Archive for February, 2014

Carpal Tunnel Syndrome, What is it?, What to do about it.

Monday, February 17th, 2014

Carpal Tunnel Syndrome (CTS) is a condition characterized by numbness, tingling, and/or pain located on the palm side of the wrist, hand and into the index, third, and half of the ring finger. It’s caused by pressure exerted on the median nerve as it passes through the “tunnel” located in the wrist. The “floor” of the tunnel is a ligament while the “walls” are made up of eight small carpal bones that lock together in the shape of a tunnel. There are nine tendons (tendons attach muscles to bones allowing us to move our fingers), sheaths covering the tendons, blood vessels, and the median nerve that ALL travel through the tunnel, so it’s packed pretty tight. ANYTHING that increases the size of any of these structures or anything “extra” that shouldn’t be there can increase the pressure inside the tunnel, pinch the median nerve, and result in the classic numb/tingling symptoms that wake people up at night, or interfere with work or driving.
In the Unites States (US), about 1 out of 20 people will suffer from CTS. Caucasians have the highest incidence rate and women are affected more than men by a 3:1 ratio between ages of 45-60 years old. Only 10% of the reported cases of CTS are under 30 years old. Occupational CTS (as of 2010) affects 8% of US workers with 24% attributed to manufacturing industry jobs. This equates to approximately 3.1 million cases of work-related CTS in 2010. The risk of developing CTS increases with age, diabetes, hypothyroid, pregnancy, taking birth control pills, having an inflammatory arthritis, being obese, pinched nerves in the neck, thoracic outlet, elbow, and others. Therefore, managing CTS requires a thorough evaluation in order to assure accuracy in the diagnosis. With this background information, let’s look at the question, WHAT CAN YOU DO TO HELP CTS? One answer is, don’t age – good luck with that! In addition to keeping your weight under control, exercise can be VERY effective and YOU can be in charge of that process, but we have to teach you the exercises.
1) The Carpal Stretch (“nerve gliding”): Place your palm on the wall near shoulder height with the fingers pointing down at the floor and press the palm of the hand flat on the wall. Lastly, reach across with the opposite hand and pull your thumb back off of the wall and hold for 5-15 seconds.
2) The Wrist Extensor Stretch: Do the same as #1 but place the back of the hand on the wall in front of you, again fingers pointing downward. Here, there is no need to stretch the thumb.
3) The “Bear Claw”: Make a fist and then open up the hand. Keep the small finger joints flexed while extending the knuckles at the base of each finger straight (not bent). Repeat 5-10x.
4) Putty Squeeze: Simply squeeze putty in your hand for two to five minutes until fatigued.
5) Yoga has been shown to reduce pain and improve grip strength in CTS patients!
Now the question, “…can these exercises prevent surgery?” The answer is “maybe.” They certainly help in some cases, but a multi-dimensional treatment plan is theBEST approach. This includes: 1) Chiropractic manipulation of the hand, wrist, elbow, shoulder, and neck; 2) Soft tissue “release” techniques of the muscles in the forearm, upper arm, shoulder, and neck; 3) Cock-up wrist splint to be used at night, and in some cases, at times during the day; 4) Ergonomic managementof your work station or situation (to minimize repetitive insult to the area); 5) Nutritional support that may include an anti-inflammatory diet and nutrients (vitamins, minerals, herbs, etc.), and 6) Managing any contributing conditionslike diabetes, hypothyroid, and/or the others. Here’s the GOOD NEWS: CHIROPRACTIC can manage these six steps, though some cases will require co-management with primary care and/or specialist.
I would be happy to fully explain and demonstrate this work to you. You only need to schedule an appointment and you can do that right from this website. Just click on the “online appointments now!” above on the menu bar and pick your appointment time.

Whiplash Injuries

Monday, February 17th, 2014

Whiplash injuries are a significant public health problem. Not only do they cause significant pain and time off from work and leisure activities, there is also a general effect on quality of life. A study in the European Spine Journal compared female patients with whiplash of the neck to patients with low back pain and another group with rheumatoid arthritis. The researchers looked at pain levels (how high or low) and how quality of life was affected. In the whiplash group, the pain levels were the highest. Overall health status was also more affected in the whiplash group, with changes mostly in social issues, vitality, emotional, and mental wellbeing.

A study in the journal Spine looked at how medical and chiropractic doctors differed in their approach to patients with whiplash. Medical doctors were more likely to have negative feelings about treating patients who have whiplash. They were also more likely to believe that there was nothing physically wrong with many patients with chronic whiplash. In terms of treatment, most medical doctors believed that nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants were effective in acute whiplash. This is despite the significant scientific evidence of problems of safety with long -term consumption of NSAIDs (e.g. stomach bleeding). In addition to questions of safety, there is virtually no evidence that these types of medications actually improve patients’ pain or overall quality of life.

The chiropractic approach to whiplash is much different from that of medical doctors. First, there is a general acceptance that the injuries are real and are not made-up by the patient. Biomechanical study of auto accidents confirms the injuries are real and mostly consist of sprain and subluxation of the joints of the neck. The spinal ligaments, muscles and disks are all affected in whiplash injury. When trauma to these tissues occurs, the sensitive nerves that go between these structures are also irritated, resulting in pain and changes in balance (e.g. dizziness, and position sense). Over time, the patient may have significant effects on their quality of life.

One study of chiropractic care in the journal Injury looked at the results in patients with chronic (i.e., long-term) whiplash injuries-which occurs in about 43% of cases. Twenty-eight patients were studied and of these 93% (n=26) had improved following chiropractic treatment.

There are important differences in your treatment when you compare the chiropractic to the medical approach to whiplash.