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Tag: rehabilitation

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

Straight Leg Test: Understanding Its Purpose

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

Straight Leg Test

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

Purpose

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

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

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

During the Test

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

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

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

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

Modifications

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

Variations

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

From Injury to Recovery with Chiropractic Care

References

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

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

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

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

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

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

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

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

By admin 0 Comments Exercises, Sleep Hygiene , , , , , , , , , , , , , , , , ,

Weight Resistance Training and Its Impact on Sleep Quality

For individuals looking to improve sleep, could weight training be the answer to increase healthy sleep?

Weight Resistance Training

Researchers found that resistance weight training improves sleep quality, among other methods like diet and sleep hygiene practices. Resistance training may improve sleep by reducing anxiety and stress, benefiting heart health, and promoting muscle recovery. Researchers examined non-medication methods of improving sleep in younger and middle-aged adults, comparing exercise, diet, and sleep hygiene practices. The findings showed that for adults under 65, resistance training is the best non-pharmacological way to improve sleep quality. (Hirohama, K. et al., 2024) These findings reinforce that sleep and exercise lead to improved restful sleep. Resistance training is highly effective compared to aerobic exercise (running or cycling) in improving sleep quality. The research shows that resistance exercise has more profound benefits than aerobic training alone.

Resistance Training and Improved Sleep

Resistance training, also called strength training or weight training, is intended to build muscle and strength using resistance. This can include:

  • Your body weight
  • Resistance bands
  • Free weights
  • Weight-lifting machines

The mechanisms by which exercise alters sleep are unknown. However, the researchers point out that weight training may improve sleep by improving mental health issues such as anxiety and depression. (Cunningham J. E. A., & Shapiro C. M. 2018) (Carbone E. A. et al., 2023) Other research on resistance training and sleep found that resistance training helped decrease anxiety and stress. (Alley J. R. et al., 2015) Resistance training can benefit heart health as it increases blood circulation. This means the heart’s vessels don’t have to work as hard during sleep when blood pressure should naturally drop, which is known as nocturnal dipping, which is great for individuals with high blood pressure.

Another reason this training may help with sleep is its impact on the body. Previous research on resistance training and sleep suggests that since weight training stresses muscle tissue, it could signal the brain that sleep is needed to repair the damage (Iowa State University, 2022). The hormone adenosine, which helps promote sleep, is a key factor in why exercise increases adenosine levels and helps the body doze off. (Roig M. et al., 2022)

How Much Resistance Training Is Needed?

Sleep doctors advise patients to perform some form of daily movement or exercise to improve sleep. The amount of resistance training an individual needs depends on their circumstances, such as underlying conditions, injuries, fitness level, physical ability, and time.

  • General guidelines from the American Heart Association recommend strength training at least twice a week.
  • The guidelines for physical activity from the Department of Health and Human Services recommend adults do a muscle-strengthening activity at least two days each week in addition to at least 150 to 300 minutes of moderate-intensity aerobic activity.
  • The meta-analysis research found that a 55-minute resistance training session consisting of three sets of 10 to 12 exercises done three times a week positively affected sleep quality.
  • They added that higher intensity and frequency of training could have a greater effect on sleep.

In other research on exercise and sleep, study participants were grouped into resistance training, aerobic, and combination workouts – both resistance and aerobic exercise. Each group engaged in 60-minute training sessions three times a week, with the combination group doing 30 minutes of resistance training and 30 minutes of aerobic exercise each session. (Iowa State University, 2022) Resistance training increased sleep by an average of 40 minutes compared to about 23 minutes for those who did an hour of aerobic exercise. A combination of aerobic and resistance increased sleep by about 17 minutes. (American Heart Association, 2022)

Previous research on resistance training and sleep found that exercise at any time can improve sleep quality compared with no strength training. However, evening sessions tend to help individuals sleep a little better. (Alley J. R. et al., 2015) Resistance exercise may offer benefits regarding the ability to fall asleep and stay asleep for those with osteoporosis, sarcopenia, anxiety, or depression.

Strength Workouts

Resistance training that targets all the major muscle groups is the goal. The Iowa State University research had participants use 12 resistance machines to perform exercises, including: 

  • Leg presses
  • Chest presses
  • Lat pulldowns
  • Bicep curls
  • Abdominal crunches 
  • Participants performed three sets of eight to 12 reps at 50% to 80% of their one-rep max. (Iowa State University, 2022)
  • One of the studies had participants work out for 30 minutes using nine different resistance machines, completing three sets of 10 reps. (Alley J. R. et al., 2015)

However, individuals can also use dumbbells such as bicep curls or chest presses, barbells for deadlifts or back squats, resistance bands for lateral shoulder raises or leg extensions, or their body weight for movements such as chin-ups or push-ups.

Other Ways to Improve Sleep Without Meds

Other non-drug methods to improve sleep include a healthy diet, proper hydration, dietary changes, and stress management like meditation. Aerobic exercise is known to improve both sleep quantity and quality. (Kovacevic A. et al., 2018) Lifestyle behaviors outside exercise are also important for sleep. Sleep hygiene refers to having healthy sleep habits and behaviors at night. This includes optimizing pre-bedtime routines to prepare the mind and body for sleep and improving bedroom environments to ensure sleep support, meaning it is cool, dark, quiet, and free from distractions like phones. Another important method of improving sleep is listening to your body and not forcing yourself to stay up late when exhausted. Pushing the brain and body to stay up later leads to chronic sleep debt. Eating sugary and high-fat foods before bed can hinder sleep patterns. Drinking caffeine after dinner or close to bedtime can disrupt the sleep cycle, as well as alcohol consumption before bed can hurt sleep quality.

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals need rest time to adjust to working out, so consult a doctor on the balance of rest and training. 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.

Weight Loss Techniques

References

Hirohama, K., Imura, T., Hori, T., Deguchi, N., Mitsutake, T., & Tanaka, R. (2024). The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials. PloS one, 19(6), e0301616. https://doi.org/10.1371/journal.pone.0301616

Cunningham, J. E. A., & Shapiro, C. M. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review. Journal of psychosomatic research, 106, 1–12. https://doi.org/10.1016/j.jpsychores.2017.12.012

Carbone, E. A., Menculini, G., de Filippis, R., D’Angelo, M., De Fazio, P., Tortorella, A., & Steardo, L., Jr (2023). Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. International journal of environmental research and public health, 20(5), 4431. https://doi.org/10.3390/ijerph20054431

Alley, J. R., Mazzochi, J. W., Smith, C. J., Morris, D. M., & Collier, S. R. (2015). Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. Journal of strength and conditioning research, 29(5), 1378–1385. https://doi.org/10.1519/JSC.0000000000000750

Iowa State University. (2022). Pumping iron may improve sleep more than cardio workouts. https://www.news.iastate.edu/news/2022/03/03/resistance-exercise-sleep

Roig, M., Cristini, J., Parwanta, Z., Ayotte, B., Rodrigues, L., de Las Heras, B., Nepveu, J. F., Huber, R., Carrier, J., Steib, S., Youngstedt, S. D., & Wright, D. L. (2022). Exercising the Sleepy-ing Brain: Exercise, Sleep, and Sleep Loss on Memory. Exercise and Sport Sciences Reviews, 50(1), 38–48. https://doi.org/10.1249/JES.0000000000000273

American Heart Association. (2022). Resistance exercise may improve sleep more than aerobic exercise. https://www.heart.org/en/news/2022/03/03/resistance-exercise-may-improve-sleep-more-than-aerobic-exercise#:~:text=The%20results%20are%20considered%20preliminary,at%20night%2C%22%20Brellenthin%20said.

Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep medicine reviews, 39, 52–68. https://doi.org/10.1016/j.smrv.2017.07.002

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Pinched Nerve in the Neck: Managing Your Pain

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

Pinched Nerve In The Neck

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

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

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

How a Pinched Nerve in the Neck Feels

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

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

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

Causes

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

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

Self-Care Relief

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

Rest

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

Heat or Ice

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

Over-The-Counter Pain Medications

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

Treatment for Severe Symptoms

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

Physical Therapy

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

Cervical Collar

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

Oral Corticosteroids

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

Steroid Injections

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

Muscle Relaxers

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

Narcotic Pain Medications

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

Neck Exercises

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

Chin to chest

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

Eyes to Sky

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

Side to Side

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

Ear to Shoulder

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

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

Healing Time

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

Revitalize and Rebuild with Chiropractic

References

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

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

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

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

By admin 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , , , ,

Scaphoid Fracture Causes and Recovery Insights

Individuals who have fractured their scaphoid bone may experience pain and swelling in the wrist just below the thumb. Can immobilization with a cast and physical therapy help?

human hand and wrist pain

Scaphoid Fracture

A scaphoid fracture is a break in one of the wrist’s small or carpal bones. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include swelling and pain in the wrist just below the base of the thumb. These fractures can be difficult to diagnose since they don’t always appear on an X-ray. If the X-ray is negative and the healthcare provider suspects a scaphoid fracture, an MRI may be necessary. Surgery may be required in more severe cases or when the injury is not healing correctly. (American Academy of Orthopaedic Surgeons, 2023)

A Break In The – Navicular Bone

The scaphoid is one of eight carpal bones in the wrist. It is located just below the thumb’s base and is shaped like a kidney bean. This bone can be identified by holding a thumbs-up position and feeling for the hollow between the two tendons below your thumb. The scaphoid is located at the base of the hollow. A break in the scaphoid bone most commonly occurs in the middle of the bone but can also happen at either end. A scaphoid fracture can be displaced or non-displaced (American Academy of Orthopaedic Surgeons, 2023)

Displaced Fracture

  • It is when the bone fragments have moved out of alignment.

Non-displaced Fracture

  • It is when the fragments are still in their normal location in the hand.

The scaphoid’s blood supply comes from a small vessel that enters the most distant part of the bone and flows back through the bone. Because of this one small blood supply, a fracture in the center can stop the circulation to the proximal portion of the bone. Because of this, scaphoid fractures need immediate diagnosis and treatment.

Symptoms

Pain or deep aching on the thumb-side of the wrist, typically after a fall on an outstretched arm, could be a scaphoid fracture. Other symptoms experienced include: (American Academy of Orthopaedic Surgeons, 2023)

  • Tenderness at the base of the hollow area.
  • Pain at the base of the hollow area.
  • Swelling in the wrist
  • Difficulty gripping objects

Pain can become worse from: (American Academy of Orthopaedic Surgeons, 2023)

  • Grasping
  • Pulling
  • Pushing
  • Pinching

Diagnosis

A healthcare provider will evaluate the hand for tenderness and pain in the hollow and/or the bone. If a break is suspected, they will order an X-ray. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) Many patients are diagnosed with a wrist sprain when they have a fracture. Diagnosis can be difficult because the fracture often doesn’t appear on X-rays until weeks after the healing process starts. Physicians commonly treat a wrist injury as a scaphoid fracture initially and then repeat X-rays within two weeks. (American Academy of Orthopaedic Surgeons, 2023) If the injury doesn’t show on an X-ray, the provider may order an MRI, as these fractures can be easier to see on an MRI. An MRI can help ensure appropriate treatment immediately. (Wong S. B. S., & Peh W. C. G. 2019)

Treatment

If a wrist fracture is diagnosed, the wrist will be immobilized in a cast. However, a healthcare provider may also put the wrist in a cast if the X-ray is negative but they suspect a fracture. This will stabilize the injury until an MRI can be performed. With immobilization and follow-up treatment, scaphoid fractures often heal without surgery. Repeat X-rays are taken over several weeks or months so the provider can make sure the injury is healing correctly. If it is not healing correctly, surgery may be recommended. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) If the fracture is displaced, healing correctly may be a challenge. In this case, a physician may recommend initial surgery to reposition the bones. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) This type of surgery involves pinning the bone in place with screws.

Healing Time

Recovery

With the wrist in a cast, individuals will be instructed on activities to avoid placing even a small amount of strain (American Academy of Orthopaedic Surgeons, 2023)

  • Lifting
  • Pushing
  • Pulling objects that weigh more than one pound.
  • Sports activities
  • Throwing
  • Climbing
  • Using tools or machinery that vibrate.

Rehabilitation is an important part of healing because immobilization takes a long time. Wrist range-of-motion exercises can be started, followed by strengthening exercises for the wrist flexors and extensors. Supination, pronation, and grip exercises are also part of physical therapy.

Complications

Scaphoid fractures can lead to serious complications, especially when not properly treated. These include: (American Academy of Orthopaedic Surgeons, 2023) (Almigdad A. et al., 2024)

Nonunion

  • This describes a fracture that fails to heal.

Carpal Collapse

  • This is a form of degenerative arthritis.

Osteoarthritis

  • This condition causes degeneration of the cartilage in the joint.

Avascular Necrosis

  • This is when the blood supply to the bone is reduced or cut off, causing the bone to die.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Skateboarding Injury Treatment

References

American Academy of Orthopaedic Surgeons. (2023). Scaphoid fracture of the wrist. https://orthoinfo.aaos.org/en/diseases–conditions/scaphoid-fracture-of-the-wrist

Clementson, M., Björkman, A., & Thomsen, N. O. B. (2020). Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT open reviews, 5(2), 96–103. https://doi.org/10.1302/2058-5241.5.190025

Wong, S. B. S., & Peh, W. C. G. (2019). The role of magnetic resonance imaging in the evaluation of scaphoid fractures. Journal of Medical Radiation Sciences, 66(1), 3–4. https://doi.org/10.1002/jmrs.316

Almigdad, A., Al-Zoubi, A., Mustafa, A., Al-Qasaimeh, M., Azzam, E., Mestarihi, S., Khair, Y., & Almanasier, G. (2024). A review of scaphoid fracture, treatment outcomes, and consequences. International orthopaedics, 48(2), 529–536. https://doi.org/10.1007/s00264-023-06014-2

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Peroneal Tendon Injuries and Their Symptoms

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

Peroneal Tendon Injuries

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

Anatomy and Function

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

Tendonitis

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

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

Typical treatment of peroneal tendonitis is accomplished by:

Ice application

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

Rest

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

Anti-inflammatory Medications

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

Physical Therapy

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

Cortisone Injections

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

Tendon Tears

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

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

Tendon Debridement and Repair

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

Tenodesis

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

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

The Difference of Using Custom Foot Orthotics

References

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

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

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

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

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Triceps Tendonitis: A Guide to Prevention and Treatment

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

Triceps Tendonitis

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

Causes

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

Symptoms

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

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

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

Diagnosis

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

Treatment

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

Self Care

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

Rest

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

Ice

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

Range of Motion Exercises

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

Physical Therapy

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

PT Modalities

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

Manual Therapy

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

Exercise

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

Activity Modification

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

Medications

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

NSAIDs

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

Pain-Relievers

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

Oral Steroids

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

Corticosteroid Injections

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

Platelet-Rich Plasma

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

Injury Medical Chiropractic and Functional Medicine Clinic

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

From Inflammation to Healing

References

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

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

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

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

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

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

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The Prevalence of Rotator Cuff Tears and Treatment Approaches

Could older individuals who do not have symptoms of shoulder pain or loss of shoulder and arm function have a rotator cuff tear?

Rotator Cuff Tear Physical Therapy

A rotator cuff tear is a common injury to the four muscles and tendons surrounding and stabilizing the shoulder joint. Studies have shown that (Geary M. B., & Elfar J. C. 2015)

  • 30% of those under the age of 70
  • 70% of those over age 80 have a rotator cuff tear. 

Physical therapy is often recommended as a first-line initial treatment for rotator cuff pain. In most cases, a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary depends on several factors a patient can discuss with their healthcare provider.

Causes

  • Overuse and repetitive motions
  • Trauma (e.g., falls, collisions)
  • Age-related degeneration

Symptoms

  • Shoulder pain, especially with overhead or rotational movements
  • Weakness and difficulty raising the arm
  • Clicking or grinding sounds in the shoulder
  • Limited range of motion

Treatment

The goal of physical therapy for a rotator cuff tear is not necessarily to heal the torn tendon but to relieve pain and improve strength by reducing inflammation and restoring shoulder joint mechanics. This is achieved through physical therapy, ice application, anti-inflammatory treatments like medications, and cortisone injections.

Physical Therapy

The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Physical therapy targets the smaller muscles around the shoulder that are commonly neglected. By strengthening these muscles, the treatment can help compensate for damaged tendons and improve the mechanics of the shoulder joint. A chiropractic physical therapy team will develop a personalized exercise program. Generally, rehabilitation will start with gentle range of motion exercises that can be accomplished using the arms to lift a mobility stick/wand overhead.

Shoulder Pulleys

  • These improve shoulder range of motion and flexibility.

Isometric Exercises

  • These exercises are for the rotator cuff muscles and may then be started.
  • This exercise can improve the contracting of the muscles around the shoulder and offer more support to the shoulder joint.

Scapular Stabilization Exercises

  • These can also be done to improve the muscles surrounding the shoulder blade’s function.
  • This can help improve how the shoulder joint, arm, and scapulae move together when using the arm.

Advanced Strengthening

  • Advanced exercises can be done with a dumbbell or resistance band.

Consult your healthcare provider or physical therapist before starting these or any other exercises for a rotator cuff tear. Doing exercises correctly prevents further pain, injury, or shoulder problems. Specific, focused exercises can help expedite and regain normal shoulder function.

Injury Medical Chiropractic and Functional Medicine Clinic

The prognosis for rotator cuff tears depends on the severity of the tear and the individual’s overall health. With proper treatment, most people can regain the full function of their shoulders. However, some may experience ongoing pain or limitations in severe cases. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Shoulder Pain Chiropractic Treatment

References

Geary, M. B., & Elfar, J. C. (2015). Rotator Cuff Tears in the Elderly Patients. Geriatric orthopaedic surgery & rehabilitation, 6(3), 220–224. https://doi.org/10.1177/2151458515583895

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Sparkling Water and Weight Loss: Does It Really Work?

Can individuals add sparkling water to their diet to help lower blood sugar and aid with weight loss?

Sparkling Water

Sparkling water is generally considered a healthy drink with health benefits. It is refreshing, increases hydration, improves digestion, and may even help with weight loss (Takahashi A. 2025) (University of Chicago Medicine, 2023). This is nothing new. A previous study suggested that carbonated water makes the body feel full. The carbonation in sparkling water can trick the stomach into feeling fuller, potentially reducing overall calorie intake by curbing snacking between meals, which could prevent overeating and weight gain. (Wakisaka S. et al., 2012) However, a new report suggests carbonated water may help with weight loss by enhancing glucose/sugar uptake and metabolism. (Takahashi A. 2025) But further research is needed.

Lower Blood Sugar Levels

The report compared the effects of carbonated water to hemodialysis, a treatment that filters blood for individuals with kidney failure. (Takahashi A. 2025) Hemodialysis turns the blood alkaline, enhancing glucose absorption and metabolism. (EurekAlert, 2025)

Researchers assume that the carbon dioxide (CO2) absorbed after drinking sparkling water and the CO2 supplied during hemodialysis behave similarly. Carbonated water may consume glucose in the blood near the stomach, temporarily lowering blood sugar levels. However, the researchers suggested that follow-up continuous glucose monitoring (CGM) studies to measure blood sugar levels before and after drinking carbonated water would be necessary to validate the effect.

This does not mean that after drinking sparkling water, there will be major changes to an individual’s weight. Something metabolically is probably happening, but it’s still barely being discovered. The impact of CO2 in carbonated water is not a standalone solution for weight loss. (Takahashi A. 2025)

Adding To A Diet

If sparkling water can help manage blood glucose, it could also affect how the body stores fat. Over time, high blood sugar levels can overwhelm the body, and excess sugar becomes stored as body fat instead of being stored properly for energy use, causing weight gain. (Centers for Disease Control and Prevention, 2024) But for the most part, according to the research, the carbon dioxide in sparkling water may help to prevent this by stimulating glycolysis, or the process the body uses to break down glucose for energy and keep blood sugar levels low. (National Cancer Institute, N.D) (Takahashi A. 2025) Further research is needed to confirm and understand how sparkling water can proficiently and effectively work for weight loss.

Carbonated water alone is unlikely to contribute to significant weight loss. However, sparkling water can be a useful tool for weight loss as part of a healthy lifestyle (Takahashi A. 2025). A balanced diet and regular exercise are still essential for effective weight management.

Weight Gain

Some researchers have questioned whether sparkling water can lead to weight gain. A study on rats and humans found a link between drinking carbonated water and increased levels of the hunger-stimulating hormone ghrelin. (Eweis D. S., Abed F., & Stiban J. 2017) This could lead to increased appetite and higher calorie consumption, but more research is needed, as sleep, physical activity levels and hydration also impact hormones.

Individuals interested in including carbonated water in a balanced diet should check the labels for the caloric content, added sugars, and sugar alcohols, like xylitol or erythritol, which can cause gas or bloating. It is ideal if the label says water and carbonation; the fewer ingredients, the better.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Chiropractic Care and Metabolism: The Hidden Link

References

Takahashi A. (2025). Can carbonated water support weight loss? BMJ Nutr Prev Health. https://doi.org/10.1136/bmjnph-2024-001108

University of Chicago Medicine. (2023). Is sparkling water good for you? What about hard seltzer? https://www.uchicagomedicine.org/forefront/health-and-wellness-articles/is-carbonated-water-good-for-you

Wakisaka, S., Nagai, H., Mura, E., Matsumoto, T., Moritani, T., & Nagai, N. (2012). The effects of carbonated water upon gastric and cardiac activities and fullness in healthy young women. Journal of nutritional science and vitaminology, 58(5), 333–338. https://doi.org/10.3177/jnsv.58.333

EurekAlert. (2025). Fizzy water might aid weight loss by boosting glucose uptake and metabolism. BMJ Nutrition Prevention & Health. https://doi.org/10.1136/bmjnph-2024-001108

Centers for Disease Control and Prevention. (2024). About insulin resistance and type 2 diabetes. Retrieved from https://www.cdc.gov/diabetes/about/insulin-resistance-type-2-diabetes.html

National Cancer Institute. (N.D.). Glycolysis. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/glycolysis

Eweis, D. S., Abed, F., & Stiban, J. (2017). Carbon dioxide in carbonated beverages induces ghrelin release and increased food consumption in male rats: Implications on the onset of obesity. Obesity research & clinical practice, 11(5), 534–543. https://doi.org/10.1016/j.orcp.2017.02.001

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Headaches and Neck Pain: Causes, Symptoms, and Treatment

Could individuals who are having headaches with neck pain need emergency treatment or need to get started with sustained physical therapy?

Headaches and Neck Pain

Headaches and neck pain are two very common symptoms. They often occur together and signal common health issues, including fatigue, sinus headaches, and migraines. The combination can also occur due to serious health issues such as a concussion or meningitis. Causes of headaches with neck pain range from various causes, such as not getting enough sleep, having the neck in an awkward position, or having a hangover, to life-threatening issues like fluid buildup in the brain. It is recommended that individuals see a healthcare provider as soon as possible to rule out any life-threatening issues. Discuss the symptoms of neck pain with headache, what can cause these symptoms, and discuss treatment and prevention.

Symptoms

Symptoms are similar to what they feel like when they occur alone. Headache can present as:

  • A feeling of fullness in the head
  • Head soreness
  • Sharp head pain
  • Throbbing head pain
  • Pounding head pain

Neck pain can present as:

  • Pain in the back of the neck
  • Pain and/or aching of the upper back and/or shoulders

Associated Symptoms

Additional symptoms are common. Symptoms associated with headaches and neck pain include:

  • Neck stiffness
  • Trouble concentrating
  • Exhaustion or sleepiness
  • Aching throughout the body
  • Nausea
  • Dizziness
  • Vertigo – feeling like the room is spinning.
  • Photophobia – discomfort when looking at bright lights.
  • A feeling of numbness or tingling down the arm

Generally, associated symptoms suggest a more severe cause and can help a healthcare provider make a diagnosis.

Emergency Help

New symptoms of headache or neck pain can indicate a serious condition. If you develop these symptoms together, get prompt medical attention.

Causes

There are a variety of medical conditions that can cause headaches and neck pain. Both of these conditions are caused by irritation of sensory nerve fibers. Sometimes, head or neck pain can spread to other areas because the sensory nerves of these structures are so close together. (Côté P. et al., 2019) Additionally, a medical condition like an infection can affect the other due to proximity. Causes of headaches with neck pain include:

Headaches

  • Sinus headaches, tension headaches, and cervicogenic headaches are usually associated with head pain, but they can also involve neck pain. (Côté P. et al., 2019)

Migraine

  • Migraines are commonly associated with headaches and often cause neck pain as well.
  • In addition, they can cause nausea and body aches.

Fatigue

  • Being tired commonly leads to temporary headaches and neck pain until thorough rest is achieved.

Alcohol Consumption and/or a Hangover

  • For many, drinking can trigger a headache.
  • This is a common migraine trigger, but it can also trigger headaches for those who don’t have migraines.

Muscle Strain

  • Prolonged or recurrent positions that strain the neck muscles, like lifting or sitting at a desk, can cause aching or pain that involves both the head and neck. (Houle M. et al., 2021)

Injuries

  • Trauma such as whiplash or falling can cause soreness in the head and neck.
  • Bruises or other injuries may be present.
  • Severe injuries can cause damage to the skull, brain, spine, spinal nerves, or spinal cord.

Concussion

  • A concussion often causes trouble concentrating, persistent headaches, and neck pain.
  • Usually, these symptoms improve within a few weeks after a mild concussion.

Meningitis

  • Inflammation or infection of the lining around the brain and spinal cord causes pain or tenderness in the head, back, and neck.
  • Neck stiffness and fever are commonly associated symptoms.

Pinched Nerve

  • Arthritis is a common cause of pressure on spinal nerves.
  • A pinched nerve in the upper spine can cause pain in the head and neck and tingling down the arm.

Herniated Disc

  • Degenerative arthritis or trauma can cause a spinal disc to press on a nerve and possibly on the spinal cord.
  • This may cause loss of sensation or weakness of the arm.

Subarachnoid Hemorrhage

  • This is a serious condition caused by bleeding of a blood vessel in the brain.
  • Irritation and inflammation can cause severe head and neck pain, possibly with seizures and loss of consciousness.

Hydrocephalus

  • Fluid can accumulate around the brain, causing pain-inducing pressure.
  • Causes include obstruction of cerebrospinal fluid flow due to brain tumors, brain infections, or congenital malformations. (Langner S. et al., 2017)

Increased Intracranial Pressure

  • Pressure on the brain and the brain’s blood vessels can cause pain.
  • Causes of pressure within the skull include hydrocephalus, head trauma, brain tumors, or swelling from a stroke.
  • Severe cases can cause lethargy or loss of consciousness.

Brain or Spine cancer

  • Cancer of the brain or within the spine can cause pain affecting the head and neck, often with other symptoms, like loss of vision.

Treatment

Talk to a healthcare provider about the following treatments. Treating headaches with neck pain includes methods that address symptoms and methods that treat the underlying cause. The medications used for headaches with neck pain often reduce both symptoms, but this depends on the cause. Treatments that can relieve both headaches and neck pain when they occur together include:

  • Getting proper sleep to alleviate fatigue.
  • Rest and rehabilitation after a concussion or another injury.
  • Physical therapy to keep muscles flexible and relaxed.
  • Non-surgical decompression and traction to decompress the spine.
  • Pain medication to relieve pain after minor trauma.
  • Migraine medication or sinus headache treatment (Petersen S. M., Jull G. A., & Learman K. E. 2019)
  • Fluids for meningitis treatment and antibiotics for bacterial meningitis.
  • Surgical procedures for a tumor or subarachnoid hemorrhage.
  • A surgical procedure to relieve hydrocephalus.

Headache Treatment

You can do a few things to relieve your headaches, and although they won’t directly take away your neck pain, your headache relief might also decrease your neck pain. These include:

  • Avoiding loud noises
  • Cranial massage
  • Applying gentle cranial pressure
  • Avoiding bright lights as much as possible
  • Using specialized migraine sunglasses

Neck Pain Treatment

Some treatments that can specifically treat neck pain include:

  • Exercise, stretching, and physical therapy (Côté P. et al., 2019)
  • Ice or heat
  • Muscle relaxants
  • Anti-inflammatory injections

Injury Medical Chiropractic and Functional Medicine Clinic

It can be difficult to know whether a serious problem is causing headaches and neck pain. The more dangerous conditions don’t necessarily cause more severe pain. This is why getting medical attention is crucial if you have these symptoms together. If you frequently have both headaches and neck pain, it can have a substantial impact on your quality of life. There are ways to manage the symptoms, including preventative measures such as physical therapy, exercises, and avoiding triggers. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Tension Headaches

References

Côté, P., Yu, H., Shearer, H. M., Randhawa, K., Wong, J. J., Mior, S., Ameis, A., Carroll, L. J., Nordin, M., Varatharajan, S., Sutton, D., Southerst, D., Jacobs, C., Stupar, M., Taylor-Vaisey, A., Gross, D. P., Brison, R. J., Paulden, M., Ammendolia, C., Cassidy, J. D., … Lacerte, M. (2019). Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England), 23(6), 1051–1070. https://doi.org/10.1002/ejp.1374

Houle, M., Lessard, A., Marineau-Bélanger, É., Lardon, A., Marchand, A. A., Descarreaux, M., & Abboud, J. (2021). Factors associated with headache and neck pain among telecommuters – a five days follow-up. BMC Public Health, 21(1), 1086. https://doi.org/10.1186/s12889-021-11144-6

Langner, S., Fleck, S., Baldauf, J., Mensel, B., Kühn, J. P., & Kirsch, M. (2017). Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 189(8), 728–739. https://doi.org/10.1055/s-0043-108550

Petersen, S. M., Jull, G. A., & Learman, K. E. (2019). Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case-control study. The Journal of manual & manipulative therapy, 27(4), 245–252. https://doi.org/10.1080/10669817.2019.1572987

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A Closer Look at the Different Stages of Frozen Shoulder

For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain?

Frozen Shoulder Stages

A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing.

Stage 1

Pre-Freezing – 1 month to 3 months

Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017)

Root Cause

A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren’t known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025)

Stage 2

Freezing – 10 weeks to 8 months

The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024)

Stage 3

Frozen – 4 months to 12 months

The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult.

Stage 4

Thawing – 5 months to 2 years

In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint’s mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable.

Treatment

Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019)

Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017)

Prognosis

The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Motion Key To Healing

References

Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. https://doi.org/10.1067/j.cpradiol.2024.03.005

Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107

Johns Hopkins Medicine. (2025). Frozen shoulder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder

UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics

Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. https://doi.org/10.5435/JAAOS-D-17-00606

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786