Should Playing Music Create Tingling Wrists?

6 Mar

Carpal tunnel syndrome (CTS) is a condition caused when pressure is applied to the median nerve as it passes through the wrist. When playing a musical instrument, especially for hours at a time for several days in a row, the fast repetitive movements of the fingers can cause the tendons—all nine of them—that travel through the carpal tunnel to rub together, creating friction. This leads to heat and eventually swelling or inflammation, which manifests as pain, numbness, and tingling. Without treatment or modifications to your practice schedule, it is likely the numbness/tingling in your hands and fingers will gradually worsen and may even completely prohibit you from playing your instrument.

We must accept that every tissue in our body has a certain capacity or threshold, and if it is exceeded, problems will surface, and there are factors that can make some of us MORE SUSEPTIBLE to CTS. Some of these differences include: female gender, age over 50, hormone imbalances (low thyroid function, diabetes, and others), birth control pill (BCP) usage, pregnancy, obesity, and manually intensive jobs. Personality can even play a role—if you’re someone who will push yourself to play through the pain, then your risk for CTS is greater.

Because both hands are typically required to play an instrument, it is more common than not that BOTH hands may eventually become symptomatic if you don’t practice some VERY SIMPLE preventative “tricks of the trade.” So what are those tricks?

Take 30-60 second mini-breaks every hour during your practice sessions to stretch. Simply BEND your wrist and fingers back as far as you can with your other hand or against  a wall (fingers pointing downward) and try to touch your palm to the wall. Hold the maximum stretch for five to ten seconds and repeat until the forearm feels looser (usually three to four times).

Another “trick” is to wear a cock-up wrist splint at night, since we cannot control our wrist/hand position when sleeping. When the wrist is bent to its maximum, the normal pressure inside the carpal tunnel increases six times or more, which can REALLY irritate the median nerve.

Doctors of chiropractic can teach you proper exercises, fit you with a wrist splint, AND check to make sure pressure on the median nerve isn’t the result of dysfunction in other anatomical areas along the course of the nerve, such as the neck.

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

Do YOU Want to Avoid Back-Related Disability?

2 Mar

In 2008, a study published in the journal Spine sought to identify EARLY PREDICTORS in an effort to reduce the number of low back pain (LBP) patients who go on to experience long-term disability. Researchers followed 1,885 low back injury claimants for a year and then later reviewed data collected during the first three weeks following their injury to identify anything that might predict a greater risk of work-related disability one year later.

According to their findings, the factors that increase the risk of work-related disability include: injury severity, the type of healthcare provider from which they initially sought treatment; worker-reported physical disability, the number of pain locations, work-related stress; no available option for job accommodation (such as light duty); and a prior injury involving a month or more off work.

Of note, one VERY important factor mentioned in the study was the type of healthcare practitioner (HCP) the injured worker first consulted with for treatment. Those who sought chiropractic care initially were far less likely to become disabled (only 5%) than those who first visited doctors who specialize in primary care (12%), occupational medicine (26%), or “other” disciplines (23%).

Studies have also noted additional benefits by seeking chiropractic care for work-related musculoskeletal injuries versus other forms of healthcare delivery, as chiropractic care reduces the likelihood for extended time off work, results in less total healthcare costs, higher quality of life, fewer medications, fewer emergency department visits, and higher levels of patient satisfaction.

In addition, LBP Guidelines published in the United States and around the world consistently recommend spinal manipulation as a FIRST form of care for most types of low back pain based on these findings. We all have the option of seeking the type of care that we believe will best solve our problem. But with the findings reported in this and many other studies, evidence STRONGLY supports that seeking chiropractic IS the logical FIRST choice!

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

How Can I Improve My Sleep Quality?

27 Feb

Here are a few ways to improve your sleep quality in spite of a busy lifestyle:

  • SET A SCHEDULE: Set a time for BOTH going to bed AND getting up in the morning, preferably at the same times each day—even on weekends.
  • EXERCISE: Try to get 20-30 minutes of exercise every day (but NOT just prior to bedtime). FIRST thing in the morning is often the best time—before we can “talk” ourselves out of it!
  • AVOID CAFFEINE, NICOTINE, & ALCOHOL: These stimulate the brain and keep us awake. Caffeine sources include coffee, chocolate, soft drinks, non-herbal teas, diet drugs, and some pain relievers. Smoking promotes light sleep and early morning waking from nicotine withdrawal. Alcohol also interferes with deep sleep and REM sleep—especially when consumed before bedtime!
  • RELAX BEFORE BED: Take a warm bath, read (but not an action-packed book), and/or perform relaxation exercises before bedtime, as studies have demonstrated these to help one fall asleep.
  • SLEEP UNTIL SUNRISE: Try to wake up with the sun or turn on very bright lights in the morning. This helps “set” the body’s biological clock and exposure to morning sunlight can help people fall asleep later that night.
  • GET OUT OF BED: If you can’t sleep, do something like read, watch TV, or listen to music until you feel tired. Anxiety about NOT being able to sleep contributes to insomnia!
  • CONTROL ROOM TEMPERATURE: Keep the temperature comfortable. If the room is either too hot or too cold, it may prevent you from both falling asleep and also reaching deep, restful sleep when you do finally clock out.
  • SLEEP AIDS: These can include sleep supplements such as valerian root, melatonin, chamomile tea, and/or kava starting with a low dose and gradually increase it as needed.

Other “lifestyle” tips on getting a higher quality sleep include: 1) keep noise and light to a minimum (use earplugs, window shades, or an eye mask); 2) avoid large meals two hours before bedtime; 3) avoid afternoon naps; 4) stop mentally taxing tasks one hour pre-bedtime; and 5) avoid emotional discussions/thoughts right before bedtime.

This list is certainly finite and could go on much longer. The BOTTOM LINE is that if you need help, your doctor of chiropractic can offer a LOT of benefits and when necessary, can work with primary care physicians and sleep specialists—all in the quest of getting you to sleep!

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.

A Brief Look at Whiplash Injuries

20 Feb

Whiplash is an injury to the soft-tissues of the neck often referred to as a sprain or strain. Because there are a unique set of symptoms associated with whiplash, doctors and researchers commonly use the term “whiplash associated disorders” or WAD to describe the condition.

WAD commonly occurs as a result of a car crash, but it can also result from a slip and fall, sports injury, a personal injury (such as an assault), and other traumatic causes. The tissues commonly involved include muscle tendons (“strain”), ligaments and joint capsules (“sprains”), disk injuries (tears, herniation), as well as brain injury or concussion—even without hitting the head!

Symptoms vary widely but often include neck pain, stiffness, tender muscles and connective tissue (myofascial pain), headache, dizziness, sensations such as burning, prickly, tingling, numbness, muscle weakness, and referred pain to the shoulder blade, mid-back, arm, head, or face. If concussion occurs, additional symptoms include cognitive problems, concentration loss, poor memory, anxiety/depression, nervousness/irritability, sleep disturbance, fatigue, and more!

Whiplash associated disorders can be broken down into three categories: WAD I includes symptoms without any significant examination findings; WAD II includes loss of cervical range of motion and evidence of soft-tissue damage; and WAD III includes WAD II elements with neurological loss—altered motor and/or sensory functions. There is a WAD IV which includes fracture, but this is less common and often excluded.

Treatment for WAD includes everything from doing nothing to intensive management from multiple disciplines—chiropractic, primary care, physical therapy, clinical psychology, pain management, and specialty services such as neurology, orthopedics, and more. The goal of treatment is to restore normal function and activity participation, as well as symptom management.

The prognosis of WAD is generally good as many will recover without residual problems within days to weeks, with most people recovering around three months after the injury. Unfortunately, some are not so lucky and have continued neck pain, stiffness, headache, and some develop post-concussive syndrome. The latter can affect cognition, memory, vision, and other brain functions. Generally speaking, the higher the WAD category, the worse the prognosis, although each case MUST be managed by its own unique characteristics. If the injury includes neurological loss (muscle strength and/or sensory dysfunction like numbness, tingling, burning, pressure), the prognosis is often worse.

Chiropractic care for the WAD patient can include manipulation, mobilization, and home-based exercises, as well as the use of anti-inflammatory herbs (ginger, turmeric, proteolysis enzymes (bromelain, papain), devil’s claw, boswellia extract, rutin, bioflavonoid, vitamin D, coenzyme Q10, etc.) and dietary modifications aimed at reducing inflammation and promoting healing.

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

What Is Cervical Spondylosis?

16 Feb

Cervical spondylosis (CS) is another term for osteoarthritis (OA) of the neck. It is a common, age-related condition that you will probably develop if you live long enough. Or, if you suffered a neck injury as a youth, it can develop within five to ten years of the injury, depending on the severity.

It is basically caused by the “wear and tear” associated with normal daily living to which some refer to as “the natural history of degeneration.” According to the Mayo Clinic, CS or OA affects more than 85% of people over 60 years old, and that is probably a conservative estimate!

Common symptoms associated with CS/OA vary widely from no symptoms whatsoever to debilitating pain and stiffness. For example, when CS crowds the holes through which the nerves and/or spinal cord travel, it creates a condition called spinal stenosis that can result in numbness, tingling, and/or weakness. In severe cases, this can even affect bowel or bladder control (which is an EMERGENCY)!

CS occurs when the normal slippery, shiny cartilage surfaces of the joint(s) gradually thin and eventually wear away from excessive friction caused by years of repetitive use related to a job, sport, or just time. Bone spurs often form, which results from the body trying to stabilize an unstable joint. In some cases, the spurs can actually fuse a joint, which often helps reduce pain. (Bone spurs can also form if the intervertebral disks or shock-absorbing pads between the vertebrae are injured or become dehydrated due to arthritic conditions.)

Risk factors associated with CS include: aging, injury, years of heavy lift/carry job demands, and jobs and/or hobbies that require the neck to be outside of a neutral position (like years of pinching a phone between the ear and shoulder). Genetics and bad habits (like smoking) also play a role in CS. Obesity and inactivity also worsens the severity of CS symptoms.

The good news is that even though most of us will have CS, it is usually NOT a disabling condition. However, CS may interfere with our normal activities. Depending on its location, pain may feel worse in certain positions, like when sneezing or coughing or with movements like rotation or looking upwards.

Stiffness is a common symptom, which can vary with weather changes. Too little as well as too much activity can be a problem, but the BEST way to self-manage CS is to keep active! Range of motion exercises, strength training, and walking all help reduce the symptoms of CS.

Doctors of chiropractic are trained to identify CS/OA. Gentle manipulation, mobilization, nutritional counseling, exercise training, modalities (and more) can REALLY HELP!

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

Is Your Shoulder Pain Caused By a Rotator Cuff Tear?

13 Feb

One of the most common causes of shoulder pain is a rotator cuff (RC) tear. To determine just how common this is, one study looked at a population of 683 people regardless of whether or not they had shoulder complaints. There were 229 males and 454 females for a total of 1,366 shoulders. (The participants’ average age was 58 years, ranging from 22 to 87 years old.)

The research team found 20.7% had full thickness rotator cuff tears. Of those with shoulder pain, only 36% had tears found on ultrasound. Of those without shoulder pain, 17% also had tears! Risk factors for an increased for tearing of the rotator cuff include a history of trauma, the dominant arm (ie your right arm if you’re right handed), and increasing age.

In a review of radiologic studies of 2,553 shoulders, researchers found full-thickness rotator cuff tears in 11.75% and partial thickness tears in 18.49% of the subjects for a total of 30.24% having some degree of tearing. In this group, about 40% of tears were found in pain-free shoulders. The researchers concluded that rotator cuff tears are common and frequently asymptomatic.

Both of these studies support the necessity to FIRST consider the patient’s clinical presentation and then correlate that with the imaging results. In other words, the presence of a RC tear on an image (usually MRI or ultrasound) does NOT necessarily mean there is pain (and vise versa)!

So what other things could be causing the shoulder pain? There are many: impingement, tendonitis, bursitis, muscle strain, capsular (and other ligament) sprain, frozen shoulder, and osteoarthritis (the “wearing out” type). Also, rheumatoid arthritis, lupus, polymyalgia rheumatica and other autoimmune types of “arthropathies,” fibromyalgia, a herniated cervical disk, shoulder dislocations, whiplash injuries, and more!

Most importantly, we must NOT forget to include referred pain to the shoulder from an impaired heart (such as coronary heart disease or heart attack), lung, liver, or gall bladder as these problems commonly refer pain to the shoulder and may represent a MEDICAL EMERGENCY!

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

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