Carpal Tunnel Syndrome, Inflammation, & Treatment Options

5 Jun

Carpal tunnel syndrome (CTS) belongs to a group of disorders called “entrapment neuropathies” and as the name implies, it is caused by the trapping of the median nerve in the carpal tunnel of the wrist. There are MANY ways to treat CTS, with some of the most effective focused on reducing inflammation.

Inflammation (from the Latin inflammatio) is commonly referred to as “swelling” and is a sequence of biological responses to harmful stimuli that include pathogens such as bacteria and viruses, damaged cells, and other irritants. It is a protective response to something abnormal that has occurred and involves our immune cells, blood supply, and more. Inflammation helps to eliminate the cause of cell injury, clean up necrotic or dead cells from area, and initiate the tissue repair process.

The hallmarks of inflammation include heat, redness, swelling, pain, and loss of function. With CTS, inflammation can arise from multiple causes. One common cause is from the rapid, repetitive rubbing together of the nine tendons that travel through the already tight carpal tunnel. This “mechanical” cause can be managed by modifying the activity by slowing down, taking breaks to allow the tissues to rest, and decreasing the force required by the job or task.

The inflammation associated with CTS can also arise from other causes that are less obvious and common than trauma or overuse. Some of these include (but are not limited to) rheumatoid arthritis (and other autoimmune forms of arthritis) and hormonal changes such as an overactive pituitary gland, an underactive thyroid, diabetes, taking birth control pills, or pregnancy.

Women are three times more likely to develop CTS than men. While hormones may play a role, women also have different shaped carpal tunnels and smaller wrists. Either way, the underlying cause must be dwelt with AS SOON AS POSSIBLE to reduce the pain, numbness, tingling, and loss of function. So how can we reduce inflammation?

An ice massage applied directly over the carpal tunnel/wrist is both easy to perform and very effective. Modifying activities that may be causing or irritating CTS is important but not always available. Night splints help to prevent extreme flexion or extension of the wrist and reduces sleep interruptions common with CTS. Chiropractic utilizes all the above plus manual therapies, like joint mobilization, and exercises/stretches that can be done at home.

As the Western diet may promote inflammation, your doctor may also recommend the Paleo diet, Mediterranean diet, or a gluten-free diet to aid in the recovery process.

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.

Exercises on a Swiss Ball Help Back Pain Patients!

1 Jun

In previous articles, we’ve explored how to individualize an exercise program for those with back pain. This month, we’ll look at why utilizing a Swiss ball may be more helpful for the back pain patient than simply doing floor-based exercises.

In a 2015 study published in the Journal of Sports Science and Medicine, researchers assigned twelve chronic (more than three months) low back pain (cLBP) patients to perform either floor- or ball-based exercises three times a week for eight weeks using four different motions or exercises.

Though subjects in both groups experienced improvements, the gains were much greater for those in the Swiss/gym ball group regarding functional improvement. CT scans of the participants in the ball group also revealed an increase in the cross-sectional area of the deep low back stabilizing multifidus (MF) muscles.

So why did the swiss ball patients fare better? A strong possibility is that the use of unstable devices such as a gym or Swiss ball forces the neuromuscular system to work harder to maintain balance. This process not only improves propropception— the body’s ability to sense where its various parts are in relation to one another for purposes of movement and balance—but it also works out additional muscle groups that are involved in normal everyday movement that may not be activated when exercising from the floor or another stable surface.

The four Swiss ball exercises included in the study:
1) Bridge-1: Lay supine (on your back) with the ball under your upper back and bring one knee toward the chest to a 90/90° hip/knee angle; hold ten seconds and repeat five times with each leg.
2) Bridge-2: Lay supine with your upper back on the floor with the ball under the pelvis; push down into the ball with the pelvis for ten seconds and repeat five times.
3) Bird-dog (kneel on all-fours—quadruped position): Place a small ball (4-6”) under one knee (kneel on it) and slowly lift and straighten the opposite leg and balance for ten seconds and repeat ten times with each leg.
4) “See-Saw:” Lay on your stomach with the ball under the pelvis/hips, balance on the forearms, raise the legs, and do a scissors-kick (as if swimming) for ten seconds ten times with each leg.

We encourage proper form and working safely within “reasonable pain boundaries” that YOU define. Gradually increase reps and sets as you improve, modify the methods, and most important, HAVE FUN!

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.

How You May Prevent a Stroke… Especially if You Experience Headache, Neck Pain, Chest Pain, and/or Visual Disturbance

29 May

We all know it’s smart to write down our symptoms before a visit to our healthcare provider, but most of us simply don’t take the time. In many cases, it may be only subtle symptoms that trigger a proper diagnosis. This is certainly true when it comes to stroke.

There are basically two types of stroke: hemorrhagic stroke and ischemic stroke. A ruptured aneurism, or a leak in an artery, can result in a hemorrhagic stroke while a blood clot that blocks an artery can give rise to an ischemic stroke. Both types often give immediate and obvious nervous system signs and symptoms that typically prompt a call for emergency services.

There is however, a less common and quite subtle type of stroke that is far less discussed and understood. This is called vertebral-basilar insufficiency (VBI) stroke, which is caused by vertebral artery dissection (VAD). This type of stroke is very rare and only occurs 0.75-1.12 times per every 100,000 person years. In VAD/VBI, there may not be ANY history of trauma or event that the person can identify, and it’s most common in 30-50 year olds (not in older-aged people like the other more common types of stroke), which also makes VAD/VBI far less suspect. Symptoms of VBI can be subtle but may include headache, neck pain, chest pain, and perhaps some transient or short-term visual disturbance (blurred vision or double vision, for example). The KEY is a sudden and/or “different” kind of headache, especially if it’s accompanied by some other unusual symptom.

In one case study, a 30-year-old female experienced an “unusual headache” and a short-term loss of her peripheral vision in her left eye with eyelid numbness. This patient also had a history of migraines that typically occurred at menstruation, which led to an inaccurate diagnosis of “ocular migraine”, and she was sent home from the ER. Soon after, she developed right-sided neck pain with a transient right-sided visual disturbance prompting her to visit a chiropractor. The “unusual type of headache” and the visual complaints that she didn’t previously have with her typical migraines caught her chiropractor’s attention. He then ordered a consult and an urgent MRA (magnetic resonant angiography) and MRI of the head confirmed the diagnosis of VAD. With a proper diagnosis and prompt treatment, her symptoms quickly resolved, and the follow-up MRA at the three-month point showed resolution of the VAD.

Neck pain and headaches are COMMON complaints for which people seek chiropractic care. In fact, chiropractic adjustments are strongly recommended in a number of current treatment guidelines. Had “a typical” chiropractic adjustment occurred and the diagnosis of VAD NOT been made, the patient may have progressed to a VBI stroke (which was already in progress BEFORE she even scheduled her chiropractic appointment). Other studies show that neck pain and headaches related to VAD precede visits to both doctors of chiropractic and medical doctors equally and subsequent treatments are typically NOT the cause, as the problem is already present. The good news is that VAD is very uncommon and will hopefully be caught by your doctor and promptly treated so stroke can be avoided.

 

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 Vitamin D and Whiplash Connection

22 May

As previously discussed, many patients with a whiplash injury also experience some degree of traumatic brain injury (TBI), which can prolong the recovery process. A 2012 study involving patients with severe TBI found the rate of favorable recovery increased 25% in participants who took a vitamin D supplement as part of their treatment plan. Why is that?

Vitamin D is a fat-soluble micronutrient that regulates inflammation and skeletal muscle size and function. Due to a systemic inflammatory response (specifically pro-inflammatory cytokines), studies have found that vitamin D levels can drop in the body by as much as 74% within three weeks of a major trauma or following a surgical procedure. This was observed in another study published in 2012 that found 77% of a group of 1,830 trauma patients had deficient or insufficient levels of vitamin D, REGARDLESS of age!

Unfortunately, experts estimate that between 30-50% of the United States population is chronically vitamin D deficient. Since vitamin D levels will drop as part of the healing process, you can imagine that people who already have poor vitamin D levels may be in for a longer course of recovery.

Not only that, but because vitamin D plays a role in keeping the musculoskeletal system strong and healthy, people with vitamin D deficiency may be at a greater risk for getting injured in the event of a car accident, collision, or slip and fall. Further, those who do get injured may have a greater risk for sustaining a more severe injury than they may might have had their vitamin D levels been adequate.

Most experts recommend spending time in the sun each day in order for the body to naturally produce vitamin D, but the combination of available sunlight due to latitude or time of year may make this less than practical. Thus, a vitamin D supplement is commonly recommended as part of a healthy lifestyle (minimum 1000 IU/day).

Doctors of Chiropractic commonly provide nutritional counseling which is a large part of the educational/treatment process. Other anti-inflammatory vitamins include magnesium, fish oil, ginger, turmeric, probiotics, and more. An anti-inflammatory diet can be extremely helpful as well!

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 for Neck Pain?… Really?

15 May

There have been MANY studies conducted on the benefits and efficacy of spinal manipulation to treat back pain—so much so that many medical doctors frequently refer patients with back pain to chiropractors for this service. But what about neck pain?

Although it’s taken a little longer to compile the evidence, there is now substantial research to support that spinal manipulation for neck pain is equally effective as it is for low back pain in regards to improving pain levels, function, and quality of life.

Multiple reviews and meta-analyses (studies that evaluate the research over a series of years) indicate that mobilization, manipulation, and exercise all work alone but appear to give the best long-term benefits when used in combination with each other.

In the acute and subacute stages of neck pain, studies show cervical manipulation is more effective than various combinations of analgesics, muscle relaxants, and nonsteroidal anti-inflammatory drugs (NSAIDs) for improving pain and function in both the short and intermediate term.

Studies show that thoracic or mid-back manipulation is also very helpful for patients with neck pain. Chiropractic approaches often include a combination of spinal manipulation, manual cervical traction, figure-8 mobilization, and deep tissue trigger point/active release forms of therapy.

As noted above, the inclusion of exercise yields the best long-term benefits, especially for chronic neck pain.

One such exercise is Cranio-cervical flexion (deep neck flexor strengthening): Tuck the chin inwards, pushing the mid part of the neck backward with or without resisting into your fingers/hands or a towel wrapped around the neck. A gradual crescendo of pressure followed by a gradual release (or decrescendo) works well!

Another great exercise is Fiber Stretching: Side-bend the head and neck while applying gentle over-pressure while simultaneously reaching downward with the opposite arm/hand, searching for tight muscle fibers. Try combining forward and backward rotations and chin glide head movements while applying the over-pressure/reach combinations, and work each tight fiber until it loosens up.

There are many other exercises your doctor of chiropractic can show you, but these are a great start!

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.

Have You Tried These Movements Before Considering Shoulder Surgery?

11 May

If you suffer from shoulder pain, here are some exercises you can do at home that really work to improve flexibility and strength. Just remember to ALWAYS stay within reasonable pain boundaries and work BOTH sides of your body, NOT just the injured shoulder!

For flexibility, start with the “Codman” Pendulum exercise. Stand or sit and lean forward so that your arm can swing like the pendulum of a clock while holding a light weight (2-5 lbs, or .9-2.26 kg initially). Move the weight in a clockwise, counter-clockwise, left-to-right, and/or forward-backward ALLOWING the shoulder to RELAX. DO NOT shrug your shoulder upward—let the shoulder go. This is usually comfortable and therefore can be done MANY times a day!

Another great beginning exercise is the Finger Wall-Walk. Stand in front of a wall and slowly walk your fingers up a wall staying within a comfortable range. Go slow and repeat several times. As you improve, rotate your trunk or stand with your body 45º, 60º, and later, 90º to the wall.

To perform the Crossover Arm Stretch, relax your shoulders and gently pull your arm across your chest using the uninvolved arm/hand to assist in the movement. Hold for up to 30 seconds and repeat with the other arm.

The Passive Internal Rotation (stick behind the back) and External Rotation (stick in front) requires a broomstick held parallel to the floor. Grip the stick with both hands held shoulder width apart and allow one arm to move the relaxed arm inward and outward. Do this as two separate exercises. Hold the end-range for up to 30 seconds each, repeat one to three times, as tolerated.

For Strengthening, the use of Thera-Tube or Band works well when anchored into the hinged side of a door. Pretend you are standing on a clock (12, 3, 6, and 9 o’clock positions) and SLOWLY pull and release the tubing three times in each of the four “clock positions,” ALWAYS staying in the pain-free range.

Your “ultimate guide” for advancing in reps, sets, and type of exercise is the comfort factor – AVOID sharp, lancinating painful movements/exercises or those that leave you sore for more than 24-48 hours afterwards. Track your recovery time after exercising to determine safety.

 

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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