Carpal Tunnel Syndrome (CTS) – “Fact Sheet”
October 2, 2009
What is it? Carpal Tunnel Syndrome (CTS) occurs when a nerve on the palm side of the wrist is pinched. It is named after the area of the wrist from where the symptoms occur. The Carpal Tunnel is basically a horseshoe shape made from 8 small carpal bones and the ends of the horseshoe are connected with a ligament thus completing the “tunnel.”
What are the symptoms? CTS symptoms include pain from swelling of the tendons inside the CT. When the nerve pinch occurs, numbness, tingling, or a half asleep sensation into the 2nd, 3rd, and 4th fingers occurs. This is often worse at night due to the wrist being bent when asleep. This often wakes the person and shaking/flicking the hand/fingers is needed to “wake them up.” Grip weakness is also associated with CTS such as difficulty opening jars.
What are the causes? Usually, over use from tasks including repetitive line work (meat/fish/poultry packing, cookie/food packing), typing, sewing, carpentry, waiting tables, and the like. Other “contributors” include hormone related conditions such as hypothyroid, dysmenorrhea, diabetes, and obesity. These fast/repetitive movements cause swelling of the tunnel’s contents (9 tendons and the median nerve) and the nerve is pushed into the ligament connecting the ends of the horseshoe/tunnel.
Who is at risk? Gender is a significant factor as women are 3x more likely to develop CTS than men as the CT may be smaller in woman. The dominant hand is often first affected and more severe. Hormone imbalances as described above also increase risk.
How is it diagnosed? The history of the symptoms as well as physical examination of the hands, arms, shoulders and neck can lead to the proper diagnosis. The exam consists of trying to reproduce the numbness into the fingers by pressing/holding over the CT and other areas where the nerve runs down the arm (including the neck where the nerve originates), tapping over the CT with a reflex hammer, bending and holding the wrists at the extreme endpoints of motion. Also, poking the skin with a sharp object and comparing the 2nd to 4th fingers to other parts of the hand and the opposite side commonly yields differences between the two sides. Questionnaires and hand diagrams completed by the patient are helpful and quantify the degree of severity. Tests used during the course of treatment help track improvements. More sophisticated testing includes an EMG (nerve conduction test) that tests the motor and sensory changes when the nerve is pinched.
How is it treated? Chiropractic approaches include manipulation of the wrist, hand, forearm, shoulder and neck, specifically addressing the areas of greatest restricted motion. Soft tissue therapy includes massage, active release, graston, trigger point, and a host of physical therapy modalities such as light/low level laser, IFC, ultrasound, microcurrent, and low frequency approaches. Exercise training to be repeated multiple times per day is very helpful. Wrist bracing especially at night is also a common treatment approach used by all health care providers. Nutritional counseling and supplementation is also very helpful.
How can it be prevented? Work station assessments, staying in shape (avoid obesity), taking “minibreaks” when doing repetitive work, and proper treatment for conditions like hypothyroid, diabetes, and other disorders associated with CTS.
To learn more about Carpal Tunnel Syndrome, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
Whiplash – Important Points To Know
September 30, 2009
What Is It? Whiplash is an injury to the soft tissues in the neck including ligaments, joint capsules, muscles and their tendons, and intervertebral disks. It can also involve the nervous system tissues in more severe cases, resulting in radiating arm pain.
How does it happen? During a car crash, most commonly a rear-end collision. The sudden jolt occurs so fast we cannot brace ourselves adequately and the head accelerates back and forth beyond the limits of the ligaments that hold our bones firmly together (often referred to as a “sprain”). Because of the significant range of motion of the neck, the weight of the head, and how is suspended on the neck, the neck is particularly vulnerable to this type of injury (more commonly worse in woman due to a more slender neck).
What are the symptoms? The primary symptom is neck or upper back pain that may develop immediately or be delayed days, weeks, and sometimes months. A partial list of possible symptoms (each injured person’s symptoms are different) include: muscles spasms, loss of movement, headache, dizziness, concentration &/or memory loss, difficulty swallowing, chewing &/or hoarseness, burning or tingling, shoulder/arm/hand radiating pain, and more.
How is it diagnosed? Even when symptoms do not seem significant, a health care provider can diagnose the condition by taking a careful history and performing a physical exam. X-rays showing a change in the curvature or contour of the neck, &/or MRI or CT scan to better assess the disk and nerve roots when pain radiates down an arm may also be indicated. When persistent concentration/memory loss is present, a consult by a neuropsychologist is helpful.
How is it treated? In most cases, non-surgical methods are usually appropriate. If you go to a medical doctor, typical approaches include a wait & watch approach and/or medications such as anti-inflammatory drugs, pain killers, &/or muscle relaxants. MD’s may refer the patient to physical therapy. When these methods fail, referral to a physiatrist may result in injection therapy (epidural steroid, facet injection, trigger point injections). Chiropractic care includes spinal manipulation, mobilization, soft tissue release techniques, exercise training, activity modification training, and physical therapy modality use (electrical stimulation, traction, ultrasound, low level laser therapy – LLLT, TENS unit). Care may also include a mix of provider approaches, when appropriate.
How can it be prevented? The degree of severity of whiplash can be decreased or maybe avoided completely with the following: the use of seatbelts (especially in high speed collisions), placing the headrest close to the head (< 1 inch) and high enough to avoid “ramping” over it. Placing the seat back more vertical/upright can minimize ramping. Do not partake in distractive activities while driving – cell phone use, adjusting the radio, taking your eyes off the road (eye contact during conversation), dosing off, reading a book (this is more common than you think!), and others. Bracing yourself has not been shown to be very helpful – whiplash happens too quickly to voluntarily brace your neck muscles. For athletes, wear appropriate protective gear when engaging in sporting activities and use proper form / technique during the athletic activity.
To learn more about Whiplash and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
Fibromyalgia and Cord Compression?
September 21, 2009
Bayonne and Scotch Plains Chiropractor Comments: Fibromyalgia is a difficult problem to diagnose or determine its cause. Since exercises, diet, and weight loss can be so helpful to fibromyalgia patients, we may think they can completely solve the problem.
Chiropractors recognize the importance of good spinal posture in affecting a variety of health problems, including fibromyalgia. It’s important to not think of the disease as having a single solution, but rather as a more complex entity, needing a comprehensive approach. But is there any research on the spine being involved in patients with fibromyalgia?
Recent research (Holman AJ. Positional cervical spinal cord compression and fibromyalgia: a novel comorbidity with important diagnostic and treatment implications. J Pain 2008; May 20 epub.) has looked into a specific problem seen in fibromyalgia patients: spinal cord compression. The scientist took MRIs of fibromyalgia patients with the neck in different positions such as max forward and backward bend. These positions can show the spinal cord is compressed/pinched where a neutrally positioned MRI or CT scan may not. In the study, 71% of patients with fibromyalgia had positional cervical spinal cord compression.
So what does this mean? It means if you have fibromyalgia there may be an undetected cervical compression problem that may also be affecting you.
Good neck posture and mobility are keys to good health. We can diagnose your condition and see if there is a spinal component to your problem that may have been overlooked. Sometimes it’s the low back pain that keeps us from exercising and ultimately getting rid of the fibromyalgia-inactivity-pain cycle. And, as the research above suggests, maybe the problem is in the neck and this needs to be addressed in a specific and comprehensive manner. Sometimes immobility in one area of the spine is compensated for in another, which can make your ability to heal somewhat lessened. Maybe the neck has been a concern of yours for a long time since the fibromyalgia symptoms came on following a neck trauma such as a whiplash. If you also suffer from headaches and have spinal pain, these are important clues that some of your symptoms may be spinally related.
It’s important to view your fibromyalgia symptoms from a global perspective, and not just think of one isolated issue as the root cause, and the only place where treatment needs to be directed.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski, DC services all of Union County and Hudson County in New Jersey
Oh, My Aching…Leg?
September 11, 2009
Certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back. When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg. When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks. The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments. The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.
When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.
When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot. It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).
When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way. Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.
To learn more about Leg and Lower Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
Five Exercises to Help Your Neck Stay Pain-Free
September 10, 2009
Scotch Plains and Bayonne Chiropractor Comments: The neck is the most flexible part of your spine and just like any other area of the body, movement exercises and good posture are important to maintain its health. Neck pains can be brought on or aggravated by how you treat this vital structure. We often neglect our neck when it comes to exercises, focusing instead on our legs or heart. So try these helpful hints and incorporate them into your daily routine.
Moving your neck slowly through all its ranges is key. It is important to do pure movements rather than combinations, rolling the neck around like a ball and socket joint (such as the hip or shoulder) is to be avoided. Instead, flex the neck forward until your chin touches the top of your chest. Then, slowly bend your neck backwards, chin to the sky These movements should not cause pain if they are done slowly and you have no pre-existing injury.
The next movement is side bending and is accomplished by trying to bend either ear towards the shoulder. Do this in front of a mirror so that you keep your head straight looking forward. Note whether you can do this the same amount to each side.
The last movement is rotation. Simply rotate your chin slowly so that you are looking over one shoulder. None of these movements should cause pain or make you dizzy. If they do, then it’s a sign you have a neck injury.
An important aspect of neck function is how the shoulder girdle influences neck posture and motion. Try rolling your shoulders forwards and backwards, stretching slowly, to help ease tension at the neck. General exercises such as fast paced walking or hiking are important for your neck too. Remember, your spine is the core of your body and walking is one of the least “injury-producers,” something you can keep up well into your later years.
Lastly, make sure your neck posture is kept upright when you are talking on the phone, driving, reading, doing other tasks, or sleeping. A very small pillow is usually best for sleeping and neck support pillows are available to help maintain the normal forward arch of the neck. A small pillow will allow your head to ease back, relaxing the muscles at the back of the neck.
To learn more about Neck Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
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