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Carpal Tunnel Syndrome Exercises

7 Aug

There are nine tendons that pass through the carpal tunnel at the wrist that connect the forearm muscles to the palm-side of the fingers. These tendons are encased in sheaths, and friction and heat can build-up inside these sheaths, leading to swelling, pressure, and pain (especially during fast, repetitive tasks). As the swelling increases and pressure builds up inside the tight space of the tunnel, the median nerve is pushed into the transverse carpal ligament, which serves as the floor of the tunnel, resulting in the symptoms we commonly associate with CTS. Stretching helps reduce this tightness and friction.

The stretching exercises listed below can BOTH help CTS as well as prevent it from occurring or re-occurring. As a warm-up:

  • Rotate the wrist in multiple directions—up, down, side-to-side, and figure 8s.
  • Spread your fingers as wide as you can and pull the fingers back using your other hand (or a wall) keeping the elbow straight.
  • Repeat step two, but this time, stretch the thumb back.

Repeat these steps five to ten times—enough to feel the forearms and hands loosen up.

The Prayer: Place your palms completely together like you are praying (keep the heels of the hands together) next to your chest and slowly lower the hands toward the floor while keeping the hands close to your body. Hold for 15-20 seconds.

Forearm Flexors: Arm straight, palm against the wall, fingers point downward, reach across and gently pull the thumb back. Hold for 15-20 seconds.

Forearm Extensors: Arm straight, back of the hand against the wall, fingers pointing downward. Hold for 15-20 seconds.

Repeat the above exercises three to four times and focus on feeling the muscles “release.” Try to do this three to five times a day, ESPECIALLY during the busy work day to “break-up” the monotony of fast, repetitive work tasks that can increase heat and friction in the sheaths surrounding the tendons that pass through your wrist.

Your doctor of chiropractic may recommend ice cupping over the wrist/s (palm side) and using a night splint on the affected wrist/s, in addition to exercises (like those above) and job modifications aimed at reducing CTS risk. Treatment may also include the use of manual therapies applied to the forearm, wrist, and hand, as well as the elbow, shoulder, and neck as these areas are frequently involved and must also be addressed to optimize the patient’s outcome.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 103
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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.

Pregnancy and Low Back Pain – Part 2

3 Aug

Back pain can become both more frequent and more intense as a pregnancy enters into the second and (especially) the third trimester. This is because the biomechanical changes that accompany pregnancy occur too fast for the body to properly adapt.

Besides the usual suggestions of bed rest, taking frequent breaks, using cold packs, and the like, there are many benefits derived from manual therapies such as manipulation, mobilization, massage, and exercise.

Chiropractors frequently offer these services, and one or a combination of these therapies can result in significant relief of back pain during pregnancy. One study reported that 94% of pregnant women receiving chiropractic treatment demonstrated clinically important improvement with substantial relief for several days following their initial treatment, with no adverse effects.

In a survey of 950 pregnant women and 87 medical providers, 31% responded that effective alternative therapies used during pregnancy included chiropractic care, massage, and yoga exercises. In a review of 400 pregnant female medical charts after delivery, 84% reported relief of back pain during the pregnancy with chiropractic care.

Studies have also shown that women with back pain during pregnancy have an elevated risk for a longer labor and delivery. Additionally, first-time pregnant women (primigravida) who received chiropractic care throughout their pregnancy averaged a 25% shorter labor time, while women who were pregnant after already having a child (multiparous) reported a 31% average shorter labor time.

Co-management and referrals between medical providers and chiropractors are becoming more common due to the growing amount of evidence published regarding the benefits of spinal manipulation during pregnancy.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Chiropractic Care and Its Many Benefits

31 Jul

Primarily, chiropractic focuses on the diagnosis and treatment of neuromuscular disorders with an emphasis on treatment utilizing manual adjustments and other types of manipulation and/or mobilization of the spine. Chiropractic is classified as a form of primary care, as anyone can choose to see a doctor of chiropractic without a referral.

A 2010 meta analysis reviewed a number of published studies to determine the strength of scientific evidence regarding the effectiveness of manual treatment for both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) conditions.

Lead author Dr. Gert Bronfort reviewed 49 relevant systematic reviews and 16 evidence-based clinical guidelines and concluded that he and the other authors of the analysis found SMT/mobilization to be effective in adults for the following: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; and several extremity joint conditions. Interestingly, Dr. Bronfort and his team noted thoracic manipulation/mobilization as effective for acute and subacute neck pain, but the evidence available at the time was inconclusive for cervical manipulation/mobilization alone for neck pain of any duration.

The evidence was also inconclusive for SMT/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Additionally, they found SMT/mobilization was not effective for asthma, dysmenorrhea (when compared to sham SMT), or stage 1 hypertension when added to an antihypertensive diet. In children, the evidence was inconclusive regarding the effectiveness of SMT/mobilization for otitis media and enuresis, and they also noted SMT/mobilization was not effective for infantile colic and asthma when compared with sham SMT.

In a 2014 follow-up study, lead author Dr. Christine Clar confirmed most of the previously “inconclusive” or “moderate” evidence ratings of the 2010 evidence report. However, the availability of new research motivated Dr. Clar to note moderate evidence for these conditions: manipulation/mobilization (with exercise) for rotator cuff disorders, spinal mobilization for cervicogenic headache, and mobilization for miscellaneous headache.

These two meta-analyses are significantly helpful for those considering chiropractic care for specific conditions. Reviews like this are planned for the future, and the list of conditions that respond well to chiropractic care should expand as areas that need further study are determined and more research is published.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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.

Chronic Pain and Whiplash

24 Jul

Most sprains and strains typically take six weeks to recover, provided the patient receives proper care, which may include self-management strategies. However, something is different about a whiplash associated disorders (WAD) injury in that many patients do not recover.

At the Whiplash 2017 Symposium held in Australia, Dr. Michele Sterling stated, “Whiplash associated disorders are a costly burden to Australian society. Up to 50% of people who experience a whiplash injury will never fully recover. Whiplash is resistant to treatment and no early management approach has yet been shown to prevent chronic pain. We are hoping this study will provide a promising treatment for chronic pain.”

Experts in the field presented important information about the development and prevention of disorders associated with a WAD injury such as chronic pain, post-traumatic stress disorder (PTSD), and depression after trauma. The University of North Carolina’s Dr. Samuel McLean reported that approximately 30% of people present to the emergency room (ER) in developed countries after trauma exposure (such as car accidents) and approximately nine out of ten are discharged without proper evaluation of these common neuropsychiatric problems. One problem in making a neuropsychological diagnosis is that these conditions often develop sometime after the initial presentation to the ER.

Dr. McLean and his team are currently researching the biological basis of brain injury in a new unprecedented study.  Participants will be enrolled at the immediate post-trauma level and will receive a comprehensive evaluation including genomic, neuroimaging, neurocognitive, behavioral, and symptom assessments. Dr. McLean states that WHEN the biology of PTSD, depression, and chronic pain is understood, then proper tools can be developed to identify the disorders and interventions to treat them can be achieved.

The problems associated with traumatic brain injury (TBI) are not new, but TBI is rarely dealt with until long after the WAD injury. Part of this is due to a lack of understanding of TBI on the doctor’s part and the other is a reluctance to discuss the symptoms of cognitive dysfunction on the patient’s part. This is because the symptoms are often vague, hard to describe, or somewhat embarrassing.

Questions specifically related to TBI include: Do you have problems staying on task? Do you easily lose your place during a discussion or thought process? Do you have to review your work more times than usual? Does it take longer to process information that you hear or read? Do you have mental fog?

Often, only when these questions are asked will the patient and doctor realize that there may be the need for a thorough neuropsychological evaluation. This study hopes to be able to develop new tools for evaluating TBI and to develop new interventions to help these patients.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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.

Chiropractic Care and Headaches

17 Jul

The cervical spine is often implicated in the onset and/or presence of headaches. This is due in part to the first three cervical nerve roots exiting out of the spine and enter the back of the head through a particularly thick group of muscles attached to the base of the skull along the nuchal ridge.

Anything that tightens up the upper cervical musculature can give rise to headache, and certainly stress has the unique characteristic of increasing neck muscle tension. Cervicogenic headache and tension-type headache are the two most commonly used terms associated with neck dysfunction.  Migraine headaches are a vascular type of headache, and these too can be greatly helped by spinal manipulation of the upper cervical region, though the mechanism of how this helps is less understood.

When patients see a chiropractor to treat their headaches, the paperwork they complete may include questionnaires regarding how their headaches impact both their wellbeing and their day-to-day activities. This data can be used to monitor a patient’s progress over time. Similarly, patients may be asked for data at each visit regarding the frequency, intensity, and duration of their headaches since their last visit in order to determine if a new approach to treatment should be considered.

Chiropractic offers multiple types of treatments with the goal of reducing neck and headache pain, restoring function to the vertebrae in the cervical spine—especially in the upper cervical region—and teaching the patient preventative methods of self-management such as exercises, ice and/or heat, and dietary modifications.

Because chiropractic includes an evaluation of the entire musculoskeletal system, a doctor of chiropractic may spot biomechanical faults lower in the body that may play a role in the headache process. A good example of this is a flat foot with ankle pronation, which creates a knocked-kneed effect and a drop in the pelvis on the same side. This can affect the curvature of the spine, causing stability issues up into the neck. In this case, prescriptive foot orthotics to correct the ankle pronation problem and/or a heel lift to correct a short leg can have dramatic benefits for headache sufferers, not to mention other spinal complaints such as low back pain.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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 Knee Cap and Knee Pain

13 Jul

The knee can be divided into four compartments—the front, inside, back, and outside—which intimately interact with each other. The compartment located in the front of the knee includes the knee cap (or patella), the groove in which it slides in, and the muscles that attach to the patella. The patella is the body’s largest “floating bone” (technically called a sesmoid bone). The function of the patella is to act as a kind of pulley that allows the knee to fully and easily extend. This area of the knee is often referred to as the “extensor mechanism”, as it is responsible for allowing the knee to extend or straighten.

When full extension cannot be accomplished, this is referred to as “extension lag” or “flexion contracture.” Extension lag is often caused by weakness of one of the four quadriceps muscles called the vastus medialis oblique (VMO), and depending on the cause of the weakness, exercises that specifically address this problem are very important in regaining the ability of the knee to fully lock out in extension.

Flexion contracture results in a similar inability to fully extend or straighten the knee, but the cause is not due to muscle weakness but rather the shortening or “contracture” of the muscles that flex the knee called the hamstrings, which are located behind the leg and knee. This can happen when patients are bed-bound, and it can become a permanent impairment if the hamstrings are not used or properly stretched on a regular basis.

Another problem associated with the patella is a softening of the cartilage behind the knee cap, which is called chondromalacia patella (CP). One symptom associated CP includes burning pain in the front of the knee, especially when the knee is bent for a prolonged period of time. Symptoms can be very intense but usually improve quickly once the knee is straightened out or the person can stand or walk.

The shape of the patella as well as the shape and depth of the groove in which the knee cap glides can be altered by trauma and/or genetic reasons. This can also predispose the patient to problems in this compartment of the knee. A common genetic example is an excessively knocked knee (technically called genu valgus). This results in the disproportionate rubbing of the patella on the outer ridge of the femoral groove, which can be painful.

Doctors of chiropractic are trained to assess, diagnose, and treat patients with knee pain utilizing manual therapies, modalities, exercise, and orthotics for foot/ankle conditions, as well as the application of braces and/or taping of the knee.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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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