From Dr. Natalie Meiri’s Clinical Pearl Stories:

                                Chiropractic Treatment for Knee Pain and Knee Problems

This was a 53 year old patient who had a chief complaint of right knee pain.  To be HIPAA compliant, I will call him Ted instead of his real name.  Ted was an avid runner for over 10 years and liked running races.  He also enjoyed bicycling, yoga and spinning class (indoor cycling). Unfortunately, he wasn’t able to do these activities without a lot of pain in his right knee. He wanted to get back to doing his activities without pain.  

Ted presented to my office 3 years after arthroscopic partial meniscectomy to his right knee. A meniscectomy is an arthroscopic procedure that removes the meniscus or trims the damaged meniscus tissue (also called a debridement).  The knee meniscus is the rubbery knee cartilage that cushions the tibia (shinbone) from the femur (thighbone).

Ted didn’t know exactly how he hurt his knee 3 years ago. It seemed to come on after twisting his knee while lifting a heavy box.  Perhaps it was from repetitive running and “old age”. Furthermore, he stated “it never felt better from the surgery and only has gotten worse”. Since the surgery, he has tried dietary and herbal supplementation, acupuncture, physical therapy and yoga. He came to see me since “everything else he had tried didn’t work”. Chiropractic was his last resort!

Ted’s Knee Pain and Problems

Firstly, Ted had pain, swelling and trouble bending his right knee most of the time. Secondly, he also experienced episodes of knee locking wherein he experienced significant pain and was unable to move the leg for a few seconds until his knee was forcefully extended. Lastly, he described a “burning sensation” at the inside of his knee.

His knee x-ray showed osteoarthritis, a degenerative “wear-and-tear” type of arthritis in his knee.  His original M.R.I. report from 3 years ago noted a partial meniscal tear. I didn’t need any further imaging at this time. I would order another M.R.I. if there was no improvement in 12 visits.

Upon examination, I found Ted had a saphenous nerve entrapment in his right leg besides from the partial meniscal tear and osteoarthritis.  So Ted’s knee pain came from 3 different problems. Nerve entrapment is a medical syndrome that develops when nerves become compressed (or entrapped) and restricted. This occurs due to a variety of causes, from trauma or injury to repeated or overuse activity.  Nerve entrapment to the saphenous nerve can occur at the inside of the knee at the adductor canal.  The adductor canal is a fibromuscular band canal that the saphenous nerve passes above the knee. This was causing Ted’s pain and burning sensation to the inside of his right knee (saphenous nerve distribution). Occasionally, nerve conduction studies are performed to assess the degree of nerve compression and nerve damage. This was not necessary in Ted’s case since he started getting some relief with treatment within 12 visits.

Ted’s Chiropractic Treatment for Knee Pain and Knee Problems

Ted’s treatments included chiropractic adjustments/ manipulation to his right knee and any associated foot, ankle, hip, pelvic or lumbar (low back) fixations (chiropractic misalignments).  Additionally, soft tissue therapy (myofascial release, pressure point and various relaxation procedures) and modalities (cold/heat therapy and electric muscle stimulation) were administered. Finally, he was given homeopathic medicines and therapeutic exercises to continue his treatment at home.

Ted gradually got pain relief and improved function in his activities.  It took nearly a year of treatment before Ted was performing his activities pain free. Ted’s knee stopped locking and the burning sensation subsided.  He also was able to perform better in yoga class with improved range of motion. Chiropractic proved to be a highly effective last resort!

Meiri Chiropractic serving West Palm Beach, Jupiter, Palm Beach Gardens, and North Palm Beach offers chiropractic treatment for knee pain and knee problems. Dr. Natalie Meiri will examine, diagnose and come up with a treatment plan to get you back to your activities. Call 561-253-8984 today to schedule an appointment.

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic Treatment for Chronic Headaches

Author: Natalie Meiri, D.C.        Posted: 9/19/20

This was a 48 year old female patient with a chief complaint of chronic headaches. To be HIPAA compliant, I will call her Kate instead of her real name. Kate had migraine headaches since she was a teenager. She described it as a one sided (unilateral) throbbing headache. She would get sensory disturbances called an aura prior to her headaches which is suggestive of classic migraines.  The auras were usually “blurriness and vision changes” in her eye. She used to only get migraine headaches once or twice a month or less which was manageable.

However, she had headaches almost everyday in the afternoon now for a year since she experienced stress and grief from a family member’s death. Her headaches lasted for several hours, causing her to seek a dark, quiet environment. These were more of a tension headache since it was (suboccipital/ bilateral) at the back of her head on both sides or around both her eyes (supraorbital/ bilateral). Kate also got the classic migraine type of headache once or twice a month. 

In the past, she was active with chores around the house cleaning and cooking after work.  She also enjoyed gardening, dinner with friends, or church activities during her leisure time after work. Currently, she just went home from work and went to sleep due to her headaches.  Her condition seemed to be getting progressively worse and was disabling. 

Moreover, migraine headaches with aura, ran in her family. Kate had a history of high blood pressure managed by her primary care doctor and several people in her family had died of a brain aneurysm. A brain aneurysm is weakness in a blood vessel in the brain that balloons and fills with blood, and can leak or rupture, causing life-threatening bleeding. Also, a key symptom of a ruptured aneurysm is a sudden, severe headache. 

Upon examination she had tender trigger points and tight muscles in the neck. And her neck x-ray taken in my office showed degenerative arthritis (osteoarthritis).  In addition, I ordered a brain CT scan with contrast (injection of contrast material into a blood vessel for evaluation) to rule out any more serious conditions that could be causing her headaches such as tumors or a TIA (transient ischemic attack or stroke that lasts only a few minutes). After all, the headaches were severe and she had a family history of brain aneurysm.  CT scanning provides more detailed information about brain tissue and brain structures than standard X-rays. Fortunately, her CT scan report came back “normal” or negative.

It was once believed that tension-type headaches were due to muscle tension. It is now recognized that although there are often tender trigger points in the neck and suboccipital area, there is no higher incidence of muscle spasm when compared with other headache types. A growing group of researchers believe that chronic tension-like headaches may represent part of a headache continuum. These patients often begin with migraine attacks that gradually transform into more frequent, less severe, tension-type headaches like Kate’s headaches. Kate however, also had her more severe migraine with aura as well about twice a month.

Kate’s treatment for chronic headaches

Once believed to be purely vascular, migraine headaches are believed to be neurogenic (caused by nervous system). Furthermore, in women, there is also a hormonal relationship. So to treat Kate’s headache continuum of tension to classic migraine, I utilized a spectrum of therapies. Firstly, she received chiropractic adjustments/ manipulation to her neck and spine along with soft tissue work (myofascial release, pressure point and various relaxation procedures) and exercises to continue at home.  Secondly, recommendations were made on diet and nutrition that triggered her headaches.  Other possible triggers for her headaches such as sleeping issues and environmental pollutants were also eliminated.  Thirdly, I did several homeopathic consultations with Kate and prescribed a number of homeopathic medicines. Kate was against drugs when possible.  Similarly, Kate knew about the rebound headaches that can occur if you take aspirin for longer than 3 days.

Kate responded well to her chiropractic treatment for chronic headaches plan of 1-2 times a week for 3 months. Kate’s headaches decreased in frequency and intensity gradually.  Finally, she was able to do the necessary chores and social activities again without going home to bed after work.    

Meiri Chiropractic serving West Palm Beach, Jupiter, Palm Beach Gardens and North Palm Beach offers chiropractic treatment for chronic headaches. Your chiropractor will examine, diagnose and determine your best course of chiropractic treatment for chronic headaches . Call us in West Palm Beach at 561-253-8984 to schedule an appointment at our chiropractic clinic and start getting the relief you need.

Meiri Chiropractic

5601 Corporate Way, Ste. 102

West Palm Beach, FL 33407

561-253-8984

Back Pain Due to a Herniated Disc and Chiropractic Care

Author: Natalie Meiri, D.C.  Posted: 9/12/20

If you have back pain due to a herniated disc and chiropractic care is your choice, surgery may be avoided!  We’ve got some great information to share below.

What is a Herniated Disc?

The term ‘disc’ is short for ‘intervertebral disc’. The disc is essentially divided into two parts: (1) a central, softer jelly like inner nucleus pulposus and (2) an outer tougher, dense connective tissue (fibrocartilaginous) annulus fibrosus surrounding it. The discs separate the bones of the spine (vertebrae).

A herniated disc refers to a problem with one of the discs that sit between the individual bones (vertebrae) that stack to make your spine. Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of the nucleus pulposus pushes out through a tear in the annulus fibrosus.  A herniated disc, which can occur in any part of the spine, can irritate a nearby nerve. 

Symptoms of a Herniated Disc

Depending on where the herniated disc is, it can result in pain or weakness in an arm or leg. In the low back, you may have leg pain below the knee.   You often will have a painful restriction in moving often more on one side. 

In the neck, sometimes there is hand weakness and in the low back, leg weakness. In the mid back the pain may start around the level of the herniation and travel around the rib cage from the back to the front of the chest or upper abdomen. 

It can cause a deep ache or sharp, electric shock like pain or numbness.  Some patients report some relief with the hand held behind the head for neck herniations. Movements such as sneezing, laughing, coughing, or any other sudden movement can exacerbate the pain.

You can have a herniated disc without symptoms. You might not know you have it unless it shows up on a spinal image such as a MRI (Magnetic Resonance Imaging) or CT (computerized tomography scan).

Causes of a Herniated Disc

A disc herniation is most often the result of a gradual, aging-related wear and tear called disc degeneration. As you age, your discs become less flexible and more prone to tearing or rupturing. However, a disc herniation can occur from a traumatic injury such as a fall or a car accident. Many people state it happened after a simple sudden twisting or bending movement. Repetitive strain over time with incorrect posture and motions, can eventually herniate a disc also. In the neck, it may cause neck and arm pain that came on after a minor injury or insidiously. There is usually a past history of multiple occurrences of the respective neck or back pain that resolved. 

Nerve root irritation may occur as a result of a disc herniation. In the past it was believed that all referred pain that was radicular (nerve root origin) was due to compression of a nerve root by a herniated nucleus pulposus.  Current thinking is that the nerve root is inflamed, but not always compressed. It is theorized that herniated disc material initiates an autoimmune inflammatory reaction or releases irritating substances. So the disc, the corresponding inflamed nerve root, or compression of the nerve root by the disc may be the source of pain.

If you have back pain due to a herniated disc and chiropractic care is your choice, surgery may be avoided.

Dr. Natalie Meiri will examine you and come up with a treatment plan to get you better. Through regular visits, you can get pain relief and improve your back health with chiropractic manipulative treatments without surgery.

“Softer” approaches involving “no rotation” chiropractic manipulative treatments such as flexion-distraction, blocking, and prone (patient face down) drop-table adjusting are available.  Meiri Chiropractic’s technique is to manipulate at sites other than the herniation. Our other therapies, such as soft tissue techniques, therapeutic exercise, electric muscle stimulation, ice/ heat therapies and homeopathic consultations, may also provide some relief for your pain. 

Call our office which serves West Palm Beach, Jupiter, Palm Beach Gardens and North Palm Beach.  Ask about your neck or back pain due to a herniated disc and chiropractic care at 561-253-8984.

 From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic Treatment for Peripheral Neuropathy in the Arm and Hand

Author: Natalie Meiri, D.C.        Posted: 9/5/20

This was a 56 year old female patient with a chief complaint of carpal tunnel syndrome in both hands. To be HIPAA compliant, I will call her Stephanie instead of her real name. Stephanie has been a secretary/ administrative assistant for over 20 years. Her problems came on gradually over the years. Subsequently, while typing at the computer, her arms and hands would go numb and tingle.  Hand weakness at times made it difficult to grasp small objects or perform other manual tasks. She also complained of neck and right shoulder pain from repetitive lifting of the phone to her ear and writing.  Stephanie fixed the incorrect ergonomics in her office, used a night splint, and was taking a B-complex vitamin, but her condition worsened. So she went to a neurologist to get some answers.

Stephanie’s neurologist ordered an EMG/NCV (electromyography and nerve conduction velocity tests are electrodiagnostic tests that measure the electrical activity of muscles and nerves). And she tested positive for carpal tunnel syndrome in both wrists.  Afterward, he also gave her a cortisone shot to her wrists which wasn’t successful. She came to see me because she didn’t want surgery if possible.

The x-rays taken in my office showed moderate osteoarthritis in her cervical (neck) and thoracic (mid back) spine. This is the “wear and tear” type of arthritis when the bones rub against one another causing pain, stiffness, inflammation, disc degeneration and bone spurs (also known as osteophytes) which can “pinch” surrounding nerves. Upon examination, I found her arm and hand pain/ numbness was coming from the entrapment (pressed or squeezing) of the median nerve at several levels:  the carpal tunnel (passageway of ligament and bones) at her wrists, pronator teres muscles in her forearms, and her right shoulder at the pectoralis minor muscle and surrounding fascia (thin casing of connective tissue).

Stephanie’s chiropractic treatment for peripheral neuropathy in the arm and hand started at 3 times a week for 2 weeks and then 1 time a week for 2 months. Firstly, her treatments included chiropractic adjustment/ manipulation to her right shoulder, both wrists, hands, cervical (neck) and thoracic (mid back) spine. Secondly, soft tissue therapy (myofascial release, pressure point and various relaxation procedures) at the entrapment sites of the median nerve in each arm was given.  Thirdly, modalities (cold/heat therapy and electric muscle stimulation) were administered. Finally, exercises for stretching, strenghening, and better posture were recommended.

Stephanie started feeling better gradually in her neck, mid back and right shoulder.  Moreover, Stephanie got relief and function back in her wrists and hands without surgery!

Meiri Chiropractic in West Palm Beach offers chiropractic treatment for peripheral neuropathy in the arm and hand. Dr. Natalie Meiri will examine, diagnose and determine the best course of treatment for you. Call us at 561-253-8984 in West Palm Beach to schedule an appointment at our chiropractic clinic and start getting the relief you need.

Meiri Chiropractic

5601 Corporate Way, Ste. 102

West Palm Beach, FL 33407

561-253-8984