Health Update: Carpal Tunnel

Carpal Tunnel Syndrome (CTS) – Can It Be Prevented?

Carpal Tunnel Syndrome or CTS is a very common problem affecting many workers and is one of the most costly conditions afflicting today’s workforce.  It is most often caused by repetitive activity using rapid movements of the arms and hands and can lead to work loss and disability when not properly managed.  CTS occurs when the median nerve that travels through the carpal tunnel (CT) located on the palm side of the wrist becomes pinched by the swelling of the 9 tendons that also travel through the CT and essentially, pinch the nerve up against the transverse carpal ligament.  This results in numbness, tingling and/or pain of the index, middle and forth fingers.

Other symptoms include sleep interruptions where shaking and flicking of the fingers is required to allow for a return to sleep.  This is frequently caused by sleeping with the wrist in a cocked position, increasing the pressure inside the already swollen carpal tunnel.  This is why a cock-up wrist splint usually helps as it disallows the wrist from bending to the extremes and the nerve is not pressured or pinched as much.  Other symptoms include weakness of the grip, making it a challenge to unscrew a jar, open a door, and even sometimes turn the key when starting a car.  Driving can also be affected as the hands often fall asleep while holding onto a steering wheel.

Pain can also affect the rest of the arm and sometimes the neck area.  The median nerve can also be pinched in more than one place and may include the neck, shoulder, elbow as well as the wrist making it necessary to have all the areas treated for a satisfying result.

People at greatest risk are women > men, workers who handle small tools, computer workers, fast repetitive line workers, and people older than 40 years of age.  People with other health conditions including rheumatoid arthritis, Lymes disease, rubella, pregnancy, birth control pill use, diabetes mellitus and menopause are at an increased risk of developing CTS.  Certain foods such as caffeine, tobacco, and/or alcohol may also contribute to CTS.

Though treatment is very important –the sooner the better- prevention is most important.  In fact, some simple approaches can make a big difference!  Some of these include modifying the position of a computer chair, keyboard, monitor, or mouse (work station modifications), alternate between different tasks to reduce the repetition of work, stretch your forearms and fingers before, during and after work, and treat any underlying conditions.  When symptoms first occur, these recommendations, as well as wearing a night wrist cock-up splint and seeing your chiropractor, will often reverse the condition without difficulty.  If you wait too long and nerve damage occurs, it becomes a more challenging process to manage CTS and at times, even surgery will not be very helpful.

Some of the non-surgical treatment approaches you might expect from your chiropractor include joint manipulation and/or mobilization applied to the neck, wrist, elbow and/or shoulder, the application of physical therapy modalities such as ultrasound, electrical stim, and/or low level laser therapy (“light” therapy), as well as the use of wrist splints.

The University of Maryland Medical Center cites two research articles on chiropractic treatment for CTS. They report good results are usually obtained and that these good results continued for at least 6 months after treatment ended.  The same reference also recommends nutrition and supplements in the management of CTS.  Some of these include: eliminate food allergens (often milk, cheese, eggs, ice cream, glutens/wheat-grains, soy, corn, and preservatives) and eating foods high in B-vitamins (dark leafy greens like spinach, kale, and sea vegetables), anti-oxidants (fruits – blueberries, cherries, tomatoes; vegetables – squash, bell peppers),  avoiding refined foods, using olive oil and adding omega 3 fatty acids to the diet (fish oil).  Other vitamins including a multivitamin, B complex, Vit. C, alpha-lipoic acid, MSM, resveratrol, Vit. D, Co-Q10, magnesium can also really help.

We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for CTS, chiropractic care is a logical first choice and we would be honored to offer our services to you.

 YOU MAY BE A CANDIDATE FOR OUR CARPAL TUNNEL SYNDROME PROGRAM
 FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Health Update: Fibromyalgia

Fibromyalgia – Does This Sounds Familiar?

“I am exhausted and hurt all over.  I can’t get to sleep at night and when I do, I wake up at the drop of a dime.  I went to my doctor and they ran some blood tests and took some x-rays and said that nothing was wrong.  I just don’t know what is wrong or what to do about it.”

This is a classic history obtained from a patient suffering from fibromyalgia or FM.  Because the onset of fibromyalgia is slow and gradual, it is common for patients to postpone visiting their health care provider until the symptoms are quite significant. The diagnosis may also be delayed as many healthcare providers do not feel fibromyalgia is a legitimate medical condition and minimize the symptoms frequently categorizing them as "depressed," which postpones an appropriate diagnosis and treatment.

The classic definition as defined by the American College of Rheumatology includes at least a three-month duration of symptoms with the presence of 11 out of 18 potential tender points although diffuse, widespread pain not necessarily restricted to these exact locations may also represent an appropriate diagnostic finding in fibromyalgia.

Fibromyalgia is more common in females and affects approximately 2% of the population in the United States. The risk of developing fibromyalgia increases with age, usually developing during early and middle adulthood but can also develop in children and older adults. Other risk factors include a positive family history where one may be more likely to develop FM if a relative suffers with the same condition.

A major risk factor of developing fibromyalgia includes is disturbed sleep pattern and this remains controversial as to whether sleeping disorders are a direct cause or simply the result of fibromyalgia. However, in either case, people with FM cannot obtain deep "restorative" sleep and feel fatigued and tired upon waking in the morning. Sleep disorders including sleep apnea and restless leg syndrome are often present in patients with fibromyalgia.

Certain conditions such as rheumatoid arthritis, irritable bowel syndrome, hypothyroid, and other endocrine/hormonal conditions may preceded the onset of fibromyalgia in which case the condition is considered "secondary fibromyalgia." Hence, a diagnostic evaluation usually includes a blood test for hypothyroid, autoimmune diseases such as rheumatoid arthritis, and a complete blood count to rule out infections and/or anemia. In most cases, these tests prove negative and the diagnosis is made by excluding other possible primary conditions.

Other causes can include physical and/or emotional trauma where a high-level of stress can trigger this condition. Although experts still debate why patients with fibromyalgia hurt so intensely, the current explanation centers around a theory called central sensitization. This is essentially a lower pain threshold where patients with FM feel pain much sooner than those without it because of increased sensitivity in the brain and/or spinal cord to incoming pain signals.

Treatment of FM relies on a multidiscipline, multifactorial approach including stress reduction, obtaining enough sleep, exercising regularly, pacing yourself, and maintaining a healthy lifestyle, including diet and exercise. Medications to facilitate sleep, treat depression and any other underlying medical conditions may be appropriate. Other highly effective treatments, according to the Mayo Clinic website, include chiropractic treatment, massage therapy, and/or acupuncture. The concepts of chiropractic treatment includes restoring movement in restricted spinal joints resulting in improved nerve function and subsequently, improved overall function and reduced pain. Chiropractic care also includes soft tissue therapies, physical therapy modalities, nutritional counseling, patient education and many utilized in-house massage therapy. We recognize the importance of including chiropractic in your treatment of FM and realize you have a choice of providers. We would be honored to be part of your management team.
                      
YOU MAY BE A CANDIDATE FOR OUR FIBROMYALGIA PROGRAM! FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Health Update: Headaches

What Is It and What Can I Do About It?

“I woke up this morning with an excruciating headache.  I thought the top of my head was going to blow off!”  “I notice as the day goes on, tightness in my neck worsens and I get a headache usually by 2-3pm.” “I don’t know if I can do my work with my headaches.”

These are common patient history entries we frequently receive at our clinic.  Headaches are one of the most common complaints prompting patients to visit a health care provider.  Many patients ask, “...what is a headache?”  The National Institutes of Health (NIH) describe four types of headache: vascular, muscular contraction or tension, traction and inflammatory.

The most common form of a vascular headache is migraine.  Migraine sufferers usually complain of severe pain on one or both sides of the head, nausea or vomiting and sometimes visual changes.  There is often a heightened sensitivity to light or noise prompting migraine sufferers to lay in a dark, quiet room until the migraine passes.  Women are more likely to suffer from migraines than men and the severity of symptoms can be so extreme that all activity must be stopped until it passes.

The next most common type of vascular headache is the toxic headache produced by a fever.  Other vascular headache types include “cluster” headaches, which are characterized by repeated episodes of intense pain that start in one spot and spread out from that spot.  These may only last a few minutes to an hour but carry a very high level of pain and activity intolerance.  Another common type of vascular headache is that resulting from high blood pressure.

Muscle contraction or tension headaches involve tightening of the facial and neck muscles.  These often start in the neck and radiate over the top or to the sides of the head.  The muscles in the neck are usually extremely tight and tender and often, moderate pressure applied with the finger or thumb to these muscles will prompt radiating pain into and/or over the top of the head.  This can also result in significant activity intolerance but usually not as severe as migraine or cluster headaches.

Traction and inflammatory headaches result because of other conditions that range from a sinus infection to a stroke.  These types of headaches can serve as a warning sign of a more significant or serious condition.  Another example is meningitis as well as other conditions affecting the sinuses, spine, neck, ear, and teeth.

The NIH suggests, when headaches occur ≥3 times a month, that “… preventive treatment is usually recommended.” Certainly, in some cases, medication may be indicated but only after ruling out a more serious condition and after exhausting less invasive treatments that carry fewer side effects.

The American Chiropractic Association recommends:
1) avoid long time periods of staying in one position (computer, sewing machine, reading, etc.) and take stretching/neck range of motion exercise breaks every ½ to 1 hour
2) Exercise – walking, low impact aerobics
3) Avoid teeth clenching (due to straining the temporomandibular – TMJ, or jaw joint)
4) Drink lots of water – stay hydrated.

Chiropractic care may include spinal manipulation (adjustments), nutritional advice (dietary suggestions, vitamin/mineral options such as a B complex), exercise, posture retraining, and relaxation techniques.  If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  If headaches are a problem, doesn’t a trial of chiropractic make sense prior to utilizing a more risk oriented treatment option?  We look forward in serving you and your family.

YOU MAY BE A CANDIDATE FOR OUR HEADACHE RELIEF PROGRAM.
CALL TODAY. 732-984-9597

Health Update: Whiplash

Whiplash – The Importance of Seatbelts


Whiplash is a very common problem afflicting millions of people each year. In fact, there are more than 6 million car accidents each year in the United States alone. Death associated with car accidents occurs every 12 minutes and each year, motor vehicle collisions (MVC) kill 40,000 people. For people aged between 2 and 34 years old, MVCs are the leading cause of death.   Another sobering statistic is somebody is injured in a car crash every 14 seconds and about 2 million people receive permanent injuries in car crashes each year. Over a five-year period, over 25% of ALL drivers were involved in a motor vehicle collision. 

The cost of car accidents averages $1000 for each American per year resulting in a $164.2 billion total cost each year in the United States.  Approximately 250,000 children are injured and car crashes, meaning approximately 700 kids are injured daily. Car crashes are the leading cause of acquired disability.   Hopefully, these rather startling statistics have gotten your attention.  Last month, we discussed various effective ways of reducing the likelihood of even being in a motor vehicle collision (MVC). As an appropriate follow-up, this discussion will cover seatbelts and their role in injury prevention and life-saving capabilities.

In general, the available evidence available is clear – seat belts save lives! Regarding backseat passengers, wearing a seatbelt is 44% more effective at preventing death than riding unrestrained. Similarly, for those positioned in the rear of a van or sport utility vehicle, the use of rear seatbelts is 73% better at preventing a fatal outcome during a car crash. In more than one half of all fatal car accidents, the victims are not properly restrained. The National Highway Traffic Safety Administration (NHTSA) in 2008 reported the use of seatbelts increased 1% over 2007 with 83% of drivers wearing their seat belts. The use of seatbelts increased to 90% on highways versus 80% on surface streets (in town). In states where rear seatbelts are required, 85% of adult backseat passengers complied versus states not mandating rear seat seatbelt use where only 66% of the passengers complied. The NHTSA has launched a campaign, "Click It or Ticket" and has provided a guide to seatbelt safety promoting the proper use of the seatbelt and have provided the following safety seatbelts tips:


Make sure your seat belt fits snugly. Seat belts worn too loosely can cause broken ribs or injuries to your abdomen.
Place the lap belt low on your hipbones and below your belly. Never put the lap belt across your belly.
Place the shoulder belt across the center of the chest between the breasts.
Never slip the upper part of the belt off your shoulder. Seat belts that are worn too high can cause broken ribs or injuries to your belly.
The most effective safety protection available today for passenger vehicle occupants is lap/shoulder seat belts combined with air bags.


There is a common myth that seatbelts cause injuries at low speeds and therefore, it is better to not wear the seatbelt when simply traveling in town. There is overwhelming evidence in almost all circumstances, seatbelts save lives, even at low speed collisions. Because the forces that occur in low-speed crashes are transferred to the contents due to the lack of crushing metal and less vehicle damage, the occupants of a car struck at a low speed can be thrown about significantly… striking the windshield, side window and other contents inside the car. We realize that you have a choice in where you choose for your health care services.  If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you.  

YOU MAY BE A CANDIDATE FOR OUR WHIPLASH TREATMENT PROGRAM
FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597