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

The Strong Core-Healthy Back Connection

Chiropractor in Burke, VAUnless you’re either very, very young or live on a remote desert island without TV, radio, Internet or print media, you’ve probably heard the term “core strength” before. Serious athletes and exercise enthusiasts talk about it at the fitness center, and so do their coaches and trainers. But did you know that chiropractors and physical therapists talk about it too? So what exactly is core strength and why do some kinds of healthcare professionals care about it so much?

As you might guess, chiropractic physicians have a particular interest in the musculoskeletal system, the complex structure of bones, muscles and connective tissues that support the body’s frame and allow it to move. We’ve recognized for a very long time that the core muscles play a major role in stabilizing this frame and promoting correct posture when the body is at rest or in motion. In particular, strong core muscles contribute to a healthy back by holding the spine in proper alignment, supporting a portion of the body’s weight and absorbing many of the stresses and impacts we all experience when we walk and run. When your core muscles are doing their job effectively, your spine is protected. You can think of this as the “strong core-healthy back connection.” Let’s talk about it in more detail…

In human beings, the majority of movement originates from the lower part of the torso (the lumbar spine and abdomen). This is the part of the body that tenses first and keeps the body balanced during running, lifting, twisting and other normal day-to-day movements. Strength in this region is a basic building block from which to develop power in other areas of the body and (as we mentioned earlier) is fundamental to maintaining good posture and spinal alignment.

Anatomically speaking, the core region of the body consists of the lower back, abdomen, pelvis and diaphragm. The main muscle groups include the transversus abdominus, internal and external obliques, rectus abdominis and erector spinae. It is these muscles that often need strengthening due to the fact that on a daily basis most of us are far less active than our ancestors who worked at more physically demanding jobs.

Instructors across a wide variety of athletic and exercise disciplines have known about the importance of core strength for a long time. Yoga and Pilates teachers, martial artists and qi gong practitioners all move from the same center of gravity and balance in the core region and view this area as the nexus of human power and energy. They stress the importance of strengthening the core through breathing exercises and meditation as well as physical movement. Since the core region of the body contains the diaphragm, ease of breathing is both a sign and result of good core strength. Back pain, on the other hand, may well be a sign that core strength needs to be improved.

For those who practice sports, proper alignment is particularly important to prevent injuries during physical exertion. If the core muscles are not strong enough to support the spine during movement, then other muscle groups will be used to perform the action with a much greater risk of damage. The rest of us also need to be conscious of our core strength since we all engage in strenuous action at various points in our lives (lifting boxes, running to catch a bus, playfully swinging a child, etc.).

While chiropractors are always willing to help patients in need of treatment, the ultimate goal of chiropractic care is for everyone to have the best possible spinal health. Good core strength definitely contributes to that, whether you are otherwise healthy or have an ongoing postural problem. If you want to improve your spinal health and posture and reduce your chance of injury, working on core strength through a balanced program of exercise is a very good—and very inexpensive—way of going about it.

If you’re interested in learning more about how you can improve the strong core-healthy back connection, call us today (703) 912-7822 or visit us at Chiropractor in Burke, VA.

What is Plantar Fasciitis?

Chiropractor in Burke, VAPlantar fasciitis (pronounced “plan-tar fash-ee-EYE-tis”) is also sometimes referred to as a heel spur. It’s a debilitating and painful condition that can make walking even a short distance difficult. The discomfort—ranging from mild to severe—is typically most pronounced near the bottom of the heel, usually toward the front, though it may also extend across the entire bottom of the foot. Plantar Fasciitis is usually at its worst first thing in the morning after you get out of bed and walk a few steps, or when you stand up after sitting for an extended period.

What exactly is plantar fasciitis?

The plantar fascia is a thick band of very tough, fibrous tissue that extends from the heel bone to the base of the toes and supports the arch of the foot. When this ligament develops micro-tears, pulls away from the heel bone or becomes inflamed, pain and bone spurs can result. The muscles in the foot may also be involved, especially if the pain occurs after long periods of standing or from chronic overwork, which causes the muscles to shorten, making them less resilient and more susceptible to micro-trauma.

What causes plantar fasciitis?

Plantar fasciitis can occur for a wide variety of reasons and it’s frequently difficult to isolate any one specific cause. That said, here are some of the primary culprits:

  • Standing for long periods of time
  • Wearing shoes with little support
  • Having flat feet
  • Having exceptionally high arches
  • Being overweight
  • A sudden increase in activity
  • Repetitive stress
  • Tight calf muscles
  • Overpronation (walking on the outsides of your feet)
  • Aging

What can be done?

Unfortunately, recovery from plantar fasciitis usually takes time and is prone to setbacks. However, there are some things you can do to help ease the pain and speed the healing process.

Rest the foot as much as possible. Applying ice to the area can help reduce the inflammation, as can taking an anti-inflammatory such as ibuprofen. Many people with plantar fasciitis find it helpful to wear Birkenstocks or other shoes that have good arch support. Custom foot orthotics and heal cups can also provide some relief. At night, wearing a boot that gently stretches the plantar fascia, Achilles tendon and calf muscles (not allowing the foot and toes to point) can help reduce morning symptoms. If you work in an office environment, rolling a baseball or lacrosse ball beneath the arch of your foot while sitting at your desk can help achieve the same thing during the day.

In the long-run, it’s important to address the cause of the problem so that it doesn’t become chronic or recurring. Fortunately, your chiropractor can help in that regard. Chiropractic physicians are experts at treating a wide variety of musculoskeletal problems—not only those that affect the back and neck, but also those that affect the extremities. To treat plantar fasciitis, your chiropractor may use a combination of therapies, including manipulation/mobilization, stretching, cold laser, and ultrasound. He or she may also recommend custom orthotics and useful exercises that you can do at home to gently stretch tight muscles and tendons. Since one common cause of plantar fasciitis is overpronation, a series of chiropractic adjustments can ensure your bones are properly aligned, allowing for greater range of motion and helping to take some of the strain off the overworked muscles and connective tissues in your feet.

Healing plantar fasciitis is a slow process that may take weeks or months. However, with good chiropractic care, conscientious at-home treatment and proper shoes, it doesn’t have to become a chronic or recurring condition. Have any questions? Please call us at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

What is Tennis Elbow? How Do You Treat It?

Tennis Elbow Relief in Burke, VATennis elbow, also called lateral epicondylitis, is an overuse injury causing pain in the outside of the elbow. This condition is caused by repeated bending back (extension) and turning (rotation) of the forearm and wrist muscles. Repeated and forceful activities such as turning a screw driver, chopping food, and swinging a tennis racquet, can lead to tennis elbow.

The elbow is formed by 3 bones: the upper arm bone (humerus), and the 2 bones of the forearm (radius and ulna). There are many muscles that cross the elbow and wrist to complete the detailed movements of the arm and hand. Muscles in the forearm involved in tennis elbow include the wrist extensors which bend the wrist back, and the supinator which turns your palm upwards.

The lateral epicondyle is the part of the upper arm bone where forearm muscles attach. Tennis elbow may involve tiny tears in tendons that attach to the outside of the elbow, resulting in irritation and pain.

Symptoms of tennis elbow include pain and burning at the outside of the elbow, and this pain usually starts gradually and without an injury. Tennis elbow can also cause difficulty lifting or grasping objects, and any repeated movement of the wrist and elbow.

Preventing tennis elbow can include using proper technique and equipment, avoiding repeated movements when able, and including stretching and strengthening of the arms in your fitness routine.

To treat tennis elbow we use a combination of Active Release Techniques, Graston Technique, Laser Therapy and Dry Needling to decrease the muscle tightness and help with tendon healing.  Typically a patient will receive treatment twice per week for two weeks followed by specific exercises like isometric and eccentric elbow exercises to further promote healing and to strength the muscles and tendons.  If you have been suffering from Tennis Elbow give our office a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

What is Plantar Fasciitis? How Do You Treat it?

Plantar Fasciitis Treatment in Burke, VAIf you experience pain in your heel or bottom of your foot with walking, prolonged standing, or when first getting out of bed in the morning, you may be suffering from a foot condition that is commonly diagnosed as plantar fasciitis.

Unfortunately, this condition often results in months and sometimes years of discomfort, and too often leads the foot pain sufferer to limit their normal activities.  It commonly interferes with their work, as well as sports and recreational activities.  Traditional treatment methods for this type of foot pain are often slow to provide relief and often do not address the true source of the problem leading to incomplete relief and a high rate of re occurrence.

Fortunately, a new treatment technique know as Active Release Techniques (ART) is proving to be a very effective method for resolving plantar fasciitis and other common foot conditions.  But before we talk about how ART works so effectively, we first need to understand how plantar fasciitis develops in the first place.

Understanding Plantar Fasciitis

The foot is a very complicated area which includes 28 different bones and many different joints.  These bones and joints have to move as the demands of the foot change.  In order to help control the position of the foot and stabilize the joints, there is an intricate system of muscles and ligaments associated with the foot and ankle.  Many of these muscles are located on the back of the calf and have long tendons that cross the ankle and foot and can have an effect on the foot and toes.

There is also another group of muscles that are located on the bottom of the foot.  The vast majority of these muscles attached into the bottom of the heel.  Additionally, located just under the skin and over the top of the foot muscles is the “plantar fascia”. This is a very tough and dense connective tissue that runs from the bottom of the heel all the way to the toes. The fascia works to support the arch of the foot and helps to stabilize the joints of the foot when bearing weight.

It is important to realize that beneath the plantar fascia the muscles are arranged in layers, and each muscle within each layer has a different job or function.  For example, some of the muscles attach all the way into the toes and act to flex and stabilize the toes, while other muscles attach into the other bones of the mid-foot to control and stabilize the arch of the foot.  For the foot and ankle to work properly, and to prevent pain and injury, not only does there have to be adequate strength and flexibility of the foot and calf muscles, but these different layers of muscles need to be able to glide freely over one another during normal use.

Throughout the day we are on our feet for a great deal.  As we stand, walk or run, it places a tremendous amount of pressure on the foot.  This creates a tension on the plantar fascia causing the muscles of the foot to contract to help support the arch and stabilize the joints of the foot.  Over time the muscles and the fascia will become strained and fatigued, and can develop small amounts of injury known as micro-trauma.  Simply stated, micro-trauma is very small scale damage that occurs in the muscles, fascia, and ligaments in response to small levels of strain.  Initially this micro-trauma is not painful, but may be perceived as a mild ache or tightness in the muscles or at the heel where the muscles attach.  Even though it is only small, this damage still needs to be repaired.  The body responds to soft-tissue injury (including micro-trauma) by laying down small amounts of scar tissue to repair the injured tissue.  Unfortunately, over time, this scar tissue will build-up and accumulate into what are known as adhesions.  As these adhesions form, they start to affect the normal health and function of the muscles.  In fact, they will often lead to pain, tightness, lack of flexibility, muscle weakness, compromised muscle endurance, restricted joint motion, and diminished blow flow.

As the muscles and fascia of the foot become strained and develop adhesions, they become very tight.  As the tightness increases, the tissues begin to pull away from the heel where they attach, which will eventually lead to pain and irritation at the bottom of the heel.  In many cases with long term muscle tightness, formation of this constant tension can even lead to a bone reaction and formation of a heel spur.  The presence of this heel spur on an X-ray has often lead to misdiagnosing the heel spur as causing the pain.  The problem is that this heel spur is very rarely the cause of pain, leading to inappropriate treatment.

In addition to causing pain and tightness these adhesions are also very sticky, affecting the ability of the muscles to stretch, contract, and slide over one another. Recall that there are several layers of muscles in the foot.  Each of these muscles has a different function, and therefore contracts at different time.  For this process to occur correctly, the muscles need to be able to glide freely on one another.  As adhesions develop, they will cause the individual muscles and different muscle layers to stick to each other, preventing this normal gliding.  When the muscles lose the ability to glide over one another, it will bind the entire area together.  Think of these adhesions like rust and grime that can build-up in an automobile.  Normally the parts of the car should be well oiled and move smoothly, but when rust and grime are allowed to build-up the car begins to break down until eventually it does not work properly and repairs are needed.  The same thing happens in the body.  Stretching or contraction of one muscle will cause a pull and tension on all of the other muscles.  This in turn will cause more and more strain on the muscles as well as increase tension at the heel.

Another common development is that the accumulation of scar tissue adhesions can affect the nerves in the region of the ankle and foot.  This occurs because, between the layers of muscles, there are nerves that run all the way from the knee, down the lower leg, around the ankle, and into the bottom of the foot.  Just as the muscles need to able to glide on each other, nerves also need to be able to glide freely between the layers of muscles.  In many cases the accumulation of scar tissue can cause the nerves to become stuck to the surrounding muscles and fascia.  Instead of the nerve easily gliding between the muscles, it becomes stretched and irritated leading to foot and heel pain.  It is quite common for a nerve entrapment at the foot or ankle to cause foot and heel pain and lead to incorrect diagnosis of plantar fasciitis.  Obviously an incorrect diagnosis will lead to incorrect treatment, which will not be effective in relieving the condition.

How Can Plantar Fasciitis and Other Similar Foot Problems Be Fixed?

The Traditional Approach:

In an attempt to treat plantar fasciitis, a variety of treatment methods are used, either on their own, or in combination with other methods.  Some of the more common approaches include anti-inflammatory medications, rest, ice, orthotics, night splints, ultrasound (US), muscle stimulation (E-Stim), stretching, and exercise.  Unfortunately, most of these traditional techniques generally require a long period of time before they provide any significant relief, and in many cases, provide only temporary relief from symptoms instead of fixing the underlying cause of the problem.

The main reason these approaches are often ineffective is they fail to address the underlying scar tissue adhesions that develop within muscles and surround soft tissues.  It is the adhesions that are binding the tissues together, restricting the normal sliding of the tissues, and potentially entrapping the surrounding nerves at the foot and ankle.

Passive approaches, including medications, rest, ice, and ultrasound, all focus on symptomatic relief and do nothing to address the muscle restrictions and dysfunction.  More active approaches, such as stretching and exercises, are often needed for full rehabilitation of the condition and to restore full strength and function of the muscles.  However, they themselves do not treat the underlying adhesions.  In fact, without first addressing the scar tissue adhesions, stretches and exercises are often less effective and much slower to produce relief or recovery from the foot condition.

A New Approach To Treating Plantar Fasciitis – ART

ART stands for Active Release Techniques.  It is a new and highly successful hands-on treatment method to address problems in the soft tissues of the body, including the muscles, ligaments, fascia and nerves.  ART treatment is highly successful in dealing with foot and ankle injuries because it is specifically designed to locate and treat scar tissue adhesions that accumulate in the muscles and surround soft tissues.  By locating and treating the soft-tissue adhesions with ART, it allows the Doctor to, 1) break-up restrictive adhesions, 2) reinstate normal tissue flexibility and movement, and 3) more completely restore flexibility, balance, and stability to the injured area and the entire kinetic chain.

You can think of an ART treatment as a type of active massage.  The Doctor will first shorten the muscle, tendon, or ligament and then apply a very specific pressure with their hands as you actively stretch and lengthen the tissues.  As the tissue lengthens the practitioner is able to assess the texture and tension of the muscle to determine if the tissue is healthy or contains scar tissue that needs further treatment.  When scar tissue adhesions are felt the amount and direction of tension can be modified to treat the problematic area.  In this sense, each treatment is also an assessment of the health of the area as we are able to feel specifically where the problem is occurring.  An additional benefit of ART is it allows us to further assess and correct problems not only at the site of pain itself, but also in other areas of the kinetic chain, which are associated with movement compensations and are often contributing factors to the problem.  This ensures that all of the soft tissues that have become dysfunctional and are contributing to the specific injury are addressed, even if they have not yet all developed pain.

One of the best things about ART is how fast it can get results.  In our experience, the many types of foot injuries respond very well to ART treatment, especially when combined with appropriate home stretching and strengthening exercises.  Although each case is unique and there are several factors that will determine the length of time required to fully resolve each condition, we usually find a significant improvement can be in gained in just 4-6 treatments.  These results are the main reason that many elite athletes and professional sports teams have ART practitioners on staff, and why ART is an integral part of the Ironman triathlon series.

To schedule an appointment give our office a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.