Back Clinic Clinical Neurology Support. El Paso, TX. Chiropractor, Dr. Alexander Jimenez discusses clinical neurology. Dr. Jimenez provides an advanced understanding of the systematic investigation of common and complex neurological complaints including headache, dizziness, weakness, numbness, and ataxia. The focus will be on the pathophysiology, symptomatology, and management of pain in relation to headache and other neurologic conditions, with the capacity to distinguish serious from benign pain syndromes.
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Neuropathy Presentation: El Paso, TX. Chiropractor, Dr. Alexander Jimenez�presents an overview of neuropathy. These are the most common neuropathies to be seen in practice.�Neuropathy is a medical term used to characterize damage or injury to the nerves, which refers to the peripheral nerves as opposed to the central nervous system. The complications which follow neuropathy depends largely on the type of nerves that are affected. According to Dr. Alex Jimenez, different neuropathies can cause numbness and tingling sensations, increased pain or the loss of ability to feel pain, muscle weakness along with twitching and cramps, even dizziness and/or loss of control over bladder function.
Neuropathy
Three primary classifications based on location of symptoms:
If sensory disruption is limited to certain modalities, it implies CNS is involved
If all sensation is affected in the area, implies PNS is involved
Determine Pattern Of Symptoms
Mononeuropathy (focal)?
Mononeuropathy multiplex (multifocal)?
Polyneuropathy (generalized)?
Motor Exam
Determine if there is change to muscle strength
Determine if there is a change in muscle tone
Determine which muscles are affected
Determine if there has been a change in reflexes
This information can help determine the level(s) of involvement
Check For Autonomic�Signs
Auscultate heart
Palpate palms
Auscultate abdomen
Assess autonomic history
For example, is patient complaining about sweating more on one side than another? Complaining of stress levels?
Suggest ANS involvement
Exams: Merck Manual Professional Version
How To Test Reflexes
How To Do The Sensory Exam
How To Do The Motor Examination
Classification Of Nerve Injuries Resulting In Neuropathy
Neurapraxia – This is a transient episode of motor paralysis with little or no sensory or autonomic dysfunction; no disruption of the nerve or its sheath occurs; with removal of the compressing force, recovery should be complete
Axonotmesis – This is a more severe nerve injury, in which the axon is disrupted but the Schwann sheath is maintained; motor, sensory, and autonomic paralysis results; recovery can occur if the compressing force is removed in a timely fashion and if the axon regenerates
Neurotmesis – This is the most serious injury, in which both the nerve and its sheath are disrupted; although recovery may occur, it is always incomplete, secondary to loss of nerve continuity
Brachial Plexopathies
Erb�s Palsy
Klumke�s Palsy
Erb�s Palsy
AKA Erb�Duchenne palsy or Waiter’s tip palsy
Most common mechanism of injury in adults is a patient who fall forward while holding onto something behind them
Can also happen to an infant during childbirth ? Results from damage to C5-6 nerve roots in the brachial plexus
Dermatomal distribution of sensory disruption
Weakness or paralysis in deltoid, biceps, and brachialis muscles resulting in �waiter�s tip� position
Klumke�s Palsy
AKA Dejerine�Klumpke palsy
Happens to infants during childbirth if arm is pulled overhead
Can also happen to adults with overhead traction injuries
Results from damage to C8-T1 nerve roots in the brachial plexus
Dermatomal distribution of sensory disruption
Weakness or paralysis in wrist flexors and pronators as well as muscles of the hand
May produce Horner�s syndrome due to T1 involvement
Results in a �claw hand� appearance
Forearm supinated with wrist hyperextended, with finger flexion
Neuropathy is a medical term used to describe a collection of general diseases or malfunctions which affect the nerves. The causes of neuropathy, or nerve damage, can vary greatly among each individual and these may be caused by a number of different diseases, injuries, infections and even vitamin deficiency states. However, neuropathy can most commonly affect the nerves that control the motor and sensory nerves. Because the human body is composed of many different kinds of nerves which perform different functions, nerve damage is classified into several types. Neuropathy can also be classified according to the location of the nerves being affected and according to the disease causing it. For instance, neuropathy caused by diabetes is called diabetic neuropathy. Furthermore, depending on which nerves are affected will depend on the symptoms that will manifest as a result. Below we will discuss several specific types of neuropathies clinically treated by chiropractors, physical therapists and physical medicine doctors alike, as well as briefly describing their causes and their symptoms.
Brachial Plexopathies
Brachial plexopathy is a type of peripheral neuropathy, which affects the nerves that transmit messages from the brain and the spinal cord to the rest of the body. This kind of nerve damage occurs when harm affects the brachial plexus, a region found on each side of the neck where nerve roots from the spinal cord branch out into each arm’s nerves. Damage, injury or a condition that impacts these nerve roots can result in pain, decreased mobility and reduced sensation in the arm and shoulder. In some cases, no cause can be identified.
Erb’s Palsy
Erb’s Palsy, also known as�Erb�Duchenne palsy or Waiter’s tip palsy, is identified as a paralysis of the arm caused by damage or injury to the nerves in the neck which form part of the brachial plexus. The most common mechanism of injury in adults with Erb’s Palsy is a patient who fell forward while holding onto something behind them. Erb�Duchenne palsy can also happen to an infant during childbirth, most commonly, but not exclusively, from shoulder dystocia during a difficult birth. To be more precise, this type of brachial plexopathy results from damage to the C5-C6 nerve roots along the brachial plexus in the neck. Symptoms of Erb’s Palsy include dermatomal distribution of sensory disruption followed by weakness or paralysis in the deltoid, biceps, and brachialis muscles, leading to the �waiter�s tip� position associated with this type of neuropathy. While many infants can recover on their own from this type of brachial plexopathy, some may require rehabilitation.
Klumpke’s Palsy
Klumpke’s Palsy, also known as Klumpke’s paralysis or�Dejerine�Klumpke palsy, is a partial palsy in the nerve roots of the brachial plexus located along the cervical spine, or neck. It is named after�Augusta D�jerine-Klumpke, an American-born French medical doctor acknowledged for her work in neuroanatomy. Klumpke’s Palsy is characterized as a form of paralysis involving the muscles of the forearm and hand, which occurs to�infants during childbirth if their arm is pulled overhead.�Dejerine�Klumpke palsy can also occur to adults with overhead traction injuries caused by harm to the C8-T1 nerve roots in the brachial plexus and upper thoracic region of the spine. Symptoms of Klumpke’s paralysis include dermatomal distribution of sensory disruption, weakness or paralysis, in the wrist flexors and pronators as well as in the muscles of the hand. This type of brachial plexopathy may often lead to Horner�s syndrome, a collection of symptoms which manifest when a set of nerves, known as the sympathetic trunk, are damaged or injured due to T1 involvement. This form of neuropathy is identified by resulting�in a �claw hand� appearance, where the forearm is supinated with the wrist hyperextended, together with finger flexion.
Entrapment Neuropathies
Entrapment neuropathy, also known as nerve compression syndrome or compression neuropathy, is best-known as nerve damage or a type of neuropathy caused by direct pressure on a nerve. Common symptoms include pain and discomfort, tingling or burning sensations, numbness and muscle weakness which affects only a particular part of the human body, depending on which nerve is affected. A nerve can become compressed as a result of a constant external force or due to a lesion, such as a tumor. Additionally, some conditions can make the nerves more susceptible to compression, including diabetes, where the nerves are rendered more sensitive to minor degrees of compression due to their already compromised supply of blood. Nerve damage caused by a single episode of harm can be considered an entrapment neuropathy, however, it is generally not classified under this group of compression neuropathy or nerve compression syndrome.
Thoracic Outlet Syndromes
Thoracic outlet syndromes are a group of disorders which develop when the nerves or blood vessels between the collarbone and the thoracic outlet, located in the region of the first rib, are compressed. As a result, this can cause pain and discomfort in the neck and shoulders as well as numbness in the fingers. There are a number of types of thoracic outlet syndromes, including neurogenic, or neurological, thoracic outlet syndrome, specifically caused by the compression of the brachial plexus, vascular thoracic outlet syndrome, which is caused specifically by the compression of the veins, known as venous thoracic outlet syndrome, or arteries, known as arterial thoracic outlet syndrome, and nonspecific-type thoracic outlet syndrome, which is considered to be idiopathic and has been described to worsen with activity. Several healthcare professionals believe that nonspecific-type thoracic outlet syndrome doesn’t exist, while others claim it to be a common disorders. However, the majority of thoracic outlet syndromes are often classified as neurogenic.
Thoracic outlet syndromes are caused by the compression of the cervical rib, an extra “rib” in the seventh cervical vertebra, subclavius muscle tension, improper posture or�excessive thoracic kyphosis, physical trauma, repetitive activity, obesity and pregnancy. Thoracic outlet syndromes can vary depending on which structures are compressed. Thoracic outlet syndromes can be diagnosed using tests, such as the Adsons test, the Allen maneuver, the Costoclavicular maneuver, the Halstead maneuver, the�Reverse bakody maneuver, the Roos test, the Shoulder compression test and the Wright test. Thoracic outlet syndromes can cause permanent neurological damage if not diagnosed and treated early.
Median Nerve Entrapment
Median nerve entrapment or median nerve entrapment syndrome, is a mononeuropathy, a condition that impacts only a single nerve or nerve group outside the brain and spinal cord, which affects the movement of or sensation in the hand. Median nerve entrapment is caused by the compression of the median nerve found in the elbow or distally in the forearm or wrist. Symptoms include sensory disruption in the lateral portion of the palmar aspect of the hand and dorsal finger tips of the same fingers. In addition, motor fibers may also be affected in the forearm, if applicable, including the muscles of the thenar eminence, such as the abductor pollicis brevis, the opponens pollicis, and the flexor pollicis brevis. Other forms of median nerve entrapment syndromes include: pronator teres syndrome and carpal tunnel syndrome.
Pronator teres syndrome is characterized as the compression of the median nerve at the elbow. It is considered rare compared to carpal tunnel syndrome. Pronator teres syndrome is caused by repetitive movement, pronator teres muscle inflammation and thickened bicipital aponeurosis. Clinical findings for this type of neuropathy include, tenderness with palpation of the pronator teres muscle, pain with resisted pronation of the arm, flexor pollicus longus and flexor digitorum profundus involvement, otherwise, symptoms manifestations for pronator teres syndrome may appear similar to carpal tunnel syndrome but without positive wrist orthopedics.
Carpal tunnel syndrome is characterized as the compression of the median nerve at the wrist. Carpal tunnel syndrome is identified by symptoms of pain and discomfort, tingling sensations in the thumb, index finger, middle finger and the thumb side of the ring fingers, and numbness. These can generally start gradually and may extend up the arm. Advanced instances of carpal tunnel syndrome may cause weakened grip strength where the muscles at the base of the thumb may waste away if left untreated for an extended period of time. In many cases, carpal tunnel syndrome may affect both hands or arms. Carpal tunnel syndrome is caused by repetitive movements, hypothyroidism, obesity, rheumatoid arthritis, diabetes and pregnancy. Orthopedic tests utilized to diagnose carpal tunnel syndrome include the use of the Tinel�s Sign, positive if tapping over the median nerve reproduces/exacerbates symptoms, the�Phalen�s Maneuver/Prayer Sign, performed by bringing the hands together, with wrists flexed, and is repeated in reverse with the wrists extended, for at least 60 seconds, and is considered positive if tests reproduce/exacerbate symptoms, and the�Wringing Test, if wringing a towel produces paresthesia.
Ulnar Nerve Entrapment
Ulnar nerve entrapment is a condition where the ulnar nerve itself becomes physically trapped or pinched, resulting in symptoms of pain, numbness and weakness which extends throughout the little finger, the ulnar half of the ring finger and throughout the intrinsic muscles of the hand. Symptoms or ulnar nerve entrapment ultimately involve sensory disruption in the medial two digits of the palmar and dorsal aspects of the hand. Symptoms of ulnar nerve entrapment may vary depending on the specific location of the ulnar nerve compression or impingement. These may also be classified as motor, sensory or both, depending on the location of the injury. If motor fibers are affected in the hand, all fingers, besides the thumb, may become weakened, described as general hand weakness. The most common location of ulnar nerve entrapment is within the cubital tunnel. Other forms of ulnar nerve entrapment include: cubital tunnel syndrome and tunnel of Guyon syndrome.
Cubital tunnel syndrome is identified by the compression or impingement of the ulnar nerve in the cubital tunnel at the elbow. It is considered to be the second most common entrapment neuropathy which affects the upper extremities, following carpal tunnel syndrome. Symptoms of cubital tunnel syndrome are characterized by pain and discomfort along the region of the ulnar nerve entrapment, along with sensory impairment, paresis and paresthesia.�Causes of cubital tunnel syndrome include, repetitive movements, hypothyroidism, obesity, diabetes, physical trauma or injury to the cubital tunnel, and prolonged sitting with pressure on bent elbow.
Tunnel of Guyon syndrome, or Guyon’s canal syndrome, is identified by the compression or impingement of the ulnar nerve at the wrist, particularly along an anatomical space in the wrist known as Guyon’s canal. Guyon’s canal syndrome may also be referred to as ulnar tunnel syndrome. Symptoms of tunnel of Guyon syndrome are similar to those of cubital tunnel syndrome with slight variations depending on the region of ulnar nerve entrapment.�Causes of tunnel of Guyon syndrome include, repetitive movements, long term crutch use, fracture of the hamate, a carpal bone, due to a ganglion cyst, hypothyroidism, obesity, rheumatoid arthritis and diabetes.�Orthopedic tests utilized to diagnose Guyon’s canal syndrome include the use of the�Tinel�s Sign, positive if test over the ulnar nerve at the wrist elicits symptoms, the Wartenberg Sign, positive if the 5th digit abducts when patient performs hard grip strength test or attempts to squeeze fingers together and reduced two-point discrimination in the hand.
Radial Nerve Entrapment
Radial nerve entrapment, also known as radial tunnel syndrome, is a condition caused by the compression of the radial nerve, which travels from the brachial plexus, to the hand and wrist. Healthcare professionals believe that radial tunnel syndrome occurs because the radial nerve becomes irritated or inflamed due to the friction caused by the impingement of the muscles in the forearm. Radial nerve entrapment manifests symptoms of sensory disruption in the lateral three and a half digits of the dorsal aspect of the hand. Motor�fibers may also be affected along the�posterior arm and extensor compartment of the forearm, and wrist drop may be seen. Other forms of radial tunnel syndrome include: spiral groove entrapment, where all radial nerve innervated muscles below entrapment are affected,�Saturday night palsy caused due to sleeping on your own arm and the brachioradialis & triceps reflexes are both diminished, supinator syndrome, caused by the compression at the arcade of Frohse with no change in reflexes. Posterior interosseous syndrome, or radial tunnel syndrome, also elicits no change in reflexes.
Sciatic Nerve Entrapment
Sciatic nerve entrapment is a condition caused by the compression of the sciatic nerve, the longest and largest nerve in the human body, which travels from the low back, down through the buttocks, thighs, legs and into the foot. The collection of symptoms which manifest as a result of sciatic nerve entrapment, including pain and discomfort, tingling and burning sensations, and numbness as well as weakness in the lower extremitites, is commonly known as sciatica. Sciatic nerve entrapment, or sciatica, can be caused by a variety of injuries and/or aggravated conditions which can lead to the compression of the sciatic nerve, including, but not limited to, disc herniation and spinal stenosis. However, symptoms of sciatic nerve entrapment may vary depending on the location of the compression of the sciatic nerve. Other conditions caused by the compression of the sciatic nerve include: piriformis syndrome, peroneal nerve entrapment and tarsal tunnel syndrome.
Piriformis syndrome is a condition which occurs due to the compression of the sciatic nerve as a result of the irritation or inflammation of the piriformis muscle. Symptoms of piriformis syndrome may include pain and discomfort, followed by numbness in the buttocks and down the leg. Symptoms may worsen with regular activities, such as sitting and running. Piriformis syndrome is caused by anatomic variation or due to piriformis overuse/tension. Piriformis syndrome diagnosis exams include, a positive Lase?gue test, where the healthcare professional�extends the patient�s leg passively, while the patient is lying supine,�test is positive if the maneuver is limited by pain, and through the use of tenderness and palpable tension in piriformis muscle which elicits symptoms.
Peroneal nerve entrapment is a condition which occurs when the peroneal or the fibular branch of the sciatic nerve are compressed at the fibular head. Tinel�s sign may be present at the fibular region of the head and/or neck. Peroneal nerve entrapment generally affects the common peroneal nerve, therefore, motor and sensory symptoms may manifest, including, weakness of the ankle dorsiflexion and eversion, or the tibialis anterior. Other symptoms of peroneal nerve entrapment may include sensory disruption on the dorsum of the foot and lateral aspect of the calf. Common peroneal nerve entrapement at the fibular head is the most common nerve entrapment syndrome in the lower extremities.
Tarsal tunnel syndrome, also known as posterior tibial neuralgia, is a condition caused by the compression of the tibial nerve as it travels through the tarsal tunnel, found along the region of the inner leg, posterior to the medial malleolus, or the bump on the inside of the ankle. Tarsal tunnel syndrome can manifest symptoms of pain and discomfort, burning or tingling sensations, and numbness along the big toe and the first three toes. However, symptoms may vary slightly depending on the area of compression, where the entire foot may manifest the symptoms previously described. Other symptoms associated with posterior tibial neuralgia include sensory changes in the sole of the foot. Tinel�s sign may be present with percussion posterior to the medial malleolus. The exact cause of tarsal tunnel syndrome may be difficult to determine and it is essential to receive a proper diagnosis to determine the source of the symptoms.
Radiculopathy
Radiculopathy is a mononeuropathy,�a condition that impacts only a single nerve or nerve group outside the brain and spinal cord, which affects the movement of or sensation in one specific area. It is often associated with neuropathy involving spinal nerve roots and presents as changes in sensory and/or motor function affecting a single or a few nerve root level(s). The most common types of radiculopathies include: sciatica and cervical radiculopathy. The most prevalent causes of radiculopathy include, disc herniation, osteophytes, spinal stenosis, trauma, diabetes, epidural abscess or metastasis, nerve sheath tumors, such as schwannomas and neurofibromas, Guillain-Barre? syndrome, Herpes Zoster, or shingles, Lyme disease, cytomegalovirus, myxedema and/or thyroid disorder, and idiopathic neuritis.
Narrowing down some of the most common causes of radiculopathy, symptoms can manifest due to disc herniation which most commonly affects the nerve roots along the C6, C7, L5 & S1 vertebrae of the spine, spinal stenosis and lumbar stenosis which may produce neurogenic claudication, and pain and weakness with ambulation. Cervical stenosis may present with mixed radiculopathy and myelopathy due to long tract involvement. Symptoms may also manifest due to trauma, because it may lead to compression, trauma or avulsion of the nerve roots, diabetes, which is most�likely to cause a polyneuropathy, but mononeuropathy is possible, and Herpes Zoster, or shingles, most often on the trunk, accompanied by vesicular lesions in a single dermatome. If pain persists past vesicular regression, radiculopathy may instead be considered post-herpetic neuralgia.
Patients with a history of radiculopathy will often complain of burning pain or tingling sensations which radiates or shoots down an affected area in a “dermatomal” pattern. Occasionally, patients will complain of motor weakness, however if onset is recent, there is often no motor involvement. The diagnosis of radiculopathy can depend on a variety of exams.�Most often, hypoesthesia may be present in the affected dermatome level. It’s recommended to�evaluate for pain, as light touch can be difficult for these patient�s to distinguish. Fasciculations and/or atrophy may be seen if radiculopathy is chronic, due to the lower motor neuron being compressed or impinged. Motor weakness may be seen in muscles innervated by the same root level. Orthopedic tests for the diagnosis of radiculopathy may include: the straight-leg raise test (SLR), where pain between 10 to 60 degrees likely indicates nerve root compression, the�Well-leg raise/Crossed straight-leg raise test (WLR), where if positive, 90 percent specificity for L/S nerve root compression may be present, the Valsalva Maneuver, where its considered positive if there is an increase in radicular symptoms, and spinal percussion, where pain may indicate metastatic disease, abscess or osteomyelitis.
Specific radiculopathy patterns may also develop as a result of different regions being affected. Radiculopathy along the T1 can cause Horner�s syndrome, a combination of symptoms caused by the disruption of a nerve pathway from the brain to the face and eye on one side of the body. This is due to its effect on cervical sympathetic ganglia, includind ptosis, miosis, anhidrosis. Radiculopathy below the L1, can cause Cauda Equina syndrome, a condition caused by damage or injury to the bundle of nerves found below the end of the spinal cord, known as the cauda equina. This type of radiculopathy may manifest symptoms of saddle anesthesia, sensory loss in the S2-S5 distribution, urinary retention or overflow incontinence, constipation, decreased rectal tone or fecal incontinence, and loss of erectile function. Individuals with these signs and symptoms must be referred for emergency care immediately to prevent permanent dysfunction.
Other patterns of neuropathy can include the cape/shawl distribution of symptoms, identified by an intramedullary lesion, such as syringomyeli, intramedullary tumor and central cord damage. Stocking and glove distribution of symptoms may manifest as a result of diabetes mellitus,�B12 deficiency, alcoholism and/or hepatitis,�HIV, and thyroid dysfunction and/or myxedema.
The cape/shawl pattern of neuropathy is characterized by symptoms occurring due to an intramedullary lesion, such as a tumor, syringomyelia or a hyperextension injury in patient with C/S spondylosis. It can also be characterized by loss of pain and temperature sensation in C/T dermatomes because of the arrangement of the lateral spinothalamic tract. The stocking and glove pattern may progress gradually depending on its specific stage. It can also be characterized as a symmetrical polyneuropathy, where the feet and legs are generally affected first, followed by the hands and arms. A vibration-like sensation in the smallest toes are also typically the first to go and the neuropathy symptoms may progress across the foot to the big toe and then upward through the ankle and leg, then hands, arms and finally to the trunk if the condition becomes severe. The most likely cause of this pattern may be attributed to diabetes mellitus, but other possible causes include, B12 deficiency, alcoholism, HIV, chemotherapy treatment, thyroid dysfunction and multiple other causes.
Diabetic Neuropathy
Diabetic neuropathy is medically defined as a collection of nerve damaging disorders associated with diabetes. These conditions are believed to occur as a result of a diabetic microvascular injury involving the small blood vessels, known as the vasa nervorum, which supply the nerves. Additionally, macrovascular conditions have also been considered to accumulate and cause diabetic neuropathy.�Diabetic neuropathy often presents as a polyneuropathy, or the simultaneous damage or disease of many peripheral nerves throughout the body, but it can also present as a mononeuropathy, usually with acute onset. Diabetic neuropathy most commonly affects the CN III, femoral and sciatic nerves. Diabetic neuropathy can affect all peripheral nerves, including the sensory neurons, motor neurons and, although rarely, the autonomic nervous system. As a result, diabetic neuropathy can affect all organs and systems, as these are all innervated. Diabetic neuropathy can manifest into a wide array of symptoms, including, but not limited to, pain, burning or tingling sensations, numbness, dizziness and trouble with balance.
Demyelinating Neuropathies
Demyelinating neuropathies can be individually defined by its two types: Acute inflammatory demyelinating polyneuropathy, best known as�Guillain-Barre? syndrome, or Chronic inflammatory demyelinating polyneuropathy.�Guillain-Barre? syndrome, abbreviated as AIDP, is identified as a rapid-onset muscle weakness caused when the immune system damages, harms or destroys the peripheral nervous system. Onset has been reported by around one to two weeks following viral infection with progressive weakness, loss of DTRs/areflexia, paresthesia in the hands and feet, more motor involvement than sensory, potential autonomic fiber involvement, elevated CSF protein, and EMG/NCV studies indicating demyelination.�Guillain-Barre? syndrome may require treatment with plasmapheresis or IV Ig therapy.�Chronic inflammatory demyelinating polyneuropathy, abbreviated as CIDP,�is identified as an acquired immune-mediated inflammatory disorder of the peripheral nervous system which appears similar to AIDP but does not follow infection. Symptoms must be present for at least 8 weeks for this diagnosis to be considered positive.�Anti-inflammatory treatments may help treat CIDP.
The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Sciatica
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
The vast array of symptoms caused by neuropathy, also known as peripheral neuropathy, reflect the fact that it may be caused by an equally broad range of ailments involving disease and damage to peripheral nerves.
Signs and Symptoms of Neuropathy
Depending on the reason and unique to each patient, signs and symptoms of neuropathy can include:�pain; tingling, burning or prickling sensations; increased sensitivity to touch; muscle weakness or wasting;�temporary or permanent numbness; paralysis; dysfunction in glands or organs; or impairment in urination and sexual functioning.
Such signs and symptoms are dependent on whether autonomic, sensory, or motor nerves, as well as a combination of them, are ultimately affected. Autonomic nerve damage can influence physiological functions like blood pressure or create gastrointestinal problems and issues. Damage or dysfunction in the sensory nerves may impact sensations and sense of equilibrium or balance, while harm to motor nerves may affect movement and reflexes. When both sensory and motor nerves are involved, the condition is known as sensorimotor polyneuropathy.
Diabetic Neuropathy Symptoms
Diabetic peripheral neuropathy, which affects between 12 and 50 percent of individuals with diabetes, is one of the most common types of neuropathy. Many times, symptoms include a gradual change in sensation, as well as pain and weakness in the feet and, although less commonly, the hands. As the neuropathy develops further, it can lead to a loss of sensation in the affected regions.
This lack of feeling raises the odds of harm to the affected areas, explains Matthew Villani, doctor of podiatric medicine at Central Florida Regional Hospital at Lake Mary. Without the pain to signal when there’s an issue, individuals with diabetic neuropathy may allow modest abrasions or blisters on their feet, for instance, to fester as sores or ulcers. “The ulcers can become infected since they are open wounds, which can also progress to bone infection. Unfortunately, it frequently requires amputations if it does progress to that point”, states Dr. Matthew Villani.
Chemotherapy-Associated Neuropathy Symptoms
Cancer patients may suffer with neuropathy induced by chemotherapy as well as by other drugs and/or medications used to treat the disease. Symptoms can include intense pain, impaired movement, changes in heart rate and blood pressure, issues with balance, difficulty breathing, paralysis, and even organ failure. After chemotherapy is done, the symptoms frequently abate swiftly, but occasionally they last more, or these may not go away at all.
HIV- and AIDS-Associated Neuropathy Symptoms
Individuals being treated for HIV or AIDS can develop neuropathy from effects of the virus and the drugs and/or medications used to treat it as well. Common symptoms include stiffness, burning, prickling, tingling, and loss of feeling in the toes and soles of their feet. Sometimes the nerves in the fingers, hands, and wrists are also affected. The drugs Videx (didanosine), Hivid (zalcitabine), and Zerit (stavudine) have been most commonly associated with neuropathic symptoms.
Inflammation-Associated Neuropathy Symptoms
Inflammation caused by infections, like herpes zoster (also known as shingles), Lyme disease, or hepatitis B and hepatitis C, may lead to neuropathy, as may inflammation caused by autoimmune disorders, such as vasculitis, sarcoidosis, or autoimmune disease. In such situations, the signs and symptoms generally include burning and tingling sensations or numbness.
Other Causes of Neuropathy Symptoms
Additional causes of neuropathy and associated signs and symptoms include metabolic disorders, such as hypoglycemia or kidney failure; autoimmune disorders, such as rheumatoid arthritis, lupus, Sjogren’s syndrome, and Guillain-Barr� syndrome; toxicity; hereditary disorders, such as Charcot-Marie-Tooth disorder; hormonal disorders; alcoholism; vitamin deficiencies; physical trauma or injury; compression; and repetitive stress. In addition, many individuals may experience idiopathic neuropathy signs and symptoms, meaning that healthcare professionals may not know the reason for their neuropathy.
Dr. Alex Jimenez’s Insight
Neuropathy can be caused by a variety of injuries and/or aggravated conditions, often manifesting into a plethora of associated signs and symptoms. While every type of neuropathy, such as diabetic neuropathy or autoimmune disease-associated neuropathy, develops its own unique group of signs and symptoms, many patients will often report common complaints. Individuals with neuropathy generally describe their pain as stabbing, burning or tingling in character. If you experience unusual or abnormal tingling or burning sensations, weakness and/or pain in your hands and feet, it’s essential to seek immediate medical attention in order to receive a proper diagnosis of the cause of your specific signs and symptoms. Early diagnosis may help prevent further nerve injury.
What are the Common Signs and Symptoms of Neuropathy?
“Although there’s a wide array of signs and symptoms associated with neuropathy, the type of pain that people encounter may be common in many aspects of the disorder”, notes Vernon Williams, MD, a sports neurologist and director of the Center for Sports Neurology and Pain Medicine at Cedars-Sini Kerlan-Jobe Institute in Los Angeles. “The character and quality of neuropathic pain will often be pain that is burning or electric in character.” Furthermore, he describes that the pain will frequently be associated with different symptoms, like paresthesia, or a lack of normal sensation associated with pain; allodynia, or a painful reaction to a stimulus that wouldn’t normally trigger pain signals; and hyperalgesia, or a striking or severe pain in response to a stimulus that normally causes moderate pain.
How is Neuropathy Diagnosed?
If you think you’re having any of the above neuropathy signs and symptoms, consult a healthcare professional. A number of tests can be done to diagnose neuropathy. “There are certain patterns of complaints that indicate neuropathy,” stated Dr. Williams, “so taking down a patient’s history which includes a description of these complaints is an important first step.”
“After that, your healthcare professional can perform a physical evaluation, including checking motor and sensory function, assessing deep tendon reflexes, as well as looking for signs and symptoms like allodynia and hyperalgesia,” Williams says. “Then we can even perform electrodiagnostic testing; the most common being electromyography and nerve conduction testing, where we can stimulate nerves and document responses, calculate the rate at which signals are being transmitted and see whether there are some areas where nerves are not transmitting signals normally,” Williams continues.
With needle tests, Williams states, “We can put modest needles into human muscles, and, according to what we see and listen together with all the needle in the muscle, we get details about the way the nerves supplying those muscle tissues are functioning. There are a number of unique tests that could be handy to identifying neuropathy, in addition to localizing where the abnormality is the most likely to be coming from”, concluded Dr.�Vernon Williams.
Often, blood tests may test for elevated blood glucose to see whether your neuropathy signs and symptoms could possibly be associated to type 2 diabetes, nutritional deficiencies, toxic elements, hereditary disorders, and evidence of an abnormal immune response. Your healthcare professional may also do a nerve biopsy, which normally involves removing a small segment of a sensory nerve to search for abnormalities, or even a skin biopsy to see if there’s a reduction in nerve endings.
To give yourself the best chance of an accurate diagnosis as well as relief from your neuropathy signs and symptoms, be prepared to describe everything you are experiencing in detail, even when you experience them, how long an episode persists, and the amount of pain, discomfort or loss of sensation or movement you experience. The more specific you are on the signs and symptoms you’re experiencing, the easier it’ll be for your doctor to understand what’s happening. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Sciatica
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
Neuropathy affects about 8 percent of individuals over the age of 55. Your nervous system is composed of 2 parts: the central nervous system and the peripheral nervous system. The nerves of your peripheral nervous system transmit messages between your central nervous system, that is your brain and spinal cord, along with the rest of the body.
These nerves regulate a massive range of functions throughout the body, such as voluntary muscle movement, involving the motor nerves, involuntary organ action, through the autonomic nerves, and also the perception of stimuli, involving the sensory nerves. Peripheral neuropathy, which is often simply referred to as “neuropathy,” is a state that happens when your nerves become damaged or injured, often times simply disrupted. It’s estimated that neuropathy affects roughly 2.4 percent of the general populace and approximately 8 percent of people older than age 55. However, this quote doesn’t include people affected by neuropathy caused by physical trauma to the nerves.
Types of Neuropathy
Neuropathy can affect any of the three types of peripheral nerves:
Sensory nerves, which transmit messages from the sensory organs, such as the eyes, nose, etc., to your brain;
Motor nerves, which track the conscious movement of your muscles; and
Autonomic nerves, which regulate the involuntary functions of your own body.
Sometimes, neuropathy will only impact one nerve. This is medically referred to as mononeuropathy and instances of it include:
Ulnar neuropathy, which affects the elbow;
Radial neuropathy, which affects the arms;
Peroneal neuropathy, which affects the knees;
Femoral neuropathy, which affects the thighs; and
Cervical neuropathy, which affects the neck.
Sometimes, two or more isolated nerves in separate regions of the body can become damaged, injured or disrupted, resulting in mononeuritis multiplex neuropathy. Most often, however, multiple peripheral nerves malfunction at the same time, a condition called polyneuropathy. According to the National Institute for Neurological Disorders and Stroke, or the NINDS, there are over 100 kinds of peripheral neuropathies.
Dr. Alex Jimenez’s Insight
Neuropathy is medically defined as a disease or dysfunction of one or more peripheral nerves, accompanied by common symptoms of pain, weakness and numbness. The peripheral nerves are in charge of transmitting messages from the central nervous system, the brain and the spinal cord, to the rest of the body. Neuropathy can affect a wide array of nerves. It is also associated with numerous underlying medical conditions and it has been reported to affect approximately 20 million individuals in the United States alone. While physical trauma, infection or exposure to toxins can cause neuropathy, diabetes has been considered to be the most common cause for neuropathy.
Causes of Neuropathy
Neuropathies are often inherited from birth or they develop later in life. The most frequent inherited neuropathy is the neurological disease Charcot-Marie-Tooth disease, which affects 1 in 2,500 people in the USA. Although�healthcare professionals are sometimes not able to pinpoint the exact reason for an acquired neuropathy, medically referred to as idiopathic neuropathy, there are many known causes for them, including: systemic diseases, physical trauma, infectious diseases and autoimmune disorders.
A systemic disease is one which affects the whole body. The most frequent systemic cause behind peripheral neuropathy is diabetes, which can lead to chronically high blood glucose levels that harm nerves.
A number of other systemic issues can cause neuropathy, including:
Kidney disorders, which permit high levels of nerve-damaging toxic chemicals to flow in the blood;
Toxins from exposure to heavy metals, including arsenic, lead, mercury, and thallium;
Certain drugs and/or medications, including anti-cancer medications, anticonvulsants, antivirals, and antibiotics;
Chemical imbalances because of liver ailments;
Hormonal diseases, including hyperthyroidism, which disturbs metabolic processes, potentially inducing cells and body parts to exert pressure on the nerves;
Deficiencies in vitamins, such as E, B1 (thiamine), B6 (pyridoxine), B12, and niacin, that can be vital for healthy nerves;
Alcohol abuse, which induces vitamin deficiencies and might also directly harm nerves;
Cancers and tumors that exert damaging pressure on nerve fibers and pathways;
Chronic inflammation, which can damage protective tissues around nerves, which makes them more vulnerable to compression or vulnerable to getting inflamed and swollen; and
Blood diseases and blood vessel damage, which may damage or injure nerve tissue by decreasing the available oxygen supply.
Additionally, if a nerve suffers from isolated bodily injury, it can become damaged, resulting in neuropathy. Nerves may suffer a direct blow that severs, crushes, compresses, or stretching them, even to the point of detaching them from the spinal cord. Common causes for these injuries are automobile accidents, falls, and sports injuries.
Nerve damage can also arise from powerful pressure on a nerve, like from broken bones and poorly fitted casts. Prolonged pressure on a nerve can also cause neuropathy, as in carpal tunnel syndrome, which occurs when the median nerve at the wrist becomes pinched. Also, persistent physical stress could inflame muscles, tendons, and ligaments, placing substantial pressure on the nerves.
Numerous infections from bacteria and viruses can lead to neuropathy by attacking nerve tissues directly or indirectly, for instance:
HIV
Shingles
Epstein-Barr virus
Lyme disease
Diphtheria
Leprosy
In addition, various autoimmune disorders, in which the body’s immune system attacks and destroys body tissue that is healthy, may result in nerve damage, including:
Peripheral neuropathy may result in several complications, as a result of disease or its symptoms. Numbness from the ailment can allow you to be less vulnerable to temperatures and pain, making you more likely to suffer from burns and serious wounds. The lack of sensations in the feet, for instance, can make you more prone to developing infections from minor traumatic accidents, particularly for diabetics, who heal more slowly than other people, including foot ulcers and gangrene.
Furthermore, muscle atrophy may cause you to develop particular physical disfigurements, such as pes cavus, a condition marked by an abnormally high foot arch, and claw-like deformities in the feet and palms. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Sciatica
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
There are many different treatments for cerebral palsy available today, however each case of cerebral palsy is as unique as the individual it affects. Because cerebral palsy can ultimately affect the normal functioning of the brain, treatment approaches which enhance the connection between the brain and the body are essential. Various treatments will work for different patients. A treatment known as physical therapy, or physiotherapy, is categorized as a non-medicinal treatment of cerebral palsy with the usage of massage, exercise, heat, and other external means of treatment.
Physiotherapy can be used to help cerebral palsy patients improve motion and motor abilities. Since cerebral palsy is a physical and movement disorder that disrupts the brain’s ability to correctly control muscle movement, physiotherapy can work wonders in helping cerebral palsy patients achieve mobility. Cerebral palsy physical therapy techniques are dependent on the degree of physical limitations of the person, and what’s going to be most beneficial to the cerebral palsy patient. Chiropractic care, can also include physical therapy techniques. Because the brain is believed to be lacking proper stimulation for functioning through cerebral palsy, chiropractic care can offer proprioception of touch for the assistance of mobility for the increased sensory stimulation of the brain through spinal adjustments and manipulations.
Physiotherapy for Cerebral Palsy
Cerebral palsy is the most common physical disability in children and it also represents the most frequent diagnosis in children who receive physical therapy. The harshness of limitations in gross motor function among children with cerebral palsy varies greatly, as some can walk without helping devices while some must use battery-powered wheelchairs. Physical therapists help children discover better ways to balance and move, as well as learn to walk, use their wheelchair, stand up with help, or go up and down stairs safely. The physical therapists engaged in physiotherapy reduce further growth of musculoskeletal problems by preventing muscle weakening, deterioration, and contracture during the suitable physiotherapy methods.
Physiotherapy usually consists of a couple kinds of treatment and helps a cerebral palsy patient to improve their gross motor abilities. Motor abilities that utilize the big muscles in the body, such as those in the arms and legs, are called gross motor abilities. This kind of physical therapy can help improve a cerebral palsy patient’s balance and motion.
Physical therapy for cerebral palsy patients consists of activities and education to enhance flexibility, strength, mobility, and function. A physical therapist also designs, modifies, and orders elastic gear to be used in the rehabilitation. Physical therapy can take place in clinics, hospitals, schools, and ought to continue in the home through a workout program. Physical treatment for cerebral palsy patients won’t be effective without an ongoing daily home program.
Physical Therapy Methods for Cerebral Palsy
A physical therapy program must include lots of exercises that include stretching, strengthening, and positioning. To elongate the muscles, the arms and legs must be transferred in ways that produce a slow, steady pull on the muscles to keep them loose. Because of the greater muscle tone of the cerebral palsy patient, they tend to have tight muscles. Therefore, it’s extremely important to perform daily stretches to maintain the arms and legs limber, allowing the child to continue to move and function. Strengthening exercises work specific muscle groups to enable them to encourage your system better and increase function. Positioning requires your system to be set in a particular position to achieve long stretches. Some places help minimize unwanted tone. Positioning can be achieved in many different ways. Bracing, abduction pillows, knee immobilizers, wheelchair inserts, sitting recommendations, and handling techniques are a part of placement techniques utilized in physical therapy for cerebral palsy patients.
New methods of physical therapy for cerebral palsy patients have taken into the water. Aquatic-based rehabilitation employs the physical properties of water to either resist or help in the operation of exercises. Cerebral palsy patients undergo muscle shortening in the majority of their involved extremities and it becomes a difficult job to lengthen the affected musculature with regular stretching while needing to manage the effects that gravity has on the spastic leg or arm. In earlier times there was clinical bias against strengthening activities for this population. But, recent study findings are revealing that kids with cerebral palsy may gain from strengthening applications and that strength is directly associated with motor function. Some of the recorded advantages are optimization of neuromuscular responses, improved motor unit contraction synchrony and facilitation of maximal muscle contraction combined with a wide available selection of motion.
Physical treatment for cerebral palsy patients does not heal spasticity but can improve impairments and limitations. Physical treatment for cerebral palsy patients is an important step towards an independent lifestyle. If these changes happen only in the therapy gym, the disability remains unchanged. Therapy must improve skills to carry out meaningful tasks in everyday life. Changing the level of handicap is the ultimate aim of physical therapy for cerebral palsy.
Occupational therapy is another element of physiotherapy used for cerebral palsy patients, and it’s used for aiding in the development of fine motor skills. Fine motor skills focus on the use of smaller muscles, such as those from the face, fingers, toes, palms, and feet. Fine motor skills have been used during daily living skills such as eating, dressing, writing, etc., and are fine tuned by occupational physiotherapy.
Physiotherapy also entails picking the right sort of adaptive equipment that could enhance a cerebral palsy patient’s motor abilities. Wheelchairs, walkers, special eating utensils and other adaptive equipment supply a patient with the liberty to accomplish some tasks on their own.
Additional types of physiotherapy like language and speech therapy might also be incorporated into a cerebral palsy patient’s program. Physiotherapy in the form of language and speech therapy that enables a cerebral palsy patient to communicate more easily with other people by developing the facial and jaw muscles, enhancing speech or sign language messages, and introducing communication resources such as computers and other visual aids.
Dr. Alex Jimenez’s Insight
Cerebral palsy is a lifelong group of movement disorders with no cure. However, several treatment options can help improve the quality of life of a patient with cerebral palsy. Chiropractic care and physical therapy, or physiotherapy, are some of the most common treatment approaches utilized to help restore strength, flexibility and mobility for individuals and children with cerebral palsy, without the need for drugs/medications and surgery. Chiropractic care can help improve many aspects associated with cerebral palsy due to the stimulation of the brain through touch, using spinal adjustment and manual manipulations to enhance sensory receptors in patients with this movement disorder. A physical therapist, as well as a chiropractor, may generally recommend a series of stretches and exercises which can improve range of motion in patients with cerebral palsy. Chiropractic care and physical therapy have the ability to develop self-sufficiency in cerebral palsy patients where it was previously absent.
Chiropractic Care for Cerebral Palsy
Several other physical therapy options can also help provide some form of relief from painful symptoms for cerebral palsy patients. Chiropractic care has become a popular, alternative treatment approach which focuses on maintaining as well as improving the overall health of the body through the use of spinal adjustments and manual manipulations. Because different areas of the body can be affected in individuals and children with cerebral palsy, chiropractic care can be beneficial towards helping those limbs regains some strength, flexibility and mobility. A chiropractor who specializes in patients with cerebral palsy can also offer several rehabilitation and physical therapy stretches and exercises to achieve the desired semblance of activity from the cerebral palsy patient. Because chiropractic care utilizes touch through spinal adjustments and manual manipulations to enhance the structure and function of the brain and the body, the sensory stimulation provided by a chiropractor can promote the migration of the brain in order to help change the receptors of the brain.
Furthermore, chiropractic care can help treat other, less noticeable aspects of the motor disorder. When used as a part of a rehabilitation and physical therapy program, chiropractic care can help improve some of the more problematic symptoms associated with cerebral palsy, including muscle spasms, seizures, and leg and arm issues through touch mobility protocols. The connection between the body and the brain has long been the center focus of chiropractic care, which is why spinal adjustments and manual manipulations are commonly utilized to enhance the stimulation of the brain, the spine, the nerves and the remaining structures of the body, especially in the case of patients with cerebral palsy, where the proper stimulation of the brain is necessary in order to restore function and improve quality of life. By carefully working to restore the natural alignment of the spine, a doctor of chiropractic, or chiropractor, can improve symptoms of back pain which may often be caused by the stress being placed on the spine�in patients with cerebral palsy. The purpose of chiropractic care and physical therapy is to improve physical movement and coordination, speech, vision and intellectual development�for patients with cerebral palsy.
Physiotherapy is an integral part in the vast majority of many cerebral palsy patients’ lives. Physiotherapy has the ability to develop self-sufficiency in cerebral palsy patients in which it was previously absent. A kid with cerebral palsy can start physiotherapy in just about any age. Speak with your child’s doctor about setting up physiotherapy program today. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Sciatica
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
Children with cerebral palsy have various needs. Some children have problems with motor skills and spasticity, but normally pick up things pretty fast. Others have a full range of issues from motor skills to esophageal and respiratory problems. Since so many kids with cerebral palsy have an array of different medical needs, there isn’t one particular type of treatment which may help each and every child. Luckily, there are a number of different therapeutic remedies to select from, which range from holistic care, water therapy, and much more.
Acupuncture
Whilst generally not adopted in Western Medicine, acupuncture has been used for centuries by Asian countries and is viewed as a medicinal art. Some families with children who have cerebral palsy take their kids to an acupuncturist to try and relieve the frequent pain related to the disorder. Other kids find relief in acupuncture for painful birth injuries such as spina bifida, Erb’s palsy, and brain damage. Acupuncture uses needles to ease pain, often instead of medication.
Aquatherapy
Aquatherapy is among the most popular and beneficials form of treatment for children with cerebral palsy, as they suffer from limb maladiess, but this might also be advantageous for children who suffer with Erb’s palsy and are trying to regain movement in their arm.
Under the supervision of a trained and experienced professional therapist, kids may gain from the strength exercise and training afforded by the anti-gravity character of a pool. In this soothing environment, a child can have a respite from some of the pain which comes with the disability (occasionally cerebral palsy causes stress on the musculoskeletal frame by simply gravity and body weight), and they can still work through the natural curative and restorative nature of water.
Behavioral Therapy (Psychotherapy)
Some birth injuries involve an intellectual disability that impacts how kids interact in social scenarios. Other children might have had physical constraints that included them being house-bound for a long time, causing them to have a deficiency in social skills or cues. Behavioral therapy, also known as psychotherapy, allows patients to work through problems they may have within their social and mental health with a behavioral health professional.
Chiropractic Care and Massage Therapy
Children with cerebral palsy may benefit from chiropractic care and massage therapy for a few different reasons. Because some children with cerebral palsy may have experienced lots of strain or stress on their musculoskeletal system as a result of the disorder, requiring chiropractic care may ultimately be fundamental towards their proper spinal alignment as well as for their overall health and wellness.
Chiropractic care is a well-known alternative treatment option which utilizes spinal adjustments and manual manipulations to treat a variety of injuries and/or conditions associated with the musculoskeletal and nervous system, including back pain.
Another reason that a patient with cerebral palsy might need chiropractic care or massage treatment is for the basic goal of extending and stretching muscles. When muscles relax as they perform through such therapies, they are more inclined to become stronger and healthier which is needed if they are going to correctly learn how to walk. This kind of treatment isn’t generally suggested for kids suffering from spina bifida because the raw exposed nerves could be inadvertently mishandled, causing more problems.
Furthermore, chiropractic care can be used to help treat other, less noticeable aspects of cerebral palsy. The theory of chiropractic care is that by healing the central area around the spine, the extremities and other parts of the body affected by the disorder can become more normalized, allowing for improved function and quality of life. Chiropractic care can also help improve strength, mobility and flexibility in children with cerebral palsy and its associated symptoms.
Conductive Education
Some children with neurological or mobility impairment found in almost any brain-related birth trauma need help performing activities that regular people learn through daily exercise, learning, and experience. Since these children don’t often have the same sorts of experiences that non-disabled people have, conductive education is a form of special education that functions as a kind of study group for life.
Conductive education provides opportunities of every day learning experiences so that kids can have the exact same general education that non-disabled individuals do.
Hippotherapy
Using equine motion and connections with horses, children with all kinds of birth injuries could learn basic occupational and speech therapy. Hippotherapy is not therapeutic horseback riding, but rather a trained practitioner introduces the child to the horse and uses the horse to access the child in ways which were previously thought of as unconventional.
Hyperbaric Oxygen Therapy
Normally short-term treatment and frequently only experienced once or twice, Hyperbaric Oxygen Therapy is a method of fast-healing for some kids that have suffered oxygen deprivation (anoxic, hypoxic, HIE, birth asphyxia, and perinatal asphyxia). If an infant is delivered and does not breathe for the upcoming instant minutes, hyperbaric oxygen treatment is a great way to introduce a lot of oxygen into the blood stream preventing or lessening the seriousness of birth injuries such as cerebral palsy.
Occupational Therapy
Occupational therapy’s main objective is to work on creating balance, strength, and gait. An occupational therapist might consult with an orthopedic surgeon to operate on strengthening and firming muscles, in which following the occupational therapist can delegate casts and orthopedic devices which also help strengthen and form muscles. These methods are to help patients learn how to walk, and also to create control and strength to stop spasticity.
The occupational therapist also trains patients to function on decision-making, abstract reasoning, problem-solving, perception, memory, sequencing, and much more.
Play Therapy
Utilizing play with a variety of different toys in various public places, kids with all kinds of birth injuries can learn to appreciate themselves. Often children with birth injuries can feel that they’re different or that they have health issues and end up stressing about their difficulties more than having fun.
While they’re having fun in play therapy, they can learn the way to interact with other kids, learn about themselves, and to construct self-confidence.
Physiotherapy and Physical Therapy
Physiotherapy and physical therapy both operate on the rehabilitation of muscle groups. This is extremely important for children with shoulder dystocia, Erb’s palsy, Klumpke’s palsy, or Brachial Plexus palsy, and, in fact, kids suffering from these birth injuries won’t regain use of their hand or arm without physical and physiotherapy. Through this type of treatment, therapists strive to receive the perfect movement from their patients through an assortment of different challenges and exercises.
This can be like occupational therapy, though the focus is mainly on what the muscle groups are doing, and not on so many different targets like occupational therapy. A physical therapist is often like a personal trainer in a gym, training, cheering, and challenging.
Respiratory, Digestive, and Dietician Therapy
Some kids with cerebral palsy encounter respiration and esophageal problems. Consequently they can experience issues with eating, breathing, and drinking, which divides into digestive and dietician treatment, addressing what foods and drinks should be consumed. Respiratory treatment may primarily tackle breathing exercises to strengthen and optimize lung development, but may also address these other concerns.
Speech and Language Therapy
Speech and language therapy can be very important for kids with cerebral palsy and other forms of brain-related birth harm. Approximately, 1 out of every 4 patients with cerebral palsy don’t have the capability to speak. Speech and language therapy helps them to work on exercises which progress the learning of speech and get kids closer to communicating effectively.
Some speech and language therapists utilize programs that help patients understand the operation of language inside individuals, and these programs also provide communication boards using pre-formed responses so that children can get in the habit of responding with particular answers until they consider trying to verbalize these answers.
Vocational Counseling
This has many different sorts of therapists, a few children could be confused or jeopardized by visiting a lot of individuals, or, worse, by having so many people invade their home. One way of approaching treatment is by using a vocational counselor, one individual who can master several distinct types of treatment.
As vocational counselors might not have exactly the exact same depth in all of these subjects as one therapist would have regarding one subject, this might be a great first step for treatment with your little one. By getting your child to adjust to only one person interacting within their lifetime, they’re more inclined to concentrate on the subjects at hand.
Afterwards, if more obstacles and more depth is required, your kid may have more assurance in different areas (and with a few social abilities from connecting with this particular counselor) and may be able to handle other therapists more efficiently.
Yoga Therapy
Normally prescribed under the direction of an occupational or physical therapist, yoga therapy is a fantastic alternative for kids whose muscles need to be loosened or lengthened. Children with cerebral palsy suffer from particularly tight muscles, so yoga therapy helps them to work on extending and on making the muscles more limb. This type of treatment might be incorporated to other sorts of therapy, and it might also be delegated as “homework” to kids with cerebral palsy for optimal flexibility and, ultimately, optimal freedom.
Dr. Alex Jimenez’s Insight
Cerebral palsy is a lifelong set of movement disorders with no cure. However, various types of treatment options can help provide some forms of relief for individuals and children with cerebral palsy as well as help restore some function and quality of life. Because cerebral palsy can affect patients differently, people with the disorder can benefit from many different therapies, including chiropractic care and physical therapy. Chiropractic care is a popular, alternative treatment option which focuses on the diagnosis and treatment of several kinds of injuries and/or conditions, including cerebral palsy. Through the use of spinal adjustments and manual manipulations, a chiropractor can help improve strength, mobility and flexibility in people with cerebral palsy.
The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Sciatica
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
Chiropractic care, recognized as a complementary or alternative health practice in the U.S., is becoming a sought after treatment for pain control in children and adults, alike. Chiropractic interventions are used to improve forms of musculoskeletal pain, including low back, shoulder, neck, headaches, hand and foot problems, as well as for particular health conditions, such as Cerebral Palsy, fibromyalgia and attention deficit hyperactivity disorder.
The Greek word “chiropractic” means “hand practice” or therapy done by hand. Chiropractic care is a hands on approach to treatment which often centers around the adjustment to the joints and spine in a way that influences the human body’s nervous system and natural defense mechanisms for the purpose of alleviating pain and improving health and wellness.
There are 2 million children and nearly 18 million adults in the United States who’ve received chiropractic or osteopathic manipulation during a 12 month period, based on the 2007 National Health Interview Survey, or NHIS. The analysis found that children who have parents that use complementary and alternative medicine, or CAM, services are twice as likely as other children to utilize complementary health services, as well.
As a matter of fact, in 2007 the CDC National Health Statistics Report #12 indicated that rehabilitation and chiropractic services would be the next most popular form of CAM treatments used on children. CAM therapies were most widely used on children for the following purposes:
Although there is little in the way of formal studies on the effects of chiropractic care for use on individuals with Cerebral Palsy, you will find reports from the chiropractic community that demonstrated improvements for the following conditions:
Arthritis
Back pain or other problems
Breathing
Drooling (release of the TMJ-muscles)
Gait patterns
Hypertonic musculature
Joint pain or stiffness
Muscle contractures
Neck pain or other problems
Pain and tension
Scoliosis or curvature of the spine
Seizures
Sleep difficulties
Other musculoskeletal conditions
Simply explained, the brain communicates with the body. Chiropractic care is established in improving the manner in which brain control and muscles work together. The neuromuscular system sends messages from your brain, down the spine and in the nerves. When there’s interference, the body isn’t able to be effective.
Chiropractic intervention aims to enhance the structural facets of the body to clear the pathway for the brain to communicate with the nerves. This can result in improved strength, balance, flexibility and coordination abilities, especially in the extremities. One intervention does not fix all, instead the intervention chosen and the location of treatment are relative to the symptom being addressed. Since Cerebral Palsy affects people differently, assorted chiropractic treatment methods are utilized to address specific issues.
History of the Evolution of Chiropractic Care
Launched in Davenport, Iowa in the late 1890s, chiropractic care has been rooted in holistic notions that, for several decades, rendered the practice controvesial. The contention of those in the chiropractic community that the only source of pain has been spinal dysfunction called vertebral subluxation has been contested by conventional medical practitioners. Additionally, physicians and other critics have questioned the capability of chiropractic care in treating ailments which aren’t connected to the neuromusculoskeletal system.
Although chiropractic care recently has gained acceptance by the medical community because of manual therapy due to its ability to alleviate pain, the practice remains rooted in spinal adjustments and manipulations as a gateway to enhancing a person’s overall health and wellness. Currently, there are chiropractors in practice which are purists, and others that think scientific research has a place in chiropractic care.
There is evidence that chiropractic care can be helpful to children with Cerebral Palsy. Some research suggests that kids that received spinal adjustments may sit and stand with more ease. Also, the research indicated that some children became active, digested food better, slept more peacefully, and appreciated improved coordination following chiropractic care.
In the publication, “Chiropractic Care of Special Populations,” writer Robert D. Mootz reports on some special treatments which have been reported to have enhanced some circumstances of Cerebral Palsy:
Adjustment of the atlanto-occipital subluxations helped with children who had difficulty with sleeping, personality disturbances, and hypertonic musculature.
Upper cervical spine adjustments created clinical improvements in a 5-year-old male with quadriplegic Cerebral Palsy.
Adjustments can be helpful in cases of cranial dysfunction in the sphenobasilar junction in children who have a history of birth trauma or head injury where motor tracts of the medulla may be compromised.
Manual release of the TMJ-related muscles, such as the masseter and temporalis, may ease excessive drooling.
Myofascial release may be used to assist in decreasing the severity of spinal distortion and aid in stabilizing gait patterns in children with spastic Cerebral Palsy who have muscle contractures in the paraspinals, lateral thigh muscles, lower extremity abductors, Achilles tendons, and wrist extensors.
What is Chiropractic Care?
Chiropractic care is considered a manipulative and body-based therapeutic system which has an impact on the human body’s systems and structures, such as the bones, joints, soft tissues, and neuromuscular system, which are manipulated beyond their passive range of movement and with proper use of force. It is a treatment which uses the adjustment and manipulation of the spine and joints to ease pain. The spinal manipulations are made using the chiropractor’s hands, and therefore are known as “adjustments.” The dysfunctions or abnormalities at the joints of the spine are known as “vertebral subluxations.” Vertebral subluxations are a group of symptoms in the spine.
Many people seek chiropractic care to address:
Neck pain
Back pain
Spinal discomfort
Inability to sit or stand
Chiropractic care is determined by three main concepts, which are:
Reductionism: attributing the cause of pain or illness to vertebral subluxation alone.
Conservatism: committing to non-invasive interventions as a mode of treatment.
Homeostasis: emphasizing self-healing.
These three notions are heeded by both traditional, purist chiropractors and “mixers” chiropractors which are influenced by evidence-based scientific findings and fundamentals. Mixers can introduce other treatments to bring relief to people including:
Ice and heat
Vitamins and nutritional supplements
Homeopathic or holistic medicine
Herbs
However,� all chiropractors use the simple tenet of this profession, vertebral subluxation, as the centerpiece of all clinical treatments, together with a combination of other interventions.
Which are the Advantages of Chiropractic Treatment, also When is Care Advised?
Although there have been several studies that assess the impact of chiropractic care on children with Cerebral Palsy, several of which have been completed have shown that children respond well to treatment.
In a 2006 study, initially published in the Journal of Vertebral Subluxation Research suggested that kids with Cerebral Palsy that were determined to have subluxations showed improvement in their mobility after one month of chiropractic care. One child demonstrated improvement in her ability to sit up, walk, and ambulate following 22 spinal alterations.
In a research published by the Journal of Pediatric, Maternal & Family Health, it was determined that a 2-year-old boy with Cerebral Palsy was relieved of many symptoms that interfered with his freedom and ability to sleep. Following seven months of care, he was able to pull himself into an upright position and was sleeping frequently. Although, other characteristics of his condition, such as uncontrolled movements, persisted.
Individuals in several walks of life, by the elderly to children, seek chiropractic care. Many indicate that they recognize significant relief from spinal adjustments and manual manipulations. However, individual advantages are dependent on a child’s condition at the beginning of care; parents with the advice of the child’s primary care physician, will want to ascertain how chiropractic care fits in with a child’s overall treatment program.
What Happens During Chiropractic Care?
At the start of a chiropractic appointment, a complete medical history will be taken to acquaint the practitioner of the symptoms that an individual is coping with. From there, a series of exams and evaluations will happen.
Among the very first of these will be an X-ray, which ought to offer some valuable information about the condition of a child’s spinal column. This information often includes:
Curvature
Misalignments (subluxations)
Abnormalities
Muscle tone changes
Tissue abnormalities
A physical examination will assist the chiropractor to find a child’s source of pain. When the assessment is finished, the chiropractor will recommend a plan of treatment, which is very likely to include adjustments. If they suspect that another condition is causing pain or discomfort, a referral will be issued.
A chiropractor will utilize several techniques to ascertain in which a subluxation, or misalignment, is present. The most frequent procedures which will help the chiropractor decide which adjustments will be necessary to bring relief to a child are:
Static palpitation � when a practitioner uses his or her hands to detect signs of misalignment
Motion palpitation � when a doctor moves bones to separate them
Leg check � moving the legs to reveal spinal subluxation
An adjustment is finished when the joints of the spine are moved past the point at which they would normally proceed in a way where it does not damage or dislocate the joints. Doing so will require the chiropractor to use gentle force and educated expertise to finish the moves. Notice, untrained individuals should not attempt to perform these procedures on another person.
There are several specific kinds of adjustment which can be used to aid a child. They include, but are not limited to:
Diversified movement � full spine manipulation
Activator technique � using a device to adjust the spine
Cox technique � low-force adjustment
Gonstead technique � using a specific path to adjust the spine
These adjustments will be created over a period of time, comprising of several appointments, to help a patient recover motion and minimize discomfort.
Chiropractors most often operate private practices, but often, their services can be found in other medical settings such as:
Hospitals
Physician�s office
Clinics
Assisted living centers
Residential facilities and nursing homes
Who Offers Chiropractic Care?
Chiropractors offer a wide range of services and, based on where an individual resides, the scope of their duties may vary. In a small number of countries, chiropractors are allowed to perform minor surgeries and write prescriptions, for others, these functions are prohibited.
Internationally, demands to practice as a chiropractor vary. In the United States, a chiropractor needs to complete a professional degree program. Accredited programs require an applicant to complete 90 credit hours of undergraduate instruction, and many others require students to earn a bachelor’s degree.
Doctors of chiropractic, nevertheless, must complete an intensive program that revolves around healing arts that many consider to be challenging in a medical college. A doctor of chiropractic, or chiropractor generally pursues a bachelor’s of science degree prior to attending a chiropractic college.
Bachelor’s degree coursework contains:
Biology
Chemistry
Physics
Nutrition
Psychology
Anatomy
Physiology
Chiropractic college curriculums include further coursework, in addition to hands-on instruction and clinical study that lasts four or five years.
Licensure is required to practice in the USA. Most states will grant licenses for those who have successfully completed an accredited program and passed an examination administered by the National Board of Chiropractic examiners.
Healthcare practitioners that choose to provide additional services such as acupuncture or massage might have to pursue other courses of research and certificates if they intend to supply these services personally.
Are There Special Considerations or Risks for Chiropractic Therapy?
Generally, chiropractic care is considered safe. In the hands of a fully-qualified practitioner, chiropractic care may cause some mild discomfort, but it should not be painful. If a child complains that treatment is extremely uncomfortable, or painful, a parent must inquire into the issue by requesting the chiropractor why this is happening. If a parent is uncomfortable with the answer, he or she should seek the care of another healthcare practitioner or chiropractor.
Often throughout the process of making an adjustment, a child and their parents will hear a popping noise. This occurs when gases escape from fluids that surround joints. This is similar to popping that happens in the joints of the feet or ankles; it isn’t indicative of a critical illness. Also, to the untrained eye, the quick and quirky alterations could appear alarming to people unfamiliar with chiropractic interventions.
Tips for Choosing a Chiropractor
According to the National Center for Complementary and Alternative Medicine, or NCCAM, a division of the National Institute of Health, which is considered the lead agency for scientific research on diverse medical and health care practices, when choosing a chiropractor, the individual must inquire:
Their experience in coordinating care with conventional health care providers
Their experience in delivering care to children
Their education, training and licensure
You also need to inquire about their experience and expertise in treating children, or adults, with Cerebral Palsy.
NCCAM also recommends that when considering an alternative and complementary wellness approach for a child:
Make sure the child has an accurate diagnosis from a licensed healthcare provider.
Understand the potential risks, benefits and effectiveness of the specific strategy.
Discuss any and CAM approaches with the child’s primary care physician before agreeing to this therapy protocol, particularly with the physician that abroad your child’s care plan so that there’s not any conflict with other kinds of therapy.
Never use any health product or practice which hasn’t been shown safe and effective to substitute or delay conventional care or prescribed drugs.
When a health care practitioner indicates a CAM approach, don’t increase the dosage or length of this treatment beyond what is advocated without professional approval.
Discuss any and all concerns about the effects of a CAM strategy with your child’s main health care provider.
To ensure coordinated and secure care, inform all your child’s healthcare providers about any CAM strategy your child uses, giving them a full picture of what you do to manage your child’s wellbeing.
Dr. Alex Jimenez’s Insight
More so now, than ever before, people are turning to alternative and complementary medicine to treat a variety of injuries and/or conditions, especially Cerebral Palsy. An increase of CAM treatment methods can offer more therapy options for people or children with CP. Although CP has no cure, a person with Cerebral Palsy can benefit from alternative and complementary medicine. Chiropractic care has been demonstrated to help improve other symptoms associated with CP. Furthermore, chiropractic care used together with physical therapy and rehabilitation can help restore some strength, mobility and flexibility for people and children with Cerebral Palsy.
The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.
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Etiology
