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Detecting Carpal Tunnel Syndrome Early

4 Feb

The early symptoms associated with carpal tunnel syndrome (CTS) are often easy to overlook or ignore because they don’t interfere too much with one’s ability to carry out their daily activities. As such, many people don’t consider it worthwhile to take the time to make and attend a doctor appointment to deal with the issue. In fact, many individuals with CTS wait months or even years before seeking care when their symptoms become too activating, limiting, and bothersome to ignore. But what if there was a way to figure out if those small complaints were indicative of early CTS from the comfort of home?

In a 2019 study, researchers evaluated the hand movements of 22 CTS patients (seven with CTS in both wrists) and 11 age-matched controls in search of simple diagnostics that could be performed outside of a clinical setting. Investigators ended up focusing on the movement of the thumb as it moved through its full range of motion.

Researchers found that the thumbs of CTS patients moved significantly slower in certain directions when compared to those without CTS. This criterion was consistent in 27 of the 29 CTS-positive wrists, a 93% sensitivity, with a 73% specificity in the non-CTS wrists.

The researchers are using this data to program a mobile app that can be used by individuals outside of a clinical setting determine if their early symptoms warrant contacting their healthcare provider for further examination. The app can also be used in workplace settings to identify workers who may be at increased risk for CTS so that preventative measures can be taken (such as changes in ergonomics, tools, or work processes).

Perhaps the most important benefit from an app that helps identify CTS patients early on is that the condition is much easier to treat when the symptoms are mild. When a patient delays care, secondary issues can manifest, scar tissue can form, and associated soft tissues can weaken. If a patient waits too long, a full recovery may not be possible, even with surgery, and they might have to learn to live with ongoing and life-limiting symptoms.

Doctors of chiropractic are trained to diagnose and manage CTS, often with a combination of manual therapies, specific exercises, anti-inflammatory recommendations (ice and nutritional), nocturnal splinting, and ergonomic modifications. They will also check elsewhere along the course of the median nerve to make sure there are no issues in the neck, shoulder, elbow, or forearm that may contribute to the patient’s CTS symptoms. If non-musculoskeletal causes are suspected, the patient may be referred to a specialist or their medical physician for additional care.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

The Lower Back and Fall Prevention

1 Feb

Serious falls can lead to a number of negative outcomes in older adults, from impaired mobility to loss of independence to early death. Thus, steps that can be taken to reduce the risk for falls will not only potentially result in a longer life, but also help support a higher quality of life in those remaining years.

Research has shown that seniors with a history of falls tend to have impaired balance and reduced muscle strength (especially in the back)—both of which are associated with advancing age. Let’s see if addressing these areas can reduce fall risk and what role chiropractic care may play in the process.

In one study, researchers compared three fall prevention approaches (educational classes, home safety assessments, and exercise training) and found that participants in the exercise group had the lowest risk for falls. Another study compared exercise on a stationary bike versus movement-based exercises using a video game system (called exergames). The results showed that the participants in the exergames group experienced greater improvements in mobility and balance. Taken together, these studies suggest that a movement-based exercise approach is effective for reducing fall risk, which coordinates with the research that shows that older adults with a history of regular exercise are less likely to have a serious fall.

A 2020 study involving active-duty military personnel with chronic back pain found that adding chiropractic care to a rehabilitative program featuring isometric and balance-focused exercises resulted in improved back pain, function, muscle strength, and balance compared with a control group that received no care. In another study, researchers observed that a twelve-week chiropractic treatment program was effective in improving sensorimotor function in older adults, which is associated with a reduced fall risk.

Finally, an analysis of data from 39 studies involving 17,626 seniors found that those with pain in the neck, lower back, hip, knee, and foot were more likely to exhibit poor balance, especially those with a history of chronic musculoskeletal pain. The results from these various studies suggest that older adults can reduce their risk for serious fall by addressing current musculoskeletal complaints—of which chiropractic care is an excellent choice—and regularly engaging in exercise to improve balance and strength.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Coffee May Benefit Colorectal Cancer Patients

25 Jan

Coffee is one of the most consumed beverages around the globe, and many individuals can’t seem to start their day without a cup or two. Past research has identified several compounds present in coffee that can offer health benefits, and new research suggests that coffee intake can also help patients under treatment for colorectal cancer.

The study, published in September 2020 in JAMA Oncology, looked at the association of coffee intake and survival in patients with advanced or metastatic colorectal cancer. In the study, which included 1,171 patients (median age 59), participants kept track of their caffeinated and decaffeinated coffee consumption for five years. The researchers observed that participants who consumed two to three cups of coffee per day were not only more likely to survive but their cancer was less likely to progress. Additionally, those who consumed at least four cups a day had even better results. The study concluded that “Coffee consumption may be associated with reduced risk of disease progression and death in patients with advanced or metastatic colorectal cancer. Further research is warranted to elucidate underlying biological mechanisms.”

The longevity benefits aren’t limited to patients with advanced colorectal cancer. A 2015 study looked at the association of coffee consumption (both caffeinated and decaffeinated) with total and cause-specific mortality in three large prospective cohorts: 1) 74,890 women; 2) 93,054 women; and 3) 40,557 men. The research team’s analysis revealed that regular coffee drinkers (one to five cups a day) had a lower risk for early death, though those who frequently consumed more than five cups a day did not experience increased longevity.

Regular coffee drinkers often report that it improves their ability to think and focus, but are there any long-term cognitive benefits to coffee? Perhaps. In 2019, researchers used advanced imaging to look for amyloid plaque build-up, a characteristic of Alzheimer’s disease, in the brains of 411 seniors without cognitive impairment. When researchers separated the data based on the participants’ coffee habits, they observed that those who consumed two or more cups of coffee a day had lower amyloid levels in the brain, suggesting a reduced risk for Alzheimer’s disease. A review of past studies has shown coffee consumption to be associated with a reduced risk of developing many diseases including type 2 diabetes, liver cancer, endometrial cancer, lethal prostate cancer, basal cell carcinoma of the skin, neurological diseases, and cardiovascular disease when consumed in moderation. Doctors of chiropractic often encourage patients to adopt a healthier lifestyle, which includes consuming vital nutrients, vitamins, and minerals, and getting regular exercise. If you enjoy coffee and do so in moderation, the current data suggests it may provide benefits beyond helping you become more alert.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Useful Tests for Diagnosing Whiplash

21 Jan

When it comes to whiplash associated disorders (WAD), the process of making an accurate diagnosis and treatment recommendation can vary from healthcare provider to healthcare provider depending on their educational background, ongoing training, and clinical experience. There is also a growing pile of research with respect to WAD that helps refine existing processes and introduce new perspectives to take on the condition and its treatment. Here are developments that can help doctors better evaluate the presence and severity of WAD.

In a 2017 study, researchers evaluated a diagnostic test that utilizes six isometric muscle fatigue tests of the neck and arm muscles in search of an inexpensive and relatively low-tech method for identifying the presence and degree of WAD injury—WAD I (no/minimal complaints/injury), WAD II (soft-tissue injury—muscle/tendon and/or ligament injury), WAD III (nerve injury), WAD IV (fracture). The study included 75 patients who had experienced a whiplash injury in the previous six hours and 75 non-injured subjects with a similar make-up (age, gender, body type, etc.).

            The investigators observed that the participants with WAD injuries fatigued at a much faster rate in each of the six tests, and those with a higher grade of WAD injury experienced fatigue even quicker. Based on the fatigue data alone, evaluators were able to identify the WAD patients with a more than 90% accuracy. While additional studies are underway to confirm these findings with more participants, this may offer healthcare providers an easy, accurate, and safe method to determine the severity of WAD injury and offer more tailored treatment recommendations in the time period immediately following an automobile collision.

A study published in 2020 used video fluoroscopy (VF) to observe both WAD patients with chronic neck pain and non-injured subjects while they performed five movements to a firm end range involving the motion of the cervical spine. Using the VF data, radiologists were able to differentiate members of the two groups with significant accuracy. The use of x-ray taken at a firm end range of each motion can also be used to make these measurements. This is important as most patients and healthcare providers don’t have ready access to VF but many times, X-rays can be done in the office or a short drive away.

The most current treatment guidelines for WAD recommend seeking care as soon as possible versus taking a wait-and-see approach. Chiropractic care is an excellent option that can reduce one’s risk for developing chronic WAD symptoms that may be more difficult to resolve.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

The Neck and Tinnitus Relationship

18 Jan

Experts estimate that approximately 10% of the adult population in the United States experienced an episode of tinnitus—the perception of sound or noise without any external auditory stimulus being present—within the last year. Tinnitus can be caused by wax buildup in the ear, medication side effect, noise-induced hearing lost, ear and sinus infections, cardiovascular disease, Meniere’s disease, brain tumors, hormonal changes in women, and thyroid disorders. One cause that gets less attention is dysfunction in the cervical spine.

While the prevalence of cervicogenic tinnitus—tinnitus that originates from the neck—is unknown, a 2015 study that evaluated 87 chronic tinnitus patients found that nearly half (47%) tested positive for cervicogenic tinnitus. Thus, individuals with ongoing tinnitus symptoms may benefit from receiving a thorough examination of their cervical spine by a doctor of chiropractic.

A 2020 case report detailed the experience of a 67-year-old female patient with a five-year history of left-sided chronic tinnitus, neck pain, and headache. Her treatment plan included exercises that emphasized the direction(s) that produced symptom relief and postural correction. Not only did the patient report significant improvements in her symptoms following her course of care, but she continued to experience relief at a follow-up appointment six months later.

This case study exemplifies the significant short- and long-term benefits that focused, tailored self-exercise (that the patient can perform at home) can have in improving chronic cervicogenic tinnitus. Chiropractic management centers on three common goals: pain management, posture improvement, and prevention. Many studies support significant short-term benefits that can be achieved with manual therapies, particularly spinal manipulation. Patients can achieve and sustain long-term benefits with exercise training when it’s specifically tailored to them.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Baker’s Cyst and Knee Pain

14 Jan

A Baker’s cyst is a swelling located in the back of the knee that can be either asymptomatic or bothersome, especially when bending the knee. Researchers estimate that up to 94% of popliteal (back of the knee) cysts are associated with an intra-articular disorder, most commonly meniscus (“cartilage”) tears, as well as osteoarthritis, inflammatory arthritis (like rheumatoid), and ACL tears.

In about 50% of healthy adult knees, there is a valvular opening located high on the inside of the knee joint that connects the joint capsule to a bursa (a fluid filled sac that functions to lubricate muscle attachments). It is thought that when there is an effusion or swelling inside the knee joint, the excess fluid flows one way to the inner knee joint bursa (called “pes anserine bursitis), which reduces pressure from inside the joint. Although there are other causes of popliteal cysts, this is the most common.

So, what can chiropractors do for the patient with a Baker’s cyst?  Chiropractic management includes both passive and active care approaches that focus on the knee joint and surrounding soft tissues to help reduce pain and swelling and improving function, as well as home exercise instruction to maintain the health of the knee joint. Such exercise recommendations can include the following:

  1. Standing calf stretch: stand upright grasping a chair or wall for balance; step back with the involved leg and flatten the heel to the floor with toes pointing as straight as comfortably possible; slowly straighten the bent knee until you feel a firm stretch behind your knee; hold for five to ten seconds and repeat five to ten times or until the muscle feels less tight; repeat on the opposite leg.
  2. Heel lift: sit with your feet flat on the floor with your knees bent 90°, lift one heel keeping the ball of the foot on the floor; push down on the knee and slowly lower the heel to its starting position; repeat ten times as tolerated and switch sides, gradually increasing reps and sets, as tolerated.
  3. Sitting hamstring stretch: sit on the ground with one leg straight out, keeping the heel on the floor; bend the ankle and bring your toes toward you; arch your low back until you feel a strong stretch in the back of the thigh and knee; lean forward as tolerated for a greater stretch; repeat five to ten times with  a three to five second hold, as tolerated.
  4. Heel Slides: lie on your back, legs straight; slowly bend one knee while sliding the heel toward your buttocks; repeat five to ten times, as tolerated, and repeat on the opposite side.
  5. Wall squats: stand with your back against a wall and slide down slowly, keeping the toes well in front of the knees; only squat down as far as you can; repeat five to ten times, as tolerated.
  6. Side-steps: place a loop or resistance band around your ankles; partially bend the knees; step sideways, alternating between the left and right foot, stepping wide enough to always keep tension on the band.

Your doctor of chiropractic can train you in these exercises and provide care to address any musculoskeletal issues that may contribute to your knee pain.

A Baker’s cyst is a swelling located in the back of the knee that can be either asymptomatic or bothersome, especially when bending the knee. Researchers estimate that up to 94% of popliteal (back of the knee) cysts are associated with an intra-articular disorder, most commonly meniscus (“cartilage”) tears, as well as osteoarthritis, inflammatory arthritis (like rheumatoid), and ACL tears.

In about 50% of healthy adult knees, there is a valvular opening located high on the inside of the knee joint that connects the joint capsule to a bursa (a fluid filled sac that functions to lubricate muscle attachments). It is thought that when there is an effusion or swelling inside the knee joint, the excess fluid flows one way to the inner knee joint bursa (called “pes anserine bursitis), which reduces pressure from inside the joint. Although there are other causes of popliteal cysts, this is the most common.

So, what can chiropractors do for the patient with a Baker’s cyst?  Chiropractic management includes both passive and active care approaches that focus on the knee joint and surrounding soft tissues to help reduce pain and swelling and improving function, as well as home exercise instruction to maintain the health of the knee joint. Such exercise recommendations can include the following:

  1. Standing calf stretch: stand upright grasping a chair or wall for balance; step back with the involved leg and flatten the heel to the floor with toes pointing as straight as comfortably possible; slowly straighten the bent knee until you feel a firm stretch behind your knee; hold for five to ten seconds and repeat five to ten times or until the muscle feels less tight; repeat on the opposite leg.
  2. Heel lift: sit with your feet flat on the floor with your knees bent 90°, lift one heel keeping the ball of the foot on the floor; push down on the knee and slowly lower the heel to its starting position; repeat ten times as tolerated and switch sides, gradually increasing reps and sets, as tolerated.
  3. Sitting hamstring stretch: sit on the ground with one leg straight out, keeping the heel on the floor; bend the ankle and bring your toes toward you; arch your low back until you feel a strong stretch in the back of the thigh and knee; lean forward as tolerated for a greater stretch; repeat five to ten times with  a three to five second hold, as tolerated.
  4. Heel Slides: lie on your back, legs straight; slowly bend one knee while sliding the heel toward your buttocks; repeat five to ten times, as tolerated, and repeat on the opposite side.
  5. Wall squats: stand with your back against a wall and slide down slowly, keeping the toes well in front of the knees; only squat down as far as you can; repeat five to ten times, as tolerated.
  6. Side-steps: place a loop or resistance band around your ankles; partially bend the knees; step sideways, alternating between the left and right foot, stepping wide enough to always keep tension on the band.

Your doctor of chiropractic can train you in these exercises and provide care to address any musculoskeletal issues that may contribute to your knee pain.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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