The Inflammation and Depression Connection

26 Jan

Depression is a mood disorder characterized by persistent sadness, loss of interest or pleasure, and disruptions in thinking, energy, or daily functioning that interfere with one’s ability to carry out daily activities. For years, depression was widely believed to result primarily from a “chemical imbalance” related to serotonin. However, a major umbrella review in the early 2020s found no consistent evidence that low serotonin levels cause depression—helping explain why many patients experience limited improvement from selective serotonin reuptake inhibitors (SSRIs) or serotonin–norepinephrine reuptake inhibitors (SNRIs). As a result, researchers have shifted toward a broader understanding of depression, including the possibility that chronic inflammation—particularly in the brain—may play a meaningful role.

Although this link between inflammation and depression may sound new, it’s actually well established in scientific literature. A meta-analysis of 38 studies involving more than 58,000 participants sought to clarify the direction of this relationship. The authors found that elevated levels of the pro-inflammatory cytokine IL-6 and the inflammatory marker C-reactive protein (CRP) predicted a higher risk of developing depression later on—and the higher these levels were, the more severe the depressive symptoms tended to be. Current evidence suggests that inflammatory signals can influence the brain by disrupting neurotransmitter function, stress-response pathways, and neuroplasticity, all of which contribute to mood regulation. Still, researchers continue working to determine exactly how much a role inflammation plays in overall depression risk and which individuals are most affected.

Growing evidence also suggests that people with depression (or at risk for it) may benefit from lifestyle habits known to reduce systemic inflammation. These include regular exercise, maintaining a healthy weight, reducing sedentary time, limiting screen time, getting quality sleep, spending time outdoors, eating an anti-inflammatory diet, managing stress, limiting alcohol intake, and not smoking. In fact, a 2024 study reported that individuals with the healthiest, lowest-inflammation lifestyles had up to a 55% lower risk of depression compared to those with the unhealthiest lifestyles.

These findings are encouraging, especially given current trends. According to recent Centers of Disease Control and Prevention and Gallup data, nearly one-third of Americans will experience an episode of clinical depression at some point in their lives, and about 17% report symptoms at any given time—a rate nearly double what was seen a decade ago. While these statistics are concerning, they also highlight the importance of addressing the factors that can reduce risk. And if pain or stiffness is keeping you from exercising or adopting healthier routines, consider seeing your chiropractor. Sometimes just a handful of visits can make it easier to move comfortably and stay active.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg PA 17055

Whiplash and the Four Phases of Injury Potential

19 Jan

Because rear-end motor vehicle collisions are the most common cause of whiplash injury, researchers have continuously sought to better understand this unique injury process, not only to derive more effective treatment strategies, but also to implement safety mechanisms in automobiles to reduce the risk of injury in the event of a car accident. As such, investigators have identified four phases of injury potential during the rapid acceleration and deceleration of the head and neck: retraction, extension, rebound, and protraction.

  • RETRACTION PHASE: Immediately after impact, the upper torso is pushed forward by the seat back while the occupant’s head remains relatively stationary, creating head retraction similar to tucking in the chin. This produces an S-shape of the cervical spine in which the upper cervical segments flex while the lower cervical segments extend. Maximal retraction may occur at or near the point of head restraint contact (depending on headrest position). A primary injury mechanism believed to be associated with this phase is a rapid pressure spike within the spinal canal caused by the sudden differential motion between the upper and lower cervical spine.
  • EXTENSION PHASE: This phase occurs immediately after the head reaches maximum retraction, sometimes even before striking the headrest, causing the occupant’s head to extend rearward as if looking upward. This places the entire cervical spine into extension. Excessive extension can also occur when no headrest is present or when the headrest is positioned too low or too far behind the occupant’s head, contributing to a hyperextension mechanism of injury.
  • REBOUND PHASE: Here, the occupant’s head reverses direction after reaching peak extension and rebounds forward. This rebound action produces some of the highest axial and shear forces measured in whiplash testing, making the cervical spine particularly vulnerable to excessive flexion forces.
  • PROTRACTION PHASE: Injury can occur after rebound when the differential motion between the head and torso is reversed—for example, when the seatbelt and shoulder harness restrain the upper torso while the head continues its forward motion. Similar to the transition from the S-shaped curve into full extension during the retraction-to-extension phase, the cervical spine here rapidly shifts into flexion, producing another pressure spike within the spinal canal like that observed during a front-end impact.

It’s important to note that this entire process occurs within 50–80 milliseconds, roughly three to four times faster than it would take for visual input from the eyes to reach the brain and for the brain to process the information and send signals to the neck muscles to activate in an attempt to brace against injury. As such, strategies employed before a collision can help protect the head and neck from injury. Experts advise positioning the headrest so that its top is at least level with the top of the head and maintaining a distance of less than two inches (five centimeters) between the back of the head and the headrest. Studies also support keeping the seat back at an angle between 100 and 110 degrees to prevent the body from sliding upward during a collision, which can place the head higher than the headrest. Of course, always wear your seatbelt. In the event of a rear-end collision, clinical guidelines consistently identify chiropractic care as an effective conservative treatment option for reducing pain and disability.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

The Neck and Low Back Connection

15 Jan

When a patient seeks chiropractic care for a condition like neck pain or low back pain, it’s natural to assume the underlying cause is located in the region where the patient feels symptoms. But this isn’t always the case. Sometimes, the primary or contributing factor to the patient’s chief complaint can be elsewhere in the body. A July 2024 study involving patients with cervical myelopathy helps illustrate this point.

Cervical myelopathy is a condition in which the spinal canal narrows due to a variety of potential causes—age-related degeneration, cervical spinal stenosis, herniated disks, trauma, rheumatoid arthritis, ossification of the posterior longitudinal ligament, or even tumors, infections, or congenital narrowing—and compresses the spinal cord. While neck pain is common, irritation of the spinal cord can produce downstream effects in the areas those nerve fibers reach. In this study, which involved 786 individuals with cervical myelopathy, two-thirds also reported low back pain.

Following treatment for cervical myelopathy, about half of those with concurrent low back pain experienced meaningful improvement in both lower back pain and function, and some even reported complete resolution. This suggests that for roughly half of these patients, the issue in their neck was a major contributing factor to their low back symptoms.

Beyond cervical myelopathy itself, several soft-tissue systems span the entire spine—including fascia, long spinal muscles, and ligamentous structures—making it possible for restrictions or dysfunction in the upper spine to influence symptoms in the lower spine. The reverse is also true: issues affecting the feet, ankles, knees, hips, or low back can lead to compensatory postural changes that place additional strain on the neck as the body works to keep the eyes level.

This helps underscore the importance of evaluating the whole patient rather than narrowing attention to the immediate area of complaint—something doctors of chiropractic are trained to do. The good news is that the hands-on care chiropractors provide can often help resolve these contributing issues, and when necessary, your doctor of chiropractic will coordinate with allied healthcare providers to support the best possible outcome.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

Tags: , , ,

Conservative Treatment for Hip Bursitis

12 Jan

Hip bursitis most often refers to trochanteric bursitis, an inflammation of the trochanteric bursa, a small fluid-filled sac located on the outer side of the hip. The primary symptom is pain on the outside of the hip near the greater trochanter—the bony bump at the top of the femur. The pain may be sharp, dull, or throbbing and often worsens with activities that load the hip, such as walking, climbing stairs, or lying on the affected side. Other possible symptoms include swelling and tenderness around the hip, redness (less common), difficulty walking or running, and limping. What role can chiropractic play in managing this condition?

While hip bursitis can result from direct trauma, infection, or complications following hip surgery—which are red flags requiring medical or emergency evaluation—the majority of cases are musculoskeletal in nature and can be managed conservatively. Common contributors include overuse or repetitive stress (friction between the iliotibial band and the greater trochanter), biomechanical abnormalities that alter gait mechanics, prolonged pressure on the hip from poor sitting posture, lumbar spine or sacroiliac joint dysfunction, or tight/overactive musculature that increases tension on the iliotibial band and irritates the bursa. Many of these factors overlap and can work together to inflame the hip bursa.

When a patient presents for chiropractic evaluation, the chiropractor will assess for postural and biomechanical changes beginning with the feet, as excessive pronation, flat feet, knee valgus (“knocking in”), and pelvic imbalance can contribute to functional leg-length differences—one of the factors associated with hip bursitis. The exam typically includes orthopedic tests to assess hip range of motion and pain provocation patterns. Imaging such as X-ray or MRI may be ordered when needed to exclude other pathology.

Short-term management focuses on reducing inflammation through rest, activity modification, and sometimes dietary changes or supplements with anti-inflammatory properties. Applying an ice pack for 15–20 minutes or performing brief ice massage (3–4 minutes) can help reduce pain and swelling. The main treatment goal is to correct the underlying mechanical issues irritating the bursa. This may involve manual therapy to improve mobility in the hip and related joints, targeted stretching and strengthening exercises to address muscle imbalances, and even a heel lift to reduce leg-length inequality, if needed. Because hip bursitis has multiple contributing factors, the specific treatment plan is individualized for each patient. If a patient does not respond to conservative care, they may be referred to their medical physician or a specialist for further evaluation to determine whether more invasive options—such as corticosteroid or platelet-rich plasma injections, or in rare cases surgery—may be appropriate.

As with many conditions, prevention is key. Maintaining a healthy weight, following an anti-inflammatory diet, stretching the hip muscles regularly, using proper posture and movement strategies during daily activities, keeping the core strong, and staying physically active all support hip health. Periodic chiropractic checkups can also help identify biomechanical issues early—before they become painful or interfere with normal function.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

Tags: ,

Nocturnal Wrist Bracing for Carpal Tunnel Syndrome

8 Jan

Carpal tunnel syndrome occurs when pressure within the wrist restricts the function of the median nerve, leading to numbness, tingling, pain, and eventually weakness in the parts of the palm, thumb, index, middle and thumb-side of the ring finger. Management focuses on reducing pressure inside the carpal tunnel, which may include manual therapies, exercises, and activity modifications designed to decrease inflammation and help the tendons passing through the wrist glide more freely. In some cases, addressing hormonal or metabolic factors that contribute to inflammation, water retention, or impaired nerve health may also be necessary. One of the simplest and most effective strategies is using a wrist brace at night. But why is this so commonly recommended in clinical guidelines?

A key point is that the shape of the carpal tunnel is not fixed. The carpal bones form a concave arch, and the transverse carpal ligament forms the roof of the tunnel. When the wrist bends out of neutral alignment, the arch narrows and compresses the structures inside. These pressure increases are not subtle. A wrist positioned just 30 degrees into flexion or extension can triple pressure inside the carpal tunnel. At the extremes of flexion or extension, pressures can increase ten-fold. Even side-to-side wrist deviation can double or triple pressure on the median nerve and surrounding tendons. Not only does this directly stress the median nerve, but using the fingers while the wrist is bent causes the flexor tendons to generate heat and friction in a crowded space, which can promote inflammation and worsen symptoms.

During waking hours, we can consciously monitor our hand positions and adjust our activities to avoid these high-pressure postures. Overnight, however, this is impossible. Many patients with carpal tunnel syndrome experience sleep disturbances because their wrists naturally drift into prolonged flexion or extension while they sleep. A nocturnal wrist brace prevents this by keeping the wrist in a neutral, nerve-friendly position. Most braces look like a soft short arm cast that supports the wrist from the palm to the mid-forearm and prevents bending.

Wearing such a brace during the day would be impractical and could interfere with manual tasks—and continuous daytime bracing may even cause irritation where the ends of the brace contact the skin. For daily activity, other types of bracing and non-bracing options are more appropriate, such as ergonomic modifications for work tasks and using a soft, beanbag or memory-foam wrist support during computer use to reduce carpal tunnel pressure. However—and your chiropractor will likely emphasize this—over-reliance on bracing can hinder long-term recovery, as the muscles controlling the hand and fingers can weaken without regular use. That’s why it’s important to pair nighttime bracing with prescribed wrist exercises, frequent breaks, avoidance of extreme wrist postures, and healthy lifestyle habits that reduce systemic inflammation.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA, 17055

Tags: , ,

The Evidence Map of Low Back Pain Treatment Options

5 Jan

Low back pain is extremely common and remains one of the leading causes of disability worldwide, resulting in substantial healthcare utilization and cost. Because of this broad impact, identifying and implementing effective, safe, and cost-efficient strategies to diagnose, manage, and prevent low back pain is essential to improve patient outcomes and reduce overall healthcare burden. In 2022, researchers conducted a comprehensive analysis of the available evidence for ten commonly recommended treatments for low back pain—five medication-based and five non-medication-based—drawn from multiple clinical practice guidelines:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) work by blocking the COX-1 and COX-2 enzymes responsible for producing prostaglandins, which influence pain sensitivity, inflammation, fever, and tissue blood flow. Evidence supports short-term improvements in pain and disability, but use is limited by potential side effects such as stomach irritation, increased bleeding risk, kidney strain, and caution in patients with certain heart conditions.
  • Acetaminophen (paracetamol) also blocks prostaglandin production, but its effects are largely restricted to the central nervous system. Importantly, available evidence shows little to no meaningful benefit for pain, function, or quality of life in patients with low back pain.
  • Opioids blunt incoming pain signals and alter how the brain interprets pain. Due to risks of misuse, dependence, and overdose, guidelines recommend restricting their use to severe acute pain or postoperative situations and strongly discourage long-term use.
  • Muscle relaxants can reduce muscle spasm through several central mechanisms. Evidence supports short-term symptom relief, but high-quality evidence is limited, and side effects—including drowsiness, dizziness, cognitive slowing, dry mouth, low blood pressure, nausea, drug interactions, and dependence—must be carefully considered.
  • Antibiotics are intended to treat infection. Evidence supporting their role in low back pain management is weak, inconsistent, and not broadly applicable.
  • Psychological or behavioral therapies can be especially valuable for patients with persistent or recurrent low back pain, as psychological factors strongly influence whether patients engage in behaviors that support or hinder recovery.
  • Staying active and avoiding bed rest are strongly recommended. Activity helps maintain function, reduce disability, and speed recovery.
  • Reassurance—emphasizing that low back pain is common, manageable, and rarely dangerous—reduces fear and catastrophizing and lowers the risk of progression to chronic pain.
  • Exercise, including both general physical activity and targeted movement strategies, provides modest but meaningful improvements in pain and disability. Exercise also reduces recurrence risk.
  • Manual therapy, which includes manipulation and mobilization, helps restore normal movement to the spine and associated tissues, reducing pain and disability. Practitioners often combine different manual techniques based on examination findings, patient preference, and clinical training and experience.

The great news is that doctors of chiropractic frequently employ a multimodal treatment approach that includes manual therapy, exercise, reassurance, and activity recommendations—among the most strongly supported options in this evidence map!

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

Tags: , , ,

← Older Entries
Newer Entries →