From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractor West Palm Beach: Chronic Neck Pain After an Auto Accident

Author: Natalie Meiri, D.C.     Posted: 10/21/24

 

This was a 40 year old male patient with a chief complaint of chronic neck pain. To be HIPAA compliant, I will call him Han instead of his real name. Han had 4 car accidents by the time he was 40 years old which caused his chronic neck pain. Moreover, he experienced headaches everyday. Also, he stated his neck hurt when he moved his right shoulder. Additionally, there was “clicking” in his anterior (front) glenohumeral joint (shoulder joint).

Han had never had the headaches until a few months ago, but had the neck pain for many years.  Recently, he had gone to the orthopedist about his condition.  And he was told it was a “pinched nerve”.  Han was given Corticosteroids to take for a week (a type of hormone that suppresses inflammation and is used to treat both local and systemic inflammation).

After the automobile accidents, he had gotten some treatment for some of the accidents.  However, his neck was chronically in pain.  Furthermore, his right shoulder problem was an injury from the gym and repetitive work from painting his home.  Han had not been to the gym in about a year due to a lack of time.  He stated his level of stress was high and wanted to return to the gym.

 

Han’s Examination and X-rays  

The cervical (neck) x-rays taken at the orthopedist office showed findings consistent with moderate osteoarthritis (wear and tear arthritis).  Upon examination, I found positive tests for a cervical (neck) radiculopathy (nerve root in the spine is compressed or irritated) with thoracic (midback) myalgia (muscle pain) diagnoses. And Han’s right shoulder tests indicated a strain/tendinitis (muscle injury) of his right shoulder. I would order an MRI of his neck if his condition didn’t improve within a month.

 

 

Han’s Treatment at Meiri Chiropractic in West Palm Beach

Firstly, he received chiropractic adjustments/ manipulation to his cervical (neck), thoracic (mid back) spine, and right shoulder.  Secondly, various soft tissue manipulation (myofascial release, pressure point and various post isometric relaxation procedures) was rendered as necessary.  Thirdly, home exercises for stretching, strengthening, stabilization and posture correction were given.

 

Han’s Chiropractic Treatment Outcome

Han started feeling better within a few visits.  Recommendations were made on diet/nutrition and lifestyle (i.e. ergonomic/posture).  He started eating better which contributed to faster healing.  Han avoided sugar and processed or fast food. And included as much fresh food as possible.  Han eventually joined a gym.  Regular exercise helped his stress level and over all health/conditioning.

The treatment took a few months or regular chiropractic care. Han responded well to his West Palm Beach chiropractic care!  Was he able to live completely pain-free?  No, because it’s impossible for anyone to be completely free of pain in life.  However, Han thought daily about improving his function and not the pain anymore.  Lastly, Han was able to live life with more energy and improved performance.

 

 

Research For Neck Pain and Chiropractic Care

A review of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation. As part of the literature review, published in the March/April 2007 issue of the Journal of Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. 

In a study funded by NIH’s National Center for Complementary and Alternative Medicine to test the effectiveness of different approaches for treating mechanical neck pain, 272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic (DC), pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with DCs and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain; compared to just 38 percent pain reduction among those who took medication.

Bronfort et al. (2012), Annals of Internal Medicine

 

Are you suffering from Chronic Neck Pain?

Meiri Chiropractic serving West Palm Beach, Jupiter, Palm Beach Gardens, North Palm Beach and the surrounding areas offers execellent chiropractic care for your neck, back and extremities (arms and legs). Call us in West Palm Beach at 561-253-8984 to schedule an appointment or to find out more about Chiropractor West Palm Beach: Chronic Neck Pain After an Auto Accident.

 

                    

 

 

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic West Palm Beach: Back Pain From Illiopsoas Syndrome

This is my clinical pearl story about Chiropractic West Palm Beach: Back Pain From Illiopsoas Syndrome.  The patient was a 50 year old female patient.  Her chief complaint was low back pain.  To be HIPAA compliant, I will call her Lilly instead of her real name. 

Lilly’s low back pain had come on a week ago.  She wasn’t able to straighten up and was bent over. In fact, lying on an exercise ball or in a fetal position in bed with pillows for support helped. Low back pain was an “on going problem” she had dealt with for years. She had gone to physical therapy (P.T.) regularly, but this time she wasn’t getting any relief from P.T.

Lilly had always tried to be active by walking or simple yoga exercises at home.  However, recently she had tried interval training.  So this entailed running for periods of intense, fast paces followed by less intense recovery.  And she thought this may have set off this severe episode of low back pain. 

.

Lilly’s Examination

Upon examination, Lilly tested positive for her low back condition.  Lily had strained (strain which occurs when a muscle or tendon is overstretched or torn) her low back.  Specifically, she had a severe iliopsoas muscle syndrome.

 

Anatomy and Function of the Illiopsoas Muscle

Firstly, the iliopsoas muscle complex is made up of three muscles that includes the iliacus, psoas major and psoas minor.  It can function as a unit or as separate muscles. The iliopsoas musculotendinous unit is part of the inner muscles of the hip. It is important for correct standing or sitting and for lumbar posture.

Secondly, the iliopsoas muscle primarily flexes the hip and participates in external (outward) rotation of the hip joint. Iliopsoas has an important role in maintaining the strength and integrity of the hip and spine. Unilateral (one sided) contraction of this muscle assists with lateral (away from body) motion of the spine. Bilateral (both sided) contraction elevates the trunk from the supine position (lying down).  The psoas can assist extension of the lumbar spine (lowback) while standing. 

Thirdly, the psoas major portion of the iliopsoas is located along the sides of the lumbar vertebrae (lowback bones) and intervertebral discs. Below it attaches to the lesser trochanter of the femur (bony protuberance of thigh bone). The iliacus of the the iliopsoas attaches to the upper two-thirds of the iliac fossa (pelvis). Below, it joins the psoas major tendon to the femur near the lesser trochanter.

 

Symptoms of Iliopsoas Muscle Syndrome

First, the symptoms from dysfunction of the iliopsoas are aggravated by walking, standing or any weight bearing activity.  You will feel relief with recumbency (lying down).  Additionally, relief is greater when the hip is flexed since this will relax the muscle.

Second, Iliopsoas Muscle Syndrome is said to be as painful as appendicitis when very acute. 

Third, the muscle can cause a painful compression/entrapment syndrome of the femoral nerve (large nerve in the front of the thigh that controls the muscles and sensation in the lower limbs).

Forth, unidentified iliopsoas and/or low back muscle dysfunctions are frequently responsible for a failed low back postsurgical syndrome.

 

Lilly’s Treatment and Outcome

 Treatment focused on restoring normal mobility to the low back and pelvis.  These treatments at Meiri Chiropractic included:

-Chiropractic manipulative therapy- to the spinal joints and associated regions (e.g. hip, pelvis). 

-Gentle myofascial release and/or post isometric relaxation techniques- to the soft tissues (e.g. iliopsoas muscles, tendons, 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 of the Illiopsoas was recommended.

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

Lilly felt better even after the first visit and within 12 visits was pain-free and functioning fully.  Moreover, Lily’s posture was  restored and improved.  Thereafter, she came in for other injuries or for supportive care/maintenance of her spine and the Illiopsoas muscle.

 

Are you suffering from Illiopsoas Muscle Syndrome? Dr. Natalie Meiri can definitely help you.  Call 561-253-8984 today for an appointment or to find out more about Chiropractic West Palm Beach: Back Pain From Illiopsoas Syndrome.

 

References:

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

Janet Travel and David Simon, Myofascial Pain and Dysfunction,  1997

 

 

There is a common misconception that chiropractors are just “spine doctors”.  However, from the very beginning, chiropractic adjustments have been delivered to the nonspinal joints as well. The nonspinal joints include the temporamandibular (TMJ), shoulder, elbow, wrist, hand, hip, knee, ankle and foot. For example, D.D. Palmer, the founder of the chiropractic profession described his treatment of the feet in 1910. In fact, applying manual procedures to the peripheral (nonspinal) joints is taught in all accredited chiropractic programs.

In this post, we explain about Chiropractic West Palm Beach:  3 Foot Conditions Caused by Forefoot Varus.

 

What is forefoot varus?

Sometimes a forefoot (front) varus (turned inward) deformity develops.  It is an osseous (bony) structural abnormality in which the plantar (bottom) forefoot remains inverted (rolled inward) relative to the plantar rearfoot. And this is when the foot is in a neutral position.  The condition causes some of the most severe overpronation problems. So pronation refers to the way your foot rolls inward for impact distribution upon landing. 

A forefoot varus deformity is said to be congenital (condition present from birth).  Research has postulated many reasons as to why infants develop a forefoot varus deformity. It is most likely the result of osseous abnormalities in the talonavicular and calcaneocuboid articulations (foot joints). 

However, you can also have a functional forefoot varus.  Here the forefoot appears inverted relative to the rearfoot, but this position is the result of soft tissue restriction.  It is not a congenital osseous malalignment deformity. 

In either case, the biomechanical defect present in the arch of the foot is the basic cause for many postural problems, hip/ back problems, and injuries of the lower extremity (limb).  Below are 3 possible injuries due to a forefoot varus.

Entrapment of Medial and Lateral Plantar Nerves (Jogger’s Foot)

Because of the forefoot varus there will be excessive calcaneal (heel) eversion (rotating the sole of the foot away from the body’s midline) as heel lift occurs during the gait. This causes injury to the foot by overstretching of the muscles involved.  So the muscles working during the stance phase that help with deceleration loose their ability to stabilize the foot/ankle. In other words, after being “overly stretched” the muscles can’t generate enough force for the next part of the gait. 

Finally, the intrinsic muscles try to compensate in an attempt to decrease the strains placed upon the stabilizing ligaments/soft tissue.  In conclusion, this may lead to hyperactivity (overworking) specifically of abductor hallucis (intrinsic muscle of great toe) throughout the gait.  Therefore, this may result in entrapment neuropathy of the medial and lateral plantar nerves (branches of the tibial nerve) underneath the deep fascia of the Abductor Hallucis muscle.

 

Plantar Fasciatiis

The plantar fascia is often injured due to a forefoot varus. Because the forefoot varus tends to collapse into a pronated position, there is repeated dorsiflexion (lifting up) of the great toe during the propulsive period of the gait.  Next, this generates a lot of strain on the plantar fascia.  The plantar fascia is mostly elastic which takes the force generated by this.  Then this force is transferred to the bony attachment (of planta fascia) at the calcaneaus (heel).  Also, it’s been noted in research that enough strain/force can be put on by the plantar fascia to even cause a stress fracture.

 

Achilles Tendinitis/Peritendinitis (Tendon inflammation)

Achilles tendinitis is another common injury due to forefoot varus.  Again, this is due to excessive pronation because of forefoot varus during the propulsive phase of the Gait.  If excessive subtalar (one of ankle joints) pronation maintains the entire lower extremity (limb) in an internally rotated position, this twists the achilles tendon. As a result, this twisting of the achilles places more strain on it during early propulsion of the gait.  Research has shown that forefoot varus is a frequent cause of “snapping injuries”  of the achilles tendon.

 

 

Chiropractic West Palm Beach:  Chiropractic Care for Forefoot Varus and 3 Foot Conditions.

Firstly, as mentioned previously, in a functional forefoot varus the forefoot appears inverted relative to the rearfoot.  The culprit is the soft tissue restriction and not a congenital (a structural birth) deformity.  In other words, the soft tissue contracture occurred over time. 

Secondly, Chiropractic Manipulative Therapy should be delivered to the joints associated with the forefoot varus.  For example, adjustments to the ankle and foot joints.

Thirdly, stretching and strengthening exercises are important.  Specifically, the muscles involved would be the peroneus longus (muscle in the lower leg that moves foot and ankle) and flexor hallucis brevis (big toe muscle) muscles to help stabilize the forefoot.

Fourthly, an orthotic may also provide additional support for a forefoot varus deformity.  Certainly, a well designed shoe even without an orthotic has the ability to support the forefoot varus.   

 

Treatment of Forefoot Varus at Meiri Chiropractic in West Palm Beach

As is the case with the spine, a detailed examination is necessary to determine the diagnosis and treatment plan for your forefoot varus and foot injury.  In addition to joint manipulation and adjustments to the extremity (limb) joints, at Meiri Chiropractic, we use soft tissue procedures, hot and cold modalities, stretching exercises, and rehabilitation exercises.

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 not only treat existing conditions, but to keep your body in its best working condition.  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 or to find out more about Chiropractic West Palm Beach: 3 Foot Conditions Caused by Forefoot Varus.

 

References: Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

                       Warren Hammer, Functional Soft Tissue Examination and Treatment by Manual Methods, 2^nd edition 1999

 

 

There is a common misconception that chiropractors are just “spine doctors”.  However, from the very beginning, chiropractic adjustments have been delivered to the nonspinal joints as well. The nonspinal joints include the temporamandibular (TMJ), shoulder, elbow, wrist, hand, hip, knee, ankle and foot. For example, D.D. Palmer, the founder of the chiropractic profession described his treatment of the feet in 1910. In fact, applying manual procedures to the peripheral (nonspinal) joints is taught in all accredited chiropractic programs.

In this post, we explain about Chiropractor West Palm Beach:  Forefoot Varus and Sciatica.

 

What is forefoot varus?

Sometimes a forefoot (front) varus (turned inward) deformity develops.  It is an osseous (bony) structural abnormality in which the plantar (bottom) forefoot remains inverted (rolled inward) relative to the plantar rearfoot. And this is when the foot is in a neutral position.  The condition causes some of the most severe overpronation problems. So pronation refers to the way your foot rolls inward for impact distribution upon landing. 

A forefoot varus deformity is said to be congenital (condition present from birth).  Research has postulated many reasons as to why infants develop a forefoot varus deformity. It is most likely the result of osseous abnormalities in the talonavicular and calcaneocuboid articulations (foot joints). 

However, you can also have a functional forefoot varus.  Here the forefoot appears inverted relative to the rearfoot, but this position is the result of soft tissue restriction.  It is not a congenital osseous malalignment deformity. 

In either case, the biomechanical defect present in the arch of the foot is the basic cause for many postural problems, back problems such as sciatica, and injuries of the lower extremity (limb).

How Sciatica Develops from a Forefoot Varus

Potential injuries associated with forefoot varus can cause postural affects due to excessive pronation of the foot.  Excessive subtalar pronation causes the talus (bone that articulates with tibia/shin bone) to adduct (move toward midline) and plantar flex (move ankle to point toe downward) which results in excessive internal (inward) rotation.  And as a result, this lowers the entire lower extremity.  In a sense, this creates a functional short leg.

With the imbalance, tensile strain is put on the iliopsoas (a deep muscle group that connects the spine to the lower limbs) and piriformis muscles. And this leads to a narrowing of the greater sciatic notch (sciatic nerve exits pelvis here) in the pelvis. As a consequence, this predisposes to entrapment of the sciatic nerve. 

Furthermore, as the lower extremity drops inferiorly (downward), the ipsilateral innominate (one of pelvic bones) is lowered. And this causes the body of the L5 vertebrae to rotate toward the “functionally shorted leg”.  This can lead to compression of the spinal discs and the joints. Indeed, overuse injury will occur if not corrected leading to sciatica and other low back conditions.

 

Chiropractor West Palm Beach:  Chiropractic Care for Forefoot Varus and Sciatica

Firstly, as mentioned previously, in a functional forefoot varus the forefoot appears inverted relative to the rearfoot.  The culprit is the soft tissue restriction and not a congenital (a structural birth) deformity.  In other words, the soft tissue contracture occurred over time. 

Secondly, your Kinetic chain is a combination of several successively arranged joints, constituting a complex unit, as links in a chain. Chiropractic Manipulative Therapy should be delivered to the joints associated with both the forefoot varus and the sciatica.  For example, adjustments to the lumbopelvic (low back and pelvis), ankle and foot joints.

Thirdly, stretching and strengthening exercises are important.  Specifically, the muscles involved would be the peroneus longus (muscle in the lower leg that moves foot and ankle) and flexor hallucis brevis (big toe muscle) muscles to help stabilize the forefoot.

Fourthly, an orthotic may also provide additional support for a forefoot varus deformity.  Certainly, a well designed shoe even without an orthotic has the ability to support the forefoot varus.   

 

Treatment of Forefoot Varus at Meiri Chiropractic in West Palm Beach

As is the case with the spine, a detailed examination is necessary to determine the diagnosis and treatment plan for your forefoot varus and back condition.  In addition to joint manipulation and adjustments to the extremity (limb) joints, at Meiri Chiropractic, we use soft tissue procedures, hot and cold modalities, stretching exercises, and rehabilitation exercises.

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 not only treat existing conditions, but to keep your body in its best working condition.  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 or to find out more about Chiropractor West Palm Beach: Forefoot Varus and Sciatica.

 

References: Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

                       Warren Hammer, Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd edition

 

 

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

Chiropractic West Palm Beach: 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. 

 

Chiropractic West Palm Beach: Diagnosis of a Herniated Disc

After an examination entailing Orthopaedic/neurologic testing, imaging will be ordered by your doctor. Next, radiographic (x-ray) evaluation of the neck is sometimes necessary to determine the degree of bony foraminal encroachment causing irritation to the nerve root. Finally, a MRI (magentic resonance imaging) may be ordered to actually visualize the herniated disc.

 

Chiropractic West Palm Beach: Symptoms of a Herniated Disc

Depending on where the herniated disc is in your spine, it can result in pain or weakness in an arm or leg. In the neck, you may have neck, arm pain or hand weakness.  You often will have a painful restriction in moving often more on one side of the neck. It can cause a deep ache or sharp, electric shock like pain or numbness.  Movements such as sneezing, laughing, coughing, or any other sudden movement can exacerbate the pain.  Some patients report some relief with the hand held behind the head for neck herniations.

 

Chiropractic West Palm Beach: Causes of a Herniated Disc

Firstly, most often, a disc herniation is the result of a gradual, aging-related wear and tear called disc degeneration. As you get older, 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. Furthermore, it may cause neck and arm pain that came on after only a minor injury or insidiously (subtle but harmful).

Secondly, repetitive strain over time with incorrect posture and motions, can eventually herniate a disc. This may be repetitive movements in sports or at work. Additionally, you may have a past history of multiple occurrences of neck pain that resolved. 

Thirdly, 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.

 

 

Chiropractic West Palm Beach: Neck Pain Due to a Herniated Disc 

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 neck and 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 very effective technique is to manipulate at sites other than the herniation. Our other therapies, such as soft tissue techniques, therapeutic exercise and electric muscle stimulation, and ice/ heat therapies may also provide some relief for your pain. 

Call our office which serves West Palm Beach, Jupiter, Palm Beach Gardens, North Palm Beach and the surrounding areas at 561-253-8984 to make an appointment.  Get out of pain today and find out more about Chiropractic West Palm Beach: Neck Pain Due to a Herniated Disc.

 

 

Meiri Chiropractic

5601 Corporate Way, Ste. 102

West Palm Beach, FL 33407

561-253-8984

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.

 

 

Do you have pain in the hand or 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 Guyon’s ulnar tunnel syndrome. This post is about Chiropractic Care in West Palm Beach: Ulnar Nerve Entrapment at the Wrist.

Chiropractic Care in West Palm Beach: Causes of Ulnar Nerve Entrapment at the Tunnel of Guyon of the Wrist

The ulnar nerve may be compressed in the tunnel of Guyon at the wrist. It could be due to a traumatic sporting activity.  For example, you may have slammed the ball while playing basketball against the rim of the hoop.  Also, prolonged pressure over the hypothenar eminence (base of fifth digit/little finger) can be a culprit. For instance, constant compression on handlebars, as with cyclists, may cause this problem (i.e. handlebar or cyclist’s palsy). Other causes include vascular abnormalities and/or a ganglion cyst.

Anatomy of the Ulnar Nerve

The ulnar nerve is one of the 5 terminal (end) branches arising from the medial (closer to mid line) 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.

Tunnel of Guyon Anatomy

The ulnar nerve enters the hand through Guyon’s canal.  This is a fibro-osseous tunnel formed by the pisiform and hook of the hamate (2 of 8 carpal/wrist bones). So the tunnel of Guyon relays the ulnar neurovascular bundle (ulnar nerve, ulnar artery/vein, lymphatic vessels) into the hand.

 

Treatment at Meiri Chiropractic for Ulnar Neuropathy at the Tunnel of Guyon of the Wrist:

Firstly, soft tissue techniques will be rendered to the contracted fibrotic muscle and collagen at entrapment sites.

Secondly, Chiropractic adjustments (chiropractic manipulative therapy) to the wrist, and associated restricted joints.  This would be along the kinetic chain and spine as necessary.

Thirdly, Therapeutic exercise will be given for stretching and strengthening.

Fourthly, if trauma or swelling is involved, ice, compression, elevation, and physical therapy modalities is utilized to reduce swelling. Ergonomic recommendations (i.e. protection with padding) and modification to change the inciting activity is necessary.

 

Are your suffering from Ulnar Nerve Entrapment at the Tunnel of Guyon at the Wrist?

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 Chiropractic Care in West Palm Beach: Ulnar Nerve Entrapment at the Wrist.