Tag Archives: pain relief

Causes of Knee Pain in Kids

11 May

Knee pain accounts for at least one-third of musculoskeletal complaints in the pediatric
population seen in healthcare clinics, including chiropractic offices. This is especially common
in active children during the growth spurts of early adolescence. Let’s review some of the most
common causes of knee pain in kids and teens and how they are typically managed.
Patellofemoral pain syndrome, or kneecap pain, is the most common cause of knee pain
in children and adolescents. Pain typically arises from behind the patella and worsens with
activities involving knee flexion, such as climbing stairs, squatting, or prolonged sitting. On
examination, pain may be reproduced with a single-leg squat, often with inward knee collapse.
Treatment includes both weight-bearing and non-weight-bearing exercises targeting the posterior
hip and quadriceps. Manual therapy and movement retraining may be used to restore normal
joint mechanics. Treatment may include a foot orthotic if excessive ankle pronation is
contributing to pain.
Osgood-Schlatter disease (OSD) is inflammation of the growth plate at the tibial tubercle
just below the kneecap, often producing a prominent bump that can irritate the patellar tendon
during running, jumping, squatting, and kneeling. Treatment typically includes patient education,
activity modification, exercise therapy, and use of an infrapatellar strap. Sinding-LarsenJohansson syndrome is similar to OSD but involves the bottom of the patella rather than the
tibial tubercle. Management follows a similar approach.
Patellar tendinopathy, or jumper’s knee, results from cumulative microtears due to
repetitive jumping, landing, and sprinting. Management includes reducing high-load activities
(while avoiding complete rest), gradually reloading the tendon as symptoms improve, and
performing strengthening and flexibility exercises for the quadriceps and hamstrings. Manual
therapy and biomechanical corrections may also help improve loading patterns.

In cases such as juvenile idiopathic arthritis, chiropractors may work in coordination with
the child’s medical physician or rheumatologist to provide supportive care—such as gentle
manual therapy and soft tissue techniques—to improve mobility and reduce muscle tension.
The good news is these conditions generally respond well to conservative management,
helping most children return to their normal activities without the need for invasive treatment.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

Tags: , , ,

Chiropractic Care for Headache Relief

4 May

Statistically, up to 20% of adults experience frequent headaches, with approximately 1–
4% reporting headaches on more than 15 days per month. While there are many types of
headaches—and within each subtype, multiple underlying causes and triggers—research
suggests that musculoskeletal factors can contribute to certain headache presentations. What
would a doctor of chiropractic look for during the initial visits to determine whether a course of
chiropractic care could benefit the headache sufferer?
The first step is to take a patient history that explores past and present health, as well as
details specific to the chief complaint—headaches, in this case. The responses help determine
whether the headache pattern is consistent with musculoskeletal referral from the neck or
surrounding tissues. Important clues include band-like pressure around the head; pain that begins
in the neck or base of the skull and may spread to the temples, forehead, or behind the eyes;
headaches triggered by prolonged computer work, poor posture, neck movement, stress, or jaw
clenching; pain that worsens after desk work or driving; improvement with massage, stretching,
or heat; and co-occurring neck stiffness or shoulder tightness.
If the patient presents with red flags—such as a new type of headache after age 50, the
worst headache of their life, recent head trauma, signs of infection (e.g., fever), or neurological
symptoms such as weakness, numbness, or vision changes—they may be referred for urgent
medical evaluation.
The history guides the physical examination, during which the chiropractor assesses
range of motion of the cervical spine—particularly the upper cervical segments—for restrictions,
asymmetries, or reproduction of symptoms. They will also palpate soft tissues in the head and
neck, including the suboccipital muscles, upper trapezius, sternocleidomastoid, temporalis,
masseter, and levator scapulae, to identify tenderness or trigger points and determine whether
these reproduce the patient’s headache. Orthopedic testing and postural assessment further help
identify musculoskeletal contributors.
The specific treatment approach varies by patient, but generally involves conservative
therapies aimed at restoring joint mobility and reducing muscle tension. This may include spinal
manipulation or mobilization, soft tissue therapy, trigger point techniques, physiotherapy
modalities, targeted exercises, and postural education. If a musculoskeletal disorder is a primary
contributor—as is often the case in tension-type or cervicogenic headaches—patients may
experience significant improvement or resolution. For other headache types, such as migraines,
care may help reduce the frequency, intensity, and duration of episodes.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

Tags: , , ,

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

Tags: , , ,

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

Tags: , , ,

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

Tags: , ,

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

Tags: , ,

← Older Entries