Can Carpal Tunnel Syndrome Be Hereditary?

Carpal tunnel syndrome (CTS) is a disorder caused by compression of the median nerve that alters the nerve’s function (neuropathy), leading to pain and numbness/tingling (paresthesia) primarily on the palm-side of the wrist and hand.  While factors like hormonal changes and repetitive motions are known to increase the risk for CTS, there might be a genetic component to the condition.

It’s known that conditions that can elevate the risk for CTS—like diabetes, thyroid disease, rheumatoid or osteoarthritis, and obesity—can run in families.  Additionally, the data show that having a family member with CTS raises the risk that you too can develop the condition, but it’s not entirely clear to what extent genetic traits are responsible versus shared environmental factors among family members. 

In 2007, at the 74th Annual meeting of the American Academy of Orthopaedic Surgeons in San Diego, Harvard professor Dr. David Ring and colleagues presented their evaluation of 117 previously published studies to determine the strength of a “cause-and-effect” relationship for CTS using a scoring system that included both biological and occupational factors.  Their analysis revealed that genetic risk factors were two times stronger than the evidence supporting occupational risk factors, such as overuse.

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Dr. Barry Simmons, chief of the Hand and Upper Extremity Service at Brigham & Women’s Hospital reported that 75-80% of CTS found in women age 50-55 is idiopathic, or of unknown cause, further supporting genetics as the primary factor.  Dr. Ring states, though the evidence suggests genetics are a risk factor for CTS, there may be epigenetic factors or environmental changes to genes based on certain foods eaten or certain activities might increase a person’s risk beyond their genetic makeup.  As of 2015, no epigenetic factors have been identified in idiopathic CTS.

The good news is that even if you have a family history of carpal tunnel syndrome, you can reduce your risk for developing CTS by managing any conditions or activities that can contribute to inflammation along the course of the median nerve.  This includes maintaining a healthy weight, eating a low-inflammation diet, getting regular exercise, taking frequent breaks from repetitive tasks involving the hand, reducing exposure to awkward hand postures and vibratory forces, etc.  If you are experiencing CTS-related symptoms in the hand and wrist, a thorough examination by a doctor of chiropractic can help identify potential causes and help you manage the condition so you can return to your normal activities as soon as possible.

 

November 1, 2019 by Chirotrust

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COULD IT ALL BE IN MY JAW?

At the best of times, our bodies work like well-oiled machines. We don’t even have to think about the movements our joints make to get us through daily life, from knees bending as we walk to our jaws opening and shutting when we chew and talk. But for people who suffer from TMJ, the simple act of chewing or even talking can cause pain in the jaw, ear aches or headaches, or neck pain.

TMJ is the common acronym people use when referring to temporomandibular joint disorders. You might also see it referred to as TMD. This is when the temporomandibular joint, the connecting point between the jaw and the skull, becomes painful or swollen. The exact cause of TMJ can often be hard to determine, as there are many factors that can contribute to this pain. Some causes include:

·      Grinding or clenching teeth, which puts pressure on the joint

·      An injury to the jaw

·      Arthritis in the joint

·      Stress, causing teeth to clench

When it comes to treating TMJ, there are many options. Over-the-counter pain medications or the use of moist hot or cold packs can help relieve symptoms. Chiropractic treatment is also an option for people suffering from TMJ. At Lansing Chiropractic Clinic, we take a holistic approach to healing, a method that is helpful with TMJ.

The first step in chiropractic treatment of TMJ is to help get the jaw working properly. If the cartilage in the joint is worn down from excessive grinding, the joint can become misaligned. Chiropractic care can relieve the tension on this area. It might even be that poor posture or spinal misalignment is contributing to TMJ, and getting everything back in line will help relieve the pain.

In addition to the work at the office, we will suggest patients do jaw exercises at home to help strengthen the joint and reduce stress. We’ll also work with you to modify certain habits that might be leading to TMJ pain. Things like clenching teeth, biting nails and excessive chewing can all contribute to TMJ. Understanding what causes the pain, being aware of your habits and alleviating the stress that might lead to those habits can all help reduce the occurrence of TMJ.

Working together with your dentist or physician, we can create a treatment plan that works for you.

If you are suffering from pain or swelling from TMJ, call Lansing Chiropractic Clinic at (708) 895-3228 for a consultation. 

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Carpal Tunnel Syndrome Linked to Migraine Headaches

Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve as it passes through the wrist that’s characterized by pain, numbness, tingling, and weakness in select parts of the hand.  The result of a 2019 study suggests that CTS may be associated with migraine headaches.  How can these two seemingly disparate conditions be related?

The study itself analyzed data gathered from a survey of nearly 26,000 adults in the United States.  In particular, the researchers looked at responses to questions about CTS-related symptoms within the previous year and whether or not respondents had a migraine in the past three months.  The results showed that 3.7% of participants had CTS symptoms in the last twelve months and 16.3% had a migraine in the last 90 days.

 

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When the research team compared those with CTS symptoms and those with migraines, they found that roughly a third (34%) of CTS-positive respondents also reported migraines, which is about 2.6 times more than study participants who did not experience CTS-related symptoms.  On the other hand, 8% of individuals in the migraine group had CTS-associated symptoms in the last year compared with just 3% in the non-migraine groups.

The relationship between the two conditions indicates they may share one or more underlying cause.  One such cause may be cervical dysfunction.  While CTS is generally described as a condition caused by compression of the median nerve at the wrist, pinching of the median nerve anywhere along its course from the neck to the wrist can generate hand/wrist symptoms.  In many cases, a patient complaining of such symptoms may have median nerve entrapment in several areas that all need to be treated to achieve a successful outcome.  While there are many potential triggers for a migraine episode, the root cause/s of the condition are not well understood.  However, several studies have found that patient with migraines are more likely to have trigger points in the neck muscles and other cervical issues, and treatment to improve function in this area can reduce the intensity and frequency of migraines.

With both conditions, it’s important to undergo a thorough examination to identify any and all contributing factors—including cervical dysfunction.  Doctors of chiropractic are trained to address such issues with manual therapies including spinal manipulation, mobilization, and trigger point therapy, in addition to modalities, nutritional recommendations, and specific exercises.

 

March 2, 2020 by Chirotrust

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Spinal Manipulation and Headaches

 

Cervicogenic headache (CGH) refers to headaches caused by dysfunction in the neck, and expects estimate that 18% of chronic headache patients have cervicogenic headaches.  Spinal manipulative therapy (SMT) is a form of treatment most commonly provided by doctors of chiropractic, and several studies have demonstrated that SMT is highly effective for patients suffering musculoskeletal disorders of the neck, including those with cervicogenic headaches.  However, there remains little consensus on the appropriate number of SMT treatments to achieve maximum benefits for CGH.

In a 2018 study, a team of researchers conducted a large-scale study involving 256 chronic CGH patients to determine how many treatments are needed to achieve optimum results using SMT for CGH.  The investigators randomly assigned participants to one of four dose levels (0,6, 12, or 18 visits) of SMT for six weeks.  The type of SMT consisted of a manual high-velocity, low-amplitude (HVLA) thrust manipulation in the cervical and upper thoracic regions.  The location of the spinal adjustment was determined by a brief, standard spinal palpatory examination from the occiput to T3 to assess for pain and restricted motion.  For older patients and/or those in acute pain, the manual therapy was modified to a low-velocity, low-amplitude mobilization.  To control for visit consistency and provider attention, patients continued to receive a light massage treatment once a patient’s assigned number of visits was satisfied, until the six-week treatment period ended.

 

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After the conclusion of the treatment phase of the study, the participants used a headache diary to keep track of their headaches for the next year.  The results showed that the patients who received the most SMT treatments had fewer headaches over the following twelve months.  More specifically, the researchers calculated that six additional SMT visits resulted in about twelve fewer days with headaches over the next year.

If you suffer from headaches, consider consulting with a doctor of chiropractic to determine if cervical dysfunction is a potential cause or contributing factor and whether you are a candidate for spinal manipulative therapy.

 

November 1, 2019 by CHIROTRUST

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9 Risk Factors for Developing Sciatica

Sciatica is a common pain problem that affects about 5% of adults. Sciatica is a symptom rather than a specific diagnosis: sciatic pain can have a number of different causes, and getting a proper diagnosis is key in getting relief from this condition.

While pinpointing the root cause of sciatica can be challenging, the medical research has established the factors that increase the risk of a person developing sciatic nerve pain.

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Here are the nine most common risk factors for developing sciatica:

1. Aging

As we get older, we lose flexibility and it takes us longer for our body to heal from injuries. One of the most common types of pain associated with aging is lower back pain, and back pain is very closely linked to sciatica.1,2

2. History of Low Back Pain

Research shows that patients who have problems with low back pain are more likely to eventually develop sciatica. Low back pain can result in a general inflammation in the lumbar spine, and this can start to spread to the sciatic nerve.

3. Smoking

It’s no secret that smoking is bad for your health, and it’s also clear that smokers are more likely to suffer from back pain and sciatica.3

Smoking isn’t just bad for your lungs and cardiovascular system; it’s also associated with inflammation, poor circulation, and a weakened immune system. This makes it harder for your body to function properly and makes it more difficult for your body to heal from injuries.

4. Overall Poor Health

Wellness is about flexibility and movement, and if our general health is poor, it’s difficult to stay active and healthy. Research shows that physical fitness is a great way to prevent and treat back pain.4

In addition, poor cardiovascular health is closely associated with a general inflammatory response in the body, which also increases the chances of musculoskeletal pain and sciatica.5

5. Obesity

Being overweight is one of the strongest predictors of back pain and other musculoskeletal problems, including sciatica.

Research shows that adipose tissue actually creates inflammatory markers which can affect our whole body, including our cardiovascular and nervous system. Remember: all sciatica pain is caused by inflammation of the sciatic nerve, and sciatica is more likely if your whole body is in an inflammatory state.

6. Work-Related Injuries

Repetitive movements or being too sedentary are detrimental to your musculoskeletal health, and this holds true for sciatica, as well.

Studies show that work-related activities can lead to sciatic nerve pain. Here are a few of the work conditions that have been associated with sciatica in the medical literature:

  • Standing or walking for long stretches.
  • Driving for long periods of time.
  • Pulling or kneeling for more than 15 minutes at a time.
  • Whole-body vibration.

If your work includes any of these activities, it’s critical to take breaks frequently, rest, and stretch a bit to prevent muscle injury and pain.

7. Sleep Problems

Research shows that poor sleep quality is associated with back pain and sciatica. This is a difficult issue, as poor sleep is also associated with other health issues, such as poor general health, obesity, and chronic pain. Sleep dysfunction is also associated with generalized inflammation, which is also linked to chronic pain.

8. Direct Injury

Less frequently, sciatica can be caused by an injury to the hip or buttocks, resulting in pain. One example of this would be sitting on a bulky wallet, which puts pressure on the nerve directly.

9. Psychological Distress

Low back pain and sciatica are linked to stress, as well. Monotonous or unsatisfying work and general stress can lead to chronic musculoskeletal pain.

A Whole Body Approach to Recovery

As you can see, many different factors play a role in the development of sciatica. Typically, it’s not just a single issue that results in pain, but a combination of factors. That’s why the most effective treatment and prevention of future episodes require a whole-body approach that looks at the root cause of your pain.

Medical References

  1. Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M. Risk factors for first time incidence sciatica: a systematic review. Physiotherapy Research International 2014 Jun;19(2):65-78. doi: 10.1002/pri.1572. Epub 2013 Dec 11. Review. PubMed PMID: 24327326.
  2. Parreira P, Maher CG, Steffens D, Hancock MJ, Ferreira ML. Risk factors for low back pain and sciatica: an umbrella review. Spine J. 2018 Sep;18(9):1715-1721. doi: 10.1016/j.spinee.2018.05.018. Epub 2018 May 21. Review. PubMed PMID: 29792997.
  3. Lee J, Taneja V, Vassallo R. Cigarette smoking and inflammation: cellular and molecular mechanisms. Journal of Dental Research 2012;91(2):142-9.
  4. Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. Published 2016 Apr 25. doi:10.3390/healthcare4020022
  5. da Cruz Fernandes IM, Pinto RZ, Ferreira P, Lira FS. Low back pain, obesity, and inflammatory markers: exercise as potential treatment. J Exerc Rehabil. 2018;14(2):168-174. Published 2018 Apr 26. doi:10.12965/jer.1836070.035

 

 

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Written by Michael Melton

Posted in acupuncture, Back pain, Back Surgery, back-pain, Chiropractic, degenerative disc disease, flexion-distraction, Pinched nerve, spinal vertebrae | Tagged , , | Leave a comment

Whiplash and Mid-Back Pain – How Can This Happen?

Research regarding whiplash or whiplash associated disorders (WAD) classically focuses on neck pain; however, the data show acute thoracic spine / mid-back (MBP) occurs in 66% of WAD injures with 23% still complaining of MBP at one-year post-injury.

It’s easy to visualize how the cervical spine or neck can be injured in an automobile collision (or sport-related collision or a fall) as the head, which weighs an average or twelve pounds, whips back and forth in a “crack-the-whip” like manner, often well beyond the normal, physiological range of motion. This same stretching (eccentric loading) followed by compression (concentric loading) also occurs in the mid-back, which can injure ligaments, joint capsules, neural structures, and more. Also, the thoracic spine contributes to 33% of flexion and 21% of rotation IN THE NECK, making the mid-back a vital spinal region that facilitates neck movement and function!

In WAD cases, mid-back pain hides in the shadows of a more obvious and often more serious neck injury, as the brain typically perceives pain from the greatest source. Additionally, the neuronal input to the sensory cortex of the brain (the area of the brain that perceives pain) is most highly represented from the head, hands, and feet and less from the mid-back or torso.

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The seat belt may also contribute to injury—both to the anterior chest region including rib cage, sternum, breast tissue, abdominal organs, as well as to the mid-back. The oblique angle of the chest-restraint is an important factor when discussing the mechanism of injury, as it causes trunk/torso rotation during the rebound or flexion phase of WAD. Another mechanism of injury includes blunt trauma, of which the driver is especially at risk due to the close proximity of the steering wheel and the chest. This can lead to contusion or bruising, fracture, and/or injury to the steering wheel and the chest. This can lead to contusion or bruising, fracture, and/or injury to the abdominal and/or chest organs (heart and lungs).

Obviously, the speed of impact, angle of the collision, bracing of the person (or lack thereof), and overall physical condition of the patient can greatly affect the outcome of WAD-related injuries. The importance of assessing the whole person is essential in obtaining an accurate diagnosis and establishing a comprehensive treatment for the WAD patient.

Chiropractic management focuses on the entire person, frequently uncovering complains in other spinal regions as well as in the extremities in WAD-related patients. Moreover, treating postural issues such as a short leg, ankle pronation, oblique pelvis, forward head posture, protracted shoulders, and more is vitally important in obtaining satisfying outcomes!

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Low Back Pain

Doctors of chiropractic offer a non-surgical, treatment protocol for both acute and chronic low back pain (LBP), as do several other healthcare delivery systems. However, due to patient preference and a rising concern for potentially harmful side-effects, many LBP patients seek management strategies that offer a natural, non-pharmaceutical approach, of which chiropractic is the most commonly sought after practitioner-type. So what evidence is there regarding the benefits of chiropractic vs. other forms of care in managing LBP and its associated pain-related functional loss?

A 2018 study published in the online Journal of the American Medical Association focused directly on this question by comparing patient outcomes of those receiving usual medical care to a second group of patients that also received chiropractic care.

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Data was collected at three sites—two large military medical centers and one smaller hospital at a military training site—over the 3.5-year time period. Eligible participants included active duty United States service members between 18 and 50 years in age who were diagnosed with mechanical low back pain.

Patients in each group received usual medical care for six weeks that included self-care, medications, physical therapy, and pain clinic referral. Participants in one group also received chiropractic care that included spinal manipulative therapy in the low back and adjacent regions and additional therapeutic procedures such as rehabilitative exercise, cryotherapy, superficial heat, and other manual therapies.

Up to six weeks after the conclusion of care, the researchers reported that patients that patients in the chiropractic group scored higher with respect to LBP intensity, disability, perceived improvement, satisfaction, and medication use. The researchers concluded that this trial clearly shows the need for chiropractic care for those suffering from LBP- reminding the reader that current LBP guidelines have embraced chiropractic care as a FIRST line of treatment for LBP.

This is not the first study to show the benefits of chiropractic care, as prior high-quality studies have reported higher patient satisfaction levels, less medication use, higher quality of life scores, and less LBP-related disability and recurrence rates for patients receiving chiropractic treatment vs. usual medical care. This article was published in a highly regarded medical journal (JAMA) and CLEARLY supports the need for chiropractic care in the management of LBP.

 

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Is It My Low Back Or My Hip?

When patients present with low back pain, it is not uncommon for pain to arise from areas other than the low back, such as the hip. There are many tissues in the low back and hip region that are susceptible to injury with have overlapping pain pathways that often make it challenging to isolate the truly injured area. Hip pain can present in many different ways.

When considering the anatomy of the low back (lumbar spine) and hip, and the nerves that innervate the hip come from the low back, it’s no wonder that differentiating between the two conditions is often difficult. Complaints may include the inside, outside, front, or back of the thigh, the knee, the buttocks, the sacroiliac joint, or the low back and yet, the hip may truly be the pain generator with any of these presentations. To make diagnosis even more complex, the hip pain patient may present one day with what appears to be sciatic nerve pain (that is, pain shooting down the back of the leg to the knee if mild or to the foot if more severe) but the next visit, with only groin pain.

When pain radiates down a leg, the almost automatic impression by both the patient and their healthcare provider is, “…it’s a pinched nerve.” But again, it could be the hip and NOT a pinched nerve that is creating the leg pain pattern. Throwing yet another wrench in the works is the fact that a patient can have more than one condition at the same time. So, they truly MAY simultaneously have BOTH a low back problem AND a hip problem. In fact, its actually unusual to x-ray the low back of a hip pain patient without seeing some low back condition(s) like degenerative disk disease, osteoarthritis (spurs off the vertebrae), or combination of these. So, how do we differentiate between hip vs. low back pain when it is common for both low back and hip pain to often coincide?

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During our history, we often ask the question, “…what activities make your pain worse?” If the patient replies that weight bearing activities like standing, walking, getting up from sitting, etc., provoke the pain (and they point to the front or side of the hip), a hip-related diagnosis is favored but it STILL may be arising from the low back or both! If they say, “…crossing my right leg over the other hurts in my groin,” then that’s getting more hip pain-specific as hip rotation is frequently lost before the forward flexion motion.

When we ask the hip pain patient to point to the area of greatest discomfort, they usually point to the front of the hip or groin, and less often to the inner and/or anterior thigh or knee. Non-weight bearing positions like sitting or lying are almost always immediately pain relieving. When there is arthritis in the hip, motion loss is often reported and may include a shorter walking stride and pain usually gets worse the longer these patients are on their feet. Initiating motion often hurts, sometimes even in bed when rolling over. During the chiropractic examination, with the patient lying on the back with the knee and hip both bent 90°, moving the bent knee outwards or inwards will almost always reproduce hip/groin area pain. Pulling on or applying traction to the affected leg usually, “…feels good.” Knee & ankle reflexes and sensation are normal but muscle strength may be weak due to pain. Bending the low back into different positions does not reproduce pain if the pain is only coming from the hip.

Though sometimes challenging, doctors of chiropractic are well-trained to be able to differentiate between hip and low back pain and will treat both areas when it is appropriate.

Chiro-Trust.org

 

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Neck Pain? We can help!

Did you know, in a given month, 31% of people will experience some sort of neck pain? Neck pain is the second most common reason why people see a chiropractor. Chiropractors have specialized training in the assessment and treatment of neck conditions. They will determine the source of the neck problems and then perform a series of corrective treatments to restore balance in the cervical spine. Chiropractic care provides a safe and effective treatment for people suffering from neck pain.

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¿Sabía que, en un mes dado, el 31% de las personas experimentará algún tipo de dolor de cuello? El dolor de cuello es la segunda razón más común por la que las personas ven a un quiropráctico. Los quiroprácticos tienen capacitación especializada en la evaluación y el tratamiento de las afecciones del cuello. Determinarán la fuente de los problemas del cuello y luego realizarán una serie de tratamientos correctivos para restablecer el equilibrio en la columna cervical. La atención quiropráctica proporciona un tratamiento seguro y eficaz para las personas que sufren de dolor de cuello.

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Sciatic Nerve/ Nervio Ciatico

The sciatic nerve is the largest nerve in the body. It is a combination of smaller nerves (nerve roots) that join together and become the sciatic nerve. When the sciatic nerve is being compressed very specific symptoms in the legs arise. Pain, numbness, tingling and/or weakness in one leg are the most common signs of sciatic nerve compression. The most common site for nerves to be compressed is as they exit the spine. As the nerves exit the spine they travel through a small opening which can be narrowed by a herniated disc, degeneration of the spine, or inflammation in the area. The nerve can also potentially be compressed by tight or spastic muscles in the low back and back of the legs. Chiropractors are well trained to treat patients who are suffering from sciatica. They will perform a detailed assessment to determine which nerves are being compressed and create a comprehensive plan to treat the problem. Your chiropractor my consult other health professionals or recommend additional test such as x-rays or MRI‘s. Chiropractic treatment and other conservative types of care are the most effective treatments for most cases of sciatica. Do you suffer from sciatica?

GIVE CHIROPRACTIC A TRY!

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El nervio ciático es el nervio más grande del cuerpo. En realidad, es una combinación de varios nervios más pequeños (raíces nerviosas) que se unen para convertirse en el nervio ciático. Cuando el nervio ciático se comprime, surgen síntomas muy específicos en las piernas. El dolor, entumecimiento, hormigueo y / o debilidad en una pierna son los signos más comunes de la compresión del nervio ciático. El sitio más común para comprimir los nervios es cuando salen de la columna vertebral. A medida que los nervios salen de la columna vertebral, viajan a través de una pequeña abertura que puede ser estrechada por una hernia discal, degeneración de la columna vertebral o inflamación en el área. El nervio también puede ser comprimido por los músculos tensos o espásticos en la parte baja de la espalda y la espalda de las piernas. Los quiroprácticos están entrenados para tratar a los pacientes que sufren de ciática. Realizarán una evaluación detallada para determinar qué nervios se están comprimiendo y crearán un plan integral para tratar el problema. Su quiropráctico puede consultar a otros profesionales de la salud o recomendar pruebas adicionales, como radiografías o resonancias magnéticas. El tratamiento quiropráctico y otros tipos de cuidados conservadores son los tratamientos más efectivos para la mayoría de los casos de ciática. ¿Sufres de ciática?

¡Visita tu quiropráctico!

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