Carpal tunnel syndrome is a condition that causes pain, numbness and tingling in the palm of the hand, the thumb and fingers. The pain is usually worse at night and causes problems with gripping and clumsiness in the hands.
The median nerve is the nerve effected in carpal tunnel syndrome as it runs through a tunnel in the wrist created by the wrist bones and ligaments. Typically carpal tunnel problems are aggrevated by working with the wrist bent in full extension or flexion. Fluid retention problems may worsen carpal tunnel (such as pregnancy or diabetes).
Often a carpal tunnel like syndrome may result from impingement of the median nerve at the pronator teres muscle in the forearm. Problems with the pronator teres are not directly linked to carpal tunnel but impinge the same nerve (median nerve). Pronator teres syndrome is usually successfully treated by Chiropractic methods especially including myofascial release.
The wrist may be tender in carpal tunnel and the muscles of the thumb may be effected and be visibly smaller.
Chiropractic management of carpal tunnel involves adjustments of the bones of the wrist as well as splinting and avoiding aggrevating activities. Additionally, myofascial release when combined with Chiropractic methods has been shown to be effective in the management of carpal tunnel.
The wrist is a complex joint that may be the cause of pain due to sports, computer work or other recreational activities. The wrist has no tendons that attach directly to the wrist and all stability at the wrist is due to the ligaments in the wrist itself. Problems with the muscles that cross the wrist and originate in the shoulder can cause pain in the wrist. Wrist problems are often the result of direct trauma, falls and overuse. Falls may cause instability if the ligaments are damaged. In athletics and computer user populations overuse is a common problem at the wrist. Positions that strain muscles repetitively are likely to result in insidious onset wrist pain. Weight lifting, rowing, and raquetball are among the most common actitivies that overstrain the wrist. Cumulative trauma is another important factor in wrist injury. Any occupational activity that is performed many times a day may be the cause of pain in the wrist and chronic overuse injury.
Insidious onset of wrist pain and pain in the forearm is most often due to overuse. If weakness or tingling is present it often means a peripheral nerve is entrapped.
The most common peripheral nerve entrapment treated by Chiropractors is the pronator teres. The pronator teres can be entrapped by such activties as weight lifting and using the hands for work. Myofascial release treatments are the most effective treatment for peripheral nerve entrapments in the wrist.
Shoulder pain is one of the most common conditions seen in athletes as well as non athletes. Often shoulder pain is hard for a person to pin point by pointing at the pain. Chiropractic care involving myofascial release techniques are often highly effective for shoulder pain. Often crackling of the shoulder is a common complaint. Most often the crackling sound comes from the clavicle or collar bone in its connections to the sternum and shoulder blade. The a-c joint or the joint of the collar bone and shoulder blade is a common site of injury. Often the joint is injured by falling on the tip of the shoulder with the arm at the side. If injured the collar bone may stick up and be visible under the skin. Arthritis of the ac joint often causes pain when the arm is raised completely over the head.
Pain at the front of the shoulder is often due to tendinitis of the biceps tendon. Throwing motions are particularly irritating to the biceps tendon. Biceps tendinitis often responds very well to Chiropractic (especially myofascial release).
The rotator cuff is another common area of pain in the shoulder. Often problems with the rotator cuff cause pain at the front of the shoulder. Often the rotator cuff is irritated in swimmers and people who do lots of overhead motions for work or sports.
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Many people suffering from lower back pain worry that their pain is caused by a disc herniation. It has been proposed that up to one third of the population has some kind of disc abnormality that is asymptomatic. Chiropractic care is safe and effective for all types of lower back pain including pain caused by disc problems.
As a general rule if pain in the legs during an episode of lower back pain travels below the knee it is likely the pain is caused, at least in part, by the disc. Numbness is more commonly seen in disc conditions. Most frequently the numbness is in the foot or ankle. Numbness is more common in disc conditions than in other types of lower back pain. People with disc problems also may have a history of recurrent episodes of lower back pain without leg pain. Most people with disc problems are between 30 and 50 years old. A disc injury is often caused by a twisting, bending injury and results in immediate leg pain. Often the leg pain aspect of a disc problem is worse than the back pain. In younger people with disc problems pain is often worse with sitting and less with standing or walking. Older people with disc problems generally have more difficulty with walking or standing.
The most useful diagnostic procedure in the Chiropractic setting is the straight leg raise. The straight leg raise is used by Chiropractors and Medical Doctors as the first line of testing to determine if an episode of back pain is due to a herniated disc or not. A positive straight leg raise test produces pain that runs down the back of the leg to the foot with raising of the leg.
It is recommended that people suffering with back and leg pain that may be a result of a disc problem should undergo about 3-4 weeks of conservative care (including Chiropractic). If no relief is achieved in the first 3-4 weeks of conservative care then an MRI is often recommended.
The Chiropractic technique of lumbar flexion distraction is often very helpful in cases of disc herniation. In flexion distraction technique the patient lies on the stomach on a special table that bends at the waist and applies a gentle traction to the joints of the lower back.
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Sciatica refers to pain that travels down the back of the leg. Most often sciatic results from irritation of the nerve roots in the lower back. The discs are the most common culprit that is responsible for irritating the nerve roots but other parts of the lower back may cause sciatica as well. One such other cause is piriformis syndrome. Piriformis syndrome usually causes a dull sciatica that comes on most insidiously than a disc condition. Problems with the disc may also directly refer pain into the leg without pinching the nerve roots.
It is generally thought that problems with the joints of the lower back including the sacro-iliac joints and facet joints do not refer sciatic type pain below the knee.
The straight leg raise test is the most common test used in the Chiropractic setting to determine if leg pain is due to a disc problem. For patients who are not able to get relief from conservative methods (including Chiropractic care) and MRI is generally used to see the extent of disc involvement. Usually a MRI is done only after one month of Chiropractic care that has not relieved the condition.