Chiropractic + Wellness

Compartment syndrome is a condition that causes pressure within a group of muscles to build up to dangerous levels. This pressure build-up begins to decrease blood flow, not allowing proper circulation, nutrients, and oxygen from getting to the nerves and muscle cells. The syndrome can be acute or chronic, and surgery can be required. Acute compartment syndrome is considered a medical emergency, usually caused by a severe injury and requires immediate treatment; otherwise, it can lead to permanent muscle damage. Chronic compartment syndrome or exertional compartment syndrome is usually not a medical emergency and is often caused by physical exertion.

Muscle Compartment

A compartment comprises a group of:

• Muscles
• Blood vessels
• Nerves
• They are kept in place by a fascia membrane.

The fascia does not stretch or expand because its job is to keep the tissues in place. If compartmental pressure builds up, swelling and bleeding may occur. When the tissues don't have enough blood to provide the proper amount of oxygen and nutrients, the tissues begin to die, leading to permanent damage. Because the fascia does not stretch if there is swelling or bleeding within a compartment, this increases pressure on the:

• Capillaries
• Nerves
• Muscles in that compartment.
• Blood circulation does not reach the compartment to supply oxygen and nutrients.
• Nerve and muscle cells get damaged.
• Compartment syndrome most often takes place in the lower leg's anterior/front calf compartment.

However, it can also develop in other areas like the:

• Legs
• Arms
• Hands
• Feet
• Buttocks

Acute

The typical symptom is pain, specifically when the muscle in the compartment is stretched.

• The pain is more intense than the injury itself.
• Flexing, contracting, or stretching the muscles increases the pain.
• Tingling or burning sensations may present.
• Muscle tightness or fullness sensation like bloating.
• Numbness or paralysis are late symptoms that usually indicate severe to permanent tissue injury.

The acute syndrome develops after a severe injury, like an automobile accident or from a broken bone. Injuries and conditions that can cause acute compartment syndrome include:

• Fractures
• Muscle contusion/bruise that goes beyond just a bump. Two examples include a motorcycle falling on the rider's leg or a football player getting hit in the leg intensely.
• Crush injuries.
• Constricting bandages - Casts and bandages that are too tight can cause the blockage of blood. If symptoms develop, remove or loosen any constricting bandages. If it is from a cast, contact the doctor immediately.
• Anabolic steroids - Taking steroids is a possible factor in compartment syndrome.

Blood circulation restoration after a blockage.

• When sleeping, a blood vessel can get blocked. Lying for a long time in a position that causes a limb to go to sleep, then shifting, moving, or getting up can contribute to the condition. This type of development can happen in individuals with neurological damage or who do not realize what is occurring. This can happen after intense intoxication with alcohol and/or drugs.
• Surgical repair of a damaged blood vessel that was blocked can result in compartment swelling.
• Permanent disability and tissue death can result unless the pressure is relieved.

Chronic Physical Exertion

The pain and swelling from the chronic condition are caused by vigorous physical activity/exercise. It most often occurs in the leg. Individuals that participate in activities with repetitive motions have an increased risk. Physical activities/sports include:

• Running
• Biking
• Swimming

This is usually not dangerous and is often relieved by discontinuing the specific exercise/s or physical activity for a while. Symptoms include:

• Pain during exercise.
• Cramping during exercise.
• Numbness
• Moving the foot is difficult.
• Muscle bulge can be seen.

Chiropractic Treatment

Leg pain should not be ignored for long as the problems could escalate into severe/dangerous territory. Chiropractic treatment is highly effective in the detection and treatment of leg pain. Chiropractors are experts in the neuromusculoskeletal system. Their expertise in promoting physical function applies to the whole body's systems, including the:

• Muscles
• Bones
• Ligaments
• Nerves
• Tendons

They are trained to diagnose and treat developing and chronic musculoskeletal problems and know when to seek specialized medical care when necessary.

Body Composition

Can't Individuals Just Exercise More and Eat Whatever They Want?

No individuals cannot just exercise/move more and eat whatever they want if they are serious about losing excess weight. A healthy diet and exercise are essential parts of the formula for effective weight loss. One study shows that being aware of diet in quality and quantity overtakes just exercising when achieving and maintaining healthy body composition changes as a vital part of maintaining a healthy lifestyle. Evaluating the effects of diet, exercise, or a combination of both revealed that long-term success was most significant in the mix of diet and exercise. Individuals can exercise vigorously, but losing weight can be very difficult if they have unhealthy eating habits or cannot stick to a healthy diet. The individual can develop other health problems from an unhealthy diet.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed Physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and issues that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Braver, Richard T. "Chronic Exertional Compartment Syndrome." Clinics in podiatric medicine and surgery vol. 33,2 (2016): 219-33. doi:10.1016/j.cpm.2015.12.002

Joubert, Sonia V, and Manuel A Duarte. "Chronic Exertional Compartment Syndrome in a Healthy Young Man." Journal of chiropractic medicine vol. 15,2 (2016): 139-44. doi:10.1016/j.jcm.2016.04.007

Schmidt, Andrew H. "Acute compartment syndrome." Injury vol. 48 Suppl 1 (2017): S22-S25. doi:10.1016/j.injury.2017.04.024

Vajapey, Sravya, and Timothy L Miller. "Evaluation, diagnosis, and treatment of chronic exertional compartment syndrome: a review of current literature." The Physician and sportsmedicine vol. 45,4 (2017): 391-398. doi:10.1080/00913847.2017.1384289

Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.

At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, health coaches, and nutritionists to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.

Salt, Sugar, and Fat Affects the Body

A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.

Changing unhealthy eating habits is up to the individual.

Individuals can be advised to cut back or cut out unhealthy diet choices. However, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.

Nutrition Discussion

Chronic pain associated with inflammation, which is linked to a poor diet, is the first step in diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.

The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen in stages. An example could be:

• Having one cheeseburger and not two.
• Having a burger without cheese.
• Eating a burger without the buns.
• Switching to a plant-based burger.
• There are many options to be explored to improve eating habits in small steps.

Willpower also has to be addressed in a controlled and supportive setting. Many individuals' eating habits are part of who they and adjusting them can be an uphill challenge. This is where the whole team comes in. To educate on:

• Methods of accountability
• Keeping a journal
• Having the family or friends eat healthy with them
• These are techniques and methods to increase willpower to make healthy changes.

Body Composition

Foods Can Support Body Detoxing

The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:

• Neutralize oxidative stress
• Lower inflammation
• Increase immunity
• Strengthen the musculoskeletal system
• Foods and nutrients that detoxify can be a part of a healthy lifestyle.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015

Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346

Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421

It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.

Inflammatory vs. Mechanical Pain

Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.

Inflammatory

Pain caused by inflammation can be described as:

• Not having a known definite cause.
• Characterized by stiffness, especially after waking up.
• Pain reduces with movement, activity, stretching, exercise.
• Is worst during the early hours of the morning.
• Is often accompanied by pain in the buttocks/sciatica symptoms.

Mechanical

Mechanical pain can be described as:

• Pain that becomes worse with activity, stretching, or exercise.
• Pain reduces with rest.
• There is no stiffness after sleeping.
• This pain is not constant but can become intense/severe for short periods.
• Pain in the buttocks/sciatica symptoms do not present.

Inflammatory and Non-Inflammatory

Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:

• Chiropractic adjusting
• Physical therapy
• Spinal decompression

Contributing Autoimmune Diseases

When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:

• Rheumatoid Arthritis

Arthritis causes the immune system to attack the joints throughout the body.

• Ankylosing Spondylitis

This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.

• Multiple Sclerosis

This is a disease where the immune system attacks nerve fibers and can lead to back pain.

• Psoriatic Arthritis

This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.

Inflammatory Pain Treatment

Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.

Chiropractic and Physical Therapy

These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:

• Chiropractic adjustments
• Flexion-distraction
• Posture correction
• Personalized exercises

Inflammation Night Pain

Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.

• Stretch Before Bed and When Waking

Performing stretches before going to bed and after waking up helps keep the body limber.

• Inspect Pillows and Mattress

Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.

Exercises

Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.

Cardio

These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:

• Swimming
• Walking
• Cycling

Strength-Building

Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:

• Cat and cow
• Upward and downward dog
• Glute Press
• Plank
• Bridge
• Superman

Body Composition

Mediterranean Lifestyle

Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:

• Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
• Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
• Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
• Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
• Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
• Go vegetarian for one day a week.
• Cut out processed meats with high levels of preservatives.
• Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
• Add dairy like cheese and Greek or plain yogurt.
• Increase physical activity into a routine.
• Talk to friends and family.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002

Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults - the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2

Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5

Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001

Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745