1.) Women have a better sense of smell than men. 2.) When you take a step, you use up to 200 muscles. 3.) Your ears secrete more earwax when you are afraid than when you aren’t. 4.) The human brain has the capacity to store everything you experience. 5.) It takes twice as long to lose new muscle if you stop working out than it did to gain it. 6.) The average person’s skin weighs twice as much as their brain. 7.) Every year your body replaces 98% of your atoms. 8.) On average, there are 100 billion neurons in the human brain. 9.) The lifespan of a taste bud is ten days. 10.) Dentists recommend you keep your toothbrush at least 6 feet away from a toilet to avoid airborne particles caused by flushing. 11.) Your tongue is the only muscle in your body that is attached at only one end. 12.) Your stomach produces a new layer of mucus every two weeks so that it doesn’t digest itself. 13.) It takes about 20 seconds for a red blood cell to circle the whole body. 14.) The pupil of the eye expands as much as 45% when a person looks at something pleasing. 15.) Your heart rate can rise as much as 30% during a yawn. 16.) Your heart pumps about 2,000 gallons of blood each day. 17.) Your heart beats over 100,000 times a day. 18.) Your hair grows faster in the morning than at any other time of day. 19.) Your body is creating and killing 15 million red blood cells per second. 20.) You’re born with 300 bones, but when you reach adulthood, you only have 206!
Chiropractic Management of Shoulder Pain
16 MarBy some estimates, shoulder complaints affect nearly half of the adult population in a
year, driving many to chiropractic offices looking for a conservative, non-surgical solution.
While back pain and neck pain are the primary reasons patients seek chiropractic care, at least
one study found that 12% of chiropractic visits in a week may involve shoulder issues. How
would a chiropractor manage a shoulder complaint?
The shoulder complex itself is made up of four separate articulations—the glenohumeral
joint, the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic joint—that
work together to support the wide range of motion available to the arm. These joints, along with
the tendons, ligaments, muscles, and other soft tissues involved in upper extremity movement,
are all at risk of injury. When assessing treatment, the first step would be to conduct a thorough
examination to properly diagnose which components of the shoulder are contributing to the
patient’s chief complaints.
Because examination findings will vary, the specific treatment approach for a given
patient will be unique. However, in a general sense, multiple therapies are typically combined
with the goal of restoring normal movement to the affected joint(s). This may include manual
therapies (manipulation, mobilization, and soft tissue techniques), stabilization exercises,
stretches, physiotherapy modalities, and anti-inflammatory measures such as ice. Activities at the
extreme ranges of motion may be limited in the short term, with a gradual return to normal
activities within pain tolerances.
The shoulder does not exist in isolation, and several studies suggest that dysfunction in
the thoracic spine can affect movement of the scapula, which in turn can limit motion in other
aspects of the shoulder. In particular, a February 2024 study found that including mid-back
chiropractic adjustments in a treatment plan for adhesive capsulitis (frozen shoulder) improved
outcomes with respect to shoulder pain, disability, and function, and a January 2025 systematic
review and meta-analysis that included ten clinical trials found that thoracic spinal manipulative
therapy also improved outcomes for patients with subacromial impingement syndrome.
Chiropractic care has been demonstrated to benefit patients with various shoulder
complaints, and the treatments used are well supported in clinical guidelines as first-line
approaches. However, it should be noted that these conditions can have a difficult recovery
process, even if the patient undergoes surgery, and it can take months or even a year to restore
normal function to the affected joints.
Brent Binder, M.S.,D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
(717) 697-1888
In-Office and At-Home Neck Pain Management
9 MarNeck pain is estimated to affect approximately 30–50% of the adult population in the
United States each year, making it second only to low back pain as a primary reason patients
seek chiropractic care. The goal of chiropractic care for neck pain is to help restore normal joint
motion and function in the cervical spine, a process that is often a collaborative effort between
care delivered during office visits and self-care performed by the patient between visits.
During office visits, neck pain patients are commonly treated with manual therapies as a
primary intervention. High-velocity, low-amplitude spinal manipulation—sometimes
accompanied by an audible pop or crack—is the technique most commonly associated with
chiropractic care. Chiropractors are also trained in lower-force approaches, including
mobilization techniques and soft tissue therapies. Treatment plans may involve more than one
type of manual therapy depending on the tissues involved, patient presentation, and clinician
judgment.
In-office care may also include cervical traction, particularly when nerve irritation is
suspected to be contributing to symptoms. To assist with short-term symptom relief, patients
may receive adjunctive therapies such as electrical stimulation (e.g., TENS), therapeutic
ultrasound, low-level laser therapy, or heat or cold therapy. In some practices, massage therapy
provided by an on-site massage therapist may also be incorporated.
Between visits, patients are encouraged to take an active role in their recovery.
Continuing to pursue normal activities within pain tolerance helps prevent muscle
deconditioning (which can increase the risk of chronic pain) and supports joint health by
promoting nutrient exchange through movement. When muscle weakness or imbalance is
identified—which is common in neck pain—patients may be instructed in specific exercises to
perform regularly as time allows. Additional guidance may include recommendations for
sleeping positions, pillow selection, and temporary work or activity modifications to support
recovery. Anti-inflammatory strategies, including dietary modifications and selected
supplements, may also be discussed when appropriate.
Once pain and functional limitations reach maximal improvement, patients are typically
released from active care. Some may be advised to schedule wellness or maintenance visits on an
as-needed or periodic basis, along with continuing neck-healthy habits in daily life. Together,
these strategies may help reduce the likelihood of future episodes or allow a subsequent neck
pain episode to be addressed earlier before it interferes with normal activities or quality of life.
The Pain Mechanisms of Chronic Low Back Pain
4 MarIn simple terms, chronic low back pain is pain affecting the lumbar spine region that lasts
longer than three months. However, chronic low back pain is not simply acute (new) low back pain
that has failed to resolve. Rather, it often reflects an overlap of two or even three distinct pain
mechanisms, each of which may need to be addressed to achieve an optimal outcome: nociceptive,
neuropathic, and nociplastic pain.
Nociceptive low back pain arises from injury or irritation of non-neural tissues, including
muscles, ligaments, tendons, and joints. This type of pain is typically localized and may feel achy,
throbbing, or sharp with movement or certain positions. During a physical examination, a doctor of
chiropractic can often reproduce symptoms with palpation or specific movements. The term nonspecific low back pain is commonly used to describe pain that is predominantly nociceptive in
nature.
Neuropathic low back pain is caused by damage or disease affecting the nervous system
itself. In the context of chronic low back pain, this is most often associated with disk herniation
compressing a nerve root, degenerative changes (such as arthritis) narrowing the spaces through
which nerves travel, or postsurgical nerve injury. This form of pain is commonly described as
burning, shooting, or electric and often radiates along the course of the affected nerve. Patients may
also experience non-painful neurological symptoms, including numbness, tingling, weakness, or
altered reflexes.
Nociplastic low back pain typically develops over time in response to an initial injury or
episode of pain. This pain is characterized by altered pain processing within the nervous system and
is often associated with widespread or shifting pain patterns, heightened pain intensity, and increased
sensitivity to touch or movement. Patients with nociplastic low back pain may restrict movement and
daily activities out of fear of worsening their condition (kinesiophobia), describe pain in amplified or
distressing terms, feel poorly equipped to manage their symptoms, and commonly report poor sleep
and elevated stress. Coexisting conditions such as headaches, irritable bowel syndrome, or
fibromyalgia are also more prevalent in this population.
Because chronic low back pain often includes a combination of nociceptive, neuropathic, and
nociplastic components, treatment approaches must be individualized. A multimodal care plan may
include manual therapies, targeted exercises, physical modalities, and anti-inflammatory strategies
aimed at restoring normal motion and function to affected nerves, joints, muscles, tendons, and
ligaments. In addition, chiropractors may employ pain education and graded activity exposure to
address nociplastic factors and help patients regain confidence in movement. When appropriate,
referral to a medical physician or specialist may also be indicated—all with the goal of helping the
patient return to normal activities of daily living in the safest and most pain-free manner possible.
Excessive Smartphone Use Can Be a Pain in the Neck
18 FebSince their introduction and rapid adoption in the mid-2000s, smartphones have become an
integral part of daily life—not only by consolidating multiple technologies into a single device, but
also by helping us stay connected with family, friends, clients, and colleagues. However, alongside
these benefits, a growing body of evidence points to significant downsides. Excessive smartphone
use has been linked to poorer mental health—particularly among teens and young adults—and may
also negatively affect physical health.
Most notably, smartphone use typically involves prolonged downward gaze. While this
posture may seem harmless at first, over time the body adapts by rounding the shoulders and shifting
the head forward from its normal centerline. Beyond its impact on physical appearance, forward head
posture places increased strain on the muscles and tendons of the neck and upper back that work to
support the head. This pattern has been colloquially referred to as “tech neck” or “text neck.” In
addition to neck pain, forward head posture may increase the risk of headaches as well as pain in the
thoracic and lumbar regions of the spine. Moreover, screen time is often sedentary time, and
excessive device use is associated with prolonged sitting and reduced physical activity—factors that
can elevate overall chronic disease risk.
A 2017 study found that smartphone use tends to peak during young adulthood, with
approximately 1 in 5 university students meeting criteria for smartphone addiction—defined as a
pattern of compulsive smartphone use marked by loss of control, psychological distress when use is
restricted, and continued use despite negative impacts on daily functioning, relationships, or health.
Women were found to be at greater risk than men. In addition, up to half of young adults exhibit
problematic smartphone-related behaviors, suggesting that these devices exert a substantial influence
on this population.
To help curb excessive smartphone use, consider the following strategies: turn off nonessential notifications; establish phone-free times (such as before bed) and keep the phone in another
room to reduce temptation; avoid bringing the phone into the restroom; use “Do Not Disturb” mode
during focused tasks; install third-party apps to track and limit daily screen time; delete time-wasting
apps; rediscover hobbies to fill leisure time; keep a paper book on hand for passive commutes or
waiting periods; and tell friends and family about your goals so they can provide accountability and
support.
Finally, if you are experiencing chronic spinal pain related to prolonged smartphone use,
consider consulting a doctor of chiropractic. Chiropractors can provide in-office care to help reduce
pain and disability, as well as prescribe simple exercises and posture strategies that can be performed
between visits to help restore healthy spinal alignment.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888
Chronic Whiplash and Neck Muscle Endurance
16 FebWhiplash-associated disorders (WAD) is an umbrella term used to characterize the
myriad symptoms that can occur when soft tissues are injured during rapid acceleration and
deceleration of the head and neck in a whiplash event, such as a rear-end automobile collision.
Despite advances in the understanding and treatment of WAD, it is estimated that nearly half of
whiplash patients continue to experience ongoing pain and disability for a year or longer. Recent
studies have identified reduced neck muscle endurance as a risk factor for chronic WAD, but
what happens in a real-world setting when neck muscle strengthening is included as part of
treatment?
To explore this question, a May 2025 study recruited 140 patients with chronic WAD
who completed pre-intervention assessments of neck pain, neck-related disability, neck function,
and psychosocial factors. Participants were then assigned to one of two treatment groups: athome exercises delivered through Internet-based instruction or in-office exercises facilitated by a
physiotherapist. Treatment frequency ranged from two to four sessions per week over a twelveweek period. Participants completed the same assessments three months and fifteen months
following the conclusion of care.
The results demonstrated that both in-person and at-home exercise approaches produced
similar improvements in neck pain, disability, and function, and these improvements were
associated with increased neck muscle endurance. While this finding provides important
confirmation that addressing impaired neck muscle endurance may help reduce persistent WAD
symptoms, the results related to psychosocial factors—how a person perceives, responds to, and
recovers from neck pain and injury—were particularly noteworthy. The data showed significant
post-treatment improvements in self-efficacy, fear-avoidance beliefs, depressive symptoms, and
catastrophizing. This is especially meaningful, as these factors are known to be present early
after injury and are strongly associated with the development of chronic WAD.
While further research is needed to confirm these findings and better understand the
underlying mechanisms involved, the results suggest that assessment of neck muscle endurance
should be included as part of the initial clinical evaluation, with targeted exercises prescribed for
patients to perform between in-person visits with their chiropractor or other healthcare provider,
if needed. Beyond the personal and family-level benefits associated with successful WAD
recovery, any intervention that reduces the risk of chronic WAD may also offer substantial
macroeconomic benefits, including improved productivity and reduced litigation-related costs,
which could ultimately contribute to lower automobile insurance expenses.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888
It Isn’t Always Carpal Tunnel Syndrome
11 FebWhen symptoms such as pain, tingling, numbness, and weakness affect the hand, the first
condition that comes to mind for most people is carpal tunnel syndrome (CTS). While CTS is the
most common nerve entrapment affecting the upper extremity, it is far from the only possible cause
of these symptoms. So how does a chiropractor determine whether the problem is CTS or something
else?
The process begins with the patient completing a detailed health history that addresses both
current symptoms and relevant medical background. This information helps determine whether
compression of the median nerve—central to a CTS diagnosis—is likely, or whether one of the other
nerves supplying the hand should be considered. During the physical examination, the chiropractor
performs specific provocative tests to help identify where the median nerve—or another nerve—may
be restricted along its course. In some cases, though not routinely required, additional diagnostic
tools such as nerve conduction studies or ultrasound may be used to help confirm the diagnosis.
If symptoms primarily involve the thumb, index finger, middle finger, and the thumb-side of
the ring finger and are reproduced by wrist compression or sustained wrist positions, classic carpal
tunnel syndrome is likely. However, compression of the median nerve at other locations along its
pathway can produce a similar symptom pattern. Potential sites include the forearm, below or above
the elbow, the shoulder, and even the neck. To further complicate matters, nerve compression can
occur at multiple sites simultaneously. For example, a 2016 study found that approximately 1 in 16
patients with CTS also had median nerve compression in the forearm, a condition known as pronator
teres syndrome.
The ulnar nerve, which supplies sensation to the pinky and the ulnar side of the ring finger,
can also become compressed as it passes through a different anatomical structure at the wrist called
Guyon’s canal. As with the median nerve, restriction of the ulnar nerve anywhere along its course
from the neck to the hand can generate similar symptoms. The same principle applies to the radial
nerve, which innervates the back of the hand and can become irritated as it passes through the radial
tunnel near the wrist. This is why a thorough history and physical examination is so critical: the
history helps identify which nerve is involved and the examination helps pinpoint where compression
may be occurring.
In most cases, conditions involving median, ulnar, or radial nerve compression respond well
to a multimodal conservative treatment approach. This may include manual therapies such as
manipulation, mobilization, and soft tissue techniques; therapeutic exercises; nighttime bracing;
activity modification; and anti-inflammatory strategies. Importantly, outcomes are typically faster
and more favorable when patients seek care early, rather than waiting months or years before
consulting with a chiropractor.
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.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888
Pain Relief Chiropractic 