Interesting News

CTS Warning Signs

~ Dr. Robert Speirs DC ~ Leave a comment

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Headaches are REALLY common! In fact, two out of three children will have a headache by the time they are fifteen years old, and more than 90% of adults will experience a headache at some point in their life. It appears safe to say that almost ALL of us will have firsthand knowledge of what a headache is like sooner or later!

Certain types of headaches run in families (due to genetics), and headaches can occur during different stages of life. Some have a consistent pattern, while others do not. To make this even more complicated, it’s not uncommon to have more than one type of headache at the same time!

Headaches can vary in frequency and intensity, as some people can have several headaches in one day that come and go, while others have multiple headaches per month or maybe only one or two a year. Headaches may be continuous and last for days or weeks and may or may not fluctuate in intensity.

For some, lying down in a dark, quiet room is a must. For others, life can continue on like normal. Headaches are a major reason for missed work or school days as well as for doctor visits. The “cost” of headaches is enormous—running into the billions of dollars per year in the United States (US) in both direct costs and productivity losses. Indirect costs such as the potential future costs in children with headaches who miss school and the associated interference with their academic progress are much more difficult to calculate.

There are MANY types of headaches, which are classified into types. With each type, there is a different cause or group of causes. For example, migraine headaches, which affect about 12% of the US population (both children and adults), are vascular in nature—where the blood vessels dilate or enlarge and irritate nerve-sensitive tissues inside the head. This usually results in throbbing, pulsating pain often on one side of the head and can include nausea and/or vomiting. Some migraine sufferers have an “aura” such as a flashing or bright light that occurs within 10-15 minutes prior to the onset while other migraine sufferers do not have an aura.

The tension-type headache is the most common type and as the name implies, is triggered by stress or some type of tension. The intensity ranges between mild and severe, usually on both sides of the head and often begin during adolescence and peak around age 30, affecting women slightly more than men. These can be episodic (come and go, ten to fifteen times a month, lasting 30 min. to several days) or chronic (more than fifteen times a month over a three-month period).

There are many other types of headaches that may be primary or secondary—when caused by an underlying illness or condition. The GOOD news is chiropractic care is often extremely helpful in managing headaches of all varieties and should be included in the healthcare team when management requires a multidisciplinary treatment approach.

Can Carpal Tunnel Be Prevented? 

~ Dr. Robert Speirs DC ~ Leave a comment

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Carpal Tunnel Syndrome (CTS) is a VERY common condition where the median nerve is compressed or squeezed as it passes through the wrist. One reason that it’s so common is because MANY daily activities require fast, repetitive use of the fingers, hands, and arms, and the friction of the rapidly moving muscle tendons inside the tunnel results in swelling and compression of the nerve. So, can CTS really be prevented?

There are many factors associated with CTS, and some risks can be prevented. For example, some conditions like diabetes, rheumatoid arthritis, and IBS increase the risk of CTS. Therefore, it would be safe to assume those who better manage such conditions would have a lower risk for developing CTS.

Due to the many factors associated with CTS, there is no “one size fits all” when it comes to treatment and prevention of CTS. With that said, here are some VERY effective methods:

1)  Ergonomic workstation modifications: Altering the work space (monitor height, keyboard/mouse style, different chair, chair/desk height, etc.) to reduce the number and speed of movements needed to perform commons work tasks.

2)  Rest periods: Insert “micro-breaks” into a busy task. Combine breaks with stretching exercises of the wrist/hand/fingers and vary job tasks between fast and slow repetitive types.

3)  Exercise: Shake the fingers and hands, lean back in a chair with the arms/shoulders stretched back (“Brugger’s Exercise”), move the neck (chin tucks, rotations, etc.), bend the hand/wrist backwards on a wall or the desk’s edge, self-massage and deep tissue release of the forearm and hand muscles. Do regular aerobic exercise (walking, swimming, biking, etc.) several times each week.

4) Posture: Sit up straight, elbows about 90° on height-adjustable arm rests or comfortably at the sides, forearms parallel to the floor; knees level or slightly lower than the hips, feet flat on the floor or on a footrest or box, if needed. Place typing materials at eye level / avoid prolonged head/neck rotation. Use a wrist rest for the keyboard and mouse, and use a headset when on the phone.

5)  Reduce hand tool forces: Choose a tool that allows the wrist to remain neutral. Avoid side to side and flexion/extension wrist positions—especially if they’re prolonged! Tool handles should NOT dig into the palm of the hand or the wrist, and should not have sharp edges. A textured handle can improve grip. Minimize vibration from power tools. Wear shock absorbing gloves. Avoid cold work environments and cold tools.

6)  Diet: Cut down on caffeine and smoking. Avoid obesity—a known risk factor of CTS! Consider an anti-inflammatory diet (Paleo, Mediterranean).

7)  Splints: A wrist cock-up splint at night prevents prolonged faulty positions and REALLY helps!

This is a partial list of preventative measures that can REALLY help. Doctors of chiropractic treat the WHOLE person and can teach you the right exercises, ways to modify your diet, offer manual therapies and modalities, and help guide you in your self-management of CTS, as this can be a lifelong affliction. A multi-modal treatment approach generally works best!

Is Surgery Always Required?

~ Dr. Robert Speirs DC ~ Leave a comment

​Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy—that is, it’s the most common place to trap a nerve in the extremities (arms or legs). CTS affects 6-11% of adults in the general population, and it occurs in women more often than men. The cause is often difficult to determine but the most common reasons can include trauma, repetitive maneuvers, certain diseases, pregnancy, being over the age of 50, and obesity.

So, is surgery the only answer? The short answer is NO! In fact, in a recent randomized clinical trial published in the Journal of Pain, researchers observed similar improvements in function when they compared the outcomes of patients who underwent surgery vs. those who received manual therapies (such as those performed several times a day at chiropractic clinics around the world) at both six months and one year later. The improvements included increased strength, function, and decreased hypersensitivity in both the surgical and non-surgical groups. Interestingly, the manual therapy group did BETTER at the one and three month assessments when compared with the surgical group (again, with no difference at six and twelve months)!

The median nerve, the culprit behind CTS, starts in the neck and travels down through the shoulder, elbow, forearm, and finally through the carpal tunnel, which is made up of eight small carpal bones that form the arch of the bridge. Entrapment of the median nerve occurs when the normally tight quarters within the carpal tunnel combine with the inflamed nine sheathed muscle tendons that push the nerve into the floor of the tunnel (a ligament), which results in CTS! The goal of therapy—both surgical and manual therapy—is to reduce the pressure within the tunnel and free up the compression of the median nerve.

Manual therapies focus on joint mobilization and manipulation to reduce joint fixations, muscle release techniques in the forearm and hand, stretching techniques, and at-home exercises that emphasize a similar stretch, the night brace, and management of any underlying contributing factor. These “underlying factors” might include diabetes, hypothyroid, taking birth control pills, weight management, and inflammatory arthritis.

 

CTS SUrgery

Food Myth #5: High Fructose Corn Syrup is worse than other sugars.

~ Dr. Robert Speirs DC ~ Leave a comment

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Sugar is everywhere and most don’t even know it.

Dextrose, sucrose, rice syrup, maltodextrin….. All sugars and all affect our bodies the same way. While these monikers may not be as well known or as much maligned as high fructose corn syrup they are just as much of a health inhibitor as HFCS and good old table sugar.

While HFCS has long been seen as the worst of a bad bunch, a 2014 review of multiple studies found there was no difference in blood glucose changes between HFCS or table sugar. Basically, your body can’t tell one from the other and all the cigars mentioned above cause similar reactions in your body. Sugar is sugar.

The biggest issue with HFCS? It is EVERYWHERE. In order to reduce your sugar intake you’ll need to know many terms for sugars and keep an eye on what you’re eating day in and day out.

 

 

 

 

http://www.eatthis.com/29-nutrition-myths-busted/

 

Entering & Exiting Your Vehicle

~ Dr. Robert Speirs DC ~ Leave a comment

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Entering and exiting your vehicle is a potential risky activity for low back pain sufferers. Follow these tips to limit problems:

 

✓ To enter the vehicle, open the door and stand with your back to the seat, legs close to the side of the vehicle. For larger vehicles, you may wish to begin by standing on the running board. Place your hands on the door and door frame to keep your movements slow and controlled then slowly lower your body into the vehicle.

✓ Tuck your head into the vehicle. Keep your knees close to each other, as though they have been taped together, brace your abdomen as though you are about to be punched in the stomach and pivot your body as a whole without twisting or bending at the waist. You may grasp the steering wheel with your right hand to help you pivot.

✓ Use a lumbar roll or other support to help maintain good posture. Position the roll slightly above your belt to support the “small of your back”. Adjust your seat so that your knees are slightly lower than your hips. Try to avoid prolonged car rides- take frequent breaks.

✓ Before exiting, create adequate space by pushing your vehicle seat back as far as possible and move the steering wheel up and out of the way. To exit, first scoot slightly to the door side edge of your seat, then keep your knees together and pivot with the same cautions that you used to enter the vehicle. When your feet are shoulder width apart and firmly on the ground or running board, grasp the door and door frame, lean forward, but be sure not to bend your back, as you tighten your abdominal muscles. Slowly thrust your hips forward to stand up.

Workers compensation cases highlight the value of chiropractic care

~ Dr. Robert Speirs DC ~ Leave a comment

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A newly published analysis of 5511 workers compensation cases highlights the value of chiropractic care: “those injured workers who first saw a chiropractor experienced shorter first episodes of compensation (vs. physical therapy alone)”.

If you or someone you know has suffered a job-related injury, call us today. Our goal is to provide the most effective care that gets you back to work ASAP!

https://www.ncbi.nlm.nih.gov/pubmed/27638518

Do you have Carpal Tunnel Syndrome?

~ Dr. Robert Speirs DC ~ Leave a comment

​Carpal Tunnel Syndrome is VERY common. If fact, it affects 3-6% of the general population, and up to 50% of those afflicted have it in both hands! So what makes it so common? Here are several reasons:

1) ANATOMY: The wrist is made up of eight small “carpal” bones that allow the wrist to bend and twist in many different positions. If you were to look at the wrist “head on,” you’d notice it is shaped like a tunnel where the eight little carpal bones make up the “roof” and the transverse carpal ligament is the “floor.” You’ll also notice nine tendons and their sheaths that pass through the carpal tunnel and attach the forearm muscles to the fingers on the palm side of the arm, blood vessels, and the median nerve. When there is less available space within the carpal tunnel (due to inflamed tendons, for example), the added pressure can compress the median nerve and result in numbness, tingling, and weakness, mostly into the second to fourth fingers.

2) JOBS: People with occupations that require fast, repetitive movements and/or a firm grip with little rest have a higher likelihood of developing CTS.

3) GENDER: Women have a greater risk of developing CTS than men due to smaller wrists and hormonal changes that may result in swelling in the wrist.

4) AGE: Individuals over age 50 have a greater risk of developing CTS, especially females.

5) GENERAL HEALTH ISSUES: There are a host of conditions that can cause and/or aggravate CTS. Some of these include rheumatoid arthritis, diabetes, osteoarthritis, low thyroid function, and space-occupying issues like a ganglionic cyst inside the tunnel. Certain medications, such as birth control pills, and some forms of chemotherapy can also cause CTS. A pinched nerve in the neck or shoulder can alter median nerve function, which can exacerbate CTS symptoms.

6) TRAUMA: A fall onto an outstretched arm can sprain and/or fracture the wrist. If a fracture occurs, the onset of CTS can be very rapid, and quick realignment of the fracture is very important.

Chiropractic care offers a non-surgical solution to CTS, which includes splinting (primarily at night and when driving but usually less often during the day as we tend to “fight” against the splint), anti-inflammatory measures (ice, nutrients such as ginger, turmeric, bioflavonoids), and manual therapies—manipulation of the fingers, hand, wrist, elbow, shoulder, and neck (as indicated) and muscle release techniques to the forearm are very helpful. There are also effective exercises that patients can do at home that include joint range of motion and muscle stretching techniques.

 

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Food Myth #4

~ Dr. Robert Speirs DC ~ Leave a comment

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Nuts are junk food and should be avoided

Nut-uh. Nuts are a great source of protein, healthy fats and nutrient but are relatively high in calories. As a result they are a great snack but you need to keep an eye on portion control.

Recent research at Harvard (heard of them?) showed that women who ate a handful of nuts 5 times a week as a snack were 20% less likely to develop type II diabetes as those that didn’t. Also, several studies have shown that having nuts as a regular part of your diet helps protect against heart disease.

Now, this isn’t licence to crush all the peanuts you want when you’re watching the game… Be smart about your intake and look for nuts like almonds, brazils, cashews, macadamias and pistachios that aren’t swimming in (admittedly delicious) salt and oil.

So when you’re planning your snacks for the Super Bowl or the next Jets game, go nuts.

 

Why do so many suffer with CTS?

~ Dr. Robert Speirs DC ~ Leave a comment

​According to the literature, carpal Tunnel Syndrome (CTS) is one of the most prevalent upper extremity complaints. In fact, it IS the most common “compression neuropathy” (of which there are many) and affects 3-6% of adults in the general population. Additionally, CTS can affect BOTH hands in up to 50% of patients with the condition!

The CAUSE of CTS is often unknown and typically comes on gradually, making it difficult to determine a definite cause or specific “date of onset” for CTS.

Symptoms such as numbness, tingling, loss of dexterity, loss of strength (like pinch or grip), and the need to shake the hand or flick the fingers to restore sensation are ALL VERY COMMON CTS SYMPTOMS. The REASON for these symptoms boils down to one thing: The median nerve in the wrist gets pinched! The cause/s can include:

1)  Repetitive motion from either work or hobbies like assembly line work or playing a musical instrument can cause swelling within the carpal tunnel, placing extra pressure on the median nerve as it passes through.

2)  Obesity can contribute to CTS due to extra fluids or fatty deposits that can build up within the carpal tunnel.

3)  Pregnancy: Elevated levels of the hormones estrogen and progesterone can cause the body to retain fluids and increase pressure in the carpal tunnel.

4) Arthritis: Osteoarthritis can lead to CTS (such as when a spur forms inside the tunnel). Rheumatoid arthritis can lead to an autoimmune response and antibodies that end up attacking the cartilage of the joints in the wrist, which can lead to CTS.

5)  Hormone-related conditions: In diabetes mellitus, the blood becomes thicker due to high sugar levels (like syrup) and can’t pass through the small blood vessels, resulting in “neuropathy,” which can make CTS more likely. In hypothyroid, low thyroid function results in “myxedema,” a specific type of swelling that makes CTS more likely to occur.

6)  Trauma: A wrist fracture could cause the carpal tunnel to “collapse” or change in shape resulting in less space for the nerve to travel through.

7)  Mass lesions: A “ganglionic cyst” is a good example. This is where joint fluid leaks out and forms a “bump” on the INSIDE the carpal tunnel, which reduces space and increases pressure in this anatomical structure.

8)  Amyloidosis: This is a rare condition where a protein substance called “amyloid” builds up in any tissue or organ. If this occurs in the wrist, it can “pinch” the median nerve as it passes through.

9)  Sarcoidosis: This is the growth of small collections of inflammatory cells called “granulomas,” which can accumulate in different parts of the body. If it occurs in the wrist, pinching can occur.

10)  Multiple Myeloma: This is a type of cancer that affects the bone marrow, and inflammation in the wrist can occur creating the pressure increase on the median nerve that can lead to CTS.

11)  Leukemia: This too is a type of cancer that involves the white blood cells, and CTS can result from its effects on the tissues in the wrist.

12)  Anatomy: The size and shape of the carpal tunnel is hereditary, and some of us have a smaller tunnel than others. If CTS is present in multiple family members, this “genetic” factor may play a role.

There are other conditions that can “mimic” CTS, but doctors of chiropractic are trained to perform an accurate history and examination so treatment can be directed in the proper manner!

Food Myth #3

~ Dr. Robert Speirs DC ~ Leave a comment

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Avoid eggs because of their cholesterol content.

Eggs got a bad rep years ago because we thought they contributed to a rise in levels of LDL (Bad) cholesterol. The most recent research shows that eggs don’t actually contribute to high cholesterol at all and are a great source of iron, zinc, lutein, vitamin D and choline, not to mention a cheap, easy source of protein.

So go ahead with your eggs tomorrow morning! You’ll be healthier for it.

 

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https://www.heartfoundation.org.au/healthy-eating/food-and-nutrition/protein-foods/eggs
https://www.eatrightontario.ca/en/Articles/Heart-Health/Understanding-Eggs-and-Cholesterol-How-many-eggs.aspx
https://www.health.harvard.edu/heart-health/are-eggs-risky-for-heart-health