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Glycogen: Fueling the Body and the Brain

Glycogen: Fueling the Body and the Brain

For individuals who are getting into exercise, fitness, and physical activity, can knowing how glycogen works help in workout recovery?

Glycogen: Fueling the Body and the Brain

glicóxeno

When the body needs energy, it draws on its glycogen stores. Low-carbohydrate, ketogenic diets and intense exercise deplete glycogen stores, causing the body to metabolize fat for energy. Glycogen is supplied through carbohydrates in an individual’s diet and is used to power the brain, physical activity, and other bodily functions. The molecules made from glucose are mainly stored in the liver and muscles. What is eaten, how often, and the activity level influence how the body stores and uses glycogen.  Restoring glycogen after physical activity or working out is a vital part of the recovery process.  The body can quickly mobilize glycogen from these storage sites when it needs fuel. Eating enough carbohydrates to reach health goals and activity levels is essential for success.

Que é

  • It is the body’s stored form of glucose or sugar.
  • It is stored in the liver and muscles.
  • It is the body’s primary and preferred energy source.
  • It comes from carbohydrates in foods and drinks.
  • It is made from several connected glucose molecules.

Produción e almacenamento

Most carbohydrates eaten are converted to glucose, which becomes the body’s main energy source. However, when the body doesn’t need fueling, the glucose molecules become linked chains of eight to 12 glucose units, forming a glycogen molecule.

Process Triggers

  • Eating a carbohydrate-containing meal will raise blood glucose levels in response.
  • Increasing glucose signals the pancreas to produce insulin, a hormone that helps the body’s cells take up glucose from the bloodstream for energy or storage.
  • Insulin activation causes the liver and muscle cells to produce an enzyme called glycogen synthase, which links glucose chains together.
  • With enough glucose and insulin, glycogen molecules can be delivered to the liver, muscles, and fat cells for storage.

Since most glycogen is found in the muscles and liver, the amount stored in these cells varies depending on activity level, how much energy is burned at rest, and the foods eaten. The muscles primarily use glycogen stored in the músculos, while glycogen stored in the liver is distributed throughout the body, mainly to the brain and spinal cord.

Body Usage

The body converts glucose to glycogen through a process called glycogenesis. During this process, various enzymes help the body break down glycogen in glycogenolysis so the body can use it. The blood has a set amount of glucose ready to go at any given time. The insulin levels also drop when the level begins to decline, either from not eating or burning glucose during exercise. When this happens, an enzyme known as glycogen phosphorylase starts breaking the glycogen down to supply the body with glucose. Glucose from liver glycogen becomes the body’s primary energy. Short bursts of energy use glycogen, whether during sprints or heavy lifting. (Bob Murray, Christine Rosenbloom, 2018) A carbohydrate-rich pre-workout drink can provide energy to exercise longer and recover quicker. Individuals should eat a post-workout snack with a balanced amount of carbohydrates to replenish glycogen stores. The brain also uses glucose for energy, with 20 to 25% of glycogen going toward powering the brain. (Manu S. Goyal, Marcus E. Raichle, 2018) Mental sluggishness or brain fog can develop when not enough carbohydrates are consumed. When glycogen stores are depleted through exercise or insufficient carbs, the body can feel fatigued and sluggish and perhaps experience mood and sleep disturbances. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)

Dieta

What foods are eaten and how much physical activity an individual does also influence glycogen production. The effects can be acute if one follows a low-carb diet, where carbohydrates, the primary source of glucose synthesis, are suddenly restricted.

Fatigue and Brain Fog

  • When first starting a low-carb diet, the body’s glycogen stores can be severely depleted and individuals may experience symptoms like fatigue and brain fog. (Kristen E. D’Anci et al., 2009)
  • The symptoms begin to subside once the body adjusts and renews its glycogen stores.

Peso da auga

  • Any amount of weight loss can have the same effect on glycogen stores.
  • Initially, individuals may experience a rapid drop in weight.
  • Over time, weight may plateau and possibly increase.

The phenomenon is partly due to glycogen composition, which is also water. Rapid glycogen depletion at the onset of the diet triggers the loss of water weight. Over time, glycogen stores are renewed, and the water weight returns. When this happens, weight loss can stall or plateau. Fat loss can continue despite the short-term plateau effect.

Exercer

If undertaking a strenuous exercise routine, there are strategies to help avoid decreased performance that may be helpful:

Carbo-loading

  • Some athletes consume excessive amounts of carbohydrates before working out or competing.
  • Extra carbohydrates provide plenty of fuel.
  • The method has fallen out of favor as it can lead to excess water weight and digestive issues.

Glucose Gels

  • Energy gels containing glycogen can be consumed before or as needed during an event to increase blood glucose levels.
  • For example, energy chews are effective supplements for runners to help increase performance during extended runs.

Low-Carb Ketogenic Diet

  • Eating a diet high in fat and low in carbohydrates can put the body in a keto-adaptative state.
  • In this state, the body begins to access stored fat for energy and relies less on glucose for fuel.

At Injury Medical Chiropractic and Functional Medicine Clinic, our providers use an integrated approach to create personalized care plans for each individual, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to restore health and function to the body.


Sports Nutrition and Sports Dietician


References

Murray, B., & Rosenbloom, C. (2018). Fundamentals of glycogen metabolism for coaches and athletes. Nutrition reviews, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001

Goyal, M. S., & Raichle, M. E. (2018). Glucose Requirements of the Developing Human Brain. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875

Winwood-Smith, H. S., Franklin, C. E., & White, C. R. (2017). Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen. American journal of physiology. Regulatory, integrative and comparative physiology, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017

D’Anci, K. E., Watts, K. L., Kanarek, R. B., & Taylor, H. A. (2009). Low-carbohydrate weight-loss diets. Effects on cognition and mood. Appetite, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009

Enhancing Intervertebral Disc Health: Strategies for Well-being

Enhancing Intervertebral Disc Health: Strategies for Well-being

For individuals who are dealing with back pain and problems, could knowing how to improve and maintain intervertebral disc health help alleviate symptoms?

Enhancing Intervertebral Disc Health: Strategies for Well-being

Intervertebral Disc Health

The spinal column comprises 24 movable bones and 33 bones called vertebrae. The vertebral bones are stacked on top of each other. The intervertebral disc is the cushioning substance between the adjacent bones. (Dartmouth. 2008)

Osos

The vertebral bones are small and round in an area called the vertebral body. In the back is a bony ring from which protrusions extend and arches and pathways are formed. Each structure has one or more purposes and includes: (Waxenbaum JA, Reddy V, Williams C, et al., 2023)

  • Stabilizing the spine.
  • Providing a space for the connective tissue and back muscles to attach.
  • Providing a tunnel for the spinal cord to pass through cleanly.
  • Providing a space where nerves exit and branch out to all areas of the body.

estrutura

The intervertebral disc is the cushioning that sits between the vertebrae. The design of the spine allows it to move in various directions:

  • Flexion or bending
  • Extension or arching
  • Tilting and rotation or twisting.

Powerful forces act upon and influence the spinal column to produce these movements. The intervertebral disc absorbs shock during movement and protects the vertebrae and spinal cord from injury and/or trauma.

Capacidade

On the outside, strong woven fiber tissues form an area called the annulus fibrosis. The annulus fibrosis contains and protects the softer gel substance in the center, the nucleus pulposus. (Y.S. Nosikova et al., 2012) The nucleus pulposis provides shock absorption, flexibility, and pliability, especially under pressure during spinal movement.

Mecánica

The nucleus pulposus is a soft gel substance located in the center of the disc that allows elasticity and flexibility under stress forces to absorb compression. (Nedresky D, Reddy V, Singh G. 2024) The swivel action alters the tilt and rotation of the vertebra above and below, buffering the effects of spinal motion. The discs swivel in response to the direction the spine moves. The nucleus pulposus is made mostly of water, which moves in and out through small pores, acting as byways between the vertebra and disc bone. Body positions that load the spine, like sitting and standing, push the water out of the disc. Lying down on the back or in a supine position facilitates water restoration into the disc. As the body ages, the discs lose water/deshidratarse, leading to disc degeneration. The intervertebral disc has no blood supply, which means that for a disc to receive necessary nutrition and for waste removal, it must rely on water circulation to stay healthy.

Coidados

Some ways of maintaining intervertebral disc health include:

  • Paying attention to posture.
  • Changing positions frequently throughout the day.
  • Exercising and moving around.
  • Applying correct body mechanics to physical activities.
  • Sleeping on a supportive mattress.
  • Beber moita auga.
  • Comer saudable.
  • Manter un peso saudable.
  • Drinking alcohol in moderation.
  • Deixar de fumar.

At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by improving an individual’s ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. Our chiropractic team, care plans, and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness & Nutrition, Acupuncture, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.


Beyond the Surface: Understanding the Effects of Personal Injury


References

Dartmouth Ronan O’Rahilly, MD. (2008). Basic Human Anatomy. Chapter 39: The vertebral column. In D. Rand Swenson, MD, PhD (Ed.), BASIC HUMAN ANATOMY A Regional Study of Human Structure. W.B. Saunders. humananatomy.host.dartmouth.edu/BHA/public_html/part_7/chapter_39.html

Waxenbaum, J. A., Reddy, V., Williams, C., & Futterman, B. (2024). Anatomy, Back, Lumbar Vertebrae. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29083618

Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. doi.org/10.1111/j.1469-7580.2012.01537.x

Nedresky D, Reddy V, Singh G. (2024). Anatomy, Back, Nucleus Pulposus. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30570994

A importancia dunha dieta curativa despois da intoxicación alimentaria

A importancia dunha dieta curativa despois da intoxicación alimentaria

Pode saber que alimentos consumir axudar ás persoas que se recuperan dunha intoxicación alimentaria a restaurar a saúde intestinal?

A importancia dunha dieta curativa despois da intoxicación alimentaria

Intoxicación alimentaria e restauración da saúde intestinal

A intoxicación alimentaria pode ser mortal. Afortunadamente, a maioría dos casos son leves e de curta duración e duran só unhas horas a uns días (Centros para o Control e Prevención de Enfermidades, 2024). Pero mesmo os casos leves poden causar estragos no intestino, causando náuseas, vómitos e diarrea. Os investigadores descubriron que as infeccións bacterianas, como as intoxicacións alimentarias, poden causar cambios nas bacterias intestinales. (Clara Belzer et al., 2014) Comer alimentos que favorezan a cicatrización intestinal despois da intoxicación alimentaria pode axudar ao corpo a recuperarse e sentirse mellor máis rápido.

Alimentos para comer

Despois de que os síntomas de intoxicación alimentaria resolveron, pódese sentir que volver á dieta habitual está ben. Non obstante, o intestino sufriu unha gran experiencia e, aínda que os síntomas agudos diminuíron, as persoas aínda poden beneficiarse de alimentos e bebidas que son máis fáciles para o estómago. Os alimentos e bebidas recomendados despois da intoxicación alimentaria inclúen: (Instituto Nacional de Diabetes e Enfermidades Dixestivas e Renais. 2019)

  • Gatorade
  • Pedialito
  • Auga
  • Té de herbas
  • Caldo de polo
  • Gelatina
  • Salsa de mazá
  • Crackers
  • regalo
  • Arroz
  • avea
  • Bananas
  • Patacas

A hidratación despois da intoxicación alimentaria é fundamental. Os individuos deben engadir outros alimentos nutritivos e hidratantes, como a sopa de fideos de polo, que axuda polos seus nutrientes e contido de líquidos. A diarrea e os vómitos que acompañan á enfermidade poden deixar o corpo gravemente deshidratado. As bebidas rehidratantes axudan ao corpo a reemplazar os electrólitos e o sodio perdidos. Unha vez que o corpo está rehidratado e pode reter os alimentos suaves, introduza lentamente os alimentos dunha dieta regular. Ao retomar a dieta habitual despois da rehidratación, recoméndase comer pequenas comidas con frecuencia, cada tres ou catro horas, en lugar de almorzar, xantar e cear a diario. (Andi L. Shane et al., 2017) Ao elixir Gatorade ou Pedialyte, lembra que Gatorade é unha bebida rehidratante deportiva con máis azucre, que pode irritar un estómago inflamado. Pedialyte está deseñado para rehidratarse durante e despois da enfermidade e ten menos azucre, polo que é unha mellor opción. (Ronald J Maughan et al., 2016)

Cando a intoxicación alimentaria é activa Alimentos que hai que evitar

Durante a intoxicación alimentaria, as persoas normalmente non teñen ganas de comer. Non obstante, para evitar o empeoramento da enfermidade, recoméndase ás persoas que eviten o seguinte mentres están enfermas activamente (Universidade Estatal de Ohio. 2019)

  • As bebidas con cafeína e o alcohol poden deshidratarse aínda máis.
  • Os alimentos graxos e os alimentos ricos en fibra son difíciles de dixerir.
  • Os alimentos e bebidas con alto contido de azucre poden facer que o corpo produza altos niveis de glicosa e debilita o sistema inmunitario. (Navid Shomali et al., 2021)

Tempo de recuperación e retomar a dieta regular

A intoxicación alimentaria non dura moito e a maioría dos casos sen complicacións resólvense en poucas horas ou días. (Centros para o Control e Prevención de Enfermidades, 2024) Os síntomas dependen do tipo de bacteria. As persoas poden enfermarse aos poucos minutos de consumir alimentos contaminados ata dúas semanas despois. Por exemplo, a bacteria Staphylococcus aureus xeralmente causa síntomas case inmediatamente. Por outra banda, a listeria pode tardar un par de semanas en causar síntomas. (Centros para o Control e Prevención de Enfermidades, 2024) Os individuos poden retomar a súa dieta habitual unha vez que desaparecen os síntomas, o corpo está completamente hidratado e pode reter alimentos suaves. (Andi L. Shane et al., 2017)

Alimentos intestinais recomendados despois do virus do estómago

Os alimentos saudables para o intestino poden axudar a restaurar o intestino microbioma ou todos os microorganismos vivos do aparello dixestivo. Un microbioma intestinal saudable é esencial para o funcionamento do sistema inmunitario. (Emanuele Rinninella et al., 2019) Os virus do estómago poden perturbar o equilibrio das bacterias intestinais. (Chanel A. Mosby et al., 2022) Comer certos alimentos pode axudar a restaurar o equilibrio intestinal. Os prebióticos, ou fibras vexetais non dixeribles, poden axudar a descompoñerse no intestino delgado e permitir o crecemento das bacterias beneficiosas. Os alimentos prebióticos inclúen: (Dorna Davani-Davari et al., 2019)

  • Feixóns
  • Cebolas
  • tomates
  • Espárragos
  • Chícharos
  • Mel
  • Milk
  • Bananas
  • Trigo, cebada, centeo
  • Allo
  • Soia
  • Alga

Ademais, os probióticos, que son bacterias vivas, poden axudar a aumentar o número de bacterias saudables no intestino. Os alimentos probióticos inclúen: (Harvard Medical School, 2023)

  • picles
  • Pan de leitura
  • Kombucha
  • chucrute
  • Iogur
  • Miso
  • kefir
  • kimchi
  • Tempeh

Os probióticos tamén se poden tomar como suplementos e veñen en comprimidos, cápsulas, po e líquidos. Debido a que conteñen bacterias vivas, necesitan ser refrixeradas. Os provedores de saúde recomendan ás veces tomar probióticos cando se recupera dunha infección estomacal. (Instituto Nacional de Diabetes e Enfermidades Dixestivas e Renais, 2018) As persoas deben consultar co seu médico para ver se esta opción é segura e saudable.

Na Clínica de Medicina Funcional e Quiropráctica Médica de Lesións tratamos lesións e síndromes de dor crónica desenvolvendo plans de tratamento personalizados e servizos clínicos especializados centrados nas lesións e no proceso completo de recuperación. Se é necesario outro tratamento, os individuos serán remitidos a unha clínica ou médico máis axeitado para a súa lesión, condición e/ou enfermidade.


Aprender sobre substitucións alimentarias


References

Centros de Control e Prevención de Enfermidades. (2024). Síntomas de intoxicación alimentaria. Recuperado de www.cdc.gov/foodsafety/symptoms.html

Belzer, C., Gerber, GK, Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh , C. e Bry, L. (2014). Dinámica da microbiota en resposta á infección do hóspede. PloS one, 9(7), e95534. doi.org/10.1371/journal.pone.0095534

Instituto Nacional de Diabetes e Enfermidades Dixestivas e Renais. (2019). Alimentación, dieta e nutrición para a intoxicación alimentaria. Recuperado de www.niddk.nih.gov/health-information/digestive-diseases/food-poisoning/eating-diet-nutrition

Shane, AL, Mody, RK, Crump, JA, Tarr, PI, Steiner, TS, Kotloff, K., Langley, JM, Wanke, C., Warren, CA, Cheng, AC, Cantey, J. e Pickering, LK (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Enfermidades infecciosas clínicas: unha publicación oficial da Infectious Diseases Society of America, 65(12), e45–e80. doi.org/10.1093/cid/cix669

Maughan, RJ, Watson, P., Cordery, PA, Walsh, NP, Oliver, SJ, Dolci, A., Rodríguez-Sánchez, N. e Galloway, SD (2016). Un ensaio aleatorizado para avaliar o potencial de diferentes bebidas para afectar o estado de hidratación: desenvolvemento dun índice de hidratación de bebidas. The American Journal of Clinical Nutrition, 103(3), 717–723. doi.org/10.3945/ajcn.115.114769

Universidade Estatal de Ohio. Kacie Vavrek, M., RD, CSSD Ohio State University. (2019). Alimentos a evitar cando tes gripe. health.osu.edu/wellness/exercise-and-nutrition/foods-to-avoid-with-flu

Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, RE, Akbari, M., Xu, H. e Shotorbani, SS (2021). Efectos nocivos de altas cantidades de glicosa sobre o sistema inmunitario: unha revisión actualizada. Biotecnoloxía e bioquímica aplicada, 68(2), 404–410. doi.org/10.1002/bab.1938

Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, GAD, Gasbarrini, A. e Mele, MC (2019). Cal é a composición da microbiota intestinal saudable? Un ecosistema cambiante segundo a idade, o medio ambiente, a dieta e as enfermidades. Microorganismos, 7(1), 14. doi.org/10.3390/microorganisms7010014

Mosby, CA, Bhar, S., Phillips, MB, Edelmann, MJ e Jones, MK (2022). A interacción con virus entéricos de mamíferos altera a produción e o contido das vesículas da membrana externa polas bacterias comensais. Revista de vesículas extracelulares, 11(1), e12172. doi.org/10.1002/jev2.12172

Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, SJ, Berenjian, A. e Ghasemi, Y. (2019). Prebióticos: definición, tipos, fontes, mecanismos e aplicacións clínicas. Foods (Basilea, Suíza), 8(3), 92. doi.org/10.3390/foods8030092

Facultade de Medicina de Harvard. (2023). Como obter máis probióticos. www.health.harvard.edu/staying-healthy/how-to-get-more-probiotics

Instituto Nacional de Diabetes e Enfermidades Dixestivas e Renais. (2018). Tratamento da gastroenterite viral. Recuperado de www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis/treatment

A guía completa para a cadeira luxada: causas e solucións

A guía completa para a cadeira luxada: causas e solucións

Can knowing treatment options for a dislocated hip help individuals expedite rehabilitation and recovery?

A guía completa para a cadeira luxada: causas e solucións

Dislocated Hip

A dislocated hip is an uncommon injury but can happen due to trauma or following hip replacement surgery. It usually occurs after severe trauma, including motor vehicle collisions, falls, and sometimes sports injuries. (Caylyne Arnold et al., 2017) A dislocated hip can also occur after hip replacement surgery. Other injuries like ligament tears, cartilage damage, and bone fractures can occur alongside the dislocation. Most hip dislocations are treated with a joint reduction procedure that resets the ball into the socket. It is usually done with sedation or general anesthesia. Rehabilitation takes time and could be a few months before full recovery. Physical therapy can help restore motion and strength in the hip.

¿Que é iso?

If the hip is only partially dislocated, it’s called a hip subluxation. When this happens, the hip joint head only partially emerges from the socket. A dislocated hip is when the head or ball of the joint shifts or pops out of the socket. Because an artificial hip differs from a normal hip joint, the risk of dislocation increases after joint replacement. A study found that around 2% of individuals who undergo total hip replacement will experience hip dislocation within a year, with the cumulative risk increasing by approximately 1% over five years. (Jens Dargel et al., 2014) However, new technological prosthetics and surgical techniques are making this less common.

Anatomía da cadera

  • The hip ball-and-socket joint is called the femoroacetabular joint.
  • The socket is called the acetabulum.
  • The ball is called the femoral head.

The bony anatomy and strong ligaments, muscles, and tendons help to create a stable joint. Significant force must be applied to the joint for a hip dislocation to occur. Some individuals report feeling a snapping sensation of the hip. This usually is not a hip dislocation but indicates a different disorder known as snapping hip syndrome. (Paul Walker et al., 2021)

Posterior Hip Dislocation

  • Around 90% of hip dislocations are posterior.
  • In this type, the ball is pushed backward from the socket.
  • Posterior dislocations can result in injuries or irritation to the sciatic nerve. (R Cornwall, T E Radomisli 2000)

Anterior Hip Dislocation

  • Anterior dislocations are less common.
  • In this type of injury, the ball is pushed out of the socket.

Hip Subluxation

  • A hip subluxation occurs when the hip joint ball starts to come out of the socket partially.
  • Also known as a partial dislocation, it can turn into a fully dislocated hip joint if not allowed to heal properly.

os síntomas

Os síntomas poden incluír:

  • The leg is in an abnormal position.
  • Difficulty moving.
  • Severe hip pain.
  • Incapacidade para soportar peso.
  • Mechanical lower back pain can create confusion when making a proper diagnosis.
  • With a posterior dislocation, the knee and foot will be rotated towards the body’s midline.
  • An anterior dislocation will rotate the knee and foot away from the midline. (Academia Americana de Cirurxiáns Ortopédicos. 2021)

Causas

A dislocation can cause damage to the structures that hold the ball in the socket and can include:

  • Cartilage damage to the joint –
  • Tears in the labrum and ligaments.
  • Fractures of the bone at the joint.
  • Injury to the vessels that supply blood can later lead to avascular necrosis or osteonecrosis of the hip. (Patrick Kellam, Robert F. Ostrum 2016)
  • A hip dislocation increases the risk of developing joint arthritis following the injury and can raise the risk of needing a hip replacement later in life. (Hsuan-Hsiao Ma et al., 2020)

Developmental Dislocation of the Hip

  • Some children are born with developmental dislocation of the hip or DDH.
  • Children with DDH have hip joints that did not form correctly during development.
  • This causes a loose fit in the socket.
  • In some cases, the hip joint is completely dislocated.
  • In others, it’s prone to becoming dislocated.
  • In milder cases, the joint is loose but not prone to becoming dislocated. (Academia Americana de Cirurxiáns Ortopédicos. 2022)

Tratamento

Joint reduction is the most common way to treat a dislocated hip. The procedure repositions the ball back into the socket and is usually done with sedation or under general anesthesia. Repositioning a hip requires significant force.  A hip dislocation is considered an emergency, and reduction should be performed immediately after the dislocation to prevent permanent complications and invasive treatment. (Caylyne Arnold et al., 2017)

  • Once the ball is back in the socket, the healthcare provider will look for bone, cartilage, and ligament injuries.
  • Depending on what the healthcare provider finds, further treatment may be necessary.
  • Fractured or broken bones may need to be repaired to keep the ball within the socket.
  • Damaged cartilage may have to be removed.

Cirurxía

Surgery could be necessary to return the joint to its normal position. Hip arthroscopy can minimize the invasiveness of certain procedures. A surgeon inserts a microscopic camera into the hip joint to help the surgeon repair the injury using instruments inserted through other small incisions.

Hip replacement surgery replaces the ball and socket, a common and successful orthopedic surgical procedure. This surgery may be performed for various reasons, including trauma or arthritis, as it is common to develop early arthritis of the hip after this type of trauma. This is why many who have a dislocation ultimately need hip replacement surgery. As a major surgical procedure, it is not without risks. Possible complications include:

  • Infección
  • Aseptic loosening (the loosening of the joint without infection)
  • Luxación da cadeira

Recuperación

Recovering from a hip dislocation is a long process. Individuals will need to walk with crutches or other devices early in recovery. Physical therapy will improve the range of motion and strengthen the muscles around the hip. Recovery time will depend on whether other injuries, such as fractures or tears, are present. If the hip joint was reduced and there were no other injuries, it may take six to ten weeks to recover to the point where weight can be placed on the leg. It could be between two and three months for a full recovery. Keeping weight off the leg is important until the surgeon or physical therapist gives the all-clear. Injury Medical Chiropractic and Functional Medicine Clinic will work with an individual’s primary healthcare provider and other surgeons or specialists to develop an optimal personalized treatment plan.


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References

Arnold, C., Fayos, Z., Bruner, D., Arnold, D., Gupta, N., & Nusbaum, J. (2017). Managing dislocations of the hip, knee, and ankle in the emergency department [digest]. Emergency medicine practice, 19(12 Suppl Points & Pearls), 1–2.

Dargel, J., Oppermann, J., Brüggemann, G. P., & Eysel, P. (2014). Dislocation following total hip replacement. Deutsches Arzteblatt international, 111(51-52), 884–890. doi.org/10.3238/arztebl.2014.0884

Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, WF e Kaye, AD (2021). Síndrome de cadeira rotura: unha actualización completa. Revisións ortopédicas, 13(2), 25088. doi.org/10.52965/001c.25088

Cornwall, R., & Radomisli, T. E. (2000). Nerve injury in traumatic dislocation of the hip. Clinical orthopaedics and related research, (377), 84–91. doi.org/10.1097/00003086-200008000-00012

American Academy of Orthopaedic Surgeons. (2021). Hip dislocation. orthoinfo.aaos.org/en/diseases–conditions/hip-dislocation

Kellam, P., & Ostrum, R. F. (2016). Systematic Review and Meta-Analysis of Avascular Necrosis and Posttraumatic Arthritis After Traumatic Hip Dislocation. Journal of orthopaedic trauma, 30(1), 10–16. doi.org/10.1097/BOT.0000000000000419

Ma, H. H., Huang, C. C., Pai, F. Y., Chang, M. C., Chen, W. M., & Huang, T. F. (2020). Long-term results in the patients with traumatic hip fracture-dislocation: Important prognostic factors. Journal of the Chinese Medical Association : JCMA, 83(7), 686–689. doi.org/10.1097/JCMA.0000000000000366

American Academy of Orthopaedic Surgeons. (2022). Developmental dislocation (dysplasia) of the hip (DDH). orthoinfo.aaos.org/en/diseases–conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/

Descubra os beneficios curativos da acupresión

Descubra os beneficios curativos da acupresión

Can incorporating acupressure provide effective relief and benefits for individuals looking to try natural treatments for common health ailments?

Descubra os beneficios curativos da acupresión

Acupressure

Acupressure is a type of complementary medicine that is rising in popularity due to its simplicity and accessibility. It can assist in treating various diseases and conditions. (Piyush Mehta et al., 2016) Anyone can learn it, and no special equipment is required. It is an effective and safe therapeutic option with no known side effects. (Youngmi Cho et al., 2021) It is a cost-effective intervention similar to acupuncture. (Lukas Israel et al., 2021)

¿Que é iso?

The concept of acupressure activates acupoints or pressure points across meridians or channels connected to various organs to balance energy and promote health. Practitioners believe that the quality or state of a person’s energy determines their health. (Piyush Mehta et al., 2016) Acupressure is the stimulation of acupoints using either the fingers or a tool. Massage techniques like Amma, Shiatsu, Tui Na, and Thai massage incorporate acupressure in their treatments and follow the same energy channels as acupuncture.

O camiño funciona

Acupressure works similarly to acupuncture. The Gate Control Theory theorizes that pleasure impulses reach the brain four times faster than pain impulses. Continuous pleasurable impulses close the neural gates and block slower messages, like pain. According to this theory, acupressure improves the pain perception threshold. (Piyush Mehta et al., 2016) Stimulating acupoints activates functional responses, like releasing hormones. These hormones serve various functions, physical, like regulating organ function, and mental, like regulating emotions, and releasing them can help improve health and well-being. (Piyush Mehta et al., 2016)

  • Acupressure is a simple and effective intervention that can be self or professionally administered.
  • Acupoints are activated in the elbows, fingers, feet, knuckles, palms, or thumbs.
  • Though acupressure doesn’t require specialized tools, they are available for convenience.
  • Some practitioners used Bian stones to activate acupoints.
  • Modern tools can assist with activating acupoints. (Piyush Mehta et al., 2016)
  • Pressing the acupoints is adequate, and inaccuracies are unlikely to cause harm or injury. (Youngmi Cho et al., 2021)

Algúns dos ferramentas available include: (Piyush Mehta et al., 2016)

  • Spinal device
  • luvas
  • Device for fingers
  • Pluma
  • anel
  • Calzados
  • Pedaleiro
  • Device for ear
  • Grapas

Beneficios

Acupressure is often used alongside modern medicine, as it treats common or coexisting symptoms, such as anxiety or stress. Some of the conditions for which acupressure may be effective include.

Redución do estrés e da fatiga

Stress and fatigue are common but often arise alongside other ailments or conditions if persistent or severe, anxiety and fatigue can significantly affect quality of life by reducing an individual’s ability to participate in daily activities. In a study looking at shift work nurses who experience stress and fatigue from the intensity of their work, acupressure significantly reduced their symptoms. (Youngmi Cho et al., 2021) In studies with breast cancer survivors, acupressure was also used to decrease fatigue levels and was shown to be an effective and low-cost option for managing persistent fatigue alongside standard care for breast cancer. (Suzanna Maria Zick et al., 2018) (Suzanna M Zick et al., 2016)

Can Help With Anxiety and Depression

Depression and anxiety can be part of a disorder or exist on their own. Acupressure may help alleviate some of the anxiety and depression that arise as part of a condition or ailment. In the shift work nurses study, acupressure helped decrease anxiety levels. (Youngmi Cho et al., 2021) In other studies, acupressure reduced anxiety scores and improved depressive symptoms in individuals with mild to moderate symptoms. (Elizabeth Monson et al., 2019) (Jingxia Lin et al., 2022) (Suzanna Maria Zick et al., 2018)

Redución da dor

Individuals experience physical pain for a variety of reasons. Pain can come from temporary deportes injuries, work, sudden awkward movements, and/or chronic illness. Acupressure can effectively reduce pain as a complementary therapy. (Elizabeth Monson et al., 2019) In a study, athletes who had a musculoskeletal sports injury reported decreased pain intensity after three minutes of acupressure therapy. (Aleksandra K Mącznik et al., 2017) In another study, breast cancer survivors showed significant improvements with acupressure. (Suzanna Maria Zick et al., 2018)

Alivio das náuseas

Nausea and vomiting are conditions that are common for those who are pregnant or undergoing chemotherapy. It also can be a medication side effect or arise with migraine or indigestion. There is evidence that acupressure may be effective in alleviating symptoms. Some researchers believe a particular type of acupressure known as auricular acupressure is the most effective for treating chemotherapy-induced nausea and vomiting alongside standard treatment. (Jing-Yu Tan et al., 2022) However, further research is needed to determine whether this is a viable, ongoing option for treating nausea and vomiting. (Heather Greenlee et al., 2017)

Dorme mellor

Acupressure can be an effective and low-cost option for managing breast cancer symptoms. One study found relaxing acupressure techniques improved sleep quality and quality of life in breast cancer survivors. Additionally, researchers note that relaxing acupressure is more effective for improving sleep and quality of life than stimulating acupressure. (Suzanna M Zick et al., 2016)

Allergy Reduction

Allergic rhinitis is inflammation caused by an allergic reaction. Previous trials have found that acupressure could improve overall health by reducing seasonal allergic rhinitis symptoms and the need for allergy medication. (Lukas Israel et al., 2021) Researchers also noted that individuals are likely to adhere to self-applied acupressure therapy as a form of self-massage. (Lukas Israel et al., 2021)

Always consult a healthcare provider before starting acupressure treatments, especially if you have any pre-existing health conditions. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. Flexibility, mobility, and agility programs are tailored for all age groups and disabilities. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.


Enhance Performance with Functional Foot Orthotics


References

Mehta, P., Dhapte, V., Kadam, S., & Dhapte, V. (2016). Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. Journal of traditional and complementary medicine, 7(2), 251–263. doi.org/10.1016/j.jtcme.2016.06.004

Cho, Y., Joo, J. M., Kim, S., & Sok, S. (2021). Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. International journal of environmental research and public health, 18(8), 4199. doi.org/10.3390/ijerph18084199

Israel, L., Rotter, G., Förster-Ruhrmann, U., Hummelsberger, J., Nögel, R., Michalsen, A., Tissen-Diabaté, T., Binting, S., Reinhold, T., Ortiz, M., & Brinkhaus, B. (2021). Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chinese medicine, 16(1), 137. doi.org/10.1186/s13020-021-00536-w

Zick, S. M., Sen, A., Hassett, A. L., Schrepf, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2018). Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors. JNCI cancer spectrum, 2(4), pky064. doi.org/10.1093/jncics/pky064

Zick, S. M., Sen, A., Wyatt, G. K., Murphy, S. L., Arnedt, J. T., & Harris, R. E. (2016). Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Clinical Trial. JAMA oncology, 2(11), 1470–1476. doi.org/10.1001/jamaoncol.2016.1867

Monson, E., Arney, D., Benham, B., Bird, R., Elias, E., Linden, K., McCord, K., Miller, C., Miller, T., Ritter, L., & Waggy, D. (2019). Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. Journal of alternative and complementary medicine (New York, N.Y.), 25(5), 517–521. doi.org/10.1089/acm.2018.0422

Lin, J., Chen, T., He, J., Chung, R. C., Ma, H., & Tsang, H. (2022). Impacts of acupressure treatment on depression: A systematic review and meta-analysis. World journal of psychiatry, 12(1), 169–186. doi.org/10.5498/wjp.v12.i1.169

Mącznik, A. K., Schneiders, A. G., Athens, J., & Sullivan, S. J. (2017). Does Acupressure Hit the Mark? A Three-Arm Randomized Placebo-Controlled Trial of Acupressure for Pain and Anxiety Relief in Athletes With Acute Musculoskeletal Sports Injuries. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 27(4), 338–343. doi.org/10.1097/JSM.0000000000000378

Tan, J. Y., Molassiotis, A., Suen, L. K. P., Liu, J., Wang, T., & Huang, H. R. (2022). Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC complementary medicine and therapies, 22(1), 87. doi.org/10.1186/s12906-022-03543-y

Greenlee, H., DuPont-Reyes, M. J., Balneaves, L. G., Carlson, L. E., Cohen, M. R., Deng, G., Johnson, J. A., Mumber, M., Seely, D., Zick, S. M., Boyce, L. M., & Tripathy, D. (2017). Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: a cancer journal for clinicians, 67(3), 194–232. doi.org/10.3322/caac.21397

Ho, K. K., Kwok, A. W., Chau, W. W., Xia, S. M., Wang, Y. L., & Cheng, J. C. (2021). A randomized controlled trial on the effect of focal thermal therapy at acupressure points treating osteoarthritis of the knee. Journal of orthopaedic surgery and research, 16(1), 282. doi.org/10.1186/s13018-021-02398-2

Explorando a bursite periscapular: síntomas e diagnóstico

Explorando a bursite periscapular: síntomas e diagnóstico

Para as persoas que experimentan dor no ombreiro e nas costas, podería ser unha posible causa a bursite periscapular?

Explorando a bursite periscapular: síntomas e diagnóstico

Bursite periscapular

A escápula/omóplato é un óso que cambia de posición co movemento do ombreiro e da parte superior do corpo. O movemento da escápula é fundamental para a función normal do ombreiro e da columna vertebral. Cando se producen movementos anormais ou repentinos do ombreiro, poden desenvolverse síntomas de inflamación e dor. (Augustine H. Conduah et al., 2010)

Función escápula normal

A escápula é un óso triangular na parte superior das costas fóra da caixa torácica. O seu lado exterior ou lateral contén a cavidade da articulación do ombreiro/glenoide, mentres que o resto do óso serve como puntos de unión para os diferentes músculos do ombreiro e das costas. A escápula desprázase na caixa torácica ao mover o brazo cara adiante e cara atrás. Este movemento chámase movemento escapulotorácico e é fundamental para o funcionamento normal da extremidade superior e da articulación do ombreiro. Cando a escápula non se desliza nun movemento coordinado, a función das articulacións do tronco e dos ombreiros pode volverse ríxida e dolorosa. (JE Kuhn et al., 1998)

Bursa escapular

Unha bolsa é un saco cheo de fluído que permite un movemento suave e deslizante entre estruturas, tecidos corporais, ósos e tendóns. As bolsas atópanse en todo o corpo, incluídas as que están diante da rótula, fóra da cadeira e na articulación do ombreiro. Cando unha bolsa se inflama e se irrita, os movementos normais poden facerse dolorosos. Hai bolsas arredor da escápula na parte superior das costas. Dous destes sacos de bolsa están entre os ósos e o músculo serrato anterior que controla o movemento escapular na parede torácica. Un saco de bursa está situado na esquina superior da escápula, preto da columna vertebral na base do pescozo, e o outro está na esquina inferior da escápula, preto da parte media das costas. Calquera ou ambos os sacos de bolsa poden verse afectados pola bursite periscapular. Hai outras bolsas ao redor da escápula e dos tendóns circundantes, pero os dous sacos de esquina tenden a ser as bolsas primarias que desenvolven bursite periscapular.

Inflamación

Cando estas bolsas se inflaman e irritan, se inchan e se engrosan, aparece a condición coñecida como bursite. Cando a bursite ocorre preto da escápula, os movementos musculares e do omóplato poden provocar molestias e dor. Os síntomas máis comúns da bursite periscapular inclúen:

  • Romper co movemento
  • Sensacións de moenda ou crepitus
  • Dor
  • Tenrura directamente sobre a bolsa (Augustine H. Conduah et al., 2010)
  • Sensacións e movementos escapulares anormais

Un exame da escápula pode mostrar movementos anormais do omóplato. Isto pode levar a voar, onde o omóplato non se suxeita correctamente á caixa torácica e sobresae de forma anormal. Os individuos con alas da escápula adoitan ter unha mecánica anormal da articulación do ombreiro porque a posición do ombreiro está alterada.

Causas

As causas da bursite periscapular poden ser variadas. O máis común é a síndrome de uso excesivo, onde unha actividade específica está a causar irritación á bolsa. Estes poden incluír:

  • Actividades relacionadas co deporte que resultan do uso repetitivo.
  • Actividades relacionadas co traballo que resultan do uso repetitivo.
  • Lesións traumáticas que provocan inflamación ou irritación da bolsa.

Algunhas condicións poden causar unha anatomía anormal ou protuberancias óseas, irritando a bolsa. Unha condición é un crecemento óseo benigno coñecido como osteocondroma. (Antônio Marcelo Gonçalves de Souza e Rosalvo Zósimo Bispo Júnior 2014) Estes crecementos poden proxectar fóra da escápula, o que provoca irritación e inflamación.

Tratamento

O tratamento da bursite periscapular comeza cun conservador Terapias. Os tratamentos invasivos raramente son necesarios para corrixir o problema. O tratamento pode incluír:

Resto

  • O primeiro paso é descansar a bursa irritada e resolver a inflamación.
  • Isto pode levar unhas semanas e pódese conseguir modificando actividades físicas, deportivas ou relacionadas co traballo.

xeo

  • O xeo é útil para reducir a inflamación e controlar a dor.
  • Saber como xear unha lesión correctamente pode axudar a controlar a dor e o inchazo.

Terapia Física

  • A fisioterapia pode aliviar os síntomas da inflamación a través de varios exercicios e estiramentos.
  • A terapia pode mellorar a mecánica escapular para que a lesión non se faga continua e recorrente.
  • O movemento anormal da escápula na caixa torácica non só pode levar ao desenvolvemento de bursite, senón que se non se abordan estas mecánicas anormais, o problema pode repetirse.

Medicamentos antiinflamatorios

  • Os medicamentos antiinflamatorios non esteroides úsanse para controlar a inflamación a curto prazo. (Augustine H. Conduah et al., 2010)
  • Os medicamentos poden axudar a bloquear a resposta inflamatoria.
  • Antes de tomar calquera medicamento, as persoas deben confirmar co seu médico que é seguro.

Inxeccións de cortisona

  • O tratamento exitoso cunha inyección de cortisona é un sinal de que a cirurxía será máis efectiva para as persoas que poidan necesitar cirurxía.
  • As inxeccións de cortisona poden ser moi útiles para administrar unha potente dose antiinflamatoria directamente no lugar da inflamación. (Augustine H. Conduah et al., 2010)
  • As inxeccións de cortisona deben limitarse en canto a cantas inxeccións se ofrecen a un individuo, pero en doses limitadas poden ser moi útiles.
  • Non obstante, as inyeccións de cortisona só se deben realizar unha vez que se confirme o diagnóstico.

Cirurxía

  • A cirurxía raramente é necesaria, pero pode ser eficaz en persoas que non poden atopar alivio con tratamentos conservadores.
  • A cirurxía úsase a miúdo para persoas con anatomía escapular anormal, como crecementos óseos ou tumores.

En Injury Medical Quiropractic and Functional Medicine Clinic, tratamos lesións e síndromes de dor crónica mellorando a capacidade dun individuo mediante programas de flexibilidade, mobilidade e axilidade adaptados a todos os grupos de idade e discapacidade. Os nosos plans de coidados de quiroprácticos e servizos clínicos están especializados e enfocados ás lesións e ao proceso completo de recuperación. Se é necesario outro tratamento, os individuos serán remitidos a unha clínica ou médico máis axeitado para a súa lesión, condición e/ou enfermidade.


Ala escapular en profundidade


References

Conduah, AH, Baker, CL, 3rd e Baker, CL, Jr (2010). Manexo clínico da bursite escapulotorácica e da escápula rotura. Saúde deportiva, 2(2), 147–155. doi.org/10.1177/1941738109338359

Kuhn, JE, Plancher, KD e Hawkins, RJ (1998). Crepito escapulotorácico sintomático e bursite. The Journal of the American Academy of Orthopaedic Surgeons, 6 (5), 267–273. doi.org/10.5435/00124635-199809000-00001

de Souza, AM, & Bispo Júnior, RZ (2014). Osteocondroma: ignorar ou investigar?. Revista brasileira de ortopedia, 49(6), 555–564. doi.org/10.1016/j.rboe.2013.10.002

Protección do pulso: como evitar lesións ao levantar pesas

Protección do pulso: como evitar lesións ao levantar pesas

For individuals who lift weights, are there ways to protect the wrists and prevent injuries when lifting weights?

Protección do pulso: como evitar lesións ao levantar pesas

Wrist Protection

The wrists are complex joints. The wrists significantly contribute to stability and mobility when performing tasks or lifting weights. They provide mobility for movements using the hands and stability to carry and lift objects securely and safely (National Library of Medicine, 2024). Lifting weights is commonly performed to strengthen and stabilize the wrists; however, these movements can cause wrist pain and lead to injuries if not performed correctly. Wrist protection can keep wrists strong and healthy and is key to avoiding strains and injuries.

Wrist Strength

The wrist joints are set between the hand and forearm bones. Wrists are aligned in two rows of eight or nine total small bones/carpal bones and are connected to the arm and hand bones by ligaments, while tendons connect the surrounding muscles to the bones. Wrist joints are condyloid or modified ball and socket joints that assist with flexion, extension, abduction, and adduction movements. (Biblioteca Nacional de Medicina. 2024) This means the wrists can move in all planes of motion:

  • lado a lado
  • Arriba e abaixo
  • Xirar

This provides a wide range of motion but can also cause excessive wear and tear and increase the risk of strain and injury. The muscles in the forearm and hand control finger movement necessary for gripping. These muscles and the tendons and ligaments involved run through the wrist. Strengthening the wrists will keep them mobile, help prevent injuries, and increase and maintain grip strength.  In a review on weightlifters and powerlifters that examined the types of injuries they sustain, wrist injuries were common, with muscle and tendon injuries being the most common among weightlifters. (Ulrika Aasa et al., 2017)

Protecting the Wrists

Wrist protection can use a multi-approach, which includes consistently increasing strength, mobility, and flexibility to improve health and prevent injuries. Before lifting or engaging in any new exercise, individuals should consult their primary healthcare provider, physical therapist, trainer, medical specialist, or sports chiropractor to see which exercises are safe and provide benefits based on injury history and current level of health.

Aumentar a mobilidade

Mobility allows the wrists to have a full range of motion while retaining the stability necessary for strength and durability. Lack of mobility in the wrist joint can cause stiffness and pain. Flexibility is connected to mobility, but being overly flexible and lacking stability can lead to injuries. To increase wrist mobility, perform exercises at least two to three times a week to improve range of motion with control and stability. Also, taking regular breaks throughout the day to rotate and circle the wrists and gently pull back on the fingers to stretch them will help relieve tension and stiffness that can cause mobility problems.

Quentar

Before working out, warm up the wrists and the rest of the body before working out. Start with light cardiovascular to get the synovial fluid in the joints circulating to lubricate the joints, allowing for smoother movement. For example, individuals can make fists, rotate their wrists, perform mobility exercises, flex and extend the wrists, and use one hand to pull back the fingers gently. Around 25% of sports injuries involve the hand or wrist. These include hyperextension injury, ligament tears, front-inside or thumb-side wrist pain from overuse injuries, extensor injuries, and others. (Daniel M. Avery 3rd et al., 2016)

Fortalecemento de exercicios

Strong wrists are more stable, and strengthening them can provide wrist protection. Exercises that improve wrist strength include pull-ups, deadlifts, loaded carries, and Zottman curls. Grip strength is vital for performing daily tasks, healthy aging, and continued success with weightlifting. (Richard W. Bohannon 2019) For example, individuals who have difficulty increasing the weight on their deadlifts because the bar slips from their hands could have insufficient wrist and grip strength.

Envoltas

Wrist wraps or grip-assisting products are worth considering for those with wrist issues or concerns. They can provide added external stability while lifting, reducing grip fatigue and strain on the ligaments and tendons. However, it is recommended not to rely on wraps as a cure-all measure and to focus on improving individual strength, mobility, and stability. A study on athletes with wrist injuries revealed that the injuries still occurred despite wraps being worn 34% of the time prior to the injury. Because most injured athletes did not use wraps, this pointed to potential preventative measures, but the experts agreed more research is needed. (Amr Tawfik et al., 2021)

Preventing Overuse Injuries

When an area of the body undergoes too many repetitive motions without proper rest, it becomes worn, strained, or inflamed faster, causing overuse injury. The reasons for overuse injuries are varied but include not varying workouts enough to rest the muscles and prevent strain. A research review on the prevalence of injuries in weightlifters found that 25% were due to overuse tendon injuries. (Ulrika Aasa et al., 2017) Preventing overuse can help avoid potential wrist problems.

Forma adecuada

Knowing how to perform movements correctly and using proper form during each workout/training session is essential for preventing injuries. A personal trainer, sports physiotherapist, or physical therapist can teach how to adjust grip or maintain correct form.

Be sure to see your provider for clearance before lifting or starting an exercise program. Injury Medical Quiropraxia and Functional Medicine Clinic can advise on training and prehabilitation or make a referral if one is needed.


Fitness Saúde


References

Erwin, J., & Varacallo, M. (2024). Anatomy, Shoulder and Upper Limb, Wrist Joint. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30521200

Aasa, U., Svartholm, I., Andersson, F. e Berglund, L. (2017). Lesións entre levantadores de pesas e levantadores de potencia: unha revisión sistemática. Revista británica de medicina deportiva, 51(4), 211–219. doi.org/10.1136/bjsports-2016-096037

Avery, D. M., 3rd, Rodner, C. M., & Edgar, C. M. (2016). Sports-related wrist and hand injuries: a review. Journal of orthopaedic surgery and research, 11(1), 99. doi.org/10.1186/s13018-016-0432-8

Bohannon R. W. (2019). Grip Strength: An Indispensable Biomarker For Older Adults. Clinical interventions in aging, 14, 1681–1691. doi.org/10.2147/CIA.S194543

Tawfik, A., Katt, B. M., Sirch, F., Simon, M. E., Padua, F., Fletcher, D., Beredjiklian, P., & Nakashian, M. (2021). A Study on the Incidence of Hand or Wrist Injuries in CrossFit Athletes. Cureus, 13(3), e13818. doi.org/10.7759/cureus.13818

Prevención e tratamento da neuropatía periférica: un enfoque holístico

Prevención e tratamento da neuropatía periférica: un enfoque holístico

Certos trastornos neurolóxicos poden causar episodios agudos de neuropatía periférica e, para os individuos diagnosticados con neuropatía periférica crónica, pode a fisioterapia axudar a mellorar a capacidade de moverse con seguridade xunto con medicamentos, procedementos e axustes de estilo de vida para axudar a controlar e xestionar os síntomas?

Prevención e tratamento da neuropatía periférica: un enfoque holístico

Tratamentos de Neuropatía Periférica

O tratamento da neuropatía periférica inclúe terapias sintomáticas e xestión médica para axudar a previr o empeoramento do dano nervioso.

  • Para os tipos agudos de neuropatía periférica, as intervencións médicas e as terapias poden tratar o proceso subxacente, mellorando a condición.
  • Para os tipos crónicos de neuropatía periférica, as intervencións médicas e os factores de estilo de vida poden axudar a previr a progresión da enfermidade.
  • O tratamento da neuropatía periférica crónica céntrase en controlar os síntomas da dor e protexer as áreas de sensibilidade diminuída de danos ou infeccións.

Autocoidados e axustes de estilo de vida

Para os individuos que foron diagnosticados con neuropatía periférica ou están en risco de desenvolver a enfermidade, os factores de estilo de vida xogan un papel importante na xestión dos síntomas e na prevención do empeoramento do dano nervioso e incluso poden evitar que se desenvolva. (Jonathan Enders et al., 2023)

Tratamento da Dor

Os individuos poden probar estas terapias de autocoidado e ver se e cales axudan a reducir o seu malestar e, a continuación, desenvolver unha rutina na que poden traballar. O coidado persoal dos síntomas da dor inclúe:

  • Colocando unha almofada térmica quente en áreas dolorosas.
  • Colocando unha almofada de refrixeración (non xeo) en áreas dolorosas.
  • Cubrindo a zona ou deixala descuberta, segundo os niveis de confort.
  • Use roupa folgada, calcetíns, zapatos e/ou luvas non feitos con material que poida causar irritación.
  • Evite o uso de loções ou xabóns que poidan causar irritación.
  • Use cremas ou loções calmantes.
  • Manter as zonas dolorosas limpas.

Prevención de Lesións

A diminución da sensación é un dos efectos máis comúns que pode provocar problemas como tropezos, dificultade para desprazarse e lesións. Previr e comprobar regularmente as lesións pode axudar a evitar complicacións como feridas infectadas. (Nadja Klafke et al., 2023) Os axustes de estilo de vida para xestionar e previr lesións inclúen:

  • Use zapatos e medias ben acolchados.
  • Inspecciona regularmente os pés, os dedos dos pés, os dedos das mans e as mans para buscar cortes ou hematomas que non se sentisen.
  • Limpar e cubrir cortes para evitar infeccións.
  • Teña moito coidado cos utensilios afiados, como ferramentas de cociña e traballo ou de xardinería.

Xestión de enfermidades

Os factores de estilo de vida poden axudar a previr a progresión da enfermidade e están estreitamente relacionados cos riscos e as causas subxacentes. Para axudar a previr a neuropatía periférica ou a súa progresión pódese facer: (Jonathan Enders et al., 2023)

  • Mantén uns niveis saudables de glicosa se tes diabetes.
  • Evite o alcohol por calquera neuropatía periférica.
  • Manter unha dieta equilibrada, que pode incluír suplementos vitamínicos, especialmente para vexetarianos ou veganos.

Terapias sen receita

Algunhas terapias sen receita poden axudar aos síntomas dolorosos e pódense tomar segundo sexa necesario. As terapias para a dor sen receita inclúen: (Michael Überall et al., 2022)

  • Spray, parche ou cremas de lidocaína tópica.
  • Cremas ou parches de capsaicina.
  • Tópico Icy Hot
  • Medicamentos antiinflamatorios non esteroides: Advil/ibuprofeno ou Aleve/naproxeno
  • Tylenol/acetaminofeno

Estes tratamentos poden axudar a aliviar os síntomas dolorosos da neuropatía periférica, pero non axudan a mellorar a sensación diminuída, a debilidade ou os problemas de coordinación. (Jonathan Enders et al., 2023)

Terapias de prescrición

As terapias prescritas para tratar a neuropatía periférica inclúen medicamentos para a dor e antiinflamatorios. Os tipos crónicos de neuropatía periférica inclúen:

  • Neuropatía alcohólica
  • Neuropatia diabética
  • Neuropatía inducida por quimioterapia

Os tratamentos prescritos para os tipos crónicos difiren dos tratamentos para os tipos agudos de neuropatía periférica.

Tratamento da Dor

Os tratamentos con receita médica poden axudar a controlar a dor e as molestias. Os medicamentos inclúen (Michael Überall et al., 2022)

  • Lyrica - pregabalina
  • Neurontin - gabapentina
  • Elavil - amitriptilina
  • Effexor - venlafaxina
  • Cymbalta - duloxetina
  • En casos graves, pode ser necesaria a lidocaína intravenosa/IV. (Sanja Horvat et al., 2022)

Ás veces, un suplemento de forza prescrito ou vitamina B12 administrado a través da inxección pode axudar a previr a progresión cando a neuropatía periférica está asociada a unha deficiencia de vitamina grave. O tratamento con receita pode axudar a tratar o proceso subxacente nalgúns tipos de neuropatía periférica aguda. O tratamento da neuropatía periférica aguda, como a síndrome de Miller-Fisher ou a síndrome de Guillain-Barré, pode incluír:

  • Corticosteroides
  • Inmunoglobulinas: proteínas do sistema inmunitario
  • A plasmaférese é un procedemento que elimina a porción líquida do sangue, devolvendo as células sanguíneas, o que modifica a hiperactividade do sistema inmunitario. (Sanja Horvat et al., 2022)
  • Os investigadores cren que hai unha asociación entre estas condicións e inflamatorias danos nos nervios, e modificar o sistema inmunitario é beneficioso para tratar os síntomas e a enfermidade subxacente.

Cirurxía

Nalgúns casos, os procedementos cirúrxicos poden beneficiar a persoas que teñen certos tipos de neuropatía periférica. Cando outra condición está a agravar os síntomas ou o proceso de neuropatía periférica, a cirurxía pode axudar a aliviar os síntomas e evitar a progresión da enfermidade. Isto demostrou ser eficaz cando o atrapamento nervioso ou a insuficiencia vascular son factores. (Wenqiang Yang et al., 2016)

Medicina complementaria e alternativa

Algúns enfoques complementarios e alternativos poden axudar ás persoas a afrontar a dor e o malestar. Estes tratamentos poden servir como unha opción continua para aqueles que teñen neuropatía periférica crónica. As opcións poden incluír: (Nadja Klafke et al., 2023)

  • A acupuntura implica a colocación de agullas en áreas específicas do corpo para axudar a reducir os síntomas da dor.
  • A acupresión implica aplicar presión sobre áreas específicas do corpo para axudar a reducir os síntomas da dor.
  • A terapia de masaxe pode axudar a relaxar a tensión muscular.
  • As terapias de meditación e relaxación poden axudar a controlar os síntomas.
  • A fisioterapia tamén pode servir como un compoñente importante para vivir con neuropatía periférica crónica e para recuperarse da neuropatía periférica aguda.
  • A fisioterapia pode axudar a fortalecer os músculos débiles, mellorar a coordinación e aprender a adaptarse aos cambios sensoriais e motores para desprazarse con seguridade.

Recoméndase ás persoas que estean considerando un tratamento complementario ou alternativo que falen co seu proveedor de atención médica primaria para determinar se é seguro para a súa condición. A Clínica de Medicina Funcional e Quiropráctica Médica de Lesións traballará co provedor de coidados de saúde e / ou especialistas do individuo para desenvolver unha solución óptima de tratamento de saúde e benestar para proporcionar alivio da dor e mellorar a calidade de vida.


Neuropatía periférica: unha historia de recuperación exitosa


References

Enders, J., Elliott, D. e Wright, DE (2023). Intervencións non farmacolóxicas emerxentes para tratar a neuropatía periférica diabética. Antioxidantes e sinalización redox, 38(13-15), 989–1000. doi.org/10.1089/ars.2022.0158

Klafke, N., Bossert, J., Kröger, B., Neuberger, P., Heyder, U., Layer, M., Winkler, M., Idler, C., Kaschdailewitsch, E., Heine, R., John, H., Zielke, T., Schmeling, B., Joy, S., Mertens, I., Babadag-Savas, B., Kohler, S., Mahler, C., Witt, CM, Steinmann, D. , … Stolz, R. (2023). Prevención e tratamento da neuropatía periférica inducida por quimioterapia (CIPN) con intervencións non farmacolóxicas: recomendacións clínicas dunha revisión sistemática de alcance e un proceso de consenso de expertos. Ciencias médicas (Basilea, Suíza), 11(1), 15. doi.org/10.3390/medsci11010015

Überall, M., Bösl, I., Hollanders, E., Sabatschus, I. e Eerdekens, M. (2022). Neuropatía periférica diabética dolorosa: comparación do mundo real entre o tratamento tópico con xeso medicado de lidocaína 700 mg e os tratamentos orais. BMJ Open Diabete Research & Care, 10(6), e003062. doi.org/10.1136/bmjdrc-2022-003062

Horvat, S., Staffhorst, B. e Cobben, JMG (2022). Lidocaína intravenosa para o tratamento da dor crónica: un estudo de cohorte retrospectivo. Revista de investigación da dor, 15, 3459-3467. doi.org/10.2147/JPR.S379208

Yang, W., Guo, Z., Yu, Y., Xu, J. e Zhang, L. (2016). Alivio da dor e mellora da calidade de vida relacionada coa saúde despois da descompresión microcirúrxica dos nervios periféricos atrapados en pacientes con neuropatía periférica diabética dolorosa. The Journal of Foot and Ankle Surgery: publicación oficial do American College of Foot and Ankle Surgeons, 55 (6), 1185–1189. doi.org/10.1053/j.jfas.2016.07.004

Cirurxía e quiropráctica: que tratamento é adecuado para vostede?

Cirurxía e quiropráctica: que tratamento é adecuado para vostede?

For individuals experiencing back pain from a herniated disc, can understanding the difference between surgery and chiropractic help individuals find the right treatment plan?

Cirurxía e quiropráctica: que tratamento é adecuado para vostede?

Surgery or Chiropractic

Living with back pain can be a nightmare, and yet many struggle without seeking care. Today, there are a vast number of surgeries and noninvasive techniques that are better at treating spine and back problems and managing symptoms. For individuals who may have a herniated disc or are curious about ways to relieve their back pain, a health care provider, physical therapist, spine specialist, and chiropractor can inform them of treatment options. Surgery and chiropractic therapy are popular treatments for a herniated, bulging, or slipped disc.

  • A herniated disc is when the cartilage discs that cushion the vertebrae shift out of position and leak out.
  • Surgery for a herniated disc involves removing or repairing the disc.
  • Chiropractic nonsurgically repositions the disc and realigns the spine.
  • Both treatments have the same goals with key differences.

A quiropraxia

Chiropractic is a system of therapy that focuses on adjusting and maintaining spinal alignment to help with back and posture problems. Chiropractors are trained and licensed medical professionals who take a nonsurgical approach, a proven therapy for chronic pain, flexibility, and mobility issues.

O camiño funciona

Chiropractic treatment encourages and supports the body’s natural healing processes. It is considered for joint pain in the back, neck, legs, arms, feet, and hands. It typically involves sessions in which the chiropractor physically and carefully adjusts the vertebrae by hand, also known as spinal manipulation or chiropractic adjustments. (MedlinePlus. 2023). A chiropractor performs a thorough medical evaluation and runs tests to establish a diagnosis. A chiropractor will develop a treatment plan that may involve a team of massage and physical therapists, acupuntores, health coaches, and nutritionists to treat affected areas with various techniques, recommend targeted exercises, adjust lifestyle and nutrition to support the treatment, and monitor progress. Combined with stretching and sustained pressure, the multiple methods can increase joint mobility and relieve pain symptoms. (National Center for Complimentary and Integrative Health. 2019) Added protocols to support or enhance chiropractic therapy include:

  • Heating and ice therapies to reduce inflammation and increase blood circulation.
  • Using devices to stimulate muscles and nerves electrically.
  • Developing relaxation and deep breathing techniques.
  • Incorporating exercises to promote rehabilitation.
  • Establishing a regular fitness routine.
  • Making adjustments to diet and lifestyle.
  • Taking certain dietary supplements.

Spinal manipulation and chiropractic adjustments have been shown to improve symptoms and restore mobility in cases of chronic back pain. One review found that individuals with chronic lumbar/low back pain reported significant improvement after six weeks of chiropractic treatment. (Ian D. Coulter et al., 2018)

Prezos

The out-of-pocket expenses of chiropractic treatment depend on a variety of factors.
Insurance may or may not cover the treatment, and the amount an individual has to pay can vary based on the severity of their case, what their plan covers, and where they live. One review found the cost can range between $264 and $6,171. (Simon Dagenais et al., 2015)

Cirurxía

There is a range of minimally invasive surgical procedures to treat herniated discs. These work to ease nerve compression by removing or replacing damaged discs or stabilizing the vertebrae, relieving pain and inflammation.

O camiño funciona

A herniated disc can happen in any part of the spine but is more common in the lower back/lumbar spine and in the neck/cervical spine. Surgery is recommended when: (Academia Americana de Cirurxiáns Ortopédicos. 2022)

  • More conservative treatments, like medications and physical therapy, are unable to manage symptoms.
  • The pain and symptoms impact daily life and functioning.
  • Standing or walking becomes difficult or impossible.
  • The herniated disc causes difficulty walking, muscle weakness, and bladder or bowel control loss.
  • The individual is reasonably healthy, without infection, osteoporosis, or arthritis.

Specific surgical procedures used include:

Cirurxía de fusión

  • Spinal fusion is the most common procedure for a lower back herniated disc.
  • It involves using artificial bone material to fuse vertebrae to increase stability and release and prevent nerve irritation and compression. (Academia Americana de Cirurxiáns Neurológicos. 2024)

Laminotomy and Laminectomy

  • Herniated disc symptoms appear from compression placed on the nerves.
  • Laminotomy involves making a small cut in the lamina, or the arch of the spinal vertebrae, to release the pressure.
  • Sometimes, the entire lamina is removed, known as a laminectomy. (Academia Americana de Cirurxiáns Neurológicos. 2024)

Discectomía

Artificial Disc Surgery

  • Another approach involves implanting an artificial disc.
  • This is most often used for hernia in the lower spine; the worn or damaged disc is removed, and a specialized prosthetic replaces the removed disc. (Academia Americana de Cirurxiáns Ortopédicos. 2022)
  • This allows for more mobility.

The success of herniated disc surgery depends on different factors. Advances in minimally invasive techniques have significantly improved long-term outcomes, with one review finding that around 80% reported good—excellent results at a six-year follow-up. (George J. Dohrmann, Nassir Mansour 2015) However, there is the possibility of recurrence. About 20% to 25% of individuals with herniated lumbar discs experience re-herniation at some point. (Academia Americana de Cirurxiáns Neurológicos. 2024)

Prezos

  • Surgery for a herniated disc is specialized, and the costs depend on the scope and scale of the treatment.
  • The individual’s specific insurance plan also determines the expenses.
  • The typical costs of surgery range between $14,000 and $30,000. (Anna N A Tosteson et al., 2008)

Choosing Treatment

When choosing between chiropractic and surgery for a herniated disc, a number of factors can determine the decision, including:

  • Chiropractic is the less invasive nonsurgical option.
  • Chiropractic adjustments cannot help certain severe cases of herniated discs.
  • Chiropractic adjustments prevent the herniated disc from getting worse and ease symptoms.
  • Surgery provides pain and symptom relief faster than chiropractic or conservative treatment but requires significant recovery time and is expensive. (Anna N A Tosteson et al., 2008)
  • Surgery may not be appropriate for individuals with osteoarthritis or osteoporosis.

Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with surgery. Generally, surgery is only recommended when noninvasive methods haven’t been able to stop or manage the pain and symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.


Quick Patient Process


References

MedlinePlus.MedlinePlus. (2023). Chiropractic. Retrieved from medlineplus.gov/chiropractic.html

National Center for Complimentary and Integrative Health. (2019). Chiropractic: in depth. Retrieved from www.nccih.nih.gov/health/chiropractic-in-depth

Coulter, ID, Crawford, C., Hurwitz, EL, Vernon, H., Khorsan, R., Suttorp Booth, M. e Herman, PM (2018). Manipulación e mobilización para o tratamento da dor lumbar crónica: unha revisión sistemática e metaanálise. The spine journal: revista oficial da North American Spine Society, 18(5), 866–879. doi.org/10.1016/j.spinee.2018.01.013

Dagenais, S., Brady, O., Haldeman, S., & Manga, P. (2015). A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC health services research, 15, 474. doi.org/10.1186/s12913-015-1140-5

American Academy of Orthopaedic Surgeons. (2022). Herniated disk in the lower back. orthoinfo.aaos.org/en/diseases–conditions/hernia-disk-in-the-lower-back/

American Academy of Neurological Surgeons. Surgeons, A. A. o. N. (2024). Herniated disc. www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc

Dohrmann, G. J., & Mansour, N. (2015). Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 24(3), 285–290. doi.org/10.1159/000375499

Tosteson, A. N., Skinner, J. S., Tosteson, T. D., Lurie, J. D., Andersson, G. B., Berven, S., Grove, M. R., Hanscom, B., Blood, E. A., & Weinstein, J. N. (2008). The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 33(19), 2108–2115. doi.org/10.1097/brs.0b013e318182e390

Xestionar a estenose espinal: opcións de tratamento

Xestionar a estenose espinal: opcións de tratamento

Estenose espinal é o termo usado para describir unha columna que se estreita. Os tratamentos varían porque o caso de cada un é diferente. Algunhas persoas experimentan síntomas leves, mentres que outras experimentan síntomas graves. Coñecer as opcións de tratamento pode axudar ao paciente e ao equipo sanitario a personalizar e personalizar un plan de tratamento segundo a condición do individuo?

Xestionar a estenose espinal: opcións de tratamento

Tratamentos de estenosis espinal

Os espazos dentro da columna poden facerse máis estreitos do que se supón, o que pode causar presión sobre as raíces nerviosas e a medula espiñal. En calquera lugar da columna vertebral pode verse afectado. O estreitamento pode causar dor, ardor e/ou dor nas costas e debilidade nas pernas e os pés. A estenose espinal ten varios tratamentos primarios. Cando se traballe con tratamentos de estenose da columna vertebral, un provedor de coidados de saúde avaliará os síntomas e comezará o tratamento con terapia de primeira liña, como medicamentos para a dor e/ou fisioterapia. Estes son a miúdo os primeiros entre os individuos con enfermidade.

Medicación

A dor crónica é un dos principais síntomas. O tratamento de primeira liña a miúdo implica o uso de medicamentos para aliviar a dor. Os medicamentos habitualmente prescritos son os antiinflamatorios non esteroides ou AINE. Estes medicamentos reducen a dor e a inflamación. Non obstante, os AINE non se recomendan para o seu uso a longo prazo, e poden ser necesarios outros medicamentos para aliviar a dor que inclúen:Sudhir Diwan et al., 2019)

  • Tylenol - acetaminofeno
  • Gabapentina
  • Pregabalina
  • Opioides para casos graves

Exercer

O exercicio pode reducir os síntomas da estenose da columna ao quitar a presión dos nervios, o que pode reducir a dor e mellorar a mobilidade. (Andrée-Anne Marchand et al., 2021) Os profesionais sanitarios recomendarán os exercicios máis eficaces para o individuo. Os exemplos inclúen:

  • Exercicios aeróbicos, como sendeirismo
  • Flexión lumbar sentado
  • Flexión lumbar en deitado
  • Extensión lumbar sostida
  • Fortalecemento da cadeira e do tronco
  • Flexión lumbar de pé

Terapia Física

Outro tratamento primario da estenose da columna vertebral é a fisioterapia, que adoita usarse xunto con medicamentos para a dor. Normalmente, os individuos son sometidos a fisioterapia de seis a oito semanas, con sesións de dúas a tres veces por semana. O uso de fisioterapia demostrou (Sudhir Diwan et al., 2019)

  • Reducir a dor
  • Aumenta a mobilidade
  • Reducir os medicamentos para a dor.
  • Reduce os síntomas de saúde mental como a ira, a depresión e os cambios de humor.
  • Para casos graves, a fisioterapia despois da cirurxía pode reducir os tempos de recuperación.

Tirantes traseiros

As correas traseiras poden axudar a reducir o movemento e a presión sobre a columna vertebral. Isto é útil porque incluso pequenos movementos da columna vertebral poden provocar irritación nerviosa, dor e empeoramento dos síntomas. Co paso do tempo, o arriostramento pode levar a un aumento positivo da mobilidade. (Carlo Ammendolia et al., 2019)

Inxeccións

Pódense recomendar inxeccións epidurales de esteroides para aliviar os síntomas graves. Os esteroides actúan como antiinflamatorios para reducir a dor e o inchazo causados ​​pola inflamación e irritación dos nervios espiñais. Considéranse procedementos médicos non cirúrxicos. Segundo a investigación, as inxeccións poden xestionar eficazmente a dor durante dúas semanas e ata seis meses, e algunhas investigacións descubriron que despois dunha inxección na columna vertebral, o alivio pode durar 24 meses. (Sudhir Diwan et al., 2019)

Procedemento de descompresión de ligamentos engrosados

Algunhas persoas poden ser recomendadas para someterse a un procedemento de descompresión. Este procedemento implica o uso dunha ferramenta de agulla fina inserida na parte traseira. O tecido do ligamento engrosado elimínase para reducir a presión sobre a columna vertebral e os nervios. A investigación descubriu que o procedemento pode reducir os síntomas e a necesidade dunha cirurxía máis invasiva. (Nagy Mekhail et al., 2021)

Tratamentos alternativos

Ademais dos tratamentos de primeira liña, os individuos poden ser remitidos a terapias alternativas para a xestión dos síntomas, incluíndo:

Acupuntura

  • Isto implica a inserción de agullas de punta fina en varios puntos de acupuntura para aliviar os síntomas.
  • Algunhas investigacións descubriron que a acupuntura pode ser máis eficaz para reducir os síntomas que a terapia física só. Ambas opcións son viables e poden mellorar a mobilidade e a dor. (Hiroyuki Oka et al., 2018)

Quiropraxia

  • Esta terapia reduce a presión sobre os nervios, mantén o aliñamento da columna vertebral e axuda a mellorar a mobilidade.

Masaxe

  • A masaxe axuda a aumentar a circulación, relaxar os músculos e reducir a dor e a rixidez.

Novas opcións de tratamento

A medida que continúan a investigación sobre a estenose espinal, están xurdindo novas terapias para axudar a aliviar e xestionar os síntomas en persoas que non responden á medicina tradicional ou que non poden participar nas terapias convencionais por varias razóns. Non obstante, algunhas probas presentadas son prometedoras; as aseguradoras médicas poden consideralos experimentais e non ofrecer cobertura ata que se comprobe a súa seguridade. Algúns novos tratamentos inclúen:

Acupotomía

A acupotomía é unha forma de acupuntura que utiliza agullas finas cunha punta pequena e plana do tipo bisturí para aliviar a tensión nas zonas dolorosas. A investigación sobre os seus efectos aínda é limitada, pero os datos preliminares mostran que podería ser un tratamento complementario eficaz. (Ji Hoon Han et al., 2021)

Terapia de células nai

As células nai son as células das que se orixinan todas as demais células. Actúan como materia prima para que o organismo cree células especializadas con funcións específicas. (Institutos Nacionais de Saúde. 2016)

  • As persoas con estenose espinal poden desenvolver danos nos tecidos brandos.
  • A terapia con células nai utiliza células nai para axudar a reparar os tecidos feridos ou enfermos.
  • A terapia con células nai pode axudar a reparar ou mellorar as áreas danadas e proporcionar alivio dos síntomas.
  • Os estudos clínicos sobre a estenose espinal informan que podería ser unha opción de tratamento viable para algúns.
  • Non obstante, son necesarias máis investigacións para confirmar se a terapia é o suficientemente eficaz como para ser amplamente utilizada. (Hideki Sudo et al., 2023)

Dispositivos de estabilización dinámica

LimiFlex é un dispositivo médico sometido a investigación e análise pola súa capacidade para restaurar a mobilidade e a estabilidade da columna vertebral. Implántase nas costas mediante un procedemento cirúrxico. Segundo a investigación, os individuos con estenose espinal que reciben LimiFlex adoitan experimentar unha maior redución da dor e dos síntomas que con outras formas de tratamento. (T Jansen et al., 2015)

Descompresión por distracción interespinosa lumbar

A descompresión da distracción interespinosa lumbar é outro procedemento cirúrxico para a estenose da columna vertebral. A cirurxía realízase cunha incisión sobre a columna vertebral e coloca un dispositivo entre dúas vértebras para crear espazo. Isto reduce o movemento e a presión sobre os nervios. Os resultados preliminares mostran un alivio positivo a curto prazo dos síntomas; Os datos a longo prazo aínda non están dispoñibles xa que é unha opción de tratamento da estenose espinal relativamente nova. (Servizo Nacional de Saúde do Reino Unido, 2022)

Procedementos cirúrxicos

Existen varios procedementos cirúrxicos dispoñibles para a estenose da columna vertebral. Algúns inclúen: (NYU Langone Health. 2024) A cirurxía para a estenose da columna adoita reservarse para persoas con síntomas graves, como entumecimiento nos brazos ou nas pernas. Cando se desenvolven estes síntomas, indica unha compresión máis notable dos nervios espiñais e a necesidade dun tratamento máis invasivo. (NYU Langone Health. 2024)

Laminectomia

  • A laminectomía elimina parte ou a totalidade da lámina, o óso vertebral que cobre a canle espiñal.
  • O procedemento está deseñado para reducir a presión sobre os nervios e a medula espiñal.

Laminotomía e foraminotomía

  • Ambas cirurxías utilízanse se a estenose espinal dun individuo afecta negativamente a unha abertura no foramen vertebral.
  • Elimínanse ligamentos, cartilaxe ou outros tecidos que constrin os nervios.
  • Ambos reducen a presión sobre os nervios que viaxan polo foramen.

Laminoplastia

  • A laminoplastia alivia a presión sobre a medula espiñal eliminando partes da lámina da canle espiñal.
  • Isto agranda a canle espiñal e alivia a presión sobre os nervios. (Columbia Neurocirugía, 2024)

Discectomía

  • Este procedemento cirúrxico consiste na eliminación de discos herniados ou abultados que exercen presión sobre a medula espiñal e os nervios.

Fusión espinal

  • A fusión da columna consiste en unir dúas vértebras mediante pezas metálicas como varillas e parafusos.
  • As vértebras son máis estables porque as varillas e os parafusos actúan como tirantes.

Que tratamento é o correcto?

Debido a que todos os plans de tratamento difiren, determinar o máis eficaz é o máis adecuado para un provedor de coidados de saúde. Cada enfoque será personalizado para cada persoa. Para decidir cal é a mellor terapia, os profesionais sanitarios avaliarán: (Instituto Nacional de Artrite e Enfermidades Musculoesqueléticas e da Pel. 2023)

  • A gravidade dos síntomas.
  •  O nivel actual de saúde xeral.
  • O nivel de dano que está a ocorrer na columna vertebral.
  • O nivel de discapacidade e como se ven afectadas a mobilidade e a calidade de vida.

A Clínica de Quiropráctica e Medicina Funcional de Lesións Médicas traballará co provedor de atención médica primaria e/ou especialistas dun individuo para axudar a determinar as mellores opcións de tratamento e preocupacións sobre medicamentos ou outras formas de tratamento.


Desbloqueo de benestar


References

Diwan, S., Sayed, D., Deer, TR, Salomons, A. e Liang, K. (2019). Un enfoque algorítmico para tratar a estenosis espinal lumbar: un enfoque baseado en evidencias. Medicamento da dor (Malden, Mass.), 20 (Suppl 2), S23–S31. doi.org/10.1093/pm/pnz133

Marchand, AA, Houle, M., O'Shaughnessy, J., Châtillon, C. É., Cantin, V. e Descarreaux, M. (2021). Eficacia dun programa de prehabilitación baseado no exercicio para pacientes en espera de cirurxía para a estenose da columna lumbar: un ensaio clínico aleatorizado. Informes científicos, 11(1), 11080. doi.org/10.1038/s41598-021-90537-4

Ammendolia, C., Rampersaud, YR, Southerst, D., Ahmed, A., Schneider, M., Hawker, G., Bombardier, C. e Côté, P. (2019). Efecto dun prototipo de cinto de estenose lumbar fronte a un apoio lumbar sobre a capacidade de marcha na estenose da columna lumbar: un ensaio controlado aleatorizado. The spine journal: revista oficial da North American Spine Society, 19(3), 386–394. doi.org/10.1016/j.spinee.2018.07.012

Mekhail, N., Costandi, S., Nageeb, G., Ekladios, C. e Saied, O. (2021). A durabilidade do procedemento de descompresión lumbar mínimamente invasiva en pacientes con estenose lumbar sintomática: seguimento a longo prazo. Práctica da dor: a revista oficial do Instituto Mundial da Dor, 21(8), 826–835. doi.org/10.1111/papr.13020

Oka, H., Matsudaira, K., Takano, Y., Kasuya, D., Niiya, M., Tonosu, J., Fukushima, M., Oshima, Y., Fujii, T., Tanaka, S., & Inanami, H. (2018). Estudo comparativo de tres tratamentos conservadores en pacientes con estenosis lumbar: estenosis lumbar con acupuntura e estudo de fisioterapia (estudo LAP). Medicina alternativa e complementaria BMC, 18(1), 19. doi.org/10.1186/s12906-018-2087-y

Han, JH, Lee, HJ, Woo, SH, Park, YK, Choi, GY, Heo, ES, Kim, JS, Lee, JH, Park, CA, Lee, WD, Yang, CS, Kim, AR e Han , CH (2021). Eficacia e seguridade da acupotomía na estenose da columna lumbar: un ensaio clínico pragmático aleatorizado, controlado e piloto: un protocolo de estudo. Medicina, 100(51), e28175. doi.org/10.1097/MD.0000000000028175

Sudo, H., Miyakoshi, T., Watanabe, Y., Ito, YM, Kahata, K., Tha, KK, Yokota, N., Kato, H., Terada, T., Iwasaki, N., Arato, T., Sato, N. e Isoe, T. (2023). Protocolo para o tratamento da estenose da canle espiñal lumbar cunha combinación de células nai mesenquimales derivadas de medula ósea ultrapurificadas e alóxenas e xel formador in situ: un ensaio controlado aleatorizado multicéntrico, prospectivo e dobre cego. BMJ aberto, 13(2), e065476. doi.org/10.1136/bmjopen-2022-065476

Institutos Nacionais de Saúde. (2016). Fundamentos de células nai. Departamento de Saúde e Servizos Humanos dos EUA. Recuperado de stemcells.nih.gov/info/basics/stc-basics

Jansen, T., Bornemann, R., Otten, L., Sander, K., Wirtz, D. e Pflugmacher, R. (2015). Vergleich dorsaler Dekompression nicht stabilisiert und dynamisch stabilisiert mit LimiFlex™ [Unha comparación de descompresión dorsal e descompresión dorsal combinada co dispositivo de estabilización dinámica LimiFlex™]. Zeitschrift fur Orthopadie und Unfallchirurgie, 153(4), 415–422. doi.org/10.1055/s-0035-1545990

Servizo Nacional de Saúde do Reino Unido. (2022). Cirurxía de descompresión lumbar: como se realiza. www.nhs.uk/conditions/lumbar-decompression-surgery/what-happens/

NYU Langone Health. (2024). Cirurxía da estenose da columna vertebral. nyulangone.org/conditions/spinal-stenosis/treatments/surgery-for-spinal-stenosis

Neurocirugía Columbia. (2024). Procedemento de laminoplastia cervical. www.neurosurgery.columbia.edu/patient-care/treatments/cervical-laminoplasty

Instituto Nacional de Artrite e Enfermidades Musculoesqueléticas e da Pel. (2023). Estenose espinal: diagnóstico, tratamento e pasos a seguir. Recuperado de www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take