Carpal Tunnel Syndrome – What Is It?

16 Jun

Carpal Tunnel Syndrome (CTS) basically occurs when pressure is applied to the median nerve as it travels through the wrist on the palm side resulting in numbness, tingling, pain, and later, weakness of the grip and pinch functions. But, the median nerve can be pinched at many other locations as it courses down from the neck to the hand, which is why we examine and treat the CTS patient from the neck down! The median nerve has been described as the “eye of the hand,” as it is one of the three major nerves formed from the brachial plexus– that “highway” of nerves made up of the C5-T2 roots leaving the neck, merging together to eventually form the three main nerves of the arm. Because the median nerve function regulates pinch and grip strength, buttoning a shirt, writing a note, driving a car, and even sleeping are ALL affected by a median nerve pinch. But WHAT is CTS? Let’s take an “inside” look!

We know that fast, repetitive motion-related jobs like meat or fish packing plants, assembly line work, sewing occupations, and the like can cause CTS over time. Look at the palm side of your wrist and wiggle your fingers. Do you see ALL THE MOVEMENT that is occurring just before the wrist in the forearm? That motion is coming from the tendons, which like shoe strings, attach the forearm muscles to the fingers. Notice ALL the movement in your forearm muscles closer to the elbow – that’s a lot of motion! There are nine tendons that are covered by a lubricating sheath that help the fast moving tendons reduce friction, thus decreasing the chances for heat build up, swelling (inflammation), and subsequent pain and loss of function. But, there is a limit or threshold that the tendons and sheaths can withstand before they just can’t keep up. These nine tendons and sheaths are quite tightly packed together as they leave the forearm and enter the carpal tunnel.

The carpal tunnel is made up of eight small wrist bones called the “carpal bones,” and ANYTHING that makes that tunnel more narrow can effectively cause CTS. If we look at what happens INSIDE the tunnel in the CTS patient, the venous blood flow and nerve flow (called “axonal transport”) is blocked when the PRESSURE inside the tunnel occurs. We all know what it feels like when a blood pressure cuff is inflated on our arm – if it’s pumped up too high or left on too long, the arm REALLY HURTS! That’s because the blood can’t get past the inflated cuff and oxygen can’t get to our muscles and tissues past the cuff and IT CAUSES PAIN!

To give you an appreciation of the pressure difference between the normal vs. CTS wrist, normally, the pressure ranges between 2 and 10 mmHg. We pump up a blood pressure cuff to about 150-200 mmHg when we take blood pressure, so this is NOT MUCH! This 2-10 mmHg pressure increases when we change the position of our fingers, wrist and forearm with wrist extension (bending the hand backwards), causing the greatest pressure increase. This is why we fit the CTS patient with a wrist “cock-up” splint to be worn at night since you can’t control your wrist position when you sleep and any bent position increases the pressure and can wake you up due to numbness, tingling, pain prompting you to shake and flick your hands and fingers until they, “…wake up.” When CTS is present, the pressure inside the tunnel goes up exponentially, meaning NOT 2 or 3 times, but 6, 12, 24 times what is normal and even higher! Now, if you add wrist bending (extension > flexion), the pressure REALLY gets high and it doesn’t take long for the nerve pinch and blood loss to wake us up. We’ve previously talked about other conditions that can make developing CTS more common or make it worse like hypothyroid, diabetes, arthritis, kidney disease, and more. AGAIN, this is because an increase is pressure results from these conditions (increased swelling = increased pressure = increased symptoms). As chiropractors, we will guide and manage your care through the healing process of CTS using a conservative, NON-SURGICAL treatment approach – TRY THIS FIRST!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

The “Aging” Lower Back – Part 2.

12 Jun

Last month, we started a series on low back pain (LBP) in the geriatric population, and we discussed osteoarthritis (OA) and degenerative disk disease (DDD). As reported last month, this group of conditions often co-exist in this population, so we will continue this discussion this month…

A unique condition associated with OA and DDD is called “spinal stenosis” (SS). Stenosis means “narrowing,” and it applies to two locations in the spine: 1) The holes through which the nerves in our neck and back exit out of the sides of the spine (called “intervertebral foramen” or, IVF); and, 2) The “spinal canal” through which the spinal cord travels. When narrowing occurs on the sides of the spine where the nerves exit, it’s called, “lateral spinal stenosis.” When the spinal canal narrows, it’s called “central spinal stenosis.” Our spinal cord starts up in the neck as an extension off the brain stem and usually ends at the junction between the middle and lower back (around T12/L1) with the “cauda equina” (which literally means, “horses tail”) and extends downward. The cauda equina is made up of many nerves that travel down and exit out the sides of the lumbar spine (through the IVFs) and sacrum (tail bone) and transfer information (motor and sensory) to and from our legs and brain. When the size of the canal through which these nerves travel close down or narrow enough, sufferers will initially start feeling vague symptoms of leg heaviness or fatigue after walking for 30 or more minutes. As years pass and the IVFs or central canal become gradually more narrow, it may get to the point where a person can only walk a short distance because their legs, “…just won’t move.” A classic complaint of SS is only being able to walk for four to five minutes prior to needing to sit down for 30 seconds to a few minutes (usually five minutes at the most) after which time the leg complaints resolve and the process repeats itself. When the nerves are compressed in these tight canals and the legs become heavy and hard to move, the term, “neurogenic claudication” is used. Another “classic” finding of SS is that RELIEF occurs when the patient bends forward, such as on a grocery cart or, simply stopping and bending over can be immediately relieving in many cases.

Chiropractic adjustments and other techniques are often very helpful in these cases if it is not too far advanced. The good news is that it usually helps, so prior to considering surgery or injections for this, give chiropractic a try – it’s less invasive and safer. We can always refer you to the next step if the condition becomes too advanced and/or if the results become less satisfying.

Compression fractures are another common cause of back pain in the elderly population. They’re often caused by minor trauma in the presence of poor bone density (osteoporosis) which accounts for about 700,000 of the 1.5 million osteoporotic fractures. Interestingly, many patients do not know what they did to cause these fractures so only 25-30% actually go to doctors and have this positively diagnosed (by x-ray). Treatment varies depending on what the percentage of fracture occurred (a little vs. a lot), and in unstable cases, a procedure called kyphoplasty (where cement is injected into the collapsed vertebral body) may be appropriate. As chiropractors, we can help this population by offering nutritional counseling to improve bone density and often provide symptomatic relief with adjustments (low force types) and other modalities.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.

Next Time You Drop Food on the Floor…

10 Jun

When you drop food on the floor, do you pick it up and eat it? If you do, you are not alone. According to a new study, 87% of people questioned said they would or already have eaten food that was dropped on the ground. Fifty-five percent of these people were women. Here is the most surprising statistic: 81% of the women who would eat the food follow what is known as “the five-second rule.” This “rule” states that food dropped on the floor is okay to eat as long as it is picked up within five seconds. Crazy? Perhaps, but there is also some science behind the idea. A new study recorded the transfer of certain common bacteria from the different types of floors to food over time (3-30 seconds). Both the type of floor and time had an impact on the transfer of bacteria. Bacteria was least likely to transfer to carpeted surfaces and most likely to transfer to tile or laminate surfaces. The bacteria was most likely to transfer to the dropped foods if they remained on the ground for more than five seconds. It also depends on how contaminated (clean or dirty) the floor surface is so don’t laugh the next time someone drops food on a seemingly clean floor, picks it up, and eats it claiming they’re abiding by the five-second rule!

Multiple Studies Show Breastfed Babies Have Higher IQs – But There is More to the Story…

9 Jun

There is quite a bit of proof that breastfeeding is superior to not breastfeeding. One benefit that has been shown in several studies is that breastfed babies have higher IQs and perform better in school. Well, now a new study sheds even more light on this subject. According to Sciencedaily: “A new study by sociologists at Brigham Young University pinpoints two parenting skills as the real source of this cognitive boost: Responding to children’s emotional cues and reading to children starting nine months of age. Breastfeeding mothers tend to do both of those things, said lead study author Ben Gibbs.” This study was published in the March 2014 issue of the Journal of Pediatrics. In other words, the authors do not believe the breast milk itself is the reason for the higher IQ and “smarter babies.” Instead, they believe it is the parenting that makes the difference.
Child development expert from Wayne State University, Dr. Sandra Jacobson, praised the study and said, “Children in the study who were breastfed for six months or longer performed the best on reading assessments because they also experienced the most optimal parenting practices.” It seems that parents who make the decision to breastfeed are also willing to make the decision to do other things that maximize the development of their children.

13 Facts You May Not Know About Your Own Body!

5 Jun

1. Nerve impulses in the brain travel as fast as 170 miles per hour (105.6 km/hr).
2. The brain operates on the same amount of power as a 10-watt light bulb.
3. Your brain uses 20% of the oxygen that enters your blood stream.
4. The brain is more active at night than during the day.
5. Eighty percent of the brain is water.
6. The largest internal organ is the small intestine.
7. The heart creates enough pressure to squirt blood 30 feet (~9 meters).
8. The acid in your stomach is strong enough to dissolve razorblades.
9. The surface area of a human lung is equal to a tennis court.
10. The hardest bone in the body is the jawbone.
11. The feet account for one quarter of all the human body’s bones.
12. The tooth is the only part of the body that can’t repair itself.
13. Facial hair grows faster than any other hair on the body.

“Success is 99% Failure.” This was one of his mottos. Find out who said this and how poor performance in school turned him into one of the biggest success stories in the world.

4 Jun

The year was 1906. The day was November 17th. The place was Hamamatsu, Japan. On that day, a baby was born that would have a major impact on the vast majority of people in the United States, Japan, and countless countries around the world.
That was the day Soichiro Honda was born. Yes, the baby born on that day would start and build the Honda Motor Company into the giant it is today.
But, it was not always smooth sailing. In fact, little Soichiro Honda got off to a pretty rough start, especially in school…
Soichiro’s father was a blacksmith and ran a bicycle repair business on the side. He would buy broken down bicycles for a cheap price, fix them, and sell them for a small profit. It is reported that Soichiro was helping his father, “straight from the cradle.” Though Soichiro was intelligent, he wanted nothing to do with formal education… and his grades reflected it.
At his school, all students were given grade reports that their parents were to stamp with their family seal. Because he did not want his parents to see his grades, Soichiro re-created their family seal stamp out of an old tire. He stamped his report card and brought it back to school.
It worked, but Soichiro did not stop there. He started helping out his friends and making family seal stamps for them as well. That is, until Soichiro make a critical error. His family name was symmetrical so it did not need to be made in reverse on the stamp. But, his friends’ family names were not symmetrical. Soichiro did not recognize and his friend’s new seals stamped backwards! The teacher noticed the mistake and Soichiro found himself in very hot water.
Soichiro’s father was very upset. He was so upset that he made Soichiro kneel in the corner for an entire day. But this story has a little twist…
You see, Soichiro’s father was not upset because Soichiro forged the family stamps. He was upset because he did not pick up on the mirror imaging and made the stamps incorrectly. That’s why he punished him.
This lesson and others like it stuck with Soichiro, and they served him well when he met with failure after failure a little later in life when he had a dream to create a piston ring engine. He devoted his entire life to accomplishing this goal. He invested all of his money (he even brought his wife’s jewelry to the pawn shop) and sunk it into his dream.
He went back to school only to drop out because he refused to take the examinations. He founded his own company (Tokai Seiki) and was doing business with Toyota until World War II put a stop to it. Once again, he did not quit. In 1946, he started “Honda Technology Research Institute” and started making mopeds. Within two years, Honda Technology Research Institute became Honda Motor Company.
In the 1960s, Soichiro fulfilled a dream and started producing cars. I think we all know where this story ends. Clearly, the take home message is that success is rarely, if ever, a straight line. There are always twists and turns. Disappointment and adaptation. More failure than success. But thank goodness you can fail 99% of the time and still be successful in the end. You just have to be willing to fail.

← Older Entries
Newer Entries →