Fitness

Carpal Tunnel Syndrome #2

~ Dr. Robert Speirs DC ~ Leave a comment

Healthcare providers tend to agree that in non-emergency situations, patients with conditions like Carpal Tunnel Syndrome (CTS) should try non-surgical treatments before consulting with a surgeon. The “PRICE” concept, that is Protect, Rest, Ice, Compress, & Elevate can be applied to most injuries, including CTS, especially in the acute/inflammatory stage. However, many of these principles also apply in the chronic stage (more than three months) of CTS.

PROTECT: For the CTS patient, many doctors commonly prescribe a wrist cock-up splint to be worn overnight, which may surprise some of you! During the day, depending on the type of work you do, a wrist splint can actually get in the way and result in increased symptoms, and at times, cause bruising at both ends of the splint (mid-forearm & mid-hand). The primary reason to use the splint at night is that one cannot control the position of their wrist during sleep, and it can often wind up bent. This increases the pressure inside the carpal tunnel up to six to eight times more than normal, potentially causing enough pain and tingling to disturb sleep. The splint guarantees a neutral wrist position, which significantly improves sleep quality and allows healing to occur.

REST: The use of a splint allows the swollen median nerve to heal. However, in order to allow the wrist to rest so inflammation can subside and the condition can fully heal, patients often need to modify their daily activities, at least for a short time. This may require job restrictions, especially if the occupation involves a fast repetitive motion type of tasks and/or forceful gripping.

ICE: The use of an “ice cup”—or an ice cube held with a washcloth to protect the fingertips from getting cold—is by far the most effective approach. Rub the ice directly on the skin over the carpal tunnel so that you experience the four stages of cooling: Cold, Burning, Aching, and Numb (C-BAN). This usually takes about four minutes, and it’s important to stop when numbness occurs, as the next stage of cooling is frostbite. This can be repeated multiple times a day and is often as effective as cortisone shots with fewer side effects (and less pain!).

COMPRESS: The wrist cock-up splint can offer some compression, but an elastic carpal tunnel wrist band will not usually interfere with most activities of daily living. Some versions include a thumb loop to keep the wrist band in place, but that may get in the way. A version without the thumb loop also works very well.

EXERCISE: Exercises performed at home and work can significantly help manage the condition. (Note: For injuries like a sprained ankle, E typically stands for ELEVATE, though it’s not practical for the CTS patient.)

Tune in next month for the unique techniques that chiropractic offers to the non-surgical care of CTS as well as the importance of preventative measures and research.

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 Carpal Tunnel Syndrome, we would be honored to render our services.

 

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I have Low Back Pain. Why?

~ Dr. Robert Speirs DC ~ Leave a comment

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Low back pain (LBP) can arise from disks, nerves, joints, and the surrounding soft tissues. To simplify the task of determining “What is causing my LBP?” the Quebec Task Force recommends that LBP be divided into three main categories: 1) Mechanical LBP; 2) Nerve root related back pain; and 3) Pathology or fracture. We will address the first two, as they are most commonly managed by chiropractors.
Making the proper diagnosis points your doctor in the right direction regarding treatment. It avoids time wasted by treating an unrelated condition, which runs the risk of increased chances of a poor and/or prolonged recovery. Low back pain is no exception! The “correct” diagnosis allows treatment to be focused and specific so that it will yield the best results.
Mechanical low back pain is the most commonly seen type of back pain, and it encompasses pain that arises from sprains, strains, facet and sacroiliac (SI) syndromes, and more. The main difference between this and nerve root-related LBP is the ABSENCE of a pinched nerve. Hence, pain typically does NOT radiate, and if it does, it rarely goes beyond the knee and normally does not cause weakness in the leg.
The mechanism of injury for both types of LBP can occur when a person does too much, maintains an awkward position for too long, or over bends, lifts, and/or twists. However, LBP can also occur “insidiously” or for seemingly no reason at all. However, in most cases, if one thinks hard enough, they can identify an event or a series of “micro-traumas” extending back in time that may be the “cause” of their current low back pain issues.
Nerve root-related LBP is less common but it is often more severe—as the pain associated with a pinched nerve is often very sharp, can radiate down a leg often to the foot, and cause numbness, tingling, and muscle weakness. The location of the weakness depends on which nerve is pinched. Think of the nerve as a wire to a light and the switch of the nerve is located in the back where it exits the spine. When the switch is turned on (the nerve is pinched), and the “light” turns on—possibly in the outer foot, middle foot, inner foot, or front, back or side of the thigh. In fact, there are seven nerves that innervate or “run” into our leg, so usually, a very specific location “lights up” in the limb.
Determining the cause of your low back pain helps your doctor of chiropractic determine which treatments may work best to alleviate your pain as well as where such treatments can be focused.

My Hip Hurts….

~ Dr. Robert Speirs DC ~ Leave a comment

hip FAI

​Is it a labral tear? 

One of the structures that is frequently blamed for hip pain is called the labrum—the rubbery tissue that surrounds the socket helping to stabilize the hip joint. This tissue often wears and tears with age, but it can also be torn as a result of a trauma or sports-related injury.

The clinical significance of a labral tear of the hip is controversial, as these can be found in people who don’t have any pain at all. We know from studies of the intervertebral disks located in the lower back that disk herniation is often found in pain-free subjects—between 20-50% of the normal population.  In other words, the presence of abnormalities on an MRI is often poorly associated with patient symptoms, and the presence of a labral tear of the hip appears to be quite similar.

For instance, in a study of 45 volunteers (average age 38, range: 15–66 years old; 60% males) with no history of hip pain, symptoms, injury, or prior surgery, MRIs reviewed by three board-certified radiologists revealed a total of 73% of the hips had abnormalities, of which more than two-thirds were labral tears.

Another interesting study found an equal number of labral tears in a group of professional ballet dancers (both with and without hip pain) and in non-dancer control subjects of similar age and gender.

Another study showed that diagnostic blocks—a pain killer injected into the hip for diagnostic purposes to determine if it’s a pain generator—failed to offer relief for those with labral tears.

Doctors of chiropractic are trained to identify the origins of pain arising from the low back, pelvis, hip, and knee, all of which can mimic or produce hip symptoms.  Utilizing information derived from a careful history, examination, imaging (when appropriate), and functional tests, chiropractors can offer a nonsurgical, noninvasive, safe method of managing hip pain.

“Other” Causes of Low Back Pain

~ Dr. Robert Speirs DC ~ Leave a comment

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Between 80% and 90% of the general population will experience an episode of lower back pain (LBP) at least once during their lives. When it affects the young to middle-aged, we often use the term “non-specific LBP” to describe the condition. The geriatric population suffers from the “aging effects” of the spine—things like degenerative joint disease, degenerative disk disease, and spinal stenosis. Fractures caused by osteoporosis can also result in back pain.

The “good news” is that there are rare times when your doctor must consider a serious cause of LBP. That’s why he or she will ask about or check the following during your initial consultation: 1) Have you had bowel or bladder control problems? (This is to make sure a patient doesn’t have “cauda equina syndrome”—a very severely pinched nerve.) 2) Take a patient’s temperature and ask about any recent urinary or respiratory tract infections to rule out spinal infections. 3) To rule out cancer, a doctor may ask about a family or personal history of cancer, recent unexplained weight loss, LBP that won’t go away with time, or sleep interruptions that are out of the ordinary. 4) To rule out fractures, a doctor may also take x-rays if a patient is over age 70 regardless of trauma due to osteoporosis, over age 50 with minor trauma, and at any age with major trauma.
Once a doctor of chiropractic can rule out the “dangerous” causes of LBP, the “KEY” form of treatment is giving reassurance that LBP is manageable and advise LBP sufferers of ALL ages (especially the elderly) to KEEP MOVING! Of course, the speed at which we move depends on many things—first is safety, but perhaps more importantly is to NOT BECOME AFRAID to do things! As we age, we gradually fall out of shape and end up blaming our age for the inability to do simple normal activities. Regardless of age, we must GRADUALLY increase our activities to avoid the trap of sedentary habits resulting in deconditioning followed “fear avoidant behavior!”
Here are a few “surprising” reasons your back may be “killing you”: 1) You’re feeling down – That’s right, having “the blues” and more serious mood disorders, like depression, can make it more difficult to cope with pain. Also, depression often reduces the drive to exercise, may disturb sleep, and can affect dietary decisions—all of which are LBP contributors. 2) Your phone – Poor posture caused by holding a phone between your bent head and shoulder (get a headset!) or prolonged mobile phone use can increase your risk for spinal pain. 3) Your feet hurt, which makes you walk with an altered gait pattern, forcing compensatory movements up the “kinetic chain” leading to LBP. 4) Core muscle weakness, especially if you add to that a “pendulous abdomen” from being overweight—this is a recipe for disaster for LBP. 5) Tight short muscles such as hamstrings, hip rotator muscles, and/or tight hip joint capsules are common problems that contribute to LBP. Stretching exercises can REALLY help!

CTS Exercises?

~ Dr. Robert Speirs DC ~ Leave a comment

​CTS Stretch

Carpal Tunnel Syndrome (CTS) is the leading cause of numbness to the middle three fingers and thumb and affects millions of Americans each year. There are MANY potential causes of CTS, and these causes can be unclear or multi-factorial. We have discussed the importance of night splints and what chiropractic can do for CTS in the recent past. This month, let’s look at what YOU can do for CTS.
“Self-help” concepts are VERY important as they empower YOU to gain control of your condition’s signs and symptoms, thus placing less reliance on those of us who manage (in this case) CTS. There is a time for “PRICE” or, Protect, Rest, Ice, Compress, Elevate, such as when most activities make symptoms worse. This is the time for splinting, reducing activities of daily living (which sometimes includes work restrictions), and the use of ice cupping or massage. Patients should initiate movement or exercise-based approaches as soon as such activities can be tolerated. Here are four different exercises you can do:
1. Fist / “Bear Claw” / Open Wide Hand: This is a three-step exercise, and you can start or stop on any of the three “steps.” A. FIST:  Make a fist and squeeze as tightly as tolerated; B. BEAR CLAW: Starting from the fist position (A), open only the palm of the hand (keep your thumb and fingers bent but straighten the big knuckle joints at the base of the fingers); C. OPEN WIDE: Straighten and spread ALL your finger joints by opening up your hand as much as possible and feel for a good stretch in the palm. HOLD each position for one to five seconds (vary the “speed” of moving between the three positions – fast, medium, and slow; emphasize what feels best if you have a preference). Repeat five to ten times or until your hands feel looser.
2. “Church Steeple”: Place your hands together in front of you (“prayer position”) touching the pads of the thumbs and all four fingertips together and spread your fingers as wide as possible. Next, separate your palms as far as you can while applying pressure against your finger/thumb tips and repeat. Alter the speed and number of repetitions until your hands feel stretched out.
3. “Shake and Flick”: Simply shake your hands as if you just washed them and you’re shaking the water off to “air dry” them. Again, alter the speed and reps until they feel loosened up.
4. Forearm Stretches: Place one arm out in front, elbow straight, and fingers pointed straight, palm up (first set). Reach with the opposite hand and pull the fingers, hand, and wrist down and back towards you until you feel a strong “pull” in your forearm muscles. Hold until the forearm muscles feels stretched (5-10 seconds). Repeat this with the palm facing down for the second set to stretch the opposite (extensor) forearm muscles.
Do these on each side two to three times each (even the “good” side) EVERY HOUR (or as often as possible). Think about what you do on a daily basis and if you work in a repetitive manner (on the job or a hobby at home), try to do these exercises DURING THE REPETITIVE ACTIVITY to help keep your symptoms from getting out of control. If you can alter the position or speed of a work or avocational activity, do so for long-term prevention purposes!
If you cannot gain control of your CTS condition, you may need additional treatment options of which chiropractic offers a safe, non-surgical approach.
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 Carpal Tunnel Syndrome, we would be honored to render our services.

8 Safety Tips to Prevent Falls

~ Dr. Robert Speirs DC ~ Leave a comment

8 tips

When the rain and snow starts to fall, so do people. In fact, falls are the leading cause of nonfatal injuries in adults 45 and older. Protect yourself from a life-changing injury this winter with these 8 safety tips.

1. Choose the right shoe. Shoes and boots need to fit properly and have soles with good traction. Snow boots or hiking boots will provide the best protection for the worst type of weather.

2. Leave early. Falls are more likely to happen when you’re in a rush. Allow yourself plenty of time to get to where you’re going.

3. Walk like a penguin. Take short steps and walk as flat-footed as possible on icy or slippery ground.

4. Keep your hands free. You’ll need them to help you balance, so avoid carrying heavy loads and keep those hands out of your pockets.

5. Remove snow and ice from walkways frequently. Don’t wait for it to melt. That could take awhile. Apply ice melt and ask for help if you need it.

6. Keep the lights on. If you have exterior lights on your home, use them to help see where you’re walking at night.

7. Advocate for your safety. If the entrances or sidewalks do not look safe outside of a business or a local venue, speak up and let someone know.

8. Keep your cell phone with you. Even if it’s just on a trip to the mailbox, bring it. In the event that a fall does occur, you may need it to call someone for help.

 

Stay vigilant and remember these tips during this winter season. If you are injured from a fall, count on our office to help get you back on your feet quickly.

5 Tips For Gym Newbies

~ Dr. Robert Speirs DC ~ Leave a comment

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Michelle Blood has a great piece for new gym members over at LifeZette.com Check out the link at the end of the page for the whole article. Getting started can be a daunting task for many; these 5 tips will help you stay motivated, safe, on task and get you to your goals.

1.) Get checked. Before you set foot into the gym to begin any workout program, it is important you get clearance from your doctor. It is easy to overlook this step in the excitement over the idea of committing yourself to getting fit. However, failure to do so can be very costly. For the following groups of people, it is extremely important to hit the doctor’s office before you hit the gym:

  • You haven’t had a physical in the past year.
  • You’re planning a significant increase in the intensity of exercise.
  • You’re undertaking a new form of exercise.
  • You have a physical condition that may be exacerbated by exercise.
  • You have concerns about your physical capability for exercise.

2.) Get comfortable. Gyms can feel intimidating when you’re new because the layout and procedures at your gym are unfamiliar, as are the pieces of equipment and the group-exercise formats. The best way to combat these sorts of concerns is to take some time to tour the gym, to observe different group-based classes, and to receive some basic instruction on use of various pieces of equipment.

Consider approaching instructors and trainers. Most are friendly and personable, and more than willing to answer any questions you have about classes or equipment. Your fellow gym members can be an indispensable source of information as well. Ask them about their experiences in a class that interests you.

By getting as much information as you can prior to joining a class, you’ll feel more comfortable participating when you make the leap and sign up for your first group class.

3.) Get equipped. Fortunately, you don’t need to break the bank to gather up a few essentials you’ll want to have when you begin your gym-based fitness journey. Though you’re not going to need an entire new wardrobe, it would be a good idea to pick up a couple of sweat-wicking items (e.g., shorts, T-shirts) and an appropriate pair of shoes.

Other items on your shopping list might include: a filtered, refillable water bottle; showering necessities; a padlock (if your gym provides lockers); and some pre and post-workout healthy snacks. Store the essentials in a sturdy bag to throw in your trunk so you’ll always be ready to hit the gym for a quick workout whenever the mood may strike you.

4.) Get a partner. Building some accountability in to your new gym routine is a great way to bolster your chances of success. Bringing a friend or family member along to the gym has a number of advantages. When you commit to another person, you give yourself the gift of subtle, positive pressure to stick to your goals.

If you’re waffling about attending class on a given day, the fact that your partner will be there waiting for you can provide that extra bit of encouragement you need to power through your reluctance and show up for class anyway.

In addition, developing a fun competition with your partner can have some spectacular results. Science has shown us, time and again, that people lose more weight when they are involved with a team or are in a competition. Be sure to keep it positive, and you can spur one another to successes neither partner might have hoped to achieve on his or her own.

5.) Get pumped. You can beat the “I just don’t feel motivated” monster in a number of ways. Finding an effective strategy for motivating yourself is somewhat a matter of trial and error. Try some of the following to discover what works best for you.

  • Create a personalized music playlist of songs that get you moving.
  • Read books and articles about people who have achieved what you hope to achieve.
  • Set up a system of rewards for yourself for meeting small goals.
  • Spend time with people who inspire you.
  • Keep a journal of your feelings before and after working out — review it when you feel tempted to skip.

Regardless of your level of experience — you can confidently succeed at the gym.

 

http://www.lifezette.com/healthzette/success-at-the-gym-five-top-tips-for-exercise-newbies/