This post is about Chiropractic West Palm Beach: Low Back Pain and Piriformis Syndrome.  Symptoms include buttock and posterior (back) leg pain.  And it comes on insidiously (gradual, subtle but with harmful effects) without any trauma. If you have Piriformis Syndrome, Chiropractic can provide relief! We’ve got some great information to share below.

 

Chiropractic West Palm Beach: What is Piriformis Syndrome?

Firstly, the piriformis is a flat, pear-shaped muscle located in the gluteal (buttock) region of the hip/proximal thigh.

Secondly, the sciatic nerve runs under the piriformis muscle where it may be compressed (pinched) by the piriformis muscle. As the biggest nerve in your body, it originates from several nerves in your lower back. These nerves branch outward from the spine and then come together at each buttock to form the sciatic nerve, which then travels down each leg. And sciatica is defined as irritation or compression of the sciatic nerve that causes pain in the buttock area with radiation to the lower leg. It is a condition characterized by pain along the course of the sciatic nerve.  This is usually a neuritis (inflammation of a nerve) and generally caused by mechanical compression or irritation of the lumbar and sacral spinal nerve roots.  However, piriformis syndrome is another cause of irritation of the sciatic nerve.

Thirdly, predisposition to piriformis syndrome may be due to an anatomically short leg (one leg is structurally shorter than the other due to bone length differences).  Other reasons could be due to excessive pronation (inward rotation of foot) of your foot or a pelvic rotation/misalignment.

Fourthly, in approximately 15 % of the population, there are two muscle bellies to the piriformis muscle.  In this case, the sciatic nerve courses between the 2 muscle bellies.

 

 

Chiropractic West Palm Beach: Piriformis Syndrome Treatment

 

Postisometric relaxation techniques or myofascial release soft tissue techniques to the piriformis muscle is important for treatment.  Indeed, chiropractic manipulative therapy (joint adjustment) without addressing the piriformis muscle would not produce a positive outcome.

Also, our other therapies, therapeutic exercise (e.g. stretching, strengthening), electric muscle stimulation, and ice/ heat therapies provide relief from piriformis syndrome. 

Dr. Natalie Meiri, your chiropractor in West Palm Beach will examine you and come up with a treatment plan to get you better. You can get fast pain relief and function better.  Moreover, you can improve your health through regular chiropractic care.

If you have back pain due to piriformis syndrome and chiropractic care is your choice, call us today at 561-253-8984!  Ask to make an appointment or find out more about: Chiropractic West Palm Beach: Low Back Pain and Piriformis Syndrome.

 

References:

Thomas Souza, (2018) Differential Diagnosis and Management for the Chiropractor

 

 

 

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic West Palm Beach: Chiropractic Care for Martial Arts Injuries in a Child 

 

This was a 13 year old patient with martial arts related injuries.  To be HIPAA compliant, I will call him Andrew instead of his real name.  Andrew was very happy, outgoing, enjoyed sports, and got straight A’s in school. He had joined a martial arts class for kids a year ago and was competing in contests.  His chief complaints were back and bilateral (both) shoulder pain.  He felt that his injuries were keeping him from competing at his best and he was always in pain.

 

Chiropractic West Palm Beach: Andrew’s mother finally brought him to see me after a visit to his pediatrician.

Andrew’s pediatrician had prescribed Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen along with rest, ice, immobilization, compression, bracing, and elevation for his pain and swelling. This seemed to help for a while, but then he was back to his original state of pain and dysfunction. 

Also, Andrew’s mother was concerned about the possible side effects including stomach upset, gastritis, and ulcers that may occur from the drugs. Furthermore, she even read on the list for the side effects of the drugs: The drugs may have a blood-thinning effect and can increase the likelihood of bleeding after a cut, deep bruise, muscle strain, or head injury. Long-term use can affect the kidney and liver.

Lastly, Andrew’s mother knew these drugs could mask pain, which can lead to further injury.

Chiropractic West Palm Beach: Andrew’s Examination at Meiri Chiropractic

Andrew presented to my office stating he had chronic pain in his neck, back and shoulders. His hyperkyphosis (severe forward curvature of the thoracic spine) was noted on observation and inspection.  And a further test indicated he had a structural kyphosis and not a functional kyphosis. 

 Additionally, upon examination, there were positive tests for his cervical (neck), thoracic (mid back) and lumbar (low back) spine and glenohumeral (shoulder) joint chief complaints. Andrew also had some tenderness and palpatory findings (examine by touching) in the muscles around the spine and both shoulders.

The thoracic x-ray of his spine taken in my office ruled out scheuermann’s disease and scoliosis.

Andrew’s neck, back and shoulder diagnoses were sprains and strains from his martial arts injuries.

What is a Sprain or a strain?

A sprain is a sudden or violent twisting injury of a joint with stretching or tearing of ligaments.  A strain occurs when a muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use. Furthermore, damage to your attached tendons can also occur with a strain.

Chiropractic West Palm Beach: Andrew’s Treatment for Martial Arts Injuries

Firstly, Andrew’s treatments consisted of chiropractic manipulation/ adjustments of the cervical , thoracic, and lumbopelvic spine, and bilateral glenohumeral joints. Secondly, soft tissue techniques (e.g. myofascial release, pressure point and post-isometric relaxation) was performed on all his tender and spasmed muscles. Thirdly, ice/heat therapy recommendations and exercises to continue his treatment at home were given. Finally, activity modification and recommendations for prevention of further injury were given.

 

 Chiropractic West Palm Beach: Andrew’s Out Come for his Treatment for Martial Arts Injuries

Andrew started feeling better within a few visits and his neck, back and shoulder conditions completely resolved within a few months.  Thereafter, Andrew continued the chiropractic care for supportive/ preventative care and he remained pain-free. Eventually, Andrew went onto win many martial arts competitions.

 

 Chiropractic West Palm Beach: Safety of Chiropractic for Kids 

The American Chiropractic Association cites a study done in 2014 confirming that chiropractic adjustments are overwhelmingly safe in infants and children. 

In 2009, a survey found that there were about 68 million pediatric visits to chiropractors. The National Board of Chiropractic Examiners’ most recent practice analysis, issued in 2010, found that about 17 percent of chiropractic patients were under age 18 — approximately 7.7 percent aged five years or younger and some 9.4 percent between ages six and 17. 

 

Dr. Natalie Meiri has helped babies and kids utilizing chiropractic adjustments, soft tissue techniques, cranial sacral therapy and therapeutic exercises. She has treated babies with ear infections, kids with ADHD, autism, scoliosis, sports/martial arts injuries and various growing problems.  Contact her at 561-253-8984 for further information on Chiropractic West Palm Beach: Chiropractic Care for Martial Arts Injuries in a Child or to make an appointment today.

 

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective

 

This is my clinical pearl story about Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective. The patient was a 70 year old male patient.  His chief complaints were low back and right hip pain.  To be HIPAA compliant, I will call him Jacob instead of his real name. 

Jacob’s right hip pain had come on 6 months ago following a fall.  The low back pain he stated he had “on and off for over 30 years”.  Jacob had always been active.  In addition to physically demanding jobs, he had a history of many sports injuries and  several car accidents.  Jacob had been under chiropractic care previously for his low back pain.

Jacob came to see me when a course of physical therapy didn’t help his right hip pain after his fall.  The orthopedic doctor had told him he had a right hip sprain from the fall.  Additionally, the orthopedist’s x-ray report noted Jacob had moderate to severe osteoarthritis (wear and tear arthritis) in his right hip.  And Jacob had noticed his hip feeling “more stiff” when he got up in the morning or from prolonged sitting over the years.

 

Jacob’s Examination and Imaging

Upon examination, Jacob tested positive for his low back and hip pain conditions.  His x-rays from the orthopedist showed degenerative arthritis (osteoarthritis) in his lumbar spine and right hip.

Jacob had a right hip sprain complicated by Osteoarthritis.

Hip Anatomy

The hip, like the shoulder, is considered a ball-and-socket joint. It is formed by the head of the femur (thigh bone) which sits in what’s called the acetabulum, a part of the pelvis. The head of the femur is large (ball) and the acetabulum (socket) is deep.  The soft tissues (refers to non-bony structures that connect, support, or surround other structures) in your hip are:

• the muscles, which allow you to move.
• the tendons, which connect your muscles to the bone.
• the ligaments are bands of tough elastic tissue around your joints. They connect bone to bone, give your joints support, and limit their movement.
• the fascia – stretchy, thin, white fibrous tissue. All your muscles are enveloped in fascia.
• the bursae – fluid-filled pads that act as cushions at the joints. Bursae reduce friction between the surfaces of a bone and soft tissue.

What is a Sprain?

A sprain is a sudden or violent twisting injury (e.g. fall) of a joint with stretching or tearing of ligaments.  As opposed to a strain which occurs when a muscle or tendon is overstretched or torn.

 

What is Osteoarthritis?

Primary Osteoarthritis occurs usually in middle-aged to elderly people (>45 years old). It is more prevalent in women (female to male 10:1). Primary means this osteoarthritis develops due to aging and the wear and tear that comes along with it.

An example would be Jacob’s hip: primary femoroacetabular (hip) osteoarthritis. Typically, your symptoms consists of hip and possibly buttock, groin, or knee pain that was insidious (came on gradually) in onset. Additionally, you note a slow stiffening, specifically internal (inward) rotation. This often results in walking with the hip held in external (outward) rotation. You may complain of low back pain due to excessive extension with weight bearing. The low back pain is really due to compensating for limited hip movement due to hip osteoarthritis.

Common joints involved in primary osteoarthritis are the hips, knees, sacroiliac joint, acromioclavicular (shoulder and collar bone), first metacarpophalangeal (part of thumb joint), first metacarpotrapezium (part of thumb joint closer to wrist), and the distal interphalangeal joints (joints at tips of fingers).

Often initially asymptomatic, you will have a gradual increase in joint stiffness and pain. Moreover, deformity may be apparent such as  herberden’s nodes in the hands (bony bumps).  If not treated, primary osteoarthritis may eventually lead to joint subluxation (dislocation) and instability.

Cause of Osteoarthritis

Primary osteoarthritis is due to progressive degeneration of the joint or joints involved by an accumulation of microtrauma.  A microtrauma is an injury resulting from repetitive stress to tissues. 

 

Jacob’s Treatment and Outcome

 Treatment focuses on restoring normal mobility to the hip joint and pelvis. These treatments at Meiri Chiropractic include:

-Chiropractic manipulative therapy- to the hip joint, pelvis and associated regions. 

-Gentle myofascial release and/or post isometric relaxation techniques- to the soft tissues (e.g. muscles, tendons, ligaments, fascia) involved.

-Electric Muscle Stimulation, Ice and Heat Therapies for pain relief and inflammation reduction.

-Therapeutic exercise- with  gentle stretching and a long-term goal of restrengthening.

-Finally, recommendations for prevention of further injury for the spine, pelvis, and hip. 

Jacob went through a general program of corrective care for 2-3 months for his hip and low back. Thereafter, he came in for “maintenance of normal joint motion and function of the spine and extremities by adjusting/manipulation” (1).  

Furthermore, therapeutic exercises for strengthening of the osteoarthritic joints were ongoing throughout his supportive care.  Finally, recommendations on an anti-inflammatory diet were beneficial.

Jacob started feeling better within the first few visits. Indeed, Jacob made great improvement in the end becoming  pain-free and gaining increased range of motion in his right hip. Also, Jacob’s hip felt less “stiff” when he woke up in the morning or sat for long periods of time.

 

Research on How Chiropractic Adjustments Can Help With Arthritis

A 2017 review in the Journal of the American Medical Association, found that spinal manipulation reduces lower back pain. And a 2013 study published in Osteoarthritis and Cartilage found that patient education combined with 12 chiropractic treatments (twice a week for six weeks) were more effective for hip Osteoarthritis than a daily stretching program or patient education alone.

 

Are you looking for the best chiropractor in West Palm Beach? Dr. Natalie Meiri can definitely help you.  Find out more about Relief From Hip Pain and Osteoarthritis: Chiropractic Care is Effective.  Call 561-253-8984 today for an appointment.

 

References:

Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011 (1)

 

 

 

Do you have pain in the hand or medial (closer to the body) forearm? You may also have paresthesia (pins and needles) into the ring and little finger of the same arm/hand.   It could be due to Ulnar Nerve entrapment at the cubital tunnel of the elbow.  This post is about Chiropractic West Palm Beach: Ulnar Nerve Entrapment at the Cubital Tunnel of the Elbow.

Chiropractic West Palm Beach: Causes of Ulnar Nerve Entrapment at the Cubital Tunnel of the Elbow

Irritation of the ulnar nerve at the elbow can be due to compression, stretch or direct trauma. A stretch injury is typically due to a valgus (turned outward) force to the elbow. Moreover, compression may be at the two heads of the flexor carpi ulnaris muscle where the nerve can get entrapped.  Also, you may have arthritis and osteophytes (bony spur) at the cubital tunnel causing nerve irritation.

Often, you may have had throwing activities (e.g. Baseball) where the ulnar nerve was medially stretched.  So the pressure in the tunnel is increased with elbow flexed and wrist extension as in throwing. Additionally, you may have slept wrong with your elbow flexed causing compression and “sleep paralysis”. 

Less common causes include lipomas, ganglions, and abnormal soft tissue structures (e.g. scar tissue).

Research indicates the cubital tunnel syndrome is the second most common compressive neuropathy in the upper extremity (limb).

Anatomy of the Ulnar Nerve

The ulnar nerve is one of the 5 terminal (end) branches arising from the medial cord of the brachial plexus (network of nerves in the shoulder).  It supplies motor and sensory innervation to the upper extremity. The ulnar nerve originates from contributions of the C8 and T1 nerve roots of the spinal cord. The nerve courses along the medial arm and forearm, and then it passes into the wrist, hand, and fingers.

The ulnar nerve provides motor (voluntary movement) innervation to part of the forearm and a majority of the hand. It supplies sensory cutaneous (skin) innervation to the medial forearm, medial wrist, and medial fifth digit, medial half of the fourth digit, and the corresponding part of the palm.

In the hand, the ulnar nerve branches to give rise to a palmar cutaneous (relating to the skin) and dorsal cutaneous branch.

 

Cubital Tunnel Anatomy

The humerus, radius and ulna bones articulate to form the elbow synovial joint. The cubital tunnel is just distal to the medial epicondyle of the humerus (upper arm).  And the cubital tunnel floor is made up of the ulnar collateral ligament and the capsule of the elbow joint.  The cubital tunnel’s ceiling is formed by Osborne’s ligament (triangular arcuate ligament) and the cubital retinaculum (fascia).  This is a ligament spanning from the medial epicondyle to the olecranon process of the elbow. And the medial epicondyle and olecranon act as the walls on either side. Lastly, the ligament is continuous with the fascia connecting the humeral and ulnar heads of the flexor carpi ulnaris muscle.

 

Treatment at Meiri Chiropractic for Ulnar Neuropathy at the Cubital Tunnel of the Elbow:

Firstly, soft tissue techniques will be rendered to the contracted fibrotic muscle and collagen.  Specifically, Flexor carpi ulnaris may be an entrapment site.

Secondly, Chiropractic adjustments (chiropractic manipulative therapy) to the wrist and the associated restricted joints along the extremity/spinal kinetic chain as necessary.

Thirdly, physical therapy (e.g. electric muscle stimulation, ice/heat) to help reduce pain and inflammation are provided. 

Fourthly, ergonomic recommendations and modification and therapeutic exercise (e.g. stretching and strengthening).

 

Are your suffering from Ulnar Nerve Entrapment at the Cubital Tunnel of the Elbow?

We offer excellent Chiropractic care for Ulnar Neuropathy. At Meiri Chiropractic, we spend the time necessary to examine, diagnose and treat every neuromusculoskeletal condition and various ailments you have. Indeed, Chiropractic is a holistic and natural way to not only treat shoulder and arm 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 West Palm Beach: Ulnar Nerve Entrapment at the Cubital Tunnel of the Elbow.