Carpal Tunnel Syndrome (CTS), named from the carpal bones in the wrist that form a tunnel around the nerve leading to the hand, is an injury usually caused by repetitive and forceful movements that result in swelling around the tendons and pinching of the median nerve, causing painful tingling, lack of muscle strength and control in the hand, and pain shooting from the hand up to the shoulder. CTS is a risk to most workers, such as those who work on the computer and also store and assembly line workers, who receive micro-traumas to their hands and wrists on a daily basis due to awkward positioning, forceful and repetitive movements, and stressful activity. [1,2]

The usual treatment for Carpal Tunnel Syndrome can extend to heavy medication and surgery, however there are alternative methods of treatment that can alleviate the symptoms and effects arising from CTS. Chiropractic treatment for CTS has been studied against conventional non-surgical medical treatment by Davis et al. [1] and was found to be effective. This offers an alternative to sufferers who are intolerant to ibuprofen, or thosewho simply wish to avoid treating with medication.

The median nerve in the wrist, which when trapped causes Carpal Tunnel Syndrome, connects to the spinal cord through the openings in the bones in the areas around the lower neck. If these bones in the spinal cord lose their ordinary position or motion, this can cause problems in the wrists or fingers. Through chiropractic treatment, these bones can be reset to the correct position and can help to treat CTS.
If Carpal Tunnel Syndrome is detected early, then surgery can be avoided, and chiropractic treatment is the leading method of non-surgical treatment. Chiropractic treatment usually involves various methods [3], with a combination of rest, ice, ultrasound, and electrical stimulation, including:
• By chiropractic manipulation therapy of the elbow and upper spine, where the joint’s soft tissue undergoes manipulation [4];
• Nutritional supplements in the diet such as B6, a vitamin that has had long-term promotion in its treatment of CTS;
• Electro-acupuncture treatment; bracing, a technique that has had extensive success, by limiting extension and flexion in the hand, and with compression on the median nerve may encourage recovery and ease the swelling in the tendons;
• Exercises for the wrist and hand designed to encourage recovery;
• Reassessing the ergonomics of the work place to minimize stress the best way as possible.
Recent studies, such as that by J. Burke et al (2007)[5], concluded that using manual therapy intervention such as soft tissue mobilization (STM) has been found to help improve the signs and symptoms of CTS, with improvements to nerve conduction latencies, wrist strength and motion.
Carpal Tunnel Syndrome can become a serious health problem, and if left too long may require surgery. If it’s caught early, then chiropractic treatment is an effective, drug-free method to ease the symptoms and pains caused by CTS, and provide long-term relief from CTS.

References
[1] P.T. Davis et al., J Manipulative Physiol Ther. 1998 (Jun);21 (5): 317-326 (1998)
[2] R.Valente and H. Gibson, J Manipulative Physiol Ther 1994;17(4):246–9 (1994)
[3] R. Perez de Leon & S. Auyong, J Chiropr Med. 2002 Spring; 1(2): 75–78. (2002)
[4] P.T. Davis and J.R. Hulbert, J Manipulative Physiol Ther 1998;21(5):356–62 (1998)
[5] J. Burke et al., J Manipulative Physiol Ther. 2007 Jan;30(1):50-61. (2007)

Exercise to reduce anterior weight bearing – do this daily for 10 days in order to reduce strain

on your neck.

• Stand with feet about 1” from wall
• Back will be touching wall
• Keep head in a neutral position
• (Don’t look up or down)
• Touch back of head to the wall
• Hold this position for 5 mins
• Do daily for 10 days

Sleepless in America?
For more than one in three Americans, getting a good night’s sleep isn’t as easy you might think. According to a recent poll by the National Sleep Foundation , a combination of daily stress and lifestyle choices (including nighttime activities as well as eating and exercise habits) is causing more than a third of the U.S. population to get fewer hours of sleep than they need. Not surprisingly, the same proportion report that sleepiness has in some way affected their quality of life.

The Long-Term Prescription for Quality Sleep.
Many studies have focused on the time we devote (or don’t devote) to sleep. However, a good night’s sleep is about more than just quantity. It’s also about quality. If you’re sleeping poorly, experts point out that developing a sensible routine and avoiding certain behaviors around bedtime can improve your chances of falling asleep quickly and sleeping soundly through the night. Here are a few of their suggestions:
• Go to bed at the same time each evening and wake up at the same time each morning.
• Exercise regularly but avoid increasing your heart rate within two or three hours of bedtime.
• Eat dinner early enough in the evening so that digestion doesn’t interfere with bedtime.
• Drink plenty or water but avoid drinking hot or cold liquids before or after bedtime.
• Reduce or eliminate caffeine and other stimulants in your diet.
• Sleep on your back and/or your side. Don’t sleep on your stomach!

When it Comes to Sleep, Little Things Matter More Than You Might Think. And They Add Up.
While finding more effective ways to manage stress and making adjustments to your lifestyle can take some time, there are several “little” things you can do right away that may improve the quantity and quality of sleep you get. These things focus on your sleeping environment itself:
• Make your room is as dark as possible at bedtime.
• Reduce background noise.
• Keep your bedroom at a cool, comfortable temperature.
• Sleep on an appropriate mattress.
• Choose the right pillow.

Is Your Pillow Doing Its Job?
Let’s face it. You probably don’t give a lot of thought to the pillow you sleep on. And you probably didn’t give your pillow much thought when you purchased it either. The truth is that most people don’t. It’s not unusual for a person (or a couple) to spend thousands of dollars on a high-quality mattress but then buy pillows that don’t support the head and neck properly. That’s because—while they understand that sleeping on the wrong mattress can quickly lead to a backache—they aren’t aware that poor alignment of the neck and upper back during sleep can lead to other, more subtle problems that they may not associate with the spine.
If a person’s head is supported by the pillow at a level that’s either too high or too low relative to the rest of the body, the neck and upper back can be placed under stress. Similar stress can also occur if their upper back is not supported along with the neck (so that the head tilts forward), or if the head is allowed to roll sideways when the person is sleeping on his or her back. Symptoms include snoring, insomnia and waking up with a headache, stiff neck or numbness in the arms and hands. If you’re experiencing these sorts of symptoms, you may be sleeping on the wrong pillow.

What Makes a Pillow “Right”?
Choosing a pillow is a very personal decision. The pillow that’s right for someone else may not be right for you. Nevertheless, we’ve provided some basic guidelines that will make it easier for you to choose the right one. The right pillow:
• Supports your head at the proper height whether you’re sleeping on your side or on your back.
• Supports both your head and neck in a neutral position while you’re sleeping on your side (Make sure there is no gap between the pillow and your neck!).
• Provides adequate support for both your neck and upper back while you’re sleeping on your back.
• Keeps your head tilted in the proper neutral position while you’re sleeping on your back.
• Prevents your head from rolling sideways while you’re sleeping on your back.
• Is easy to move on.
In general, you’re looking for a pillow that supports your neck, cushions your head and keeps your spine in alignment. It must be comfortable!

Purchasing Tips

• Know what you like. Do you prefer a pillow that’s “bouncy” or one that can be “molded” to the shape of your head and neck? How “dense” do you like your pillow to feel? Is it important to you that the material “breathes” and offers good insulation from heat and cold? Maybe you prefer a pillow made of synthetic or hypo-allergenic material? The more clearly you can describe your preferences, the more likely it is that a knowledgeable salesperson will be able to help you find your ideal pillow.

• Don’t skimp. Like most things, pillows can differ a great deal in the quality of their construction and materials. They also (naturally) differ a great deal in their price. Buy a better quality pillow if you can, since they’re generally made of materials that will provide better support, comfort and durability. But keep in mind that the first priorities are comfort and function. Just because a pillow is expensive doesn’t mean it’s right for you.

• Take the time to “test drive” and compare. Many department stores, mattress retailers and specialty bedding shops will have sample pillows that you can try. If possible, follow the “Ten Minute Rule” and test drive pillows in your favorite sleeping positions. Remember—you and your pillow will be spending about eight hours together every night for several years, so it makes sense to choose wisely now.

• Avoid buying a matched set of pillows for yourself and your partner. Keep in mind that your partner probably needs a different pillow that you do.

Get an Expert Opinion from the Doctor Who Understands Your Neck and Back Best
If you’re not sleeping as well as you used to, or if you’re waking up with a headache, stiff neck or numbness in your arms or hands, we invite you—and your pillow—to visit our office. As chiropractic physicians, we understand that the way you sleep affects your health. And that your health affects the way you live your life. Call today to schedule an appointment. Sometimes a small thing (like a new pillow) can make a big difference!

Headaches are a common source of pain for a large number of Americans.  95% of women and 90% of men have had at least one in the past 12 months.  And for about 45 million of us, those headaches are chronic.

While a wide variety of over-the-counter and prescription medications have been developed to relieve this pain, they generally do little to address the underlying cause of the problem.  In addition, many of these compounds can have unwanted side effects, particularly if they’re used often, over a prolonged period of time or in combination with other medicines.  A growing awareness of both the limitations and risks of pharmaceuticals has led many headache sufferers to explore alternative approaches to managing them, including chiropractic.

Understanding Headaches

Headaches occur for many reasons and can vary greatly in their intensity and duration.  They may arise on their own (these are termed “primary headaches” and account for about 90% of all headaches) or be triggered as a result of some other health condition (described as “secondary headaches”).  Chiropractic physicians most commonly encounter three types of headaches in their work.

• Tension headaches are primary headaches that are brought on by unrelieved muscular contractions in the head, neck and shoulders, usually as a result of stress that cannot find an outlet.  These muscular contractions can themselves become the source of broader tension and stress throughout the body, setting in motion a feedback loop that eventually produces a headache.

• Migraine headaches are also primary headaches.  They are sometimes referred to as vascular headaches because they happen when blood vessels in the head suddenly expand, or “dilate”.  However, we know that the nervous system and genetic factors are also leading contributors.  Sufferers report a wide range of triggers and related symptoms.  Research into the exact cause of migraines is ongoing, and the condition has stubbornly resisted efforts to find a pharmaceutical “silver bullet”.

• Cervicogenic headaches are secondary headaches produced when pain begins in the neck or back of the head and is referred to the forehead or the area behind, in and around the eyes.  Trauma, chronic tension and disease are some of the more common initial sources of neck pain that is referred to the head.  Trigger points in the neck, shoulder blade and spine may also be sources of these headaches, though they can be much more difficult to identify.

How Chiropractic Can Help

There is a large and growing body of medical research that suggests chiropractic care can be effective in preventing or reducing the frequency and severity of primary headaches.  There is also some evidence that it may have benefits for cervicogenic headache sufferers.

Chiropractic manipulation of the spine and neck is used to improve the alignment of the spine and relieve muscle tension.  It also reduces nerve irritation and improves vascular flow.  Your chiropractic physician may also include massage and other therapies as part of a well-rounded treatment plan.  He or she will likely suggest exercise, stretching and relaxation techniques as well as nutritional strategies designed to help prevent future headaches.

If you or someone you know is looking for lasting relief from chronic headaches, we encourage you to call your doctor of chiropractic today.  The sooner you make the call, the sooner we can help you put an end to the suffering.

Headaches and Chiropractic.  American Chiropractic Association.  Accessed August 2011.

http://www.acatoday.org/content_css.cfm?CID=2186

Encyclopedia of Alternative Medicine.  AltMD.  Accessed August 2011.

http://www.altmd.com/Articles/Headache–Encyclopedia-of-Alternative-Medicine

Information for Patients.  American Headache Society.  Accessed August 2011

http://www.achenet.org/education/patients/index.asp

Research Spotlight:  Study of Spinal Manipulative Therapy for Neck-Related Headaches Reports Findings on Dose and Efficacy.  National Institutes of Health, National Center for Complementary and Alternative Medicine.  Accessed August 2011.

http://nccam.nih.gov/research/results/spotlight/041310.htm

National Institutes of Health MedlinePlus.  Accessed August 2011.

http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm

What is Sciatica?

Many people use the term sciatica incorrectly. Sciatica is pain along the path of the sciatic nerve which extends from the lower back down each leg. Sciatica is a symptom (like itching), it is not a diagnosis (like Parkinson’s disease). Sciatica can range from an occasional nuisance to excruciating pain that makes walking near impossible. There can be multiple underlying reasons for your sciatic nerve pain. A chiropractor can help find the root cause of the problem with an exam and may also order some diagnostic imaging such as an x-ray, MRI or CT scan to examine the underlying structures.
To answer the question, ‘what is sciatica’ it is helpful to explain some of the relevant anatomical structures. The sciatic nerve is both the longest and the widest nerve in your body. It begins in the lower back as five separate nerves that extend from five different vertebrae – L4, L5, S1, S2, and S3. These nerves meet up to form one large bundle which runs through the buttocks and down the entire length of the leg. The sciatica nerve is responsible (directly or indirectly) for nearly all the sensation in your leg including the skin of the thigh and gluts.
Sciatica occurs when there is compression or irritation of the sciatic nerve. The pain is felt in the low back and leg, but the site of the pain isn’t always the site of the underlying issue. Since the sciatica nerve is so long and travels around or through the large muscles of the buttocks, it takes an expert to determine if the pain is coming from disc compression, from muscle spasms or from something else. Again, sciatica is a symptom, not a diagnosis.
While sciatica is most often associated with pain, other symptoms may be present such as tingling, numbness, or muscle weakness. The pain can be nearly constant or intermittent. If you think you are experiencing sciatic nerve pain, keep a record of the location, duration and intensity of the pain. Your specific history plays an important role in determining the cause of the pain.
Treatment for sciatica depend on the underlying cause, so there is no one recommended course of treatment for all sciatic pain sufferers. Chiropractors use a variety of non-invasive approaches that include spinal manipulation, physical therapy, targeted stretching and active muscle release. They’ll also discuss the role that nutrition and hydration play in reducing tissue inflammation and keeping discs healthy. The spine, discs, muscles and soft tissue all have a role to play in sciatica and should be evaluated and treated as a connected system.
The most important thing to take away from this article is that sciatica (sciatic nerve pain) is a symptom of an underlying condition. You’ll only start to get better once the underlying condition is identified and this is done through a combination of an exam, history and recommended diagnostic imaging.

Pain coming from compression or irritation of the sciatic nerve is called sciatica. Sciatica – which can include pain,
tingling, numbness and muscle weakness – is really a symptom indicating an underlying problem, not a diagnosis in and
of itself. This article will explore in detail the findings of a recent controlled study
comparing spinal manipulation (chiropractic) and surgery for people whose sciatica did not respond to traditional medical treatment approaches. The study discussed here was conducted by the National Spine Center in Alberta Canada and
published in October of 2010 in the Journal of Manipulative and Physiological Therapeutics1. The
40 study participants all had sciatica lasting over 3 months which had not responded to
treatment with pain medications, lifestyle modifications, physical therapy, massage therapy or
acupuncture. They had all been referred by their primary care physicians to spinal surgeons who
had deemed them appropriate surgery candidates. Instead of having all the patient proceed with surgery, they were split into two groups – one group to undergo a surgical microdiscectomy and the other group to be treated with
standardized chiropractic spinal manipulation by a single chiropractor. (If not satisfied with the
results they obtained from their assigned method, the patients were allowed to switch to the
other treatment plan after 3 months.)
So what happened? Both groups made significant improvements over baseline scores – meaning
that they saw noticeable improvements whereas previous approaches had failed. A full 60% of
the study participants benefitted from chiropractic spinal manipulation to the SAME degree as if
they underwent surgery. And, after l year there was no difference in outcome success based on the treatment method. That means that a full 60% of people referred for surgery by their
primary care physicians and accepted as surgical candidates by the neurosurgeon could
actually get similar results with chiropractic. That is a lot of potentially unnecessary cutting,
anesthesia and ER time.
There is one paragraph in the results section of this study that is easy to overlook, but incredibly
important. There were originally l20 candidates of which 60 met the study criteria and were
asked to participate. Of these 60, 20 refused. Why? Because they had never been offered spinal
manipulation as an alternative to surgery! They didn’t want to participate in the study and be
randomly placed in the surgery group without first trying the spinal manipulation! This is
incredibly telling. Not only does it demonstrate that there is still a lot of education about
chiropractic that needs to happen among the public and among primary care providers, it also
demonstrates that people understand the risks and costs of surgery and want to exhaust other
possibilities first.
This was the first study to ever look at people who had failed traditional medical management
of sciatica. Currently most patients that fail ‘conservative care’ are referred for a surgical
evaluation. Now we know that 60% of these folks could avoid surgery and get similar long-term
outcomes with chiropractic.
Please share this article with anyone considering surgery for sciatica.

1 McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ., Manipulation or microdiskectomy
for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. 2010;
Oct;33(8):576-84.