Correct Behaviors that Cause Upper-Cross Syndrome

25 Jun

Upper-cross syndrome (UCS) patients often demonstrate postural defects such as forward head posture, forward or rounded shoulders, and thoracic kyphosis. These postures are becoming more common as computers and device use assumes an even greater part of our lives and can lead to weakness in the muscles in the mid-back and front of the neck along with tightness of the chest muscles and the muscles in the rear of the neck. Viewing the body from the side, if you connected the groups of tight muscles with a line and did the same for the weak muscles, it would form a cross or X. 

A 2019 survey conducted by Common Sense Media revealed that 20% of eight-year-old children own a cell phone. By age eleven, more than half of kids have a phone and by their high school years, 84% own phones. As they age, kids spend more and more time on their phones, clocking in five hours a day as preteens and increasing use to more than seven hours a day during late adolescence. A 2023 study that included 45 teenagers found that 17 exhibited upper-cross syndrome with nearly half having forward head posture and four-in-five having rounded shoulders. 

Adults who spend their working day in front of the computer screen and their evenings watching TV or using electronic devices like tablets and smartphones are even more likely to have upper-cross syndrome and the musculoskeletal issues that can accompany it. In another 2023 study that included 99 office workers with neck and shoulder pain, researchers observed that 100% had rounded shoulders, 43.4% had forward head posture, and 54.3% had thoracic hyperkyphosis with muscle tightness in the pectoralis minor (100%), levator scapulae (93.0%), and upper trapezius (98.3%) muscles—all hallmarks of upper-cross syndrome. A 2014 study found that about half of office workers have neck and shoulder pain at any given time and nearly a third report persistent neck and shoulder pain. 

The good news is that upper-cross syndrome can be addressed with a combination of chiropractic care, at-home exercises/therapies, and lifestyle/work modifications. Your doctor of chiropractic may employ a variety of manual therapies to restore normal movement to the joints in the neck, upper back, and shoulders. Between visits, you may be asked to perform exercises to help restore good posture, which may include strengthening weakened muscles, like the deep neck flexors. As they will be more familiar with your unique situation, your doctor of chiropractic will be able to offer more specific advice with the aim of reducing your current pain/disability and lowering the chances for a future episode.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Can Hip Osteoarthritis Be Prevented?

20 Jun

Hyaline cartilage is the slick, translucent tissue that lines joint surfaces and allows for the smooth movement of joints in the body, including the hip. If the structure or health of this cartilage is compromised, it can gradually wear away, leading to joint pain, stiffness, and disability. Eventually, the hip osteoarthritis patient may have no choice but to accept a dramatically reduced lifestyle or undergo total hip arthroplasty. Is it possible to prevent osteoarthritis of the hip or at least slow its progression?

Unfortunately, the answer isn’t a firm yes or no. There appears to be a genetic component to osteoarthritis risk, so you may be destined for the condition. However, it does appear that if you manage to avoid major trauma to the hip and stay physically active and otherwise live a healthy lifestyle, then it may be possible to significantly reduce the risk for developing the condition and requiring surgical intervention. 

Between 2014 and 2017, researchers in Germany conducted a study in which nearly 24,000 patients with either hip or knee osteoarthritis received usual care or participated in a structured program focused on guidelines-recommended therapies and patient empowerment, including lifestyle changes and exercise interventions. Patients in the experimental group were 33.6% less likely to be hospitalized or undergo joint replacements related to their knee/hip. 

 Chiropractic care offers a unique opportunity for patients as the initial history typically includes a comprehensive review of systems including all aspects of health, both past and present. This approach often extends care well past the primary presenting complaint (hip pain, in this case) to include patient education regarding diet/nutrition, stress management, sleep quality enhancement, and more. Additionally, a doctor of chiropractic will assess related areas of the body to identify problems that can affect normal movement patterns (the foot, ankle, knee, pelvis, low back) as addressing these issues may be critical to help the patient achieve a satisfactory outcome.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Complementary and Alternative Approaches to Multiple Sclerosis

15 Jun

Multiple sclerosis (MS) is a chronic neurological autoimmune disease that affects an estimated 2.5 million people globally and accounts for about $85 billion a year in both direct and indirect healthcare costs in the United States alone. Typical MS symptoms and clinical presentations can include sensory loss affecting sight (optic nerve), weakness (motor nerves/brain), facial muscle weakness (facial cranial nerve), ataxia (cerebellum, motor cortex, spinal cord), vertigo (inner ear, vestibular branch of the cranial nerve), pain, fatigue, bladder/bowel control, and psychological disorders. Because the condition is not fully understood and has been linked to both genetic and environmental causes, there’s no one-size-fits-all treatment available to MS patients. Conventional pharmaceutical approaches may have a limited effect, and these immunomodulating or immunosuppressing drugs can lead to adverse allergic reactions that affect the skin and other organs. This has led many patients and researchers to explore alternative and complementary treatment approaches to help slow the progression of the disease and improve a patient’s quality of life.

An October 2022 systematic review looked at ten previously published randomized-control trials to investigate the effects of manual therapies in reducing symptoms in MS patients. The authors concluded that Swedish massage, acupressure, and reflexology interventions lasting 10-30 treatments spread over 4-10 weeks were effective for improving fatigue, pain, spasticity, psychological state, and physical function. 

In addition to hands-on treatment, there have been several studies exploring the role of diet and specific nutrients in MS management. Dietary approaches such as the Mediterranean diet, ketogenic diet, and the dietary approaches to stop hypertension (DASH) diet have been linked to better cognitive health and greater preservation of the thalamus (an area of the brain that relays motor and sensory data to the cerebral cortex). In particular, omega-3 fatty acid supplementation may reduce the severity of some MS symptoms and oleic acid—a fatty acid found in cooking oils, meats, cheese, nuts, seeds, eggs, pasta, milk, avocados, and olives—may stimulate the production of the regulatory T cells that help keep the immune system from attacking the central nervous system.

Staying active may also benefit MS patients. One study found that using an activity tracker helped lower the risk for relapsing-remitting MS symptoms and improved the participants’ ability to maintain normal activities, including working. There’s also research to suggest the obesity, depression, and poor sleep can have a detrimental effect on MS patients, so maintaining a healthy weight and good mental health and sleep hygiene are also important. 

As with many health conditions, early detection and treatment is second only to prevention. In the case of MS, a review of medical records of more than 85,000 adults revealed that those who would eventually develop MS were more likely to make doctor visits for issues such as urinary problems, visual disturbances, abnormal skin sensations, impaired movement, and dizziness in the time preceding their diagnosis. Recognizing these clusters of symptoms can help doctors identify patients who may be at increased risk for MS earlier in the course of the disease when treatment may be more effective.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Exercise Can Hasten Whiplash Recovery

10 Jun

Whiplash-associated disorders (WAD) can be a challenging condition to manage, and the current data suggests that up to half of WAD patients may continue to experience pain and disability for up to a year following their car accident, slip and fall, or sports collision. Exercise therapy has long been considered a meaningful treatment option for many musculoskeletal conditions, but what does the current research reflect with respect to the role of exercise therapy for the WAD patient?

In 2021, researchers conducted a systematic review and meta-analysis that included 27 studies in order to gauge the effect of exercise therapy compared with other treatments, placebo interventions, or no treatment. They found that exercise therapy had short-term effects on neck pain and medium-term effects on neck-related disability, but they concluded that “the current evidence is weak” with respect to exercise as a sole treatment for WAD.

However, when used in combination with other treatments, exercise therapy can be quite beneficial to the WAD patient. In addition to the advice to stay active or even start exercising in some capacity (even if that means taking a short walk each evening to begin with), WAD patients may be prescribed more specific, neck/shoulder/upper back exercises to restore posture and strengthen the deep muscles that often become deconditioned in patients with the condition.

In addition to exercise recommendations, your doctor of chiropractic may employ a multimodal approach that includes manual therapies (massage, manipulation, mobilization, active release technique, trigger point therapy, and more); physical therapy modalities (electric stim, ultrasound, class IIIb and IV lasers, pulsed electromagnetic field, traction); patient education (including emphasizing the importance to resume normal activity as soon as possible); and ergonomic assessments (to minimize work stress and strain). When psychosocial barriers to recovery exist, your chiropractor may team with allied healthcare providers that offer cognitive behavioral therapy and other needed services.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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Carpal Tunnel Syndrome and Hand Positions

5 Jun

The wrist is very flexible, and the reason the wrist is so supple is because it’s made up of eight small carpal bones that are lined up in two rows of four bones each. Along with the transverse carpal ligament, these rows of carpal bones form an actual tunnel in which nine muscle tendons (and their sheaths) and the median nerve pass. If inflammation or swelling occurs that reduces the space in the carpal tunnel, then the median nerve can become compressed and restricted, which stimulates the various symptoms commonly linked to carpal tunnel syndrome (CTS). Another factor that can limit space in the carpal tunnel has to do with hand positions.

In a 2023 study, researcher utilized high-frequency, diagnostic ultrasound (HFDU) to specifically look at median nerve position changes and cross-sectional area of the nerve when the wrist is bent upward (dorsiflexion) and downward (palmar flexion) in 85 patients (110 affected hands) diagnosed with mild (n=38), moderate (n=30) and severe (n=42) CTS as well as 25 healthy control subjects (50 hands). Compared with the control wrists, the CTS-affected wrists exhibited much greater median nerve compression against the floor of the tunnel (the transverse carpal ligament) in both bent wrist positions. The researchers also used a diagnostic technology called nerve conduction velocity to confirm that this compression at the end-ranges of wrist flexion and extension are associated with dysfunction of the median nerve.

While this finding is interesting, it just reinforces what many healthcare providers already know about CTS: symptoms worsen at the end ranges of motion, and prolonged, awkward wrist postures should be avoided. That’s why one of the most common tools used to manage CTS is a nocturnal wrist splint to prevent the wrist from bending during sleep. However, it’s generally not recommended to wear a wrist splint at all times as immobilization could lead to deconditioning of the muscles in the region and worsen the patient’s situation.

In addition to avoiding prolonged bending of the wrists, CTS patients are also instructed to try to keep the wrist in a neutral position, take frequent breaks, and avoid high vibration exposure when performing hands-on work or hobby-related tasks because it can increase inflammation in the carpal tunnel and exacerbate symptoms and slow recovery. 

Successful management of CTS may also involve addressing non-musculoskeletal factors that can promote inflammation or swelling in the wrist, such as diabetes. Patients may also receive advice on inflammation-promoting foods to avoid or supplements to take to reduce inflammation in the body. Your chiropractor will also assess the full course of the median nerve starting at the neck to make sure there are no other areas in which the nerve’s motion is restricted since it’s not uncommon for this to occur in multiple sites.  

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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Greater Access to Chiropractic Reduces Low Back Pain Costs

31 May

Not only is low back pain a musculoskeletal condition that will affect nearly everyone at least once in their lifetime, but it also accounts for a significant portion of all healthcare expenditures. When an individual experiences low back pain, they have a variety of treatment options, including chiropractic care. While there is an abundance of literature available on the safety and effectiveness of chiropractic treatment for the low back pain patient, perhaps just as interesting is the cost and societal benefits associated with chiropractic management of low back pain.

Past research has shown that greater access to chiropractic care is linked to a lower reliance on primary care services for treatment for a condition like low back pain, which is handy as experts predict a severe shortage of primary care physicians in the near future.  But is the inverse true, does reduced access to chiropractic lead to greater utilization of primary care?

In a 2019 study, researchers examined Medicare claim data concerning nearly 40,000 older adult chiropractic patients who moved to an area with less access to chiropractic care. The research team observed that following their move, the seniors were more likely to visit their primary care physician for spine conditions, which can lead to potentially harmful opioid prescriptions, unwarranted testing, and invasive procedures, including surgery. This equated to an additional cost of nearly $115,000 per 1,000 beneficiaries on medical services or $391 million nationally. 

In another study, researchers looked at the healthcare costs and utilization of 2.5 million adults with low back pain and leg pain. They found that 1.2% received surgery and these patients accounted for 29.3% of all healthcare costs among the study population. The data also show that many of the patients who received non-surgical care underwent advanced imaged within 30 days of diagnosis and/or without an initial trial of hands-on care (like chiropractic care), which is contrary to treatment guidelines. A 2022 study that looked at low back pain patient experiences found that 41.7% who underwent back surgery had minimal non-pharmaceutical, non-operative treatment in the six months before their operation. 

BOTTOM LINE: The current research suggests that greater access to chiropractic care not only provides large cost savings to the public and private insurance agencies, but patients who utilize chiropractic care for low back pain are less likely to receive treatment that may be less effective and may carry greater risks for adverse side effects.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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