Archive by Author

Who Gets Carpal Tunnel Syndrome?

14 Sep

Though carpal tunnel syndrome (CTS) affects 4% of the population, some individuals have a much greater risk for the condition, and several factors may need to be addressed to achieve a successful outcome.

Trauma: An acute trauma, such as a bone fracture, can lead to CTS. However, repetitive stress injuries are more commonly associated with the condition.

Anatomy: Not all wrists are equal, and some individuals, especially biological women, may have a narrower carpal tunnel, which increases the chances that the tendons passing through the region will become inflamed and compress the median nerve.

Arthritis: Osteoarthritis can cause spur formations that project into the tunnel and increase pressure on the nerve. Rheumatoid arthritis results in inflammation in the joints of the wrist and the lining around tendons, which can also place pressure on the median nerve as it passes through.

Hormones: Hormonal changes due to pregnancy, menstruation, menopause, birth control pills, hormone replacement therapy, diabetes, hypothyroid, kidney disease, lymphedema, etc. can lead to swelling or inflammation in the carpal tunnel, which can place pressure on the median nerve.

Medications: Certain medications can increase the risk for CTS such as anastrozole, a drug used in breast cancer treatment; diphosphonates, a class of medications used to treat osteoporosis; oral anticoagulants; and more. (When non-musculoskeletal causes are present, care may require co-management with the patient’s medical physician.)

Work Environment: Workplace factors that contribute to CTS include a cold environment, vibrating tools, awkward neck/arm/hand positions, no breaks, prolonged computer mouse work, and more. Individuals who work jobs characterized by fast, repetitive, and forceful, grip/pinch-related activities may be up to 2.5 times more likely to develop CTS.

Other Musculoskeletal Conditions: It’s possible for the median nerve to be compressed as it passes through the neck, shoulder, elbow, and forearm, which can stimulate CTS-like symptoms in the hand and wrist, even if there is no compression in the carpal tunnel itself. It’s also common for patients to have median nerve entrapment in one of these locations in addition to compression at the carpal tunnel. A patient’s doctor of chiropractic will need to review the patient’s health history and examine the entire course of the median nerve to identify all the contributing factors in order to achieve an optimal outcome.

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.

Choose Chiropractic FIRST for Low Back Pain

10 Sep

When it comes to a condition like low back pain, does it matter what type of healthcare provider a patient initially visits for treatment? A study published in 2015 looked at this question and found that the type of healthcare provider a patient initially consulted had a dramatic effect on both their short-term and long-term prognosis.

In the study, researchers monitored 719 patients with low back pain, 403 of whom initially consulted with a medical physician and the rest first sought care from a doctor of chiropractic. The results showed that the patients in the chiropractic care group not only experienced a greater reduction in their low back pain, but they were also more satisfied with their experience. Additionally, the average cost of treatment for the chiropractic patients was $368 (US dollars) lower than the average cost of treatment in the group that received care from their medical doctor. The study clearly favored chiropractic care as the initial treatment choice for patients with low back pain.

In a 2019 study, researchers reviewed medical records from over 216,000 patients without a history of opioid use and who had new-onset back pain to see if initial provider choice influenced future prescription narcotic use. The data showed that 22% of patients received a prescription for an opioid in the short-term; however, patients who consulted with a doctor of chiropractic first were even less likely to require either a short-term or long-term prescription than those who visited a medical doctor initially. The authors of the study concluded, “Incentivizing use of conservative therapists may be a strategy to reduce risks of early and long-term opioid use.”

Another study followed a set of 2,870 acute and chronic low back pain patients for four years. The research team observed that chiropractic care provided more favorable short-term outcomes for patients with chronic back pain, while both acute and chronic low back pain patients reported better outcomes in the long term, especially in chronic patients with leg pain extending below the knee.

Seeing a chiropractor first can also reduce the chances a patient will require a surgical procedure to address their back pain. A 2013 study published in Spine looked at data from Washington state worker’s compensation cases and found that 43% of injured workers with a back injury who initially consulted with a surgeon ended up having surgery while just 1.5% of those who first received chiropractic treatment eventually had a surgical procedure for their back pain—a massive difference.

TAKE-HOME MESSAGE: Seek chiropractic care FIRST to receive the most satisfying, efficient, and cost-effective approach for managing acute or chronic low back 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.

The Reason Blood Pressure May Rise in the Winter

24 Aug

A 2009 study that monitored over 8,800 elderly French adults found that an individual’s blood pressure can fluctuate with the seasons. In particular, the researchers observed that as temperatures fell, both systolic and diastolic blood pressure could rise to unhealthy levels, but they were unable to determine why.

However, a study published just five years later may have solved the mystery. The solution has to do with the molecule nitric oxide. Nitric oxide is a vasodilator, meaning that it causes the walls of blood vessels to relax and expand, with a resulting reduction in blood pressure.

Researchers have discovered that nitric oxide is stored in the dermal vasculature at levels much greater than are found circulating in the bloodstream. When exposed to long-wave ultraviolet (UVA) rays, the skin releases some of that stored nitric oxide into the bloodstream. Because individuals tend to spend less time in the sun during the winter months, there are fewer opportunities for the skin to release nitric oxide into the blood, dilate blood vessels, and moderate blood pressure. This may also help to explain why stroke and blood vessel rupture (aneurism) are more common in the winter months among the elderly.

How can one maintain healthier levels of nitric oxide in their bloodstream when it’s not convenient to spend time in the sunshine? The answers may be found in diet and exercise.

A 2018 study found that eating leafy greens and root vegetables and drinking beetroot juice effectively increased nitrate plasma (blood) levels for the purpose of enhancing exercise performance.

In 2020, researchers observed that schoolteachers in South Africa with greater physical fitness levels had higher levels of nitric oxide in their blood, as well as lower systolic and diastolic blood pressure readings. The research team concluded, “These results may suggest that even moderate physical activity could increase nitric oxide synthesis capacity, which in turn may mitigate the development of cardiovascular disease in this population.” 

The take home message is that to maintain a healthier blood pressure, consider getting plenty of sunshine, eating leafy green and root vegetables (or drink beetroot juice), and exercising!

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.

Whiplash Associated Headaches

17 Aug

One of the symptoms commonly associated with whiplash associated disorder (WAD) is headaches. The current research suggests that up to 50% of patients who experience whiplash-associated headaches may continue to suffer from them for up to a year or more, and many of those will continue to have headaches as late as five years following their whiplash injury event. There are many potential causes for WAD-related headaches, which can include cervical injury, jaw dysfunction (TMJ), psychological distress (depression and anxiety), brain structure abnormalities (concussion), and/or overuse of headache medications.

To address these potential causes of whiplash associated headaches, treatment may include the following:

MANUAL THERAPIES: Mobilization and manipulation, which are commonly used by doctors of chiropractic, have been demonstrated to be effective for reducing pain and improving function for many conditions, including WAD and headaches of cervical origin. Treatment may also involve massage and physical therapy modalities, depending on the patient’s needs.

EXERCISE: A review of research published between 1990 and 2015 found that craniocervical, cervicoscapular, and posture correction exercises can be helpful in the treatment of whiplash-related headaches.

STAY ACTIVE: Try to carry on with normal activities within pain tolerances, as movement is needed to keep soft tissues healthy and to ensure a continuous supply of nutrients to the cervical disks. Don’t use a cervical collar to immobilize the neck unless directed to do so by your doctor.

NUTRITIONAL SUPPORT: There are several vitamins and supplements that have been shown to reduce inflammation and/or reduce pain. These include flavonoids, curcuminoids, omega-3 fatty acids, taurine, and vitamin D. Adopting an anti-inflammatory diet can also aid in the healing process.

Doctors of chiropractic frequently use a combination of these approaches when managing WAD patients to help reduce pain and disability and assist the patient in returning to their normal activities as soon as possible.

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.

Forward Head Posture and Neck Pain

13 Aug

Neck pain is one of the most common complaints that drive patients to seek chiropractic care. Sometimes the cause of injury is a known traumatic event, but in many cases, neck pain is the result of wear and tear from poor posture—forward head posture in particular.

The head, which weighs 10-11 lbs. (4.5-5 kg), typically rests above the shoulders. When an individual’s head leans forward to look at a computer screen or to look downwards at their smartphone/tablet, the muscles in the rear of the neck and upper back/shoulders need to work harder to keep the head upright.

Experts estimate that for each inch (2.54 cm) of forward head posture, the head feels about 10 lbs. heavier to the muscles that attach to the back of the head and neck. To illustrate this, pick up a 10-pound object like a bowling ball and hold it close to your body. Then, hold it away from your body with your arm outstretched and feel how much heavier it seems and the strain it places on your body to maintain that position for even a short time.

In the short term, forward head posture is something the body can manage, but over time, the muscles can fatigue and the strain can injure the soft tissues in the back of the neck, shoulders, and upper back. To adapt, some muscles may become stronger (and some may atrophy), the shoulders can roll forward, the cervical curve can straighten, etc. Researchers have observed that forward head posture can also reduce neck mobility, especially with rotation and forward flexion movements. While these changes can lead to several negative health issues, neck pain is perhaps the most obvious and common.

When a patient presents for chiropractic care for neck pain, postural deficits will likely need to be addressed to achieve a satisfactory outcome. This can be achieved with manual therapies to restore proper motion in the affected joints and with exercises to retrain the muscles that may have become deconditioned. Additionally, a patient will need to develop better postural habits, especially when interacting with their electronic devices. While the process can take time, the good news is that it’s possible to reduce forward head posture, which can also lower the risk for neck pain recurrence.

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.

Common Shoulder Sports Injuries

10 Aug

With many sports requiring overhead movements that can place the shoulder at the extreme end of its range of motion, it’s not surprising that shoulder injuries are so common among athletes. For instance, up to 50% of NCAA college football players have some history of shoulder injury, which comprises about 10-20% of total injuries in the sport. When looking at collegiate quarterbacks, one study found that shoulder injuries accounted for more than half of injuries among players in the position. When it comes to sport-related shoulder injuries, these are the three most common (and to complicate matters, they often co-occur):

1) SLAP (or labrum) tears: Superior (top) Labral tear from Anterior (front) to Posterior (back) tear is a term used to describe a torn piece of cartilage located along the rim of the socket. The labrum adds depth to the cup, which helps to stabilize the ball in the socket. Individuals with a SLAP tear will often report a loss of motion and power, a feeling like their shoulder could pop out of socket, and a deep ache that is hard to pinpoint when attempting overhead movements.

2) Shoulder instability or dislocation: With contact sports, there’s the opportunity for a collision that can dislocate the ball of the shoulder joint (the end of the humerus bone) from the shoulder socket. Because the muscles in the front of the shoulder tend to be larger and stronger, the dislocation will more often occur in that direction. Symptoms can include a severe, sudden initial pain followed by short bursts of pain as well as swelling and a noticeable deformity in the appearance of the shoulder.

3) Rotator cuff tears (RCTs): This is common in sports that require repetitive overhead motion like baseball (especially among pitchers), swimming, and tennis. Symptoms include a deep, hard to locate ache, weakness, and reduced range of motion (especially overhead or to the back).

In general, early/prompt care yields the best results. While there are instances when a prompt surgical procedure is warranted, treatment guidelines typically emphasize non-surgical therapies first with surgery only after all other options have been exhausted. Chiropractic management of these conditions will often involve a multi-modal management approach that includes manual manipulation and mobilization to the shoulder’s multiple joints, the neck, and the mid back; specific shoulder exercise instruction; physical therapy modalities (ice, electrical stim, ultrasound, laser, pulsed magnetic field, and more); and nutritional recommendations.

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.
← Older Entries
Newer Entries →