight Leg Raise Test. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30969539

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Pinched Nerve in the Neck: Managing Your Pain

Can physical therapy help individuals with a pinched nerve in the neck?

Pinched Nerve In The Neck

A pinched nerve in the neck can cause pain, numbness, and weakness that extends through the neck, shoulder, and arm. (American Academy of Orthopaedic Surgeons, 2024) Over-the-counter pain medications, resting the muscles, and gentle stretching can help. However, if you’re still in pain after a few days, see a healthcare provider. Common treatments include:

  • Rest
  • Over-the-counter (OTC) pain meds
  • Physical therapy
  • Steroid injections
  • Wearing a neck collar

Surgery is rarely needed, but it can provide relief if other treatments don’t help. Most of the time, a pinched nerve resolves within days or weeks.

How a Pinched Nerve in the Neck Feels

The term for neck nerve pain is cervical radiculopathy (cervical spine pain). Common symptoms of a pinched nerve in the neck are: (American Academy of Orthopaedic Surgeons, 2024)

  • Sharp pain that extends into the shoulder and arm.
  • The pain worsens, or there is a shooting sensation when turning the head.
  • Tingling or feeling of pins-and-needles in the fingers or hand.
  • Weakness in the arm, shoulder, or hand.
  • Numbness or loss of feeling.

Often, these symptoms occur only on one side. Some find their pain less when they lift their hand onto their head, which can relieve pressure on the nerve.

Causes

The cervical spine is the spinal cord area around the neck. It’s made up of seven vertebrae. Nerves branch off the spinal cords in the spaces between the vertebrae. Nerve compression occurs when the space between two vertebrae is reduced, putting pressure on the nerve, pinching it, and causing pain. Pinched nerves develop from age because the spinal discs between the vertebrae become compressed over time. Age causes about 70% to 80% of nerve compression. Other factors that cause pinched nerves include: (Harvard Health Publishing, 2021)

  • Degenerative disc disease
  • A herniated disc
  • Injuries like car accidents falls, or other trauma to the spine
  • Spinal stenosis

Self-Care Relief

If you have nerve pain and think it is a pinched nerve, self-care can help (National Institute of Neurological Disorders and Stroke, 2025)

Rest

  • Find a comfortable position and try to allow the muscles in your neck to relax and rest.

Heat or Ice

  • Warmth and coolness can relieve pain and inflammation.
  • Use a warm or cool compress for 15 minutes at a time.

Over-The-Counter Pain Medications

  • Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can help bring relief.

Treatment for Severe Symptoms

If pain doesn’t resolve within a few days, or if it is so bad that you can’t go about daily activities, it’s recommended to see a healthcare provider. They can diagnose a pinched nerve after a physical exam and may also recommend imaging, including an X-ray, CT scan, MRI, or EMG, to reveal what’s causing the symptoms. After diagnosing the condition, the healthcare provider will develop a personalized treatment plan, which may include the following (Harvard Health Publishing, 2021)

Physical Therapy

  • Physical therapy can help build strength and flexibility in the neck.
  • This is especially important if there is frequent nerve pain in the same spot.

Cervical Collar

  • A soft cervical collar is a brace that fits around the neck.
  • It supports your head so the neck muscles can relax, facilitating healing.
  • The collar can also keep the head from turning in painful ways.

Oral Corticosteroids

  • Oral steroids like prednisone can help reduce inflammation.
  • If inflammation or swelling in the neck puts more pressure on the nerve, they can help.

Steroid Injections

  • Steroid shots right into the painful tissue reduce inflammation right away.

Muscle Relaxers

  • These medications keep the muscles in the neck from seizing up.
  • As the muscles relax, this brings pain relief.

Narcotic Pain Medications

  • Narcotic pain medications can be used short-term by individuals who have severe pain.
  • A healthcare provider will inform the patient of the benefits and drawbacks of these medications, which include opiates.  

Neck Exercises

Gentle stretches can help alleviate the pain and strengthen the muscles. (National Health Service, 2025)

Chin to chest

  • Bring your chin toward your chest.
  • Hold for 20 seconds, then return to a neutral position.
  • Do this five times.

Eyes to Sky

  • Lean your head back and look toward the sky.
  • Hold for 20 seconds, then return to your starting position.
  • Do this five times.

Side to Side

  • Turn your head to the right as far as possible, bringing your chin in line with your shoulder.
  • Hold for 20 seconds, then turn as far as possible toward the left.
  • Repeat four times.

Ear to Shoulder

  • Bring your ear down toward your shoulder.
  • Hold for 20 seconds, then repeat the exercise on the other side.
  • Alternate between the right and left, stretching each side five times.

While it’s normal for exercises to hurt from stretching the muscles, they should never hurt more than a five on a pain scale of 1 to 10. If they do, stop exercising (National Health Service, 2025)

Healing Time

Healing and recovery depend on the severity of the injury. Some individuals find that the pain from a pinched nerve goes away in days, while for others, it can last for weeks. The pain goes away and then returns. If pain doesn’t go away with the conservative treatments or lasts more than a few days, talk with a healthcare provider or return for a second visit. Rarely do individuals need surgery to bring pain relief. The healthcare provider will discuss whether surgery is the best option and what to expect regarding pain relief. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Revitalize and Rebuild with Chiropractic

References

American Academy of Orthopaedic Surgeons. OrthoInfo. (2024). Cervical radiculopathy (pinched nerve). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/

Harvard Health Publishing. Publishing, H. H. (2021). Treating a pinched nerve. https://www.health.harvard.edu/pain/treating-a-pinched-nerve

National Institute of Neurological Disorders and Stroke. (2025). Pinched Nerve Definition. Retrieved from https://www.ninds.nih.gov/health-information/disorders/glossary-neurological-terms#-P-

National Health Service. Service, N. H. (2025). Exercises for neck problems. https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/exercises-for-neck-problems

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Cheddar Cheese Nutritional Value Explained

While cheddar cheese’s high-calorie count and saturated fat content have nutritional drawbacks, can a moderate amount be an enjoyable part of a healthy diet?

Cheddar Cheese

Cheddar is a hard, cow’s milk cheese known for its dense, layered texture and nutty flavor. It is a favorite cheese served in quesadillas, mac and cheese, or on burgers. However, cheddar cheese nutrition isn’t considered ideal.

Nutrition

Nutrition information for 1 ounce/28 grams of cheddar cheese. (U.S. Department of Agriculture, 2019)

  • Calories – 120
  • Fat – 10 grams
  • Sodium – 190 milligrams
  • Carbohydrates – 0 grams
  • Fiber – 0 grams
  • Sugars – 1 grams
  • Protein – 7 grams
  • Calcium – 201.6 milligrams
  • Vitamin A – 95.7 micrograms
  • Vitamin B12 – 0.3 micrograms

Carbohydrates

  • Cheddar contains zero carbohydrates, meaning it has no fiber and little sugar.

Fats

  • Most health concerns focus on fat and saturated fat content. (Lordan R. et al., 2018)
  • Whole-milk cheddar is high in total fat – 10 grams per ounce.
  • Saturated fat – 6 grams per ounce.
  • Traditionally, nutrition recommendations have advised consuming a diet low in saturated fat to reduce the risk of cardiovascular disease.
  • However, research suggests saturated fat in whole foods like cheese may not harm heart health. (Astrup A., Geiker N. R. W., & Magkos F. 2019)
  • Further research is needed to determine the pros and cons of saturated fat in dairy. (Hirahatake K. M. et al., 2020)

Protein

  • It provides 7 grams per 1-ounce serving, and protein accounts for over 30% of cheddar’s calories.
  • This can significantly add to one’s daily intake.

Vitamins and Minerals

  • Calcium is a micronutrient at 200mg (or 20% of daily value) per ounce.
  • One ounce provides 10% daily vitamin A recommendation and 14% phosphorus, plus small amounts of zinc, selenium, and riboflavin.
  • Cheddar cheese can be relatively high in sodium at 190mg per ounce if trying to cut down on salt. (U.S. Department of Agriculture, 2019)

Health Benefits

Builds Healthy Bones

Builds Muscle

  • Protein performs a variety of functions in the body.
  • Protein helps build muscle; it’s necessary to produce enzymes, give structure to cells, maintain fluid balance, and more. (Carbone J. W., & Pasiakos S. M. 2019)

Calorie-Dense

  • Cheddar is calorie-dense, which increases its satisfaction factor.

May Help Weight Loss

  •  There is the belief that cheese causes weight gain; however, the full-fat dairy paradox, which goes against dietary guidelines, is the idea that full-fat dairy products may be healthier than low-fat or fat-free dairy,
  • Research now suggests removing fat from dairy products may make them more likely to cause weight gain, making full-fat the better choice for weight management. (Soltani S., & Vafa M. 2017)

Compatible With Keto and Low-Carb Diets

  • Because of cheddar’s high fat percentage, it’s compatible with high-fat nutrition plans.
  • With zero carbohydrates, cheddar also fits well in low-carb diets.

Low Lactose

  • Cheddar is one of the harder, aged cheeses that’s quite low in lactose.
  • This means lactose-intolerant individuals can often eat it without unpleasant symptoms like bloating, stomach upset, and gas.

Allergies

  • Although it is low in lactose, cheddar still contains casein and whey, two components that can trigger an immune response in individuals with a dairy allergy. (He, M. et al., 2017)

Storage and Safety

Cheddar does not technically require refrigeration. However, storing it in the fridge will help it last longer. According to the USDA, unopened cheddar can last up to six months in the refrigerator, and opened packages can last three to four weeks. Because it’s a hard cheese, cheddar even takes well to freezing, but this will not extend its life more than refrigeration. The USDA estimates cheddar can be frozen for about six months.

Preparation

Cheddar can be added to any number of cheesy dishes or, of course, served alone with crackers. It doesn’t require high heat to become nice and melty. Try adding a whole-grain base and veggies to increase the nutrients in dishes like cheesy casseroles, Mexican dishes, sandwiches, or pasta.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Osteoporosis

References

U.S. Department of Agriculture. FoodData Central. (2019). Cheddar Cheese. Retrieved from https://fdc.nal.usda.gov/food-details/494681/nutrients

Lordan, R., Tsoupras, A., Mitra, B., & Zabetakis, I. (2018). Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned?. Foods (Basel, Switzerland), 7(3), 29. https://doi.org/10.3390/foods7030029

Astrup, A., Geiker, N. R. W., & Magkos, F. (2019). Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts. Advances in nutrition (Bethesda, Md.), 10(5), 924S–930S. https://doi.org/10.1093/advances/nmz069

Hirahatake, K. M., Astrup, A., Hill, J. O., Slavin, J. L., Allison, D. B., & Maki, K. C. (2020). Potential Cardiometabolic Health Benefits of Full-Fat Dairy: The Evidence Base. Advances in nutrition (Bethesda, Md.), 11(3), 533–547. https://doi.org/10.1093/advances/nmz132

Malmir, H., Larijani, B., & Esmaillzadeh, A. (2020). Consumption of milk and dairy products and risk of osteoporosis and hip fracture: a systematic review and Meta-analysis. Critical reviews in food science and nutrition, 60(10), 1722–1737. https://doi.org/10.1080/10408398.2019.1590800

Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. https://doi.org/10.3390/nu11051136

Soltani, S., & Vafa, M. (2017). The dairy fat paradox: Whole dairy products may be healthier than we thought. Medical journal of the Islamic Republic of Iran, 31, 110. https://doi.org/10.14196/mjiri.31.110

He, M., Sun, J., Jiang, Z. Q., & Yang, Y. X. (2017). Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study. Nutrition journal, 16(1), 72. https://doi.org/10.1186/s12937-017-0275-0

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Cauda Equina Syndrome: Symptoms and Treatments

Cauda equina syndrome/CES is a rare condition in which the nerves in the lower back are compressed. It can include sciatica as one of its symptoms. Individuals presenting with symptoms that could be CES are advised to see a healthcare provider as soon as possible, as delaying treatment can lead to permanent damage.

Cauda Equina Syndrome

A cluster of nerve roots called the cauda equina, Latin for horse’s tail, sends and receives messages to the legs, bladder, and other body parts. Cauda equina syndrome is a rare condition in which nerve roots in the lower spinal cord are compressed. This compresses the nerves and disrupts motor and sensory function in the bladder and lower extremities. The most common cause is a ruptured or herniated disc in the lumbar area. This usually occurs when a severe disc herniation compresses the nerve bundle at the base of the spinal cord, causing significant neurological dysfunction like bladder/bowel issues and numbness in the saddle area. If found early, it is treated with surgery within 24 to 48 hours of symptom onset.

Initial Signs

Symptoms can occur acutely, in hours, or gradually over weeks or months. One of the first signs and most common symptoms is urinary retention, where the bladder fills, but there is no normal sensation or urge to urinate. (American Association of Neurological Surgeons, 2024) Other symptoms include: (Gardner A., Gardner E., & Morley T. 2011)

  • Severe low back pain
  • Sciatica
  • Pain, numbness, or weakness in one or both legs
  • Saddle anesthesia, which is numbness or other nerve sensations around the anus and the area that sits.
  • A loss of reflexes in the extremities
  • Sexual dysfunction that comes suddenly
  • Loss of bowel control
  • Overflow urination

There are two stages based on urinary symptoms (Fairbank J., & Mallen C. 2014)

CES-Incomplete CES-I

CES-Retention CES-R

  • Bladder control is completely lost.

Causes

The most common cause is a ruptured or herniated disc in the lumbar area. Other possible causes may include: (American Association of Neurological Surgeons, 2024)

Trauma or injury to the spine

  • that leads to fractures or dislocations (gunshots, falls, auto accidents)

Tumors or Infections

  • It can compress the cauda equina nerve bundle.

Spinal Stenosis

  • Narrowing of the spinal column can be either congenital or acquired.

Bone Spurs

Tuberculosis or Pott’s Paralysis

  • Pott’s paralysis is a neurological complication of tuberculosis (TB) of the spine.
  • TB is a bacterial infection that usually affects the lungs but can spread to the spine.

Iatrogenic Side Effects

  • Injuries or illnesses that result from medical or surgical treatment

Spinal Lesions or Malignant Tumors

  • A spinal lesion refers to any abnormal growth or damage within the spine.
  • It can include benign (noncancerous) and malignant (cancerous) tumors.
  • A malignant tumor is a cancerous growth within the spine; essentially, a malignant tumor is a type of spinal lesion with the potential to spread to other parts of the body.

Spinal Infection, Inflammation, Hemorrhage, or Fracture

  • A spinal infection refers to a bacterial, fungal, or viral infection that occurs within the bones of the spine (vertebrae) or the surrounding tissues, potentially causing pain, inflammation, and, in severe cases, neurological complications like weakness or paralysis;
  • Spinal inflammation is a general term for swelling or irritation within the spinal column.
  • Spinal hemorrhage” indicates bleeding within the spinal canal.
  • A spinal fracture refers to a break in one or more of the vertebrae in the spine.

Spinal Arteriovenous Malformations (AVMs)

  • A spinal arteriovenous malformation (AVM) is a rare condition in which the arteries and veins in the spinal cord tangle abnormally.
  • This can damage the spinal cord over time.

Complications from Lumbar Surgery

  • Lumbar surgery can have several complications, including infections, blood clots, nerve damage, and spinal fluid leaks.

Spinal Anesthesia

  • Spinal anesthesia is a regional anesthesia that blocks pain and sensation in the lower body.
  • It involves injecting a local anesthetic medication into the subarachnoid space surrounding the spinal cord.
  • The exact cause is not fully understood, but it can involve direct nerve root injury from the needle, inflammation caused by the anesthetic, or a spinal hematoma compressing the nerve roots.

Spinal Birth Defects

Diagnosis

Diagnosis requires a medical history of symptoms, general health, activity level, and a physical exam to assess strength, reflexes, sensation, stability, alignment, and motion. (​American Association of Neurological Surgeons, 2024) Testing includes: 

Blood Tests

  • These test for infections.

MRI

  • These yield three-dimensional images of the spinal cord, nerve roots, and surrounding areas.

Myelography

  • X-ray or computerized tomography (CT) imaging is enhanced by the injection of contrast material into the cerebrospinal fluid spaces, which can show displacement of the spinal cord or spinal nerves.

Specialized Nerve Testing

  • This could be nerve conduction velocity tests and testing electrical activity in muscles or electromyography.

Treatment

The extent of urinary problems can determine treatment protocols. A CES diagnosis is usually followed by emergency surgery within 24 to 48 hours to relieve compression of the nerves. Moving quickly is essential to prevent permanent complications such as nerve damage, incontinence, or leg paralysis. (American Association of Neurological Surgeons, 2024)

  • Depending on the cause, corticosteroids also may be prescribed to reduce swelling.
  • Antibiotics may be needed if an infection is responsible for CES.
  • For situations in which a tumor is the cause, surgery to remove it may be necessary, followed by chemotherapy and/or radiation.
  • The outcome with CES-I during surgery is generally favorable.
  • Those whose CES has deteriorated to CES-R tend to have a less favorable prognosis.

Post Surgery Therapy

After surgery, CES can be challenging to deal with. If bladder function has been impaired, recovery of control can take time.

  • It may be necessary to use a catheter or to wear disposable underwear. (American Association of Neurological Surgeons, 2024)
  • Frequent urinary infections are also a potential complication.
  • Loss of bladder or bowel control can be psychologically distressing, impacting social life, work, and relationships.
  • Sexual dysfunction can also occur, contributing to relationship difficulties or depression.

Therapy with a mental health professional may be recommended. When damage is permanent, it will be important to include family and friends in the adjustment to living with a chronic condition. Psychological counseling and/or a support group can be helpful. Other specialists who can help include: (American Academy of Orthopaedic Surgeons, 2024)

  • Occupational therapist
  • Physical therapist
  • Physiotherapist
  • Sex therapist
  • Social worker

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Disc Herniation

References

American Association of Neurological Surgeons. (2024). Cauda Equina Syndrome. https://www.aans.org/patients/conditions-treatments/cauda-equina-syndrome/

Gardner, A., Gardner, E., & Morley, T. (2011). Cauda equina syndrome: a review of the current clinical and medico-legal position. European Spine Journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20(5), 690–697. https://doi.org/10.1007/s00586-010-1668-3

Fairbank, J., & Mallen, C. (2014). Cauda equina syndrome: implications for primary care. The British journal of general practice: the journal of the Royal College of General Practitioners, 64(619), 67–68. https://doi.org/10.3399/bjgp14X676988

American Academy of Orthopaedic Surgeons. (2024). Cauda equina syndrome. https://orthoinfo.aaos.org/en/diseases–conditions/cauda-equina-syndrome

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Left Side Lower Back Pain: Effective Relief Techniques

Should individuals experiencing lower left back pain see a healthcare provider if it lasts more than a few weeks?

Left Side Lower Back Pain

Lower left back pain can impact your ability to go about your day. If left-side lower back pain lasts longer than a week, it is considered chronic back pain, which can severely impact one’s quality of life. This type of pain has various causes. Muscle or spine and nerve damage, including sciatica, can cause pain. Organs in the lower back, including the kidneys, can cause pain. Pregnancy-related changes, fibromyalgia, and other conditions can cause lower left-side back pain in females.

Causes

Back pain is common and affects almost everyone. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023) Lower left back pain can have many causes, ranging from muscle and spine issues to organ infections. One way to help tell what’s causing the symptoms is to determine whether there is also sciatica, sharp or burning pain that radiates down one side of the body. It happens when the sciatic nerve gets compressed or irritated. Possible causes include (Penn Medicine, 2020)

Muscle Injury

  • A muscle injury from an accident or injury can be a cause that can appear with or without sciatica.
  • If this is the cause, you’ll notice that the pain improves with rest but worsens after you’ve sat for a long time or after getting up from sleep.
  • There may also be a limited range of motion, tenderness, or swelling.

Arthritis or Bone Conditions

  • Arthritis and bone issues, like osteoporosis, can also be a cause.
  • This can happen if the arthritis is in the left hip or the root cause is on the right side, but the body compensates by overusing muscles on the left side of the back.

Unhealthy Posture and Body Positioning

  • Unhealthy postures and body positioning can contribute to back pain and musculoskeletal problems.
  • To avoid straining the muscles, try sitting and standing straight and keeping all the joints at a 90-degree angle.
  • Move around every 20-30 minutes and stretch out.

Kidneys

  • The kidneys are located in the middle back.
  • Kidney infections or kidney stones could cause pain on the left side.
  • Other symptoms include pain when urinating, fever, and nausea.

Ulcerative Colitis

  • Ulcerative colitis, inflammation of the large intestine, can also cause lower left back pain in some cases.
  • If this is the cause, there may also be abdominal pain, cramping, nausea, and fatigue.

Uterine-Related Pain

  • Several conditions related to the uterus can cause back pain symptoms, including PMS, period cramps, endometriosis, and more.
  • Sometimes, these conditions cause pain on both sides, but some individuals may experience pain just on the left side.

Pregnancy

  • The weight gain, hormonal changes, and limited movement can also contribute to lower left back pain. (Cedars Sinai, 2024)

Spinal Disease

Sciatica

Some causes can also cause sciatica.

In many cases, over-the-counter anti-inflammatory medications can help with sciatica. If it persists, it is recommended to see your healthcare provider to find the root cause. The causes include: (Aguilar-Shea, A. L. et al., 2022)

Herniated disc

  • A disc that pops out of place can add pressure to the sciatic nerve.

Spinal Stenosis

  • Spinal stenosis, or spine narrowing, can also cause sciatic symptoms.

Spondylolisthesis

  • Occurs when vertebrae are out of alignment, leading to sciatic symptoms.

Pregnancy

  • Pregnancy-related growth and bodily changes oftentimes lead to sciatic nerve symptoms and sensations.

Muscle Spasms

  • Spasms like piriformis syndrome, a spasm of the muscle in the buttocks, can cause back pain.

Surgery

  • It’s normal to have back pain for up to six weeks after a back procedure.
  • However, if there is new or worsening lower left back pain after surgery, consult the healthcare provider. (Penn Medicine, 2017)

Describing Symptoms

Knowing how to describe your symptoms when seeing a healthcare provider is helpful. Answering these questions can help explain symptoms (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

  1. Have you had any accidents or injuries?
  2. Did the pain come on suddenly or gradually?
  3. Are you experiencing any limits to your range of motion?
  4. Do you have any numbness or tingling?
  5. What helps with the pain?
  6. What makes the pain worse?
  7. Do you have other symptoms, like a fever or trouble urinating?

Self Care

  • Self-care includes rest, ice, heat, and over-the-counter anti-inflammatory medications.
  • Non-steroidal anti-inflammatory drugs can help with pain.
  • Sleeping on a firm mattress and maintaining a healthy posture can help manage and improve symptoms. (See Q. Y., Tan J. B., & Kumar D. S. 2021)

Prescribed Treatment

  • Your healthcare provider may recommend massage, chiropractic care, and acupuncture treatments.
  • If pain can’t be managed at home, your healthcare provider may suggest prescription medications, including muscle relaxers.
  • These can allow the tissue to heal and reduce your pain as well.
  • If you have severe sciatica or vertebrae that have slipped out of place, the healthcare team might recommend a steroid injection into the lower left back to reduce pain by reducing inflammation.
  • In addition to prescription treatments, your healthcare provider might recommend physical therapy to retrain movements, build strength, and help prevent back pain.

Moving Around

It’s important not to move too much. Rest is important for healing, although don’t stop moving entirely. These tips can also help (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

  • Sleep on a firm mattress that will support your back.
  • Get a comfortable, ergonomic chair for your job.
  • If you work on your feet, learn to practice healthy posture and use shoes and insoles to facilitate and maintain correct posture.
  • Once you’ve healed, building your core strength may help avoid lower back pain in the future.

Injury Medical Chiropractic and Functional Medicine Clinic

Talk with a healthcare provider and request a referral to a specialist who can help with long-term management. 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 mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Lower Back Pain Chiropractor Treatment

References

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back pain. Retrieved from https://www.niams.nih.gov/health-topics/back-pain

Penn Medicine, B. T., MD. (2020). 4 reasons you may have back pain on only one side. Penn Medicine. https://www.pennmedicine.org/updates/blogs/musculoskeletal-and-rheumatology/2017/november/back-pain-on-one-side

Cedars Sinai. (2024). Back pain during pregnancy. https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-González, R., & Paredes, I. (2022). Sciatica. Management for family physicians. Journal of family medicine and primary care, 11(8), 4174–4179. https://doi.org/10.4103/jfmpc.jfmpc_1061_21

Penn Medicine, V. G., MD. (2017). Back pain that won’t go away—even with surgery. Penn Medicine. https://www.pennmedicine.org/updates/blogs/musculoskeletal-and-rheumatology/2017/november/back-pain-that-wont-go-away

See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. https://doi.org/10.11622/smedj.2021086

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

Peroneal Tendon Injuries and Their Symptoms

Are individuals with high foot arches or participating in sports involving repetitive ankle motion at risk for developing peroneal tendon injuries?

Peroneal Tendon Injuries

The peroneal tendons connect the muscles of the outer side of the lower leg to the foot. They may be acute—occurring suddenly—or chronic—developing over time. The basic types of peroneal tendon injuries are tendonitis, tears, and subluxation. 

Anatomy and Function

The two major peroneal muscles (peroneus longus and peroneus brevis) are outside the lower leg, next to the calf muscles. The peroneal tendons run along the outer side of the ankle and attach to the foot, connecting these muscles to bone. They help stabilize the ankle joint, point the foot downward (plantarflexion), and turn the foot outward (eversion). In normal gait, the motion of the peroneal muscles is balanced by the muscles that invert the foot or rock the foot inward from the ankle.​ The two peroneal tendons sit one on top of the other right behind the fibula (the smaller lower leg bone). This closeness can contribute to problems with the peroneal tendons, as they rub together behind the ankle.

Tendonitis

The most common problem is inflammation or tendonitis. The tendons are usually inflamed just behind the fibula bone at the ankle joint. This part of the fibula is the bump on the outside of the ankle, and the peroneal tendons are located just behind that bony prominence. Tendonitis can either result from repetitive overuse or an acute injury. Common symptoms of tendonitis include:

  • Pain behind the ankle
  • Swelling over the peroneal tendons
  • Tenderness of the tendons
  • Pain usually worsens if the foot is pulled down and inwards, stretching the peroneal tendons.
  • X-rays of the ankle are taken.
  • MRI may show inflammation and fluid around the tendons. (Walt J. & Massey P. 2023)

Typical treatment of peroneal tendonitis is accomplished by:

Ice application

  • Applying ice to the area can help reduce swelling and control pain.

Rest

  • Resting is important to allow the tendon to heal.
  • A supportive device (walking boot or ankle brace) or crutches can help in severe cases.
  • Braces and boots provide support, reduce tendons’ stress, and allow rest and inflammation to subside.

Anti-inflammatory Medications

  • Motrin or Aleve are anti-inflammatory and can reduce the swelling around the tendon.

Physical Therapy

  • Physical therapy can help restore normal ankle joint mechanics, help with swelling and pain relief, and correct strength imbalances.

Cortisone Injections

  • Cortisone injections are low-risk if administered to the area around the tendon and not more often than every three months.
  • Ultrasound guidance can help ensure the medication is injected into the correct area. (Walt J. & Massey P. 2023)

Tendon Tears

Tears can occur and are more likely to happen in the peroneus brevis tendon. Tears are believed to be the result of two issues with the tendon. One is the blood supply. Tears of the peroneus brevis tendon almost always occur in the area where the blood supply and nutrition of the tendon are the poorest.

The second issue is the closeness between the two tendons, causing the peroneus brevis tendon to be wedged between the peroneus longus tendon and the bone. (Saxena A., & Bareither D. 2001) Tears of the peroneus brevis tendon are often treated with the same treatments for tendonitis. About half of the tears diagnosed by imaging are found to be asymptomatic. For individuals who don’t find lasting relief from symptoms, surgery may be necessary. Surgical options for peroneal tendon tears (Dombek M. F. et al., 2001)

Tendon Debridement and Repair

  • During a tendon debridement, the damaged tendon and the surrounding inflammatory tissue are removed.
  • The tear can be repaired, and the tendon can be tubularized to restore its normal shape.

Tenodesis

  • A tenodesis is a procedure where the damaged area of the tendon is sewn to the normal tendon.
  • In this case, the damaged segment of the peroneal tendon is removed, and the ends left behind are sewn to the adjacent remaining peroneal tendon.
  • Tenodesis is often recommended for tears involving more than 50% of the tendon. (Castilho R. S. et al., 2024)

Depending on the surgical procedure, Recovery after surgery can take several weeks of restricted weight-bearing and immobilization. Following immobilization, therapy can begin. Recovery is usually six to 12 weeks, depending on the surgery, but a full return to sports and activities may take several months. Risks of surgery include infection, stiffness, skin numbness near the incision, persistent swelling, and persistent pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Difference of Using Custom Foot Orthotics

References

Walt, J., & Massey, P. (2025). Peroneal Tendon Syndromes. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31335074

Saxena, A., & Bareither, D. (2001). Magnetic resonance and cadaveric findings of the “watershed band” of the Achilles tendon. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 40(3), 132–136. https://doi.org/10.1016/s1067-2516(01)80078-8

Dombek, M. F., Orsini, R., Mendicino, R. W., & Saltrick, K. (2001). Peroneus brevis tendon tears. Clinics in podiatric medicine and surgery, 18(3), 409–427.

Castilho, R. S., Magalhães, J. M. B., Veríssimo, B. P. M., Perisano, C., Greco, T., & Zambelli, R. (2024). Minimally Invasive Peroneal Tenodesis Assisted by Peroneal Tendoscopy: Technique and Preliminary Results. Medicina (Kaunas, Lithuania), 60(1), 104. https://doi.org/10.3390/medicina60010104

By admin 0 Comments Sleep Hygiene, Therapy , , , , , , , , , , , ,

Managing Periodic Limb Movements of Sleep for Better Rest

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

Periodic Limb Movements of Sleep

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

Causes

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

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

Symptoms

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

Type of Movements

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

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

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

Diagnosis

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

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

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

Treatment

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

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

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

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

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

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to restore health. Individuals can recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Revitalize and Rebuild with Chiropractic Care

References

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

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

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

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

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Triceps Tendonitis: A Guide to Prevention and Treatment

Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?

Triceps Tendonitis

Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.

Causes

The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)

Symptoms

Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:

  • Redness
  • Warmth
  • Swelling
  • Pain
  • Loss of function

With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.

Diagnosis

A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.

Treatment

Several types of treatments include self-care, physical therapy, and medications.

Self Care

Triceps tendonitis can be treated at home if symptoms are addressed early. These include:

Rest

  • Rest the triceps tendon by avoiding activities that cause pain for a few days.

Ice

  • Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
  • Massage the area with an ice cube for several minutes.

Range of Motion Exercises

  • Decrease stiffness in the elbow with gentle range of motion exercises.
  • Slowly bend and straighten the elbow in a pain-free range, 10 times.
  • Repeat several times per day.

Physical Therapy

Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)

PT Modalities

  • Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
  • Examples include ultrasound, electrical stimulation, and light therapy.

Manual Therapy

  • Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.

Exercise

  • Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.

Activity Modification

  • A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
  • Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.

Medications

Medications that are used to treat the condition (Aurora Health Care, 2025)

NSAIDs

  • Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
  • Many are available over-the-counter, including Aleve, Bayer, and Advil.
  • These medications can also be prescribed in higher doses by a healthcare provider.

Pain-Relievers

  • Additional over-the-counter medications such as Tylenol can help decrease pain.

Oral Steroids

  • These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
  • Long-term use of oral steroids can cause more damage to the tendons. (Spoendlin J., Meier C., Jick S. S., & Meier C. R. 2015)

Corticosteroid Injections

  • Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
  • However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)

Platelet-Rich Plasma

  • PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
  • The liquid is then injected into the tendon.
  • PRP is controversial; some studies support its use, while others do not.
  • While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.

Injury Medical Chiropractic and Functional Medicine Clinic

Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Inflammation to Healing

References

Orthopedic & Spine Center. (N.D.). Triceps Tendonitis or Weightlifter’s Elbow. https://www.osc-ortho.com/resources/elbow-pain/triceps-tendonitis-or-weightlifters-elbow/

Harvard Health Publishing. (2014). Tendonitis. https://www.health.harvard.edu/diseases-and-conditions/tendonitis

Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. https://doi.org/10.12965/jer.1836636.318

Aurora Health Care. (2025). Tendonitis symptoms & treatment. https://www.aurorahealthcare.org/services/orthopedics/conditions/tendonitis

Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. https://doi.org/10.3109/07853890.2015.1074272

NYU Langone Health. (2024). Therapeutic injections for bursitis & tendinitis in adults. https://nyulangone.org/conditions/bursitis-tendinitis/treatments/therapeutic-injections-for-bursitis-tendinitis

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Unlock the Potential of Parsley Tea for a Healthy Lifestyle

Can drinking parsley tea help improve overall health?

Parsley Tea

Parsley is commonly used as a garnish and to increase flavor in dishes. Some use parsley leaves instead of salt in their food to reduce their sodium intake. It is widely available in grocery stores and can be grown at home. Parsley tea is an herbal tea. Surprisingly, parsley tea benefits health, but not all of this is supported by scientific evidence. There are different kinds of parsley:

  • Curly leaf (Petroselinum crispum)
  • Flat leaf (Petroselinum neapolitanum) or Italian parsley.
  • Parsley is high in vitamins A, B, C, E, and K.
  • Parsley also provides fiber, iron, copper, calcium, and potassium.

The kind used in tea is up to you, based on flavor preferences.

Benefits

Parsley is believed to have various benefits, some of which are derived from consuming parsley tea. For example, parsley is used to freshen breath; however, adding sugar reduces dental benefits. Many women also suggest that parsley helps to ease menstrual cramps, and others say that consuming parsley or tea helps them eliminate excess water weight. However, further research is needed to support its benefits that include: (Ganea M. et al., 2024)

  • Asthma
  • Cough
  • Digestive problems
  • Menstrual problems
  • Fluid retention and swelling (edema)
  • Urinary tract infections
  • Kidney stones
  • Cracked or chapped skin
  • Bruises
  • Insect bites
  • Liver disorders
  • Tumors

Preparation

The quickest way to enjoy parsley tea is to use a parsley tea bag. Brands are available online and in health food stores. Parsley tea bags are manufactured using dried leaves, which can be stored in a cool, dry place and last much longer than fresh parsley. The herb is inexpensive, and making parsley tea at home is also cheap and easy.

Choose Parsley

  • Flat or curly.
  • Remove the leaves from the stems.
  • Gather about 1/8-1/4 cups of leaves for each cup of tea.
  • Place the leaves at the bottom of your cup or in a tea infuser.
  • Note: you can also use a French press to make parsley tea.
  • To do so, place the loose leaves at the bottom of the French press.

Heat Water

  • Once boiling, fill the cup or press with hot water.

Allow the Leaves to Steep

  • For about four minutes.
  • Steep longer if you prefer a stronger cup.
  • If you are new to parsley tea, start with a weaker cup and gradually increase the strength as you get used to the taste.

Remove the Parsley Leaves

  • With a spoon, remove the infuser and discard the leaves.
  • If you use a press, place the plunger on top and slowly press down to separate the leaves from the tea.
  • Flavor your tea with lemon or a little sugar (optional).

Side Effects

The FDA generally recognizes parsley as safe (GRAS). However, consuming large amounts—more than you would typically consume in amounts commonly found in food—can be dangerous. Having a cup of tea daily is not considered a large amount, but if you make tea with parsley oil or ground parsley seeds, your intake could be much higher than normal. Individuals who consume too much parsley may experience anemia and liver or kidney problems. (Alyami F. A., & Rabah D. M. 2011) Individuals who have diabetes, fluid retention, high blood pressure, or kidney disease should talk to their doctor to see if consuming parsley is safe for them, as it may cause side effects that can worsen their condition. Patients who undergo surgery are advised to avoid parsley in the two weeks before their procedure.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our 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, functional medicine, acupuncture, electroacupuncture, and various medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Optimizing Your Wellness

References

Ganea, M., Vicaș, L. G., Gligor, O., Sarac, I., Onisan, E., Nagy, C., Moisa, C., & Ghitea, T. C. (2024). Exploring the Therapeutic Efficacy of Parsley (Petroselinum crispum Mill.) as a Functional Food: Implications in Immunological Tolerability, Reduction of Muscle Cramps, and Treatment of Dermatitis. Molecules (Basel, Switzerland), 29(3), 608. https://doi.org/10.3390/molecules29030608

Alyami, F. A., & Rabah, D. M. (2011). Effect of drinking parsley leaf tea on urinary composition and urinary stones’ risk factors. Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 22(3), 511–514.

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Discover the Delightful World of Rice Noodles

Can incorporating rice noodles be a healthy alternative to traditional pasta for individuals looking to change their normal routine?

Rice Noodles

Several alternatives are available to replace wheat-based pasta, including:

  • Black beans
  • Chickpeas
  • Edamame
  • Lentils
  • Rice

Like gluten-free pasta, rice noodles are made with rice flour instead of semolina wheat. Different types of rice, such as brown and white, can be used to make rice noodles. The ingredients are typically rice flour, water, and tapioca starch for texture. Compared with wheat pasta, rice noodles have a mild flavor and texture.

Nutrition

Rice noodle calories and nutrition information is for 1 cup of cooked noodles. (U.S. Department of Agriculture, 2020)

  • Calories – 187
  • Fat – 0.4 grams
  • Carbohydrates – 41.8 grams
  • Protein – 3.1 grams
  • Fiber – 1.75 grams
  • Sugar – 0.05 grams
  • Sodium – 438 milligrams

Carbohydrates

Regular spaghetti noodles are made with semolina, which comes from durum wheat. Rice noodles are a healthy source of complex carbohydrates, with 41.8g of carbohydrates per serving. Individuals who follow a low-carb diet or track their carb intake should consider portion sizes when enjoying rice noodle dishes.

Fats

Rice noodles contain less than 1g of fat per serving. However, the fat content of meals may vary depending on the other ingredients, sauces, and toppings. Foods high in fat, such as vegetable oils, nuts, seeds, avocados, fish, and eggs, will increase the total fat.

Protein

Rice noodles have 3.1g of protein per serving. Although they are not a significant source of protein, they can be paired with other protein sources, such as meat, fish, or tofu, to make high-protein meals.

Vitamins and Minerals

Rice noodles contain small amounts of:

  • Calcium
  • Iron
  • Magnesium
  • Zinc

Health Benefits

The noodles are an alternative to regular pasta, which can be a healthful addition to a well-balanced diet and make for a great gluten-free pasta alternative.

Energy Levels

  • Because they are predominantly made of carbohydrate calories, they are beneficial for increasing and sustaining energy levels.

Gluten-Free Alternative

  • Rice noodles are especially beneficial for individuals who follow a gluten-free diet.
  • Individuals with celiac disease and non-celiac gluten sensitivity should read rice noodle packaging carefully to ensure it is gluten-free.
  • The noodles are also suitable for vegan, vegetarian, low-fat, and low-calorie diets.

Allergies

The noodles are inherently gluten-free because the main ingredient is rice flour. However, individuals with gluten intolerance should ensure no cross-contamination occurs with other non-gluten-free ingredients. Individuals with dietary allergies should check the label to see if cross-contamination may have occurred during processing or if a rice noodle product contains added allergens. Rice noodles are also free of other common allergens, including dairy, soy, eggs, fish, nuts, and wheat.

Preparation

They are cooked by boiling them in water, which rehydrates them. Once cooked, they can be used like regular pasta noodles. They are commonly used in stir-fries and Italian pasta dishes and can be used as substitutes for wheat, egg, and ramen noodles. If a recipe calls for any noodles, use rice noodles instead to change up the texture and flavor.

Storage and Safety

The noodles should be stored in a cool, dry place like the pantry. They come in vacuum-sealed packaging or boxes, so they do not need refrigeration until cooked.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our 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, functional medicine, acupuncture, electroacupuncture, and various medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Atherosclerosis: The Joint Pain Connection

References

U.S. Department of Agriculture, FoodData Central. (2020). Rice Noodles, cooked. Retrieved from https://fdc.nal.usda.gov/food-details/1101528/nutrients