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By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Athletes, Exercises , , , , , , , , , , , , , , , , , , ,

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

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

Center of Gravity Explained: A Comprehensive Guide

What is the body’s center of gravity to understand and maintain a healthy posture and balance?

Center of Gravity

The human center of gravity, or COG, also known as the center of mass, with the two terms being interchangeable, is where the body’s weight appears to be concentrated. It’s a point in space where the entire body’s mass can be concentrated. When standing upright, the COG is generally located behind the navel and in front of the sacrum, around the level of the second vertebra. (Le Huec, J. 2011) The center of gravity is related to posture, including issues such as swayback, the design of posture exercise programs, and much more.

  • Gravity is a downward pull or force the Earth exerts on the body, creating weight. (NASA, 2013)
  • The center of gravity (COG) is where a body’s weight is equally balanced in all directions. (Physiopedia, 2025)
  • When the COG is defined, it is done from the reference of a static, standing position.
  • Because the body is in motion when we change positions, the COG is located in a new position with each new position.
  • The center of gravity is the point around which all the parts balance, which may be inside or outside the body.
  • Even slight changes in position can change where the COG is. (Physiopedia, 2025)

Key aspects of the COG

Location

  • When standing upright, the COG is typically found at the second vertebral level, behind the navel and in front of the sacrum. (Le Huec, J. 2011)

Shifting COG

  • The COG can shift depending on body position, posture, and movements like bending forward or backward. (Physiopedia, 2025)

Balance Impact 

  • The relationship between the COG and the base of support (the area of the body in contact with the ground) is fundamental to maintaining balance.

Variations

  • There can be variations in the COG location based on factors like gender (men tend to have a slightly higher COG), body shape, and even conditions like obesity or chronic low back pain. (Physiopedia, 2025)

Biomechanics

  • Understanding the COG is crucial in biomechanics and movement analysis, as it’s an index of total body motion and how the body responds to external forces.

The Human Center

The center of gravity is the point at which the body’s mass is equally balanced. This point changes depending on one’s position:

  • Arms up/down
  • Leaning
  • Turning

With strength and flexibility training, the human body can change its center of gravity, as gymnasts and dancers do.

  • When standing, the center of gravity is normally located behind the navel and in front of the sacrum bone (made up of five vertebrae fused vertically) at about the second vertebra level. (Hasegawa K. et al., 2022)
  • Because the body has moving parts, its overall shape changes every time it moves. Carrying something like a suitcase or grocery bag or wearing a backpack adds weight to some areas but not others, changing the center of gravity as it does.
  • The center of gravity is a continually changing point inside or outside the body that represents where the weight or mass of the rest of the body is equally balanced in every direction.
  • This point can and does change based on what is being carried and how it is carried, as well as body position and movements.

Chronic Lower Back Pain

  • A study in the Journal of Back and Musculoskeletal Rehabilitation found that individuals with chronic lower back pain tend to have their center of gravity located excessively towards the back. (Kim D. H., Park J. K., & Jeong M. K. 2014)
  • In the study, the individuals had decreased low back strength upon extension and a reduced normal low back curve.
  • The researchers found that those with chronic lower back pain whose center of gravity was too far back may need physical therapy to retrain the body to overcome strength and balance challenges to re-establish and maintain a healthy posture.

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.

Enhance Your Lifestyle Today with Chiropractic Care

References

Le Huec, J. C., Saddiki, R., Franke, J., Rigal, J., & Aunoble, S. (2011). Equilibrium of the human body and the gravity line: the basics. 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 Suppl 5(Suppl 5), 558–563. https://doi.org/10.1007/s00586-011-1939-7

NASA. Jet Propulsion Laboratory, California Institute of Technology. (2013). What is gravity? Retrieved from https://gracefo.jpl.nasa.gov/news/5/what-is-gravity/

Physiopedia. (2025). Centre of gravity. https://www.physio-pedia.com/Centre_of_Gravity

Hasegawa, K., Amabile, C., Nesme, M., & Dubousset, J. (2022). Gravity center estimation for evaluation of standing whole body compensation using virtual barycentremetry based on biplanar slot-scanning stereoradiography – validation by simultaneous force plate measurement. BMC musculoskeletal disorders, 23(1), 22. https://doi.org/10.1186/s12891-021-04948-5

Kim, D. H., Park, J. K., & Jeong, M. K. (2014). Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 27(2), 231–237. https://doi.org/10.3233/BMR-130442

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

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

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Advanced Practice Registered Nurses (APRN), Chiropractic Care, Sleep Hygiene , , , , , , , , , , , , , , , , ,

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
  1. The bone graft promotes growth between the two bones.
  2. The hardware stabilizes the vertebrae and prevents movement while they fuse and grow together.
  3. The hardware goes inside, or internal fixation.
  4. Although rare, a severe spinal fracture or deformity may need external fixation.
  5. 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

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

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

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

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

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.

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet, El Paso TX, Exercises , , , , , , , , , , , , , , , , ,

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

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

Running Fartlek Training for All Skill Levels

Can adding fartlek training improve speed and endurance for runners and running enthusiasts?

Running Fartlek Training

Fartlek training, which means speed play in Swedish, is a form of running training that involves alternating between bursts of fast running and slower recovery jogging.

  • It is a form of interval or speed conditioning.
  • It involves varying one’s pace throughout their run, alternating between fast treks and slow jogs.
  • Workouts are unstructured and allow runners to decide the duration and intensity of the fast and slow sections.
  • Unlike formal interval training, this flexibility offers a new way to improve speed, endurance, mental preparedness, and stamina.

Training Benefits

Traditional interval training uses specific timed or measured segments. Fartleks are more unstructured, with work-rest intervals based on how the body feels. With fartlek training, individuals can experiment with pace and endurance as they run, which helps them tune in to their body and adjust how it performs. Many runners enjoy the training because it involves speed work and is more flexible and less demanding.

  • A stopwatch is not needed for time intervals.
  • Training doesn’t have to be done on a track and can be performed on all terrain, such as roads, trails, or hills.
  • The training stresses the body’s systems, leading to faster speeds and improving anaerobic threshold. (Bacon, A. P. et al., 2013)
  • Improves the anaerobic threshold and increases the body’s ability to train longer at higher intensities. (Mazurek K. et al., 2016)
  • This is due to an increased VO2 max, which measures how much oxygen the body can take in and use.
  • A better VO2 Max generally leads to improved performance. (Scribbans T. D. et al., 2016)

Disadvantages

  • Training includes a higher risk of injury and strain.
  • Beginners are more prone to shin splints.
  • The training is demanding, so it should not be done daily.

Workout

The method is to vary brief periods of slightly higher pace into regular runs (Kumar P. 2015). Maintain a faster pace for a short distance or time interval, such as 200 meters or 30 seconds. Intervals can vary throughout the workout, and landmarks such as streetlights or telephone poles can be used to mark segments instead of measuring miles or meters. Once a fast segment is completed, slow to below-normal running cadence until the body fully recovers and breathing returns to normal. Return to running normally and incorporate slightly faster intervals later in the run.

  • Fartleks should be short because they are intense.
  • The actual higher-pace portion of the run should last up to 30 seconds.
  • Gradually add more time to the faster-paced portion as conditioning improves, up to 60 seconds.

Training Example

An example of a 40- to 45-minute fartlek workout suitable for beginners.

  • 10-minute warm-up at a light pace
  • 1 minute on (fast pace)
  • 2 minutes off (easy)
  • 2 minutes on
  • 1 minute off
  • Repeat the set 3 to 4 times
  • 10-minute cooldown at an easy pace

Remember that beginners should go slow when introducing fartlek training into their workouts. It is more intense and can increase the risk of injuries and strains, such as shin splints. Get help from a running coach or trainer if you are unsure how to incorporate the training into your routine.

Training on a Treadmill

Speed play can be done on a treadmill. The idea is to find ways to create speed variation intervals and help relieve treadmill boredom. Some examples include:

  • If watching television, use commercials to go into speed intervals.
  • At the gym, make a game out of the sprints and/or
  • Speed up during certain parts of songs where you can feel the energy moving you faster.

One precaution is learning to use the treadmill’s buttons to increase and decrease the pace. This can slow you down and disrupt form, so maybe do longer durations for each phase so there is less contact with the control panel.

Injury Medical Chiropractic & Functional Medicine Clinic

Fartlek training is an excellent way to add variety, fun, and interest to running. This speed work can also enhance performance, increase cardiovascular output, and allow individuals to run at higher intensities for longer periods. 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.

Building a Stronger Body

References

Bacon, A. P., Carter, R. E., Ogle, E. A., & Joyner, M. J. (2013). VO2max trainability and high-intensity interval training in humans: a meta-analysis. PloS one, 8(9), e73182. https://doi.org/10.1371/journal.pone.0073182

Mazurek, K., Zmijewski, P., Krawczyk, K., Czajkowska, A., Kęska, A., Kapuściński, P., & Mazurek, T. (2016). High-intensity interval and moderate continuous cycle training in a physical education programme improves health-related fitness in young females. Biology of Sport, 33(2), 139–144. https://doi.org/10.5604/20831862.1198626

Scribbans, T. D., Vecsey, S., Hankinson, P. B., Foster, W. S., & Gurd, B. J. (2016). The Effect of Training Intensity on VO2max in Young Healthy Adults: A Meta-Regression and Meta-Analysis. International journal of exercise science, 9(2), 230–247. https://doi.org/10.70252/HHBR9374

Kumar, P. (2015). Effect of fartlek training for developing endurance ability among athletes. Int J Phys Ed Sports Health., 2(2), 291-293. https://www.kheljournal.com/archives/2015/vol2issue2/PartE/3-3-75-957.pdf

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

Postural Assessment for Optimal Movement Efficiency

Can postural assessments help identify problems with how a person stands or sits, which can lead to various musculoskeletal issues?

Postural Assessment

Proper posture is an exercise in which the muscles support the skeleton in a comfortable, stable, and efficient alignment. Healthy posture is present when the body is still and when moving. However, numerous factors can affect and hinder posture. These include daily wear and tear, injury, illness, or a condition. A posture assessment is a process that identifies posture issues and their root causes, often using visual and palpation techniques, and can help determine appropriate treatment or exercises. (Science Direct, 2007)

Visual Assessment

  • Observing the body’s alignment and symmetry from different angles (anterior, posterior, and lateral views).

Palpation

Movement Analysis

  • Assessing how a person moves and if there are any limitations or compensations. (Physiopedia, 2025)

Importance and Benefits

Early Identification

  • Helps identify potential problems early, before they become more serious.

Targeted Treatment

  • Allows for the development of personalized treatment plans to address specific postural issues.

Injury Prevention

  • It can help prevent injuries by addressing underlying postural imbalances.

Postural Assessment Tools

Some tools used include:

Basic Assessment

Stand Upright

  • The patient stands with their feet shoulder-width apart, arms relaxed at their sides, and looks straight ahead. (Science Direct, 2007)

Alignment Observation

  • Head: Is the head aligned over the shoulders, forward, or tilted?
  • Shoulders: Are the shoulders level, or are they rounded forward?
  • Back: Is the back straight, or is there excessive curvature (kyphosis or lordosis)?
  • Pelvis: Is the pelvis level or tilted forward or backward?
  • Knees: Are the knees straight or slightly bent?
  • Feet: Are the feet flat on the ground, or is there excessive arch or pronation?

Palpate for Muscle Imbalances

Consider the Patient’s Activity Level and History

Wall Test

  • The patient stands against a wall with their feet shoulder-width apart and heels about 6 inches from the baseboard.
  • If they have good posture, their ears will be vertically aligned with their shoulders, and their head will be no more than three finger widths from the wall. (Physiopedia, 2025)

Postural Issues Examples

Rounded Shoulders (Hyperkyphosis)

  • Forward rounding of the upper back.

Forward Head Posture

  • Head positioned too far forward.

Lordosis

  • Excessive inward curve of the lower back.

Flat Back

  • Reduced natural curve of the lower back.

Muscle Imbalances

Professionals Who Can Perform a Posture Assessment

Physiotherapists

  • Professionals trained in assessing and treating musculoskeletal problems.

Chiropractors

  • Professionals who focus on the spine and nervous system.

Fitness Professionals

  • Personal trainers or other fitness professionals can use posture assessments to help clients improve their posture and movement.

Ergonomists

  • Professionals who specialize in designing workspaces and environments to promote good posture and reduce strain.

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider to learn what interventions would help the most. 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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Multidisciplinary Evaluation and Treatment

References

ScienceDirect. (2007). Postural Assessment – an Overview. Evidence-Based Manual Medicine, 2007. https://www.sciencedirect.com/topics/medicine-and-dentistry/postural-assessment#recommended-publications

Singla, D., & Veqar, Z. (2014). Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR, 8(4), LE01–LE4. https://doi.org/10.7860/JCDR/2014/6836.4266

Du, S. H., Zhang, Y. H., Yang, Q. H., Wang, Y. C., Fang, Y., & Wang, X. Q. (2023). Spinal posture assessment and low back pain. EFORT open reviews, 8(9), 708–718. https://doi.org/10.1530/EOR-23-0025

Physiopedia. (2025). Sports Screening: Postural Assessment. https://www.physio-pedia.com/Sports_Screening:_Postural_Assessment#:~:text=Postural%20assessment%20as%20part%20of,tone%20can%20cause%20postural%20faults.

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

Post Surgery Leg Strengthening Tips for Patients

What are some leg-strengthening exercises that will expedite recovery for athletes and physically active individuals who have undergone leg surgery?

Post Surgery Leg Strengthening

Leg muscles may weaken after hip, knee, ankle, or foot surgery. This happens because those muscles are not used as much during recovery. Gaining back strength and muscle endurance after an injury or surgery is an important step in recovery. Leg exercises can help regain mobility and prevent complications like blood clots and pressure sores after surgery or an injury, which is why engaging in post-surgery leg strengthening is important once the doctor gives the ok.

Benefits

post-surgery leg strengthening exercises have several benefits, including

  • Rebuilds strength and confidence
  • Retraining for optimal mobility and flexibility
  • Prevents pressure sores
  • Prevents blood clots

When the leg muscles are contracted, they move blood like a pump, maintaining proper circulation. Moving in a bed after surgery also helps prevent pressure sores from forming and blood clots. A physical therapy team will determine the right leg exercises for each individual and their injury/condition. This is an important step when moving forward after surgery. (Hoogeboom T. J. et al., 2014)

Starting Out

The first exercises should target all the major muscles of the leg. (Madara K. C. et al., 2019)

Gluteal Sets

This isometric exercise means the muscles contract while no motion occurs at the hip joints. To perform:

  • Lie on your back and tighten your buttock muscles.
  • Hold the muscles tight for 5 seconds, then relax.
  • Repeat 10 or 15 times.
  • Gluteal sets can be done several times per day.

Heel Slide

Heel slides can help regain strength in the major muscles of the leg. To perform:

  • Lie on your back.
  • Bend the knee of the surgical leg and slowly slide the heel toward your butt.
  • Slide as far as possible and hold for 5 seconds.
  • Slowly return to the starting position and repeat.

Short Arc Quad

The short arc quad, or SAQ, is a simple way to get the quadricep muscles working. To perform:

  • Lie on your back with a towel roll, small ball, or something similar under the knee.
  • Slowly straighten the knee.
  • Tighten the quad muscle on the top of the thigh.
  • Hold for 3 seconds, then relax.
  • Repeat 10 to 15 times.

Quad Set

This exercise helps get the quad muscles working. It also helps control the position of the kneecap. To perform:

  • Lie on your back.
  • Place a small towel roll under the knee.
  • Try to press the back of the knee flat against the floor.
  • Hold for 10 seconds and release.
  • Repeat 10 to 15 times.

Individuals can complete quad sets bilaterally or with both knees simultaneously. This makes the stronger leg help strengthen the weaker side.

Straight Leg Raise

To perform:

  • Lie on your back.
  • Lift your leg straight off the floor until it is at the height of the opposite bent knee.
  • Hold for 10 seconds and slowly lower.
  • Repeat 10 to 15 times.

Be sure to keep the knee straight for the entire exercise. Keep the opposite knee bent for comfort. To ensure the knee is straight, individuals can complete a quad set first and then the straight leg raise. The exercise can be more challenging by increasing repetitions or adding a 2- to 3-pound ankle weight on the thigh. For even more challenge, add the ankle weight to the ankle.

Hamstring Strengthening

Working out the hamstrings after injury or surgery is important. The hamstring muscles bend the knee and extend the hip backward. To perform:

  • Lie on your stomach.
  • Bend one knee to raise the lower limb straight in the air.
  • Hold for 5 seconds and lower slowly.
  • Repeat 10 to 15 times.

Once the exercise is easy to do, increase the repetitions to 30. Individuals can also try adding a 2- to 3-pound ankle weight.

Physical therapy can help individuals regain mobility after injury or surgery. A therapist may prescribe exercises as part of an at-home exercise program. Over time progress will go from simple exercises to more challenging ones to improve balance and mobility. (Madara K. C. et al., 2019)

Injury Medical Chiropractic & Functional Medicine Clinic

Before starting this or any other exercise program, consult a doctor and a physical therapist to find the right exercises for your situation. 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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Are You Recovering From Ankle Sprains?

References

Hoogeboom, T. J., Dronkers, J. J., Hulzebos, E. H., & van Meeteren, N. L. (2014). Merits of exercise therapy before and after major surgery. Current opinion in anaesthesiology, 27(2), 161–166. https://doi.org/10.1097/ACO.0000000000000062

Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni, J., Jr., & Raisis, L. (2019). PROGRESSIVE REHABILITATION AFTER TOTAL HIP ARTHROPLASTY: A PILOT AND FEASIBILITY STUDY. International Journal of Sports Physical Therapy, 14(4), 564–581.

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

Lidocaine Patch for Pain Relief: An Overview

For individuals experiencing lower back pain and sciatica symptoms, can using a lidocaine patch help?

Lidocaine Patch

Lidocaine patches are in a drug class called local anesthetics (MedlinePlus, 2025) (Food and Drug Administration, 2022). They relieve pain in small body areas by blocking the nerves from sending pain signals. The Food and Drug Administration approved lidocaine 5% or 1.8% patches for relieving postherpetic neuralgia (PHN) pain. These lidocaine patches are prescription-only (Food and Drug Administration, 2022). They are available either by prescription or over the counter and are commonly used for back pain and other areas. Over-the-counter lidocaine, 4% patches, can be used to relieve minor aches and pains, including back pain. However, further research is needed to recommend the use of lidocaine patches as an effective method of pain relief. (Department of Veterans Affairs/Department of Defense, 2022) (North American Spine Society, 2020)

The Patch

They are available in prescription and over-the-counter forms. Over-the-counter forms come as a 4% patch in various brands, such as (MedlinePlus, 2025)

  • Aspercreme
  • Lidocare
  • Salonpas

Prescription-only patches come in 5% or 1.8% patches and are approved to relieve long-term nerve pain from shingles in adults. Zlido is a brand name for a 1.8% lidocaine patch. Five percent lidocaine patches are available generically. (DailyMed, 2018) (Food and Drug Administration, 2021) The safety and effectiveness in children are unknown. (Food and Drug Administration, 2022)

Other Lidocaine Forms

As a local anesthetic, it is available in several other forms, including:

  • Spray
  • Topical cream
  • Lotion
  • Liquid
  • Ear drops
  • Eye gel
  • Injection
  • It is also available as a short-term intravenous infusion for abnormal heart rhythm. (DailyMed, 2025)

Effectiveness

Clinical trials have shown that the patches effectively relieve chronic low back pain. However, these studies were nonrandomized and did not include a control group to compare against the treatment group. (Santana J. A., Klass S., & Felix E. R. 2020) The results may be subject to potential biases. For this reason, further evidence is needed to support lidocaine patches’ effectiveness in reducing low back pain. (North American Spine Society, 2020) High-quality randomized and controlled clinical trials are necessary to study the effectiveness. (North American Spine Society, 2020) (Santana J. A., Klass S., & Felix E. R. 2020)

How to Use Safely

In general, keep the following in mind (MedlinePlus, 2025)

  • Use according to the directions on the box and the healthcare provider’s recommendations.
  • Do not use on broken or inflamed, swollen skin.
  • Do not apply heat like heating pads or electric blankets over patches.
  • Avoid getting water on or around the patch.
  • Avoid letting a patch near your eyes to limit eye irritation.
  • Fold the sticky sides of the used lidocaine patches together and safely throw them away, keeping them away from children and pets.

How to use (MedlinePlus, 2025)

  • Clean and dry the affected area before placing the patch.
  • Apply to the affected body area as directed.
  • Wash your hands after touching the patch.
  • Remove the patch after what is usually recommended after eight hours.

How Quickly Does It Work?

The amount of medication absorbed into the blood depends on how long the patch is placed on the body and how much is covered with the patch. In a study, healthy participants wore three lidocaine patches on their backs for 12 hours on and 12 hours off during 24 hours. Lidocaine levels were highest at 11 hours. At the end of the 24 hours, there was still some lidocaine left in the bloodstream. (Food and Drug Administration, 2022)

Individuals with PHN may notice a difference in pain intensity after four hours of using the patch. (Rowbotham, M. C. et al., 1996) (Food and Drug Administration, 2022) Experts may suggest using patches for four weeks for those who experience pain after their shingles rash disappears. However, if there is still pain after these four weeks, it is recommended to see a pain specialist. (Gross, G. E. et al., 2020)

Side Effects

Common side effects are typically mild skin reactions where the patch is.  These reactions are usually temporary and will disappear within a few minutes or hours. Examples include: (Food and Drug Administration, 2022)

  • Irritation
  • Itchiness
  • Abnormal or burning sensation
  • Redness
  • Swelling
  • Blisters
  • Bruises
  • Skin bumps
  • Skin color changes
  • Skin peeling

Potentially serious side effects include: (Food and Drug Administration, 2022)

Serious Allergic Reaction

  • Severe allergic reactions are rare, but it is possible.
  • Symptoms include breathing problems, itchiness, and rash.

Methemoglobinemia

  • Methemoglobinemia is a condition that makes it hard for red blood cells to carry oxygen.
  • Individuals may experience symptoms of blue-looking skin, headache, lightheadedness, shortness of breath, abnormal heart rhythm, or seizures.

Using too many lidocaine patches to cover large parts of the body or using the patches longer than 12 hours within 24 hours may cause side effects that may include heart-related effects, such as a slow heart rate and low blood pressure.  Individuals may also experience the following side effects (Food and Drug Administration, 2022)

  • Hot or cold sensation
  • Numbness
  • Dizziness
  • Ringing ears
  • Lightheadedness
  • Mood changes
  • Drowsiness to unconsciousness
  • Vision changes
  • Seizures
  • Tremors
  • Vomiting

Injury Medical Chiropractic & Functional Medicine Clinic

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. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Sciatica Causes and Treatments

References

National Library of Medicine. MedlinePlus. (2025). Lidocaine transdermal patch. Retrieved from https://medlineplus.gov/druginfo/meds/a603026.html

Food and Drug Administration. (2022). Lidoderm label. Retrieved from https://www.accessdata.fda.gov/spl/data/eedfe43b-1019-19a0-e053-2995a90a7696/eedfe43b-1019-19a0-e053-2995a90a7696.xml

Department of Veterans Affairs/Department of Defense. (2022). VA/DoD clinical practice guideline for the diagnosis and treatment of low back pain. Retrieved from https://www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPGFinal508.pdf

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: diagnosis and treatment of low back pain. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

National Library of Medicine. DailyMed. (2018). Label: lidocaine patch. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c66f3b9-6e04-47ab-8d94-21e89ceec154

Food and Drug Administration. (2021). Ztlido label. Retrieved from https://www.ztlido.com/wp-content/uploads/2022/12/ZTlido-LABEL.pdf

National Library of Medicine. DailyMed. (2025). Lidocaine-lidocaine hydrochloride injection, solution. Retrieved from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f1b26274-a55e-4321-b96c-ce0df830f205

Santana, J. A., Klass, S., & Felix, E. R. (2020). The Efficacy, Effectiveness and Safety of 5% Transdermal Lidocaine Patch for Chronic Low Back Pain: A Narrative Review. PM & R: the journal of injury, function, and rehabilitation, 12(12), 1260–1267. https://doi.org/10.1002/pmrj.12366

Rowbotham, M. C., Davies, P. S., Verkempinck, C., & Galer, B. S. (1996). Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia. Pain, 65(1), 39–44. https://doi.org/10.1016/0304-3959(95)00146-8

Gross, G. E., Eisert, L., Doerr, H. W., Fickenscher, H., Knuf, M., Maier, P., Maschke, M., Müller, R., Pleyer, U., Schäfer, M., Sunderkötter, C., Werner, R. N., Wutzler, P., & Nast, A. (2020). S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG, 18(1), 55–78. https://doi.org/10.1111/ddg.14013