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Muscles Retighten: Why Ongoing Care Is Essential

Why do the muscles retighten days or weeks later for individuals who have received massage or chiropractic adjustments?

Muscles Retighten

Muscles can retighten again days or weeks after chiropractic treatment and/or a massage. A few factors may cause this.

  • Muscle memory: The body’s natural tendency to return to its previous state of tension.
  • This includes all the unhealthy postures/positioning 
  • Delayed inflammatory response.
  • The body’s natural healing process
  • How muscles respond to manipulation
  • The need for ongoing maintenance of muscle health

After a massage, muscles can experience a temporary increase in soreness or tightness as the body heals from any minor damage or inflammation caused by the massage. Additionally, if the underlying issue causing muscle tightness is not addressed, the muscles may revert to their original state over time. (Cleveland Clinic, 2024)

Causes

Causes for muscles to retighten.

Underlying Issues

  • If the root cause of the muscle tightness is not addressed, such as unhealthy posture, injuries, repetitive motions, or muscle imbalances, it can lead to further complications.
  • In that case, the muscles may return to their original state after a few days or weeks.

Delayed Onset Muscle Soreness (DOMS)

  • For example, muscles feel sore after intense exercise, and individuals can also experience DOMS after a massage, especially if they are particularly tight or if it’s been a while since their last massage. (Healthline, 2020)

Delayed Inflammatory Response

  • Massage can sometimes cause microscopic tears or inflammation in muscle tissue, which triggers the body’s natural healing process.
  • This response can cause soreness and temporary tightness, as the body repairs the damaged tissue even after the initial massage. (Essential Chiropractic, 2025)

Muscle Memory

  • The body tends to revert to habitual patterns of muscle tension, especially if the underlying cause of the tightness isn’t addressed.
  • Muscles can retain how they were manipulated during the massage and may revert to their original tightness if they haven’t been consistently relaxed.

Muscle Guarding

  • The individual and body can subconsciously tense muscles to avoid pain or soreness, even after the massage. 
  • This muscle guarding can counteract the benefits of the massage and lead to a renewed cycle of tension. (Bhimani R. H., & Soomar D. 2019)

Muscle Health Maintenance

  • Regular Maintenance
  • Muscles need consistent care to maintain their optimal state of health and function.
  • Regular massages and other lifestyle changes, such as stretching and strengthening exercises, can help maintain muscle flexibility and reduce the likelihood of muscle tightness returning.

Individual Variation

  • Factors like the type of massage received, the frequency of massages, and individual body responses can all influence how long a massage’s benefits last. (Cleveland Clinic, 2024)

Massage Treatment

Muscles can retighten after a massage due to the body’s response to the pressure and manipulation during the treatment. This can include individual sensitivity to massage, the type of massage, and hydration levels, which can also play a role.

Type of Massage

  • Deep tissue massage, which focuses on specific muscle groups and applies deeper pressure, may cause more soreness than other types of massage.
  • Some individuals may be more sensitive to massage and experience soreness, even with a gentle massage. (Cleveland Clinic, 2024)

Muscle Fiber Manipulation

  • Deep tissue massage can break down spasms or microtears in muscle fibers, leading to soreness.
  • This is similar to the microscopic tears that occur during exercise, which are necessary for muscle repair and growth.

Dehydration

  • Individuals who are not adequately hydrated may experience increased soreness after a massage. (Cleveland Clinic, 2024)

Lactic Acid Buildup

  • During an intense massage, particularly deep tissue, lactic acid can build up in the muscles, leading to soreness and tightness. 
  • (Healthline, 2020)

Muscle Tensions

  • If the muscles were particularly tense or knotted before the massage, the manipulation could lead to soreness as the knots get worked out.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Secrets of Optimal Wellness


References

Cleveland Clinic. (2024). How to Relieve Muscle Soreness After a Massage. https://health.clevelandclinic.org/why-does-my-body-feel-worse-after-a-massage

Healthline. (2020). How to Relieve Sore Muscles After a Massage. https://www.healthline.com/health/sore-after-massage#causes-of-soreness

Essential Chiropractic and Physiotherapy. (2025). Muscle Ache After Massage: Common Causes and Relief. https://essentialchiropractic.co.uk/muscle-ache-after-massage-common-causes-and-relief/#:~:text=Post%2Dmassage%20soreness%20is%20a,hours%20as%20the%20muscles%20recover.

Bhimani, R. H., & Soomar, D. (2019). Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 44(5), 271–281. https://doi.org/10.1097/rnj.0000000000000151

Length of Time for Muscle Tightness Relief

For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?

Length Of Time to Loosen Tight Muscles

Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.

Factors Influencing Timeline

Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)

Severity of Tightness

  • Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.

Underlying Causes

  • If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)

Individual Factors

  • Genetics, age, and overall health can influence how quickly muscles adapt to stretching.

Consistency

  • Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)

Stretching Routine

The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.

Consistency

Hold Time

  • Hold static stretches for at least 30 seconds.
  • Longer holds (1-2 minutes) can provide deeper benefits.

Long-term Gains

  • For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)

Initial Changes

  • Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.

Influencing Factors and Results

  • Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)

What To Expect

Improvements

  • Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)

Longer-Term Changes

  • Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.

Maintenance

Treatment Options

  • Stretching, physical therapy, massage, and other therapies can help alleviate tight muscles and promote recovery. (Spine Medicine and Surgery of Long Island, 2024)
  • Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.

The length of time to see results means consistency and patience are important.

Injury Medical Chiropractic and Functional Medicine Clinic

As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional MedicineAcupunctureElectro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.


Understanding Long-Lasting Injuries


References

Spine Medicine and Surgery of Long Island. (2024). How Long Do Muscle Knots Last? Spine Medicine and Surgery of Long Island. https://www.spinemedli.com/how-long-do-muscle-knots-last/#:~:text=The%20duration%20of%20a%20muscle,chronic%20pain%20if%20left%20untreated.

Peterson Physical Therapy. (2024). How Long Does It Take to Improve Flexibility? https://petersenpt.com/how-long-does-it-take-to-improve-flexibility#:~:text=Over%20the%20years%2C%20I’ve,takes%20to%20become%20more%20flexible.

Healthline. (2023). Everything You Need to Know About Muscle Stiffness. https://www.healthline.com/health/muscle-stiffness

Mayo Clinic. (2023). Stretching: Focus On Flexibility. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/stretching/art-20047931#:~:text=Stretch%20in%20a%20smooth%20movement,hold%20for%20around%2060%20seconds.

Harvard Health Publishing. (2022). Everyday Stretching. https://www.health.harvard.edu/everyday-stretching#:~:text=A%20daily%20regimen%20will%20deliver,or%20three%20times%20a%20week.

Migraines & Neck Pain: Understanding the Connection

Find out how migraines and neck pain can disrupt your day and explore solutions to help you regain your comfort and peace.

Introduction

As a Nurse Practitioner with over 20 years of experience in physical and functional medicine, I’ve seen firsthand how chronic migraines—especially those linked with neck pain—can derail lives. Migraines are more than just severe headaches; they are complex neurological events often triggered by musculoskeletal dysfunction, stress, inflammation, and poor posture.

What’s often overlooked in traditional care models is the close relationship between cervical spine health and migraine activity. By integrating chiropractic care, postural retraining, and functional nutrition, we can significantly reduce migraine frequency and severity for many patients.

In this comprehensive post, we’ll explore:

  • The anatomical and physiological link between neck pain and migraines
  • The role of fibromyalgia in exacerbating migraine symptoms
  • Evidence-based chiropractic interventions
  • Postural and ergonomic corrections
  • Anti-inflammatory nutritional strategies

The Link Between Neck Pain and Migraines: Cervicogenic and Neurovascular Overlap

Patients often describe their migraine episodes beginning with a deep ache or stiffness in the neck, which gradually radiates toward the skull. This isn’t coincidental—it’s anatomical. Many migraines are cervicogenic in origin, meaning they arise from dysfunctions in the cervical spine.

The Cervical Trigeminovascular Connection

Cervicogenic headaches and migraines share overlapping pathways, particularly involving the trigeminocervical complex—a convergence of sensory nerves from the cervical spine and trigeminal nerve that transmits head and facial pain. Misalignment, muscular tension, or inflammation in this area can trigger the trigeminal-autonomic reflex, activating symptoms like:

  • Throbbing head pain
  • Light and sound sensitivity
  • Visual aura
  • Nausea

According to Vicente et al. (2023), activation of this reflex and extracranial autonomic involvement may underlie migraine generation when cervical structures are compromised. This suggests that structural or functional issues in the neck—such as joint hypomobility or myofascial tension—can act as primary migraine triggers.

Common Migraine-Associated Neck Pain Triggers

  • Cervical spine misalignment
  • Postural kyphosis and forward head posture
  • Muscular tension from occupational strain or emotional stress
  • TMJ dysfunction
  • Inadequate sleep or poor sleep posture

Fibromyalgia: An Amplifier of Migraines and Neck Pain

Patients with fibromyalgia are particularly susceptible to migraines due to central sensitization—a phenomenon in which the central nervous system becomes hypersensitive to stimuli.

In these patients, mitochondrial dysfunction plays a key role. As Janssen et al. (2021) highlight, both fibromyalgia and migraines are associated with impaired cellular energy metabolism. Symptoms in fibromyalgia patients often include:

  • Intensified migraine episodes
  • Musculoskeletal tenderness in the neck, trapezius, and occiput
  • Sleep disturbances and fatigue
  • Amplified pain response to touch (allodynia)

Understanding this connection allows for more targeted and effective treatment plans. Interventions must address not just musculoskeletal alignment but also systemic inflammation and nervous system regulation.


Tension Headaches Explained- Video


Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

Chiropractic interventions can be transformative for patients experiencing migraines related to neck dysfunction. Techniques such as cervical spine manipulation, soft tissue release, and muscle energy techniques (METs) help restore balance and reduce pain signaling.

Key Chiropractic Techniques:

  • Suboccipital Release: Alleviates deep muscle tension that compresses the greater occipital nerve
  • Cervical Mobilization: Increases joint range of motion and reduces localized inflammation
  • Myofascial Release: Targets the tight fascia and deep muscle layers in the upper back and neck
  • Instrument-Assisted Soft Tissue Mobilization (IASTM): Enhances blood flow and breaks down fibrotic tissue

Research by Mayo & Keating (2023) demonstrates that chiropractic spinal manipulation can significantly reduce migraine frequency and symptom duration, especially when combined with ergonomic education and exercise.

2. Postural Retraining and Ergonomics: Reducing Structural Strain

Modern lifestyle habits, such as prolonged screen use and poor workstation design, contribute significantly to cervical dysfunction and subsequent migraines.

Postural Interventions:

  • Craniocervical Flexion Exercises: Strengthen deep neck flexors and reduce forward head posture
  • Scapular Stabilization Routines: Reinforce shoulder and thoracic posture
  • Workstation Ergonomic Adjustments: Monitor elevation, lumbar support, and keyboard positioning

A 2021 study by de Almeida Tolentino et al. confirms that correcting head and neck posture can significantly reduce the frequency of migraines and improve functional disability scores in migraine sufferers.

3. Anti-Inflammatory Nutrition: Healing from Within

Nutritional strategies play a crucial role in modulating inflammation and stabilizing the nervous system. Many patients experience relief by identifying and avoiding dietary migraine triggers such as:

  • Aged cheeses
  • Processed meats (high in nitrates)
  • MSG, aspartame, and high-sugar foods
  • Alcohol, especially red wine

Functional Nutrition Recommendations:

  • Elimination Diets: Help identify food triggers and reduce systemic inflammation (Gazerani, 2020)
  • Magnesium Supplementation: Reduces cortical spreading depression and improves vascular tone (Shin et al., 2020)
  • Omega-3 Fatty Acids: Found in fatty fish, flaxseed, and chia, these combat neuroinflammation
  • Riboflavin (Vitamin B2): Shown to reduce the frequency of migraines when taken consistently
  • CoQ10: Improves mitochondrial function and energy production in the brain

Integrating these supplements and dietary shifts can offer long-term, sustainable relief by addressing underlying metabolic and neurological dysfunctions.


Integrated Care Planning: The Functional Medicine Model

In my clinical practice, treating migraines associated with neck pain involves more than adjusting the spine or prescribing a supplement—it requires a systems-based approach.

A Sample Care Plan May Include:

  • Initial chiropractic assessment and spinal X-rays (if indicated)
  • Trigger point mapping and musculoskeletal evaluation
  • Nutritional intake analysis with elimination diet guidance
  • Prescription of cervical mobility and posture exercises
  • Functional labs to assess inflammatory markers and micronutrient status
  • Co-management with neurologists for medication tapering (when appropriate)

The goal is to transition patients from episodic crisis management to proactive wellness, reducing reliance on pharmaceuticals and emergency interventions.


Empowering Patients Through Education and Collaboration

One of the most rewarding aspects of integrative care is educating patients about how their lifestyle, posture, diet, and spinal alignment interact to affect migraine frequency and severity.

By understanding the why behind their symptoms, patients are more empowered to:

  • Recognize and avoid migraine triggers
  • Adhere to treatment protocols
  • Participate in preventive strategies like exercise and stress reduction

When patients are viewed not just as symptoms but as whole individuals, outcomes dramatically improve. As we tailor care to their unique physiology and environment, we foster long-term healing—not just temporary relief.


Conclusion: Migraines and Neck Pain—An Opportunity for Functional Healing

The connection between migraines and neck pain is more than coincidental—it’s a deeply interwoven neurovascular and musculoskeletal relationship. As functional and physical medicine providers, we have the opportunity to address this relationship holistically.

Through chiropractic care, ergonomic corrections, anti-inflammatory nutrition, and nervous system regulation, we can guide patients toward a life with fewer migraines, improved neck mobility, and greater vitality.

By looking beyond the head and acknowledging the role of the cervical spine and systemic health, we not only reduce pain—we restore function, purpose, and quality of life.


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with neck pain associated with migraines. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce migraines from reappearing and causing neck pain. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.


References

Aguilar-Shea, A. L., Membrilla Md, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Aten Primaria, 54(2), 102208. https://doi.org/10.1016/j.aprim.2021.102208

Al Khalili, Y., Ly, N., & Murphy, P. B. (2025). Cervicogenic Headache. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939639

de Almeida Tolentino, G., Lima Florencio, L., Ferreira Pinheiro, C., Dach, F., Fernandez-de-Las-Penas, C., & Bevilaqua-Grossi, D. (2021). Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol, 21(1), 249. https://doi.org/10.1186/s12883-021-02290-w

Di Antonio, S., Arendt-Nielsen, L., & Castaldo, M. (2023). Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract, 66, 102817. https://doi.org/10.1016/j.msksp.2023.102817

Gazerani, P. (2020). Migraine and Diet. Nutrients, 12(6). https://doi.org/10.3390/nu12061658

Janssen, L. P., Medeiros, L. F., Souza, A., & Silva, J. D. (2021). Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance. An Acad Bras Cienc, 93(suppl 4), e20210618. https://doi.org/10.1590/0001-3765202120210618

Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022). Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus, 14(8), e27830. https://doi.org/10.7759/cureus.27830

Mayo, Z., & Keating, C. (2023). Manual Therapy and Exercise for the Management of Chronic Neck Pain With Multiple Neurovascular Comorbidities: A Case Report. Cureus, 15(3), e36961. https://doi.org/10.7759/cureus.36961

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8). https://doi.org/10.3390/nu12082184

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). https://doi.org/10.3390/diagnostics13040590

Disclaimer

Moringa Uses in Everyday Health Routines

Curious about moringa? Explore its incredible health benefits and why you should consider adding it to your diet.

Introduction

As a seasoned nurse practitioner with two decades of experience in physical and functional medicine, I have encountered countless patients struggling with joint inflammation. Many describe persistent joint pain that flares up after simple daily activities, tenderness in their extremities, or morning stiffness that gradually improves throughout the day. Chronic joint inflammation, often associated with conditions like arthritis, can significantly impact one’s quality of life. While conventional treatments such as NSAIDs and corticosteroids can provide relief, they also come with potential side effects. This has led many individuals to explore natural remedies, one of the most powerful being moringa oleifera.

Moringa: A Nutritional and Medicinal Powerhouse

Moringa, commonly referred to as the “Miracle Tree,” is native to parts of Africa and Asia and has been used for centuries in traditional medicine. This nutrient-dense plant is packed with essential vitamins, minerals, antioxidants, and bioactive compounds that promote overall health and well-being. The nutritional composition of 100 grams of dried moringa leaves includes:

  • Protein – 9 grams
  • Vitamin C – 51.7 mg
  • Vitamin A – 378 mcg
  • Calcium – 185 mg
  • Potassium – 337 mg
  • Iron – 4 mg
  • Magnesium – 147 mg
  • Fiber – 2 grams

One of moringa’s most notable attributes is its anti-inflammatory effects, which can alleviate joint pain and stiffness associated with arthritis and other musculoskeletal conditions.

Understanding Inflammation and Joint Pain

Inflammation is the body’s natural response to injury, infection, or chronic conditions like osteoarthritis and rheumatoid arthritis. It can be classified as acute or chronic:

  • Acute inflammation occurs as a temporary protective response, causing redness, swelling, and warmth in the affected area.
  • Chronic inflammation is prolonged and can contribute to progressive tissue damage, joint stiffness, and pain.

For individuals dealing with chronic joint pain, controlling inflammation is crucial to maintaining mobility and preventing long-term complications.

How Moringa Reduces Inflammation

Moringa contains a unique combination of antioxidants, anti-inflammatory compounds, and immune-boosting nutrients that work synergistically to combat inflammation. Here’s how it helps:

1. Rich in Antioxidants

Moringa is loaded with powerful antioxidants such as quercetin, kaempferol, and chlorogenic acid, which neutralize free radicals and inhibit inflammatory enzymes. Studies show that these antioxidants help reduce oxidative stress, a major contributor to joint inflammation.

2. Contains Natural Anti-Inflammatory Compounds

Moringa’s isothiocyanates have been shown to have strong anti-inflammatory properties, helping to regulate inflammatory gene expression and reduce the production of pro-inflammatory cytokines. This is particularly beneficial for individuals with autoimmune-related joint diseases such as rheumatoid arthritis.

3. Supports Immune Function

Since chronic inflammation is closely linked to immune dysfunction, moringa’s immune-boosting properties play a crucial role in modulating inflammatory responses. Rich in vitamin A, vitamin C, and beta-carotene, moringa strengthens the immune system, promoting a balanced inflammatory response and reducing excessive immune activation.


Unlocking The Secrets Of Inflammation-Video


Moringa for Joint Pain & Arthritis

For individuals experiencing arthritis-related joint pain, moringa may serve as a natural alternative to conventional pain relievers. Here are some key benefits:

1. Reduces Joint Swelling and Stiffness

Moringa’s anti-inflammatory properties help reduce joint swelling and stiffness, making it easier to move without discomfort. Research suggests that moringa extracts can lower pro-inflammatory cytokines, helping to restore joint function.

2. Prevents Cartilage Breakdown

The high antioxidant content in moringa helps protect against cartilage degradation, a major cause of joint pain in conditions such as osteoarthritis. By reducing oxidative stress and inflammation, moringa supports joint integrity and prevents further deterioration.

3. Improves Joint Mobility and Flexibility

Many individuals who incorporate moringa into their diet report enhanced joint mobility and flexibility, allowing them to maintain an active lifestyle.

How to Incorporate Moringa Into Your Daily Routine

Adding moringa to your diet is a simple and effective way to harness its health benefits. Here are several ways to consume it:

1. Moringa Powder

  • Mix 1-2 teaspoons of moringa powder into smoothies, soups, or teas for a nutrient-rich boost.

2. Moringa Capsules

  • Ideal for busy individuals, moringa capsules provide a convenient way to incorporate this superfood into your daily routine.

3. Moringa Tea

  • Steeping moringa leaves in hot water for 3-5 minutes creates a soothing, anti-inflammatory herbal tea.

4. Moringa Oil (Ben Oil)

  • Applying moringa oil directly to affected joints can provide additional topical pain relief and reduce inflammation.

Scientific Evidence Supporting Moringa’s Anti-Inflammatory Benefits

Several studies have validated the anti-inflammatory and joint-protective properties of moringa:

  • A 2023 study published in the Journal of Inflammation Research found that moringa extracts significantly reduced pro-inflammatory cytokines in individuals with arthritis.
  • Research from the International Journal of Molecular Sciences highlights moringa’s ability to modulate inflammatory gene expression, reducing chronic inflammation at the molecular level.
  • A 2022 study in the Phytotherapy Research Journal showed that moringa supplementation improved joint mobility and reduced pain in osteoarthritis patients over a 12-week period.

Final Thoughts

Moringa is a powerful, natural remedy for joint inflammation and pain relief. Its anti-inflammatory, antioxidant, and immune-modulating properties make it an excellent alternative to conventional treatments for arthritis and other inflammatory joint conditions. Incorporating moringa into a balanced diet and healthy lifestyle can enhance joint mobility, reduce pain, and improve overall well-being.

For those seeking a holistic approach to joint health, moringa stands out as a safe, effective, and research-backednatural supplement. Whether consumed as a powder, tea, capsule, or oil, moringa can be a game-changer in managing joint inflammation and supporting long-term musculoskeletal health.


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the various effects of incorporating moringa to reduce the inflammatory effects that are causing joint pain. When asking important questions to our associated medical providers, we advise patients to implement small changes to their daily routine, like incorporating anti-inflammatory foods into their diets to reduce the effects of joint inflammation and restore mobility. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.


References

Arora, S., & Arora, S. (2021). Nutritional significance and therapeutic potential of Moringa oleifera: The wonder plant. J Food Biochem, 45(10), e13933. https://doi.org/10.1111/jfbc.13933

Bibi, N., Rahman, N., Ali, M. Q., Ahmad, N., & Sarwar, F. (2024). Nutritional value and therapeutic potential of Moringa oleifera: a short overview of current research. Nat Prod Res, 38(23), 4261-4279. https://doi.org/10.1080/14786419.2023.2284862

Chis, A., Noubissi, P. A., Pop, O. L., Muresan, C. I., Fokam Tagne, M. A., Kamgang, R., Fodor, A., Sitar-Taut, A. V., Cozma, A., Orasan, O. H., Heghes, S. C., Vulturar, R., & Suharoschi, R. (2023). Bioactive Compounds in Moringa oleifera: Mechanisms of Action, Focus on Their Anti-Inflammatory Properties. Plants (Basel), 13(1). https://doi.org/10.3390/plants13010020

Cuellar-Nunez, M. L., Gonzalez de Mejia, E., & Loarca-Pina, G. (2021). Moringa oleifera leaves alleviated inflammation through downregulation of IL-2, IL-6, and TNF-alpha in a colitis-associated colorectal cancer model. Food Res Int, 144, 110318. https://doi.org/10.1016/j.foodres.2021.110318

Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Ann Rheum Dis, 80(7), 884-890. https://doi.org/10.1136/annrheumdis-2020-218744

Sailaja, B. S., Hassan, S., Cohen, E., Tmenova, I., Farias-Pereira, R., Verzi, M. P., & Raskin, I. (2022). Moringa isothiocyanate-1 inhibits LPS-induced inflammation in mouse myoblasts and skeletal muscle. PLOS ONE, 17(12), e0279370. https://doi.org/10.1371/journal.pone.0279370

Vergara-Jimenez, M., Almatrafi, M. M., & Fernandez, M. L. (2017). Bioactive Components in Moringa Oleifera Leaves Protect against Chronic Disease. Antioxidants (Basel), 6(4). https://doi.org/10.3390/antiox6040091

Xiao, X., Wang, J., Meng, C., Liang, W., Wang, T., Zhou, B., Wang, Y., Luo, X., Gao, L., & Zhang, L. (2020). Moringa oleifera Lam and its Therapeutic Effects in Immune Disorders. Front Pharmacol, 11, 566783. https://doi.org/10.3389/fphar.2020.566783

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GI Disorders Treatment: Seeking the Best Solutions

Discover key insights into GI disorders treatment to help manage symptoms and improve gastrointestinal health.

Introduction

Do you often feel bloated after meals? Experience persistent constipation or digestive discomfort? Or perhaps you suffer from joint stiffness and muscle pain with no clear cause? Many people are unaware that their gut health can significantly impact their musculoskeletal system. Emerging research highlights the intricate connection between gastrointestinal (GI) health and musculoskeletal function, showing that poor gut health can contribute to systemic inflammation, nutrient deficiencies, and chronic pain.

As a nurse practitioner specializing in physical and functional medicine, I have seen firsthand how addressing gut health can lead to profound improvements in musculoskeletal function and overall well-being. This article explores the gut-musculoskeletal connection and evidence-based, non-surgical strategies to alleviate pain and restore balance.


The Gut-Musculoskeletal Connection: How GI Disorders Impact the Body

1. Systemic Inflammation and Musculoskeletal Pain

Inflammation is a key player in both GI disorders and musculoskeletal conditions. When gut health is compromised—due to factors such as poor diet, stress, or dysbiosis—the body mounts an immune response, leading to chronic inflammation.

GI disorders like irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and small intestinal bacterial overgrowth (SIBO) are commonly associated with systemic inflammation. Research has shown that inflammatory mediators released from the gut can trigger widespread pain and contribute to conditions like fibromyalgia, arthritis, and chronic fatigue syndrome (Casini et al., 2024).

2. Nutrient Malabsorption and Musculoskeletal Dysfunction

The gut is responsible for absorbing essential nutrients that support musculoskeletal health. Celiac disease, inflammatory bowel disease (IBD), and chronic diarrhea can impair nutrient absorption, leading to deficiencies in:

  • Vitamin D (essential for bone health and immune regulation)
  • Magnesium (necessary for muscle relaxation and nerve function)
  • B Vitamins (important for energy metabolism and nervous system function)
  • Omega-3 Fatty Acids (anti-inflammatory properties)

Deficiencies in these nutrients can manifest as muscle cramps, weakness, joint pain, and fatigue, often mimicking other musculoskeletal disorders.

3. Gut Dysbiosis and the Nervous System

The gut, often referred to as the “second brain,” has a profound relationship with the nervous system. Gut dysbiosis, or an imbalance in gut bacteria, can lead to increased intestinal permeability (leaky gut), allowing toxins and inflammatory molecules to enter the bloodstream. This, in turn, can trigger immune responses that contribute to chronic pain, joint stiffness, and muscle dysfunction (Casini et al., 2024).

Additionally, the gut-brain axis plays a significant role in pain perception. When gut health is compromised, it can disrupt neurotransmitter production (such as serotonin and dopamine), leading to increased pain sensitivity and mood disorders like anxiety and depression.

4. Visceral-Somatic Reflex and Referred Pain

GI disorders often create referred pain patterns, where discomfort originating in the gut is perceived as musculoskeletal pain.

  • GERD may cause chest and upper back pain.
  • IBS can lead to lower back and pelvic discomfort.
  • Chronic constipation can contribute to hip and sacroiliac joint pain.

This phenomenon, known as the visceral-somatic reflex, occurs when irritation in the internal organs triggers nerve responses that are felt in corresponding musculoskeletal structures (Farmer & Aziz, 2009).


Fighting Inflammation Naturally: Video


Functional and Non-Surgical Approaches to Restoring Gut and Musculoskeletal Health

1. Dietary Modifications for Gut Health

Optimizing gut health begins with nutrient-dense, anti-inflammatory dietary choices. Some effective dietary approaches include:

  • Anti-Inflammatory Diet: Emphasizes whole foods, omega-3s, and antioxidants.
  • Elimination Diet: Identifies and removes food sensitivities that trigger inflammation.
  • Low FODMAP Diet: Reduces fermentable carbohydrates that can cause bloating and gut distress.

A well-balanced diet supports gut microbiome diversity, reduces systemic inflammation, and promotes nutrient absorption (El-Salhy, 2019).

2. Probiotics and Prebiotics for Gut Microbiome Support

Restoring gut microbiome balance is crucial for reducing inflammation and improving digestion.

  • Probiotics: Contain beneficial bacteria that support gut integrity and immune function.
  • Prebiotics: Fiber-rich foods that nourish beneficial gut bacteria.

Studies show that probiotics and prebiotics help modulate the immune system, restore gut barrier function, and reduce pain associated with GI disorders (Roy & Dhaneshwar, 2023).

3. Stress Management for Gut-Musculoskeletal Health

Chronic stress exacerbates GI dysfunction and musculoskeletal pain. Incorporating stress-reducing techniques can significantly improve both systems:

  • Mindfulness & Meditation: Reduces gut sensitivity and pain perception.
  • Cognitive Behavioral Therapy (CBT): Helps manage stress-induced GI symptoms.
  • Breathwork & Yoga: Improves vagal nerve function, aiding digestion and relaxation.

4. Manual Therapies for Musculoskeletal and Gut Health

Various hands-on therapies can alleviate both GI and musculoskeletal symptoms:

  • Osteopathic Manipulative Therapy (OMT): Improves gut motility and reduces referred pain.
  • Visceral Manipulation: Releases abdominal restrictions to improve digestion.
  • Massage Therapy: Alleviates stress-related gut dysfunction and musculoskeletal tension.

5. Acupuncture for Gut and Pain Management

Acupuncture is an evidence-based approach that can modulate the autonomic nervous system, reduce inflammation, and improve gut motility. Studies show that acupuncture helps relieve IBS-related pain, bloating, and constipation(Li et al., 2023)


Conclusion: A Holistic Approach to Gut and Musculoskeletal Health

The connection between GI health and musculoskeletal function is undeniable. Chronic pain, joint stiffness, and muscle dysfunction often stem from underlying gut issues, making an integrative approach essential for effective treatment.

By incorporating functional medicine strategies such as dietary modifications, gut microbiome support, stress reduction, manual therapies, and acupuncture, individuals can address the root causes of dysfunction rather than just treating symptoms. These holistic, non-surgical interventions empower patients to take control of their health, reduce chronic pain, and achieve lasting well-being.

As a nurse practitioner specializing in physical and functional medicine, my goal is to help individuals restore balance to their gut and musculoskeletal systems. If you’re experiencing persistent pain, digestive issues, or unexplained musculoskeletal discomfort, it’s time to explore a functional medicine approach tailored to your needs.


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the effects of GI disorders on not only the gut system but also the musculoskeletal system. While asking important questions to our associated medical providers, we advise patients to implement small changes like physical activities and small dietary changes to their diet to reduce the chances of GI disorders from returning. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.


References

Casini, I., Massai, L., Solomita, E., Ortenzi, K., Pieretti, S., & Aloisi, A. M. (2024). Gastrointestinal Conditions Affect Chronic Pain and Quality of Life in Women. Int J Environ Res Public Health, 21(11). https://doi.org/10.3390/ijerph21111435

El-Salhy, M. (2019). Nutritional Management of Gastrointestinal Diseases and Disorders. Nutrients, 11(12). https://doi.org/10.3390/nu11123013

Farmer, A. D., & Aziz, Q. (2009). Visceral pain hypersensitivity in functional gastrointestinal disorders. Br Med Bull, 91, 123-136. https://doi.org/10.1093/bmb/ldp026

Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol, 62(6), 591-599. https://www.ncbi.nlm.nih.gov/pubmed/22314561

Li, X., Liu, S., Liu, H., & Zhu, J. J. (2023). Acupuncture for gastrointestinal diseases. Anat Rec (Hoboken), 306(12), 2997-3005. https://doi.org/10.1002/ar.24871

Malone, M., Waheed, A., & Samiullah, S. (2018). Functional Gastrointestinal Disorders: Functional Lower Gastrointestinal Disorders in Adults. FP Essent, 466, 21-28. https://www.ncbi.nlm.nih.gov/pubmed/29528206

Roy, S., & Dhaneshwar, S. (2023). Role of prebiotics, probiotics, and synbiotics in management of inflammatory bowel disease: Current perspectives. World J Gastroenterol, 29(14), 2078-2100. https://doi.org/10.3748/wjg.v29.i14.2078

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Insights on Kyphosis & Treatment Approaches

Discover effective treatment approaches for kyphosis, its causes and symptoms while enhancing your posture today.

Introduction

How often do you catch yourself slouching after hours at a desk or scrolling through your phone? Do you experience persistent neck strain, shoulder tightness, or upper back discomfort? While many people recognize poor posture as an annoyance, few realize that long-term postural dysfunction can contribute to kyphosis—a spinal condition characterized by excessive forward curvature of the thoracic spine.

As a nurse practitioner with 20 years of experience in physical medicine and musculoskeletal health, I have seen firsthand how kyphosis affects both young and older adults, often leading to pain, mobility limitations, and even systemic complications. With a background that includes chiropractic care integration, I emphasize a multidisciplinary approach to kyphosis treatment, focusing on conservative therapies that address spinal alignment, muscle strength, and postural control.

This article explores the environmental causes of kyphosis, its impact on the musculoskeletal system, and evidence-based treatment strategies, including chiropractic adjustments, physical therapy, and postural rehabilitation.


What is Kyphosis? Understanding the Spinal Deformity

Kyphosis refers to an excessive anterior curvature of the thoracic spine, exceeding 40 degrees. While a mild thoracic curve is normal, excessive kyphosis can lead to visible postural changes, musculoskeletal pain, and even respiratory or gastrointestinal complications in severe cases.

Types of Kyphosis

There are several classifications of kyphosis, each with distinct causes:

  • Postural Kyphosis: The most common type, usually seen in adolescents and office workers, resulting from prolonged slouching and weak spinal musculature.
  • Scheuermann’s Kyphosis: A more rigid spinal deformity due to wedge-shaped vertebrae, typically diagnosed in teenagers.
  • Osteoporotic Kyphosis: Common in older adults due to vertebral compression fractures from osteoporosis.
  • Congenital Kyphosis: A rare condition present from birth due to abnormal vertebral development.

If left untreated, kyphosis can progressively worsen, leading to significant postural, neurological, and functional impairments.


Environmental Factors Contributing to Kyphosis

While genetic predisposition plays a role in kyphosis development, environmental and lifestyle factors significantly contribute to the condition. Understanding these risk factors can help with prevention and early intervention.

1. Poor Posture & Prolonged Sedentary Behavior

Chronic slouching, improper ergonomics, and excessive screen time encourage adaptive shortening of the anterior muscles (pectorals and upper abdominals) while weakening the posterior chain (erector spinae and scapular stabilizers). This imbalance reinforces thoracic kyphosis over time.

2. Sedentary Lifestyle & Weak Core Stability

A lack of functional movement and spinal stabilization exercises leads to postural instability, increasing the likelihood of kyphotic progression. A weak core and underactive back extensors contribute to poor spinal support, leading to excessive forward bending of the thoracic spine.

3. Heavy Backpacks & Improper Lifting Mechanics

In children and adolescents, carrying overweight backpacks can accelerate kyphotic posture by exerting excessive downward pressure on the spine. Similarly, incorrect lifting mechanics in adults (e.g., repetitive forward bending with poor lumbar support) increase spinal stress, contributing to degenerative kyphosis.

4. Osteoporosis & Age-Related Bone Loss

Older adults, particularly postmenopausal women, are at a higher risk of developing osteoporotic kyphosis due to decreased bone density. Compression fractures in the thoracic vertebrae can lead to irreversible spinal deformity, making early bone health management critical.

5. Spinal Injuries & Degenerative Disc Disease

Trauma, herniated discs, and chronic spinal degeneration can disrupt normal vertebral alignment, leading to structural kyphosisDegenerative changes in the intervertebral discs contribute to spinal instability, loss of disc height, and increased forward curvature of the thoracic spine.


Symptoms & Effects of Kyphosis on the Musculoskeletal System

Kyphosis not only alters spinal alignment but also leads to cascading effects throughout the musculoskeletal system. Depending on severity, symptoms may range from mild discomfort to functional disability.

Common Symptoms of Kyphosis

Upper Back Pain & Stiffness: Chronic discomfort, particularly between the shoulder blades and mid-thoracic region.
Limited Mobility & Flexibility: A rigid thoracic spine reduces spinal extension, affecting overall movement.
Neck & Shoulder Tension: Forward head posture and rounded shoulders cause excessive strain on the cervical spine, leading to cervicogenic headaches and referred pain.
Muscle Fatigue & Weakness: Over time, kyphotic posture weakens the paraspinal muscles, reducing spinal endurance.
Breathing & Digestive Issues: Severe kyphosis can compress the thoracic cavity, leading to restricted lung expansion and impaired digestion.

Neuromuscular Impact of Kyphosis

Cervical Involvement: Increased kyphotic curvature forces cervical hyperextension, straining the posterior neck muscles and contributing to occipital headaches, vertigo, and TMJ dysfunction.

Thoracic & Lumbar Impact: Kyphosis can trigger compensatory hyperlordosis in the lumbar spine, increasing stress on the lower back and contributing to disc degeneration and sciatic symptoms.

Biomechanical Dysfunction: Altered gait mechanics, hip instability, and reduced balance have been observed in patients with significant kyphotic curvature (Lorbergs et al., 2017).


Understanding Long-Lasting Injuries- Video


Effective Treatment Approaches for Kyphosis

1. Chiropractic Care for Kyphosis Management

Chiropractic therapy is one of the most effective non-invasive treatments for managing kyphosis-related pain and improving spinal alignment. Research has shown that chiropractic spinal manipulation can improve mobility, reduce pain, and enhance postural stability (Norton et al., 2022).

Key Benefits of Chiropractic Adjustments:

1Spinal Realignment: Chiropractic adjustments restore normal vertebral positioning and reduce excessive thoracic curvature.
Improved Postural Control: Chiropractic care strengthens postural awareness, spinal mobility, and core stability.
Reduced Muscle Tension & Nerve Compression: Manual therapy alleviates trigger points, myofascial restrictions, and nerve impingements contributing to kyphotic discomfort.
 –Enhanced Flexibility & Range of Motion: Stretching techniques combined with spinal mobilization restore thoracic extension and shoulder mobility.

2. Physical Therapy & Postural Rehabilitation

Physical therapy plays a crucial role in strengthening the posterior chain, improving spinal stability, and reinforcing proper movement mechanics.

Thoracic Extension Exercises (e.g., foam rolling, wall angels)
– Core Stabilization & Strength Training (e.g., dead bugs, planks)
– Scapular Retraction & Strengthening (e.g., rows, reverse flys)
Cervical & Lumbar Postural Corrections

3. Bracing for Kyphosis Correction

In adolescents with Scheuermann’s kyphosis, bracing can help prevent worsening curvature during growth phases.

4. Postural Ergonomics & Lifestyle Modifications

– Ergonomic Workstations: Maintaining neutral spine alignment while sitting reduces kyphotic strain.
– Daily Mobility Exercises: Incorporating yoga, Pilates, or spinal decompression exercises can improve flexibility.
– Weight Management & Bone Health Optimization: Vitamin D, calcium supplementation, and weight-bearing exercises support spinal integrity.

Final Thoughts: Addressing Kyphosis Proactively

Kyphosis is a progressive condition that requires early intervention and a multidisciplinary treatment approach. By combining chiropractic adjustments, targeted physical therapy, and ergonomic modifications, patients can significantly reduce pain, improve posture, and enhance spinal function.


Injury Medical Chiropractic & Functional Medicine Clinic

We associate with certified medical providers who implement the importance of the causes and symptoms of kyphosis. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to reduce the effects of kyphosis from affecting the cervical and thoracic areas. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.


References

Fortner, M. O., Oakley, P. A., & Harrison, D. E. (2017). Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics((R)): a case report utilizing a multimodal mirror image((R)) rehabilitation program. Journal of Physical Therapy Science, 29(8), 1475-1480. https://doi.org/10.1589/jpts.29.1475

Jenkins, H. J., Downie, A. S., Fernandez, M., & Hancock, M. J. (2021). Decreasing thoracic hyperkyphosis – Which treatments are most effective? A systematic literature review and meta-analysis. Musculoskelet Sci Pract, 56, 102438. https://doi.org/10.1016/j.msksp.2021.102438

Lam, J. C., & Mukhdomi, T. (2025). Kyphosis. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/32644371

Lorbergs, A. L., Murabito, J. M., Jarraya, M., Guermazi, A., Allaire, B. T., Yang, L., Kiel, D. P., Cupples, L. A., Bouxsein, M. L., Travison, T. G., & Samelson, E. J. (2017). Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc, 65(10), 2257-2264. https://doi.org/10.1111/jgs.15038

Norton, T. C., Oakley, P. A., & Harrison, D. E. (2022). Improving the cervical lordosis relieves neck pain and chronic headaches in a pediatric: a Chiropractic Biophysics((R)) (CBP((R))) case report with a 17-month follow-up. Journal of Physical Therapy Science, 34(1), 71-75. https://doi.org/10.1589/jpts.34.71

Oakley, P. A., Gage, W. H., Harrison, D. E., & Mochizuki, G. (2024). Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics((R)) case report. Journal of Physical Therapy Science, 36(11), 756-764. https://doi.org/10.1589/jpts.36.756

Ogura, Y., Dimar, J. R., Djurasovic, M., & Carreon, L. Y. (2021). Etiology and treatment of cervical kyphosis: state of the art review-a narrative review. J Spine Surg, 7(3), 422-433. https://doi.org/10.21037/jss-21-54

Disclaimer

Maslow’s Hierarchy of Needs in Healthcare Settings

With over 20 years of experience as a Nurse Practitioner, I have witnessed firsthand the transformative power of a holistic, patient-centered approach in healthcare. One framework that has consistently guided my practice is Maslow’s Hierarchy of Needs—a theory that not only underscores the essence of humanistic care but also provides a practical roadmap for addressing patient concerns from the most basic to the most advanced levels of well-being. In this comprehensive post, we will explore how Maslow’s model informs modern clinical practice, enhances patient outcomes, and drives innovative strategies in holistic healthcare. This discussion is tailored for the college-educated physician and healthcare professional, blending clinical insight with evidence-based strategies to achieve optimal patient care.


The Humanistic Perspective in Modern Healthcare

Historical Roots and Clinical Relevance

The humanistic perspective emerged in the mid-20th century, as psychologists began to shift away from strictly deterministic theories toward one that celebrated human potential. Grounded in the ideas of psychoanalytic theory and behaviorism, humanism champions the belief that every individual possesses an inherent drive toward self-actualization—a journey of growth, creativity, and personal fulfillment. As clinicians, understanding the humanistic perspective means recognizing that each patient’s health is influenced not just by biological factors but by an intricate interplay of environmental, social, and psychological forces.

The humanistic approach emphasizes the importance of empathy, active listening, and genuine patient engagement. It rejects the notion that human behavior is solely predetermined by genetics or early life experiences. Instead, it invites both the patient and practitioner to consider how current experiences and social contexts contribute to one’s health. By integrating humanistic principles into clinical practice, healthcare providers are better equipped to address pain, discomfort, and emotional distress in ways that promote healing and personal growth. This patient-centric model has been shown to improve treatment outcomes and foster a supportive therapeutic environment.


The Foundations of Humanistic Care: Maslow’s Hierarchy of Needs

Abraham Maslow and the Evolution of Humanistic Theory

Abraham Maslow, an American humanistic psychologist, revolutionized our understanding of human motivation with his groundbreaking work on the hierarchy of needs. Maslow’s theory posits that human beings are driven by a series of needs arranged in a hierarchical order—from the most fundamental physiological necessities to the pinnacle of self-actualization. His research focused on the growth potential of healthy individuals, asserting that every person has an innate desire to become the best version of themselves.

Maslow observed that individuals move through different stages of need fulfillment. Once basic physiological and safety needs are met, higher-level needs such as love, esteem, and ultimately self-actualization come into focus. This progression is not merely a theoretical construct; it serves as a practical framework for understanding patient behavior and guiding therapeutic interventions. For example, a patient struggling with sleep deprivation or malnutrition (physiological needs) is unlikely to engage meaningfully in discussions about self-improvement or creative pursuits (self-actualization).

The Five Stages of Maslow’s Hierarchy

Maslow’s hierarchy is traditionally divided into five distinct levels:

  1. Physiological Needs: The essential requirements for human survival (e.g., breathing, food, water, sleep, shelter).
  2. Safety Needs: The desire for security and protection from physical and emotional harm.
  3. Love and Belonging: The need for social connections, relationships, and a sense of community.
  4. Esteem: The need for self-respect, recognition, and validation from others.
  5. Self-Actualization: The drive to realize one’s full potential and engage in creative, meaningful endeavors.

Each level builds on the previous one, creating a dynamic model that is both flexible and profoundly insightful. As we delve into each stage, I will share clinical insights and real-world examples that illustrate how addressing these needs can lead to improved patient outcomes.


Maslow’s Hierarchy of Needs in the Clinical Setting

1. Physiological Needs: The Cornerstone of Health

Definition and Clinical Importance

Physiological needs represent the most fundamental prerequisites for human survival. In the healthcare setting, these include vital functions such as breathing, nutrition, hydration, sleep, and shelter. When a patient’s basic physiological requirements are unmet, it becomes nearly impossible for them to focus on recovery or engage in higher-level self-care activities.

As a Nurse Practitioner, my initial assessment of every patient prioritizes these core needs. Whether it’s ensuring a patient receives proper nutritional support during hospitalization or managing sleep disorders in a primary care setting, addressing physiological needs is always the first step toward comprehensive care. For instance, in patients with chronic illnesses, nutritional interventions and hydration management are critical to stabilizing their condition before any further therapeutic measures are considered.

Clinical Strategies for Meeting Physiological Needs

  • Comprehensive Assessment: A thorough history and physical examination to identify deficiencies in nutrition, sleep, and overall health.
  • Tailored Interventions: Implementing individualized care plans that focus on dietary support, hydration therapy, and sleep hygiene education.
  • Interdisciplinary Collaboration: Working with dietitians, sleep specialists, and other healthcare professionals to address complex physiological challenges.
  • Patient Education: Empowering patients with knowledge about the importance of a balanced diet, regular sleep patterns, and consistent hydration.

By ensuring that these foundational needs are met, we set the stage for addressing more advanced levels of patient well-being. When a patient’s body is well-nourished and functioning optimally, they are better positioned to benefit from interventions aimed at psychological and social improvements.


2. Safety Needs: Building a Secure Environment

Understanding Safety in Healthcare

Once physiological needs are secured, patients naturally seek safety—both physically and emotionally. Safety needs in healthcare encompass not only protection from injury and disease but also the assurance of emotional and financial security. In clinical practice, the perception of safety can significantly impact a patient’s willingness to engage with their treatment plan.

Patients who feel unsafe due to factors such as a lack of stable housing, economic insecurity, or exposure to trauma (including PTSD or transgenerational trauma) often experience heightened levels of stress and anxiety. This emotional turbulence can interfere with their recovery and overall health outcomes. As healthcare providers, it is our responsibility to create an environment where patients feel secure, supported, and empowered.

Clinical Applications and Interventions

  • Establishing a Trustworthy Environment: Clear communication, patient confidentiality, and a non-judgmental approach are essential in building trust.
  • Safety Protocols: Implementing rigorous safety measures in clinical settings—from infection control to fall prevention—ensures that patients are protected from harm.
  • Trauma-Informed Care: Recognizing the signs of past trauma and tailoring interventions to avoid triggering negative memories or responses. This might include modifying examination techniques or adjusting the clinical environment.
  • Financial Counseling: Assisting patients in navigating insurance and healthcare costs to alleviate economic anxieties. In some cases, referrals to social services or financial advisors can be beneficial.

For example, a patient recovering from a natural disaster or interpersonal trauma may require not only physical healing but also a dedicated care plan that addresses their emotional security. By validating their experiences and providing a safe space for recovery, we enable them to move forward with confidence.


3. Love and Belonging: Fostering Social Connections

The Need for Connection in Healing

Beyond the basic requirements for survival and security lies the essential human need for love and belonging. In the realm of healthcare, fostering strong interpersonal relationships is critical. Patients who feel connected to their family, friends, or community tend to exhibit better coping mechanisms and improved recovery trajectories.

From my experience, establishing a rapport with patients is not merely about delivering medical care—it is about building a therapeutic relationship that honors their need for connection. Whether through a warm conversation, a supportive smile, or active listening, small gestures can significantly impact a patient’s emotional state.

Strategies for Enhancing Love and Belonging in Clinical Practice

  • Patient-Centered Communication: Engaging patients in meaningful dialogue about their lives, interests, and challenges helps to build trust and rapport.
  • Family Involvement: Encouraging family participation in care discussions and decision-making processes. This collaborative approach reinforces the patient’s support system.
  • Group Support Sessions: Organizing support groups or community meetings for patients dealing with similar conditions can provide a network of empathy and understanding.
  • Cultural Competence: Respecting and integrating cultural, religious, and social backgrounds into care plans. Recognizing diverse perspectives ensures that every patient feels seen and valued.

For instance, I once cared for a patient undergoing cancer treatment who felt isolated due to the emotional toll of the disease. By coordinating with social workers and organizing peer support meetings, we were able to create a network of care that not only improved her emotional well-being but also had a positive effect on her treatment outcomes.


4. Esteem Needs: Empowering the Patient

The Role of Self-Esteem in Health

Esteem needs are pivotal in fostering a sense of self-worth and confidence in patients. This stage of Maslow’s hierarchy is all about recognition, respect, and validation—both from oneself and from others. In the clinical environment, patients who feel valued and respected are more likely to engage in their treatment plans and take proactive steps toward recovery.

For many patients, especially those dealing with chronic illnesses or long-term disabilities, the journey to rebuild self-esteem can be challenging. As Nurse Practitioners, we have the opportunity to empower our patients by recognizing their strengths, celebrating their achievements, and encouraging them to set realistic goals for self-improvement.

Clinical Practices to Enhance Esteem

  • Positive Reinforcement: Offering genuine praise for small victories can boost patient morale. Whether it’s adhering to a medication regimen or making lifestyle changes, every step counts.
  • Collaborative Goal Setting: Involving patients in the development of their care plans fosters a sense of ownership and accomplishment.
  • Therapeutic Interventions: Utilizing counseling and cognitive-behavioral techniques to address negative self-talk and build resilience.
  • Peer Recognition: Facilitating opportunities for patients to share their experiences and successes with one another, reinforcing that they are not alone in their journey.

I have witnessed many patients transform their outlook on life simply by receiving consistent, respectful, and affirming feedback from their care team. When patients feel that their efforts are recognized, they are motivated to maintain positive behaviors and strive toward higher levels of self-care.


5. Self-Actualization: Reaching the Pinnacle of Well-Being

The Pursuit of Personal Fulfillment

Self-actualization represents the highest level of Maslow’s hierarchy—a state where individuals strive to realize their full potential. For patients who have met their basic, safety, love, and esteem needs, the drive toward self-actualization can manifest in various ways, from artistic expression and creative problem-solving to the pursuit of lifelong learning and personal growth.

In my practice, I have seen that self-actualization is not a destination but a continuous journey. Even as patients work to manage chronic conditions, they often seek opportunities to express their individuality, pursue hobbies, or engage in community activities. This pursuit of personal fulfillment is integral to their overall well-being and can significantly enhance the quality of life.

Fostering Self-Actualization in Clinical Care

  • Individualized Care Plans: Tailoring interventions that recognize and nurture each patient’s unique talents and aspirations. Whether a patient aspires to return to work, engage in creative arts, or volunteer, care plans should reflect these goals.
  • Holistic Health Programs: Implementing programs that integrate physical, mental, and emotional health. Workshops, creative therapy sessions, and mindfulness practices are excellent avenues for fostering self-actualization.
  • Patient Empowerment: Encouraging patients to take an active role in their care, emphasizing that they are partners in the journey toward wellness.
  • Long-Term Follow-Up: Establishing regular check-ins that go beyond physical health metrics to assess personal growth and emotional fulfillment.

For example, I once worked with a patient who had a deep passion for painting despite facing significant health challenges. By coordinating with community art programs and providing flexible treatment schedules, we enabled him to pursue his creative interests while managing his medical condition. His renewed sense of purpose was not only inspiring but also correlated with measurable improvements in his overall health.


Clinical Implications of Maslow’s Hierarchy of Needs

A Framework for Patient-Centered Care

Maslow’s Hierarchy of Needs offers a powerful framework that guides the development of patient-centered care strategies. By systematically addressing each level of need, clinicians can create more comprehensive and effective treatment plans. Here are several clinical implications:

  • Improved Patient Engagement: When patients see that their basic needs are being met, they are more likely to engage in conversations about long-term health goals.
  • Holistic Assessment: The hierarchical model encourages healthcare professionals to consider not just the physical symptoms but also the emotional, social, and psychological factors affecting health.
  • Tailored Interventions: Recognizing the dynamic nature of human needs allows clinicians to tailor interventions based on the patient’s current life circumstances, rather than applying a one-size-fits-all approach.
  • Enhanced Therapeutic Relationships: By acknowledging the multifaceted aspects of a patient’s well-being, clinicians build trust and rapport, which are essential for successful long-term outcomes.

Real-World Application in Clinical Practice

Over the past two decades, I have integrated Maslow’s model into daily clinical routines. This integration involves routine assessments that extend beyond physical examinations to include discussions about emotional security, social support, and personal aspirations. For instance, during routine check-ups, I routinely ask patients about their living conditions, social networks, and any recent changes in their personal lives. This comprehensive approach not only helps identify potential barriers to recovery but also enables early intervention—whether that means referring a patient to a mental health specialist or connecting them with community support services.

The impact of this approach is evident in improved patient satisfaction scores, better adherence to treatment plans, and more favorable clinical outcomes. Patients report feeling more understood and valued when their care addresses all dimensions of their well-being.


Addressing Challenges and Variability in Patient Needs

Navigating Multidirectional Movement Through the Hierarchy

While Maslow’s hierarchy is often depicted as a linear progression, real-world patient experiences are far more dynamic. Patients may oscillate between different levels of need depending on life events, personal circumstances, or even shifts in mental health. For example, an individual who is generally self-actualized may experience a temporary regression to safety needs after a traumatic event such as job loss or a significant health scare.

In clinical practice, it is crucial to recognize that patient needs are fluid. A thorough, ongoing assessment is essential to determine which level of need is currently most pressing. This multidirectional movement requires flexibility in care plans and a readiness to adjust therapeutic interventions as the patient’s circumstances evolve.

Strategies for Managing Variability in Care

  • Regular Reassessments: Scheduling periodic evaluations to reassess the patient’s needs across all levels of the hierarchy.
  • Interdisciplinary Collaboration: Working closely with mental health professionals, social workers, and community organizations to address sudden shifts in patient needs.
  • Customized Care Plans: Designing flexible care strategies that can be adjusted as patients move between levels of need.
  • Patient Education: Informing patients about the fluid nature of their needs and the importance of addressing both immediate and long-term aspects of their well-being.

By adopting these strategies, clinicians can better manage the complexities of patient care, ensuring that each intervention is tailored to the current stage of the patient’s life and health journey.


Integrating Maslow’s Hierarchy into Modern Nursing Practice

A Comprehensive, Interdisciplinary Approach

Modern healthcare increasingly recognizes the importance of holistic and integrative approaches to patient care. Maslow’s Hierarchy of Needs provides a structured yet flexible framework that aligns well with interdisciplinary practices. Many medical providers—including those in injury medical chiropractic, functional medicine, and other complementary fields—integrate these principles into their clinical approach to pain management and overall wellness.

In my practice, I have observed that when healthcare providers from different specialties align their strategies around a common understanding of patient needs, the results are profoundly positive. Whether working in a hospital setting, a community clinic, or private practice, the principles of humanistic care create an environment where patients are seen as whole individuals rather than a collection of symptoms.

Best Practices for Clinical Integration

  • Interdisciplinary Rounds: Regular meetings with a team of healthcare professionals from various disciplines to discuss complex cases using Maslow’s framework.
  • Holistic Documentation: Incorporating detailed assessments of physical, emotional, and social needs into patient records to guide treatment decisions.
  • Patient-Centered Workshops: Organizing workshops and support groups that address various aspects of the patient experience—from nutrition and exercise to mental health and creative expression.
  • Technology and Telemedicine: Leveraging modern technologies to monitor patient progress across multiple domains, ensuring that care remains comprehensive and integrated.

By embracing these practices, healthcare providers can ensure that every patient receives care that is as unique as their individual needs and circumstances.


Case Studies and Practical Examples

Case Study 1: A Holistic Approach to Chronic Disease Management

Consider a patient with type 2 diabetes who has struggled not only with blood sugar management but also with feelings of isolation and low self-esteem. Through a holistic care plan guided by Maslow’s hierarchy, we addressed the patient’s physiological needs by optimizing their medication regimen and dietary plan. Next, we ensured their safety by providing education on hypoglycemia prevention and creating a secure home care plan.

Recognizing the patient’s need for love and belonging, we connected them with a community support group for individuals managing diabetes. To enhance their esteem, we set small, achievable goals and celebrated every improvement in their condition. Finally, we encouraged the patient to pursue hobbies that fostered a sense of self-actualization, such as joining a local walking club and participating in creative arts sessions. This comprehensive approach not only improved the patient’s physical health but also enhanced their emotional and social well-being.

Case Study 2: Trauma-Informed Care in a Post-Disaster Setting

In another instance, I cared for a patient who had recently experienced a natural disaster. The trauma from the event had left the patient with significant anxiety and a sense of insecurity, even though their physiological needs were largely met. By prioritizing safety needs, we implemented a trauma-informed care plan that involved counseling, the creation of a secure living environment, and financial planning support. In time, as the patient’s safety concerns were addressed, we worked together to rebuild their social connections and self-esteem, eventually guiding them toward self-actualization through community involvement and personal creative projects.

These case studies exemplify the real-world application of Maslow’s Hierarchy in clinical practice. They highlight the importance of addressing every level of need—physiological, safety, love and belonging, esteem, and self-actualization—to foster lasting improvements in patient outcomes.


Future Directions and Continuous Improvement

Embracing Innovation in Holistic Healthcare

The integration of Maslow’s Hierarchy of Needs into modern nursing practice is an evolving journey. As healthcare continues to embrace technological advancements and innovative care models, the core principles of holistic, patient-centered care remain as relevant as ever. Emerging trends in digital health, personalized medicine, and telemedicine are enhancing our ability to monitor and address the diverse needs of patients across all levels of the hierarchy.

Looking ahead, I believe that the continued collaboration between interdisciplinary teams will further refine our understanding of patient motivation and behavior. By harnessing data analytics and patient feedback, healthcare providers can develop even more nuanced approaches to care that align with the dynamic nature of human needs.

Advancing Education and Professional Development

For fellow healthcare providers and nurse practitioners, ongoing education in humanistic care and holistic health practices is essential. Engaging in professional development opportunities—such as conferences, workshops, and academic courses focused on patient-centered care—can deepen our understanding of Maslow’s theory and its practical applications. Furthermore, mentoring new clinicians on the importance of addressing all dimensions of patient well-being is a crucial step in cultivating a new generation of healthcare professionals dedicated to holistic, integrative care.


Conclusion: A Call to Holistic, Patient-Centered Care

In conclusion, Maslow’s Hierarchy of Needs is more than just a theoretical model; it is a powerful clinical tool that informs every aspect of patient care. By addressing the fundamental needs that drive human behavior, we can create a therapeutic environment that promotes healing, resilience, and personal growth. As a Nurse Practitioner with over 20 years of experience, I have seen firsthand how a comprehensive, humanistic approach transforms lives—both for our patients and for the practitioners who care for them.

Through careful assessment, interdisciplinary collaboration, and a steadfast commitment to holistic care, we can ensure that every patient’s journey toward well-being is both meaningful and effective. Whether it’s through the optimization of physiological health, the creation of a secure and supportive environment, or the fostering of social connections and self-esteem, each step in Maslow’s hierarchy is a step toward a healthier, more fulfilling life.

I encourage all healthcare professionals to embrace the principles of humanistic care and integrate Maslow’s Hierarchy of Needs into their daily practice. By doing so, we not only enhance clinical outcomes but also reaffirm the profound impact of empathy, understanding, and patient-centered care in modern healthcare.


Final Thoughts

The journey toward self-actualization—whether for our patients or ourselves as practitioners—is continuous and ever-evolving. As healthcare providers, our role is to facilitate this journey by addressing each level of need with compassion, expertise, and a commitment to holistic well-being. By integrating the timeless insights of Maslow’s Hierarchy of Needs into our clinical practice, we create a foundation for better health outcomes, improved patient satisfaction, and a more compassionate healthcare system overall.

In sharing these insights, I hope to inspire fellow clinicians and healthcare professionals to reflect on the multifaceted nature of patient care. Let us continue to learn, adapt, and innovate, ensuring that every patient receives the comprehensive care they deserve. Through empathy, education, and a steadfast commitment to humanistic values, we can truly make a difference in the lives of those we serve.


Injury Medical Chiropractic & Functional Medicine Clinic

We associate with certified medical providers who implement Maslow’s hierarchy of needs for our patients in a clinical approach to their pain and discomfort. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine and provide them with a place to have a positive and safe experience. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

Boston-Leary, K., Alexander, G. R., & Davis, S. (2024). Leveraging Maslow’s Hierarchy of Needs to Build Nursing’s More Inclusive Future. Nurs Adm Q, 48(1), 55-64. https://doi.org/10.1097/NAQ.0000000000000613

Carroll, A., Collins, C., & McKenzie, J. (2025). Physician wellbeing in a national rehabilitation hospital, a qualitative study utilizing Maslow’s hierarchy of needs as a framework for analysis. BMC Health Serv Res, 25(1), 175. https://doi.org/10.1186/s12913-025-12310-x

Hayre-Kwan, S., Quinn, B., Chu, T., Orr, P., & Snoke, J. (2021). Nursing and Maslow’s Hierarchy: A Health Care Pyramid Approach to Safety and Security During a Global Pandemic. Nurse Lead, 19(6), 590-595. https://doi.org/10.1016/j.mnl.2021.08.013

Kenrick, D. T., Griskevicius, V., Neuberg, S. L., & Schaller, M. (2010). Renovating the Pyramid of Needs: Contemporary Extensions Built Upon Ancient Foundations. Perspect Psychol Sci, 5(3), 292-314. https://doi.org/10.1177/1745691610369469

Taormina, R. J., & Gao, J. H. (2013). Maslow and the motivation hierarchy: measuring satisfaction of the needs. Am J Psychol, 126(2), 155-177. https://doi.org/10.5406/amerjpsyc.126.2.0155

Xu, J. X., Wu, L. X., Jiang, W., & Fan, G. H. (2021). Effect of nursing intervention based on Maslow’s hierarchy of needs in patients with coronary heart disease interventional surgery. World J Clin Cases, 9(33), 10189-10197. https://doi.org/10.12998/wjcc.v9.i33.10189

Disclaimer

By integrating these principles into our practice, we reaffirm that healthcare is not merely a technical pursuit—it is a profoundly human endeavor. Let us strive to meet every need, from the basic to the aspirational, and in doing so, help our patients realize their fullest potential.

Left Side Lower Back Pain: Effective Relief Techniques

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

Left Side Lower Back Pain

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

Causes

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

Muscle Injury

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

Arthritis or Bone Conditions

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

Unhealthy Posture and Body Positioning

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

Kidneys

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

Ulcerative Colitis

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

Uterine-Related Pain

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

Pregnancy

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

Spinal Disease

Sciatica

Some causes can also cause sciatica.

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

Herniated disc

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

Spinal Stenosis

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

Spondylolisthesis

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

Pregnancy

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

Muscle Spasms

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

Surgery

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

Describing Symptoms

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

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

Self Care

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

Prescribed Treatment

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

Moving Around

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

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

Injury Medical Chiropractic and Functional Medicine Clinic

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


Lower Back Pain Chiropractor Treatment


References

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

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

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

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

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

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

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

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