The Levator scapula is a muscle in your neck that originates on the transverse processes of C1-C4 and inserts on the superior part of the medial border of the scapula. The primary actions of this muscle are to elevate the scapula and rotate the glenoid fossa downward. It also rotates the neck to the same side and assists in extension. When this muscle is tight it restricts neck rotation resulting in the classic “stiff neck”. With a forward head position the Levator is often stretched and over worked. To help combat this you must get the head back by releasing the anterior chest and neck muscles. Trigger points in this muscle refer pain into the angle of the neck and down the shoulder blade.
Chronic Pain
A Few Sleep Tips From Us To You
Your mattress and the position you sleep in may affect your spine.
✓ Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses.
✓ Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach.
✓ Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms.
Here are a couple of tips to help you get in and out of bed more comfortably:
✓ To lie down: Sit on the edge of the bed, pull your arms to your sides and tilt your body into the bed, maintaining the bend of your knees at 45 degrees. Finally, bring your feet into in a lying position or roll onto your back.
✓ To get up: From a side-lying position with your knees bent, push your body upright into a sitting position, swinging your legs over the edge of the bed as you rise.
If you find that you wake up sore then you may be suffering from any number of conditions that get worse overnight.
Trigger points in the masseter muscle
The masseter is the main muscle that moves your jaw. It originates on the zygomatic arch and maxilla, and inserts on the coronoid process and Ramus of the mandible. It’s actions are to elevate the mandible and close the jaw. The deep fibres of this muscle also retrude the mandible. This muscle commonly harbours trigger points as a result of teeth grinding. Trigger points in this muscle are often also associated with tmj dysfunction. Trigger points in the upper part of this muscle will refer pain to the upper molars and maxilla often felt as sinusitis. Trigger points in the lower portion of this muscle refer to the lower molars and temple. All trigger points can cause tooth sensitivity
So I’ve got Whiplash; now what?
Whiplash, or “Whiplash Associated Disorders” or WAD, is the result of a sudden “crack the whip” of the head on the neck due to a slip and fall, sports injury, a violent act, or most commonly, a motor vehicle collision (MVC), particularly a rear-end collision. In describing “what can I expect” after a whiplash injury, one thing is for certain, there are many faces of whiplash, meaning the degree of injury can range from none to catastrophic depending on many factors, some of which are difficult or impossible to identify or calculate. Let’s take a closer look!
Even though the good news is that most people injured in a car crash get better, 10% do not and go on to have chronic pain, of which about half have significant difficulty working and/or doing desired everyday activities. There is a “great debate” as to the way experts describe “chronic whiplash syndrome” (CWS) as well as how these cases should be managed. Some feel there is something PHYSICALLY wrong in the CWS patient, especially if severe neck or head pain persists for more than one year. There is some proof of this as Dr. Nikolai Bogduk from the University of Newcastle in Australia and colleagues have used selective nerve blocks to anesthetize specific joints in the neck to determine exactly where the pain is generated. The patient then has the option to have that nerve cauterized or burned and pain relief can be significant in many cases. Dr. Bogduk and his group admit that these CWS patients have more psychological symptoms, but they feel this is the result of pain, not the CAUSE.
On the other hand, experts such as Dr. Henry Berry from the University of Toronto report the EXACT OPPOSITE. He argues that it’s not JUST the physical injury that has to be dealt with but also the person’s “state of mind.” Dr. Berry states that when stepping back and looking at all the complaints or symptoms from a distance, “…you see these symptoms can be caused by life stress, the illness ‘role’ as a way of adjusting to life, psychiatric disorders, or even [made up by the patient].” Berry contends that it’s important to tell the patient their pain will go away soon, advises NO MORE THAN two weeks of physical therapy, and sends people back to work ASAP.
Oregon Health Sciences University School of Medicine’s Dr. Michael D. Freeman, whose expertise lay in epidemiology and forensic science, disagrees with Dr. Berry stating that the scientific literature clearly supports the physical injury concept and states, “…the idea that it is a psychological disturbance is a myth that has been perpetuated with absolutely no scientific basis at all.” Dr. Freeman states that 45% of people with chronic neck pain were injured in a motor vehicle crash (which includes three million of the six million of those injured in car crashes every year in the United States).
Here’s the “take home” to consider: 1) CWS occurs in about 10% of rear-end collisions; 2) Some doctors feel the pain is physically generated from specific nerves inside the neck joints; 3) Others argue it’s a combination of psychological factors and care should focus on preventing sufferers from becoming chronic patients.
Many studies report that chiropractic offers fast, cost-effective benefits for whiplash-injured patients with faster return to work times and higher levels of patient satisfaction.
We realize you have a choice in whom 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 requires care for Whiplash, we would be honored to render our services.
Up Close & Personal With Headaches.
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.
Most of know someone who has been affected by headaches. If they are looking for help and information please feel free to contact us at 204-586-8424 or at info@aberdeenchiropractic.com.
Mind = Blown
Carpal tunnel syndrome (CTS) is a very common condition. According to a report by the Bureau of Labor Statistics (BLS), CTS ranks SECOND among the major disabling diseases and illnesses in ALL private industries. The BLS states that workers with CTS may eventually have to give up their livelihood. They cite one study in which almost half of all CTS patients changed their jobs within 30 months following their diagnosis. Due to the controversy surrounding the issue of CTS and worker’s compensation, workers do not always receive compensation benefits.
The KEY to long-term cost containment associated with CTS is EARLY DIAGNOSIS and PREVENTION! The challenge is getting the worker to identify early symptoms and NOT feel intimidated to report them, which could then lead to prompt care and possibly job modifications, resulting in the best chance of preventing a more complicated and far more costly problem.
Because of the many factors that contribute to and/or cause CTS, there is similarly no one way to prevent it from happening. Treating any/all underlying medical condition(s) is important. Using simple common sense can go a long way to help minimize some of the risk factors that predispose a person to work-related CTS and other cumulative trauma disorders (CTDs).
For example, watching and mimicking veteran workers can be a great guide as to how to maximize efficient work methods while minimizing unnecessary stresses and strains. Other preventative “tricks” include learning how to adjust the work area, handle tools, or perform tasks that minimize hand/wrist strain. Maintaining proper posture and exercise programs to strengthen the fingers, hands, wrists, forearms, shoulders, and neck may also help prevent CTS.
Many companies have taken action to help prevent repetitive stress injuries. In one study, 84% of the companies surveyed reported that they were modifying equipment, tasks, and processes as part of a prevention effort; nearly 85% analyzed their workstations and jobs; and 79% purchased more ergonomic equipment. Unfortunately, there is NO EVIDENCE that any of these methods can completely protect a worker against CTS. Often, the best approach is to relocate the worker to a less repetitive job, but this is not always an option.
Doctors of chiropractic can observe the worker through a video or during a factory tour/visit and often identify ergonomic problems that can result in a low-cost, easy modification. Simple modifications coupled with quality care, patient education, and cooperation from BOTH the worker and the employer can typically help yield the best outcome for the CTS patient.
Trigger points in the suboccipitals.
The suboccipitals are a group or four muscles that attach to the transverse and spinous process of C1 and C2 and the occipital bone.
These muscles provide extension side bending and rotation movements between the occiput and C1 and C2. These muscles are often overloaded due to postural strain. A classic example being sitting in front of a computer all day.
When these muscles are overloaded trigger points can develop. Pain and symptoms of trigger points in the suboccipitals include head pain that penetrates into the skull but is difficult to localize.
Patients are likely to describe the pain as “all over” including the occiput, eye and forehead, but without any clarity. Trigger points in these muscles are often associated with tension head aches
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Brain injury after whiplash?
In a 2010 study, researchers examined MRIs taken from 1,200 patients (600 whiplash and 600 non-whiplash neck pain patients) and noted that those who had sustained whiplash were more likely to have a brain injury than non-whiplash neck pain patients.
The specific type of brain injury found is a form of herniation called Chiari malformation, where the bottom part of the brain (the cerebellum) drops through the opening in the base of the skull called the foramen magnum. Their findings showed an alarming 23% of the whiplash cases studied had this anatomical abnormality.
Dr. Michael Freeman, Dr. Ezriel Kormel, and colleagues collaborated in this effort and evaluated the patients using MRI in both recumbent (laying down) AND upright positions. Interestingly, they found 5.7% and 5.3% of those in the non-whiplash neck pain group and 9.8% and 23.3% in the whiplash group had the Chiari malformation using the recumbent vs. upright MRI positions, respectfully.
Dr. Kormel stated, “This condition can be quite painful and endanger the patient’s health, with symptoms that may include headaches, neck pain, upper extremity numbness and tingling, and weakness. In a few cases, there can also be lower extremity weakness and brain dysfunction.” In a radio interview, he added the advice that ANYONE suffering from whiplash should see a healthcare provider immediately.
This study is important for a number of reasons. First, it revealed that there is often a more serious injury when whiplash occurs than what is initially found. Second, psychological findings like depression, anxiety, and difficulty coping with the decreased ability or inability to be productive at home or work may suggest the presence of an anatomical injury which simply has not yet been found. Third, MRI is frequently ONLY performed in a laying down position. This study didn’t find much difference between laying vs. weight-bearing MRI positions in the non-whiplash neck pain patients but not so in the whiplash neck pain group! In this group, the ability for MRI to detect Chiari malformation/brain injury more than doubled using weight-bearing MRI.
Expanding the last point, since one out of five whiplash patients had a brain injury that is more likely to be detected using a non-traditional upright MRI position, a “new” standard” for the use of MRI in the evaluation of the whiplash patient should be considered. This is especially important in those cases that are non-responsive to quality care or if their doctor had only ordered a recumbent MRI previously.
Doctors of all disciplines should be aware of this study and the need for a more thorough evaluation, especially when a whiplash patient is not responding as one might expect.
Fibromyalgia and Exercise
Are there differences in lifestyle between people with vs. without fibromyalgia (FM)?
A recent study found women with FM found spend more time engaged in sedentary behaviors and less time in physical activity. In the study, researchers followed 413 female patients with FM and 188 age-matched healthy female controls. Researchers used three different approaches to access physical activity: a triaxial accelerometer to examine sedentary time, time spent in physical activity, and step counts.
They discovered those who suffered from FM spent an average of 39 more minutes per day in sedentary activity and 21 fewer minutes per day in light physical activity, 17 fewer minutes per day in moderate physical activity, and 19 fewer minutes per day in moderate-to-vigorous physical activity. In addition, those with FM took a mean of 1,881 fewer steps that those without FM.
Now, this isn’t really a surprise given the fact that people with FM are in pain and more likely to have difficulties sleeping and tolerating prolonged activities. After comparing the sufferers to the non-sufferers, the researchers found only 21% of FM patients vs. 46% of non-FM controls achieved the recommended 150 minutes/week (a little over 20 min. / day) of “moderate-to-vigorous” physical activity. They also found that only 16% vs. 45%, respectively, walked the recommended ≥10,000 steps per day.
One of the BEST forms of exercise for most people is walking. A walking program should be a staple exercise. It’s important to note that this should be GRADUALLY introduced so as to avoid an overuse injury—strain or sprain of the muscles and joints. This gradual introduction into activity is ESPECIALLY important for the FM sufferer as overuse injuries can make them afraid to do something that can REALLY help when done correctly!
Carpal Tunnel Basics
Here it is: carpal tunnel syndrome (CTS) in a nutshell!
WHAT: CTS is caused by an injury to the median nerve (MN) as it travels through the wrist.
WHERE: The eight small carpal bones and a ligament form a tunnel in which tendons and nerves pass through to reach the hand.
HOW: The MN gets pinched/irritated from repetitive stress.
WHY: The tunnel is tight as it includes the MN and nine rapidly moving muscle tendons!
PROGRESS: CTS usually starts slow and often progresses over weeks, months, even years.
SYMPTOMS: Pain, numbness, tingling, and/or weakness of the hand, sparing the little finger.
PROGNOSIS: CTS is easier to treat shortly after it starts, and waiting too long to seek care may lead to worse outcomes.
RISK FACTORS: 1) family history (genetics); 2) women are more likely to suffer from CTS than men; 3) age over 50; 4) manual jobs; 5) pregnancy; 6) conditions like diabetes, hypothyroid, rheumatoid arthritis (RA), osteoarthritis, autoimmune diseases (includes RA, certain types of thyroid disease), gout, kidney disease (especially dialysis patients), Down syndrome, amyloidosis, acromegaly, tumors on the median nerve; 7) medications (those that affect the immune system such as interleukin-2, possibly corticosteroids), anti-clotting drugs such as warfarin, hormone replacement, BCPs; 8) obesity; 9) smoking; 10) alcohol abuse; and 11) trauma/injuries (fractures, tendonitis).
TREATMENT: Ideally, treatment should begin as soon as possible after symptoms first start, but this RARELY occurs due its slow and gradual onset. Non-surgical care includes anti-inflammatory care (ice, anti-inflammatory nutrients—ginger, turmeric, bioflavonoids; NSAIDs like ibuprofen), wrist splinting (primarily at night), corticosteroid injections, job/ergonomic modifications, exercises (yoga, stretching, strengthening, and aerobic fitness), low level laser therapy, ice, acupuncture, and chiropractic care. Chiropractic care includes MANY of the above PLUS manual therapies applied to the neck, shoulder, arm, wrist, and hand.
Aberdeen Chiropractic 