Archive for April, 2013


Carpal Tunnel Syndrome – What Makes My Hands Numb?

Monday, April 22nd, 2013

Carpal Tunnel Syndrome (CTS) sufferers frequently report a cluster of symptoms, but almost all have one symptom in common – numbness, usually in digits 2-4 on palm-side of the hand. CTS is usually attributed to an over-use type of injury such as repetitive work including (but not limited to): typing, assembly work, packaging jobs, machine operators, and many more. Last month, we discussed CTS “Facts” and learned many important points about CTS. This month’s focus centers around the common question, “….where is this numbness coming from?”

To answer this, let’s review the anatomy: The carpal tunnel is made up of 8 small “carpal bones” that form an arch or tunnel, and the base of the tunnel is formed from the transverse carpal ligament. There are nine tendons that attach muscles in the forearm to each finger and work when we grip or form a fist with our hand. Wiggle your fingers and look at your wrist and forearm – do you see all the activity or movement going on?

The tendons travel through sheaths which help lubricate the sliding tendons. When we move our fingers fast (such as typing, playing piano, performing assembly work, etc.), friction and heat builds up, resulting in swelling. If adequate rest does not occur, the increased pressure from the swollen tendons end up squeezing all the contents within the tunnel, which includes the median nerve. It’s the median nerve pinch that results in the numbness, tingling, and/or pain into the index, third and forth fingers.

There are other conditions that can either complicate or cause CTS. These include: hypothyroid disease (due to myxedema), diabetes (due to neuropathy), inflammatory arthritis (of which there are several kinds – rheumatoid is the most common), and pinching of the nerve either in the neck, shoulder, elbow or forearm (called double or multiple crush syndrome).

The reason chiropractic helps so much is that we can alleviate the pressure on the nerve from the neck down to the wrist and restore nerve function. This alleviates the multiple sleep interruptions, weakness in the grip that is so common, as well as helping to restore the nerve’s function. Many studies support the success of chiropractic and CTS – try it first as surgery should be the last resort.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend or family member require care for CTS, we would be honored to render our services.

Does Neck Surgery Improve Long-Term Outcomes?

Monday, April 22nd, 2013

How many times have you heard, “I have a pinched nerve in my neck and have to have surgery.” Though there certainly are cases where surgical intervention is required, surgery should ONLY be considered after ALL non-surgical treatment approaches have been tried first (and failed). It is alarming how many cases of cervical radiculopathy (i.e., “pinched nerve”) end up being surgically treated with NO trial of non-surgical care. Hence, the focus of this month’s article will look at research (“MEDICAL EVIDENCE”) that clearly states neck surgery DOES NOT improve the long term outcomes of patients with chronic neck pain.

Chronic neck pain (CNP) is, by definition, neck pain that has been present for a minimum of three months. This category of neck pain is very well represented, as many neck pain sufferers have had neck pain, “…for years” or, at least longer than three months. Depending on the intensity of pain and it’s effect on daily function, many patients with CNP often ask their primary care provider, “…is there anything surgically that can be done?” The desire for a “quick fix” is often the focus of those suffering with neck pain. Unfortunately, according to recent studies, there may not be a “quick fix” or, at least surgery is NOT the answer. The December 2012 issue of The European Spine Journal reports that spine surgery did NOT improve outcomes for patients with CNP. Moreover, they pointed to other studies that showed some VERY STRONG REASONS NOT to have spine surgery unless everything else has failed. One of the reasons was a higher hospital readmission rate after spine surgery. Another reported that most studies on surgical vs. conservative [non-surgical] care showed a high risk of bias, suggesting the research on surgical intervention was biased in the research approach used. They further reported, “The benefit of surgery over conservative care is not clearly demonstrated.” It is important to point out that the research analyzed studies that included patients with and without radiculopathy (radiating arm pain from a pinched nerve), and myelopathy (those with pinching of the spinal cord creating pain, numbness, weakness in the legs, and/or bowel / bladder dysfunction).

In February of 2008, the Neck Pain Task Force published overwhelming evidence that research supports the use of cervical spinal manipulation in the treatment of both acute and chronic neck pain with or without radiculopathy. Bronfort published similar findings in 2010 in a large UK based study that looked at the published evidence supporting different types of treatment for various conditions. They found cervical spine manipulation was effective for neck pain of ANY duration (acute or chronic). Chiropractic utilizes manipulation, manual traction, mobilization, muscle release techniques, home cervical traction, exercise, as well as a multitude of physiotherapy modalities when managing patients with CNP. Given the overwhelming research evidence that surgical intervention for CNP is NOT any better than non-surgical care, the greater amount of negative side-effects, and the obviously long recovery time post-surgically, chiropractic treatment of anyone suffering from CNP should be tried FIRST.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Low Back Pain and Travel Tips

Monday, April 22nd, 2013

Low back pain (LBP) is a common complaint when it comes to traveling, whether it’s in a car, bus, train or airplane. Traveling is hard on our joints, muscles and nerves for many reasons. Traveling requires us to do something our bodies are not used to, such as prolonged sitting in a cramped area. Remember the last time you had the middle seat on a plane? Also, unless you have a very unique exercise routine, injuries commonly occur from hoisting carry-ons into overhead bins or yanking them off the baggage claim belt. This month’s article will offer tips about traveling and things you can do to minimize risk of irritating or creating LBP. Bon voyage!

If no one comes to help, and you end up having to complete this often unpleasant task yourself, think before you lift. Break the lift into small movements or actions. For example, when placing your carry-on into an overhead bin, keep the luggage close to your body since the farther away from your body you hold the bag, the heavier it becomes to your lower back (up to 10x the load!). Try this method: 1st lift the bag to the arm of the seat that lies below the overhead bin; next lift it to the top of the seat back top; and then (the hard part), squat down, arch your low back, grip the bag, and in a smooth continuous movement, raise the bag up and onto the edge of the overhead bin. At that point, wiggle it in the rest of the way. Another important point about lifting is to try to avoid twisting, ESPECIALLY if combined with bending. A bend / twist combination is often the cause of a low back injury. Try to pivot your feet to move your body to avoid your back from twisting.
There are MANY other traveling tips that we have not yet discussed. Look forward to next month’s Health Update for LBP for more!

We realize you have a choice in who you choose to provide your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.