Physio

Do you have CTS?

~ Dr. Robert Speirs DC ~ Leave a comment

​Carpal Tunnel

Carpal tunnel syndrome (CTS) can be an extremely painful and activity-limiting condition. It affects many people of all ages and genders, though women are affected more often than men. But how do you know if what you are suffering from is truly CTS or if it’s another condition that’s producing the symptoms in your hand or wrist?
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the wrist. However, the median nerve travels out of the neck, through the shoulder, elbow, and forearm before it passes through the wrist and into the hand. Pinching of the median nerve ANYWHERE along its course can give rise to the signs and symptoms of CTS including numbness, tingling, and/or pain into the hand and index, third, and thumb-side half of the fourth digits, and sometimes the thumb. If the pinch is significant enough, weakness can also occur. Sometimes the median nerve can become compressed at both the wrist and other body sites as it travels from the spinal cord to your hand, that’s why it’s important for a doctor to check for impingements along the entire course of the nerve.
 
But compression of the median nerve isn’t the only thing that can produce symptoms in the hand. Here are a couple of the more common conditions that are often confused with CTS:
1)  Ulnar neuropathy: This is pinching of the ulnar nerve (at the neck, shoulder, elbow, or wrist) but this gives rise to a similar numbness/tingling BUT into the pinky-side of the fourth and the fifth fingers (not the thumb-side of the hand). The most common pinch location is either at the neck or the inner elbow, the latter of which is called “cubital tunnel syndrome” or CuTS.
 
2)  Tendonitis: There are a total of nine tendons that pass through the carpal tunnel that help us grip or make a fist. Similarly, there are five main tendons on the back side of the hand that allow us to open our hands and spread our fingers. ANY of these tendons can get strained or torn, which results in swelling and pain as well as limited function BUT there is usually NO NUMBNESS/TINGLING!
 
3)  DeQuervain’s disease: This is really a tendonitis of an extensor tendon of the thumb and its synovial sheath that lubricates it resulting in a “tenosynovitis.” This creates pain with thumb movements, especially if you grasp your thumb in the palm of your hand and then bend your wrist sideways towards the pinky-side of the hand.
 
Chiropractors are well-trained to diagnose and treat patients with CTS. And if you don’t have CTS but another condition listed above, they can offer treatment (or a referral, if necessary) to help resolve it so you can return to your normal activities as soon as possible.

Chiro & Concussions

~ Dr. Robert Speirs DC ~ Leave a comment

head-shot2

​Whiplash Associated Disorders (WAD) is the appropriate terminology to use when addressing the myriad of symptoms that can occur as a result of a motor vehicle collision (MVC). In a recent publication in The Physician and Sports Medicine (Volume 43, Issue 3, 2015; 7/3/15 online:1-11), the article “The role of the cervical spine in post-concussive syndrome” takes a look at the neck when it’s injured in a car accident and how this relates to concussion.

It’s estimated about 3.8 million concussion injuries, also referred to as “mild traumatic brain injury” (mTBI), occur each year in the United States. Ironically, it’s one of the least understood injuries in the sports medicine and neuroscience communities. The GOOD NEWS is that concussion symptoms resolve within 7-10 days in the majority of cases; unfortunately, this isn’t the case with 10-15% of patients. Symptoms can last weeks, months, or even years in this group for which the term “post-concussive syndrome” (PCS) is used (defined as three or more symptoms lasting for four weeks as defined by the ICD-10) or three months following a minor head injury (as defined by the Diagnostic and Statistical Manual of Mental Disorders).

There have been significant advances in understanding what takes place in the acute phase of mTBI, but unfortunately, there is no clear physiological explanation for the chronic phase. Studies show the range of force to the head needed to cause concussion is between 60-160g (“g” = gravity) with 96.1g representing the highest predictive value in a football injury, whereas as little as 4.5g of neck acceleration can cause mild strain injury to the neck. In spite of this difference, the signs and symptoms reported by those injured in low-speed MVCs vs. football collisions are strikingly similar!

Research shows if an individual sustains an injury where the head is accelerated between 60-160g, it is HIGHLY likely that the tissues of the cervical spine (neck) have also reached their injury threshold of 4.5g. In a study that looked at hockey players, those who sustained a concussion also had WAD / neck injuries indicating that these injuries occur concurrently. Injuries to the neck in WAD include the same symptoms that occur in concussion including headache, dizziness/balance loss, nausea, visual and auditory problems, and cognitive dysfunction, just to name a few.

The paper concludes with five cases of PCS that responded well to a combination of active exercise/rehabilitation AND passive manual therapy (cervical spine manipulation). The favourable outcome supports the concept that the neck injury portion of WAD is a very important aspect to consider when treating patients with PCS!

This “link” between neck injury and concussion explains why chiropractic care is essential in the treatment of the concussion patient! This is especially true when the symptoms of concussion persist longer than one month!

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 honoured to render our services.

Stiff neck and trigger points.

~ bryancobb ~ Leave a comment

Myofascial trigger points in the neck muscles are one of the most common causes of neck pain and stiffness. Poor posture and stress can cause muscles in the neck to become overworked and strained. When this happens trigger points will form. These points of contracted muscle will cause pain, referred pain (often into the head), as well as stiffness and weakness. Trigger points won’t resolve on there own, a manual release such as trigger point massage is required to treat the problem.

Brachioradialis trigger points.

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The Brachioradialis muscle is a muscle located in your forearm. It helps to flex the elbow during semi pronation, such as when drinking a cup of coffee or holding a phone to your ear. When trigger points form in this muscle pain can be felt in the forearm, back of the elbow, and even into the hand.

Trigger points and myofascial pain.

~ bryancobb ~ Leave a comment


Sensitive areas of tight muscle fibers can form in your muscles after injuries or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome.

What is myofascial pain syndrome?

~ bryancobb ~ Leave a comment

Myofascial pain syndrome is a chronic pain disorder. In this condition, pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body. This is called referred pain.

This syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.

Trigger points in the lateral pterygoid.

~ bryancobb ~ Leave a comment

The lateral pterygoid muscle is involved in movement of the jaw. It can become become strained from chronic clenching of the jaw and grinding of the teeth. When this happened trigger points can form. This leads not only to pain and refered pain, but also dysfunctional joint mechanics. This muscle is a major player in TMJ dysfunction syndrome.

Trigger points in the multifidus muscle.

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The multifidus muscle is a long muscle that travels the length of the spine. It has different actions on different parts of the spine. It extends and laterally flexes the cervical and lumbar spine, and rotates the thoracic spine. Trigger points in this muscle are common due to poor posture and bad movement mechanics. Trigger points in the lumbar area area are a common cause of low back pain. These lower points can also refer into the abdomen. Points that form in the cervical region will refer pain down the neck into the shoulder blade area.

~ bryancobb ~ Leave a comment

The rectus femoris muscle is one of your quad muscles. It acts primarily to extend the knee but it also helps to flex the hip. This muscle is often overloaded from athletic activity, but it also can become chronically shortened from prolonged sitting. Trigger points will refer pain deep into the knee producing a deep ache felt into the joint.