Tag Archives: mechanicsburg pa chiropractor

Wrist Tendonitis vs. Carpal Tunnel Syndrome

16 Apr

When an individual experiences symptoms like pain, numbness, tingling, and weakness in the thumb,
index finger, middle finger, thumb-side of the ring finger, and part of the palm, the first thought may be carpal
tunnel syndrome. While it’s the most common peripheral neuropathy, other conditions with overlapping
symptoms must be ruled out during the initial physical examination. One potential contributing cause of carpal
tunnel-like symptoms is cervical radiculopathy.
Five nerve roots exit the lower cervical spine and combine into a structure called the brachial plexus,
from which the median nerve emerges and continues down the arm to supply sensation and muscle function to
part of the hand. Compression or irritation of several of these nerve roots—most commonly C6, C7, and C8—
can result in downstream symptoms in the arm and hand that closely resemble carpal tunnel syndrome.
In one study that included 866 patients with either suspected cervical radiculopathy or carpal tunnel
syndrome, researchers found that roughly one-in-four had both conditions. Another study examining patients
on a surgical waiting list for carpal tunnel release reported that a significant percentage also showed
degenerative changes in the cervical spine near the level where the C6 nerve root exits, suggesting that
coexisting neck pathology may contribute to hand symptoms in some cases.
If a patient presents with suspected carpal tunnel syndrome, how might their chiropractor determine if
cervical radiculopathy may be an underlying cause or contributing factor? First, the chiropractor will review
the patient’s intake history for clues such as whether hand symptoms flare during episodes of neck discomfort;
symptoms are felt anywhere between the neck and hand; numbness extends into the pinky or outer side of the
hand; certain neck positions worsen symptoms; if there’s coexisting neck pain or stiffness; if there is the
presence of headaches or shoulder blade pain; and if there is any history of neck trauma.
During the physical examination, several orthopedic and neurologic tests may be performed to
evaluate for possible cervical radiculopathy. These may include cervical distraction (gentle upward traction is
applied to the head to determine whether arm symptoms improve); the upper limb tension test (specific arm
and neck movements are used to reproduce or alter symptoms); and cervical range-of-motion testing to assess
whether certain neck movements, particularly at end range, provoke arm or hand symptoms. The chiropractor
may also assess deep tendon reflexes to identify asymmetries between sides; perform upper extremity strength
testing to evaluate for myotomal weakness; and conduct dermatomal sensory testing of the thumb (C6), middle
finger (C7), and pinky (C8) to determine whether sensory changes follow a cervical nerve root pattern rather
than an isolated median nerve distribution.
If cervical radiculopathy is identified as a contributing factor, treatment will focus on restoring normal
movement and function to the affected joints and surrounding tissues to relieve pressure on the involved nerve
roots. This may include manual therapies, therapeutic modalities, traction, nighttime bracing (when
appropriate), and specific exercises or stretches to perform between visits. Many patients experience
significant improvement with conservative care. However, if findings suggest a condition outside the
chiropractor’s scope of care or if more invasive treatment is required, referral to an appropriate medical
specialist will be recommended.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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Hip Pain Characteristics That Can Inform Diagnosis

9 Apr

The hip is a ball-and-socket joint in which the femoral head meets the pelvis, supported by
several layers of cartilage and other soft tissues that allow for a wide range of motion. While this
design provides mobility, it also creates multiple opportunities for instability and irritation that can
result in what is generally referred to as hip pain. However, there are many potential causes of hip
pain, and the specific characteristics of a patient’s symptoms can help guide the healthcare
provider—such as a doctor of chiropractic—on what to evaluate during the physical examination.
Anterior (front) hip pain may suggest osteoarthritis, particularly in middle-aged and older
individuals with gradual symptom onset and pain that increases after prolonged sitting or walking. In
contrast, younger and more athletic adults who present with groin pain that worsens during hip
flexion and rotation may have femoroacetabular impingement or a labral tear. Sport collisions or
other forms of trauma can also result in hip flexor muscle strains that produce pain in the front of the
hip.
Lateral (side) hip pain is often associated with greater trochanteric pain syndrome, especially
in middle-aged women who report discomfort when lying on the affected side. In many cases, there
is no clear inciting injury, and the area may be painful or tender when touched or palpated.
Posterior (back) hip pain is less commonly due to a primary hip joint condition and is more
often referred from another structure. Potential sources include the lumbar spine, sacroiliac joint
dysfunction, deep gluteal syndrome (also known as piriformis syndrome), or strain or tendinopathy at
the proximal hamstring attachment.
Certain red-flag conditions require urgent referral to an emergency department or specialist.
These include femoral neck fracture—typically in older adults with osteoporosis or after a fall or
trauma—often presenting with inability to bear weight and a shortened, externally rotated leg; septic
arthritis, which may involve fever, severe joint pain with movement, and elevated inflammatory
markers on blood or joint fluid testing; and avascular necrosis, in which interruption of blood supply
to the femoral head causes bone tissue death, potentially leading to joint collapse, chronic pain, and
limited mobility (often requiring MRI for diagnosis).
The good news is that many causes of hip pain, aside from these red-flag conditions, respond
well to conservative chiropractic care. Treatment is often multimodal and may include a combination
of manual therapies such as manipulation, mobilization, and soft-tissue techniques; therapeutic
exercises and stretching; temporary activity modification followed by gradual return to normal
activities; physiotherapy modalities to support healing; and nutritional recommendations aimed at
reducing inflammation. If dysfunction in an adjacent area, such as the low back or knee, is
contributing to the hip condition, these regions may also need to be addressed to achieve the best
outcome

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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A Role for Chiropractic in Managing Chronic Rhinosinusitis

6 Apr

Chronic rhinosinusitis is an inflammatory condition of the nasal and sinus lining that lasts
longer than twelve weeks. It’s estimated that roughly 10–12% of adults in the United States are living
with chronic rhinosinusitis at any given time, with many experiencing symptoms for years. Managing
the condition can be challenging, as it’s driven by a mix of contributing factors that may include
chronic inflammation of the sinus lining, immune dysregulation, lingering microbes, structural
factors, and environmental exposures such as air pollution and cigarette smoke. Because the
accumulation of fluid and inflammatory material in the sinuses is a key component of the disease
process, treatments that help facilitate drainage may provide symptom relief. To that extent, therapies
provided by doctors of chiropractic may have a role in caring for some patients with chronic
rhinosinusitis.
Manual therapies performed by chiropractors can help address fluid build-up both directly
and indirectly. Specific techniques such as lymphatic drainage use gentle manual pressure and
stretching to stimulate lymphatic vessels that help move excess fluid out of tissues, which may
reduce pressure and congestion. Tightness in the muscles and soft tissues that attach to the head and
neck can also restrict normal fluid movement. For this reason, myofascial release, mobilization, and
manipulative therapies aimed at restoring normal motion in the face, head, neck, and upper back may
be beneficial for some individuals.
This potential benefit is illustrated in a case series involving 14 patients with chronic
rhinosinusitis who also experienced craniofacial pain. Those who received manual therapy to address
craniofacial dysfunction over a seven-week period reported improvements in both craniofacial pain
and the severity of their sinus symptoms, while patients in a comparison group that did not receive
hands-on care reported no meaningful improvement.
Additional studies suggest that manual therapies may help improve sinus drainage, reduce
facial pain and pressure, enhance nasal airflow, and improve quality of life—particularly when
chronic rhinosinusitis is accompanied by neck muscle tension or headaches associated with cervical
spine dysfunction. Other reports indicate that some patients who have not responded to conventional
medical management, including those who have undergone sinus surgery or who wish to avoid
surgery, may experience symptom relief with conservative manual therapy treatment.
While current evidence does not support chiropractic care as a first-line treatment for chronic
rhinosinusitis, manual therapies provided by doctors of chiropractic may play a supportive role as
part of a comprehensive care plan. This may be especially relevant for patients who have difficulty
managing symptoms with usual care alone. Individuals interested in this approach should speak with
their healthcare provider to determine whether a trial of chiropractic care may be appropriate for their
situation.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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Core Strengthening to Reduce Low Back Pain Risk

2 Apr

Low back pain is one of the most common and disabling conditions worldwide. It’s estimated that
nearly 200 million acute episodes of low back pain occur each year, of which roughly 20% persist for longer
than three months. With the aging of the global population combined with the obesity epidemic, low back pain
is expected to become an even more substantial physical health issue in the coming decades.
Because weakness in the core muscles that help stabilize the spine has been linked to up to a threetimes increased risk of new-onset low back pain, improving endurance and control in this muscle group may
help reduce one’s risk. The core muscles include the abdominals, back, and gluteal muscles. In addition to
stabilizing the spine to help stay upright, strong core muscles are important for maintaining balance through
proprioception and for supporting the wide range of motion the trunk performs—from rotation, to bending
forward, to side-bending, and backward movement. Key core-strengthening exercises include:

  • Front plank: Lie face down and prop yourself up on your elbows under your shoulders. Lift your body
    onto your elbows and toes (or knees for an easier version). Keep your body in a straight line from
    shoulders to heels, tighten your stomach and glutes, and avoid letting your hips sag or rise. Hold 10–
    30 seconds, repeat three to five times, working up to a 60-second hold.
  • Side plank: Lie on one side with your elbow directly under your shoulder. Lift your hips off the floor
    so your body forms a straight line from shoulders to feet. Keep your core tight and don’t let your hips
    roll forward or backward. For an easier version, bend your knees and lift your hips. Hold 10–25
    seconds per side and repeat three to five times.
  • Bird dog: Start on hands and knees with hands under shoulders and knees under hips. Tighten your
    stomach slightly and keep your back flat. Slowly extend one arm forward and the opposite leg
    backward. Keep hips level and avoid arching your back. Hold for five to ten seconds, return to start,
    then switch sides. Do eight to twelve repetitions per side.
  • Glute bridge: Lie on your back with knees bent and feet flat on the floor about hip-width apart.
    Tighten your stomach and squeeze your glutes. Lift your hips until your shoulders, hips, and knees
    form a straight line. Avoid arching your lower back. Hold three to five seconds at the top, then slowly
    lower. Perform ten to fifteen repetitions for two to three sets.
  • Dead bug: Lie on your back with arms straight up and knees bent at 90 degrees. Tighten your stomach
    gently so your lower back stays flat against the floor. Slowly lower one arm overhead and extend the
    opposite leg toward the floor. Only go as far as you can without your back arching. Return to start and
    switch sides. Perform eight to twelve slow, controlled repetitions per side.
    Further strategies to reduce the risk of low back pain include maintaining a healthy weight; improving
    workstation ergonomics; practicing good posture, especially when sitting and lifting; engaging in regular lowimpact aerobic exercise such as walking or swimming; following a balanced, minimally processed dietary
    pattern (such as a Mediterranean-style diet); avoiding tobacco use; and stretching before and after physical
    activity, especially the hamstrings which are often overly tight in low back pain cases. While these practices
    may not completely prevent low back pain, they can improve the changes for a speedier recovery as well
    reduce the risk of recurrence.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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A Practical Tool for Assessing Health and Longevity

30 Mar

As we age, it is natural to become more concerned about our longevity, especially if we have
experienced health challenges or engaged in unhealthy behaviors earlier in life. One way to assess probabilistic
near-term (under five years) and long-term (10–25 years) mortality risk is to use an assessment known as the
Deficit Index, also called the Frailty Index. Essentially, the index evaluates health across many different
domains. Each item is scored as 0 (not present), 0.5 (a mild or partial problem), or 1 (a severe or fully present
problem). The individual deficit scores are added together and then divided by the total number of items
assessed (61 in this example) to produce a final index value between 0 and 1. Below are commonly included
deficit domains:

  • Chronic Medical Conditions: Hypertension, diabetes mellitus, coronary artery disease, stroke or TIA,
    osteoarthritis, osteoporosis, chronic lung disease, chronic kidney disease, cancer (current or past)
  • Activities of Daily Living (ADLs): Difficulty bathing, dressing, transferring, using the bathroom,
    feeding, shopping, managing medications, managing finances, preparing meals, using transportation
  • Mobility & Physical Performance: Difficulty walking one block, difficulty climbing stairs, slow
    walking speed, poor balance, use of cane/walker/wheelchair, fall/s within previous year
  • Symptoms & Somatic Complaints: Chronic pain, fatigue or low energy, shortness of breath, dizziness,
    poor appetite, sleep problems, urinary incontinence
  • Cognitive Function: Memory complaints, difficulty concentrating, diagnosed mild cognitive
    impairment, dementia, difficulty following instructions
  • Psychological & Emotional Health: Depressive symptoms, anxiety, low mood most days, anhedonia,
    high perceived stress, poor coping skills
  • Sensory Impairments: Poor vision (even with correction), poor hearing, difficulty communicating due
    to sensory loss
  • Nutrition & Body Composition: Unintentional weight loss, low BMI, sarcopenia or muscle weakness,
    difficulty chewing or swallowing
  • Social & Environmental Factors: Living alone, social isolation, limited social support, financial strain,
    low physical activity, limited access to care
  • Laboratory & Physiological Abnormalities: Anemia, elevated inflammatory markers, abnormal
    glucose regulation, low vitamin D, reduced kidney function markers
    In population studies, scores below 0.10 are considered robust and associated with low mortality risk
    over the next 10–20+ years; scores of 0.10–0.15 are considered pre-frail and associated with low five-year
    mortality but increased 10–20 year risk; scores of 0.15–0.25 indicate moderate frailty and a substantially
    elevated 5–10 year mortality risk, with many studies showing a roughly 50–70% chance of death within the
    next decade; scores of 0.25–0.40 indicate severe frailty and high near-term mortality, with up to a 50% chance
    of death within ~3 years and very high five-year mortality; and scores of 0.40 or higher indicate extreme frailty
    and are associated with very high 1–3 year mortality and markedly shortened survival.
    Importantly, this assessment and others like it are not intended to predict exactly how many years any
    one individual has left. Rather, they help visualize how multiple health factors combine to reflect overall
    biological aging and vulnerability. The goal is not fatalism, but insight, so that efforts to improve strength,
    nutrition, mobility, mental health, sleep, and social connection can reduce frailty, improve quality of life, and
    potentially extend both lifespan and health span.

Brent Binder M.S., D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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Whiplash-Related Somatosensory Tinnitus

25 Mar

Most people associate tinnitus with excessive noise exposure, such as the ringing that
can follow a rock concert. However, tinnitus can also develop following a whiplash event,
such as the rapid acceleration and deceleration of the head and neck that occurs during a
motor vehicle collision. While a crash may involve loud noises that can temporarily affect
hearing, the persistent nature of tinnitus associated with whiplash-associated disorders
(WAD) suggests a different underlying mechanism.
Research in this area is ongoing, but the leading explanation involves a process
known as somatosensory modulation. The nervous system has sensory receptors throughout
the body that relay information to the brain, where it is interpreted as somatosensory input—
including touch, body position, temperature, and pain. Importantly, the somatosensory
system shares neural connections with other sensory systems, including the auditory system.
When somatosensory input is altered—due to injury, irritation, or persistent pain
signals from tissues of the head and neck—it can interfere with how the brain processes
information from other systems, such as sound. In this way, whiplash does not necessarily
cause direct injury to the auditory system. Instead, injury to cervical muscles, joints, or
related nerves may disrupt normal sensory signaling, leading the brain to misinterpret
auditory information and produce the perception of ringing in the ears.
In June 2025, researchers studied 80 patients experiencing WAD-associated tinnitus
and assigned them to either an intervention group or a control group. The intervention group
received a combination of manual therapy, stretching exercises, and relaxation techniques
aimed at reducing muscle tension and addressing myofascial trigger points in the head and
neck region, while the control group was placed on a waitlist and received no treatment. As
expected, patients in the intervention group demonstrated improvements in pain and cervical
range of motion. Notably, they also reported a reduction in tinnitus symptoms, suggesting
that addressing dysfunction in the head and neck may help normalize somatosensory
modulation contributing to tinnitus.
Doctors of chiropractic commonly incorporate these types of therapies as part of a
multimodal approach to managing patients with whiplash-associated disorders. Restoring
normal motion and function to the cervical spine may help alleviate not only neck pain but
also associated symptoms, such as tinnitus. In cases where symptoms do not improve,
referral to an appropriate medical specialist may be warranted.

Brent Binder M.S.,D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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