Carpal Tunnel Syndrome: More “Fun Facts!”

Did you know that Carpal Tunnel Syndrome (CTS) can affect anyone? None of us are immune to developing CTS as roughly 1 out of 20 of us will develop CTS in our lifetime! This month, let’s look at some of the risk factors for developing CTS.

1. Race: Caucasians carry the greatest risk of developing CTS.
2. Gender: Women are three times more likely than men to develop CTS. This may be because female wrists are smaller and shaped a little differently than male wrists, but hormonal differences are probably the most important reason for this variance.
3. Pregnancy: Up to 62% of pregnant women develop CTS. This is thought to be due to the excess fluid retention that normally occurs during pregnancy and most likely stems from the elevation in hormone levels that NORMALLY occurs during pregnancy. The prevalence in the first, second, and third trimesters is 11%, 26%, and 63%, respectively, thus supporting the fact that the risk increases with the length of the pregnancy. Though CTS usually resolves after giving birth, symptoms can continue for as long as three years following delivery!
4. Birth Control Pill (BCP): The use of BCPs increases CTS risk due to an increase in hormonal levels similar to the CTS risk increase during pregnancy.
5. Occupational: Workers in highly repetitive, hand-intensive occupations (such as line work, sewing, finishing, meat processing, poultry or fish packing) have a higher rate of developing CTS.
6. Injury to the wrist or hand: An obvious example is a wrist fracture from a slip and fall, sports injury, or blunt trauma like a car accident. When there is a direct pinch on the median nerve, nerve damage can occur quite quickly, and as a result, the onset of symptoms can be very fast. Less obvious injuries, which usually have significantly slower onsets, include repetitive motion injuries, often referred to as “cumulative trauma disorders” and include a group of conditions such as tendonitis, sprain/strain, bursitis, and other types of soft tissue injuries.
7. Certain conditions: Nerve damaging conditions that can cause CTS include diabetes and alcoholism. Other conditions that can contribute and/or cause CTS include menopause, obesity, thyroid disorders, kidney failure, and more.
8. Inflammatory conditions: These include several types of arthritis such as rheumatoid, lupus, and others. Osteoarthritis is technically NOT an “inflammatory” condition but it can cause CTS by compressing the median nerve via a bone spur formed within the carpal tunnel.
9. Faulty work stations: A job site has A LOT to do with whether or not a person develops CTS. Though jobs that require fast, repetitive movements pose the greatest risk (see #5 above), other work-related factors that may be controllable can also significantly contribute to the development of CTS. Some of these include the shape of tools such as screwdriver handles shaped like a gun (pistol) which allow for better alignment of the wrist than a “normal” straight screwdriver handle. Another is a power tool that may have too much vibration or torques too hard at the end of a cycle. A handle that is too cold/hard (e.g., metal handle) or that may be too large for the worker’s hand is an additional factor to consider. Positioning the work so that the wrists can stay straight vs. bent can be VERY helpful. In fact, if some of these “ergonomic” factors are not fixed, CTS can be next to impossible to remedy. Also, poor posture in the back, neck, and the rest of the body can result in compensatory faulty postures elsewhere. Look in a mirror and poke your chin out towards the mirror. Now look at your shoulders. See how they roll forward and feel the strain in your upper back and neck? Keep your chin tucked in, NOT out. This can make a BIG difference in your posture!

Weekly Health Update—Chiropractic: Dare to Compare.

Mental Attitude: Meditation Benefits.
According to an analysis of 47 clinical trials involving over 3,500 patients, meditation offers benefits to people with depression, anxiety, and pain similar to antidepressant medications. The researchers behind the study also note that meditation does not have the potential negative side-effects of antidepressant drugs.
JAMA Internal Medicine, January 2014

Health Alert: Hygiene and Diabetes?
Researchers at the University of Helsinki Children's Hospital believe the rise in auto-immune diseases, like type 1 diabetes and allergies, may be linked to a corresponding rise in hygiene standards. The so-called "hygiene hypothesis" suggests that less bacterial exposure during childhood may hinder the development of a child's immune system. The researchers point out that Finland has the highest incidence of type 1 diabetes in the world but neighboring countries with lower hygiene stands have much lower reports of the auto-immune disease.
University of Helsinki Children's Hospital, January 2014

Diet: Avocado Please.
According to a new study, participants who ate half of a fresh avocado with lunch were 40% less hungry three hours later and 28% less hungry five hours later. Most of the fat content in avocados is monounsaturated fat and studies have shown that regularly consuming this type of fat can reduce levels of bad cholesterol in the blood, as well as reduce the risk of stroke and heart disease.
Nutrition Journal, January 2014

Exercise: A Quick Walk?
Walking at a moderate pace for 180 minutes over the course of a week (30 minutes a day for five days or 60 minutes a day for three days) has been demonstrated to significantly improve mild to moderate depression.
Harvard Medical School, November 2005

Chiropractic: Dare to Compare.
Patients with chronic (>13 weeks) spinal pain were placed into one of three types of care: acupuncture, medication, or spinal manipulation. After 30 days of treatment, only the manipulation group showed significant reduction in pain intensity and improvements across all outcome measurements.
Journal of Manipulative and Physiological Therapeutics, July 1999

Wellness/Prevention: Watch What You Eat!
A study involving 224 adolescent females found that the increased consumption of dietary fat was significantly linked to an increase in abdominal fat, regardless of total calorie intake or physical fitness. The accumulation of abdominal fat is harmful as it increases the risk of suffering from cardiovascular problems, diabetes mellitus, arterial high blood pressure, high cholesterol level, etc. According to lead researcher Dr. Idoia Labayen, "Until now it was thought that even with an unbalanced diet, you somehow compensated for it if you got plenty of physical exercise. In this study we have shown that this is not the case."
Clinical Nutrition, January 2014

Whiplash Management

Whiplash usually occurs as a result of a car crash when the head moves in a fast, uncontrolled way in many possible directions. The forwards-backwards movement is described in a classic “whiplash” injury but side-to-side, rotational, or a combination of movements often occur, especially if we add in the factor of the head being turned or rotated when the impact occurs, regardless of how the car is hit. This month, let’s talk treatment!

Think of “Whiplash Management” in steps:

STEP 1: IMMEDIATELY seek chiropractic attention following a whiplash injury: This is important as studies show delayed treatment is associated with worse outcomes after the dust settles. To avoid long-term disability, DON’T WAIT! Pain usually scares people into a guarded, protective way of thinking. The longer you wait, the greater the muscle tightness, spasm, weakening, and your increased fear of activity because of the pain!

STEP 2: REDUCE INFLAMMATION: The words “pain” and “inflammation” are quite synonymous. If you feel “hurt,” you are “inflamed.” We must begin anti-swelling/inflammation measures ASAP after an injury like whiplash. The BEST/safest approach is an ICE PACK – rotate it on/off/on/off/on every 15 minutes (1.25 hours/session) three times a day OR, CONTRAST ice with heat (10 min. ice/5 min. heat x3, ending with ice = 40 min.). BOTH methods produce a PUMP-like effect to quickly get rid of the inflammation. You also have the option of OTC medications (Aspirin, ibuprofen, and naproxen) but these NSAIDs (non-steroidal anti-inflammatory drugs) carry significant side-effects for some people, the most evident early on being stomach upset/irritation (later, liver and kidney damage) so be careful! You don’t want to have to treat an ulcer on top of your whiplash! Consider anti-inflammatory nutrients, herbs, vitamins, and food – they’re safe and effective (we’ve discussed these previously – SEARCH the web for more information).

STEP 3: AVOID INACTIVITY: This is important since the “natural” thing to do is nothing, “…because it hurts!” WE will guide you in this process as you need to know how much and what type of activity is safe and appropriate. You have to “interpret” the pain as being either safe or harmful and then you react accordingly. You MUST tell us the type of pain (sharp, knife-like is harmful vs. a “good” stretch type of hurt is safe), how much pain there is (7-10 on a 0-10 scale is potentially harmful), how constant it is, and what helps/hurt (what have you tried and learned so far). THEN, we will guide you appropriately (with your help)!

STEP 4: DO NORMAL ACTIVITY: This dovetails our last point. Get on with your normal activities as avoiding work and other ADLs (activities of daily living) leads to “disability thinking” or thinking you’re worse than you are. DON’T LET THAT HAPPEN. Talk to us!!!

STEP 5: AVOID prolonged faulty postures: Whether it’s a conversation with a person who is NOT directly in front of you, a faulty computer screen position, talking in a car without turning your body (look straight ahead), or talking on the phone, CHANGE IT!

STEP 6: COMPLY with a home-based exercise program: This is HUGE! We will guide you in this process. We will start with ice and then possibly a home traction device, isometrics followed by Theratube or band (isotonic) exercises, posture training, and much more. You NEED guidance in this area – let us HELP YOU!

Fibromyalgia Dietary Considerations - Part 2

Fibromyalgia (FM) management must include dietary considerations, just ask ANY FM sufferer! Last month, we concentrated on the types of foods that reduce inflammation, but the question remains, what foods should we go out of our way to avoid? In other words, what should we NOT eat (and why)? Let’s take a look!

As we all know, it’s MUCH EASIER to simply grab a cookie, a chocolate bar, or go through the drive-through at McDonald’s and eat on the fly. This has become “the rule” for many of us as we trim down our meal times to fit in other tasks. We seem to have our priorities mixed up and have become preoccupied in our busy lives using the excuse that “…eating simply takes too long.”

The “avoid” list starts with stop eating junk food. It’s like pollution to our body as it clogs and clutters up our digestive system and the absorbed by-products include “bad” fat like trans-fats & saturated fats that can damage the heart. These fats are found in highly processed foods, red meats, and high-fat processed meats like bacon and sausage. Many of these meats are also high in salt, another “no-no” for heart health reasons, particularly for those with high blood pressure. Other sources of saturated fat include lamb, pork, lard, butter, cream, whole milk, and high-fat cheese. Some plant sources of saturated fat include coconut oil, cocoa butter, palm oil, and palm kernel oil. The U.S. Department of Agriculture’s 2005 Dietary Guidelines recommends that adults get 20-35% of their calories from fats. At a minimum, we need at least 10% of our calories from fat.

Other foods to avoid are white flour-based foods such as bread and pasta. This is primarily because white flour is derived from grains which are gluten rich (wheat, oats, barley, rye) and as we discussed last month, very inflammatory to our body! Simply avoiding gluten can be the nucleus of a great diet with benefits like increased energy, less mental fog, and weight loss without really trying! Sugar is also found in many products that we like eating. It’s found in juices, soda, pastries, candy, most desserts, as well as pre-sweetened cereals. Even ketchup has sugar in it! Another “bad guy” comes from the nightshade family of plants that includes tomatoes, eggplant, potatoes (but NOT sweet potatoes), sweet and hot peppers, ground cherries (a small orange fruit similar to a tomato), and Goji berries. These plants contain a chemical alkaloid called solanine that triggers pain in some people.

Weight reduction is another way to reduce pain and inflammation. If your Body Mass Index is over 25, (“Google” a BMI calculator and check yours) then you may need to lose weight! There are MANY diets one can follow, but to keep it simple embrace one approach first and see what kind of results you get. Try the “Paleo diet” as it is a gluten-free approach. The Mediterranean diet is similar and then there is the Aitkin’s Diet, the Zone Diet, etc., etc. Try eliminating the three most abused unhealthy foods in your diet (like soda, ice cream, chocolate, etc.) as that too can yield great results. Make sure your thyroid is working properly if you can’t lose weight with these approaches. Simply put, foods high in sugar, saturated fat, and white flour cause overactivity of our immune system which can lead to joint and muscle pain, fatigue, and damage to blood vessels.

Eliminating these foods and eating the foods discussed last month is good for all of us, not JUST those suffering from fibromyalgia!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Weekly Health Update—Chiropractic: Car Wrecks and Disk Injuries.

Mental Attitude: Green Spaces?
Researchers have discovered that moving to greener areas can improve a person's mental health over the long-term. During a 5-year study, people who moved into greener areas experienced an immediate improvement in mental health that persisted for at least three years. Those who moved to a more built-up area with less green space experienced a decline in their mental health. The authors of the study suggest creating more green spaces in towns and cities (parks and gardens) could bring lasting benefits to public health.
Environmental Science & Technology, January 2014

Health Alert: Excessive Alcohol Consumption.
Nearly forty million American adults drink too much alcohol, although most are not considered alcoholics. According to the Centers for Disease Control and Prevention, high weekly use is considered 15 or more drinks for men and eight or more drinks on average for women. Excessive alcohol consumption causes premature death (79,000 deaths annually in the United States alone) and costs the economy $224 billion a year.
Centers for Disease Control and Prevention, January 2014

Diet: High-Protein Diet Linked to Kidney Problems!
A Spanish study found that rats fed a long-term, high-protein diet (57% of total calories from protein) had a higher risk for developing kidney stones and other renal diseases than rats fed a lower protein diet (13% of total calories from protein). The authors of the study stress that even though these results are derived from rat subjects, their findings should translate to humans and anyone on a high-protein diet should be closely monitored for kidney-related issues.
Nutricion Hospitalaria, January-February 2013

Exercise: Decreased Risk for Heart Attack Later in Life.
A Swedish study involving over 740,000 males found that lack of aerobic fitness at age 18 corresponds to a greater risk for a heart attack later in life. According to lead researcher Dr. Peter Nordström, "As far as we know, this is the first study to investigate the links between an objective measure of physical fitness in teenagers and risk of heart attack in the general population. Further studies are needed to investigate the clinical relevance of these findings, but given the strong association that we have found, the low cost and easy accessibility of cardiovascular training, and the role of heart disease as a major cause of illness and death worldwide, these results are important with respect to public health."
European Heart Journal, January 2014

Chiropractic: Car Wrecks and Disk Injuries.
A disk injury can cause chronic neck pain following a car accident. If the outer wall of the disk (the annulus) is torn and does not properly heal, stress on the nerve endings in the annulus may cause neck pain during normal activities.
North American Spine Society, January 2014

Wellness/Prevention: Un-Happy Employees are More Likely to Smoke.
According to the Gallup research, employees who are emotionally disconnected from their jobs are 20% more likely to smoke than employees who are either neutral or excited about their work. Previous research has shown that disengaged employees are more likely to suffer from stress, obesity, and chronic health problems.
Gallup, August 2013

Chiropractic and Sinus Headaches

Sinus headaches refer to pain in the head typically in and around the face. Most of us are knowledgeable about two of our four sinuses: the frontal (forehead) and maxillary (our “cheek bones”). The other two sinuses (called ethmoid and sphenoid) are much less understood. As chiropractors, many patients ask us about sinus problems, as all of us have had a stuffy nose due to a cold and have felt this pain in our face and head. Those of us who have suffered from sinus infections REALLY know how painful sinusitis can get! This month, let’s take a look at our sinuses and what we can do to self-manage the problem.

First, an anatomy lesson... As stated above, there are four paired, or sets, of sinuses in our head: Maxillary: Pain/pressure in the cheekbones, sometimes referring pain to the teeth. These drain sideways (if you lay on your side, the side “up” drains down into the downside maxillary sinus and into the nose). Frontal: Pain/pressure in the forehead. These drain downward (when we’re upright, looking straight ahead). Ethmoidal: Pain/pressure between and/or behind the eyes. These drain when we lean forwards. Sphenoidal: Cause pain/pressure behind the eyes, top of the head and/or back of the head (which can be extreme). These drain best when lying face pointing down towards the floor, but they can be stubborn to drain!

Sinusitis, or rhinosinusitis, by definition is an inflammation of the sinus lining (mucous membrane) and is classified as follows: Acute – a new infection which can last up to four weeks and are divided into two types: severe and non-severe; Recurrent acute – four or more separate acute episodes within one year; Subacute – an infection lasting 4-12 weeks; Chronic infections lasting >12 weeks; and Acute exacerbation of chronic sinusitis – recurring bouts of chronic sinusitis.

One cause of sinusitis can include an “URI” (upper respiratory tract infections) most often in the form of a virus (such as rhinovirus -- there are over 99 types have been identified, or better known as “the common cold”). Bacteria can also cause a sinus infection. These infections tend to last longer and can follow a viral infection. A third cause is a fungal infection. These are more common in diabetic and other immune deficient patients. Chemical irritants such as cigarette smoke and chlorine fumes can also trigger sinusitis. Chronic sinusitis can be caused by anything that irritates the sinuses for >12 weeks (viruses, bacteria, environmental irritants, tooth infections, and more). Allergies are also a common cause of sinusitis whether they are environmental and/or food/chemical induced.

Chiropractic care for sinusitis includes primarily symptomatic care with sinus drainage techniques such as facial and cranial bone manipulation/mobilization, lymphatic pump and drainage techniques, instruction in self-stretch of the sinuses (such as an outward pull of the cheek bones in different positions of the head), nutritional counseling (such as 1000mg of vitamin C every 2-4 hours) and anti-inflammatory herbs and vitamins (see prior Health Updates), cervical and mid-back manipulation, training in nasal saline rinsing (Nasaline, Nettie Pot), moist heat (towels, steam), and of course, chicken soup! Co-management with your primary care doc may be needed at times, if medications are warranted.

Weekly Health Update—Chiropractic: The Cause of Post Car Accident Neck Pain.

Mental Attitude: Depression's Influence on Severe Rheumatoid Arthritis Sufferers!
Based on data provided by 322 patients with severe rheumatoid arthritis, researchers have identified that a patient's psychological state can affect self-reported measurements about how their body responds to different treatments and therapies. The researchers recommend rheumatologists be aware of their patient's mental state when assessing the efficacy of their treatment plan.
Arthritis Care & Research, December 2013

Health Alert: Smoking is a $289 Million Dollar a Year Burden!
During the last half-century, 20 million Americans have died as a consequence of smoking and 16 million more continue to suffer from smoking-related conditions. The combined healthcare expenses and lost economic productivity that results from smoking-related illnesses costs the United States (US) about $289,000,000 each year. According to the Centers for Disease Control and Prevention, one in every thirteen children alive in the US right now will die prematurely from smoking-related diseases unless current smoking rates drop!
Centers for Disease Control and Prevention, January 2014

Diet: Diet Soda Not Helpful for Dieters!
A new study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health finds that drinking diet soda may not help dieters lose weight. Using data from the long-term National Health and Nutrition Examination Survey, researchers discovered that, even though people who drink diet sodas are drinking fewer calories, they tend to consume just as many or more total calories than people who drink sugary beverages. According to lead author Dr. Sarah Bleich, "The results of our study suggest that overweight and obese adults looking to lose or maintain their weight--who have already made the switch from sugary to diet beverages--may need to look carefully at other components of their solid-food diet, particularly sweet snacks, to potentially identify areas for modification."
American Journal of Public Health, January 2014

Exercise: How to Keep that New Year’s Resolution.
Recording goals in a fitness diary, reflecting on successes and failures, and being held accountable by others are key strategies that have been found to maximize the achievement of all goals, including New Year’s resolutions.
Loughborough University, January 2014

Chiropractic: The Cause of Post Car Accident Neck Pain.
After a car accident, the cause of neck pain may be unknown. Muscles and ligaments can become strained and even inflamed, but they usually heal within six to ten weeks. Pain that lasts longer is usually due to injury to the disk, facet joint, or both. Facet joint pain is the most common cause of chronic neck pain after an accident. Facet joint pain may occur alone or along with disk pain and may sometimes be mistaken for muscle pain.
North American Spine Society, January 2014

Wellness/Prevention: Breastfeeding and Rheumatoid Arthritis?
A study of 7,000 older Chinese women showed that those who breast fed their children had a 50% reduced risk for rheumatoid arthritis later in life.
Rheumatology, January 2014

Low Back “ON-THE-GO” Exercises (Part 2)

Low back pain (LBP) is a reality in most of our lives at one point or another. It can range from being a “nag” to being totally disabling. Let’s look at some exercises for the low back that can be done from a STANDING position so that they can be: 1) Performed in public (without drawing too much attention) and 2) Repeated every one to two hours with the objective to AVOID LBP from gradually getting out of control (STOP the “vicious cycle” so LBP stays “self-managed”).

RULES: 1) DON’T do any exercise that creates SHARP pain; 2) Stay within “reasonable” pain boundaries; 3) DO these multiple times a day WHEN you feel tight, stiff, sore (take 10-30 sec. every hour rather than 15 min. twice a day).

STANDING LOW BACK EXERCISE OPTIONS:

1. STANDING HAMSTRING/GROIN STRETCH: 1) Place your heel on a chair/bench. 2) Arch your low back until you feel a “draw” or pull in the back of the leg. 3) Bend your ankle towards you – feel the pull in your calf). 4) If needed, bend forwards or bend the support leg knee for additional stretch. 5) Hold for 3-10 seconds or until it feels loose. 6) ROTATE your body to the opposite side until you feel the pull in your groin and hold 3-10 sec. 7) Switch legs!
2. STANDING BACK EXTENSIONS: 1) Place the backs of your hands on your low back. 2) Slowly arch the lower back over your hands – stop if you feel pinch/sharp pain. 3) Release the pressure and re-apply multiple times. 4) Hold for 3-10 seconds or, until it feels loose. 5) REVERSE and bend over to touch your toes and hold until you feel loose.
3. STANDING HIP FLEXOR STRETCH: 1) Stand straddled with one leg behind the other. 2) Rotate your back leg hip forwards (try to line up the left with the right so the pelvis is square). 3) Tuck in your pelvis (flatten the curve in the low back). 4) Bend backwards until the pull in the groin increases. 5) Hold for 3-10 seconds or, until it feels “loose.” 6) REPEAT on the opposite side.

Remember, DO these MANY times a day (at least once every hour). We have many others as well (ask us)!

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 back pain, we would be honored to render our services.

Weekly Health Update—Chiropractic: Can Neck Pain Affect Brain Activity?

Mental Attitude: Be Positive!
Young people with positive attitudes such as self-belief, aspiration, flexibility, and an appetite to learn were associated with less hyperactivity, fewer emotional problems, fewer problems with fellow pupils, greater inclination to help others, were happier, and slept better.
Think Forward, January 2014

Health Alert: Alarming Rate of Overweight and Obese in Developing Countries.
In the last three decades, the amount of overweight and obese people in developing countries has skyrocketed from 250 million to almost one billion people. In comparison, richer nations have seen a rise from 200 million to 600 million overweight and obese people over the same period of time. Dr. Steve Wiggin explains, "On current trends, globally, we will see a huge increase in the number of people suffering certain types of cancer, diabetes, strokes and heart attacks, putting an enormous burden on public healthcare systems."
Overseas Development Institute, January 2014

Diet: Vitamin E.
A study involving 140 elderly men and women found that those with higher levels of vitamin E in their bodies were less likely to suffer from cognitive decline. Foods rich in vitamin E include spinach, almonds, sunflower seeds, avocados, shrimp, rainbow trout, olive oil, broccoli, and pumpkin.
Experimental Gerontology, January 2014

Exercise: As Effective as Medications.
Doctors from the Stanford University School of Medicine reviewed the results of 305 studies involving over 300,000 patients and have determined that exercise may be as effective as medication in preventing early death in people who've had heart attacks or strokes. Furthermore, regular exercise lowers the risk of early death, helps one stay lean, and reduces the risk of heart disease, stroke, type 2 diabetes, depression, some cancers, and cognitive decline. Despite this information, only 21% of American adults meet the government's recommendations for exercise: 150 minutes per week of moderately intense aerobic activity and muscle strengthening activities two days a week that work all the major muscle groups.
British Medical Journal, January 2014

Chiropractic: Can Neck Pain Affect Brain Activity?
Transcranial magnetic stimulation measurements taken on chronic neck pain patients both before and after spinal manipulation showed that manipulation improved cerebellar motor processing in their brains. The cerebellum is the part of the brain that plays an important role in fine-tuning the body's movements.
Journal of Manipulative and Physiological Therapeutics, October 2013

Wellness/Prevention: Decreasing Cancer Risk.
Over an 8-year study period, postmenopausal women who closely followed the American Cancer Society's Nutrition and Physical Activity Cancer Prevention Guidelines had a 17% lower cancer risk, a 20% lower risk of cancer-related death, and a 27% lower risk of death from all causes. According to lead author Dr. Cynthia Thomson, "The message is simple and clear: If you want to reduce your risk for cancer, even later in life, eat a healthy diet, be active daily, avoid or limit alcohol, and don't smoke."
US National Institutes of Health, January 2014