Duncan Blog

Dr. Eric Duncan Blog

Duncan Chiropractic Group P.C.

http://www.doctorofbrighton.com

Tuesday, October 25, 2011

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome - What Can You Do For It?

        Carpal tunnel syndrome or, CTS, is a common condition that drives many patients to chiropractic clinics asking, "...what can chiropractic do for CTS?" 

        As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:
  1. A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work - especially if it's fast and repetitive.  Your doctor will also need to learn about your "co-morbidities" or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.
  2. A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.
  3. Treatment can include manipulation, soft tissue release, PT modalities (eg., electric stim., ultrasound).
  4. Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

        Here are some of the things that you, the CTS sufferer can self-manage:

  • A Carpal tunnel splint  is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.
  • Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times / day) such as: A. The "Bear claw" (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand) B. Tight Fist / open hand (fully open - spread and extend the fingers and then make a fist, with the hand). C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm - hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch! D. Wrist range of motion (dorsiflexion/palmar flexion) - Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times. E. Wrist range of motion (pronation/supination) - Place forearm and whole hand on table-- elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times. F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed. G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down. H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.
  • Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

        We realize you have a choice in who 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 require care for CTS, we would be honored to render our services.

Tuesday, October 11, 2011

Health Update: Low Back Pain

 
 Low Back Pain: Where Is My Pain Coming From?

        Low back pain can emanate from many anatomical locations (as well as a combination of locations), which always makes it interesting when a patient asks, "...doc, where in my back is my pain coming from?"  In context of an office visit, we take an accurate history and perform our physical exam to try to reproduce symptoms to give us clues as to what tissue(s) may be the primary pain generators. In spite of our strong intent to be accurate, did you know, regardless of the doctor type, there is only about a 45% accuracy rate when making a low back pain diagnosis?  This is partially because there are many tissues that can be damaged or injured that are innervated by the same nerve fibers and hence, clinically they look very similar to each other. In order to improve this rather sad statistic, in 1995 the Quebec Task Force published research reporting that accuracy could be improved to over 90% if we utilize a classification approach where low back conditions are divided into 1 of 3 broad categories:
  1. Red flags - These include dangerous conditions such as cancer, infection, fracture, cauda equina syndrome (which is a severe neurological condition where bowel and bladder function is impaired). These conditions generally require emergency care due to the life threatening and/or surgical potential.
  2. Mechanical back pain - These diagnoses include facet syndromes, ligament and joint capsule sprains, muscle strains, degenerative joint disease (also called osteoarthritis), and spondylolisthesis.
  3. Nerve Root compression - These conditions include pinching of the nerve roots, most frequently from herniated disks. This category can include spinal stenosis (SS) or, combinations of both, but if severe enough where the spinal cord is compromised (more commonly in the neck), SS might then be placed in the 1st of the 3 categories described above.

        The most common category is mechanical back pain of which "facet syndrome" is the most common condition. This is the classic patient who over did it ("The Weekend Warrior") and can hardly get out of bed the next day. These conditions can include tearing or stretching of the capsule surrounding the facet joint due to performing too many bending, lifting, or twisting related activities. The back pain is usually localized to the area of injury but can radiate down into the buttocks or back of the thigh and can be mild to very severe.

        We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Wednesday, October 5, 2011

Tip of the Month





        By the time you read this, if you have children, they are already back in school. If they are, then you know what it's like to try to pack a healthy and safe lunch every day. Not too long ago officials from the Oklahoma State Department of Health offered some great tips to help parents out:

    Keep everything clean when packing the lunch. Use hot, soapy water to clean hands, clean preparation surfaces, and clean utensils. Wash your hands before you prepare or eat food. Wash insulated lunch bags with warm soapy water after each use.
    Use an insulated lunch box to help keep foods cold. Insulated, soft-sided lunch totes are best for keeping perishable foods chilled. You can also use a thermos to keep milk or juice cold until lunchtime. Perishable foods should not be out of refrigeration for more than two hours.
    Use freezer gel packs that are widely available in stores. If you cannot get freezer gel packs, freeze a juice box or plastic water bottle overnight and put that into the lunch box next to the sandwich.
    Keep your lunch in the coolest place possible! If there is a refrigerator at school, put your lunch in there. If not, keep it out of the sun and away from the heat.
    Pack shelf-stable foods, especially if you have a brown paper bag lunch. These food items include fresh fruits and vegetables, crackers, peanut butter sandwiches, canned meats, shelf-stable cheeses, packaged pudding, and canned fruits and juices.
    Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Blot dry with a paper towel before packing them in your child's lunch.
    Use a thermos to keep soup, chili and stew hot. Use an insulated bottle stored in an insulated lunch box. Fill the bottle with boiling water, let stand for a few minutes, empty, and then put in the piping hot food. Keep the insulated bottle closed until lunch to keep the food hot.
    Make sure kids wash their hands before eating lunch. Encourage at least 20 seconds - about the time it takes to sing two choruses of the "Happy Birthday" song - of hand washing in warm soapy water.
    Discard perishable leftovers after lunch.  Discard all used food packaging since bacteria can grow on plastic bags, aluminum foil, and paper. If you're packing your child's lunch with reusable bags, be sure to wash them daily with soap and hot water.

Remember, we're always here to help your body heal
and maintain the health you deserve.

Did You Know?


        Nuts and seeds just might boost your brainpower and balance your moods. Everything from the most common nuts -- such as walnuts, hazelnuts, cashews and almonds -- to the more exotic seeds and nuts can clear up that "brain fog" and enable you to think clearer and be happier than you ever imagined. 

        Walnuts are "brain food."  Walnuts are made up of 15 to 20 percent protein and contain linoleic (omega-6 fatty acids) and alpha-linoleic acids (omega-3 fatty acids), vitamin E and vitamin B6, making them an excellent source of nourishment for your nervous system.  A healthy nervous system means both clearer and happier thinking.  Under-consumption of omega-3-rich foods may actually lead to depression. The same walnuts that you can find in the baking aisle of just about any grocery store may also boost your mood. 

        Walnuts aren't the only nut with mood-boosting omega-3s, either. Flax seeds are an excellent source for omega-3s, making them a viable source for those who don't like to eat fish, the most common source of omega-3s. 

        Cashews are high in magnesium, which can "open up" the blood vessels in your body, including those in your brain. When more oxygen-rich blood nourishes your brain, like any organ, it operates better. By providing your body with phenylalanine, adding almonds to your diet can do wonders for your mental and neurological health. Additionally, almonds are high in riboflavin, which may boost your memory. Peanuts and pecans provide another important nutrient for optimal brain function, choline.  Choline aids in both memory and brain development.  Seeds and nuts are essential to a healthy, well-functioning brain.

Survey Says Chiropractic Outperforms Other Back Pain Treatments - Even Medication


        SURVEY SAYS!!!!  If you have back pain... you are probably old enough to remember Richard Dawson first yelling that phrase on the popular 70s and 80s game show, The Family Feud. If not - it doesn't matter - you just learned something interesting about American pop culture and game show history.

So, What Does The Survey Really Say?

        According to an August 9, 2011 article on chiroeco.com, "In a new survey, chiropractic outperformed all other back pain treatments including prescription and over-the-counter medications, deep-tissue massage, yoga, and Pilates. According to the American Chiropractic Association (ACA), this news reinforces the use of conservative care options as a first line of defense against pain.
        The survey, released by a leading consumer product rating and survey publisher in late July, found that 65 percent of those surveyed using chiropractic care for back pain said it helped a lot. Only 53 percent of respondents using prescription medications found them as helpful.
        "Additionally, about half of those surveyed who are using deep-tissue massage, yoga or Pilates said those treatments helped a lot and only 28 percent of respondents using over-the-counter medications reported that they helped a lot.
        "Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain."
        One serious eye-opener was that only 28% of respondents said over-the-counter medications helped a lot.
        It has been known for quite some time that common over-the-counter non-steroidal anti-inflammatory medications (NSAID) have serious side effects.  One of these side effects is that an estimated 16,500 people die every year.
        Natural, conservative options like Chiropractic, deep tissue massage, yoga, and Pilates are most likely better and safer choices when it comes to relieving back pain.

What About Neck Pain And Headaches?

       Neck pain is very common and it can make your life miserable. If you suffer from headaches... there is a very good chance you suffer from a common type of headache called "cervicogenic headache."  This type of headache is caused by a problem in your neck.
        One way to tell you might suffer from cervicogenic headaches is to identify if any neck motions cause the headaches or increase their severity.
        Also, take a good look at yourself in the mirror.  Does your head tilt to one side?  Is your head posture bad?  In other words, does your head stick out in front of you instead of sitting back over your torso?  You'll probably need a trained eye (like your Chiropractor's) to see that one.