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!
Hip Pain Characteristics That Can Inform Diagnosis
9 AprThe hip is a ball-and-socket joint in which the femoral head meets the pelvis, supported by
several layers of cartilage and other soft tissues that allow for a wide range of motion. While this
design provides mobility, it also creates multiple opportunities for instability and irritation that can
result in what is generally referred to as hip pain. However, there are many potential causes of hip
pain, and the specific characteristics of a patient’s symptoms can help guide the healthcare
provider—such as a doctor of chiropractic—on what to evaluate during the physical examination.
Anterior (front) hip pain may suggest osteoarthritis, particularly in middle-aged and older
individuals with gradual symptom onset and pain that increases after prolonged sitting or walking. In
contrast, younger and more athletic adults who present with groin pain that worsens during hip
flexion and rotation may have femoroacetabular impingement or a labral tear. Sport collisions or
other forms of trauma can also result in hip flexor muscle strains that produce pain in the front of the
hip.
Lateral (side) hip pain is often associated with greater trochanteric pain syndrome, especially
in middle-aged women who report discomfort when lying on the affected side. In many cases, there
is no clear inciting injury, and the area may be painful or tender when touched or palpated.
Posterior (back) hip pain is less commonly due to a primary hip joint condition and is more
often referred from another structure. Potential sources include the lumbar spine, sacroiliac joint
dysfunction, deep gluteal syndrome (also known as piriformis syndrome), or strain or tendinopathy at
the proximal hamstring attachment.
Certain red-flag conditions require urgent referral to an emergency department or specialist.
These include femoral neck fracture—typically in older adults with osteoporosis or after a fall or
trauma—often presenting with inability to bear weight and a shortened, externally rotated leg; septic
arthritis, which may involve fever, severe joint pain with movement, and elevated inflammatory
markers on blood or joint fluid testing; and avascular necrosis, in which interruption of blood supply
to the femoral head causes bone tissue death, potentially leading to joint collapse, chronic pain, and
limited mobility (often requiring MRI for diagnosis).
The good news is that many causes of hip pain, aside from these red-flag conditions, respond
well to conservative chiropractic care. Treatment is often multimodal and may include a combination
of manual therapies such as manipulation, mobilization, and soft-tissue techniques; therapeutic
exercises and stretching; temporary activity modification followed by gradual return to normal
activities; physiotherapy modalities to support healing; and nutritional recommendations aimed at
reducing inflammation. If dysfunction in an adjacent area, such as the low back or knee, is
contributing to the hip condition, these regions may also need to be addressed to achieve the best
outcome
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
A Role for Chiropractic in Managing Chronic Rhinosinusitis
6 AprChronic rhinosinusitis is an inflammatory condition of the nasal and sinus lining that lasts
longer than twelve weeks. It’s estimated that roughly 10–12% of adults in the United States are living
with chronic rhinosinusitis at any given time, with many experiencing symptoms for years. Managing
the condition can be challenging, as it’s driven by a mix of contributing factors that may include
chronic inflammation of the sinus lining, immune dysregulation, lingering microbes, structural
factors, and environmental exposures such as air pollution and cigarette smoke. Because the
accumulation of fluid and inflammatory material in the sinuses is a key component of the disease
process, treatments that help facilitate drainage may provide symptom relief. To that extent, therapies
provided by doctors of chiropractic may have a role in caring for some patients with chronic
rhinosinusitis.
Manual therapies performed by chiropractors can help address fluid build-up both directly
and indirectly. Specific techniques such as lymphatic drainage use gentle manual pressure and
stretching to stimulate lymphatic vessels that help move excess fluid out of tissues, which may
reduce pressure and congestion. Tightness in the muscles and soft tissues that attach to the head and
neck can also restrict normal fluid movement. For this reason, myofascial release, mobilization, and
manipulative therapies aimed at restoring normal motion in the face, head, neck, and upper back may
be beneficial for some individuals.
This potential benefit is illustrated in a case series involving 14 patients with chronic
rhinosinusitis who also experienced craniofacial pain. Those who received manual therapy to address
craniofacial dysfunction over a seven-week period reported improvements in both craniofacial pain
and the severity of their sinus symptoms, while patients in a comparison group that did not receive
hands-on care reported no meaningful improvement.
Additional studies suggest that manual therapies may help improve sinus drainage, reduce
facial pain and pressure, enhance nasal airflow, and improve quality of life—particularly when
chronic rhinosinusitis is accompanied by neck muscle tension or headaches associated with cervical
spine dysfunction. Other reports indicate that some patients who have not responded to conventional
medical management, including those who have undergone sinus surgery or who wish to avoid
surgery, may experience symptom relief with conservative manual therapy treatment.
While current evidence does not support chiropractic care as a first-line treatment for chronic
rhinosinusitis, manual therapies provided by doctors of chiropractic may play a supportive role as
part of a comprehensive care plan. This may be especially relevant for patients who have difficulty
managing symptoms with usual care alone. Individuals interested in this approach should speak with
their healthcare provider to determine whether a trial of chiropractic care may be appropriate for their
situation.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
Core Strengthening to Reduce Low Back Pain Risk
2 AprLow back pain is one of the most common and disabling conditions worldwide. It’s estimated that
nearly 200 million acute episodes of low back pain occur each year, of which roughly 20% persist for longer
than three months. With the aging of the global population combined with the obesity epidemic, low back pain
is expected to become an even more substantial physical health issue in the coming decades.
Because weakness in the core muscles that help stabilize the spine has been linked to up to a threetimes increased risk of new-onset low back pain, improving endurance and control in this muscle group may
help reduce one’s risk. The core muscles include the abdominals, back, and gluteal muscles. In addition to
stabilizing the spine to help stay upright, strong core muscles are important for maintaining balance through
proprioception and for supporting the wide range of motion the trunk performs—from rotation, to bending
forward, to side-bending, and backward movement. Key core-strengthening exercises include:
- Front plank: Lie face down and prop yourself up on your elbows under your shoulders. Lift your body
onto your elbows and toes (or knees for an easier version). Keep your body in a straight line from
shoulders to heels, tighten your stomach and glutes, and avoid letting your hips sag or rise. Hold 10–
30 seconds, repeat three to five times, working up to a 60-second hold. - Side plank: Lie on one side with your elbow directly under your shoulder. Lift your hips off the floor
so your body forms a straight line from shoulders to feet. Keep your core tight and don’t let your hips
roll forward or backward. For an easier version, bend your knees and lift your hips. Hold 10–25
seconds per side and repeat three to five times. - Bird dog: Start on hands and knees with hands under shoulders and knees under hips. Tighten your
stomach slightly and keep your back flat. Slowly extend one arm forward and the opposite leg
backward. Keep hips level and avoid arching your back. Hold for five to ten seconds, return to start,
then switch sides. Do eight to twelve repetitions per side. - Glute bridge: Lie on your back with knees bent and feet flat on the floor about hip-width apart.
Tighten your stomach and squeeze your glutes. Lift your hips until your shoulders, hips, and knees
form a straight line. Avoid arching your lower back. Hold three to five seconds at the top, then slowly
lower. Perform ten to fifteen repetitions for two to three sets. - Dead bug: Lie on your back with arms straight up and knees bent at 90 degrees. Tighten your stomach
gently so your lower back stays flat against the floor. Slowly lower one arm overhead and extend the
opposite leg toward the floor. Only go as far as you can without your back arching. Return to start and
switch sides. Perform eight to twelve slow, controlled repetitions per side.
Further strategies to reduce the risk of low back pain include maintaining a healthy weight; improving
workstation ergonomics; practicing good posture, especially when sitting and lifting; engaging in regular lowimpact aerobic exercise such as walking or swimming; following a balanced, minimally processed dietary
pattern (such as a Mediterranean-style diet); avoiding tobacco use; and stretching before and after physical
activity, especially the hamstrings which are often overly tight in low back pain cases. While these practices
may not completely prevent low back pain, they can improve the changes for a speedier recovery as well
reduce the risk of recurrence.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055 (717) 697-1888
A Practical Tool for Assessing Health and Longevity
30 MarAs we age, it is natural to become more concerned about our longevity, especially if we have
experienced health challenges or engaged in unhealthy behaviors earlier in life. One way to assess probabilistic
near-term (under five years) and long-term (10–25 years) mortality risk is to use an assessment known as the
Deficit Index, also called the Frailty Index. Essentially, the index evaluates health across many different
domains. Each item is scored as 0 (not present), 0.5 (a mild or partial problem), or 1 (a severe or fully present
problem). The individual deficit scores are added together and then divided by the total number of items
assessed (61 in this example) to produce a final index value between 0 and 1. Below are commonly included
deficit domains:
- Chronic Medical Conditions: Hypertension, diabetes mellitus, coronary artery disease, stroke or TIA,
osteoarthritis, osteoporosis, chronic lung disease, chronic kidney disease, cancer (current or past) - Activities of Daily Living (ADLs): Difficulty bathing, dressing, transferring, using the bathroom,
feeding, shopping, managing medications, managing finances, preparing meals, using transportation - Mobility & Physical Performance: Difficulty walking one block, difficulty climbing stairs, slow
walking speed, poor balance, use of cane/walker/wheelchair, fall/s within previous year - Symptoms & Somatic Complaints: Chronic pain, fatigue or low energy, shortness of breath, dizziness,
poor appetite, sleep problems, urinary incontinence - Cognitive Function: Memory complaints, difficulty concentrating, diagnosed mild cognitive
impairment, dementia, difficulty following instructions - Psychological & Emotional Health: Depressive symptoms, anxiety, low mood most days, anhedonia,
high perceived stress, poor coping skills - Sensory Impairments: Poor vision (even with correction), poor hearing, difficulty communicating due
to sensory loss - Nutrition & Body Composition: Unintentional weight loss, low BMI, sarcopenia or muscle weakness,
difficulty chewing or swallowing - Social & Environmental Factors: Living alone, social isolation, limited social support, financial strain,
low physical activity, limited access to care - Laboratory & Physiological Abnormalities: Anemia, elevated inflammatory markers, abnormal
glucose regulation, low vitamin D, reduced kidney function markers
In population studies, scores below 0.10 are considered robust and associated with low mortality risk
over the next 10–20+ years; scores of 0.10–0.15 are considered pre-frail and associated with low five-year
mortality but increased 10–20 year risk; scores of 0.15–0.25 indicate moderate frailty and a substantially
elevated 5–10 year mortality risk, with many studies showing a roughly 50–70% chance of death within the
next decade; scores of 0.25–0.40 indicate severe frailty and high near-term mortality, with up to a 50% chance
of death within ~3 years and very high five-year mortality; and scores of 0.40 or higher indicate extreme frailty
and are associated with very high 1–3 year mortality and markedly shortened survival.
Importantly, this assessment and others like it are not intended to predict exactly how many years any
one individual has left. Rather, they help visualize how multiple health factors combine to reflect overall
biological aging and vulnerability. The goal is not fatalism, but insight, so that efforts to improve strength,
nutrition, mobility, mental health, sleep, and social connection can reduce frailty, improve quality of life, and
potentially extend both lifespan and health span.
Brent Binder M.S., D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
(717) 697-1888
Whiplash-Related Somatosensory Tinnitus
25 MarMost people associate tinnitus with excessive noise exposure, such as the ringing that
can follow a rock concert. However, tinnitus can also develop following a whiplash event,
such as the rapid acceleration and deceleration of the head and neck that occurs during a
motor vehicle collision. While a crash may involve loud noises that can temporarily affect
hearing, the persistent nature of tinnitus associated with whiplash-associated disorders
(WAD) suggests a different underlying mechanism.
Research in this area is ongoing, but the leading explanation involves a process
known as somatosensory modulation. The nervous system has sensory receptors throughout
the body that relay information to the brain, where it is interpreted as somatosensory input—
including touch, body position, temperature, and pain. Importantly, the somatosensory
system shares neural connections with other sensory systems, including the auditory system.
When somatosensory input is altered—due to injury, irritation, or persistent pain
signals from tissues of the head and neck—it can interfere with how the brain processes
information from other systems, such as sound. In this way, whiplash does not necessarily
cause direct injury to the auditory system. Instead, injury to cervical muscles, joints, or
related nerves may disrupt normal sensory signaling, leading the brain to misinterpret
auditory information and produce the perception of ringing in the ears.
In June 2025, researchers studied 80 patients experiencing WAD-associated tinnitus
and assigned them to either an intervention group or a control group. The intervention group
received a combination of manual therapy, stretching exercises, and relaxation techniques
aimed at reducing muscle tension and addressing myofascial trigger points in the head and
neck region, while the control group was placed on a waitlist and received no treatment. As
expected, patients in the intervention group demonstrated improvements in pain and cervical
range of motion. Notably, they also reported a reduction in tinnitus symptoms, suggesting
that addressing dysfunction in the head and neck may help normalize somatosensory
modulation contributing to tinnitus.
Doctors of chiropractic commonly incorporate these types of therapies as part of a
multimodal approach to managing patients with whiplash-associated disorders. Restoring
normal motion and function to the cervical spine may help alleviate not only neck pain but
also associated symptoms, such as tinnitus. In cases where symptoms do not improve,
referral to an appropriate medical specialist may be warranted.
Brent Binder M.S.,D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
(717) 697-1888
Wrist Tendonitis vs. Carpal Tunnel Syndrome
23 MarFast and repetitive hand and finger movements with little rest time can cause the sheaths that cover the
tendons passing through the carpal tunnel to become inflamed, placing increased pressure within the tunnel,
compressing the median nerve, and stimulating the symptoms associated with carpal tunnel syndrome. Injury
or overuse of the tendons themselves can also cause symptoms that may be thought of as carpal tunnel
syndrome. How does a doctor of chiropractic determine which condition a patient has, carpal tunnel syndrome
or wrist tendonitis?
The first step involves the patient’s history and initial consultation. In addition to providing
information on their past and current health issues, the patient may be asked specific questions about their
presenting complaint, such as whether they recall what caused their symptoms, when the symptoms first
became noticeable, what makes the symptoms feel better or worse, what their exact symptoms are, and what
time of day the symptoms are best or worst, for example.
Based on the information provided, the chiropractor will conduct a physical examination. The exam
will include observation; palpation (touching and pressing); range of motion assessments of the arm, wrist,
hand, and fingers; and neurological tests of the upper extremity, including reflexes, muscle strength (such as
grip and/or pinch), and sensation testing (for example, light touch or distinguishing between sharp and dull).
To rule out red-flag issues—such as fracture or advanced joint disease—an X-ray may be ordered. Other
diagnostic studies, such as ultrasound or nerve conduction velocity testing, may be of use to help confirm a
suspected diagnosis.
If carpal tunnel syndrome is suspected, symptoms such as pain, numbness, tingling, and reduced
sensation will follow the course of the median nerve into the thumb, index finger, middle finger, and the
thumb-side of the ring finger, though symptoms may also travel up the forearm. Symptoms may worsen at
night and during the day when the wrist is bent up or down or held in one position for prolonged periods.
Orthopedic tests that involve flexing the wrists for 60–90 seconds, tapping over the carpal tunnel, and
manually compressing the carpal tunnel will also be positive in carpal tunnel syndrome. When performed, a
nerve conduction study will typically show slowed median nerve function across the wrist.
In cases of wrist tendonitis, pain will be localized to a specific tendon with tenderness at one precise
point, and symptoms will mostly be felt in the wrist or forearm rather than the fingers. Symptoms may be
described as achy, sharp, or pulling pain, without numbness or tingling, that worsens with gripping, lifting,
twisting, or resisted motion. With rest, symptoms will usually improve. Diagnostic imaging may show tendon
thickening or inflammatory changes.
Treatment will depend on examination findings, but in general, with carpal tunnel syndrome, the
approach used will be intended to reduce compression on the median nerve, potentially with activity
modifications and ergonomic changes to reduce inflammation while tissues heal. With wrist tendonitis, heavier
activity will be reduced initially to allow the tendon to recover, followed by specific exercises to increase
tendon strength and load tolerance. The good news is that doctors of chiropractic are well-equipped to
distinguish between these conditions and manage them using an effective, non-surgical, conservative approach.
Brent Binder M.S., D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
(717) 697-1888
Pain Relief Chiropractic 