Is Surgery Necessary for Carpal Tunnel Syndrome?

19 Jul

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy—that is, it’s the most common place to trap a nerve in the extremities (arms or legs). CTS affects 6-11% of adults in the general population, and it occurs in women more often than men. The cause is often difficult to determine but the most common reasons can include trauma, repetitive maneuvers, certain diseases, pregnancy, being over the age of 50, and obesity.

So, is surgery the only answer? The short answer is NO! In fact, in a recent randomized clinical trial published in the Journal of Pain, researchers observed similar improvements in function when they compared the outcomes of patients who underwent surgery vs. those who received manual therapies (such as those performed several times a day at chiropractic clinics around the world) at both six months and one year later. The improvements included increased strength, function, and decreased hypersensitivity in both the surgical and non-surgical groups. Interestingly, the manual therapy group did BETTER at the one and three month assessments when compared with the surgical group (again, with no difference at six and twelve months)!

The median nerve, the culprit behind CTS, starts in the neck and travels down through the shoulder, elbow, forearm, and finally through the carpal tunnel, which is made up of eight small carpal bones that form the arch of the bridge. Entrapment of the median nerve occurs when the normally tight quarters within the carpal tunnel combine with the inflamed nine sheathed muscle tendons that push the nerve into the floor of the tunnel (a ligament), which results in CTS! The goal of therapy—both surgical and manual therapy—is to reduce the pressure within the tunnel and free up the compression of the median nerve.

Manual therapies focus on joint mobilization and manipulation to reduce joint fixations, muscle release techniques in the forearm and hand, stretching techniques, and at-home exercises that emphasize a similar stretch, the night brace, and management of any underlying contributing factor. These “underlying factors” might include diabetes, hypothyroid, taking birth control pills, weight management, and inflammatory arthritis.

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.

I’m Told I Have “Facet Syndrome” – What Is It?

18 Jul

As stated in previous articles, low back pain (LBP) can arise from many different structures. Lumbar facet syndrome is one that involves the facet joint and includes both acute (new) and chronic (old) varieties. The facet joint is synonymous with the zygapophyseal joint, so if you hear that word, don’t let it throw you off! Approximately 45% of patients with chronic low back pain suffer from “facet syndrome” (FS) in which the facets are the low back pain generator.

There are many conditions that give rise to FS. Some of these include the straining of the surrounding joint capsule (the capsule holds the joint securely together), joint hypomobility (reduced motion in the joint), a synovial cyst (similar to a ganglion on the back of the wrist but its located inside the joint), and degeneration (also called osteoarthritis—the wearing out type of arthritis).

Because facet syndrome can accompany other conditions, a doctor of chiropractic must evaluate each patient individually and manage each person appropriately. In “pure” facet syndrome, pain rarely ever passes the level of the knee and does not cause neurological loss (weakness, loss of reflex, etc.). It can create numbness but usually NOT beyond the knee. Pain is usually not worsened by hip movements such as straight leg raise or hip rotation.

The facet joint’s “job” (at least in part) is to limit or guard twisting movements in the upper lumbar/low back region, and the lower lumbar facets are shaped to limit motion when bending forwards and backwards. Facet joints are unique because they are innervated by specific nerves that can be blocked by injecting an anesthetic agent to determine if the facet (and its innervating nerve) is the main source of pain. The surrounding capsule around the facet joint contains mechanoreceptors (cells that detect movement) and nociceptors (cells that detect pain) that fire when the facet joint is compressed/jammed or over-stretched. These nociceptors can become “hypersensitized” (very irritable) when they remain inflamed over time.

In many patients, injury to a facet joint is the result of many microtraumas over a period of time and not one single isolated event. For example, repeatedly bending backwards, twisting, and leaning to one side can stretch the joint capsule and fatigue it until some capsular tissues finally “give” and it inflames which generates pain.

These joints commonly become arthritic with age, which is one reason people over 50-60 years old commonly present with FS. Osteoarthritis results in a narrowing of the joint space and causes a more permanently “jammed” joint. This is one reason many elderly people walk partially bent over—as bending forwards opens the facet joints and “feels good!”

The good news is that chiropractic manipulation is a highly effective treatment for facet syndrome, and most patients feel much better within the first or second week of care (often within three to five visits).

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.

The Important Benefits of Drinking Enough Water!

18 Jul

With the availability of beverages like coffee, tea, soda, and juice, it’s easy to miss out on one of the most important liquids that should fill our cup—water.

So how much water should a person drink to stay healthy? One study conducted by the Mayo Clinic found that properly hydrated women consume about 2.7 liters (91 fluid ounces) of total water a day. That being said, factors like physical activity, hot or humid weather, high altitude, or having an illness can play a part in how much fluid a person should take in.

Drinking enough water has important health benefits. Here are just a few:

  • Weight Control – Not only does switching out a high-sugar, caloric beverage for water help reduce excess energy consumption, but it may also aid in determining whether or not the body is signaling for food or hydration. One study found that obese individuals who drank more water had increased energy expenditure and weight change when blood carbohydrate and insulin concentrations were not elevated.
  • Protects Against Cardiovascular Disease – A recent study found a connection between dehydration and negative endothelial function with impaired cardiovascular health in humans. The study out of the European Journal of Nutrition claims that, “Mild dehydration can impair vascular function nearly as much as smoking a cigarette.”
  • Stabilizes the Brain – Research into adolescent dehydration discovered that inadequate consumption of water can cause headaches, irritability, poorer physical performance, and reduced cognitive function. It is unlikely that these ailments are restricted to the adolescent age demographic.
  • The Harvard School of Public Health claims “Drinking enough water is essential for physiological processes such as circulation, metabolism, temperature regulation, and waste removal.”

So, how do you know if you’re drinking enough water? Here are some things to look out for that may indicate dehydration: decreased urine output, dry skin, headaches, constipation, dizziness, dry mouth, or fatigue.

Foods You Can Eat to Reduce Inflammation

14 Jul

A new study conducted by researchers from the University of Florida may give another reason why older people complain about pain more than those who are younger.  The small, preliminary study has suggested for the first time that inflammation may occur quicker and at a higher magnitude—and stays around longer—when seniors experience pain.  This might mean that older adults are more susceptible to developing chronic pain.  It also gives yet another reason to attempt to decrease inflammation as soon as possible.  Getting treatment as quickly as possible after an injury or the onset of pain may be critical in decreasing the chances of the pain getting worse and becoming chronic.

While reducing inflammation following an injury is important, inflammation isn’t just associated with pain. Higher than normal levels of inflammation can trigger many disease processes including cancer, heart disease, diabetes, and Alzheimer’s disease.

One of the best things a person can do to help keep inflammation in check is eat foods with anti-inflammatory properties. According to ScienceDaily, a study by scientists from the University of Liverpool’s Institute of Aging and Chronic Disease, “has identified food stuffs that can help prevent chronic inflammation that contributes to many leading causes of death.”  Their work shows that diets rich in fruits and vegetables, which contain polyphenols, protect against age-related inflammation and chronic diseases.  According to researcher Sian Richardson, “The results of our study suggest that (poly)phenols derived from onions, turmeric, red grapes, green tea, and açai berries may help reduce the release of pro-inflammatory mediators in people at risk of chronic inflammation.  Older people are more susceptible to chronic inflammation and as such they may benefit from supplementing their diets with isorhamnetin, resveratrol, curcumin, and vanillic acid or with food sources that yield these bioactive molecules.”

Remember, we’re always here to help your body heal and maintain the pain free body you deserve.

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

Man Sentenced to Death Is Recognized as a Hero 40 Years Later…

12 Jul

You’ve probably heard the old adage that truth is often stranger than fiction.  This is actually only part of the actual quote that is rarely used in its full length and seldom attributed to its originator. It goes…

“Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn’t.”

 Who originally said that?  None other than Mark Twain.  If you like interesting and insightful quotes, Twain in a person you should look up.  He was very insightful and not afraid to speak his mind.

Now back to the story… but you may want to keep that quote in mind as you read on…

It was some time in the early 1940s.  The place was Poland.

Hitler and the Nazis had a plan to exterminate certain races of people and conquer the world.  But not everyone knew it… yet.

Many countries were ignorant to Hitler’s plans or they simply chose to turn a blind eye.  “But he is doing it over there – not here,” was a common excuse to ignore Germany’s actions.  That attitude proved costly to many…

Witold Pilecki joined the Polish resistance soon after the Nazis invaded Poland.  When mysterious camps started popping up all over the country, he suspected the they had a nefarious purpose and he set out on a mission to discover what was really going on.

So he did something completely unimaginable… He deliberately got himself arrested by the Nazis so that he could infiltrate one of the camps: Auschwitz.

He spent 2.5 long years suffering at Auschwitz in order to send information to the world that the Nazis were actually running death camps, and this intelligence was used to try to convince Germany’s enemies to send help.

How did he send this information back to compatriots?  He built a radio in the death camp using various  parts that had been smuggled in.

When help didn’t arrive, Pilecki escaped and set out to contact the London-based Polish government-in-exile in an effort to try to get help for all the suffering people in Auschwitz and the other concentration camps. But the Allies did not believe his dispatches could be true.  They thought his claims were exaggerated or false because they could not believe that so many had been killed in the death camps during the preceding years.

When Poland later fell under the control of Communists, he was sentenced to death on charges of espionage and the illegal crossing of the borders under a false name. After the fall of communism towards the end of the 20th century, Pilecki’s true contributions to the war effort were finally recognized by his countrymen, all charges against him were posthumously dropped, and he was decorated with the highest honors the Polish military could offer.

So there you have it.  A man who sacrificed his own life by willingly entering a Nazi death camp to try to save Poland (and the world) wasn’t recognized as the hero he was until over 40 years after his death.

The truth certainly can be stranger than fiction, but it is because “fiction is obliged to stick to possibilities; Truth isn’t.”

We love helping our patients and their friends and relatives through their tough times and getting them feeling better! We are here to help you stay feeling better and looking younger! Don’t be a stranger. You really can afford Chiropractic care! Don’t wait until you can no longer move!

While Your Pain May Not Be All in Your Head, What’s in Your Head May Play a Role in How Much Pain You Feel. Here’s Why…

11 Jul

For most people, pain is an infrequent nuisance. For others, it’s a burden that influences every aspect of their lives. It’s one of the most common and difficult problems people face. And if you suffer with pain, you are not alone.

Check out these mind-boggling statistics..

Here are the number of Americans affected by each of the following conditions:

            Cancer – 1.4 million (According to the American Cancer Society)

             Coronary Heart Disease (Including Heart Attack and Chest Pain) and Stroke – 18.7 million people (According to the American Heart Association)

            Diabetes – 20.8 million people (diagnosed and estimated undiagnosed, according to the American Diabetes Association.)

The National Centers for Health Statistics reports that pain affects an estimated 76.2 million people, which is more than diabetes, heart disease, and cancer combined.

In fact, pain is cited as the most common reason Americans go to the doctor. It is a leading cause of disability, and it is a major contributor to healthcare costs.

According to the National Center for Health Statistics (2006): “More than one-quarter of Americans (26%) age 20 years and over report that they have had a problem with pain of any sort that persisted for more than 24 hours.

 “Adults age 45-64 years were the most likely to report pain lasting more than 24 hours (30%). Twenty-five percent (25%) of young adults age 20-44 reported pain, and adults age 65 and over were the least likely to report pain (21%).”

What Are Commonly Reported Pain Conditions?

According to the report: “When asked about four common types of pain, respondents of a National Institute of Health Statistics survey indicated that low back pain was the most common (27%), followed by severe headache or migraine pain (15%), neck pain (15%), and facial ache or pain (4%).

“Back pain is the leading cause of disability in Americans under the age of 45. More than 26 million Americans between the ages of 20-64 experience frequent back pain.

 “Adults with low back pain are often in worse physical and mental health than people who do not have low back pain: 28% of adults with low back pain report limited activity due to a chronic condition, as compared to 10% of adults who do not have low back pain. Also, adults reporting low back pain were three times as likely to be in fair or poor health and more than four times as likely to experience serious psychological distress as people without low back pain.”

It’s clear that pain is common and can be life changing, but what if you could affect how much pain you feel…

Simply By the Way You Think?

A team of German researchers say you probably can.  Here is how…

You have probably heard of the placebo effect.  It occurs when people experience positive results from a fake or sham treatment (like a sugar pill) because they expected it to be helpful.

Dr. Katharina Schwarz from the Institute of Psychology at the Julius-Maximilians-Universität Würzburg (JMU) in Bavaria, Germany notes, “The placebo effect often works quite well when treating pain and depression.”

Her research shows that the mere expectation of getting a drug can alleviate symptoms and make patients feel better. She adds, “And those are not just the patient’s subjective sensations, it can actually be measured physiologically.”

Dr. Katharina Schwarz is an expert on how expectations influence perception and behavior, and she did an amazing experiment that showed just how much a person’s expectations of pain actually affected how much pain they felt.

In the experiment, men were given a stimulus and asked to rate how much pain they felt.  Later that day, they were given information that either told them that men feel more pain than women or vice versa.  The researchers backed up the claim with reasons like women have a higher threshold for pain because they endure childbirth or men don’t feel as much pain because of their ancestral role as hunters, etc.

They repeated the experiment the next day.  The participants who thought that men were less sensitive rated the pain as being much less intense than they did on the previous day. However, those who had learned that women have a higher pain tolerance considered themselves more sensitive to pain than before.

According to Dr. Schwarz, “I want to increase the awareness, especially of students, for these mechanisms and in particular for the ones that have a negative impact on people.”

Past studies have demonstrated that patients who feel like they’ll never get better don’t respond to treatments as well as patients who are confident their condition will improve.

Another study recently published in the journal Cell Reports finds that pain actually changes cells—which may explain why some people continue to feel pain in an area long after their injury heals. Investigators from King’s College London observed slight epigenetic changes in the immune cells around damaged nerves. These changes to the epigenome persisted long after the cells were replaced by newer cells weeks or months later, giving the impression such cells had a “memory” of the previous injury. The researchers suspect these modifications to the epigenome alter which genes are expressed in those cells and may make them more sensitive to pain in the future.

So what does all this mean for you?

For starters, even though many people live with pain, it’s not normal, so it’s important to consult with a doctor who can help identify the underlying cause of your pain and treat it. It’s also important that you are confident that such a treatment will benefit your condition. If you suffer from back pain or other musculoskeletal complaints, then there’s a great chance that chiropractic treatment can help you get out of pain and back to living your life.

Don’t forget, if you ever have any questions or concerns about your health, talk to us. Contact us with your questions. We’re here to help and don’t enjoy anything more than participating in providing you natural pain relief.

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