Restaurant work takes a toll on the body with the repetitive moving, bending, twisting, reaching, prepping, cutting, serving, and washing. This is especially true of the shoulders, arms, and hands. When individuals avoid treating their aches and pains, this can lead to chronic pain conditions that can cause severe and permanent damage to the musculoskeletal system. Chiropractic can alleviate the tingling and pain by removing the compression, re-stretching/lengthening, and strengthening the muscles and nerves to perform at optimal levels.
The arms and hands are designed to accomplish various tasks. When functioning normally, tasks can be performed flawlessly. Repetitive/Overuse or trauma can cause nerve compression, stiffness, and pain, decreasing function and affecting daily routines.
Carpal tunnel syndrome is one of the most common disorders that affect the arm and hands.
The carpal tunnel is a space where a nerve and several tendons pass. If the nerve becomes compressed, it can cause numbness, tingling in the fingers, pain, and muscle weakness, making it difficult to grip objects.
Discomfort and pain start gradually in one or both hands.
It can cause tightness and pain in the shoulder, forearm, wrist, and hand.
It can also cause numbness in the palm and fingers.
Avoid scheduling multiple consecutive long shifts for jobs that require repetitive hand motions.
Sticking To A Meal Plan
Identify personal motivation to stick to a meal plan other than improving body composition. To keep motivation high, individuals need to identify other reasons behind goals. This could be:
Saving money from the food budget.
Spending time with loved ones preparing a healthy recipe.
Setting an example to family and friends.
It can be whatever motivates you.
Reassess and tweak the meal plan as needed.
Nutritional needs or dietary preferences change.
Meal planning should be a dynamic process.
Don’t get disappointed if not going as planned.
Refocus by making changes as needed.
Gentzler, Marc D, and Janan A Smither. “Using practical ergonomic evaluations in the restaurant industry to enhance safety and comfort: a case study.” Work (Reading, Mass.) vol. 41 Suppl 1 (2012): 5529-31. doi:10.3233/WOR-2012-0872-5529
Laperrière, Ève et al. “Work activity in foodservice: The significance of customer relations, tipping practices and gender for preventing musculoskeletal disorders.” Applied ergonomics vol. 58 (2017): 89-101. doi:10.1016/j.apergo.2016.05.013
Masear, V R et al. “An industrial cause of carpal tunnel syndrome.” The Journal of hand surgery vol. 11,2 (1986): 222-7. doi:10.1016/s0363-5023(86)80055-7
Video gaming has grown to over 150 million individuals in the United States playing. Around 60% of Americans play video games every day, with the average gamer being 34 years old. Playing video games for an extended amount of time takes a toll on the body. Individuals are experiencing the same kind of pains and aches from sitting and standing all day at work or school. Sitting positions, holding the controllers, and the different accessories can impact the nerves, muscles, and Posture. E-sports professionals understand the physical toll their bodies take with constant practice, tournaments, clinics, etc. They do cardiovascular conditioning, strength train, and stretch to improve their gaming abilities and also take into account:
Taking steps can prevent strain, injuries and minimize the risk of long-term damage. If strain and injuries are present, professional chiropractic treatment can help alleviate the pain, rehabilitate/strengthen the muscles, ligaments, tendons, and recommend exercises and stretches.
Video Gaming Posture
Proper Posture is vital to maintaining spinal as well as overall health. Poor Posture is the most common cause of back and neck pain.
Video Gaming Positions
Common gaming positions include the couch slouch where the gamer is slumped back into the couch with their feet up. This can lead to low back pain and sciatica. The full-on position is where the individual leans forward, elbows on their knees, head tilted forward, and staring up at the screen. Hours in these positions cause the neck, back, and other body areas to stiffen, generating soreness from the restricted movement. Many gamers use ergonomic gaming chairs. They have found that using the gaming chair improves Posture, eliminating the forward head and rounded shoulders. Gaming chairs can provide the health benefit of sitting correctly, reducing and eliminating neck and back tension or strain.
Injuries and Health Issues
Common musculoskeletal issues caused by excessive gaming and lack of movement include:
Elbow, arm, wrist pain
General hand pain
Carpal tunnel syndrome
The intensity of gaming can cause the shoulders to tense up and stiffen. When using the controller, the shoulders can slightly lift, building up lactic acid, interrupting blood circulation, causing an accumulation of unwanted toxins inflaming trigger points. A chiropractic massage will release tightened muscles, provide relaxation, and increase the blood flow.
Hand and Wrist Treatment
The most used body parts for video games include the hands and wrist. Individuals grip the controllers or constantly use the keyboard and mouse. No matter what form of input is used, prolonged use can cause hand and wrist injuries. Injuries include:
Hand muscle aches
Chiropractic focuses on specific areas to help treat the body through a hand and wrist massage. Advanced techniques include electrical muscle stimulation to help stimulate and loosen the muscles. A chiropractor will recommend stretches and exercises, and hand/wrist supports, guards, or special gloves to alleviate muscle pains while still playing.
Neck and Back Adjustments
Poor posture can result in a misaligned spine or back muscle spasms. During extended game sessions, pain and fatigue can begin to present. A chiropractic adjustment can realign the muscles and set them back in place. The tissue surrounding the neck may thicken and focus on a specific area. Leaning too far forward or using a heavy gaming headset can result in a forward head posture placing a constant strain on the neck. Chiropractic adjustments will loosen the tissue and release any tension. Stretches and exercises will be recommended as well.
Body composition refers to how various substances in the body are proportioned. A few examples of the components that make up the body include:
All of these components generate balance in the body. When individuals exercise, they begin to notice changes in their body composition. For individuals that exercise regularly, it is vital to track weight gain, weight loss, and changes in body composition. This is to ensure that they aren’t losing muscle mass. As individuals exercise, muscle fibers are torn. During the recovery process, muscles are rebuilt. Overtraining can lead to muscle mass reduction because the body cannot catch up and rebuild the number of muscle fibers, eventually leading to lost muscle.
Emara, Ahmed K et al. “Gamer’s Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports.” Current sports medicine reports vol. 19,12 (2020): 537-545. doi:10.1249/JSR.0000000000000787
Geoghegan, Luke, and Justin C R Wormald. “Sport-related hand injury: a new perspective of e-sports.” The Journal of hand surgery, European volume vol. 44,2 (2019): 219-220. doi:10.1177/1753193418799607
McGee, Caitlin, et al. “More Than a Game: Musculoskeletal Injuries and a Key Role for the Physical Therapist in Esports.” The Journal of orthopedic and sports physical therapy vol. 51,9 (2021): 415-417. doi:10.2519/jospt.2021.0109
McGee, Caitlin, and Kevin Ho. “Tendinopathies in Video Gaming and Esports.” Frontiers in sports and active living vol. 3 689371. 28 May. 2021, doi:10.3389/fspor.2021.689371
Zwibel, Hallie et al. “An Osteopathic Physician’s Approach to the Esports Athlete.” The Journal of the American Osteopathic Association vol. 119,11 (2019): 756-762. doi:10.7556/jaoa.2019.125
Today, we are constantly tapping, scrolling, clicking, using our hands, fingers, and thumbs on smartphones, tablets, computers, etc. Constant repetitive use has increased the development of carpal tunnel syndrome. If tingling, numbness, soreness, or electrical sensations have begun to develop in the hands, especially the index finger, thumb, or palm, carpal tunnel prevention measures can help before it becomes severe.
Carpal tunnel syndrome is the medical terminology for a pinched nerve. It is the median nerve that passes through the narrow carpal tunnel passageway of ligaments and bones at the base of the hand. This tunnel houses the median nerve and the tendons that allow the fingers to bend. The median nerve generates physical sensation in the index, middle, ring finger, and palm near the thumb. Compression of the nerve or inflammation can cause tingling, numbness, and pain in any and/or all of the hand areas. It can also cause the fingers to bend awkwardly; however, this symptom develops over time. There are so many different causes of carpal tunnel syndrome that it is almost impossible to avoid with the constant overuse/repetition of the hands.
Work – tasks, typing, mouse use, writing, scanning, etc.
Doctors recommended approach for carpal tunnel prevention is to take action at the first sign/symptom. The most effective preventative measures include:
Using a computer mouse – moving, clicking, using the scrolling wheel, etc.
Cooking – chopping, slicing, mixing, squeezing, etc.
Make sure to take frequent breaks from the motion.
Carpal tunnel is more likely to develop if the nerves and muscles are overused for a long time without stopping. When focused on a task, we often don’t realize how the repetitive motions cause strain until a sting or pinch makes us stop. Taking a hand break is essential to give the muscles, tendons, ligaments, and nerves time to relax and stay loose. The break only has to be a few minutes to be effective.
Repetitive Movements and Proper Hand Form/Posture
Repetitive hand or wrist motions in everyday activities sometimes cannot be helped. It is recommended to try to switch hands when performing the task, space it out over the day, take frequent breaks, stretch, and gently shake out the hands throughout the day. Make sure any pressure on the hands or wrists is as light as possible and evenly distributed. Keep the wrists straight or slightly bent and use light tools if possible. Proper posture is crucial for carpal tunnel prevention. Many individuals don’t realize the back, neck, and wrists are intricately connected. Poor posture like hunching over the computer, shoulders rolled forward, and forward neck posture can cause the nerves and muscles of the arm to become compressed, causing tingling, numbing, pain symptoms because they’re not properly aligned. The compression can run down the arms and affect the wrists and hands as well.
Carpal Tunnel Prevention Supportive Accessories
It is also recommended to consider integrating supportive accessories, like ergonomic keyboards, mice, wrist splints, keypad cushions, etc. These tools can support the body and keep the wrists and hands healthy, comfortable, and pain-free. Wrist splints can help by keeping the wrist in a straight, neutral position without thinking about it. This reduces stress on the area and absorbs the pressure of everyday tasks on the carpal tunnel and median nerve. Individuals can also wear the splint at night to support and train the wrist to stay straight throughout the day. Taking action before the symptoms become severe is highly recommended. Talk to a chiropractor or physical therapist for exercises, stretches, and general tips to help with carpal tunnel prevention.
A Snack and A Meal
Without proper planning, the calories an individual consumes from snacks can add up. A recent survey found that snacking contributes 586 calories for men and 421 calories for women per day. Weight loss, weight gain, and weight maintenance come down to calories in vs. calories out.
Eating snacks that are too high in calories or snacking too much can disrupt and derail health goals.
It’s essential to know what a snack consists of, what to look for on a label, and how to plan.
Snacks come in a range of calories, depending on individual goals.
For many, 100-200 calories are recommended for snacks.
Individuals that need increased calories may require a higher calorie snack.
The number of snacks eaten per day depends on individual needs and goals.
It’s best to plan and factor snacks into the overall meal plan to avoid overeating.
Bowling is a fun physical activity that is enjoyable for all ages. Today, there are college bowlers, recreational bowlers, amateur, semiprofessional, professional leagues, and tournaments worldwide. Although it might not be the first sport that comes to mind when thinking of injuries and chronic pain conditions, it can place significant stress on the muscles and tendons of the upper and lower body. It is important to know and understand how to avoid injuries.
How Bowling Injuries Happen
There are two main causes of injuries and chronic pain related to bowling. The first is poor mechanics, and the second is repetitive over-use. Both cause/develop painful symptoms that can turn into injuries that become chronic conditions. Many injuries are caused by:
Slip and fall accidents
Players dropping the ball on their feet
The majority of injuries come from overuse/repetition and improper body mechanics.
Overuse injuries result from repetitive and/or strenuous actions/movements that place profound stress on the body’s musculoskeletal system.
For example, a semi-pro and professional bowler will play fifty or more games a week. This means throwing a sixteen-pound ball for ten frames per game. When consistently repeated over and over, this can cause serious wear and tear to the body. With amateur and recreational bowlers, they don’t play as much, so they don’t experience overuse injury as much, but what they do experience is improper/poor form techniques that shift the body in non-ergonomic ways, wrong equipment like oversized/too-small shoes that can cause awkward postures and body motions, a ball that is too heavy causing an individual to overthrow and strain their arms, backs, hips, and legs. Or a ball with small finger holes that get stuck or too large, causing finger, hand, arm, shoulder pulls strains, and sprains.
Common Bowling Injuries
The most common injuries and conditions associated with bowling include:
Many of the injuries can lead to tendonitis or arthritis later in life.
Hand pain after bowling, specifically in the fingers
A clicking or popping when moving the fingers
A finger gets locked in a bent position
Rest, and no bowling is recommended. How long a rest depends on how long the symptoms have been presenting. Physical therapy, along with chiropractic exercises, can help improve finger strength. Splinting the finger could be required to improve the condition. If all fails or does not generate adequate relief, hand surgery could be optioned with a trigger finger release. The surgery allows the finger to move more freely.
This usually happens to bowlers that want to generate a lot of spin on the ball. If the thumb’s hole is too tight, it can pinch the ulnar nerve inside the thumb. If the thumb injury is not serious, rest and getting the correct ball size can correct the issue. This is where purchasing a personal bowling ball can help.
This is an injury to one or more of the ligaments in the fingers. It most often takes place in the collateral ligaments along the sides of the fingers inside the ball. The ligament/s gets stretched or torn when the finger is forced beyond its normal range of motion. Common symptoms of a finger sprain include swelling, tenderness, stiffness, and pain in the affected finger. This usually occurs from:
The weight of holding the ball with the fingers alone
A poor release
Using a ball that doesn’t properly fit the fingers
A finger sprain falls into grades on the severity of how much the ligament is stretched or torn:
Stretching or microscopic tearing.
Less than 90% of the ligament is torn.
More than 90% of the ligament is torn. Grade three sprains can be accompanied by joint instability and immobility.
A herniated disc is when the discs get injured/damaged from overuse, wear, and tear, or a traumatic injury to the spine. The disc can dry out, become less flexible, bulge out, or rupture. Bowlers are constantly:
Bending during the final approach and throw
Carrying a heavy ball
Shifting, twisting, and releasing, increasing the pressure within the discs
In bowling, the majority of herniated discs happen in the low back. The most common symptom is backaches and back pain. Lumbar herniated discs left untreated can cause sciatica.
Avoid and Prevent Injury
The best way to prevent injury is to stay aware of body position, mechanics, equipment, and what the body says.
Stretching is one of the best things to avoid injury before practicing, competing, or just playing. Stretching will increase flexibility, especially in the wrist, hand, arm, and low back.
Continually using poor techniques over and over is a perfect set-up for injury. Working with a coach will ensure the proper form. This is important when it comes to generating spin on the ball, as well as, making sure the grip does not place too much strain on the hands.
Using the right ball
The ball being used might not be the right fit for your hand or strength. The holes could be too far apart, causing strain on the fingers. Get as much information as possible and try out different styles and weights to get a comfortable feel for the right ball.
Hard-core bowlers could be overdoing it. Cutting back, and creating a balance will allow the body to recover thoroughly and not cause flare-ups.
Getting in shape
Studies show that individuals who bowl and do not exercise significantly increase the risk of a back injury than those who exercise their back and core. Bowling is not as strenuous as other sports, but it still requires the body to be able to handle the stress.
Test Body Composition
Testing body composition regularly is the best way to ensure the body stays healthy. Tracking body composition tracks Lean Mass and Fat Mass gain or loss. The information provided allows the individual to make the necessary changes to ensure they stay fit and healthy.
Diet needs to be adjusted to match the individual’s current activity level, or risk running a caloric surplus. A great way to optimize diet is to use Basal Metabolic Rate which will make sure the body is getting enough nutrients to fuel muscle growth, and lose belly fat.
Physical activity that fits the new lifestyle
Increase physical activity levels that work with current lifestyle. This does not mean performing at high levels every day. Be active on a schedule that works for you. Two days of strength training a week offer great physical and mental benefits. The key is to maintain the balance between food consumption and exercise/physical activity that fits your current lifestyle.
Almedghio, Sami M et al. “Wii knee revisited: meniscal injury from 10-pin bowling.” BMJ case reports vol. 2009 (2009): bcr11.2008.1189. doi:10.1136/bcr.11.2008.1189
Kerr, Zachary Y et al. “Epidemiology of bowling-related injuries presenting to US emergency departments, 1990-2008.” Clinical pediatrics vol. 50,8 (2011): 738-46. doi:10.1177/0009922811404697
Kisner, W H. “Thumb neuroma: a hazard of ten pin bowling.” British journal of plastic surgery vol. 29,3 (1976): 225-6. doi:10.1016/s0007-1226(76)90060-6
Miller, S, and G M Rayan. “Bowling related injuries of the hand and upper extremity; a review.” The Journal of the Oklahoma State Medical Association vol. 91,5 (1998): 289-91.
The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.
The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:
Get injured or damaged in some way; there is increased potential for various injuries.
The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:
Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:
Decreased range of motion
Fractures and Dislocations
Reduced range of motion
Soft Tissue Injuries and Amputations
Deformity with or without tissue loss/bone loss
Warmth/Heat around the area
Reduced range of motion
Fever is rare in hand infections
Loss of tissue
The texture of the skin change
Areas of tissue blackened
High-pressure Injection Injury
Muscle, tendon, ligament tears
Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.
Loss of motion
Loss of strength
Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
Exposure of structures – tendons, bones, joints, arteries, veins, or nerves
A medical examination can include a medical history and physical examination.
Past medical history
Does the patient have diabetes or arthritis?
Is the patient right or left-handed?
Extracurricular activities and hobbies
How does the patient use their hands?
How did the injury occur, mechanism of injury?
Does the patient smoke?
Visual inspection look at the injury
Sensory nerve exam feeling
Vascular exam circulation of blood supply
Muscular and tendon exam movement and strength
Bone exam broken bones or dislocated joints
A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly
Artificial Sweeteners And Muscle Gain
Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:
Fruit with nuts or nut butter
Hummus with whole-grain crackers
Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.
Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177
Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5
MedscapeReference.com. High-Pressure Hand Injury.
MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.
Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016
One area to consider is driving. When it comes to carpal tunnel syndrome pain most individuals think about keyboard typing, as the source of arm, wrist, and hand pain. This is true, but carpal tunnel can develop from:
Any repetitive motion
Bending at the wrist
Vibrations going through the wrist
Long-distance truckers, those who drive for business or regular long pleasure trips on winding mountain roads can take a toll on the muscles, tendons, ligaments of the arms and hands. Combining a regular job, stacking, scanning, lifting, and typing away most of the day, then long commutes, and weekends driving around, an individual can begin to present with arm, hand, and finger pain.
Signs and Symptoms
Carpal tunnel can sneak up when least expected. Most individuals begin to feel a burning, tingling, or numbness in the thumb and first two fingers, and for some, the palm, as well. Discomfort or pain usually presents at night and in the morning. If the condition becomes worse, individuals often feel the need to shake out the hand or wrists, trying to bring relief from the pain and tightness. It can affect one hand or both hands. The pain can continue to increase and climb up the arm. Then normal tasks like pumping gas or writing with a pen become unbearable.
Carpal Tunnel Syndrome
The median nerve controls the sensations to the palm, the thumb, and the four fingers of the hand. The nerve runs through a small passageway in the wrist called the carpal tunnel. Swelling or thickening of the tendons narrow the tight space and irritate the nerve.
There are different ways to diagnose the condition. To avoid damaging the median nerve, it is important to get a diagnosis as early as possible.
Apply pain ointment/cream before driving and keep on hand
A chiropractor is a highly trained specialist in the entire body’s musculoskeletal system. Chiropractic treatment can help avoid developing chronic pain and surgery in the future. Correcting subluxations and restoring optimal blood and nerve energy flow in the arms, hands, and rest of the body is the objective. Chiropractic investigates and treats the compression of nerves anywhere in the body, including the forearm and wrist. Realigning the spine, shoulder, elbow, and wrist, blood circulation and nerve impulses will flow freely once again. A chiropractor could also recommend:
The treatment plan will depend on each individual’s unique case and circumstances. At Injury Medical Chiropractic and Functional Medicine Clinic, we care about each individual’s situation and are committed to doing whatever it takes to alleviate the pain and get the individual back to optimal health.
Soluble and Insoluble Fiber
All plant-based foods are generally a combination of soluble and insoluble fibers. Soluble fiber dissolves in water and turns into a gel substance when it passes through the gastrointestinal tract. Foods high in soluble fiber include:
Insoluble fiber does not dissolve in water. The term roughage generally refers to this type. Roughage speeds up transition time in the digestive system. This is the basis for eating more insoluble fiber, to prevent constipation by helping food move through the system. Foods high in insoluble fiber include:
Whole wheat bread
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Savage, Robert. �Re: Carpal Tunnel syndrome and work.��Journal of hand surgery (Edinburgh, Scotland)�vol. 30,3 (2005): 331; author reply 331. doi:10.1016/j.jhsb.2005.02.007
Haas, DC et al. �Carpal tunnel syndrome following automobile collisions.� Archives of physical medicine and rehabilitation�vol. 62,5 (1981): 204-6.
Shoulder and arm pain can be debilitating, especially when there is no obvious cause or injury that needs to be treated. A rare condition known as brachial neuritiscan cause spasms along with pain down the arm, followed by numbness, tingling, and weakness. If not diagnosed and treated early, the symptoms can worsen with time. The pain experienced can be described as sharp, searing, and shooting. Brachial neuritis can be intense and disabling when it presents for hours and even days.
Utilizing a chiropractic approach, shoulder and spinal adjustments can provide relief and a faster healing/recovery from the inflammatory condition. Individuals experiencing shoulder, arm, and possible hand pain should consult with a chiropractor about a potential home and clinic treatment plan to improve their condition.
Medical History and Examination
The process of diagnosing brachial neuritis involves an individual’s medical history and physical exam. More complicated cases could require imaging studies and electrodiagnostic tests. The first steps in diagnosing the cause of shoulder and/or arm pain include:
Information will be collected on an individual’s:
Recent illnesses or injuries
How and when symptoms began
A chiropractor will palpate or inspect by feeling the neck, shoulder, and arm for irregularities. Then they will examine the range of motion, strength, and reflexes. If the individual’s history and physical exam suggest that the cause could be brachial neuritis or other condition involving the nerves, imaging studies, and diagnostic tests could be required to evaluate further.
Symptoms of Brachial Neuritis
The condition is also known as Parsonage-Turner Syndrome. It affects the brachial plexus, a set of nerves that run from the neck and upper back to the shoulders. The condition usually affects only one side of the body and presents randomly.
What happens is the nerves become inflamed.
Inflammation can be triggered through an autoimmune response. This is often the result of an infection, surgical procedure, or other internal stressors. The inflammation can lead to severe debilitating shoulder pain over a few days.
This also leads to long-term numbness, weakness in the shoulder and arm.
The pain becomes worse with movement.
Typically, the pain goes away on its own within a few days.
Numbness, weakness, or tingling in the shoulder or arm continues.
Over time the symptoms begin to worsen and, if left untreated, could lead to muscular atrophy of the arm.
The pain and weakness can make it difficult to move the arm, leading to decreased strength.
Symptoms can last up to a year or more.
This is why individuals have to find ways to strengthen their shoulder/arm despite the condition.
Treatment requires a pain management program until the pain subsides. Once the pain is manageable, chiropractic, physical therapy, exercises, and stretches could improve mobility and strength. Chiropractic can provide relief and tools necessary to prevent the worsening of symptoms. Chiropractic helps to:
Chiropractic manipulation will ensure that the nerves near the brachial plexus do not become compressed, but if they are, then chiropractic can be utilized to decompress/release them. In addition, trigger point release and massage can help alleviate the tension in the surrounding tissues of the arm and shoulder.
A chiropractor will educate the individuals on effective pain management techniques for home, including ice/heat therapy and stretching exercises. These techniques will help restore the proper alignment and flow of the spinal vertebrae, nerves, and muscle tissues, allowing the body to heal quickly, naturally, and more effectively.
Chiropractic Shoulder Pain Treatment
Feinberg, Joseph H, and Jeffrey Radecki. Parsonage-turner syndrome. HSS journal: the musculoskeletal journal of Hospital for Special Surgery vol. 6,2 (2010): 199-205. doi:10.1007/s11420-010-9176-x
Keyboards and mice come in all sorts of colors and styles, which is great but for those that work on a computer for a job, using the right type is essential to prevent injury keeping the hands, wrists, and arms healthy and moving.
Overuse can cause painful musculoskeletal disorders like:
From the beginning of this design, there was a realization that angling and splitting the keys would reduce the bending of the hands. The first split keyboard typewriter was manufactured in 1886.
The idea of splitting and angling the keys was implemented into ergonomic keyboard designs with the alphanumeric keys being separated at an angle into two sloped sections. For a� non-touch typist, this can be difficult to use, as some keyboards only angle the keys without splitting into halves.
The split design reduces the sideways bending of the hand but also important is the reduction of vertical bending.
However, this can be overcome by taking some simple steps like:
Flattening the keyboard feet on the desk can keep the hands flat
Putting the keyboard on a vertical tilted tray can also help improve the hands’ posture
Keyboards are available in left and right-handed styles
Choosing a Mouse
The shape along with the location of the mouse in relation to the keyboard is important for maintaining a healthy hand posture. Here are some considerations when choosing a mouse. The mouse buttons should:
Have easy clickability
Is easy to move around/feels natural
The screen cursor should move accurately with your movements
There are mice with programmable buttons allowing you to control additional functions. Important things to check:
Make sure the size and shape of the mouse feels natural in your hand
Hold the mouse in a neutral position meaning your hand should not be bent up, down or sideways
Position and operate the mouse with your upper arm relaxed and close to your body, and don’t reach too far forward or too far out to the side
There are keyboards with a separate numeric pad that allows the mouse to be located closer to the keyboard. Some keyboards include a cursor positioning device like a trackball, touchpoint or touchpad. These types eliminate having to reach for a mouse. However, it is a good practice to mix it up using the keyboard for certain operations and the mouse for others. This allows different muscles and ligaments to work while the others take a break.
The Ideal Setup
All keyboards and mice are designed differently. The key is to find well-made products that are built with ergonomic injury prevention as the focus. You can use trackballs, touchpads, and pen mice instead of a regular mouse.
Find what works for you, is ergonomic, comfortable and easy to use and will keep your hands in a neutral posture. If you do a lot of typing and mouse movement, your hands are going to get tired even with top designed keyboards and mice. Take frequent short rest and stretch breaks to let your muscles recover. The stretching exercises should include the:
Upper back muscles
Working like this will protect you against over-use injuries.
Carpal Tunnel Chiropractic Treatment
Chiropractic care is one of the most common forms of treatment for carpal tunnel syndrome. Foremost, a doctor of chiropractic will evaluate the extent of the condition as well as diagnose the individual to determine any underlying cause behind the condition. Through a series of chiropractic adjustments and manual manipulations, the hand, wrist, and arm are adjusted to reduce the pressure around the median nerve, and ultimately reducing the symptoms.
Carpal tunnel syndrome, or CTS, is a condition where the nerve that runs from the forearm into the hand gets compressed. Carpal tunnel can cause significant pain and result in numbness that makes using your hand practically impossible.
Carpal tunnel affects�approximately 3% of the population. Carpal tunnel sufferers, fortunately, there are effective treatments that do not require surgery. Chiropractic care can help relieve the pain of carpal tunnel, and can often improve mobility and range of motion in the process.
What is it?
The term �carpal tunnel� refers to an actual tunnel created by ligaments and bones in the wrist. Tendons and median nerves travel from the forearm through the carpal tunnel in the wrist and into the hand. When the median nerve becomes compressed inside the carpal tunnel�usually due to injury or inflammation�it can lead to the symptoms associated with CTS.
The exact cause of CTS is not always easy to identify, but there are many factors that can play a role. A family history of CTS makes it more likely that you will develop the condition. Repetitive work, such as a job on an assembly line, is known to increase the risk of CTS. Wrist injuries can also cause carpal tunnel. There are other contributing factors that are not as obvious, such as pregnancy, menopause, and dialysis.
The first signs of carpal tunnel often include a feeling of pins and needles in the wrist, hands, and fingers. You may notice some numbness from time to time, especially after using the wrist in a way that causes compression�like performing a task over and over at work.
Over time, the symptoms can become more severe. Eventually, carpal tunnel can lead to a loss of coordination with the thumb, then other digits. Pain may not be significant at first, but tends to get worse and the condition progresses.
Chiropractic Can Help
Standard medical treatments for carpal tunnel include using anti-inflammatory drugs, refraining from using the wrist/hand, wearing a splint and eventually surgery. While these treatments can sometimes be effective, the risks associated with surgery are significant. Carpal tunnel surgery may or may not fix the problem, and as with any surgery, can sometimes cause more issues than it helps.
Learning to Protect Yourself
Chiropractic care offers a safe alternative to standard medical care, one that is non-invasive and minimizes the need for medications and their potential side effects. Chiropractic treatments for carpal tunnel can help to reduce inflammation and minimize pain. But chiropractic goes further than just treating the symptoms�it can also help you avoid aggravating the condition so that it can heal.
Chiropractors are trained in proper movement and ergonomics. Your chiropractor can help you understand what you are doing that is causing the carpal tunnel to begin with. He or she can also advise you on ways to adjust your movements to protect your wrists moving forward. You may be able to learn new ways of doing things that will allow you to achieve your goals without risking injury.
One of the fundamentals of chiropractic care is improving strength and mobility to aid in healing and protect from further injury. Your chiropractor can guide you through exercises to make you stronger. Once you know how to do the exercises, you can do them at home to continue to gain strength.
Schedule An Appointment
Carpal tunnel sufferers, don’t wait any longer and contact us to schedule an appointment. We will get you the relief you need!
Piano players will sit or stand at a piano or keyboard, often in the same position for hours. A clarinet player must keep their head, neck, and jaw in a precise position in order to play properly. A guitarist must sit for long periods while holding the guitar in a certain position while moving their fingers over the frets in a very precise manner.
In other words, musicians put their bodies through some vigorous training. They practice for hours a day and engage their bodies in repetitive motions for long periods of time.
It’s no wonder that many musicians complain of headaches, migraines, carpal tunnel, clicking jaw, numbness in the fingers, and back and neck pain!
Some of this pain can be debilitating and make it more difficult for them to perform their normal activities. Many live with chronic pain.
There was a time when these conditions were considered to be just a part of playing an instrument and the musician would push through the pain. However, many are turning to chiropractic and are enjoying not only a pain-free life but improved performance as well.
The Way Playing an Instrument Affects the Body
Some doctors liken musicians to athletes � instrumental athletes. They do have very similar practices such as practicing for hours a day so that they can perfect their abilities and skills. And like athletes, they also experience certain break downs within the body.
Posture is a common malady as the musician may stand or sit a certain way in order to play their instrument. This prolonged activity can lead to imbalances in the spine, pelvis, and other parts of the body.
When the body is not in balance, it cannot function as it should. Organs are affected and other the body may try to make accommodations for the imbalance which only exacerbates the problem.
This is further compounded each time the musician plays their instrument because by doing so they are consistently underworking and overworking certain muscles. This can lead to further imbalance.
The muscles that are worked, the ones used to play the instrument, get shorter, tighter, and stronger as scar tissue forms. By contrast, the underworked muscle groups stay underdeveloped and get weak. This muscular imbalance puts a great deal of stress on the spine and other joints in the body like the fingers, wrists, and elbows
They may also experience Repetitive Strain Injury or RSI. This condition is often quite painful and is concentrated in the soft tissues, nerves, tendons, and muscles.
These areas may become painful or inflamed when performing repetitive activities, pressing against hard surfaces, vibrations, awkward sustained positions, and forceful exertions. This causes the body to become out of alignment but also impacts the function of the skeletal system, nervous system, and muscular system.
Chiropractors are very good for musicians because the can assess misalignments in their spine and make adjustments. When proper original alignment is stored to the body, it begins to function properly. This leads to a decrease in pain and other symptoms that may be experienced due to the long hours of playing an instrument.
Musicians also benefit from chiropractic because it can make them better at what they do. When the pain is decreased or eliminated and the other symptoms are relieved, it is easier to play.
When the spine is in proper alignment and the body is balanced, the musician will experience a boost in energy, their muscles will not fatigue as quickly, and their muscles will be more relaxed. With all those benefits, it�s no wonder that chiropractors and musicians make beautiful music together.
De Quervain’s Tenosynovitis, also called �washerwoman sprain,� is a condition of the hand that typically affects people who do continuous, fast, repetitive movements. The patient can experience a sudden onset of the condition or it can be gradual, beginning with tenderness in the thumb area and slowly progressing. It can restrict activity, but it doesn�t have to be a long-term disability. Chiropractic care can help relieve the symptoms of De Quervain�s Tenosynovitis and the hand can return to normal function.
What Is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a condition affecting the thumb side of the wrist. It is a very painful condition that makes many everyday activities difficult or impossible. Many activities like playing golf, lifting a child, garden work, and racket sports can worsen the condition.
What are the Symptoms ofDe Quervain’s Tenosynovitis?
There are several distinctive symptoms of De Quervain�s tenosynovitis which include:
Pain near or at the base of the thumb
Difficulty moving or controlling the thumb and wrist when doing activities that involve pinching or grasping
Swelling near or at the base of the thumb
A �catch� or �sticking� sensation when moving the thumb
If the condition is allowed to progress or goes untreated it can involve the forearm and entire thumb, causing pain and swelling in those areas. The pain and symptoms can be exacerbated by movements that involve the wrist and thumb. The symptoms can last for a long time, weeks or even months.
What causes De Quervain’s Tenosynovitis?
The exact cause of De Quervain�s Tenosynovitis is not known, but the condition is commonly associated with chronic overuse of the wrist. There are tendons that connect the wrist and lower thumb, enabling movement like grasping, gripping, pinching, and wringing. The tendons slide through a sheath as they facilitate the movement. Over time, the sheath can swell and thicken which inhibits the amount of the tendon�s movement. When the movements are repetitive, it can cause irritation of the sheath, resulting in inflammation.
Who is at Risk for De Quervain’s Tenosynovitis?
Research has identified several groups that are at risk for developing De Quervain�s Tenosynovitis:
30 to 50 years of age with a higher concentration statistically around 40
African ethnicity or descent
Caring for a child or baby
Works at a job that involves repetitive wrist and hand motions
This condition has typically been considered to be one that affects people who are middle-aged. However, with the popularity of texting, many young people experience symptoms of De Quervain�s. In one study, more than half of students who texted extensively were labeled positive for De Quervain�s.
What are the Treatments for De Quervain’s Tenosynovitis?
Treatment for De Quervain�s Tenosynovitis include:
Resting the affected thumb and wrist
Bracing or immobilization
Ice to the affected area
Anti-inflammatory medications like ibuprofen and naproxen
If standard treatment is not effective it may be necessary to seek medical attention. If the condition is severe or chronic, the doctor may inject corticosteroid directly into the tendon sheath. Surgery for De Quervain�s is not common, but it may be deemed necessary in order to release the thumb. The speed of healing and the�degree of normal use of the thumb depends on the treatment chosen and if the activity that exacerbates the condition is stopped.
Can Chiropractic Help De Quervain’s Tenosynovitis?
A chiropractor may recommend rest, ice, and bracing for a patient with De Quervain�s Tenosynovitis. Upon reviewing the patient�s lifestyle and habits, he or she may also advise ergonomic changes, modification of activity, and reduce exposure to positions that exacerbate the symptoms. Soft tissue therapies may be used to quickly bring relief to the soft tissue, minimizing the inflammation and pain. As the pain decreases, the chiropractor will recommend specific strengthening and stretching exercises that involve the wrist, thumb, and forearm.
With regular care and modification to activities, the condition can be healed and full mobility of the thumb and wrist can be restored.
In all cases, Orthopedic hand surgical referral is required
Colles fx: m/c d/t FOOSH+pronation. m/c inOSP/elder women. Rare in men and if occurs need DEXA to avoid hip Fx etc. Young pts: high-energy trauma. Typically extra-articular.50%-cases show Ulna styloid (US) Fx.
Imaging: x-rad is sufficient, CT in complex Fx, MRI helps with ligament tears and TFC.
Rx: if extra-articular and <5-mm distal radius shortening and <5-degree dorsal angulation closed reduction+casting is sufficient. ORIF in complex cases.
�Image Dx: distal rad impaction/shortening,dorsal angulation of distal fragment, carefully examine if intra-articular extension, 50% US Fx
Smith Fx: Goyrand in French literature. Considered as reversed Colles, otherwise almost identical, I.e., 85% extra-articular, 50%US Fx, OSP/elderly women, young pts-high-energy trauma. Differences: mechanismFOOSHwith flexed wrist thus m. Less frequent.
Imaging steps: (see Colles Fx) C
Complications: similar to Colles Fx
Rad Dx: 85% extra-articular with volar(anterior) angulation of the distal fragment,radial shortening. Carefully examine cortical breach suspecting intra-articular extension that can be named as Smith type 2 or Reversed Barton Fx (next)
Rx: similar approach as in Colles.
Barton fx: FOOSH, impaction of distal radius similar to Colles but the Fx line extends from the dorsal radial aspect into radiocarpal joint resulting with dorsal slip/dislocation of the carpus.
Imaging: 1st sept x-radiography often with CTto examine intra-articular Fx extension and operative planning
Rad Dx: distal radius Fx extending from dorsal into the radiocarpal joint with a variable degree of displacement, the proximal slip of the carpus
If Fx line extends from the volar aspect into the wrist joint named Reversed Barton aka Smith type 2 (above bottom image)
Complications: similar to all distal radius Fx
Rx: operative with ORIF
Chauffeur’s/backfire Fx aka Hutchinson Fx: intra-articular Fx of Radial styloid. The name derives from the time when the car had to be started with a hand crank that could backfire inducing wrist dorsiflexion and radial deviation.
Imaging: x-radiography is sufficient. CT may be helpful if Fx not readily shown by x-rays.
Rx: operative with percutaneous lagscrewin all cases d/t intra-articularnature
Die-Punch Fx: impaction Fx by the Lunate bone into distal articularLunate fossa of the Radius. IntraarticularFx. Derives its name from a technique to shape (impress) a hole in industrial machining “die-punch.”FOOSH injury.
Imaging: 1st step x-rays, may be equivocal d/t subtle depression of the Lunate fossa then CT scanning is most informative.
Rad Dx: impacted lunate fossa region with intra-articular Fx extension. This can present as a comminuted Fxarticular Fx of the Distal Radius.
Rx: operative d/t intra-articular Fx
Construct arcs of Gilula when evaluating carpal injuries. An Important step required to avoid missing subtle changes in carpal alignment and cortical continuity
Scaphoid bone Fx: m/c Fx carpal bone. D/tFOOSH wrist extended radially deviated. Location of Fx is most important to prognosis: Waist-m/c location (70%). May have 70-100%chance of AVN. Proximal pole Fx: 20-30% with a high risk of non-union. Distal pole-10%shows better prognosis. Distal pole Fx is m/c in children. Key clinical sign; pain in the snuffbox.
Imaging: 1st step-x-radiography but 15-20%missed d/t occult Fx. Special views required. Thus MRI is the most sensitive and specific for early occult Fx. Bone scintigraphy has98/100% specificity & sensitivity esp. 2-3 days after the onset. Key rad. Dx: Fx line if evident, displacement and obscuration of scaphoid(navicular) fat pad, examine for scapholunate dissociation. If proximal bone appears sclerotic-AVN occurred. MRI: low on T1 & high on T2/STIR/FSPD d/t bone edema, a�low signalFx line can be noted.
Rx: Spica cast should be applied if clinically suspected even w/o x-ray findings. For waistFx-cast for 3-mo for prox pole 5-mo immobilization. ORIF or percutaneous pinning with a Herbert screw.
Scapholunate Ligaments Dissociation
SNAC wrist: scaphoid non-union advanced collapse. Often d/t non-union and dissociation of scapholunate ligaments (SLL)with progressive radiocarpal and intercarpalDJD. The Proximal scaphoid fragment is attached to Lunate with distal dissociating and rotating�signet ring� sign on x-rays.
SNAC wrist may often result in DISI
Rx: progressive DJD may lead to four-corner arthrodesis
Scapholunate advanced collapse (SLAC wrist): SLLdissociation with progressive intercarpal and radiocarpal DJD and volar or dorsal carpal displacement (DISI & VISI). Causes: trauma, CPPD, DJD, Kienboch disease (AVN of Lunate), Preiserdisease (AVN of Scaphoid).
SLL dissociation will lead to Dorsal or VolarIntercarlate aka Intercarpal Segmental Instability (DISIor VISI).
Rad Dx: Dx underlying cause. X-rays demonstrate dorsal or volar angulation of the Lunate with increased or decreased scapholunate angle on the lateral view. On frontal view: Terry Thomas sign or widening of scapholunate distance 3-4-mm as the upper limit of normal.
�MRI may help with ligament evaluation and pre-surgical planning
Rx: often operative with late DJD. Four-corner arthrodesis
Triquetrum Fx: 2nd m/c carpal bone Fx. M/C dorsal aspect is avulsed by the�tough Dorsal radiocarpal ligament. Cause: FOOSH.
Imaging: x-radiography wrist series is sufficient. Best revealed on the lateral view as an avulsed bone fragment adjacent to the dorsum of the Triquetrum. CT may help if radiographically equivocal.
Rx: conservative care
Complications: rare, may persist as pain on the dorsum of the wrist
Hook of the Hamate Fx: m/c occurs in batting sports (cricket, baseball, hockey, impact by a golf club, etc.) 2% of carpusFx.
Imaging: x-radiography may fail to detect an Fx unless “carpal tunnel view” is used. CT may help if x-rays unrewarding.
Clinically: pain, positive pull test, weak, painful grip. Deep ulnar n. Branch may be affected within the�Guyon canal.
Rx: usually non-operative, but chronic non-union may require excision.
DDx: bipartite hamate
�Lunate vs. Perilunate dislocation: Lunate is m/c dislocated carpal bone. Overall infrequent carpal injury. However, often missed!
Occurs with FOOSH and wrist extended and ulnar deviated. Imaging: 1st step x-rays. Ifunrewarding or require more complex injury evaluation CT scanning.
Key Rad DDx: DDx Lunate from perilunate dislocation. Lunate dislocation: lunate lost its contact with distal radius �spilled teacup� on the lateral. Perilunate dislocation: Lunate maintains its contact with distal radius despite the Capitatedorsally dislocated. Lunate dislocation is additionally helped to identify a �pie sign� d/t Lunate overlapping the Capitate
Rx: emergency reduction and operative repair of torn ligaments
Metacarpal & Phalangeal Injuries
Bennett Fx: intra-articular but noncomminuted impact-type Fx of the base of 1st MC bone of the thumb. X-radiography is sufficient.
Rad Dx: characteristic triangular fragment of bone on the ulnar aspect of the 1st MCbase, often with radial subluxation of the remaining radial aspect of the 1st MC
Complications: DJD, non-union, etc.
Rx: prone to instability/non-union requiring an operative care
Rolando Fx: aka comminuted Bennett with Y or T-configuration. More complex injury. It is unstable requiring operative care
Gamekeeper thumb: traditionally described as a chronic tear of the�ulnar (medial) collateral ligament at 1stMCP in English Gamekeepers’ who performed neck twisting/killing of small game. An acute injury may also be named as Skier’s thumb. This injury can be ligamentous w/o a fracture and an avulsion injury at the 1st proximal phalanx base.
Complication: Stener lesion or displacement of torn ligament over Adductor pollicis muscle that cannot heal w/o surgical repair. MRI Dx is required.
Avoid thumb stress views that can induce a Stenerlesion
Imaging: x-radiography followed by MRI to Dx Stenerlesion. MSK US can be used if MRI is unavailable.
�Stener lesion on MRI & MSUS: ulnar collateral stump is more superficial to Adductor pollicis aponeurosis and appears like a low signal mass-like stump forming so-called “yo-yo on the string sign” reported both on MRI and MSK US.
Rx: often operative
Boxer Fx: m/c MC Fx. An extra-articular usually non-comminuted or minimal comminuted Fx through m/c the 5th and sometimes the 4th MCneck-head junction (occasionally through the shaft) resulting in volar head angulation. Mechanism: direct impact as in clenched fist punching hard surface (e.g., facial bones/wall punching) hence 95% in young males.
Imaging: x-radiography hand series is sufficient
Rad Dx: Fx line transverse or oblique through MCneck with volar head angulation. Evaluate the degree of displacement, critical to report.
N.B. If the same mechanism fractures the 2ndand 3d MC in the same anatomic area, it may require operative care.
Phalangeal hand Fx: m/c skeleton Fx (10% of all Fx). Sports and industrial injuries dominate
Imaging: x-radiography with hand series or PA/lateral finger views will suffice
Rad Dx: if prox phalanx Fx, distal fragment is angled volarly with prox fragment dorsally. Distal phalanx may be angled dorsally. Key observation: nail bed injury, which considered an open Fx with a�risk of infection.
Rx: if <10-degree angulation-buddy-taping with motion rehab. CRPP vs. ORIF can be considered in complex cases-Orthopedic hand surgeon referral
Complication: loss of motion, necrosis, infection.May result with amputation
For additional common injuries: PIP is m/c dislocated joint. Mullet (Baseball) finger, Jersey finger and other injury refer to:
Felon: septic infection of the fingertip pulp typically with Staph.Aureus. Causes: needle prick(diabetics), paronychia, nail splinters, etc. m/c in index and thumb, presenting with pain, swelling, etc.
D/t specific pulp anatomy theinfection>swelling leads to pulp compartment syndrome-pressure and necrosis.
Rx: operative with incision distal to DIP, irrigation/debridement
Pediatric Wrist Injury
Incomplete Fx: Greenstick Fx, Torus (Buckle)Fx, Bowing (Plastic) deformity/Fx. D/t FOSHe.g. fell off the monkey bar. m/c affects <10-years-old.
Rx: usually non-operative (closed reduction and casting)
Distal Radioulnar Joint (DRUJ) Instability-common injury following trauma as in FOOSHwith wrist hyperextension and rotation and disruption of DRUJ ligaments and TFCcomplex. Avulsion of ulnar styloid with the�dorsal or volar displacement of distal ulnar should be noted.
Imaging steps: x-rays initially, MRI may identify ligaments and TFC damage, MSKUScan help with ligaments tearing.
Wrist DJD-typically is secondary to trauma, scapholunate dissociation, SLAC, SNAC wrist, CPPD, Keinboch or Preiser Disease and others.
May lead to major functional loss
Imaging: typically presents as radiocarpal JSL, subchondral sclerosis,osteophytosis, subcortical cysts, and loose bodies. Typically additional induces intercarpal degeneration and particularly Tri-scaphe joint.
MRI may be helpful with early recognition of scapholunate dissociation, Lunate/Navicular AVN.
If isolated MCP OA noted considerCPPD & Hemochromatosis (Hook-like osteophytes)
Typically painless except 1st CMC OA
DIPs-Heberden nodes, PIPs-Bouchard nodes
Erosive OA (occasionally called�inflammatory OA�)
A Spectrum of OA but producing central proximal erosions at DIPs and PIPsresulting with very characteristic �gullwing� appearance. No systemic inflammation (no CRP, RF, Anti-CCP Ab)typically in middle-aged/elderly females, like Hand OA, often seen in families
Rheumatoid Arthritis (RA)-chronic systemic inflammatory disease of unknown etiology, targeting synovial joints, tendons with multiple systemic involvement (lung, CVS, Ocular, Skin, etc.) Pathology: Tcell>Macrophage/APC>mediatedautoimmune process resulting in pannus formation and gradual destruction of ST, cartilage, bone,�and other tissues. 3% FemalesVS.1% Males. Environmental triggers: infection, trauma, smoking,�and others in a genetically susceptible individual. 20-30%may be disabled after 10-years.
Due to his significant craftsmanship in San Antonio, TX, Ottis Hamlet must largely rely on the use of his best tools: his hands. Unfortunately, Mr. Hamlet developed debilitating symptoms in both of his arms because of carpal tunnel syndrome, which dramatically impacted his capacity to participate in his occupation and therefore affecting his quality of life as a result. Ottis Hamlet was able to find relief for his hand and wrist pain with Dr. Alex Jimenez through a trip to El Paso, TX and he received chiropractic treatment for his carpal tunnel syndrome, preventing the need to undergo any surgical interventions.
Carpal Tunnel Chiropractic Treatment
Carpal tunnel syndrome is a medical condition resulting from the compression of the nerve that travels via the wrist and in the lymph nodes. Typical symptoms include pain, tingling sensations and numbness, at the thumb, index finger, middle finger, and the thumb side of this ring fingers. Symptoms normally begin gradually and may continue throughout the day. Symptoms may stretch throughout the arm and also diminished grip power may also happen. Carpal tunnel syndrome may be diagnosed according to its symptoms.
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Numbness in any portion of the hand or in specific fingers, followed by a tingling sensation and sharp pain traveling through the hands can occur as a result of various underlying conditions. Many people report symptoms suggesting the development of carpal tunnel syndrome but, although diagnosis might indicate the cause for the condition, sometimes a diagnosis could point to the incorrect root of the problem.
The median nerve and various other tendons travel from the forearm to the hand through a small indentation in the wrist known as the carpal tunnel. The role of the median nerve is to provide movement and feeling in the thumb and first three fingers, excluding the smallest finger in the hand. When an individual begins experiencing the associated symptoms of carpal tunnel syndrome, such as tingling, numbness, weakness, or pain in the fingers or hand, these could be the result to an impingement of the median nerve at the carpal tunnel, generally caused by irritation on the nerves of the wrist.
Thoracic Outlet Syndrome
Although many people could experience numbness in their fingers, the compression could be occurring at another region within the body. Regardless of the cause of your symptoms, if you�re experienced numbness in the hands and fingers, you should consider seeking chiropractic care.
Carpal tunnel syndrome is a condition caused by an impingement of the median nerve found at the wrist, usually causing symptoms of hand and finger numbness, tingling sensations, weakness, and pain. But, occasionally, the symptoms associated with carpal tunnel syndrome can be caused by complications to the spine, generally the cervical spine. For more information on the subject matter, please feel free to ask Dr. Jimenez or contact us at (915) 850-0900.
Carpal tunnel syndrome is a condition involving numerous symptoms affecting the hands and wrists. This painful condition is caused when the median nerve, found within the carpal tunnel of the wrist along with other tendons in the hand, becomes compressed.
The median nerve functions by controlling nerve sensations and impulses from the palm area of the fingers and the thumb as well as to the muscles in the hand, providing feeling and movement. When the tendons become irritated, causing inflammation and swelling, an impingement of the median nerve occurs, resulting in carpal tunnel syndrome. The pinched nerve may then develop a variety of symptoms most commonly associated to the condition.
Symptoms of Carpal Tunnel Syndrome
Trauma from an accident to the hand or wrist and/or overuse from repetitive activities, such as constant typing on a keyboard, are common reasons carpal tunnel syndrome develops. The added pressure begins to irritate and compress the median nerve, leading to the impairing symptoms of pain, among others.
The most common symptoms include pain, numbness, a tingling sensation, and weakness on the hands, wrists, and forearms. Pain and numbness in these areas is usually intense. The discomfort from these symptoms can affect an individual�s everyday lifestyles. Gripping objects may become difficult as carpal tunnel syndrome progresses over time due to loss of muscle strength. The tingling sensations radiating from the hand is often described as a feeling of �pins and needles� through the hands, wrists, and forearms.
By Dr. Alex Jimenez
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