A common source of joint fixation/chiropractic subluxation (hypomobility) and dysfunction is periarticular (surrounding joint) soft tissue injury with its resultant fibrosis (thickening or scarring of the tissue) and loss of elasticity and strength. So soft tissue injury and fibrosis may result from trauma to muscular, tendinous, myofascial, or ligamentous tissue. And you may have had acute trauma or repetitive injury to the area to cause it. 


Chiropractic Adjustments Restore Motion


First, an inflammatory response is triggered resulting in an extracellular (taking place outside of cell) accumulation of exudates (fluid that leaks out of blood vessels) and blood. Platelets (tiny blood cells that help your body form clots to stop bleeding) then release thrombin (molecule which helps in clotting process) converting fibrinogen into fibrin, which organizes into collagenous scar tissue. This results in a variety of soft tissue and articular (joint) adhesions.


Second, the above response can often be excessive especially in traumatic neuromusculoskeletal injuries. Therefore, therapies for minimizing inflammatory exudates are helpful.  This will in turn reduce pain and muscle spasm. Ultimately, this leads to early pain-free mobilization and flexible repair.


Third, early care and mobilization provide the best opportunity for optimal healing.

In contrast, bed rest and prolonged inactivity increases the chances of long-term disability and eventually lost time from work.


Fourth, the exudates that arise due to injury and inflammation gets the next step ready of connective tissue repair. Moreover, the matrix for the development of granulation tissue (new connective tissue) and scar formation is set. And the formation of granulation tissue is mostly carried out by the rapid increase of fibroblasts (cells that contribute to the formation of connective tissue).  Next, fibroblasts synthesize and deposit collagen tissue. At first, the collagen is poorly organized.  And additional collagen cross-linkages to reorganize along planes of stress which improves the tensile (stretchability) strength of the injured area sets forth.


Fifth, this repair and remodeling process may take months and may result in less than optimal healing and extensibility (stretchability) of the involved tissue.  Of course, immobilization slows recovery. This results in a loss of strength and flexibility and possible intra-articular (within the joint) fatty adhesions.  Immobilization also leads to dehydration, causing proteoglycans (substance which provides hydration and swelling pressure to the tissue enabling it to withstand compressional forces) to get closer and stick together. 


In conclusion, if injury or immobilization leads to decreased flexibility, therapies such as chiropractic adjustments are directed toward the restoration of motion.


Dr. Natalie Meiri adjusts a patient
Dr. Natalie Meiri adjusts a patient


Myofascial Cycle of Pain


Myofascial refers to the muscle or of the fascia (layer of connective tissue that supports tissues and organs) surrounding the muscleSo myofascial conditions are triggered by many reasons.  This can become self-perpetuating sources of pain, muscle spasm, and joint dysfunction.

Additionally, painful conditions which cause chronic muscle hypotoncity (deficient tone) are additional origins of restricted joint motion. In other words, muscle contraction, once initiated, may become a self-perpetuating source of pain and muscle hypotoncity.  Protective splinting in the joint’s intrinsic muscles may further this process by stopping passive joint movement and the pain-inhibiting qualities of certain joint receptors.

If contractions continue, over time they may develop into muscle contractures.  This is a result of adaptational shortening and loss of elasticity from disuse or underuse. Problems capable of producing muscle contraction are: trauma, structural inadequacies, visceral (organ) disease, emotional distress, and exposure to cold.


Myofascial Cycle Summary


  1. Joint Dysfunction leads to muscle strain.
  2. Muscle strain is caused by: Repetitive use, Emotional tension, Chronic postural stress, Exposure to cold, Visceral disease, Physical trauma, structural inadequacies, uncoordinated movements
  3. Vasoconstriction (narrowing of blood vessels by small muscles in their walls) and ischemia (inadequate blood supply) is caused by the pain of muscle strain. So pain causes muscle splinting. This in turn leads to retained metabolites and edema (inflammation).
  4. Sustained contraction happens due to vasoconstriction/ischemia and along the way myofascial syndromes and joint dysfunction occur.
  5. Fibrous reaction occurs finally and leads to soft tissue contractures.
  6. And Soft tissue contractures lead to Persistent joint and somatic (skin, muscles, joints, and bones) dysfunction as the end result.

Some Causes of Chiropractic Subluxations: Stopping the Myofascial Pain Cycle


Behaviors or bad habits can cause subluxations.  For example the following may contribute: continuously carrying a purse or bag on the same side of your body, sleeping on your stomach, sleeping with a pillow that is too big or too flat for you, crossing your legs or looking down at a computer monitor for long periods of time, sitting for long hours, and improper lifting. Also, de-stressing and decreasing your exposure to cold (e.g. excessive air conditioning) may help. 

Meiri Chiropractic utilizes the best joint manipulation and adjustments to the spine and peripheral joints. We provide soft tissue procedures, hot and cold modalities, stretching/ rehabilitation exercises, and homeopathic consultations as well.

At Meiri Chiropractic in West Palm Beach we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Through regular chiropractic visits, you can get pain relief and improve function. Chiropractic is a holistic and natural way to treat existing conditions.  And your body will be in its best working condition with regular chiropractic care.  Meiri Chiropractic has been offering effective chiropractic care in Palm Beach county since 2006.  Many of our patient reviews note our excellence.  Call us today at 561-253-8984 in West Palm Beach to make an appointment.


References: Thomas Bergman, David Peterson, (3rd edition) Chiropractic Technique: Principles and Procedure



From Dr. Natalie Meiri’s Clinical Pearl Stories: Chiropractic Care for Mid-Back and Right Hand Pain Over the Holidays


This was a 45 year old patient who was getting ready for the Christmas holidays. To be HIPAA compliant, I will call her Kathlyn instead of her real name.  Kathlyn was at a holiday party when a “7 foot tall enormous man” gave her a “bear hug”.  She stated “although I was happy to see my friend, the hug injured my spine”.   To make matters worse, she was getting her Christmas gifts ready when she somehow injured her right hand. She presented to my office the next day with mid back and right hand pain.

Kathlyn hadn’t gone to urgent care or her primary care, just took some NSAIDS (Non-steroidal anti-inflammatory drugs) without much relief.   On the intake form she reported pain in her midback and right hand.


Kathlyn’s Examination and Treatment

Upon examination, there were positive tests for her thoracic spine (midback) as well as the right hand/fingers.  After that, I explained her diagnosis (strain of thoracic spine and sprain of right hand), prognosis and treatment plan.

Firstly, Kathlyn’s chiropractic treatment for thoracic strain and right hand sprain consisted of chiropractic manipulation/ adjustments of the thoracic spine, right hand, and associated regions.  Associated regions that were adjusted were her cervical spine (neck), lumbar spine (low back) and right wrist which were misaligned (subluxations or intersegmental dysfunctions). Secondly, soft tissue therapy (myofascial release, pressure point and various post isometric relaxation procedures) and modalities (cold/heat therapy and electric muscle stimulation) were administered as needed. Thirdly, she was given therapeutic exercises to continue her treatment at home. Fifthly, Kathlyn was given a brace to wear during strenuous activities for her right hand.



What is a strain?

A strain is an overstretching and tearing of musculotendinous tissue. Tendons are connective tissue that attach a muscle to other body parts, usually bones.


What is a sprain?

A sprain involves a ligament.  It is a short band of tough, flexible fibrous connective tissue.  Furthermore, it connects two bones together in proper articulation at the joints.

A Joint injury in which some of the fibers of a supporting ligament are torn or ruptured is a sprain.  However, the continuity of the ligament remains intact in a sprain.  Grade 1 (mild) sprains cause slight stretching and tiny tears in the ligament. Kathlyn had a grade 1 sprain of her right hand. Grade 2 (moderate) sprains refer to partially torn ligaments with pain and swelling.


Kathlyn’s Outcome

The outcome for Kathlyn was excellent! She felt a little better immediately from the first visit.  Moreover, after only a few visits she enjoyed the rest of the holiday season pain-free.


Chiropractic Care for Mid-Back and Right Hand Pain Over the Holidays

Many people “throw their back out” every year around the holidays. This could be due to stress or “holiday bear hugs” as in the case of Kathlyn. Chiropractic is powerful and great at com-batting the negative effects of stress on the body. Adjustments restore joint mobility and function, resolves joint inflammation and reduces the patient’s pain.

Do you know someone who is in need of chiropractic care this holiday season? Contact Dr. Natalie Meiri of Meiri Chiropractic today at 561-253-8984 to learn more about Chiropractic Care for Mid-Back and Right Hand Pain Over the Holidays or to schedule an appointment.




Your feet and ankles are important for the balance of your whole body. Not only do your feet and ankles provide support, they absorb shock.  The stability of your feet and ankles are important for walking, running and jumping. And your feet and ankles have to provide mobility while adapting to different terrain.

Shock absorption is distributed through complex movements through your kinetic chain.  So these forces from various movements are distributed through the lower extremity from your feet/ankle to the knee, hip, and then the pelvis. Therefore, dysfunction at your ankles or feet may have consequences throughout your entire body. Furthermore, your foot problems may be local or referred.  In other words, the need for lower-extremity compensation may result in pain somewhere else, including low back pain.


Problems in the Feet

Most foot complaints are due to lack of proper support or inappropriate footwear. Ill-fitting or irritating shoes may result in corns or calluses, sesamoiditis (inflammation of the sesamoid bones in the ball of the foot and the tendons they are embedded in) or aggravation of hallux valgus (bunion) at the first toe, or fat pad syndrome at the heel . Moreover, tight-fitting shoes may also cause compression of metatarsals (5 forefoot bones).

Also, if the foot is too mobile (i.e., hyperpronated), there may be a lack of support.  This may cause plantar fasciitis and strain of the tibialis posterior muscle (deep calf muscle). Indeed, proper shoes are important.  And if you have any forefoot (front of foot) or hind foot (back of foot) abnormalities (i.e. varus or valgus) you are more likely to strain your feet.  

Complicating Factors

Firstly, as the furthest part of your body, your foot is commonly affected by vascular disorders. Arterial occlusive (inadequate blood flow due to narrowing of the arteries) disorders block blood flow. Valvular insufficiency in veins along with gravity may lead to vascular stasis (veins can’t send blood back to heart).

Secondly, neurologic dysfunction associated with metabolic neuropathies can occur.  For instance, as seen with diabetic neuropathy.

Thirdly, being bare footed may lead to trauma. In contrast, the supported foot is susceptible to the pressure effects and biomechanical alterations of footwear. Especially if you are diabetic this can lead to unnoticed and untreated problems due to sensory deficits (i.e. touch, temperature, pain and other sensations).

Common Conditions of the Foot and Ankle

Some common conditions involving the foot and ankle that are biomechanical in nature include the following:

  1. First toe-hallux valgus/rigidus (stiff first toe), turf toe (sprain to the main joint of the big toe), and sesamoiditis
  2. Metatarsalgia (pain and inflammation in the ball of your foot)
  3. Peroneal tendinitis (inflammation in the tendons that run along your outer ankle/foot)
  4. Plantar fasciitis (inflammation of fascia tissue on the bottom of your feet)
  5. Achilles tendon/heel-tendinitis, bursitis (painful inflammation of small, fluid-filled sacs that cushion the bones, tendons and muscles near your joints) and fat pad syndrome
  6. Neuropathy

In addition to the above, ankle inversion and eversion sprains are very common. The most common are plantar flexion/inversion (foot turned inward) sprains. Also, chronic ankle pain and/or instability is not uncommon following repeated ankle sprains.

It is important not only to treat the acute injury, but also to prevent future occurrences. This often entails evaluation of the activity or sport coupled with a post injury rehabilitation program.


Chiropractic for Ankle and Foot Pain and Conditions at Meiri Chiropractic in West Palm Beach

Are your suffering from ankle or foot pain? We offer excellent Chiropractic adjustments/manipulation to the ankle, foot and associated areas (i.e. knee, hip, pelvis). Soft tissue techniques along with the use of modalities (i.e. heat therapy, electric muscle stimulation) and rehabilitation/home exercises are utilized along with the adjustments to get you pain-free.

At Meiri Chiropractic, we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Chiropractic is a holistic and natural way to not only treat foot and ankle pain, but to keep your body in its best working condition. We have been offering effective chiropractic care in West Palm Beach since 2006. Many of our patients reviews note our excellence. Call us today at 561-253-8984 to make an appointment or to find out more about Chiropractic for Ankle and Foot Pain and Conditions.