Tag Archives: mechanicsburg pa chiropractor

Nutritional Post-Surgical Management of CTS.

14 Dec

Obviously, the goal of all health care providers, including chiropractic management of Carpal Tunnel Syndrome (CTS), is to AVOID surgical intervention, but this is not always possible. Last time, we looked at herbal approaches to reduce inflammation with the focused goal of preventing surgical need. But, as chiropractors, we also care for patients post CTS surgery, and one of our treatment approaches beyond manual therapies includes nutritional management.

As we all know, during the surgical process, tissue damage occurs due to incisions, removal of injured tissue, and other factors. Depending on the “success” of the surgical procedure, damage to the nerves causing numbness, weakness, and/or other nerve related symptoms can occur. Often, nerves will regenerate during the healing process but not always 100%. This may be due to factors such as the amount of tissue damaged during the surgery, the length of time CTS had been present pre-surgery, how well the patient follows post-surgical instructions, as well as the general health and overall condition of the patient. A healthy diet along with certain specific vitamins can play a positive role in tissue healing and nerve regeneration. Here are some examples:

Folate or vitamin B9 has been reported to have beneficial effects on the genes located within the nerve cells that help to regulate the healing process. One study published in 2010 reported that folate helped to promote nerve repair in the central nervous system (CNS) in rats, which is unique as typically nerve damage in the CNS does not usually regenerate. Anti-inflammatory benefits have also been reported with vitamins B6, B9, and B12.

Cobalamin or Vitamin B12 has also been reported to facilitate nerve regeneration after injury. This, along with the anti-inflammatory benefits, supports the use of B12 in the post-surgical CTS patient.

Vitamin D may also play a significant role in nerve regeneration after surgery. In one study, vitamin D2 was found to have a positive effect on nerve regeneration. Another study reported that D3 and calcium together has strong anti-inflammatory benefits.

Vitamin B6: There is evidence that supports the use of B6 both before and after surgery. Some feel B6 acts directly on nerve repair and others report a diuretic (fluid reducing) benefit. One cause and/or complication of CTS is fluid retention, which commonly occurs in conditions such as pregnancy, the use of birth control pills, obesity, diabetes, and others. Thus, keeping fluids in our tissues under control can certainly help CTS patients. Most studies agree that less than 200mg of B6 per day is safe. The dosage should be carefully monitored as numbness/tingling (a common CTS symptom) can be a sign of B6 toxicity.

Vitamin C has long been reported to facilitate in the wound healing process. It also is an effective anti-inflammatory agent, a common problem in the cause of CTS as well as a negative post-surgical side effect. A dose of 1000-3000mg/day spread out throughout the day is beneficial to the post-surgical healing process.

Vitamin E: As far back as 1967, Vitamin E been reported to reduce inflammation. More recent studies report that when used in combination with vitamin C, the two together works even better in reducing inflammation than either one alone. Also, this combination was found to improve the body’s ability to use insulin, which may also facilitate healing in the post-surgical CTS patient.

There are many others we didn’t get to (such as B1, 3, 5; zinc, Bromelain, and Quercetin). Bottom line: Eat healthy, exercise, don’t smoke, and fortify your diet with these nutrients!

We realize you have a choice in who 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 require care for CTS, we would be honored to render our services.

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Low Back Pain and Common Mistakes (Part 2).

14 Dec

Last time, we started a great discussion on “what NOT to do” for low back pain (LBP). Let’s continue that focus!

5. STAY STILL: You’ve heard, “…don’t do that – you’ll get a bad back!” There is something to be said about being careful, but one can be too cautious as well. In order to determine how much activity vs. rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short (within minutes to hours), then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.” Talk to us about the proper way to bend, lift, pull, push, and perform any activity that you frequently have to do that often presents problems. There is usually a way to do that activity more safely!

6.  SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but non-surgical care at least for 4-6 weeks and maybe several months is usually the best approach. As the old saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as: a) bowel or bladder weakness &/or, b) progressive neurological losses (worsening weakness in the leg). If there are no “surgical indicators” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this group. There are guidelines that we all should follow and they all support non-surgical care initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic carries the highest patient satisfaction.

7. DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner, reduce your ability to lift heavy weight (if you’re a weight lifter), or cycle as fast.  Though this seems obviously silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears (at least at present), that is applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic competitive activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, as stated last month, there is a “right vs. wrong” time to exercise and WAY to exercise. For example, when LBP occurs in flexion but reduces in extension, there is plenty of evidence published that performing exercises INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Low Back Pain and Common Mistakes.

14 Dec

We often read about what to do for low back pain (LBP), but do we look at LBP from the perspective of “what NOT to do!”

ICE vs. HEAT: If you ask your doctor, “what’s better for my back, ice or heat?” the answer is either one or the other or, “…whichever you like better.” This leaves the LBP patient at a loss of who or what to believe. So, let’s settle this once and for all. Ice should be tried first because it will rarely make the LBP worse, whereas heat can. Ice is an “anti-inflammatory” agent, meaning it reduces swelling. Ice reduces congestion or pushes painful chemicals and fluids that accumulate out of the injured area when there is inflammation and usually feels good (once it’s numb), maybe not initially because it’s cold. Heat does the opposite of ice. It’s a vasodilator meaning it pulls fluids INTO the area. Sure, it feels “good” initially, but often people will say it makes them worse later. That’s because the additional fluid build up in an already inflamed area is kind of like throwing gasoline on a fire. When LBP is chronic (it’s been there >3 months), heat MAY be preferred. Contrast therapy or, alternating between the two can work as an effective “pump” pushing out fluids (with ice) and pulling in fluids (with heat). Here, start and end with ice so the first and last things done are “anti-inflammatory.”

IGNORE YOUR LBP: The comment, “I was just hoping it would go away,” has been used by all of us at some point. Though LBP can get better over time, it’s simply impossible to know when or if it will. If you have suffered from back pain previously, then you already know that getting in quickly for a chiropractic adjustment BEFORE the reflex muscle spasm sets up can stop the progression, often before it reaches a disabling level. If you want to reduce the chances of missing work or a golf game due to LBP, come in immediately when the “warning signs” occur – you know, that ‘little twinge’ in your back that’s telling you, “…be careful!”

BED REST: There is a time for rest and a time for exercise, but knowing what to do when is tricky. Another “true-ism” is the best exercise when done too soon may harm you, but when done at the right time will really help. So, here are some general guidelines: a) no more than 24-48 hours of mostly bed rest; b) walking is usually a great, safe starting activity after or even during the first 48 hours; c) avoid activities that create sharp pain (like bend, lift, twist combinations); d) use ice or contrast therapies a lot during that initial 48 hours; e) follow our exercise instructions and treatment plan – we’ll guide you through this process.

FOCUS ON X-RAY OR MRI FINDINGS: Did you know that about 50% of us have bulging disks, and 20% of us have herniated disks in our low back and yet have NO pain? That’s right! Many of us have “disk derangement” but no symptoms whatsoever. Similarly, the presence of arthritis on x-rays may have no relationship to an episode of LBP. It’s easy to blame an obvious finding on an image for our current trouble, but it may be misleading. In fact, it can even make a person fearful of doing future activities that may be just fine or even good for us. The WORST thing for some types of arthritis is to do nothing. That will just lead to more stiffness and pain! More later!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Carpal Tunnel Syndrome & Herbs.

14 Dec

Carpal Tunnel Syndrome (CTS) is a condition caused by the compression of the median nerve as it travels through the carpal tunnel in the wrist. The “source” of median nerve compression can be soft tissue swelling, such as tendonitis, bursitis, synovitis, capsulitis, etc. Last month, we discussed nutritional supplementation for CTS in general. This month, the focus is on specific herbs that can help this potentially disabling condition.

Chamomile functions as a natural “tranquilizer.” It’s used for muscle pain (as a relaxant), but can also help other problems such as menstrual disorders, headaches, and tension. Chamomile facilitates relaxation of tight muscles and has an anti-inflammatory property that soothes cramps.

Kava Root is an herbal plant that is well known for its muscle relaxing benefits. It is particularly helpful with extreme muscle pain.

Valerian is a very effective relaxant that dates back to the medieval times for curing ailments associated with muscle spasms such as muscle cramps and neck problems.

Catnip is also a natural muscle relaxant, and is a member of the mint family. It is used as a sedative and muscle relaxer. Headaches due to tension have been treated using a poultice containing catnip. Catnip has also been found to reduce swelling in joints and reduce soft tissue injuries such as tendonitis, bursitis, and capsulitis.

Cayenne Pepper is a popular herb used in cooking and can be found in many recipes. Cayenne pepper has been found to significantly relieve the pain of muscle cramping.

Horseradish has been reported to relieve extreme muscular stress involved in cramps and muscle pain. One approach is mixing a few drops of horseradish oil in bath water to reduce soreness associated with muscle aches.

Lavender flower oil is well known as a very effective muscle relaxant that provides relief caused by muscular tension. Using a circular motion while massaging the oil over the achy muscle can be particularly soothing. In addition to the mind/body relaxation benefits, an increase in circulation allows the tense muscles to relax and heal.

Licorice has the ability to reduce inflammation associated with muscle pain.

Devil’s Claw is a very popular anti-inflammatory herb that dates back to the 18th century for the treatment of arthritis and many other painful conditions. It’s also used as an effective muscle relaxer.

Peppermint oil has been used to treat conditions associated with muscles aches. Pouring some drops of peppermint oil in a hot bucket of water to soak a foot, ankle or lower leg (possibly combined with Epson salt) can be very relieving.

Other natural muscle relaxants include Cramp bark, Passiflora, Bergamot, Cardamom, Basil, Ginger root, and others.

It is appropriate to COMBINE these natural herbal approaches with other treatments that are known to work well in the treatment of CTS. Chiropractic can provide: 1. Manipulation and mobilization of the neck, shoulder, elbow forearm, wrist, hand, and fingers; 2. Cock-up splints to be worn at night and at times during the day such as driving; 3. Physical therapy modalities such as electric stim, ultrasound, light or laser therapy, magnetic field; 4. Work station and other ergonomic modification recommendations; 5. Exercise training, and more.

We realize you have a choice in who 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 require care for CTS, we would be honored to render our services.

 

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Fibromyalgia – Do We Know The Cause?

14 Dec

Fibromyalgia (FM) is a condition that is characterized by widespread pain, fatigue and an increased pain response. Symptoms can include tingling of the skin, muscle spasms, weakness in the arms and legs, nerve pain, muscle twitching, bowel disturbances, chronic sleep disturbances, and more. So, what can cause such a widespread, whole body condition? Though the “cause” of FM is unknown, several hypotheses have emerged. Here is what we know:

The brains of FM patients: Structural and functional differences have been identified in the brains of FM vs. healthy individuals. What is unclear is whether these identifiable brain changes cause the FM symptoms or are the result of an unknown cause. Some experts have reported that the abnormal brain findings may be the result of childhood stress, or prolonged, severe stress at any time in life. An area commonly affected is called the hippocampus, which plays a crucial role in maintaining cognitive functions, sleep regulation, and pain perception.

Lower pain threshold: Due to an increased reactivity of pain-sensitive nerve cells in the spinal cord and brain (called “central sensitization), FM patients feel pain sooner and worse than non-FM subjects.

Genetic predisposition: It has been reported that FM is often found in multiple family members. This genetic propensity also includes other conditions that often co-exist in FM patients such as chronic fatigue syndrome, irritable bowel syndrome (IBS), and depression.

Stress & lifestyle: Stress by itself may be an important cause of FM. It is not uncommon to develop FM after suffering from post-traumatic stress disorder. An association between physical and sexual abuse both in childhood and adulthood has also been identified. Poor lifestyle issues including smoking, obesity, and lack of physical activity increase the risk of developing FM.

Dopamine dysfunction: Dopamine is a chemical needed for neurotransmission and plays a role in pain perception. It is also connected to the development of restless leg syndrome (RLS), which is a frequent complaint of FM patients. Medications found effective for RLS such as pramipexole (also used for the treatment of Parkinson’s disease) can be helpful for some FM patients.

Abnormal serotonin metabolism: Another neurotransmitter, serotonin, regulates sleep patterns, mood, concentration, and pain and can be involved in causing FM. Decreases in other neurotransmitters (especially norepinephrine), when combined with serotonin depletion, can especially cause FM (more so in women than men). Hence, medications like duloxetine (Cympalta) originally used to treat depression and painful diabetic neuropathy, have been found to help FM patients, especially women.

Deficient growth hormone (GH) secretion: Abnormal levels of GH have been found in FM patients, but studies report mixed results when treating FM with GH.

Psychological factors: Strong evidence supports the association of FM and depression. Similarities include neuroendocrine abnormalities, psychological characteristics, physical symptoms and similar treatment benefits using the same approach (medication, counciling, etc.).

Physical Trauma: Trauma can increase the risk of FM. One report found a direct association with neck trauma and increased risk of developing FM.

Small bowel bacterial overgrowth: This can contribute to FM and may explain the association with IBS. The autoimmune response to the presence of bacteria resulting in FM symptoms has been hypothesized in these cases.

CONCLUSION: As previously stated, it is clear that a “team” of providers is needed to effectively treat FM. We’d be honored to be part of your team!

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

 

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Headaches and Chiropractic Care.

14 Dec

Did you know that 9 out of 10 Americans suffer from headaches? There are many different types of headaches with a multitude of symptoms including achy, throbbing, nausea, vomiting, dizziness, numbness, blinding, noise, light and/or odor sensitivity, and more. The causes of headaches can include genetics (familial traits like migraine headaches), stress or tension (probably one of the most common), environmental (allergies, seasonal, bright sunlight, loud noises, certain foods), behavioral (insomnia, excessive exercise, blood sugar problems, depression), and many more.

Environmental factors can “trigger” the onset of a headache. About 95% of headache sufferers have “primary headaches” such as tension, migraine, or cluster headaches. The other 5% may be caused by other physical conditions or problems and the headache serves as a “warning sign” that something else is wrong. The “key” in the 5% of potentially dangerous types of headaches is to pay attention to when there is a rapid onset (“…it came out of nowhere fast!”), if they are very intense, and are “different” from other headaches previously suffered. When nervous system symptoms occur that are unusual for that person, such as lapses in memory, the person is not responding, rapid onset of dizziness, balance disturbance,  and/or a “blinding sharp pain,” these should trigger a warning sign that something specific and potentially dangerous may be causing the headache.

For the main 95% of headaches sufferers, neck tension is a common complaint with the headache. Research supports that spinal manipulative therapy (SMT), the primary form of care utilized by chiropractors, is an effective option for tension headaches. A 2001 Duke University study reported that SMT resulted in almost immediate improvement for those headaches originating in the neck, had fewer side effects, AND longer-lasting relief of tension-type headaches compared to those receiving commonly prescribed medication. Another study found that SMT was effective, not only for relieving the headache, but had a sustained benefit AFTER it was discontinued after a 4-week treatment period. This was NOT seen in a similar tension-type headache group receiving prescribed medication treatment only.

Here is how to help yourself:

Improve your posture: Most of us are “chin pokers” and “slouchers.” The weight of the head pulls on the neck and upper back muscles and when held in that fixed position while driving, typing, watching TV, the static muscle tension can create a headache.

Take “mini-breaks” every 30-45 minutes from static fixed positions and perform some exercises. A good stretch is to reach over to the opposite side of the head and gently pull to stretch the sides of the neck. Repetitively, poke and tuck your chin in & out to stretch different muscle fibers. Then, add flexion, extension and/or rotation to the same movements for about 10 sec./side. Try it now!

Avoid clenching your teeth and shrugging your shoulders. We do these things without being conscious that we’re even doing it. Those static loads play havoc with our neck muscles.

Drink plenty of water – at least 8 oz., 8x/day (more when exercising or pregnant). If you want to be more accurate, take your current weight and divide by 2. (Eg., 130# person = 65oz./day; 190# = 95oz./day).

If you have chronic headaches, COME SEE US! This is what we do, and it helps A LOT!

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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