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Post Surgery Leg Strengthening Tips for Patients

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

Post Surgery Leg Strengthening

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

Benefits

post-surgery leg strengthening exercises have several benefits, including

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

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

Starting Out

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

Gluteal Sets

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

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

Heel Slide

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

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

Short Arc Quad

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

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

Quad Set

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

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

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

Straight Leg Raise

To perform:

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

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

Hamstring Strengthening

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

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

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

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

Injury Medical Chiropractic & Functional Medicine Clinic

Before starting this or any other exercise program, consult a doctor and a physical therapist to find the right exercises for your situation. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Are You Recovering From Ankle Sprains?


References

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

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

Personal TENS Devices: A Modern Approach to Pain Relief

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

Pulled Muscle: Understanding the Healing Process

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.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

  • 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

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains

Enzymes and Their Role in Biological Functions

Enzymes’ function is to help trigger bodily processes ranging from digestion to blood clotting to growth. What is the best way to support enzyme production?

Enzymes

Enzymes are proteins that act as biological catalysts. They cause and speed up crucial chemical reactions and help the body complete necessary chemical reactions. They are vital for many biological processes, including digestion, metabolism, and molecule building and breaking down. This includes breaking down food, facilitating growth, and forming blood clots. Too little of a certain type can lead to serious health implications like a fatal buildup of toxins. Individuals missing a certain kind of enzyme or having too little of it can develop serious health conditions.

Function

They help speed up chemical reactions in the body (National Human Genome Research Institute, 2025). They facilitate chemical reactions in everything from digesting food to muscle growth. Enzymes facilitate this by binding to a cell, creating the reactions needed. With enzyme binding, chemical reactions can occur without destroying the cell. (Nemours KidsHealth, 2023) Each cell in the body has thousands of enzymes to help facilitate all the complex reactions to maintain health. (National Human Genome Research Institute, 2025)

Factors Affecting Production

In healthy individuals, the body produces the enzymes it needs. However, metabolic disorders can occur if the body does not produce enough of a certain type. (Kennedy Krieger Institute, 2025) These disorders can be serious and are usually caused by a genetic malfunction that impacts production.

Types

There are thousands of different types. Digestive enzymes, for example, aid in the breakdown of food and convert it into energy. Common enzymes that are critical for health include (Nemours KidsHealth, 2023)

Amylase

  • Digestive helps break down starches.

Aspartate aminotransaminase (AST) and Alanine Aminotransaminase (ALT)

  • Help the liver convert sugar into energy.

Creatine Kinase (CK)

  • Helps muscles create energy.

DNA Polymerase

  • Facilitates growth by allowing DNA to duplicate.

Glucose-6-Phosphate Dehydrogenase

  • Keeps red blood cells healthy by preventing damage to the cell.

Lipase

  • A digestive enzyme that helps break down fats and oils.

Protease

  • Digestive helps break down proteins.

Thrombin

  • Causes blood to clot.

Deficiencies

If the body doesn’t make enough of a certain enzyme, it cannot undergo the bodily processes that the enzyme helps facilitate. This can lead to a variety of symptoms. Some are minor, like not being able to eat lactose. Others are serious, like developmental delays caused by the build-up of toxins. (Kennedy Krieger Institute, 2025) Usually, these deficiencies are caused by genetics.

Types

There are various deficiencies. Some are very rare, while others can lead to conditions such as: (Nemours KidsHealth, 2023)

Lactose Intolerance

  • This is caused by not having enough of the enzyme that breaks down lactose, a sugar found in milk, leading to gas and bloating.

Tay-Sachs Disease

  • An often fatal disease caused by a missing hexosaminidase, which is responsible for breaking down fats

Gilbert’s Syndrome

  • This is caused by a missing enzyme that removes waste product (bilirubin) from the blood, leading to bilirubin buildup and
  • Jaundice or yellowing of the skin and whites of the eyes

Galactosemia

  • This leads to slow growth and trouble gaining weight, which is caused by the missing galactose-1-phosphate uridylyltransferase (GALT), which helps break down a sugar called galactose.

Phenylketonuria (PKU)

  • This is caused by having too little phenylalanine hydroxylase, which breaks down a protein called phenylalanine, causing brain damage.

Morquio Syndrome

  • This is caused by having too few enzymes that break down glycosaminoglycans, a type of sugar molecule.
  • This leads to bone and growth abnormalities.

Wilson’s Disease

  • A liver disease is caused by a missing protein that helps break down copper in the body.

Enzyme Production Support

Eat a healthy, well-balanced diet of fruits and vegetables to support enzyme production. Avoid processed foods, especially those that are very fatty (Johns Hopkins Medicine, 2025). The body produces all the necessary enzymes unless the individual has a genetic condition. Supplements aren’t usually required, but they can help with lactose intolerance or digestion in cystic fibrosis patients. (Nemours KidsHealth, 2023)

One supplement type, pancreatic enzyme replacement therapy (PERT), is available. PERT is an FDA-regulated prescription medication prescribed to patients with serious illnesses such as cystic fibrosis. (U.S. Food and Drug Administration, 2019)

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.


Chiropractic Care and Metabolism: The Hidden Link


References

National Human Genome Research Institute. (2025). Enzyme. Retrieved from https://www.genome.gov/genetics-glossary/Enzyme

Nemours KidsHealth. (2023). Enzymes. https://kidshealth.org/en/parents/enzymes.html

Kennedy Krieger Institute. (2025). Metabolic disorders. https://www.kennedykrieger.org/patient-care/conditions/metabolic-disorders

Johns Hopkins Health. (2025). Digestive enzymes and digestive enzyme supplements. https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements#:~:text=You’re%20better%20off%20building,your%20diet,%20especially%20fried%20foods.

U.S. Food and Drug Administration. (2019). FDA approves new breakthrough therapy for cystic fibrosis. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-breakthrough-therapy-cystic-fibrosis

Cupping as Alternative Medicine for Pain Relief

For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?

Cupping Therapy

This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)

Increasing Blood Circulation

  • The suction draws blood to the area, which can help reduce inflammation and promote healing.

Releasing Muscle Tension

  • The suction can stretch and pull on muscles, which can help relieve pain and tightness.

Breaking Up Adhesions

  • The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.

Detoxifying the Body

  • Some practitioners believe that cupping can help remove toxins from the body.

It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)

Benefits

  • Pain relief, especially for muscle and joint pain
  • Reduced inflammation
  • Improved circulation
  • Increased range of motion
  • Detoxification

Procedure

The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:

Preparation

  • The practitioner cleans the area where the cups will be placed.
  • They may apply oil or massage cream to the skin for easier movement of the cups.

Techniques

Dry

  • The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
  • The cup is then placed on the skin, which adheres due to the negative pressure.
  • The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.

Wet

  • Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
  • This allows blood to flow into the cup, creating a more intense suction.

Aftercare

  • The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
  • The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.

The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)

It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)

Risks

The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:

Bruising

  • It can cause temporary bruising at the site of the cups.

Skin Irritation

  • Some people may experience skin irritation or burns from the suction.

Infection

  • There is a small risk of infection if the cups are not properly sterilized.

Who should avoid the therapy?

Those with skin conditions like eczema and psoriasis should avoid cupping, as it may worsen them. (National Center for Complementary and Integrative Health, 2018

Injury Medical Chiropractic & Functional Medicine Clinic

It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. 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 Medicine: The Power of Chiropractic Care


References

Cleveland Clinic. (2023). Cupping Therapy. https://my.clevelandclinic.org/health/treatments/16554-cupping

Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. https://doi.org/10.1016/j.jams.2018.02.001

National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from https://www.nccih.nih.gov/health/cupping

Quadriceps Stretches: Essential for Leg Health

Can stretching quadriceps help relieve stiffness and pain and improve flexibility for individuals with consistently tight quadriceps?

Quadriceps Stretches

Walking, running, biking, and other daily activities can tighten the quadriceps muscles. The quadriceps are four muscles in the front of the thigh that extend the leg and strengthen the knee. Stretching the quadriceps may be a part of a home or gym exercise program or physical therapy treatment to maintain quadricep flexibility. Resting the quadriceps with an exercise program can greatly maximize mobility and prevent injury.

Tight quadriceps may sometimes result from injuries such as patellofemoral stress syndrome or iliotibial band friction syndrome. The quads may also become tight for individuals with spinal stenosis or other related problems with the lower back. (International Sports Sciences Association, 2023) Ely’s test, also known as the Duncan-Ely test, is one way to determine whether your quadriceps are tight. It is a physical examination used to assess the flexibility and potential spasticity of the rectus femoris muscle (a quadriceps muscle) by passively flexing the patient’s knee. Lie on your stomach and try to touch your foot to your buttocks. If you can’t, the rectus femoris, one of the main muscles, may be tight and benefit from quadricep stretches. (Olivencia, O. et al., 2020)

Safety and Precautions

Before trying this or any other exercise program, consult a healthcare provider to ensure exercise is safe for you and your conditions. A professional can help diagnose any overuse injury that might be causing tight quadriceps. Quadriceps stretches will be a little more comfortable after warming up. A few minutes of walking or biking will warm the quadriceps muscles to stretch more easily.

Stretches

To stretch the quadriceps, try the standing, side-lying, and prone quadriceps stretch once fully warmed up and after a workout. Individuals who frequently experience quadriceps tightness should stretch them daily. Incorporate all or some of these stretches into a cool-down or off-day flexibility routine.

Standing Stretch

The standing quadriceps stretch can be done anywhere in the office, gym, or outside. All you need is a place to stand. Here is how:

  • While standing, hold onto a countertop or back of a chair to help with balance.
  • Bend your knee by grasping your ankle.
  • Move your foot toward your buttocks.
  • Gently pull on your ankle to bend your knee as far as possible.
  • Maintain position for 30 seconds.
  • Return to the standing position.
  • Repeat the exercise 3 to 5 times with each leg.
  • Stop stretching if there are any sharp pains.

Side-Lying Stretch

The side-lying quad stretch lengthens the quadriceps. On the floor in a supported position can help focus on the stretch. Here’s how:

  • Lie on your side.
  • Bend the knee of your top leg as far as you can, gently pulling with your hand.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

Prone Stretch

Stretch the quadriceps while lying on your stomach. In this position, the floor helps to stabilize the pelvis, minimizing rocking and maximizing the stretch. To do the stretch:

  • Lie on your stomach.
  • Bend your knee back as far as you are able.
  • Grab your ankle to pull your foot toward your buttocks.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

If you have difficulty reaching your ankle, pull the leg up, wrap a towel or strap around the ankle, and use it to pull. This can help stretch the quadriceps effectively even if you cannot reach the ankle easily.

Injury Medical Chiropractic & Functional Medicine Clinic

Consult a healthcare provider or physical therapist to learn the recommended quadriceps stretches or other strengthening exercises. Keeping the quadriceps healthy will help keep the knees moving and maximize functional mobility. 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.


Chiropractic Care For Leg Instability


References

International Sports Sciences Association. (2023). How to Release Tight Quads in 2 Simple Steps. ISSA. https://www.issaonline.com/blog/post/how-to-release-tight-quads-in-2-simple-steps

Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., Kolber, M. J., Kaplan, & Kolber (2020). THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. International journal of sports physical therapy, 15(5), 776–782. https://doi.org/10.26603/ijspt20200776

Sleep Cervical Neck Roll for Better Rest

Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?

Sleep Cervical Neck Roll

Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.

For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.

Neck Support During Sleep

The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)

  • Individuals can purchase a cervical roll online or at a store or pharmacy.
  • Individuals can also contact a physical therapist to help them obtain a cervical roll.

Making Your Own

Making a cervical roll is simple to do. Here’s how:

  • Using a hand towel.
  • Fold it in half.
  • Slide the towel into the pillowcase along the lower edge.
  • Be sure the towel is tucked in so it doesn’t slip out.
  • Individuals can place tape around it so it stays in the rolled shape.

The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)

If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.

Injury Medical Chiropractic & Functional Medicine Clinic

A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. 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.


The Road To Recovery: Chiropractic Care


References

Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6

Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2

Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530

Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain

Finger Pulley Anatomy: Understanding Your Fingers’ Structure

Finger pulley injuries are unique digital injuries distinct from sprains or dislocations. They occur specifically in rock climbers and occasionally in baseball pitchers. What are the symptoms, diagnoses, and treatments available?

Finger Pulley Injury

A finger pulley injury, common in activities like climbing, involves damage to the fibrous bands (pulleys) that hold tendons against bones. This causes pain, swelling, and potentially bowstringing of the tendons.

  • Finger pulleys are structures that hold tendons against the bones of the fingers.
  • Injury symptoms include pain, swelling, and a popping sound heard at the time of the injury.
  • Finger pulley injuries, or ruptures of the digital pulley, are seen almost exclusively in rock climbers. (Miro P. H. et al., 2021)

This activity stresses the digits when maneuvering along uneven surfaces while supporting the entire body’s weight. The injuries result from the mechanics of the finger tendons and joints and the position the fingers hold while rock climbing. Rock climbing has grown in popularity. The only other sport in which this injury has been described is baseball, in pitchers. The forces acting on the finger are very different in these activities, but both place high stress on the finger pulleys.

Digital Pulleys

Everyone has structures in their fingers called digital pulleys. These pulleys hold the tendons against the bones of the fingers. Each finger has eight pulleys, but only two are considered critical to prevent the finger tendons’ bowstringing (when one pulley gives out or ruptures). This can result in various injury outcomes, from a simple strain of the pulley to ruptures of multiple pulleys in a single digit. Pain, stiffness, and an inability to fully flex the finger can occur. (Carruthers K. H., Skie M., & Jain M. 2016) In severe situations, when the tendons are bowstringing, the tendon may lift away from the finger when making a fist.

Symptoms

Pain and Tenderness

  • Localized pain and tenderness at the finger’s base, particularly when gripping or bending. Pain on the palm side of finger and tenderness with pressure

Swelling

  • Swelling and bruising around the affected finger joint, especially on the palm side.

Popping Sound

Stiffness and Difficulty Bending

  • Stiffness and pain when bending the fingers or difficulty gripping. Difficulty forming a fist

Bowstringing

  • Visible displacement of the tendon from its normal position, causing a bulge at the finger’s base.

Most commonly, the middle or index digit is the injured finger. The two critical pulleys in the finger are designated the A2 and A4. (Carruthers K. H., Skie M., & Jain M. 2016) Individuals may see swelling, redness, and inflammation at the base of the finger (A2) and/or in the space between the two finger joints closest to the tip of the finger (A4). In rock climbers, either or both of those pulleys may be injured. In baseball pitchers, the injury is typically isolated to the A4 pulley.

Causes

  • Overuse and Repetitive Strain: Frequent or intense gripping or crimping, common in rock climbing and other activities, can cause pulley injuries.
  • Dynamic or Sudden Movements: Desperate or dynamic moves or poor technique can lead to injury.
  • Excessive Force: Pulleys can rupture when the force exerted on them is too great.
  • Mechanism of injury: The A2 pulley is the most commonly injured, followed by the A4 pulley.

Diagnosis

Emergency treatment is generally unnecessary. However, it is important to have suspected digital pulley injuries examined by a specialist within several days to a week after the injury. The most important aspect of an evaluation is determining whether the injury has caused the bowstringing of the tendons. Imaging tests may be performed to help with the diagnosis and plan treatment. An ultrasound is recommended as the initial imaging technique. (Miro P. H. et al., 2021)

If an ultrasound is inconclusive, an MRI may be advised. Sometimes, an MRI is performed with the finger held straight and then bent to see if the tendons are bowstringing. An X-ray can also help exclude other causes of finger pain, including sprains and fractures.

Treatment

Conservative Care

  • Immobilization, physical therapy, and pulley-protective measures, such as splints or taped fingers, are often used.

Surgery

  • Surgery may be necessary for severe grade IV injuries where conservative care fails.
  • Only in situations where there are multiple pulley ruptures or if there is delayed treatment should surgery be necessary.

Rehabilitation

  • Focuses on regaining flexibility, strength, and grip function through exercises and physical therapy.

If the tendons do not bowstring, treatment usually protects the injured finger until swelling and pain subside. If there is bowstringing of the tendons, more careful management of the injury is needed. Individuals who suspect a pulley injury rest or splint the finger and use nonsteroidal anti-inflammatory drugs as necessary for pain until they can get a medical evaluation. (Carruthers K. H., Skie M., & Jain M. 2016) Physical therapy is recommended for most injuries, along with immobilization, the H-tape method, and a protective pulley splint. (Miro P. H. et al., 2021) Specialized splints and therapy techniques can allow the pulleys to heal properly.

Returning to activity varies significantly with the severity of the injury. With mild pulley strains, full activity can be resumed as soon as swelling and pain have subsided. Treatment for full ruptures being treated non-surgically is typically between one and three months. For individuals requiring surgical reconstruction of a pulley injury, restrictions may apply up to a year after the surgery.

Injury Medical Chiropractic & Functional Medicine Clinic

To prevent complications, a healthcare provider should evaluate pulley injuries as soon as possible. Treatment most often consists of physical therapy, but surgery may be necessary. 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.


Sports Injury Treatments


References

Miro, P. H., vanSonnenberg, E., Sabb, D. M., & Schöffl, V. (2021). Finger Flexor Pulley Injuries in Rock Climbers. Wilderness & environmental medicine, 32(2), 247–258. https://doi.org/10.1016/j.wem.2021.01.011

Carruthers, K. H., Skie, M., & Jain, M. (2016). Jam Injuries of the Finger: Diagnosis and Management of Injuries to the Interphalangeal Joints Across Multiple Sports and Levels of Experience. Sports Health, 8(5), 469–478. https://doi.org/10.1177/1941738116658643

Abdominal Self Massage Techniques for Constipation

For individuals struggling with constipation, a common digestive issue, could performing abdominal self-massage help bring relief?

Abdominal Self Massage

Constipation refers to having a bowel movement fewer than three times per week. In addition to stress, certain lifestyle issues can lead to constipation, including not getting enough fiber, exercise, and proper hydration. Many also experience constipation while traveling. Abdominal self-massage involves gently massaging the stomach with your hands, either in a circular motion or with strokes, to improve digestion, relieve constipation, and reduce bloating. Performing self-massage on and around the abdomen can help ease constipation in several ways, such as stimulating the muscles, producing bowel movements, and soothing chronic stress. (Sinclair M. 2011)

Massage and Constipation

Abdominal massage can provide several benefits, including:

Stimulates and Improves Digestion

  • Massage stimulates the muscles and nerves that control digestion, promoting bowel movements and reducing constipation.

Reduces Bloating

  • Massaging the abdomen may help to reduce bloating and gas by gently moving fluids and gases through the digestive system.
  • In addition, it can help soften stool, speed up the movement of stool through the gut, and reduce the need to use laxatives. (University of Michigan Medicine, 2021)

Relieves Constipation

  • Abdominal massage can help with constipation by encouraging bowel movements.

Reduces Pain and Discomfort

  • Some find that abdominal massage helps to reduce pain and discomfort related to digestive issues.
  • Massage can help relax tense abdominal muscles and reduce pain associated with conditions like irritable bowel syndrome (IBS).

Improved lymphatic drainage

  • Massage helps move lymphatic fluid, which carries waste products and toxins away from the abdominal area.

Research

Although massage isn’t a standard treatment for constipation, some research shows it may help restore regularity. A report reviewed several clinical trials focusing on abdominal massage and its use as a treatment for chronic constipation. The results showed that abdominal massage may provide relief by promoting peristalsis, a series of muscle contractions that help move food through the digestive tract.  The report also found that massage may help lessen colonic transit time, which is when digested food passes through the colon or last segment of the digestive tract. The report determined that abdominal massage can help alleviate constipation-related pain and discomfort. (Sinclair M. 2011)

In clinical trials, individuals with constipation reported improved quality of life after abdominal self-massage. However, some research suggests that using abdominal massage for constipation relief will not decrease the use of laxatives, the most commonly used treatment. (Lämås K. et al., 2009)

How to Massage

Various massage techniques may help relieve constipation and promote bowel movements. These are typically performed while lying down.

  • One technique involves placing the palm on the abdomen and making small, circular, clockwise motions around your belly button.
  • Individuals can also widen these circles so that the massage covers their entire abdomen.
  • Another technique begins by placing your hand below your breastbone, then gliding that hand down the length of your abdomen in one smooth stroke.
  • Repeat the movement with the other hand and continue this cycle for a few minutes.
  • When practicing self-massage, use light and gentle pressure, then gradually increase the pressure.
  • If you experience pain or tenderness, lighten up and return to a comfortable pressure level.

Try performing massage twice daily, aiming for a 20-minute session. Incorporating deep breathing into each session may also help. Before trying a massage or any home remedy, it is recommended to discuss it with a healthcare provider to see if it’s appropriate and safe. Pregnant women, for example, should avoid any massage on their abdomen. Constipation can sometimes signal an underlying condition that requires medical treatment, such as an underactive thyroid. Other symptoms like abdominal pain may be present, but sometimes constipation may be the only symptom.

Other Remedies

Self-massage alone is unlikely to treat chronic constipation; the goal should be to improve overall digestion to keep the organs functioning properly. To maintain regularity, it’s essential to drink plenty of water daily, eat enough fiber-rich foods, and engage in physical activity. Other alternative treatments include therapies like:

  • Acupressure
  • Biofeedback
  • Probiotics

Before trying self-massage, consult a medical caregiver to ensure it is safe and correct for the individual. Abdominal massage may not help with painful bloating caused by disease, infection, or other reasons.

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.


Massage Therapy Rehabilitation


References

Sinclair M. (2011). The use of abdominal massage to treat chronic constipation. Journal of bodywork and movement therapies, 15(4), 436–445. https://doi.org/10.1016/j.jbmt.2010.07.007

University of Michigan Medicine. (2021). Self-abdominal massage. https://www.med.umich.edu/1libr/MBCP/AbdominalSelfmassage.pdf

Lämås, K., Lindholm, L., Stenlund, H., Engström, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation–a randomized controlled trial. International journal of nursing studies, 46(6), 759–767. https://doi.org/10.1016/j.ijnurstu.2009.01.007

Complex Regional Pain Syndrome: A Patient’s Guide

Individuals dealing with chronic pain following a minor injury, surgery, or trauma could be experiencing complex regional pain syndrome. What are the symptoms, diagnosis, and treatments available?

Complex Regional Pain Syndrome

Reflex sympathetic dystrophy syndrome (RSDS), more commonly known as complex regional pain syndrome (CRPS), is a chronic pain condition where a person experiences severe, persistent pain in a limb, usually following an injury, that is significantly more profound than from the initial trauma. It is considered a neuroinflammatory disorder in which the body’s response to injury is dysregulated. The condition is characterized by severe burning pain, often in an arm or leg, that can occur following a minor injury, surgery, or trauma. It is associated with abnormal changes in skin temperature, swelling, and sensitivity to touch, usually affecting the affected area’s nerves, skin, muscles, blood vessels, and bones. Other names it is known by include:

  • Causalgia
  • Shoulder-Hand Syndrome
  • Sudeck’s Atrophy

Causes

CRPS is a chronic pain condition believed to result from dysfunction in the central or peripheral nervous systems (National Institute of Neurological Disorders and Stroke, 2017). It involves irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the ability to activate pain pathways after tissue or nerve injury, resulting in CRPS. Another theory is that CRPS, which follows an injury, is caused by triggering an immune response and continuous inflammation symptoms (swelling, redness, warmth). (Goh E. L., Chidambaram S., & Ma, D. 2017) It is believed to have multiple causes producing similar symptoms.

Triggers

There can be numerous triggers, including:

Symptoms

CRPS usually affects one of the extremities (arm, leg, hand, or foot). The primary symptom is intense, continuous pain. (National Institute of Neurological Disorders and Stroke, 2017) Other symptoms can include

  • Burning pain
  • Swelling
  • Increased skin sensitivity
  • Extreme sensitivity to touch, often causing significant disability in the affected limb.
  • Stiffness and swelling in affected joints
  • Skin color changes – blotchy, purple, pale, red.
  • Skin temperature changes – warmer or cooler than the opposing extremity.
  • Skin texture changes – shiny, thin, sweaty.
  • Changes in nail and hair growth patterns.
  • Pain can spread, for example, from the finger to the entire arm and the opposite extremity or from the left to the right arm.
  • Emotional stress can cause symptoms to worsen.

Some experts suggest three stages during which progressive changes occur in the affected area’s skin, muscles, joints, ligaments, and bones (Harvard Health Publishing, 2023). However, further research is needed.

Stages

Stage One

  • Lasts 1 to 3 months
  • Severe, burning pain
  • Muscle spasm
  • Joint stiffness
  • Rapid hair growth
  • Skin color and temperature changes (Stanford Medicine, 2025)

Stage Two

  • Lasts from 3 to 6 months
  • Pain becomes more intense
  • Swelling
  • Decreased hair growth
  • Nails are cracked, brittle, grooved, spotty
  • Softened bones
  • Stiff joints
  • Weak muscle tone

Stage Three

  • Pain is continuous
  • Muscle atrophy
  • Severely limited mobility
  • Irreversible changes to skin and bone
  • Contractions of muscles and tendons – limbs may be twisted

Diagnosis

  • A patient’s clinical history – signs and symptoms are the major factor in diagnosis.
  • The diagnosis is difficult because many symptoms overlap with other conditions. (Goh E. L., Chidambaram S., & Ma, D. 2017)
  • There is no specific blood test or other diagnostic tests.
  • X-rays may show osteoporosis, and nuclear bone scans may show characteristic uptake patterns that help diagnose.

Treatments

Treatment focuses on relieving painful symptoms and can include: (Goh E. L., Chidambaram S., & Ma, D. 2017)

  • Physical therapy and exercise
  • Psychotherapy to alleviate stress, anxiety, and depression
  • Sympathetic nerve blocks
  • Surgery
  • Spinal cord stimulation
  • Intrathecal drug pumps

Medications

These can include:

  • Topical analgesics
  • Anti-seizure drugs
  • Antidepressants
  • Corticosteroids
  • Opioids

It is estimated that there are 50,000 new cases every year in the United States. (Tajerian M., & Clark J. D. 2016)

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.


The Root Causes of Pain


References

National Institute of Neurological Disorders and Stroke. (2017). Complex regional pain syndrome fact sheet. Retrieved from https://www.ninds.nih.gov/sites/default/files/migrate-documents/CRPS_FactSheet-E_508C.pdf

Goh, E. L., Chidambaram, S., & Ma, D. (2017). Complex regional pain syndrome: a recent update. Burns & Trauma, 5, 2. https://doi.org/10.1186/s41038-016-0066-4

Bruehl S. (2015). Complex regional pain syndrome. BMJ (Clinical research ed.), 351, h2730. https://doi.org/10.1136/bmj.h2730

Harvard Health Publishing. (2023). Complex Regional Pain Syndrome (CRPS). https://www.health.harvard.edu/a_to_z/complex-regional-pain-syndrome-crps-a-to-z

Stanford Medicine. (2025). Complex Regional Pain Syndrome (CRPS). https://med.stanford.edu/pain/about/chronic-pain/crps.html

Tajerian, M., & Clark, J. D. (2016). New Concepts in Complex Regional Pain Syndrome. Hand Clinics, 32(1), 41–49. https://doi.org/10.1016/j.hcl.2015.08.003