active Release Techniques

Not Just Back Doctors: Chiropractors and Carpal Tunnel Syndrome

Chiropractor in Burke, VAWhile doctors of chiropractic have a well-deserved reputation for helping patients overcome back problems, they are actually experts in diagnosing and treating a wide range of health conditions that affect the musculoskeletal and nervous systems. Many of these conditions involve the extremities—arms, legs, hands and feet—rather than the back, neck or hips. Carpal Tunnel Syndrome (CTS) is one example.

What causes CTS?

CTS affects about one in a thousand people each year, mostly women. It is essentially a mechanical problem caused by the median nerve being compressed as it runs through the carpal tunnel, a passageway made up of tendons, ligaments and bones that runs from the wrist to the hand.

In many cases, the precise cause of carpal tunnel syndrome isn’t clear. An injury to the wrist (sprains, strains or broken bones, for instance) may sometimes trigger CTS. So might strong vibrations from power tools or heavy machinery. Repetitive movements that place stress on this area of the body can also play a role. The tendons that control finger movement all run through the carpal tunnel, so when they become inflamed and swollen the amount of space is reduced, putting increased pressure on the median nerve.

Who’s most at risk?

Women. As mentioned earlier, women are at greater risk of CTS than men. There are a number of theories as to why women tend to suffer from CTS more frequently than men. One is that they have smaller wrist bones, and thus a smaller space through which tendons can pass. Another is that hormonal shifts may play a role, particularly during pregnancy and around menopause.

People with a genetic predisposition. Some people may have a genetic predisposition for CTS. Approximately one out of four people has a close family member who has also has the disorder.

Workers who perform repetitive, forceful movements that place localized stress on the wrist. Those who have jobs that involve repetitive movements of the arm are more likely to develop carpal tunnel syndrome. Assembly line workers, carpenters and violinists would all be in relatively high-risk occupations. But what about heavy computer users? Interestingly, although long-term computer use was previously thought to contribute to CTS, there is now conflicting information about the relationship between keyboarding and CTS. Some studies, such as one from 2007 published in the journal Arthritis and Rheumatism, have found that those who use a keyboard intensively at work actually have a significantly lower risk of developing CTS. It’s worth mentioning that some leisure activities can also contribute to the risk of CTS. Knitting, golfing and anything else that requires you to grip items in your hands for long periods of time could raise your risk.

Why chiropractic care?

CTS treatment has been evolving rapidly across the last few years, so it’s important to visit a healthcare provider who keeps current on the latest research and works with carpal tunnel patients on a regular basis. Among the most commonly recommended treatments for carpal tunnel syndrome are using a wrist splint, resting the wrist and taking pain relievers. Surgery is usually viewed as a last resort that should be considered only after more conservative treatment options have been exhausted.

Recent research has focused on the role of manual therapies—particularly specialized manipulation and mobilization techniques—as well as exercise in relieving pain and restoring range of motion. Chiropractic treatment for CTS (specifically soft tissue mobilization) has been shown to be both safe and effective compared to conventional non-surgical medical treatment, helping to improve nerve conduction latencies, wrist strength and mobility.

Chiropractors (and physical therapists) may also prescribe at-home strengthening and stretching exercises to help relieve pain and improve function in the affected hand and wrist. These approaches offer natural alternatives to sufferers who can’t tolerate common over-the-counter anti-inflammatories or painkillers, or who simply wish to avoid medication altogether.

When it comes to carpal tunnel syndrome, early diagnosis and treatment are the keys to success. The sooner this condition is addressed, the more non-invasive therapeutic choices exist for the patient. So if you suspect that you or someone you care about is suffering from CTS, please give us a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

NOVA Chiropractic & Wellness Center
8992 Fern Park Drive BurkeVA22015 USA 
 • (703) 912-7822

Tips for Pain-Free Gardening

Chiropractor in Burke, VAWho says that gardening isn’t hard work? Anyone who’s spent a weekend tending a backyard plot knows that there’s a LOT of physical labor involved. This sort of activity can put quite a strain on your muscles, especially those in your back. With this in mind, here are some suggestions for making the most of your time in the garden while saving your back.

Use some common sense.

Gardening is physical activity—it can involve lifting, reaching, twisting and pulling. If you don’t garden regularly or aren’t otherwise physically active, be sure to start slowly and work your way up to longer gardening sessions. Warm up your back muscles with some stretching before you go out, particularly in colder weather. Be sure to keep drinking water nearby and to take breaks often. If you start to feel any pain, stop and rest. Otherwise, you risk injuring your back and making it impossible to do anything at all in your garden until your back has healed.

Plan your garden to reduce the amount of labor you’ll need to maintain it later.

  • Use mulch on the surface of your garden and avoid leaving bare spots. This will reduce weeds and help the soil retain moisture, so you don’t have to water as often.
  • Use raised flowerbeds, which are both attractive and help reduce the need to bend down. You can even grow vines and other trailing plants around the edges.
  • Make sure your flowerbeds are narrow enough that you don’t have to reach too far over them.

Choose your plants carefully.

  • Remember that slow-growing shrubs are less trouble to maintain than perennials or annuals.
  • Use fruit trees grown on dwarf rootstocks. This will allow you to pick fruit at a reasonable height.
  • Consider ground-covering plants to keep weeds under control. Weeding is notoriously hard on the back because of all the bending over.

Use the right tools.

  • Use forks and trowels with long handles and other tools with extenders to reduce your need to reach.
  • Make sure your pruners and loppers are sharp and have ratchet systems. Cutting will be easier and there will be less strain on your back and shoulders.
  • Get a holster for smaller garden tools and attach it to your belt, so you don’t have to keep reaching down to pick them up.
  • Avoid heavy watering cans for irrigation. If you use a can, only fill it half way.

Reduce the need for digging.

If you spread compost and fertilizer or manure over a flowerbed surface in the late autumn, the soil has time to settle before spring planting. Worms will take organic matter into the soil and you won’t have to dig so much. This approach requires initial digging to level the soil and remove weeds, but over time you will be able to dig less and less. Many gardeners feel that this method is better than traditional “double digging” because it leaves the soil structure intact. Consult a specialist at your local gardening center for more details on this back-saving approach to gardening.

As chiropractic physicians, we have a particular interest in your musculoskeletal health and overall well-being. If either you or someone you care about has questions or concerns in these areas, we encourage you to call our office today at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

Neck Pain – The MOST Important Exercises (Part 2)

neck-headacheAs stated last month, exercises that focus on improving posture, flexibility, strength, and coordination are important for creating a well-rounded cervical rehabilitation program. Our discussion continues this month with stretching and strengthening exercises.

STRETCHING: Since our neck muscles have to hold up our 12 pound (~5.5 kg) head, it’s no wonder why our neck muscles seem to be tight almost all the time. Here are two ways to stretch the neck: 1) You can simply drop the chin to the chest, look at the ceiling, try to touch your ear to your shoulder (without shoulder shrugging) on both sides, and rotate the head left to right and vice versa (six directions). 2) You can use gentle pressure with your hand and assist in the active stretch by gently pulling into the six directions described in #1 by applying “over-pressure” at the end-range of motion (staying within “reasonable pain boundaries”).

STRENGTHENING: Most people have a forward head carriage, meaning their head normally rests in front of their shoulders. The further forward the head sits, the greater the load on the muscles in the back of the neck and upper back to hold it up. This position promotes a negative spiral or “vicious cycle” that can lead to many complaints including (but not limited to) neck pain, headaches, balance disturbances, and in the long-term, osteoarthritis. There are two important groups of muscles that require strengthening: the deep neck flexors and deep neck extensors.

1) The deep neck flexors are muscles located directly on the front of the cervical spine and are described as being “involuntary” or unable to be voluntarily contracted. Hence, we have to “trick” the voluntary outer “extrinsic” (stronger) muscles into NOT WORKING so the deep, intrinsic ones will contract. You can do this by flexing your chin to the chest and pushing your neck (not head) back over your shoulders into resistance caused a towel wrapped around the back of the neck. If you feel your chin raise towards the ceiling, you’re doing it WRONG! Keep the chin tucked as close to the chest as possible as you push your neck (not your head) backwards. If you’re doing it correctly, your chest should raise towards the ceiling as you push your chin down and neck back. Try it!

2) The deep neck extensors are strengthened in a very similar way EXCEPT here you DO push the back of HEAD back into your towel while keeping your chin tucked tightly into your chest. Do three reps, holding each for three to five seconds and switch between the two for two to three sets.

We will finish this discussion next month with important coordination exercises!

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 neck pain or headaches, give us a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

Neck Pain – Management Strategies

Chiropractor in Burke, VAAs discussed last month, when you make an appointment for a chiropractic evaluation for your neck pain, your Burke chiropractor will provide both in-office procedures as well as teach you many self-help approaches so that as a “team”, together WE can manage your neck pain or headache complaint to a satisfying end-point. So, what are some of these procedures? Let’s take a look!

In the office, you can expect to receive a thorough history, examination, x-ray (if warranted), and a discussion about what chiropractic care can be done for you and your condition. Your doctor will map out a treatment plan and discuss commonly shared goals of 1) Pain reduction, 2) Posture/alignment restoration, and 3) Prevention of future episodes. Pain reduction approaches include (but are not limited to) joint mobilization and/or manipulation, muscle/ligament stretching techniques, inflammation control by the use of physical therapy modalities (such as electrical stimulation), ice, and possibly anti-inflammatory vitamin / herbal therapies. Your chiropractor will also teach you proper body mechanics for bending/lifting/pulling/pushing, and help you avoid positions or situations where you might re-injure the area. Posture/alignment restoration can include methods such as spinal manipulation / mobilization and leg length correction strategies (heel and/or sole lifts, special orthotic shoes, and/or foot orthotic inserts). These are often GREAT recommendations as they “work” all the time they are in your shoes and you don’t have to do anything (except wear them)! The third goal of future episode prevention is often a combination ongoing treatments in the office and strategies you can employ at home. This includes (but is not limited to): 1) whether you should use ice, heat, or both at times of acute exacerbation; 2) avoiding positions or movements that create sharp/lancinating pain; 3) DOING THE EXERCISES that you’ve been taught ON A REGULAR BASIS; and 4) eating and an “anti-inflammatory” diet (lean meats, lots of fruits/veggies, and avoid gluten – wheat, oats, barley, rye).

Let’s talk exercise! Your doctor of chiropractic will teach you exercises that are designed to increase range of motion (ROM), re-educate a flat or reversed curve in the neck, and strengthen / stabilize the muscles in the neck. Studies show that the deep neck flexor muscles – those that are located deep, next to the spine in the front of the neck – are frequently weak in patients with neck pain. These muscles are NOT voluntary so you have to “trick” them into contracting with very specific exercises. Your doctor will also teach you exercises that you can do EVERY HOUR of your work day (for 10-15 seconds) that are designed to prevent neck pain from gradually worsening so you aren’t miserable by the end of work. Along these lines, he/she will discuss the set-up of your work station and how you might improve it – whether it’s a chair, desk, computer position, a table/work station height issue, or a reaching problem; using proper “ergonomics” can REALLY HELP! Your doctor will also advise you not to talk on the phone pinching the receiver between your head and shoulder, to face the person you are talking to (avoiding prolonged head rotation), to tuck in your chin as a posture training exercise, and more. Cervical traction can be a GREAT home-applied, self-help strategy, and these come in many varieties. Proper positions for the head when sleeping and a properly fitted contoured pillow is also important since we spend about 1/3 of our lives asleep!

We realize you have a choice in whom you consider for your health care and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, call us today at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

Neck Pain – The MOST Important Exercises (Part 1)

Poor PostureNeck pain can occur for many different reasons, but what can you do about it? That’s the BIG question! As discussed last month, exercise training is an important part of the chiropractic management process. Let’s take a close look at which exercises are MOST important with respect to self-management strategies.

There are several goals or reasons to perform neck exercises. We will break these down into four main categories: Posture, stretch, strengthening, and coordination.

POSTURE: The biggest culprit in this category is the forward head carriage. If you look around a crowded airport, bus stop, train station, or mall, you can see MANY examples of this. If fact, this faulty posture is estimated to occur in 66-90% of the population! Also, forward head posture is STRONGLY associated with decreased respiratory muscle strength, which can reduce lung capacity and our ability to breath by as much as 30%! It’s also linked to tension headaches, altered eye and ear function, high blood pressure, and over time it can lead to arthritis, herniated disks, pinched nerves, and more. The “classic” appearance is the position of the head is too far forward, the shoulders roll forwards and the upper back sticks out. Did you know that for every inch the head glides forwards from the proper position, there is a 10 lbs (~4.5 kg) increase of weight that the neck and upper back muscles have to hold up? Using an average 12 lbs (~5.4 kg) head, a 5 inch (~12.7 cm) forward head carriage places an extra 50 lbs (~23 kg) of weight on the upper back/neck muscles for a 62 lbs (~28 kg) total! So, LET’S FIX IT!

Here is one exercise that may help your posture: Look straight ahead and 1) Tighten your core by performing an abdominal brace. This is done by contracting your belly muscles so that when you poke your thumbs into your sides and front, you feel a firm abdominal muscle wall. You don’t have to “brace” at a 100% of maximum, shoot for 25-50% or just enough to feel the muscles contract. Relax and contract several times so you’re sure you can feel the muscles tighten up. Keep a curve in your lower back when you do this (don’t slouch). 2) Lift your chest – don’t just tuck you head back! This will improve the rounded shoulders and slouched upper back posture. Think of lifting your chest towards the ceiling more than just sticking it out. Notice in a mirror how much improvement occurs already! 3) Perform chin retractions – do 10 retractions every hour (set the timer on your cell phone to remind you)! Do this gently, slowly, and to a firm end-point of movement. If you feel like you are creating a “double or triple chin,” you are doing it right! If you do the ten reps every hour, then in an eight hour work day, you’ll have done 80 posture corrections! This a GREAT way to “re-program” your nervous system and when you find yourself doing this WITHOUT THINKING, it will have become a new (and good) habit! Stay tuned next several months for more neck exercises focused on STRETCH, STRENGTHEN, and COORDINATION training!

If you, a friend, or family member requires care for neck pain or headaches, give our office a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.