Headaches

Headaches are common in our fast-paced, pressure-filled world. There are many causes of headaches, including physical trauma, emotional stress, nutritional deficiencies, or chemical toxins. In addition, if your neck and/or back are out of alignment (Subluxated), this can affect nerves, muscles, and even blood flow to your head. In fact, 80% of all headaches are cervicogenic, which means they are caused by problems stemming from the neck. Too often, we turn to over-the-counter medications to relieve our discomfort. Unfortunately, these only mask the underlying sources of pain.

People around the world continue to turn to chiropractic for headache treatment. It was estimated in 1995 by the National Institutes of Health that approximately 48 million people in the USA used chiropractic treatment, and the numbers around the world are growing. A recent trial, completed for a PHD thesis at Macquarie University, by Dr Peter Tuchin, showed that 60% of migraine sufferers had a reduction in their symptoms during the course of the treatment with Chiropractic care.

Dr JS Wight in the ACA Journal of Chiropractic (1978) reviewed headaches and chiropractic treatments since 1923, and found a success rate between 72% and 90%. The benefits at times seemed to last for years after the treatments.

After your initial chiropractic examination, we can determine if chiropractic health care is the best alternative for treating your chronic headaches. A combination of chiropractic adjustments and nutritional and lifestyle changes can dramatically reduce the frequency and intensity of headaches. Back to top

Neck Pain

Your neck is the most vulnerable part of your spine. Not only does it support your 10- to12-pound head, maintain a gentle forward curve, and permit head rotation, but it must also allow the free flow of nerve impulses to the head, face, hands and the rest of your body. Besides discomfort and annoyance, chronic neck pain is a sign that something is wrong. Many everyday things can cause neck pain, such as watching TV, using your computer, reading a book or falling asleep in a chair or on an airplane. The temporary pain that results can resolve on its own, especially when the offending activity is discontinued. When it doesn't, a more serious underlying problem may be indicated.

Early detection of neck problems is critical. In many cases the problem may be due to a disc injury, degenerative arthritis, or a pinched nerve. Early diagnosis and treatment of neck problems has a much higher probability of a favorable outcome. See which treatment is right for you. See our Chiropractic Care page.

The most common cause of neck pain is due to functional distortions in the spine resulting from vertebral subluxations. These subluxations are seen in cases of a reversed cervical curve, and whiplash and joint instability. The body responds by tightening muscles in the neck, "splinting" the joint to protect it from further insult.

Most of the pain-sensing nerves in the neck are located in the pairs of facet joints on the back side of each vertebra. These smooth, interlocking surfaces allow you to rotate your head and bend your head up and down. If these joints become locked or fixated, neck pain can result. Chiropractic care can help restore proper joint motion.

A more difficult problem to correct is the degenerative changes to the disc and spinal bones that result from neglect. Years of uncorrected spinal problems can cause bone spurs, disc thinning and other forms of spinal decay. These types of problems respond more slowly. Disc degeneration responds well to Spinal Decompression. Your doctor can determine if this is a good course of treatment for you.

Our response to stress - from Deadlines to Rush-hour traffic, Family obligations and Work pressures - is another common cause of neck pain. Each of us is susceptible to our body's unconscious response to people and circumstances. These perceptions can show up as episodes of neck pain. If the weakest link in our bodies is our neck, stress shows up there. While chiropractic care cannot reduce the stress of your busy life, it can help improve your ability to handle and tolerate it. Without drugs or surgery!

Whiplash

Many people are involved in car accidents during their lifetime. By far the most common auto accident is when one car collides in to the rear-end of another car. During such an accident, the passenger in the front vehicle gets their head forcefully jerked backward and then forward causing injury to the structures of the back and front of the neck. This type of injury is often called a whiplash. Even at low speeds, the amount of force generated by such an accident is very strong and can cause trauma to the ligaments, muscles, facet joints, discs and the spinal nerves. Besides neck pain and immobility, symptoms such as headaches, nausea, vertigo, arm and shoulder pain, tingling in the hands and fingers and weakness of the arm and hand are associated with whiplash injury. It is very important to get immediate evaluation and x-rays to rule out the possibility of fracture. However in most cases, the injuries are usually to the soft tissues and joints. Proper management is essential to recover from the pain and symptoms of whiplash and to prevent future disability. Our doctors are educated in "Spinal Trauma" and trained to manage your injury from beginning to end. Back to top

Low Back Pain

Low back pain is a common health problem affecting more than 80% of the population - making it second in prevalence only to the common cold. Although most of us are aware that the common cold is due to a viral infection, back pain is often a mystery to most of its sufferers.

Anatomy

To understand back pain it is important to understand the anatomy of the spine. The spinal bones or vertebrae of the lower back consist of joints at the back of the spine called facets that link vertebrae to one another and serve to guide the motion of the spine. The intervertebral discs connect the bodies of the vertebrae. They are composed of a form of tough cartilage that encases a soft material in the centre of the disc called the nucleus. The primary function of the disc is a shock absorber and a spacer between the vertebrae. Ligaments and muscles also connect the vertebrae. The bottom wedge shaped bone at the bottom of the spine is the sacrum and is joined to the two pelvic bones at the sacroiliac joint. In a canal located between the body and the facets of the vertebrae is the spinal cord. The spinal nerves exit the spine between the vertebrae.

Causes of Back Pain

The majority of back pain patients have not experienced any trauma, accidents or major injuries prior to the onset of their problem. The cause of most back pain is the cumulative affect of improper sitting posture, poor work habits, incorrect lifting, lack of proper exercise and other lifestyle-related factors. All of these factors cause stress and imbalances on the spine and eventually pain. This is why people often injure their back by just bending over to pick up a piece of paper. The spine was already compromised and just the simple act of bending was enough to set off the problem. When this occurs, the surrounding back muscles go into spasm to protect the stressed or injured tissues of the back. Back to top

Disc Problems

Prolonged sitting, especially in a slouched position, causes increased pressure upon the intervertebral discs and creates imbalances in the muscles surrounding the spine. Eventually the lower spine loses its normal function and no longer can accommodate the normal day-to-day stresses in one's life.

Ultimately, the intervertebral disc develops small fissures or cracks allowing the soft nucleus to protrude the disc outward. If the disc pushes upon sensitive tissues one feels pain and this is often referred to as a slipped disc. If the disc presses on the spinal nerve a person can develop sciatica which is defined as pain, tingling, numbness and sometimes weakness in their lower extremities. Sometimes if the disc protrusion or herniation is large and the condition is not managed correctly, surgery is required to remove the herniated disc material. Back to top

Sciatica

Sciatica can be a distracting pain that starts in the lower back and extends down into one or both legs. Those suffering from sciatica are often in their 40s and 50s. It usually begins as an acute pain in the lower back and then extends down the back of either leg. The pain usually worsens with long periods of sitting or standing.

Like a large river created by smaller streams, five pairs of nerves exit the spine in the lower back to form the two sciatic nerves. The soft, pulpy disc between each spinal bone is often involved. While a disc can't "slip," it can bulge, herniate or rupture. This can put direct pressure on the nearby nerves. The result? Swelling. Inflammation. Pain when coughing, sneezing or with others kinds of movement.

Sciatica often worsens with extended bed rest. Pain pills or muscle relaxers are unable to correct the nerve compression caused by the bulging disc. Physical therapy merely works the area to increase your tolerance to pain. Surgery often involves cutting away disc tissue or removing bone to make room for the nerve.

Fortunately, Spinal Decompression and or Chiropractic care has proven to be quite helpful.

Improving joint motion with a series of Chiropractic adjustments and or Spinal Decompression has produced results for millions. "Before" and "after" images of the lower back often show improved disc height and spacing. Many patients report that they can resume their lives and that their symptoms disappear, without resorting to drugs or surgery.

Causes

It's easy to trace some spinal problems to an event, such as a car accident. Yet, sciatica is often the result of cumulative damage. Years of bad posture, poor muscle tone, excess weight or countless other causes set the stage. Then, something simple like bending over to tie your shoes can trigger an episode. Spinal decay can be another culprit. Instead of disc thinning that puts pressure on the sciatic nerve roots, arthritic bone spurs can intrude into the space normally reserved for the nerve. Back to top

Scoliosis

Scoliosis is tragic. It causes both physical pain and emotional suffering. This sideways bending of the spine shows up as abnormal posture and then finally, deformity.

If allowed to advance, it can interfere with the lungs, heart and many other vital organs. Scoliosis affects boys more frequently, and girls between the ages of 8 to 18. The cause varies. Some are born with this spinal deviation (congenital). Others get it from assuming a distorted head or hip position (habitually). Sadly, in many cases the cause is still unknown. In the beginning, when easiest to correct, there are rarely symptoms. However, an alert parent may notice that a high shoulder or low hip makes clothing fit poorly. Back and leg pains may develop but are often overlooked as merely "growing pains." Neglect is the biggest danger. If allowed to run its course, scoliosis can steadily worsen. Early detection is critical. Severe cases can involve surgery. This procedure attaches steel rods to force the spine to straighten..

First, a thorough examination helps detect scoliosis in its early stage. Then, corrective action can begin at once. The primary course of care is a program of specific chiropractic adjustments. These help improve the function and structure of the spine, as well as, strengthening muscles and improving posture.

Chiropractic care has helped countless young children reclaim their health, posture and their self-esteem.

Isn't a certain amount of sideways curvature normal?

Any type of sideways curvature is abnormal. From the back, the spine should appear straight. When scoliosis is present, there are usually two curves: a primary curve in one direction and a compensatory curve in the opposite direction (commonly called an "S-shaped" curve).

Does a lack of calcium cause scoliosis?

No. However, there are a growing number of authorities who believe uncorrected spinal damage from the birth process may be involved. Others suggest that using infant/toddler walkers to encourage early walking may be a culprit. Make sure your son or daughter uses both shoulder straps on their backpacks and their load doesn't exceed 15 percent of their body weight.

What's the best time for a scoliosis examination?

As with the case of many health problems, early detection can improve the likelihood of correction. Wise parents consult our office soon after the birth of their child. Then they follow up with periodic chiropractic checkups throughout their child's developing years.
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Stress

Not all stress is bad. A 20-minute workout for a fit and trim 65-year old is good stress. The same workout for an out-of-shape 35-year old would likely be bad stress!

Whether your body considers stress good or bad is largely a function of how well it can accommodate it. Ultimately, this capacity is based on the condition of your nervous system.

Stress is part of everyday living. In fact, a stress-free life would be boring! Life is enjoyable when we have ample resources to experience and overcome the stresses we face.

Physical Stress

A whiplash injury from a car accident is an obvious source of physical stress. As is repetitive motions, a slip and fall, lack of sleep or overdoing it in the garden. Early on, learning to walk, ride a bike and the birth process itself are sources of physical stress.

It's not the stress-it's your reaction to it that matters!

Accumulated stress exhausts our reserves. Then, something as simple as mowing the lawn can put us over the edge. Chiropractic care, Therapeutic Life Style Changes and Sports Therapy helps restore your adaptive capacity.

Chemical / Environmental Stress

Common sources of chemical stress include poor nutrition, sugar, refined carbohydrates and unhealthy fats. Drugs, preservatives, tobacco, alcohol, vaccinations, pollen and a host of other substances also affect our nervous systems, muscle tone and our spine. The problem isn't the pollen or chemical but your body's inability to adapt and process these chemical stressors. Symptoms can appear when you lose your ability to adapt.

Emotional Stress

Fear, grief, anger and other emotions affect our entire body. Notice the posture of someone who is sad or depressed. Frustration, or a sense of powerlessness at work, is a common form of emotional stress.

Clearly, it's not the stress, but our response to it that is critical. Chiropractic care, Therapeutic Life Style Changes (Fit-Life) and Sports Therapy can help you respond more resourcefully and aid your nervous system in "bouncing back".

If you lack the reserves to adapt to stress in a healthy way, it takes a toll. If your body reacts by "tripping a circuit breaker," causing vertebral subluxation, Chiropractic care is likely to help.

How can stress affect my spine?

Think of your spinal cord as a guitar string - the greater the tension, the higher the note. Your nervous system has "tone" as well. With each stressor, your body tightens up, like bracing yourself for a tight curve on a roller coaster. The weakest joints of your spine are forced out of their normal position. Like the shrill notes from an over-tightened string, your body loses its capacity to respond to the full range of human experience. And ill health can result.

Can chiropractic care and exercise solve all my stress?

If only it were that easy... Much of the emotional stress we experience is largely self-induced. Imagine how much pain and suffering result from attaching inappropriate meanings to events in our lives. Or the constant burden we experience by not forgiving others. Stress is a natural part of life. Chiropractic care and exercise can't eliminate stress, but it can help increase your body's capacity to accommodate it.
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Sport Injuries

Introduction

In the past, sport injuries were mostly limited to professional athletes, adolescents participating in school sports programs, and men participating in weekend activities such as rugby. However, more and more people of all ages and both sexes are doing regular sports and fitness activities. There are greater numbers of women participating in what was once thought of as "traditional men's" sports, such as soccer, basketball and rugby. We see a large majority of people involved in such activities as golf, tennis, running, aerobic classes or weight training. No matter what activity one does, there is always the risk of injury. Injury can be broken down into two basic types: Trauma such as a slip, fall or collision and over-use or repetitive strain.

Traumatic Injuries

The majority of these injuries usually have the greatest impact on the ligaments of a joint, the tissue that connects bones to bones. More severe traumatic injuries will have a larger effect on the tendons, tissue that attaches muscle to bone. Contact sports carry a higher risk of fractures and dislocations. A strain is any injury to either a muscle or its tendon and a sprain to ligaments. The most common areas for these types of injuries are the ankles, knees, and the shoulders though other areas can be affected, including the low back and neck. Of course, injuries to the neck and low back can be quite serious as the spinal cord or spinal nerves can also be involved.

Traumatic injuries can vary from a mild "muscle pull" or ankle twist to a serious problem requiring surgery. It all depends upon the degree of tearing of the tissues, the location, and the age of the person. Most sprains and strains are associated with some degree of swelling and sometimes internal bleeding especially with the ankles and knees. With all strains and sprains proper management is very important especially during the initial stages of the injury to insure proper healing and no future disability.

The following is an acronym for the post-injury management of sprains and strains especially if no professional help is available:

PRICE:

P - Protect the injury from further damage
R - Rest the injury
I - Ice the injury to reduce swelling, bleeding, muscle spasm and pain
C - Compress the injury with a specialised support or elastic bandage to support the injured tissues
E - Elevate the injury if necessary when dealing with ankles and knees.

Of course it is important to get the injury properly assessed by a health care professional in order to know the extent of damage. Most of these injuries can recover without residual disability with proper care during the various stages of healing. If the injury is not managed carefully some sprains and strains can leave us with long lasting problems of joint instability, painful or weak joints and muscles, and lack of mobility. The doctors at Precision Sport & Spine are trained in the management of sports injuries and can give you the proper advice and treatment to insure that your injury will heal fully with the least amount of residual problems in the future.

Overuse or Repetitive Strain Injuries

These injuries are becoming more and more common especially among people pursuing sports such as golf, tennis, bowling or any other activity that requires the same motion over and over. Even running, especially on a treadmill can cause such problems. Some of these problems have been discussed in greater detail in other sections of the website (for example: tennis or golf elbow.)

Basically these conditions occur when we are involved in a repetitive activity that causes a very slight strain to tissues, especially tendons and muscles. The primary activity, in and of itself, would not cause a problem; however, performing this activity many times has a cumulative affect. After some time the muscle or other affected tissues develop microtrauma (swelling and tears within the fibers of the tissues) that no longer permit proper function of the joint, resulting in pain, stiffness and disability. There are two types of factors that predispose a person to these types of problems: 1. Intrinsic or found within one's own body 2. Extrinsic or external factors that can often be changed or controlled by the individual.

Common Intrinsic factors of Injury
1.   Age - the older we are the easier it is to get injured
2.   Congenital abnormalities - some people are born joint or muscle problems
3.   Previous injuries - previously injured joints or muscles often lack proper function Common Extrinsic factors of Injury:

Common Intrinsic factors of Injury
1.   Equipment - improper grip size of tennis racquet, worn out running shoes
2.   Playing surface - playing soccer on hard surfaces, uneven treadmill
3.   Improper technique - improper golf grip or swing
4.   Poor conditioning - doing activity when out of shape
5.   Lack of warm-up - not stretching or preparing for activity
6.   Increased frequency or duration - not building up slowly
7.   Flexibility - too stiff to do activity correctly
8.   Stress - being tired or stressed can cause number 3 or 7

As we can see there are a great deal of extrinsic factors that are within our control. However most of us need assessment by a qualified health professional to determine the nature of the injury as well as the solution to the problem. If left untreated these injuries can heal improperly causing chronic reoccurring problems, greatly affect your life and possibly limiting a favourite activity. Aside from eliminating the cause, treatment is often required to stabilize the condition. The treatment might include joint manipulation, massage, therapy modalities, bracing and specific exercises. Back to top

Shoulder Injuries

Introduction

The complexity of the shoulder joint allows for a wide range of movements and activities. Anatomically, the shoulder involves three different bones - the scapula, the clavicle, and the humerus - including many connecting ligaments, and approximately 20 different muscles. The main articulation, the gleno-humeral joint (ball & socket joint), is connected by ligaments and a group of muscles (and their tendon attachments) known as the rotator cuff. Problems with the rotator cuff are common causes of shoulder pain and disability.

As with other joints, shoulder problems can be caused by trauma as with sports injuries, mechanical dysfunction due to imbalances in the muscles, or by simple 'wear and tear' of the tissues surrounding the joint. Arthritic changes can occur in the shoulder joint but are not as common as seen in the weight bearing joints of the spine, hips and knees.

Anatomy

Problems in the shoulder often originate in the cervical spine, as the nerves from this region innervate all of the muscles and other tissues of the shoulder, arm and hand. If these nerves are irritated, the shoulder muscles can become tight or weak, causing dysfunction in the normal mechanics of the joint, especially in the rotator cuff. A similar situation can occur if one overuses the shoulder in sports such as tennis and golf or other repetitive activities. People who sit too much in a slouched position or with the shoulders rounded or drooped forward are also at risk for developing these imbalances and shoulder problems.

Rotator Cuff Syndrome

Regardless of the reason, if the muscular imbalances, ligamentous instability and irritation to the shoulder are not corrected, pain and limitation of normal motion will eventually develop. The severity can vary from a slight catching, clicking or pain in the shoulder to an inability to raise the arm and shoulder overhead. This painful condition is often called Shoulder Impingement or Rotator Cuff Syndrome and can afflict individuals of all ages.

Frozen Shoulder

Another common problem, especially among middle age women is " frozen shoulder. " This often debilitating condition occurs when the ligaments and tendons of the glenohumeral (ball & socket) joint get so irritated that adhesions (scar tissue) develop, freezing and severely limiting the motion of the joint, This results in not only an extreme limitation of shoulder motion but extensive pain on motion; making it difficult for some individuals to even get dressed! Left alone a frozen shoulder can progressively worsen with time; therefore, it needs to be addressed by a professional such as a chiropractor who specializes in Sports Therapy before the problem becomes permanent.
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Knee Injuries

Introduction

Besides spinal conditions, knee pain and disability is one of the most common ailments of the musculoskeletal system. Problems with the knees can be classified into three categories: 1) poor mechanics or overuse of the knee joint, 2) traumatic injury from events such as sport injuries and falls, and 3) problems due to arthritic changes in the joint.

Patella Femoral Syndrome ( Knee Cap Pain )

Poor mechanics of the knee joint, and the associated stress upon the soft tissues of the knee, is by far the most common cause of non-traumatic pain. The most common part of the knee affected by this is the patella or knee-cap. Often the patella (knee cap) does not move smoothly or does not move sufficiently on the femur (thigh bone) during bending of the knee. This causes abnormal stresses upon the tendons, cartilage and ligaments. This condition is often called chondromalacia patella or CMP though a better term is patella femoral syndrome. The problem usually originates when there are imbalances in the quadricep muscles of the thigh which attach to and move the patella.

The associated pain is experienced during activity, especially stair climbing, running, jumping and after getting up from prolonged sitting. Women are more predisposed to this problem due to use of high heels.

Repetitive Knee Strain

Overuse Injury Imbalances in other muscle groups that attach to the knee can also lead to pain and dysfunction. As an example, the muscles on the inside of the thigh when strained and tight can cause pain on the medial side (inside) of the knee.

Lower back problems especially in the sacroiliac joints, are one of the main reasons for imbalances in the muscles associated with knee movement and subsequent knee problems. Foot problems that cause gait or walking abnormalities such as pronation, are another cause of mechanical knee pain.

The main treatment for mechanical or overuse injuries to the knee is to re-establish proper balance of the muscles and ligaments, restore proper movement to the patella and other joints of the knee, correct subluxations of the sacroiliac joints and correct any foot problems. In certain cases, a brace is used to help with the alignment of the patella or to stabilize the joint.

Chiropractors specialized in Sports Therapy are ideally trained to provide the proper diagnosis and management of these problems.

Trauma

Traumatic injuries often occur during sports that involve running and jumping, such as football and basketball, and with activities such as skiing. When the knee is stretched or twisted beyond the strength of the ligaments, that hold the joint together, tearing of these tissues can occur causing a sprain. The muscles that move the knee can also be torn during injury causing a strain or pull of the muscle. As with a sprain, a muscle strain can vary from a minor injury that requires little care to a severe injury requiring surgery. The knee also contains two special "cartilages" - the menisci - between the tibia and the femur that provide for smooth movement and cushioning. These cartilages can also be torn during trauma and often require surgical repair or removal if damaged severely. Traumatic knee injuries can cause severe pain and swelling and require immediate evaluation and attention. In most cases a qualified chiropractor can manage these conditions, though there are some injuries that do need the expertise of an orthopedic surgeon. In any case, it is important to stabilize the injured joint and ice if possible until you can get the injury evaluated. Please see the section on Sports Injuries for additional information regarding this topic.

Treatment

If poor mechanics or traumatic injuries are not corrected at an early age, the tissues of the knee joint especially the cartilage will eventually begin to wear out. As a result the bones rub upon one another and changes such as bone spurs can occur. This painful condition is known as degenerative joint disease or osteoarthritis and is often progressive with age. Common treatment often involves medications such as NSAIDS (non-steroidal anti-inflammatory drugs) though conservative treatment such as Chiropractic Care, and Sports Therapy (exercise rehab) can be helpful in alleviating some of the pain. There is some evidence that nutritional substances such as Glucosamine and Chondroitin can be helpful in the long term management. People can often help themselves by keeping their weight down, doing exercises especially in the pool, and wearing cushioned shoes or insoles. Back to top

Tennis Elbow

Introduction

Tennis elbow is a term used to describe pain originating on the outside or lateral side of the elbow. This condition arises from an irritation or inflammation of the tendons of one or more forearm muscles. This occurs at their attachment to the bony protuberance close to the elbow joint, known as the lateral epicondyle. Therefore the medical term for this condition is lateral epicondylitis, meaning an inflammation of the epicondyle. If the condition is located on the inside or medial side of the elbow it is often referred as Golfer's Elbow or medial epicondylitis. This, however, is not as prevalent as lateral epicondylitis.

Causes

There are many causes for Epicondylitis - not just tennis & golf - as any activity that involves repetitive gripping of objects can result in this affliction. Some individuals develop tennis or golfer's elbow from prolonged carrying of heavy bags, knitting, chopping food, and/or computer work using improper wrist and arm posture. With sports, the problem arises when we are new to the game, use an improper technique, try out new racquets or clubs, or increase the intensity or duration of exercise without the proper preparation.

Sometimes the condition can be so severe that it is difficult to even grip and lift one's coffee cup!

Some cases involving epicondylitis can be attributed to problems further up the arm or even in the neck. If someone has a cervical disc condition or spinal subluxation, the nerves that control the forearm muscles may become irritated causing the muscles to tense and put marked strain on the tendon attachment(s). In these circumstances, this predisposes an individual to elbow pain from any of the above mentioned causes. If left untreated it is possible that the joints of the elbow can become subluxated, further complicating the condition.

Treatment

Epicondylitis is a condition that rarely resolves of its own accord, and so requires proper medical management. A qualified medical professional such as a chiropractor can determine the exact cause of the problem and initiate the proper care and treatment. This might include modalities such as ultrasound, electrotherapy, massage, hot and cold treatments, bracing and home stretching and exercises. Chiropractic adjustments to the elbow joint have proven extremely effective in the overall management of this problem. Back to top

Carpel Tunnel Syndrome

Introduction

Carpal Tunnel Syndrome falls into the category of neurological conditions called nerve entrapment disorders. This condition by far is the most common of these disorders. This problem occurs when a nerve is trapped or constricted between other tissues of the wrist, where the carpal bones are located, causing irritation and dysfunction of the nerve.

Anatomy

The Carpal Tunnel is located in the underside of the wrist and is a passageway in which the Median nerve travels in order to innervate the hand and fingers. Along with the Median nerve, the Carpal Tunnel contains the nine tendons of the forearm muscles that are responsible for bending and flexing of the fingers and thumb. There are also arteries and lymphatic vessels that supply circulation to the hand located within the tunnel. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a strong band of connective tissue called the transverse carpal ligament. The diameter of the carpal tunnel is about the same as the index finger making the carpal tunnel a densely packed space. The flexor tendons, arteries and Median nerve are expected to glide smoothly past each other during wrist and finger movement.

If the tendon size increases from inflammation or hypertrophy (abnormal growth), or if the carpal tunnel size decreases because of a mechanical dysfunction of the carpal bones, the Median nerve can become constricted or entrapped within this tunnel. The initial symptoms of carpal tunnel syndrome usually include pain, numbness, paresthesia (pins and needles) and tingling in the fingers and hands especially the thumb and adjacent two fingers. These symptoms are especially noticeable at night and often wake people from their sleep. The individual has to sit up in bed and shake-out and/or rub the hands in order decrease the these unpleasant sensation. The hands can also feel clumsy, weak and fatigue easily with activity. Over time, the ability to grasp small objects using the thumb and fingers can be affected dramatically and if left untreated, can lead to total dysfunction of the hand.

Some common causes and associated conditions are:

Repetitive and forceful grasping with the hands
Prolonged computer usage especially with poor wrist position
Activities that require repetitive bending of the wrist
Broken or dislocated bones in the wrist which produce swelling
Arthritis, especially the rheumatoid type
Thyroid gland dysfunction
Diabetes
Hormonal changes associated with menopause or pregnancy

Although any of the above can predispose one to carpal tunnel syndrome, in many cases the cause is considered to be unknown. The reason being is that the onset occurs at such a slow gradual pace, it goes unnoticed for some time. However people who perform jobs that use vibration tools and machinery, and/or work in extreme temperatures are often subjected to this condition. Even household activities as simple as repetitive wringing of clothes by hand can help cause this syndrome. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. This is becoming a major concern in the developed world where people of all ages are spending much of their time typing on a keyboard & clicking on a mouse

Treatment

Proper diagnosis and management of this condition is essential in order to curtail the disabling symptoms associated with the advancement of CTS. Precision Sport & Spine Doctors are educated on how to properly diagnosis and treat this problem and can offer many sufferers relief and an alternative to surgery. Treatment can include wrist decompression therapy, cold laser therapy, ultrasound to help reduce inflammation, electro therapy to strengthen weak muscles of the forearm, soft tissue massage to stretch contracted tissues and adjustments of the dysfunctional joints of the wrist. You might be advised to wear a splint or support, especially at night, to help hold the wrist in a neutral position to decompress the carpal tunnel. Your treatment should also include specific exercises to stretch and/or strengthen muscles of the forearm and hand.

For those of you contemplating surgery, you should be aware of the dismal statistics. Fifty percent of all carpel tunnel surgeries are unsuccessful. Thus, exhausting all conservative measures is advisable as any surgical complication may not be reversible.
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Foot & Ankle Pain

Introduction

The average person takes between 8,000 and 10,000 steps per day. In addition many of us are engage in activities such as running and aerobic exercise that add many more steps and stress to our poor over worked feet. It is no wonder that many people have aches and pain in this part of the body. Factors such as flat feet or over-pronated feet, our walking and running style, the type of shoe used can determine if we will get foot and ankle pain. However these factors can also affect the health of your back, knees and legs. Below are a few of the common conditions that affect the feet and ankle.

Pes Planus ( Flat Feet )

Flat feet or Pes planus as it is called by the medical community is very common and it is estimated that at least one quarter of the population has flat feet. We are all born with flat feet and somewhere between the ages 3-10 we develop and arch. However in certain people this development never occurs. Besides genetic causes, there are a number of factors that can cause flat feet or predispose people to the condition. Sometimes people develop arches only to have them collapse later in their life. This often depends upon their lifestyle, job and level of activity. Age and weight also play a role in the condition's development. Middle-aged people who have been working on their feet for years often experience flat feet, as do overweight people who are placing added stress on their feet and legs.

Having flat feet does not necessarily mean you will experience pain. It's possible for people to have the condition and never feel any discomfort. For people who do develop pain, it usually occurs in the feet and knees, and possibly in the hips and lower back. If you suspect you have flat feet and do experience pain you should see your chiropractor to determine a plan of management that can ease pain and prevent further symptoms from developing. A number of options, including prescribing arch-supporting insoles called orthotics and performing joint adjustments can improve foot function and alleviate any symptoms.

Plantar Fasciitis ( Heel Pain )

One of the most common of the foot ailments is heel pain and the cause is usually inflammation of the plantar fascia (plantar fasciitis). The plantar fascia, is a band of connective tissue that surrounds the muscles on the bottom of the foot. It connects the heel bone to the ball of the foot, supporting the arch, protecting the foot and absorbing shock.

Patients with plantar fasciitis often complain of pain in the morning after first standing when they get out of bed and when the stand after they sat for a while. The pain originates just in front of the heel bone, but can spread over the entire bottom of the foot. Over time, inflammation associated with the condition can lead to the development of scar tissue, calcium deposits and eventually heel spurs. These spurs are a bony growth on the front part of the heel bone (calcaneus) where the plantar fascia attaches and can cause sharp stabbing pain with walking.

There are many factors that contribute to the development of plantar fasciitis though people who have other foot conditions, especially pes planus (flat feet) and over-pronation are most susceptible. One of the most important factors is muscle imbalances between the calf muscles and the muscles on the bottom of the foot (both attach to the calcaneus or heel bone). Often the calf muscles get short and tight exerting a strong pull upon the back of the calcaneus. This causes undo stress upon the smaller and weaker plantar muscles and its fascia that attach to the other side of the calcaneus. Wearing high heels will cause a shorting and tightening of the calf muscles as well as running and jumping activities. Other factors that stress the plantar fascia include: sudden strenuous activity after a period of long-term inactivity, abnormal walking patterns, improper footwear, walking on hard or uneven surfaces especially barefooted, and obesity.

People who are constantly on their feet, such as nurses, teachers and waiters, are more susceptible, as are athletes who participate in foot-stressing activities such as aerobics, volleyball, running, basketball and tennis.

Once one develops plantar fasciitis, it is often difficult to manage and can become very painful and persistent. A chiropractor will be able to determine the cause of your problem and what treatments are best suited. These might include ultrasound therapy, joint manipulation, muscle stretching and strengthening exercises, special strapping and in some cases orthotics.

Hallux Valgus

Bunions, Hallux valgus, is a condition where the big toe or hallux deviates towards the outside of the foot often times almost overlapping or bumping into the adjacent toe. It is a slow developing condition that usually develops as a bump on the inside of the big toe often called a bunion.

The pain associated with Hallux Valgus is usually felt during weight bearing activities such as walking or prolonged standing. However if someone has developed a bunion the pain can be present at rest and if often described as a "numbing" or "burning" sensation in the big toes.

To be exact, the actual problem is not in the bone itself but in the joint between the big toe and the 1st metatarsal bone, the 1st metatarsal-phalangeal. It is the damage to this joint that causes the pain and deformity associated with Hallux Valgus. The condition is usually the result of wear and tear over a long period of time from factors such as over-pronation, which causes abnormal pressure on the big toe and first metatarsal during walking. Other causes of hallux valgus include inflammatory arthritis that can damage the joint and cause degenerative changes. A broken toe that does not heal properly can also predispose a person to hallux valgus. However one of the more common causes of the problem is the high heeled and pointed-toe shoes that women often wear. These shoes not only put extra stress upon the joint but also help to push the big toe to the outside. It's no wonder that women have the condition much more often than man.

If you have hallux valgus, your chiropractor can examine your foot to determine which factors contributed to your condition. He or she can then use a number of techniques and modalities to decrease pain and improve your foot's function.

Metatarsalgia ( Pain in the ball of the foot )

Metatarsalgia is sometimes called ball-of-foot pain, a pain in the area on the sole of the foot just behind the toes where the foot bends during walking. The pain is actually caused by a problem in one or more of the five metatarsal bones that extend from about half way up the foot to the toes.

While many patients with metatarsalgia feel pain where their metatarsal bones join their toe bones, some also feel pain along the entire length of the metatarsals and possibly between them. Problems in this area can vary from a stiff feeling when you move these bones to a burning or stinging sensation. This depends upon whether the problem is due to a dysfunction in the joints or an irritation to the nerves as they travel along the metatarsals.

The cause of the condition can vary but more commonly is due to either structural or functional reasons. An example of a structural cause is metacarpal bones that are either too long or too short causing abnormal mechanics in the feet and far too much stress upon this area. Flat feet or excessive arch can also alter the stresses on the metatarsals causing similar symptoms

There are other factors that can affect these bones that are often in the control of the individual. These include excess body weight, tight or high-heeled shoes, and excessive or poor running or athletic training. Excess weight and wearing high-heeled shoes increases stress upon the metatarsal which leads to joint pain and nerve irritation. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma.

Regardless of the cause, your chiropractor can effectively care for metatarsalgia. After determining what factors are underlying your condition, he or she can offer a variety of non-invasive therapies including orthotics as well as advice on how you can avoid future pain.

Achilles Tendonitis

Achilles tendonitis is a painful and often debilitating inflammation of the Achilles tendon, also called the heel cord. This large tendon is an extension of the two biggest calf muscles and runs down the back of the lower leg attaching to the heel bone or calcaneus. Injury to this important tendon can make it difficult or even impossible to walk. The problem may be caused by a sudden single incident such as jumping, but more commonly it results from an accumulation of smaller stresses that produce small tears in the tendon over time. In most cases, the appearance of symptoms is gradual. The discomfort may be relatively minor at first, but gradually worsens if the patient tries to "work through" the pain. Many Achilles tendonitis sufferers attribute their initial discomfort to the aches and pains that accompany age or fatigue. In severe cases, a total rupture of the tendon can occur, resulting in traumatic damage and severe pain. Such injuries can make walking virtually impossible and may even require corrective surgery.

Achilles tendonitis is often associated with athletes and performers such as dancers who are involved in running and jumping activities especially involving sudden starts and stops. However, women who typically wear high-heeled shoes are also at risk especially if they switch to sport shoes for exercise. In these cases, the Achilles tendon and muscles gradually adapt to a shortened position created by wearing high-heels, as the heel does not have to stretch all the way to the ground. When this occurs, the switch to exercise or flat shoes forces the Achilles tendon to stretch further than it is accustomed to causing stress and inflammation. For these reasons, high heels should not be worn everyday. If they are deemed necessary, stretching should be done every morning and night to keep Achilles tendon lengthened. Achilles tendonitis often appears in middle-aged people, especially men who are athletes, due to the changes that occur in the foot as we age. Our arch tends to flatten as we grow older causing over-pronation and increased stress upon the Achilles tendon, the calf and foot muscles. Similarly, problems are also common in the "weekend warrior". This is typically a person who exercises infrequently or those who are just starting to exercise and decide to "push it to the max". In such people, the muscles and tendon have little flexibility due to inactivity. Overdoing exercise in the beginning, can cause tendonitis. Therefore, people who are just starting to exercise after a long layoff should stretch properly, start slowly, and increase gradually.

Regardless of the cause of the problem if one is experiencing the symptoms of Achilles tendonitis they should consult a qualified professional such as a chiropractor to manage the problem before it becomes severe. Back to top

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