For individuals experiencing back pain, can lying in the supine position help bring relief?
Supine Position
The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)
Medical Uses
Examinations
Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)
Procedures
It’s also used for various procedures, such as lumbar punctures and injections. (Steris Healthcare, 2025)
Surgery
Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures.
It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)
Overall Health
Natural Position
Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.
Back Pain Relief
Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)
Acid Reflux
However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)
Sleep Apnea
The supine position can worsen sleep apnea in some individuals.
Clinical Uses
A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
Many bed exercises begin in this position for rehabilitation.
Back Care
Here are a few recommendations to relieve low back pain using the supine position.
First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
Start breathing and relaxing, allowing the tension to drain out of the muscles.
In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
At that point, the fingertips should feel the transverse abdominal muscle engage.
Release and repeat 10 times.
After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.
For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.
Variations
Lawn Chair Position
This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.
Frog-Leg Position
The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)
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.
Thoracic Spine Pain
References
ScienceDirect. (2009). Supine Position. Morrey’s The Elbow and Its Disorders (Fourth Edition), 567-577. https://doi.org/https://doi.org/10.1016/B978-1-4160-2902-1.50042-5
Nurse.com. (2024). What Is Supine Position? https://www.nurse.com/nursing-resources/definitions/what-is-supine-position/#:~:text=During%20routine%20physical%20examinations%2C%20the,easier%20to%20perform%20comprehensive%20assessments.
STERIS. (2025). The Complete Guide to Patient Positioning. https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning#:~:text=The%20most%20common%20position%20used,and%20elevating%20the%20sternal%20notch.
MedicalNewsToday. (2022). What is the supine position? https://www.medicalnewstoday.com/articles/supine-position
Aurora BayCare Medical Center. (N.D.). Lumbar stabilization hooklying position. https://ahc.aurorahealthcare.org/fywb/baycare/x06913bc.pdf
Can understanding the mechanics of the throwing motion help to understand why it may cause shoulder pain, the symptoms of a shoulder problem, the diagnosis, and the treatment options available?
Throwing a Ball and Shoulder Pain
The throwing motion is a complex shoulder movement that requires the mechanics of muscles, tendons, joints, ligaments, and bones. They all must move in a synchronized and stable pattern to move the shoulder joint. When these mechanics are interrupted or altered, inflammation can result in pain symptoms. (Wardell M., Creighton D., & Kovalcik C., 2022)
The labrum stabilizes the ball in the socket of the shoulder.
The shoulder blade rotation coordinates with the arm to ensure mobility. (Itoigawa Y. et al., 2023)
The throwing motion generates high torque and acceleration forces acting on the shoulder joint and the surrounding muscles, ligaments, and tendons.
Causes of Pain
Pain when throwing can come from the:
Shoulder blade
Shoulder joint – cartilage and labrum
Rotator cuff muscles and tendons
Nerves that control the muscles’ function
The shoulder blade is attached to the upper back by ligaments, muscles, and tendons. The various muscles and tendons that control the movement of the shoulder blade impact movements. Abnormalities of any area can lead to shoulder dysfunction and pain when throwing. (Wardell M., Creighton D., & Kovalcik C., 2022) The most common is the tightness of the posterior shoulder capsule, causing a loss of normal internal rotation of the shoulder. If this is causing pain, individuals may notice that they can’t reach up as high on the side with the painful shoulder when reaching behind their back.
Symptoms
Whether an athlete or playing catch in the backyard, shoulder function abnormalities can cause significant pain. Some symptoms include.
Aching Pain
Often deep in the shoulder or extending down the upper arm.
Dead Arm
Lack of strength in the throwing motion.
Pain at Night
Pain can awaken you from sleep.
Diagnosis
Finding a healthcare provider familiar with sports injuries can be helpful. They can best determine if a structural abnormality needs to be addressed. (American Academy of Orthopaedic Surgeons, 2021)
Treatment
Most can improve with nonsurgical treatments. The earliest phase of treatment is resting the joint and reducing inflammation. Treatments can include:
Ice
Anti-inflammatory medications
Cortisone injection
Once the inflammation has subsided, the source of the discomfort can be addressed.
Physical Therapy
Therapy can include:
A structured shoulder stretching and strengthening program will help.
The physical therapist will focus on scapular mobility when managing shoulder joint problems.
Stretching to improve internal rotation or any other lost motion can help allow a more normal throwing motion.
Strength exercises are often aimed at the rotator cuff, as these muscles initiate proper shoulder movements and stabilize the shoulder joint.
Maintaining flexibility and strength of the periscapular muscles (muscles that attach to the scapula bone) is important to ensure that the scapular movements are coordinated with the throwing motion.
Suppose improvements are not made within three months of therapy, or individuals can’t return to competitive sports within six months. In that case, the individual may need to return to their healthcare provider or see an orthopedic specialist who may recommend surgery. (American Academy of Orthopaedic Surgeons, 2024)
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.
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.
Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
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 frustrating 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.
Lumbar Spine Injuries in Sports: Chiropractic Healing
References
Wardell, M., Creighton, D., & Kovalcik, C. (2022). Glenohumeral Instability and Arm Pain in Overhead Throwing Athletes: A Correlational Study. International journal of sports physical therapy, 17(7), 1351–1357. https://doi.org/10.26603/001c.39800
Itoigawa, Y., Koga, A., Morikawa, D., Kubota, A., Uehara, H., Maruyama, Y., Takazawa, Y., & Ishijima, M. (2023). Posterior shoulder stiffness was associated with shoulder pain during throwing in college baseball players: assessment of shear wave elastography. European journal of orthopaedic surgery & traumatology: orthopedie traumatologie, 33(4), 1237–1244. https://doi.org/10.1007/s00590-022-03286-z
American Academy of Orthopaedic Surgeons. (2021). Shoulder Injuries in the Throwing Athlete. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-injuries-in-the-throwing-athlete/
American Academy of Orthopaedic Surgeons. (2024). Shoulder Impingement/Rotator Cuff Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis
Get started with calisthenics and experience amazing results. Bodyweight training can elevate your fitness game effortlessly.
Introduction
Musculoskeletal disorders (MSDs) are among the leading causes of pain, disability, and diminished quality of life worldwide. Whether stemming from repetitive occupational stressors, sedentary behavior, age-related degeneration, or trauma, these disorders disrupt the foundational biomechanics of the human body. As a nurse practitioner with two decades of experience in physical and functional medicine, I have observed how integrated, non-surgical interventions—particularly calisthenics and chiropractic care—offer sustainable solutions for patients grappling with pain and mobility challenges.
This article outlines how calisthenics, or bodyweight movement training, when combined with chiropractic care, provides a comprehensive, cost-effective, and evidence-informed approach to restoring musculoskeletal health. We’ll also explore specific exercises, patient protocols, and the neurobiological underpinnings that make this combination both powerful and accessible.
Understanding Musculoskeletal Disorders: A Functional Medicine Perspective
Musculoskeletal disorders encompass a wide range of conditions affecting the bones, muscles, tendons, ligaments, and joints. These include:
Low back pain
Cervical radiculopathy
Myofascial pain syndrome
Shoulder impingement
Chronic joint stiffness and instability
Sacroiliac dysfunction
Postural imbalances and movement disorders
From a functional medicine lens, MSDs are not isolated pathologies but often part of a larger systemic imbalance involving inflammation, poor posture, neuromuscular dysfunction, and biomechanical inefficiencies.
Importantly, many patients present with overlapping risk profiles—including obesity, insulin resistance, sedentary lifestyle, poor proprioception, and autonomic dysregulation—that exacerbate their musculoskeletal pain. In these cases, surgery should be a last resort. Instead, conservative, holistic interventions often yield long-term relief and functional restoration without the side effects and costs associated with pharmacological or surgical approaches.
Why Non-Surgical Interventions Matter
Non-surgical treatments, especially those grounded in functional and physical medicine, provide several advantages:
Minimized risk: Avoids complications from anesthesia, surgical infection, or post-operative dependency on opioids.
Root-cause resolution: Treats underlying movement dysfunction, not just the symptoms.
Sustainability: Teaches patients to manage their health independently through lifestyle, movement, and alignment.
Among these interventions, two stand out: chiropractic spinal care and calisthenics-based rehabilitation.
Calisthenics: The Foundation of Functional Movement
What Is Calisthenics?
Calisthenics refers to bodyweight resistance training aimed at improving strength, coordination, balance, and flexibility. Exercises such as squats, lunges, planks, push-ups, glute bridges, and dynamic mobility drills engage multiple muscle groups without external weights, making them safe, scalable, and accessible to all fitness levels.
Unlike high-intensity interval training (HIIT) or gym-based hypertrophy programs, calisthenics emphasizes:
Neuromuscular integration
Proprioceptive feedback
Core stabilization
Functional joint loading
🔍 SEO Keywords: calisthenics for low back pain, bodyweight exercises for musculoskeletal pain, functional movement therapy, non-surgical back pain relief
Calisthenics and Health Optimization
Evidence shows that regular participation in calisthenic-based movement routines can:
Improve metabolic health and reduce risk of chronic disease (Bellissimo et al., 2022)
Reverse deconditioning associated with sedentary behavior
Enhance musculoskeletal and cognitive function by improving circulation and neuroplasticity (Osuka et al., 2020)
This makes calisthenics not only a therapeutic intervention but also a preventive strategy for aging-related degeneration and functional decline.
Chiropractic care focuses on restoring spinal and joint alignment through manual and mechanical manipulations. When spinal segments are misaligned—known as subluxations—they interfere with normal neuromuscular signaling and alter gait, posture, and joint mechanics.
Key benefits include:
Pain reduction through neural reflex modulation
Improved range of motion in affected joints
Myofascial release and decreased muscle hypertonicity
Autonomic balance through vagal nerve upregulation
Coulter et al. (2018) documented chiropractic’s efficacy in reducing back pain severity, improving function, and lowering opioid dependence in patients with chronic low back pain.
The Synergy Between Calisthenics and Chiropractic Care
While chiropractic adjustments realign and decompress joints, calisthenics reinforces these changes by retraining the neuromuscular system. This dual approach ensures that postural corrections are maintained long-term through active engagement and movement retraining.
Key Integration Strategies:
Post-Adjustment Stabilization Patients are guided through low-load activation drills (e.g., glute bridges, bird-dogs) immediately after spinal manipulation to “lock in” proper alignment via muscle memory.
Corrective Exercise Protocols Calisthenic movements are used to correct postural syndromes like upper-crossed and lower-crossed syndrome by strengthening underactive muscles and releasing hypertonic patterns.
Home-Based Exercise Programs These simple, equipment-free routines promote daily movement, increase patient autonomy, and reduce reliance on in-office care.
Neuromuscular Re-education Calisthenics enhances proprioceptive feedback and motor planning, essential for individuals with chronic pain and poor movement literacy (Mear et al., 2022).
Evidence-Based Calisthenics for Musculoskeletal Pain
Calisthenics for Low Back Pain: 4 Foundational Exercises
1. Glute Bridge
Target: Gluteus maximus, hamstrings, core Why: Strengthens posterior chain to decompress lumbar spine How to Perform:
Lie on your back, knees bent, feet flat.
Engage core, press through heels, lift hips.
Hold 5 seconds; repeat 15 reps × 3 sets.
2. Bird-Dog
Target: Multifidus, erector spinae, transverse abdominis Why: Enhances spinal stability and cross-body coordination How to Perform:
On all fours, keep spine neutral.
Extend opposite arm and leg; hold 10 seconds.
Alternate sides; repeat 10 reps per side × 3 sets.
3. Wall Sit
Target: Quadriceps, glutes, lumbar stabilizers Why: Promotes spinal neutrality and knee-hip coordination How to Perform:
Slide into seated position against a wall.
Hold for 20–30 seconds; repeat 3–5 times.
4. Pelvic Tilt
Target: Core musculature, pelvic stabilizers Why: Teaches lumbar-pelvic control and relieves tension How to Perform:
Supine with knees bent.
Flatten lumbar spine against the floor.
Hold 10 seconds; repeat 10–15 reps × 3 sets.
💡 Pro Tip: Begin with isometric holds and progress to dynamic variations once stability improves.
Calisthenics in Functional Rehabilitation Protocols
Functional medicine emphasizes root-cause resolution and the restoration of systemic balance. In musculoskeletal care, this means addressing:
Inflammation and oxidative stress with nutrition and supplementation
Mitochondrial dysfunction with movement and breathwork
Autonomic dysregulation via vagal toning and neuromuscular re-patterning
Calisthenics fits into this paradigm by improving cellular oxygenation, lymphatic flow, and biomechanical alignment—without the need for expensive gym equipment or medication.
Case Example: Chronic Low Back Pain
A 48-year-old patient presents with chronic mechanical low back pain, obesity (BMI 31), and poor core strength. Her job requires prolonged sitting. A personalized treatment plan includes:
Chiropractic adjustments to the lumbar and thoracic spine
Dietary counseling to reduce inflammatory load
Calisthenic regimen of:
Bird-dogs for stabilization
Wall sits for quadriceps activation
Daily pelvic tilts to train lumbar control
Within 8 weeks, she reports reduced pain (VAS score from 7 to 3), improved posture, and increased daily movement tolerance.
Final Thoughts: Empowering Movement for Long-Term Health
Movement is medicine—particularly when it’s accessible, functional, and patient-led.
Calisthenics combined with chiropractic care offers a powerful, evidence-based approach to treating musculoskeletal disorders. This integrative strategy not only alleviates pain but also addresses the underlying biomechanical dysfunctions that contribute to chronic conditions. As a nurse practitioner practicing at the intersection of functional medicine and physical rehabilitation, I’ve seen firsthand how this combination can restore vitality, independence, and resilience in patients of all ages.
By embracing calisthenics as a therapeutic modality—and not just a fitness trend—we enable patients to become active participants in their healing journey. Whether managing chronic back pain, recovering from injury, or optimizing performance, bodyweight movement is one of the most effective and sustainable tools we can offer.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of assessing individuals with musculoskeletal disorders affecting their daily routines. When asking important questions to our associated medical providers, we advise patients to incorporate exercises like calisthenics to help reengage the musculoskeletal system while reducing muscle pain within the lumbar region. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Bellissimo, G. F., Ducharme, J., Mang, Z., Millender, D., Smith, J., Stork, M. J., Little, J. P., Deyhle, M. R., Gibson, A. L., de Castro Magalhaes, F., & Amorim, F. (2022). The Acute Physiological and Perceptual Responses Between Bodyweight and Treadmill Running High-Intensity Interval Exercises. Front Physiol, 13, 824154. https://doi.org/10.3389/fphys.2022.824154
Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. https://doi.org/10.1016/j.bjpt.2020.06.003
Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J, 18(5), 866-879. https://doi.org/10.1016/j.spinee.2018.01.013
Mear, E., Gladwell, V. F., & Pethick, J. (2022). The Effect of Breaking Up Sedentary Time with Calisthenics on Neuromuscular Function: A Preliminary Study. Int J Environ Res Public Health, 19(21). https://doi.org/10.3390/ijerph192114597
Osuka, Y., Kojima, N., Sasai, H., Ohara, Y., Watanabe, Y., Hirano, H., & Kim, H. (2020). Exercise Types and the Risk of Developing Cognitive Decline in Older Women: A Prospective Study. J Alzheimers Dis, 77(4), 1733-1742. https://doi.org/10.3233/JAD-200867
Zemkova, E., & Zapletalova, L. (2022). The Role of Neuromuscular Control of Postural and Core Stability in Functional Movement and Athlete Performance. Front Physiol, 13, 796097. https://doi.org/10.3389/fphys.2022.796097
Individuals dealing with pain in the buttocks and in the back of the thigh, along with numbness and tingling down to the bottom of the foot, may be experiencing hamstring syndrome, a condition caused by pressure on the sciatic nerve. What is the recommended treatment?
Hamstring-Syndrome Relief
The hamstrings are three muscles in the back of the thigh, extending from the pelvis or upper thigh across the back of the knee to the leg. This muscle group is important for bending the knee, straightening the hip, and stabilizing the knee. The sciatic nerve is a large nerve that runs from the lower back down the legs. It usually passes near or through these muscles, and the pelvis then runs under these muscles in the thigh. Hamstring syndrome refers to pain in the buttock and back of the thigh, often radiating down the leg, caused by compression or irritation of the sciatic nerve at the hamstring-insertion point on the ischial tuberosity, typically due to tight or scarred tissue. (Sakari Orava, 1997)
Pain Location
The pain is primarily felt in the buttock and back of the thigh, sometimes extending down the leg. It’s characterized by pressure on the sciatic nerve, which runs through the buttock and into the back of the thigh, where it supplies the hamstring muscles. (Kaiser Permanente, 2024)
Tight, tendon-like, or scarred bands of tissue at the hamstring’s insertion point/ischial tuberosity can irritate the sciatic nerve.
Compression
These bands can compress the nerve, especially when sitting or during activities that involve hip flexion and knee extension.
Traction
The sciatic nerve can also be stretched or irritated by the hamstring tendons.
Symptoms
Pain in the buttock and back of the thigh may radiate down the leg.
Pain that is worse when sitting, stretching the hamstrings, or during activities like running. (Puranen J. & Orava S. 1988)
Numbness or tingling in the back of the leg
Differential Diagnosis
It’s important to differentiate hamstring syndrome from other conditions that could be causing similar symptoms, including:
Piriformis syndrome
Ischiogluteal bursitis
Hamstring muscle strains
Treatment
Hamstring syndrome relief may consist of the following:
Conservative
Initial treatment focuses on rest, ice, stretching, and over-the-counter pain relievers.
Physical Therapy
Exercises to strengthen and stretch the hip and hamstring muscles can be beneficial. (Zion Physical Therapy, 2023)
Injections
In some cases, injections with cortisone and numbing medicine may be used to reduce nerve inflammation and pain. (Lower Limb Surgery, 2024)
Surgery
In severe cases, surgery may be necessary to release the compressing bands and free the sciatic nerve. (Lower Limb Surgery, 2024)
Injury Medical Chiropractic & Functional Medicine Clinic
Talk to a healthcare provider about 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.
Kaiser Permanente. (2024). Hamstring Syndrome: Care Instructions. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hamstring-syndrome-care-instructions.abr3618
Puranen, J., & Orava, S. (1988). The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American Journal of Sports Medicine, 16(5), 517–521. https://doi.org/10.1177/036354658801600515
Zion Physical Therapy. (2023). Hamstring Tendinitis Vs. Hamstring Syndrome. https://www.zionpt.com/post/hamstring-tendinitis-vs-hamstring-syndrome
Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?
Leg Cramp Causes
A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from
Dehydration
Muscle overexertion
They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
They can also be a side effect of certain medications.
Sensation
Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)
Causes
The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:
Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
Respiratory diseases of the lungs and airways
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)
Self-Care
Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)
Change Body Positions
Moving can help relieve tension and pain.
If the leg cramps happen at night, stand up and take a few steps.
Massage
Gently rubbing the cramped muscle can help it relax.
Stretch
Stretching the cramping muscle can help it relax.
Apply Heat
If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.
Treatment
There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)
Exercises and Stretches
Knowing which muscle to target when stretching the leg is important. If the cramp does not resolve after the first stretch attempt, try again.
Place palms flat against the wall at shoulder height.
Step the cramping leg away from the wall around 12 to 18 inches.
Keep your heels flat on the floor.
Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
Hold for 30 to 60 seconds.
Prevention
They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)
Drink plenty of water.
Stretch the leg muscles before you go to bed.
Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
Properly cool down after a workout.
Stretch the leg muscles before and after exercising.
Maintain a healthy body weight.
Contact a Healthcare Provider
Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)
Change in skin color, including redness or a deeper tone than normal
Cramps that last more than a few minutes or occur frequently
Muscle weakness
Severe pain from the cramps
Swelling
Warm skin
Injury Medical Chiropractic & Functional Medicine Clinic
Talk to a healthcare provider about leg cramps 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.
Is Motion Key to Healing?
References
Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. https://www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs
National Library of Medicine. (2020). Muscle cramps. Retrieved from https://medlineplus.gov/musclecramps.html
Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. https://doi.org/10.1007/s40279-019-01162-1
Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. https://doi.org/10.1002/14651858.CD009402.pub3
American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. https://orthoinfo.aaos.org/en/recovery/knee-conditioning-program/
Unlock the potential of gua-sha and chiropractic care. Learn how it can enhance your well-being and relieve tension.
Introduction: Rethinking Musculoskeletal Pain Through a Functional Medicine Lens
As a nurse practitioner with two decades of experience in physical and functional medicine, I’ve seen firsthand how musculoskeletal pain disrupts lives—whether it’s the desk-bound professional with chronic neck tension, the athlete recovering from overuse injuries, or the aging adult with persistent back discomfort. While pharmaceutical interventions may offer temporary relief, the key to long-term healing often lies in a more integrative approach.
Gua Sha therapy, a time-tested East Asian technique, combined with chiropractic care, offers a powerful, evidence-informed, and non-surgical strategy to alleviate musculoskeletal pain, restore function, and improve mobility. In this article, we’ll explore how these two modalities complement each other, the science behind their synergistic benefits, and how they can be integrated into a personalized treatment plan to support whole-body healing.
What Is Gua Sha Therapy? A Functional Medicine Perspective
Gua Sha (pronounced “gwah-shah”) is a traditional healing modality rooted in Traditional Chinese Medicine (TCM), involving the use of a smooth-edged instrument—often made of jade, rose quartz, or stainless steel—to gently scrape the skin in targeted areas. The goal? To release stagnation, promote microcirculation, and activate the body’s innate healing response.
The term “Gua” means “to scrape” and “Sha” refers to the reddish marks that appear on the skin, signifying the release of stagnant blood and toxins. These marks typically fade within a few days and are a normal part of the healing process.
In the modern clinical setting, Gua Sha has evolved into a sophisticated tool used by physical therapists, chiropractors, acupuncturists, and functional medicine providers. It’s particularly effective in addressing myofascial tension, trigger points, chronic inflammation, and reduced mobility due to soft tissue adhesions.
How Gua Sha Alleviates Musculoskeletal Pain
Musculoskeletal pain is often multifactorial—stemming from overuse, injury, postural imbalances, or systemic inflammation. When these factors are left unaddressed, they can lead to myofascial restrictions, scar tissue formation, and neuromuscular dysfunction, perpetuating a cycle of pain and immobility.
Gua Sha works by:
Disrupting fascial adhesions and encouraging tissue remodeling
Enhancing microvascular circulation, accelerating the delivery of oxygen and nutrients to the affected tissues
Activating the parasympathetic nervous system, shifting the body from “fight or flight” to “rest and repair”
Reducing pro-inflammatory cytokines and promoting anti-inflammatory responses (Chu et al., 2021)
Stimulating lymphatic flow, helping to reduce edema and clear metabolic waste
Releasing trigger points in hypertonic muscle groups, particularly in the neck, shoulders, lower back, and limbs
These mechanisms align well with the goals of functional medicine: identifying and treating root causes rather than masking symptoms.
Chiropractic Care: Aligning Structure and Function
Chiropractic care focuses on restoring proper spinal alignment and joint mobility through manual manipulation techniques. It is based on the principle that optimal nervous system function depends on structural integrity, particularly of the vertebral column.
Common benefits of chiropractic care include:
Pain reduction in the back, neck, and extremities
Improved range of motion and posture
Decompression of nerve roots, reducing radiculopathy and referred pain
Enhanced proprioception and neuromuscular coordination
Prevention of degenerative joint changes through biomechanical correction
A growing body of research supports chiropractic adjustments as an effective, evidence-based option for managing musculoskeletal conditions, especially when integrated into a multimodal treatment approach (Trager et al., 2024).
Discovering the Benefits of Chiropractic Care- Video
Gua Sha and Chiropractic Care: A Synergistic Duo
When Gua Sha is combined with chiropractic care, the result is a comprehensive therapeutic approach that targets both soft tissue restrictions and structural misalignments. This synergy accelerates healing and maximizes outcomes by preparing the body for more effective manual adjustments.
Here’s how the two modalities work together:
Gua Sha Therapy
Chiropractic Care
Breaks down adhesions in fascia and muscle tissue
Restores joint alignment and spinal biomechanics
Stimulates lymphatic and circulatory systems
Reduces nerve impingement and improves neural signaling
Releases tension in overactive muscle groups
Restores balance and mobility in underactive joints
Supports parasympathetic activation
Reinforces proprioceptive and neuromuscular patterns
One specific chiropractic application of Gua Sha is the Graston Technique, a modern adaptation that uses stainless steel instruments to identify and treat areas of soft tissue fibrosis. The goal is similar—restore mobility, reduce pain, and promote tissue healing (Deshmukh & Phansopkar, 2023).
Clinical Applications: When to Consider Gua Sha + Chiropractic Integration
As a nurse practitioner in functional medicine, I often incorporate both Gua Sha and chiropractic care for patients with:
These patients often report improved mobility, reduced inflammation, and greater pain relief when Gua Sha is included in their care plan—especially when timed before or after a chiropractic adjustment to reduce soft tissue guarding and enhance adjustment efficacy.
The Science: What Does the Research Say?
Numerous studies support the physiological effects of Gua Sha on circulation, inflammation, and pain modulation:
A 2021 study by Chu et al. found that Gua Sha therapy significantly increased microcirculation and decreased inflammatory markers in patients with chronic muscle pain.
Wang et al. (2020) highlighted Gua Sha’s role in stimulating the du meridian (governing vessel) and clearing blood stasis, promoting faster soft tissue recovery.
Knezevic et al. (2021) emphasized that musculoskeletal pain often arises from the interplay between soft tissue dysfunction, trigger points, and neural sensitization—areas where Gua Sha can provide targeted relief.
Trager et al. (2024) affirmed that chiropractic care continues to show promise as a cost-effective, non-pharmacological solution to chronic spinal pain and joint dysfunction.
Together, these therapies create a healing environment that supports the body’s biomechanical, neurological, and energetic systems.
Safety Considerations and Contraindications
While Gua Sha is a safe and gentle therapy, it is not suitable for everyone. Contraindications include:
Bleeding disorders or anticoagulant use
Severe varicose veins or vascular fragility
Active skin infections, open wounds, or dermatologic conditions
Recent surgeries with unhealed incisions
Always consult with a licensed provider trained in both modalities to determine appropriateness and ensure personalized, safe care.
Optimizing Results: A Functional Medicine Approach to Musculoskeletal Recovery
Incorporating Gua Sha and chiropractic care into a broader functional medicine care plan often yields the most sustainable results. Complementary strategies may include:
The body is a system of systems. Addressing musculoskeletal dysfunction holistically allows patients to heal not just their symptoms but the root cause of imbalance.
Conclusion: Empowering Patients With Integrative Pain Solutions
Musculoskeletal pain is one of the most common complaints in modern healthcare, yet the solution doesn’t have to be invasive, pharmaceutical, or surgical. By combining the ancient wisdom of Gua Sha with the mechanical precision of chiropractic care, we unlock a deeply therapeutic pathway toward healing, function, and resilience.
As a nurse practitioner grounded in both physical and functional medicine, I encourage patients and providers alike to explore the synergistic power of these modalities. When integrated skillfully and applied with intention, Gua Sha and chiropractic care can dramatically improve musculoskeletal health, restore balance, and empower patients to reclaim their active lives.
Injury Medical & Functional Medicine Clinic
We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal pain by incorporating Gua-Sha and chiropractic care. When asking important questions to our associated medical providers, we advise patients to utilize Gua-Sha combined with chiropractic care to reduce musculoskeletal pain and restore soft tissue mobility in the extremities. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.
References
Chu, E. C., Lin, A. F. C., & Chu, V. (2023). The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus, 15(8), e43068. https://doi.org/10.7759/cureus.43068
Chu, E. C. P., Wong, A. Y. L., Sim, P., & Kruger, F. (2021). Exploring scraping therapy: Contemporary views on ancient healing – A review. J Family Med Prim Care, 10(8), 2757-2762. https://doi.org/10.4103/jfmpc.jfmpc_360_21
Deshmukh, N. S., Jr., & Phansopkar, P. (2023). Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial. Cureus, 15(11), e48246. https://doi.org/10.7759/cureus.48246
Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. https://doi.org/10.1016/s0140-6736(21)00733-9
Trager, R. J., Bejarano, G., Perfecto, R. T., Blackwood, E. R., & Goertz, C. M. (2024). Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med, 13(19). https://doi.org/10.3390/jcm13195668
Wang, Y. W., Xi, Z. W., Pu, B., Chen, G. Y., Ma, Y. F., Liu, D. L., & Xu, X. (2020). Gua sha therapy for chronic low back pain: A protocol for systematic review. Medicine (Baltimore), 99(40), e20606. https://doi.org/10.1097/MD.0000000000020606
For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?
Back Pain When Walking
Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.
Muscle Issues
Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)
Strains
Occur when the fibers in the back are overstretched or torn.
Pain from muscle strains is usually worse during activity and better when resting.
Sprains
It occurs when the ligaments that connect bone to bone become detached.
If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.
Fatigue
It can happen from overexertion and lead to lower back pain when walking.
It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.
Degenerative Disc Disease
Between each vertebra is a disc that provides cushioning between the bones.
As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)
Sciatica
Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)
Numbness
Tingling
Muscle cramps
Leg muscle weakness
Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.
Lumbar Spinal Stenosis
Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
It causes the space surrounding the spinal cord to narrow.
Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.
Hyperlordosis
Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)
Prevention Strategies
Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)
Wear shoes made for walking.
Perform gentle lower back stretches before walking.
Start slowly by walking for a few minutes, then gradually increase the time.
Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
Warm up and cool down by walking slowly at the beginning and end of the walk.
This allows the back and leg muscles to warm up before exercise and recover afterward.
Walk at a slow to moderate pace/speed that allows one to converse.
Standing up straight while walking or standing upright reduces pressure on the lower back.
Alternative Exercise
If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)
Elliptical Trainer
This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.
Recumbent Biking
will keep the back upright, which is recommended if there is more pain when bending forward.
Upright Stationary Biking
This is recommended if the back pain improves when bending forward.
Walking In A Pool
This activity provides benefits while reducing pressure on the spine.
To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).
Water Aerobics
This activity provides cardiovascular health benefits with decreased pressure on the back.
Injury Medical Chiropractic & Functional Medicine Clinic
See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your condition. 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.
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
American Association of Neurological Surgeons. (2024). Low back strain and sprain. https://www.aans.org/patients/conditions-treatments/low-back-strain-and-sprain/
Hospital for Special Surgery. (2024). Degenerative disc disease. https://www.hss.edu/condition-list_degenerative-disc-disease.asp
American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica
American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/
American Academy of Orthopaedic Surgeons. (2020). Spine basics. https://orthoinfo.aaos.org/en/diseases–conditions/spine-basics/
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173
Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. https://www.health.harvard.edu/exercise-and-fitness/get-started
Hospital for Special Surgery. (2023). Best types of exercise for back pain. https://www.hss.edu/article_best-exercise-lower-back-pain.asp
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)
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.
For individuals managing chronic pain conditions, can incorporating a personal TENS device help?
Personal TENS Device
Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.
How It Works
TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.
Uses
TENS units are used to treat a variety of conditions, including:
Arthritis
Muscle cramps
Neck pain
Back pain
Pelvic pain
Knee pain
Osteoarthritis
Fibromyalgia
Tendinitis
Bursitis
Diabetes-related neuropathy
Pelvic pain from periods or endometriosis
Features
Portability
TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)
Electrodes
The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.
Adjustable Settings
Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.
Benefits
Non-Invasive
TENS therapy is a non-invasive method for relieving pain.
Drug-Free
It can provide pain relief without the need for medication.
Convenient
TENS units are small, portable, and relatively discrete.
Precautions
Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)
Head
Eyes
Mouth
Front of the Neck
Chest and upper back at the same time
Numb areas
Broken skin
Tumors
There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.
Effectiveness
Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)
Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)
Injury Medical Chiropractic & Functional Medicine Clinic
Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. 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.
Don’t Ignore Post-Accident Pain
References
National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/
Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30725873
Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. https://doi.org/10.1016/j.pain.2013.07.043
Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. https://doi.org/10.2217/pmt.14.13
What are the recommendations for a pulled muscle injury to fully recover?
Pulled Muscle Recovery Time
A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015) Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.
Timeline
The timeline for recovering from a pulled muscle depends on the injury’s severity.
Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)
Grade 1 (mild)
Heals in a few days.
A microscopic tear or stretch in the muscle fiber.
It might feel sore, but you can still use the muscle.
Grade 2 (moderate)
Heals in four to six weeks.
A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.
Grade 3 (severe)
Heals in several months
This type of muscle strain causes a complete tear, also known as a rupture.
It results in intense pain, significant swelling, and inability to use the muscle.
Surgery may be required in some cases.
Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.
Body Parts More Susceptible To Injury
The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)
Neck – levator scapulae and trapezius
Shoulders – rotator cuff muscles
Lower back – erector spinae
Groin – adductors
Front of the thigh – quadriceps
Behind the thigh – hamstrings
Calves – gastrocnemius and soleus
Healing Stages and Factors
Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).
Inflammatory Stage (zero to three days)
When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
Rest is important during this stage to prevent the injury from getting worse.
Repair Stage (three to 21 days)
Damaged muscle fibers are repaired and regrow during this stage.
Collagen fills in any tears to rebuild damaged muscle tissue.
Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.
Remodeling Stage (three weeks to one year)
Repaired tissue gets stronger and adapts to regular movement.
Scar tissue may form.
Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.
Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
Prolonged rest can slow healing, so maintain a balance between rest and exercise.
Ice
Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
Ice helps control inflammation by limiting blood flow to the injured area.
Compression
Use compression stockings or wrap the injured part in bandages to help reduce swelling.
Ensure the binding is not too tight so circulation is not cut off.
Elevation
Raise the injured area above heart level throughout the day.
This helps reduce swelling by allowing fluids to drain away from the injury site.
Heat
After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.
Eat Healthy
Get enough protein for muscle repair.
Maintain Hydration
Drink plenty of water to help with circulation and muscle lubrication.
Massage and Physical Therapy
These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.
Over-the-counter Medications
If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
Only use as directed.
These steps can help promote faster healing and expedite returning to normal daily activities.
When to Resume Normal Activity
Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)
Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
Slowly resume normal activities, avoiding overexerting the injured area.
Gradually increase activity levels and stop if there is any pain.
Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.
Contact a Healthcare Provider
While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)
Pain persists or worsens after seven to 10 days.
This can indicate a more serious injury, such as a severe torn muscle.
Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.
A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.
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.
Say Goodbye to Pain with Chiropractic Care
References
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