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Back to Health with Correct Ergonomics and Chiropractic Care: Driving Posture (Part 6) is about how to make changes in your daily life for better posture and health. So posture is the way that you hold your body at any given moment, whether sitting, standing, or being active. And ergonomics is a science dedicated to studying human posture that is most healthy for our bodies.

Many patients seek chiropractic care for pain relief. However, your chiropractor should also help you decide which aggravating activities are unnecessary and must be eliminated.  This is important for prevention of rein-jury and for further future trauma.

Get started with some facts in our latest post regarding Driving Posture.

 

“Car Posture”

Of course, how many hours per day you spend in your car is a major factor. However, the type of lumbar (low back) support you have is important.

When you have inadequate lumbar support, this causes a posture of a loss of your normal lumbar lordosis (curve).   Next, your chest “collapses” along with the forward rounding of your shoulders.  Furthermore, your head may extend into a more anterior (front) position.

Most cars have seats with little or no lumbar support.  So most people spend many hours per day looking over the dashboard in a forward head posture.  In conclusion, this results in muscle and joint strain.

Therefore, you must have an adequate lumbar support of some kind.  This support is necessary whenever riding in a car whether as a driver or passenger. Some car seats now have a built-in adjustable lumbar support.  Moreover, if not, you can purchase one or make one.

 

Making a Lumbar Support at Home

Firstly, to make a lumbar support, a firmly rolled towel will suffice.  It provides a desirable combination of firmness and resilience. Secondly, try to make it approximately 12 inches wide and 3-4 inches in diameter. Thirdly, it should be placed in the seat back at the height about where a belt would normally go around your waist. The support can be adjusted up or down on the seat for comfort. Fourthly, the towel roll can be used as a more permanent lumbar support.  This is either in the car, at home or in the office.  In addition, you could even  slip it into an attractive cover and tye it to the seat. This will make it easier to use. Fifthly, it is important that the size of the roll be an appropriate fit for you.

Seated posture which completely eliminates your lumbar lordosis may feel helpful for brief periods.  This is due to the postural variation occurring. But can, by itself, cause muscle strain if maintained for a prolonged time, as when driving a car. To relieve tension during prolonged sitting, you should stretch regularly by changing your position.

Finally, any type of seating should allow for body symmetry and support of the normal spinal curves with a minimum of muscular energy. 

 

 

Your chiropractor is your partner in your healthcare. At Meiri Chiropractic in West Palm Beach, we’ll work with you to get the relief and health you need through chiropractic care. Together, we can be on the lookout for life and work situations where you experience pain in relation with poor posture. Pain is our body’s way of warning us of problems, so don’t ignore it. Shape up your life! Check your posture today.📞Contact Meiri Chiropractic today at 561-253-8984 to make an appointment or to learn more about Back to Health with Correct Ergonomics and Chiropractic Care: Driving Posture (Part 6).

 

 

Back to Health with Correct Ergonomics and Chiropractic Care: (Standing Posture) Part 5 is about how to make changes in your daily life for better posture and health. So posture is the way that you hold your body at any given moment, whether sitting, standing, or being active. And ergonomics is a science dedicated to studying human posture that is the most healthy for our bodies.

Many patients seek chiropractic care for pain relief, but your chiropractor should also help you decide which aggravating activities are unnecessary and must be eliminated.  This is important for prevention of rein-jury and for further future trauma. Get started with some facts in our latest post.

 

Standing/Upright Posture

Round – shouldered posture is an important mechanical activating and perpetuating factor for the myofascial pain cycle. Continued round shouldered posture causes adaptive shortening of muscles in the area leading to pain and dysfunction. 

These syndromes can cause arm pain and weakness.  Indeed, there is a significance in that what happens in a certain part of the body effects another part.  Furthermore, it is crucial to remember that everything is connected.  What happens from the feet up to the head position influences your body.  Moreover, whether you are standing or sitting this is occurring. Your feet and your pelvis are crucial support structures, but so are all the other body structures.

 

“Think Tall”

One simple technique you can do to develop good posture and movement is to “think tall”.  Go ahead and lengthen yourself. Move your head upward in relation to your body (away from your body, making yourself taller). Then your body will follow and come into good alignment. Of course it is not practical for a person to perform this slight movement every minute of the day.  Nevertheless, the more often the movement is performed, with every daily movement activity, the easier it becomes.  Matthias Alexander deserves credit for his principle of movement that uses the conscious mind to change subconscious muscle patterns.

 

Relaxation

For relaxation in the sitting position, a well designed chair with adequate lumbar support and the correct height armrests is necessary. When standing or walking, you should focus on the floor under the feet, trying to feel the texture and hardness of the carpet, flooring, or concrete with each step. Unnecessary muscles tension is relieved by this.  Similarly, while resting, sensation should be concentrated on the bed that supports the body, on the texture/softness of the sheets, and on the shape of the supporting surface. In conclusion, this concentration on the underlying support beneath the body encourages relaxation.

Muscle relaxation

Firstly, muscles relax more fully immediately following a gentle contraction. Secondly, when lying down and trying to relax, you can feel the difference in muscle tension.   Thirdly, before and after the contraction of individual muscle groups you can feel change. Fourthly, interestingly, relaxation is an active process that requires intense concentration. Fifthly, this concentration on relaxation helps to clear the mind for sleep.

 

Lastly, training in biofeedback and mind management, such as meditation, can help people learn how to relax their muscles. Additionally, during exercise, a pause for several deep breaths greatly aids muscular relaxation between cycles. This permits time for return of circulation, helps you to reduce chronic tension of the muscles and perform your exercise with better form.

 

Your chiropractor is your partner in your healthcare.

At Meiri Chiropractic in West Palm Beach, we’ll work with you to get the relief and health you need through chiropractic care. Together, we can be on the lookout for life and work situations where you experience pain in relation with poor posture. Pain is our body’s way of warning us of problems, so don’t ignore it. Shape up your life! Check your posture today.📞Contact Meiri Chiropractic today at 561-253-8984 to make an appointment or to learn more about Back to Health with Correct Ergonomics and Chiropractic Care: Standing Posture (Part 5).

 

 

 

 

Back to Health with Correct Ergonomics and Chiropractic Care: Sleeping Posture (Part 4) is about how to make changes in your daily life (sleeping) for better posture and health. So posture is the way that you hold your body at any given moment, whether sitting, standing, or being active. And ergonomics is a science dedicated to studying human posture that is the most healthy for our bodies.

Many patients seek chiropractic care for pain relief, but your chiropractor should also help you decide which aggravating activities are unnecessary and must be eliminated.  This is important for prevention of rein-jury and for further future trauma. Get started with some facts in our latest post.

 

Both Dynamic and Static Posture is Important

Both static (when you are still) or dynamic (when you are moving) poor posture in various forms strongly influences your myofascial pain cycle. Therefore, how you sleep is important. If you are causing postural strain while sleeping, it must be identified and resolved. 

 

Sleeping Posture: Bed and Mattress

The best sleeping posture is supine (on the back) in a firm bed with adequate support of the cervical lordosis (neck’s natural curve).  Furthermore, soft beds cause strain on your body.  Therefore, a firm mattress is preferable. One solution is placing a plywood bed board almost as big as the mattress between the mattress and the bed spring. Also, sleeping prone (on stomach) must be corrected.  This causes your head to be turned to one side and puts undue strain on the cervical (neck) joints and muscles.

 

Sleeping Posture: Pillow

A soft pliable pillow will provide support of your cervical lordosis.  Place it under the head and neck and bring the two comers up over your shoulders. When lying on your back, you should pull the corners of the pillow forward between the shoulder and your cheeks. Make sure your shoulders rest on the bed and not on the pillow.  Your cervical (neck) spine should be in line with the thoracic spine (mid back). Additionally, this encourages a shoulder-down position.  Specifically, this avoids shortening and cramping of the chest and scapula (shoulder blade) muscles (e.g. upper trapezius). Lastly, you may wish to carry your own home pillow on trips.

 

Side Sleepers

Side sleeping is acceptable.  However, side sleepers should focus pillow support between the head and neck, not the shoulder.  And you should sleep on a bed that supports the spine in a neutral position.  Only one soft comfortable pillow of adequate thickness to maintain a normal cervical lordosis is necessary. When you lie on the affected side, the pillow under the head should be thick enough.  A pillow bunched up between the neck and shoulder will keep the head in neutral.  It will prevent tilting of the head that would cause neck strain.

 

 

Your chiropractor is your partner in your healthcare.

At Meiri Chiropractic in West Palm Beach, we’ll work with you to get the relief and health you need through chiropractic care. Together, we can be on the lookout for life and work situations where you experience pain in relation with poor posture. Pain is our body’s way of warning us of problems, so don’t ignore it. Shape up your life! Check your posture today.📞Contact Meiri Chiropractic today at 561-253-8984 to make an appointment or to learn more about Back to Health with Correct Ergonomics and Chiropractic Care: Sleeping Posture (Part 4).

 

 

Back to Health with Correct Ergonomics and Chiropractic Care: Sitting  (Part 3) is about how to make changes in your daily life (sitting posture) for better posture and health. So posture is the way that you hold your body at any given moment, whether sitting, standing, or being active. And ergonomics is a science dedicated to studying human posture that is the most healthy for our bodies.

Many patients seek chiropractic care for pain relief, but your chiropractor should also help you decide which aggravating activities are unnecessary and must be eliminated.  This is important for prevention of rein-jury and for further future trauma. Get started with some facts in our latest post.

Sitting Posture

The fairly typical poor posture of someone sitting is:  flattening of the lumbar spine (low back), excessive  thoracic (mid back)  kyphosis (exaggerated, forward rounding of the upper back), round – shouldered  posture, anterior head (forward head ) positioning , and a depressed chest.

How can this poor sitting posture effect your health?

 

Firstly, this discourages normal diaphragmatic breathing (abdominal breathing and deep breathing). The diaphragm is a thin muscle that separates the chest from the abdomen and abdominal muscles.  And Diaphragmatic breathing involves slowly breathing in through the nose and then out through the mouth using the diaphragm. Secondly, diaphragmatic breathing helps boost the amount of oxygen in the blood, lowers blood pressure and heart rate, and reduces muscle tension. Thirdly, diaphragmatic breathing (e.g. relaxation technique) may be used to help relieve stress, pain, and anxiety. 

Moreover, poor sitting posture restricts thoracic (mid back) expansion. Additionally, this abnormal breathing leads to a compensation pattern and overload of the cervical (neck) muscles of accessory respiration.  So when prolonged, such poor sitting posture results in muscle and joint stress and eventually pain.

 

 Improving poor sitting posture when working at a computer:

-Your chair should have a backrest, a seat which is slightly hollowed out at the bottom to allow room for the buttocks, and firm upholstery.

-Seat height should be low enough so that your feet rest flat on the floor without compression of the thigh by the front edge of the seat.

-A foot rest may be used, if necessary, to avoid under-thigh compression.

-The lower edge of your back rest is positioned to support the lumbar spine (low back). And the upper edge of the backrest should reach high enough to cover and support at least the inferior (lower) edges of your scapulae (shoulder blade).

-Computer monitors which are too high or too low, or with glare on the glass, cause abnormal cervical (neck) postures. This occurs while you are trying to read the screen. Indeed, the screen can be cleaned.  And a phone book can raise a computer screen that is too low.  Also, seating adjustments may correct a screen that is too high. Lastly, special screen covers can cut unnecessary glare.

-If working on a computer, your keyboard should be kept as close to lap level as possible. If no keyboard table is available, it is better to have the keyboard on the knees (lap) than on a desk. Similarly, if typing, the under surface of the typing table should fit just above the knees/lap. This is so that your arms and shoulders do not need to be raised to reach the typewriter keys. As mentioned previously, if necessary a separate keyboard can fix this problem.

 

Chairs to be used for reading, socializing or watching TV, (not for eating)

The chair must have armrests that are high enough to provide support for the elbow. Without armrests, there will be a tendency to cross the arms in front of the chest for comfort. This causes the muscles across the front of the chest to shorten and rounds the shoulders forward.

If reading or writing, your chair should be pulled as close to the desk as possible. Your work should be kept as close to the body as possible. And the eyes instead of the head/neck should be turned down to look at the work.

 

Your chiropractor is your partner in your healthcare.

At Meiri Chiropractic in West Palm Beach, we’ll work with you to get the relief and health you need through chiropractic care. Together, we can be on the lookout for life and work situations where you experience pain in relation with poor posture. Pain is our body’s way of warning us of problems, so don’t ignore it. Shape up your life! Check your posture today.📞Contact Meiri Chiropractic today at 561-253-8984 to make an appointment or to learn more about Back to Health with Correct Ergonomics and Chiropractic Care: Sitting Posture (Part 3).

 

 

From Dr. Natalie Meiri’s Clinical Pearl Stories:

  Chiropractic Care is Possible After Neck and Back Surgery

This was a 64 year old patient who presented to my office with neck, back and left shoulder pain following a car accident.  She marked pain on her neck, back and drew a line going down her left shoulder for pain on the intake form. To be HIPAA compliant, I will call her Saskia instead of her real name. 

The current accident was her second accident. The first auto accident was 10 years ago. And she had surgery on her neck and low back due to this prior accident. So Saskia was questioning what treatment options were still available since she had a history of surgery.  “Is chiropractic still an option, even after major spinal surgery?” Indeed, she soon found out Chiropractic Care is Possible After Neck and Back Surgery.

Saskia’s Medical History

Saskia had a laminectomy nearly 10 years ago on her neck and low back following her previous car accident. A laminectomy is a surgical procedure that removes a portion of the vertebral bone called the lamina, which is the roof of the spinal canal. Also known as decompression surgery, a laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves. It is a major spine operation.

She had the laminectomy on her C6-C7 and L4-L5 vertebra (neck and lower back spinal bones).  Saskia suffered from a herniated disc in both areas of her spine which caused a radiculopathy (nerve root compression). 

Saskia came to see me because she “didn’t want any more surgery or drugs if possible”. Spinal surgery is often one of the last options a patient chooses.  This is after exploring medications, physical therapy, and chiropractic.  Also, the surgery may be to no avail and not have a good outcome.  Saskia also remembered the extremely intense and year-long recovery period.

 

Saskia’s Exam and Imaging

Upon examination, Saskia had positive tests for her cervical (neck), thoracic (mid back), lumbar (low back), and left shoulder.

I ordered X-rays of her spine and left shoulder.  It showed osteoarthritis (wear and tear arthritis) throughout her spine. Her left shoulder x-ray showed mild osteoarthritis.  I would send Saskia out for further imaging (i.e. magnetic resonance imaging, MRI) or a electromyography (EMG) and nerve conduction study (NCS) for the left shoulder if there wasn’t any improvement within 12 visits. 

 

Saskia’s Chiropractic Treatment: Low Force Techniques Were Considered to be Safer

Firstly, Saskia’s chiropractic treatment consisted of chiropractic manipulation/ adjustments of the spine utilizing low force techniques.  Moreover, the adjustments were delivered around the level of the laminectomy, but not at where the laminectomies were performed with the following techniques: flexion distraction, hand-held mechanical adjusting instrument, SOT (sacro-occipital technique) blocking.  For her thoracic and left shoulder,  a low intensity/low amplitude diversified (hands on) adjustment was performed. Additionally, associated regions that were adjusted were both hips , which were misaligned (subluxations or intersegmental dysfunctions) due to the conditions she had.

Secondly, soft tissue therapy (myofascial release, pressure point and various post isometric relaxation techniques) and modalities (cold/heat therapy and electric muscle stimulation) were administered.

Thirdly, she was given therapeutic exercises to continue her treatment at home. 

 

 

Saskia’s Outcome for Treatment at Meiri Chiropractic

Saskia started feeling better within the first few visits. After a few months of treatment, she regained  her range of motion and strength back. Chiropractic adjustments normalize function, restore joint mobility, resolves joint inflammation and reduces the patient’s pain.  Even for post-surgical cases, patients can get fast pain relief and over time improve function.

Do you know someone like Saskia who is in need of chiropractic treatment? Chiropractic Care is Possible After Neck and Back Surgery!  Contact Dr. Natalie Meiri of Meiri Chiropractic today serving North Palm Beach, Jupiter, Wellington, Palm Beach Gardens and the surrounding areas. Get the relief you need and deserve! We also offer chiropractic care for many other ailments. Call 561-253-8984 to learn more or to schedule an appointment.

 

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There are many causes for hip pain, and loose bodies can be a culprit.  Loose bodies are fragments of detached cartilage or bone inside the hip joint. These fragments may be free floating (unstable) or embedded in the joint or tendon.

Loose bodies in the hip may appear as a lumbar (low back) spinal condition.  You will have a twinge like pain that may occur during walking.  Furthermore, the pain is felt on the anterior (front) thigh from the groin to the knee.  Your leg may weaken suddenly from the pain. You may have recurrences of this pain and weakness that comes and goes. 

Hip Pain from loose bodies and Chiropractic care is about what causes loose bodies and how chiropractic manipulation of the hip helps. However, x-rays are definitely needed for diagnosis before manipulation.

 

Causes of Loose Bodies:

There are many reasons for the loose bodies including: hydroxyapatite deposition disease, osteoarthritis (wear and tear arthritis), osteochondritis dissecans, labral tears, and trauma. 

 

Hydroxyapatite crystal deposition disease (HADD)

Calcium hydroxyapatite crystal deposition disease is characterized by the presence of basic calcium phosphate crystals (mostly hydroxyapatite).  And these crystals are deposited in the periarticular (around joint) soft tissues (e.g. tendons). So a common diagnosis of tendinitis or bursitis causing joint pain could be due to an underlying HADD. 

You will have pain, tenderness, localized swelling and reduced range of motion. And  You may be 40-70 year old.This is especially in the shoulder, elbow, wrist, fingers, hip, ankle, foot and spine.  

 

Labral Tear

The labrum of the hip is a dense fibrocartilaginous ring.  It is attached to the bony margin of the circumference of the acetabulum (socket for hip bone where femur fits).

You may have intermittent twinge like pain, catching and giving way of the hip.  Sometimes, a painful pop or click within the hip joint may occur.

Chiropractic manipulation and manual treatment for a loose body in the hip due to a labral tear may be helpful.  A MRI for a positive diagnosis is necessary. 

 

Osteochondritis Dissecans

A disorder of adolescence in which a small segment of subchondral bone (bone plate supporting the articular cartilage) undergoes ischemic necrosis ( loss of blood flow to bone tissue, which causes the bone to die). 

First, this usually occurs following trauma or a vascular occlusion (blood flow blockage). Second, it may heal spontaneously or form a loose body. Third, the segment of bone will separate and become displaced into the joint cavity.  Fourth, this forms an intraarticular (within joint) loose body.  Fifth, the separated loose body has various possibilities: reattachment, displacement and embedding into synovium (joint tissue), remaining free in the joint cavity, or resorption.

Osteochondritis Dissecans occurs mostly in 11-20 year old boys.  The knee is most commonly affected followed by the ankle, elbow and hip. Symptoms include joint effusion, painful joint motion, clicking, locking and localized tenderness. Also, it may have come on after trauma. 

 

Chiropractic Care of the Spine and Extremities (Hip) at Meiri Chiropractic:

Firstly, the treatment plan includes Chiropractic Manipulative Therapy to the spine and extremity (e.g. hip) joint.

Secondly, manipulation of muscle contractures with soft tissue techniques (e.g. post isometric relaxation and/or myofascial release techniques).

Thirdly, therapeutic exercises for strengthening of the joint will help for active care at home. 

Fourthly, recommendations on anti-inflammatory diet will be of benefit for patients.

 

Research on How Chiropractic Adjustments Can Help

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.

 

Getting regular chiropractic treatment at a West Palm Beach chiropractic center can help naturally relieve hip pain and dysfunction. Chiropractic is a holistic and natural way to not only treat existing conditions, but to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984 to make an appointment or to learn more about Hip Pain from Loose Bodies and Chiropractic Care.

 

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

 

 

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic Adjustments for Foot Pain from Metatarsalgia

 

This was a 45 year old patient who had a chief complaint of pain on the bottom of the foot, specifically at the sole. To be HIPAA compliant, I will call her Beatrice instead of her real name.  Beatrice had treated with another chiropractor prior to seeing me.  She had foot problems he wouldn’t address.  He would only work on her spinal complaints.  

 

Beatrice’s History

Beatrice worked all day on her painful feet.  Moreover, she didn’t know how she developed this problem.  There was no trauma. Beatrice went to a podiatrist with no relief.  He told her she had metatarsalgia.

However, the podiatrist did tell her the culprit could be the improper shoes she often wore.  Beatrice’s high heels transferred extra weight to the front of her feet.  And this could have caused metatarsalgia. Beatrice also wore shoes with a narrow toe box. 

Beatrice started wearing athletic shoes with a lot of support and padding, but her feet continued to hurt. Even the orthotics she got at the podiatrist didn’t help.  She didn’t want a cortisone shot or surgery. The podiatrist had prescribed NSAIDS (Non-steroidal anti-inflammatory drugs) which gave her very little relief.  

 

 

What is Metatarsalgia?

Metatarsalgia is defined as pain and inflammation in the ball of the foot. It can have varied causes. Typically, the pain is experienced in the padding directly below the toes. The metatarsals are the five long bones in the midfoot. They are located between the tarsal bones and the phalanges.

 

Metatarsalgia pain can consist of numbness, shooting pain, and/or soreness, especially when flexing the toes. Indeed, injuries to the balls of feet are common in athletes.  Also, metatarsalgia is a repetitive injury. It is prevalent in those who spend a lot of time on their feet.  Metatarsalgia is a very common foot problem.

 

Causes of Metatarsalgia

There are a lot of reasons for Metatarsalgia.  Some may be related to gait mechanics (how you walk), foot anatomy, and/or foot and ankle deformity/malformation (e.g. hammer toes, pes planus (low arch) or pes cavus (high arch).

 

Furthermore, chronic stretching of the transverse ligaments may be an underlying reason. These ligaments run across and connect together the heads of all the metatarsal bones.

 

Firstly, excessive weight or repetitive activity may injure these ligaments. Secondly, direct trauma from jumping or landing on the toes with running or jogging can be a cause.  Thirdly, standing for long periods of time in high-heeled shoes is definitely a contributing factor.  Fourthly, shoes with too narrow a toe box will also cause compression and pain. Lastly, your feet may have a chiropractic subluxation of the metatarsal heads.

 

Beatrice’s Examination and Imaging

Upon examination, there were positive tests for Beatrice’s feet for Metatarsalgia. The x-rays she brought in from her podiatrist’s office showed degenerative osteoarthritis of both her feet. 

 

Beatrice’s Treatment

Beatrice was given instructions on the use of a metatarsal pad placed just proximal (next) to the metatarsal heads.  And room was left after placement of the pad for the first and fifth metatarsal heads.  The pad was only utilized during the beginning (acute stage) of her care.

Chiropractic adjustments were performed to the metatarsal restricted joints and associated regions.  Associated regions that were adjusted were her other foot joints and ankles that were restricted.  Beatrice was also adjusted full spine to keep her aligned and functioning optimally.

Next, 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.

Finally, she was given therapeutic exercises to continue her treatment at home.

 

Beatrice’s Outcome

The outcome for Beatrice was excellent! She started feeling better immediately from the first few visits.  By the end of 12 visits, she was pain-free and her feet were functioning optimally. Beatrice returned for as needed care for her feet. 

 

Chiropractic 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 for Metatarsalgia?  Contact  Meiri Chiropractic today at 561-253-8984 to learn more about  Chiropractic Adjustments for Foot Pain from Metatarsalgia or to schedule an appointment.

 

 

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From Dr. Natalie Meiri’s Clinical Pearl Stories:

Computer and Video Game Injuries in Kids: Chiropractic Care is Effective

 

This is my clinical pearl story about Computer and Video Game Injuries in Kids: Chiropractic Care is Effective. Arnold was a 10 year old child who liked playing video games and spent many hours on his computer a day.  His chief complaint one day in the office was that his thumbs, neck and mid back hurt from playing video games continuously for 4 hours. This was double the amount of time he normally spent daily!  His mom brought him in the next day.  I will call him Arnold instead of his real name to be HIPPA compliant. 

 

Arnold’s Examination

Upon examination, Arnold tested positive for his neuromusculoskeletal injuries: Myalgia (muscle pain) in his mid back and strain in his neck and thumbs.

 

Computer and Video Game Injuries: Repetitive Trauma

It is common to have a postural problem for individuals who work at desks. Prolonged sitting at a desk combined with the repetitive activity of typing or using the mouse for your computer causes postural problems and/or repetitive motion injuries. Furthermore, we are texting (ie. Text neck) and looking on smart phones with a forward neck position. 

This sedentary lifestyle which eliminates a variety of movements cause pain and dysfunction. Moreover, Kids and teenagers can also develop a slumped posture due to heavy back packs, hunching over homework or video games.   

 

Prevent computer and video game injuries

By correcting ergonomic issues and limiting these types of repetitive injuries, long term damage can be avoided.    Indeed, excessive gaming in front of a screen can result in postural stresses from lack of movement.  Additionally, it can cause eyestrain, wrist, arm, elbow, hand, thumb strain and even carpal tunnel syndrome.

 

Some Tips (what to do) to Avoid Repetitive Injury at the computer and while video gaming

 

• Taking frequent short breaks and doing stretching exercises while working or gaming. Also, switch up the activity.
• Sit at an adjustable desk that is specially designed for computer use
• Having the computer screen at eye level or slightly lower
• Ensuring your keyboard is at a height that allows your elbows to rest comfortably at your sides.
• Ensuring your forearms are nearly parallel to the floor and at the same level as the keyboard.
• Using an ergonomic chair that is designed to prevent the spine from losing its natural curve while sitting
• Adjusting your chair such that your feet are always resting flat on the floor, or using a footstool

Kids should be interested in a variety of hobbies, and activities.  And especially physical activities like sports.  Simply sitting all day can lead to obesity and even problematic emotional or aggressive behavior.  Kids should have a limit. Sensible time for playing could be a maximum of 1-2 hours a day for computer and video games with lots of breaks during these sessions.  Getting the right keyboard, mouse and furniture that is suitable for your child’s height is essential.

Arnold’s Treatment and Outcome at  Meiri Chiropractic:

 

Firstly. Chiropractic manipulation or mobilization of the cervical (neck) and thoracic (mid back) spinal joints and both thumbs/hands.

Secondly, soft tissue manipulation to the muscles involved.

Thirdly, exercises focusing on stretching tight muscles and strengthening weak muscles.

Fourthly, recommendation on redesign of work environment and ergonomics.

Fifthly, postural advice/ recommendation of frequent breaks with stretching.

Finally, after the first visit, Arnold started feeling better!  And within a few visits, he was completely healed.

 

Computer and Video Game Injuries in Kids: Chiropractic Care is Effective

Most children and adolescents regularly experience physical injuries from ordinary play and sports. However, with the increasing popularity of computer and video games, some kids are now feeling the same kind of pains and aches that adults get from sitting behind their desks all day. Chiropractic care can help to offset the postural stresses and lack of movement linked to gaming and sitting at a computer all day. 

Are you experiencing pain due to poor posture or repetitive motion injury?  Chiropractors can help posture problems and repetitive motion injuries for you and your family. Call 561-253-8984 today for an appointment.

 

Do you have pain, weakness, and paresthesia (tingling, numbness or “pins and needles”) in your arm/forearm (below the elbow)?  You may have dull, sore achiness in the extensor muscles (muscles that extend wrist/hand) below your elbow. The pain may be more prominent at night and after use. These are all symptoms of Radial Neuropathy/Entrapment below the elbow. Read on to learn about Elbow and Forearm Pain Due to Radial Neuropathy: Chiropractic Can Help.

 

Anatomy of the Radial Nerve

The radial nerve is the terminal (end) continuation of the posterior (back) part of the brachial plexus. And the brachial plexus is a bundle of nerves that originate from nerve roots in the cervical (neck) and upper thoracic (torso) sections of the spinal cord (C5-T1). Ultimately, the brachial plexus creates a network that connects to the nerves in the arm. Therefore, the radial nerve contains fibres from nerve roots C5 – T1.

It arises from the axilla and exits the axilla inferiorly (below).  Next, it supplies branches to the long and lateral heads of the triceps brachii muscle.

The radial nerve then descends down the arm.  It travels in a shallow depression within the surface of the humerus (long upper arm bone), known as the radial groove.

To enter the forearm, the radial nerve travels anterior (front of) to the epicondyle of the humerus, through the cubital fossa of the elbow. The nerve then ends by dividing into two branches:

• Deep branch (motor) – innervates (supplies) the muscles in the posterior (back) compartment of the forearm.
• Superficial branch (sensory) – contributes to the cutaneous (skin) innervation of the dorsal (back) hand and fingers.

 

Compression of the Radial Nerve from Elbow to the Wrist

The Radial nerve divides into its two major branches, the posterior interosseous and the superficial radial nerve at the level of the radiocapitellar joint (elbow joint).  Above the elbow the radial nerve innervates the brachioradialis and extensor carpi radialis longus and brevis.  Therefore, entrapment below the elbow joint does not affect these muscles. 

Posterior interosseous nerve compression depends on where the compression occurs. There may be involvement at the radial tunnel, causing what is known as the radial tunnel syndrome or along the distal course of the nerve (including the radial tunnel) in which case it’s called the posterior interosseous nerve syndrome.

 

Radial Tunnel Syndrome aka Resistant Tennis Elbow:

If you have what appears to be tennis elbow, but is resistant to therapy, it could actually be radial tunnel syndrome.  And you may have unremitting pain around the lateral epicondyle (bump on outer side of elbow) of the elbow.

 

What is radial tunnel syndrome?

This is a compressive neuropathy of the posterior interosseus nerve (PIN) branch of radial nerve in the radial tunnel. The radial tunnel is about 2 inches long. It goes from the capitellum (rounded knob-like structure at end of humerus where meets elbow) of the humerus (long bone of upper arm) and the radial head of radius to the supinator muscle. 

The boundaries of the radial tunnel is formed by the supinator (broad muscle in the posterior compartment of the forearm, curved around the upper third of the radius), extensor carpi radialis longus/extensor carpi radialis brevis (both muscles in forearm extend hand a wrist), and brachioradialis ( muscle of the forearm that flexes the forearm at the elbow).

 

Locations of compression within the Radial Tunnel

Locations of compression within the radial tunnel include:

–fibrous bands over the anterior (front of) radial head and capsule (of elbow joint) at the the entrance to the tunnel

-a recurrent fan of blood vessels that supplies the brachioradialis and the extensor carpi radialis longus, the ulnar half of the tendon and fascia of the extensor carpi radialis brevis muscles

–under the fibrous arch at the proximal edge of of the supinator called the arcade of frohse and below the fascial arcade at the distal lateral border of the supinator muscle. 

The arcade of frohse seems to be the most common area of entrapment in this area.  Researchers stated that in 10% of patients with lateral epicondylitis (tennis elbow) there is a co-existent radial tunnel syndrome due to radiocapitellar bursitis (inflamed bursa at elbow).

 

Causes of Radial Tunnel Syndrome

Radial tunnel syndrome is caused by direct compression by anatomic structures as mentioned above.  Additionally, in athletes by vigorous contraction of the extensor musculature can trigger it. Furthermore, it can occur with one very strenuous effort.  However, more often it is due to repetitive pronation and supination (rotating palm downward or upward), although wrist extension can aggravate it.  The syndrome is found especially in athletes who lift weights, golf, swim and participate in racquet sports. 

 

Posterior Interosseous Nerve Syndrome:

Radial tunnel syndrome refers to a rare compressive neuropathy of the posterior interosseous nerve (PIN) as it passes through the radial tunnel as described above.  So radial tunnel syndrome has pain without motor or sensory dysfunction. And with the PIN compression syndrome, a more severe compressive neuropathy occurs. Ultimately, with PIN there is wrist extensor muscle  weakness as well as pain. Again, the PIN is a branch of the radial nerve at the elbow.  It supplies motor innervation to the dorsal (top) extensor compartment of the forearm and sensory innervation to the dorsal wrist.

Causes of Posterior Interosseous Nerve Syndrome (pins)

The main site of compression is at the arcade of frohse at the elbow.  Other causes can be vascular anomalies (abnormalities), synovitis, edema, ganglion, bursa or lipoma. Of course, overuse such as repetitive pronation and supination are culprits as well.

 

Treatment at Meiri Chiropractic for Radial Neuropathy:

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 elbow, wrist, and associated restricted joints.  This would be along the kinetic chain  and spine which is important.

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 to change the inciting activity is necessary.

Are your suffering from elbow or forearm pain from Radial Neuropathy?

We offer excellent Chiropractic care for Radial 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 Elbow and Forearm Pain Due to Radial Neuropathy: Chiropractic Can Help.

From Dr. Natalie Meiri’s Clinical Pearl Stories:

Chiropractic Care for Cervical Radiculopathy

 

This was a 68 year old patient who had neck and left hand numbness and pain. To be HIPAA compliant, I will call him Wallace instead of his real name.  Wallace had treated with another chiropractor prior to seeing me.  He had gone to physical therapy for his lower back which was much better.  However, Wallace’s orthopedist thought his cervical spine (neck) condition was a surgical case.  After trying another chiropractor and acupuncture, he presented to my office.

Wallace worked as a handyman for 30 years and attributed some of his neck problems to his daily work activity.  However, he really didn’t know why this had occurred.  What really bothered him was the constant numbness in his last 2 fingers (4^th and 5^th digits) and weakness in his left hand. 

Wallace had been prescribed NSAIDS (Non-steroidal anti-inflammatory drugs) which gave him very little relief.  

 

Wallace’s Examination and Imaging

Upon examination, there were positive tests for his cervical spine (neck) as well as the left hand-4^th and 5^th finger symptoms giving the diagnosis of C8 radiculopathy. 

I ordered X-rays of Wallace’s cervical spine. The findings in his x-rays were a reversal in the natural lordotic curve and moderate to severe osteoarthritis (wear and tear arthritis). 

I would order a M.R.I. if he wasn’t improving in a month or 12 visits. 

After that, I explained his diagnosis (radiculopathy of C8 nerve root and osteoarthritis), prognosis and treatment plan.

 

 

Wallace’s Treatment

Firstly, Wallace’s chiropractic treatment for C8 radiculopathy consisted of chiropractic manipulation/ adjustments of the cervical spine (at levels above the C8 nerve root) and associated regions.  Associated regions that were adjusted were his thoracic and lumbar spine (low back) 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, he was given therapeutic exercises to continue his treatment at home.

Fourthly, Wallace was given recommendations on his activities of daily living (ergonomics on posture etc) at home and work. 

Lastly, his visits started at 2-3 times a week for 4 weeks and than 1-2 times a week thereafter for 3 months. 

 

What is a radiculopathy?

Cervical radiculopathy is a neurologic condition resulting from compression or inflammation of the cervical nerve roots (initial segment of nerve leaving central nervous system). The nerve compression is caused by narrowing of the neural foramen (opening in spine for nerve exit) due to cervical spondylosis (osteoarthritis), disc (small rubbery cartilage between spinal vertebrae) herniation, trauma, or an abnormal curve of the spine. The majority of cases of cervical radiculopathy stem from degenerative disease (osteoarthritis) in the cervical spine.

In Osteoarthritis, your disk desiccates (drying out) over time.  This can lead to decreased disk height, hypertrophy of the uncinate joint (joint becomes bigger), foraminal stenosis (nerve exit gets smaller) and cervical radiculopathy occurs.  Finally, disk degeneration and herniation trigger a pro-inflammatory cascade causing further nerve root irritation.

Indeed, trauma or swelling can contribute to symptoms.  Cervical radiculopathy can less commonly be caused by tumors, infection, or changes in blood flow. 

 

Wallace’s Outcome

The outcome for Wallace was excellent! He started feeling better immediately from the first few visits.  Moreover, after a few weeks of continued care his function improved. His range of motion greatly improved and he gained the strength back in his hands.  By the end of his 3 months of corrective care, he was pain-free and functioning optimally. Wallace returned for once a month supportive/maintenance care after this.

 

Chiropractic Care for Cervical Radiculopathy at Meiri Chiropractic

So Cervical radiculopathy is a medical condition where there can be symptoms of pain, weakness, and/or numbness as a result of a pinched or irritated nerve in the neck.  Cervical radiculopathy will cause loss of function and/or symptoms in one or both arms.  And Chiropractic 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 for cervical radiculopathy? Contact Dr. Natalie Meiri of Meiri Chiropractic today at 561-253-8984 to learn more about Chiropractic Care for Cervical Radiculopathy or to schedule an appointment.