Tag Archives: mechanicsburg pa chiropractor

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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Wrist Tendonitis vs. Carpal Tunnel Syndrome

23 Mar

Fast and repetitive hand and finger movements with little rest time can cause the sheaths that cover the
tendons passing through the carpal tunnel to become inflamed, placing increased pressure within the tunnel,
compressing the median nerve, and stimulating the symptoms associated with carpal tunnel syndrome. Injury
or overuse of the tendons themselves can also cause symptoms that may be thought of as carpal tunnel
syndrome. How does a doctor of chiropractic determine which condition a patient has, carpal tunnel syndrome
or wrist tendonitis?
The first step involves the patient’s history and initial consultation. In addition to providing
information on their past and current health issues, the patient may be asked specific questions about their
presenting complaint, such as whether they recall what caused their symptoms, when the symptoms first
became noticeable, what makes the symptoms feel better or worse, what their exact symptoms are, and what
time of day the symptoms are best or worst, for example.
Based on the information provided, the chiropractor will conduct a physical examination. The exam
will include observation; palpation (touching and pressing); range of motion assessments of the arm, wrist,
hand, and fingers; and neurological tests of the upper extremity, including reflexes, muscle strength (such as
grip and/or pinch), and sensation testing (for example, light touch or distinguishing between sharp and dull).
To rule out red-flag issues—such as fracture or advanced joint disease—an X-ray may be ordered. Other
diagnostic studies, such as ultrasound or nerve conduction velocity testing, may be of use to help confirm a
suspected diagnosis.
If carpal tunnel syndrome is suspected, symptoms such as pain, numbness, tingling, and reduced
sensation will follow the course of the median nerve into the thumb, index finger, middle finger, and the
thumb-side of the ring finger, though symptoms may also travel up the forearm. Symptoms may worsen at
night and during the day when the wrist is bent up or down or held in one position for prolonged periods.
Orthopedic tests that involve flexing the wrists for 60–90 seconds, tapping over the carpal tunnel, and
manually compressing the carpal tunnel will also be positive in carpal tunnel syndrome. When performed, a
nerve conduction study will typically show slowed median nerve function across the wrist.
In cases of wrist tendonitis, pain will be localized to a specific tendon with tenderness at one precise
point, and symptoms will mostly be felt in the wrist or forearm rather than the fingers. Symptoms may be
described as achy, sharp, or pulling pain, without numbness or tingling, that worsens with gripping, lifting,
twisting, or resisted motion. With rest, symptoms will usually improve. Diagnostic imaging may show tendon
thickening or inflammatory changes.
Treatment will depend on examination findings, but in general, with carpal tunnel syndrome, the
approach used will be intended to reduce compression on the median nerve, potentially with activity
modifications and ergonomic changes to reduce inflammation while tissues heal. With wrist tendonitis, heavier
activity will be reduced initially to allow the tendon to recover, followed by specific exercises to increase
tendon strength and load tolerance. The good news is that doctors of chiropractic are well-equipped to
distinguish between these conditions and manage them using an effective, non-surgical, conservative approach.

Brent Binder M.S., D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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Chiropractic Management of Shoulder Pain

16 Mar

By some estimates, shoulder complaints affect nearly half of the adult population in a
year, driving many to chiropractic offices looking for a conservative, non-surgical solution.
While back pain and neck pain are the primary reasons patients seek chiropractic care, at least
one study found that 12% of chiropractic visits in a week may involve shoulder issues. How
would a chiropractor manage a shoulder complaint?
The shoulder complex itself is made up of four separate articulations—the glenohumeral
joint, the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic joint—that
work together to support the wide range of motion available to the arm. These joints, along with
the tendons, ligaments, muscles, and other soft tissues involved in upper extremity movement,
are all at risk of injury. When assessing treatment, the first step would be to conduct a thorough
examination to properly diagnose which components of the shoulder are contributing to the
patient’s chief complaints.
Because examination findings will vary, the specific treatment approach for a given
patient will be unique. However, in a general sense, multiple therapies are typically combined
with the goal of restoring normal movement to the affected joint(s). This may include manual
therapies (manipulation, mobilization, and soft tissue techniques), stabilization exercises,
stretches, physiotherapy modalities, and anti-inflammatory measures such as ice. Activities at the
extreme ranges of motion may be limited in the short term, with a gradual return to normal
activities within pain tolerances.
The shoulder does not exist in isolation, and several studies suggest that dysfunction in
the thoracic spine can affect movement of the scapula, which in turn can limit motion in other
aspects of the shoulder. In particular, a February 2024 study found that including mid-back
chiropractic adjustments in a treatment plan for adhesive capsulitis (frozen shoulder) improved
outcomes with respect to shoulder pain, disability, and function, and a January 2025 systematic
review and meta-analysis that included ten clinical trials found that thoracic spinal manipulative
therapy also improved outcomes for patients with subacromial impingement syndrome.
Chiropractic care has been demonstrated to benefit patients with various shoulder
complaints, and the treatments used are well supported in clinical guidelines as first-line
approaches. However, it should be noted that these conditions can have a difficult recovery
process, even if the patient undergoes surgery, and it can take months or even a year to restore
normal function to the affected joints.

Brent Binder, M.S.,D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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In-Office and At-Home Neck Pain Management

9 Mar

Neck pain is estimated to affect approximately 30–50% of the adult population in the
United States each year, making it second only to low back pain as a primary reason patients
seek chiropractic care. The goal of chiropractic care for neck pain is to help restore normal joint
motion and function in the cervical spine, a process that is often a collaborative effort between
care delivered during office visits and self-care performed by the patient between visits.
During office visits, neck pain patients are commonly treated with manual therapies as a
primary intervention. High-velocity, low-amplitude spinal manipulation—sometimes
accompanied by an audible pop or crack—is the technique most commonly associated with
chiropractic care. Chiropractors are also trained in lower-force approaches, including
mobilization techniques and soft tissue therapies. Treatment plans may involve more than one
type of manual therapy depending on the tissues involved, patient presentation, and clinician
judgment.
In-office care may also include cervical traction, particularly when nerve irritation is
suspected to be contributing to symptoms. To assist with short-term symptom relief, patients
may receive adjunctive therapies such as electrical stimulation (e.g., TENS), therapeutic
ultrasound, low-level laser therapy, or heat or cold therapy. In some practices, massage therapy
provided by an on-site massage therapist may also be incorporated.
Between visits, patients are encouraged to take an active role in their recovery.
Continuing to pursue normal activities within pain tolerance helps prevent muscle
deconditioning (which can increase the risk of chronic pain) and supports joint health by
promoting nutrient exchange through movement. When muscle weakness or imbalance is
identified—which is common in neck pain—patients may be instructed in specific exercises to
perform regularly as time allows. Additional guidance may include recommendations for
sleeping positions, pillow selection, and temporary work or activity modifications to support
recovery. Anti-inflammatory strategies, including dietary modifications and selected
supplements, may also be discussed when appropriate.
Once pain and functional limitations reach maximal improvement, patients are typically
released from active care. Some may be advised to schedule wellness or maintenance visits on an
as-needed or periodic basis, along with continuing neck-healthy habits in daily life. Together,
these strategies may help reduce the likelihood of future episodes or allow a subsequent neck
pain episode to be addressed earlier before it interferes with normal activities or quality of life.

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The Pain Mechanisms of Chronic Low Back Pain

4 Mar

In simple terms, chronic low back pain is pain affecting the lumbar spine region that lasts
longer than three months. However, chronic low back pain is not simply acute (new) low back pain
that has failed to resolve. Rather, it often reflects an overlap of two or even three distinct pain
mechanisms, each of which may need to be addressed to achieve an optimal outcome: nociceptive,
neuropathic, and nociplastic pain.
Nociceptive low back pain arises from injury or irritation of non-neural tissues, including
muscles, ligaments, tendons, and joints. This type of pain is typically localized and may feel achy,
throbbing, or sharp with movement or certain positions. During a physical examination, a doctor of
chiropractic can often reproduce symptoms with palpation or specific movements. The term nonspecific low back pain is commonly used to describe pain that is predominantly nociceptive in
nature.
Neuropathic low back pain is caused by damage or disease affecting the nervous system
itself. In the context of chronic low back pain, this is most often associated with disk herniation
compressing a nerve root, degenerative changes (such as arthritis) narrowing the spaces through
which nerves travel, or postsurgical nerve injury. This form of pain is commonly described as
burning, shooting, or electric and often radiates along the course of the affected nerve. Patients may
also experience non-painful neurological symptoms, including numbness, tingling, weakness, or
altered reflexes.
Nociplastic low back pain typically develops over time in response to an initial injury or
episode of pain. This pain is characterized by altered pain processing within the nervous system and
is often associated with widespread or shifting pain patterns, heightened pain intensity, and increased
sensitivity to touch or movement. Patients with nociplastic low back pain may restrict movement and
daily activities out of fear of worsening their condition (kinesiophobia), describe pain in amplified or
distressing terms, feel poorly equipped to manage their symptoms, and commonly report poor sleep
and elevated stress. Coexisting conditions such as headaches, irritable bowel syndrome, or
fibromyalgia are also more prevalent in this population.
Because chronic low back pain often includes a combination of nociceptive, neuropathic, and
nociplastic components, treatment approaches must be individualized. A multimodal care plan may
include manual therapies, targeted exercises, physical modalities, and anti-inflammatory strategies
aimed at restoring normal motion and function to affected nerves, joints, muscles, tendons, and
ligaments. In addition, chiropractors may employ pain education and graded activity exposure to
address nociplastic factors and help patients regain confidence in movement. When appropriate,
referral to a medical physician or specialist may also be indicated—all with the goal of helping the
patient return to normal activities of daily living in the safest and most pain-free manner possible.

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