Carpal Tunnel Syndrome – Why Is It So Bad at Night?

3 May

For those who have carpal tunnel syndrome (CTS), it’s no surprise that CTS is frequently most expressive during the night, often to the point of interrupting sleep and/or making it difficult to fall back to sleep. So why is that?

The primary reason for nighttime CTS symptoms has to do with the wrist, as it is very difficult to sleep with the wrist held in its “ideal” or least irritating position. In fact, most people favor “curling” the back of the hand under the chin or bending the hand/wrist backwards under the head. When the wrist is bent in either direction, it can increase the pressure inside the wrist, which can generate the various symptoms associated with CTS.

One study evaluated the pressure inside the carpal tunnel while participants slowly moved their wrists. The researchers found many movements didn’t need to exceed 20 degrees before the pressure increased enough within the carpal tunnel to generate symptoms.

Because it doesn’t take a lot of movement to build up excessive pressure in the wrists of those with CTS, many doctors recommend the use of a “cockup splint” for the nonsurgical
treatment of CTS in order to help keep the wrist in a neutral position.

Wrist posture is also an important factor during the day. One study looked at typing on a tablet PC, which allowed people to work in nontraditional settings. As screen size reduced, the posture required to type became more limited and accelerated the usual rate of pain onset in the neck, elbows, and wrists.

This study also looked at three different positions used when working on touchscreen devices: desk, lap, and bed. The healthy subjects completed six, 60-minute typing sessions using three
virtual keyboard designs: standard, wide, and split. The researchers monitored the position of the wrist, elbow, and neck while the participants typed and followed up each session with questionnaires designed to measure discomfort.

The research team reported that typing in bed required greater wrist extension but resulted in a more natural elbow position than typing at a desk. The angled split keyboard significantly reduced the wrist deviation vs. the standard or wide keyboard designs. All three regions—the neck, elbow, and wrist—exhibited more movements (13% to 38%) towards the end of the one hour sessions, which correlated with a significant increase in pain in every body region investigated. Overall, using a wider keyboard while sitting at a desk was the most tolerable position among study participants.

What is causing my back pain?

2 May

Low back pain (LBP) can arise from disks, nerves, joints, and the surrounding soft tissues. To simplify the task of determining “What is causing my LBP?,” the Quebec Task Force recommends that LBP be divided into three main categories: 1) Mechanical LBP; 2) Nerve root related back pain; and 3) Pathology or fracture. We will address the first two, as they are most commonly
managed by chiropractors.

Making the proper diagnosis points your doctor in the right direction regarding treatment. It avoids time wasted by treating an unrelated condition, which runs the risk of increased chances of a poor and/or prolonged recovery. Low back pain is no exception! The “correct” diagnosis allows treatment to be focused and specific so that it will yield the best results.

Mechanical low back pain is the most commonly seen type of back pain, and it encompasses pain that arises from sprains, strains, facet and sacroiliac (SI) syndromes, and more. The main difference between this and nerve rootrelated LBP is the ABSENCE of a pinched nerve. Hence, pain typically does NOT radiate, and if it does, it rarely goes beyond the knee and normally does not cause weakness in the leg.

The mechanism of injury for both types of LBP can occur when a person does too much, maintains an awkward position for too long, or over bends, lifts, and/or twists. However, LBP can also occur “insidiously” or for seemingly no reason at all. However, in most cases, if one thinks hard enough, they can identify an event or a series of “microtraumas” extending back in time that may be the “cause” of their current low back pain issues.

Nerve root-related LBP is less common but it is often more severe—as the pain associated with a pinched nerve is often very sharp, can radiate down a leg often to the foot, and cause numbness, tingling, and muscle weakness. The location of the weakness depends on which nerve is pinched. Think of the nerve as a wire to a light and the switch of the nerve is located in the back where it exits the spine. When the switch is turned on (the nerve is pinched), and the “light” turns on — possibly in the outer foot, middle foot, inner foot, or front, back or side of the thigh. In fact, there are seven nerves that innervate or “run” into our leg, so usually, a very specific location “lights up” in the limb.

Determining the cause of your low back pain helps your doctor of chiropractic determine which treatments may work best to alleviate your pain as well as where such treatments can be focused.

Chocolate – Is It Actually “Good” for Me?

28 Apr

Often referred to as a “sinful indulgence,” chocolate is usually not thought of as a healthy food choice. However, in the last 20-30 years, there has been growing evidence that there are indeed health benefits associated with chocolate consumption! Let’s take a closer look!

Chocolate is made from tropical Theobroma cacao tree seeds. The earliest use of chocolate dates back to the Olmec civilization in Mesoamerica (1200 – 400 B.C.E.), the precursor to the Mayan and Aztec cultures (currently the states of Veracruz and Tabasco). Following the 15th/16th centuries, chocolate became extremely popular in Europe. Today, millions indulge daily on this unique, rich, and sweet-tasting food with the average American consuming around 4.5 kg (close to 10 pounds) per year!

So what is it in chocolate that makes it so good? The answer includes its richness in flavonoids and flavanols (such as anthocyanidin and epicatechins). In general, the darker the chocolate, the greater the amount of flavonoids and flavanols. These substances are thought to have antioxidant properties, which help neutralize free radicals—nasty things that can damage cells all over the body. Inflammation as well as pollution, UV exposure, and cigarette smoke all increase free radical production. This leads to oxidative stress, which is closely associated with heart disease, cancer, arthritis, stroke, immune deficiency, and more!

Studies have shown that chocolate can reduce both blood pressure and the chance for stroke! Cocoa flavanols are reportedly helpful in reducing inflammation and relaxing blood vessels, which lowers blood pressure, lowers total cholesterol, and increases the “good guy blood fat” or high-density lipoproteins (HDLs). All of this adds up to a reduced risk of heart disease and stroke!

A study published in 2012 looked at the association between chocolate consumption and the risk of stroke in a population of over 30,000 men in Sweden over a ten-year time frame. They found that moderate consumption of chocolate may lower the risk of stroke—“moderate” meaning about 63 grams/week (there are about 43 grams of chocolate in an average chocolate bar). Another study found that fruits and vegetables also lower the risk of stroke as did drinking four cups of black tea per day.

Getting back to chocolate, there may also be a link between eating chocolate and improved cognitive (brain) function. So not only is it smart to eat chocolate, but it may also MAKE YOU SMARTER! This correlates well with an association between dementia prevention and chocolate consumption. Harvard Medical School scientists suggest that two cups of hot chocolate a day may keep the brain healthy and prevent memory decline in older people. Another active ingredient in chocolate is lavado, in which a 2014 study found may reduce or block damage to nerve pathways found in Alzheimer’s disease patients.

Of course, there are “down sides” to eating chocolate. One is the sugar and calorie issue with the negative side effects of obesity, tooth decay, and diabetes. Another is an increased risk of forming calcium oxalate kidney stones, as chocolate / cocoa are high in oxalate. To gain the benefits of cocoa without the worry of sugar and calories, you can purchase cocoa-rich powders and supplements that can be added to beverages. So ENJOY your chocolate, but remember moderation, like in so many other things in life, is “KEY!”

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, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Whiplash & Recovery – How Long Does It Take?

26 Apr

First, what is whiplash? It’s a lot of things, which is why the term WAD or Whiplash Associated Disorders has become the most common term for the main signs and symptoms associated with a whiplash injury. WAD is usually associated with a motor vehicle collision, but sports injuries, diving accidents, and falls are other common ways to sustain a WAD injury.

To answer the question of the month, in most cases, the recovery rate is high and favors those who resume their normal daily activities. The worse thing you can do when you sustain a WAD injury is to not do anything! Too much rest and inactivity leads to long-term disability. Of course, this must be balanced with the degree of injury, but even when the injury requires some “down time,” stay as active as possible during the healing phase.

Many people recover within a few days or weeks while a smaller percentage require months and about 10% may only partially recover. So what can be done to give you the best possible chance to fully recover as soon as possible?

During recovery, you can expect your condition to fluctuate in intensity so “listen” to your body, let it “guide” you during activity and exercise, and stay within “a reasonable boundary of pain” during your activity. Remember, your best chance for full recovery FAVORS continuing a normal lifestyle. Make reasonable modifications so you can work, socialize, and do your “normal” activities!

The KEY: Stay in control of your condition – DO NOT let it control you! Here are some tips:

  • POSTURE CONTROL: Keep the weight of the head back by gliding your chin back until you “hit” a firm end-point. Then release it slightly so it’s comfortable—this is your NEW head position!
  • FLEXIBILITY: Try this range of motion (ROM) exercise… Slowly flex your neck forwards and then backwards, then bend your neck to the left and then the right, and then rotate it to the left and to then to the right. THINK about each motion and avoid sharp, knife-like pain; a “good-hurt” is okay! Next, do the same thing with light (one-finger) resistance in BOTH directions. Try three slow reps four to six times a day!
  • MUSCLE STRENGTH: Try pushing your head gently into your hand in the six directions listed above to provide a little resistance. Next, reach back with both hands or wrap a towel around your neck and pull forwards on the towel while you push the middle of your neck backwards into the towel doing the chin-tuck/glide maneuver (same as #1). Repeat three to five times slowly pushing, and more importantly, release the push slower! This is the MOST IMPORTANT of the strengthening exercises in most cases! Next, “squeeze” your shoulder blades together followed by spreading them as far apart as possible (repeat three to five times).
  • PERIODIC BREAKS: Set a timer to remind yourself to do a stretch, get up and move, to tuck your chin inwards (#1) and do some of #2 and #3 every 30-60 minutes.
  • LIFTING/CARRYING/WORK: Be SMART! Do not re-injure yourself. Change the way you handle yourself in your job, in the house, and while performing recreational activities.
  • HOUSEHOLD ACTIVITIES: Use a dolly to move boxes and keep commonly used items within easy reach (not too high or low).

Be smart, stay educated, work within the range your body tells you is “safe” and most importantly, STAY IN CONTROL!!!

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 Whiplash, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Neck Pain Prevention Tips

25 Apr

Neck pain is very common! According to one study, between 10-21% of the population will experience an episode of neck pain each year with a higher incidence rate among office workers. Between 33-65% will recover within one year, but most cases become “chronic, recurrent” meaning neck pain will come and go indefinitely. The more we can learn WHAT to do to prevent these episodes, the better.

  1. SLEEP: Use a cervical pillow so the NECK is fully supported during sleep. This keeps your head in alignment with your spine. Also, if possible, sleep on your back!
  2. OFFICE: Position the computer screen so that it’s at or slightly below eye level and straight in front of you. The “KEY” point is that you feel comfortable with the height of the monitor. Keep your chin “tucked in” so the 10-11 pound (4.5-5 kg) weight of your head stays back over your shoulders—this will place less of a load on your upper back and neck muscles to hold your head upright! Set a timer on your cell phone to remind you to get up and move around every 30-60 minutes.
  3. TELEPHONE: If you are using the phone a lot during the day, GET A HEADSET! If you are pinching the phone between your shoulder and ear, you WILL have neck problems!
  4. EXERCISE: Studies show people who are more physically active are less likely to report neck pain.
  5. NUTRITION: Search for information on the “anti-inflammatory diet.” It’s basically fruits, veggies, and lean meat, with a few other twists. Also, stay hydrated by drinking plenty of water each day.
  6. LIFT/CARRY: A heavy purse, brief case, or roller bag can really hurt your neck. Take ONLY what you need and put the rest in a secondary bag that stays in your car or where you can access it when needed. Switch to a backpack if possible vs. a heavy brief case.
  7. SELF-MASSAGE: Reach back and dig your fingers into your neck muscles and “work” the tight fibers back and forth until they loosen up. Roll your head over the top edge of a chair by sliding down until the top of the chair back rests in your neck. Search for the tight fibers and work them loose!
  8. WHIPLASH: If you are injured, DO NOT WAIT! Those who seek chiropractic care shortly after an accident have less long-term trouble!

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 neck pain or headaches, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR NECK PAIN!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Fibromyalgia: A Whole Body Approach

21 Apr

Fibromyalgia is a complicated disorder that’s difficult to diagnose because it involves multiple body systems. As a result, there are a myriad of factors in the body that can play a role in a patient’s symptoms. That said, it’s best to take a whole body approach when it comes to treating a complex condition like FM, starting with the nervous system.

When a patient presents to a chiropractor, the initial examination will look at the body as a whole and will not be limited the main area of complaint. This includes a postural examination in regards to individual leg length (to see if one is shorter); the height of the pelvis, shoulder, and occiput (head); and a gait assessment to evaluate the function of the foot, ankle, knee, hip/pelvis, spine, and head.

Because the nervous system is housed in the spine and cranium, chiropractors specifically look at how the spine compensates for abnormal function elsewhere in the body. When spinal segmental dysfunction is present, altered neurological function often coincides, which results in the symptoms that drive people to the office.

The benefits of spinal manipulative therapy (SMT)—the primary form of treatment delivered by doctors of chiropractic—have been recognized by all other healthcare professions including medical doctors, physical therapists, and osteopathic physicians. In fact, referring patients to chiropractors for SMT has become very commonplace in the healthcare environment. Research has proven SMT to be a FIRST course of care and highly recommended for MANY complaints, especially low back, mid-back, and neck pain, headaches, and many more!

Because fibomyalgia (FM) involves the WHOLE BODY—hence its definition of “wide spread pain,” chiropractic offers a unique approach because it too benefits the whole body by restoring function to the nervous system. For example, when balance is off due to a short leg (this affects 90% of the population to some degree), it can tilt the pelvis, which then places stress on the spine so that it must curve (scoliosis) to keep the head level. Correcting the short leg with a heel lift can restore balance to the pelvis, take pressure off the spine, and relieve some of a patient’s pain symptoms.

In prior articles, we have looked at the many benefits chiropractic offers the FM patient in addition to SMT and other manual therapies. Some of these include tips for improving sleep, exercise training (very important in managing FM), diet—specifically an anti-inflammatory diet (rich in anti-oxidants)—and supplementation (such as magnesium, malic acid, omega-3 fatty acids, vitamin D3, Co-enzyme Q10, and more).

Most importantly, studies show that the FM patient is BEST served when a “team” of healthcare professionals work together on behalf of the FM patient. Depending on a patient’s needs, the team can include a doctor of chiropractic, a primary care doctor, a massage therapist, a clinical psychologist, and others.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

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