Category: Chiropractic Conditions

What is a carpal tunnel?

What causes Carpal Tunnel Syndrome (CTS) and who gets it?

Pain relief from Carpal Tunnel Syndrome.Carpal Tunnel Syndrome (CTS), the most common repetitive-stress injury affects millions of people a year. It is a manifestation of nerve and tissue damage caused by fast, forceful and seemingly harmless repetitive wrist and hand motions. Carpal Tunnel Syndrome is one of the most widespread occupational health problems we face today. With our growing reliance on computers there seems to be no end in sight. Pressure on the median nerve is responsible of carpal tunnel syndrome and the pain associated with it. The median nerve is responsible for neural impulses to the thumb, index finger, middle finger and 1/2 of the ring finger as well as part of the palm.

Pressure on the median nerve can be caused by an injury or sustained use from common activities like typing, chopping, hammering, or pushing. njury often occurs in production and manufacturing workplaces. Common repetitive activities that cause CTS include cutting meat, dressing poultry, assembling auto-mobiles, and secrateral or office work. CTS frequently causes temporary or permanent disability, imposing substantial costs on employers. Carpal Tunnel Syndrome costs GM an estimated $250 million per year, including worker compensation payments.

Carpal Tunnel Syndrome Symptoms

Carpal Tunnel Syndrome has a wide range of symptoms including burning pain, numbness, and tingling in the wrist, hands, and fingers as well as weakness, or loss of grip strength. Loss of sleep, due to discomfort, are often a result of Carpal Tunnel Syndrome. At the onset of CTS you may feel a shooting pain in the shoulders, and tenderness, swelling, tingling and burning in the fingers and hands. As CTS progresses, these symtoms become so acute and that an afflicted person no longer can perform the simplest of tasks, such as grasping objects.

The longer the swelling compresses or pinches the median nerve, the greater the chance that some of the nerve cells will die. When enough nerve cells die, hand muscles deteriorate and lose their ability to grip. CTS sufferers may become permanently disabled if they ignore the symptoms. Atrophy (shrinking and weakness) to some of the muscles in the hand is a long-term result of untreated Carpal Tunnel Syndrome.

Double Crush

Double Crush and Carpal Tunnel SyndromeThe median nerve travels trough the neck, also referred to as the cervical region of the spine, and then travels down to the armpit, or axial region. At this point the brachial plexus is – a complex web of nerves. At this point the media nerve travels down the arm, past the elbow, into the forearm and then into the wrist, hand and fingers. The median nerve can be injured anywhere along this path. The classic carpal tunnel syndrome is when this nerve is injured in the wrist but this is often not the case it can often be injured in any place along the nerve. If this happens in more than one place you have a double crush syndrome.

When a peripheral nerve such as the median nerve gets compressed or crushed in two or more areas, that is called a “double crush syndrome” or a “double crush injury”. This condition was first described in a British medical journal called the Lancet (in 1973). There are four areas in which it is common for the nerve to get entrapped. The first three areas are not in the wrist at all. The first and second most common area of entrapment in carpal tunnel syndrome is the neck, especially after a whiplash or whiplash like injury. The second most common area is in the shoulder and this often happens for three reasons tendonitis, bursitis, or anterior shoulder fixation. The third are outside of the wrist is the forearm, the pronator teres muscle can put pressure on the median nerve as it runs through the muscle belly.

finally the median nerve may get entrapped in the carpal tunnel itself which is a tunnel in the wrist. The carpal tunnel in the wrist contains nine flexor tendons and the median nerve, this does not leave much room for inflammation or scare tissue. When the flexor tendons are irritated, they become inflamed and swell up, and in doing so, crush the little median nerve which also runs through the same pathway.

Treatment for Carpal Tunnel Syndrome

The medical approach to treating carpal tunnel syndrome includes pain pills, steroid injections and surgery. Non-surgical treatments for CTS include immobilization, cold and hot therapy, aspirin, cortisone, infra-red heat ultrasound, electrical stimulation, paraffin baths, various types of physical therapy, and anti-inflammatory drugs. All of these have a rather poor track record. The drugs don’t fix anything, they just mask symptoms. You may buy some time, but ultimately it’s going to catch up to you.

In the most severe cases, surgery is performed to enlarge the Carpal Tunnel and repair ligaments. Statistics from the National Center for Health indicate that 2.4 million visits were made to physicians in 1999 because of CTS, of which 1 million were made to orthopaedic surgeons. And the surgery, in addition to having a poor success rate (57% of all surgeries fail – according to the research), there’s also a risk of scar tissue formation, wrist instability and other long-term problems.

At Mahler Family Chiropractic Center, offer a unique approach to treating carpal tunnel syndrome. Our methods address ALL areas of potential involvement. We take the pressure off the nerve, and use cold laser to reduce inflammation so you can finally get permanent relief! Additionally our approach is safe, no toxic drugs and no risky invasive surgery. To see what we can do to help you, call us to schedule a free no-obligation consultation.

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By: Paul R. Mahler DC
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What is lower back pain?

If you have low back pain chiropractic can help you

Eighty percent of individuals suffer from some form of back pain in their lifetimes, and back pain is the second most common cause for people visiting the doctor. Back pain, particularly lumbar pain, is outnumbered only by upper-respiratory infections. Seventy five million Americans will have back pain every year, and 80 percent of the adult population will have some type of low back pain. It is the most frequent reason for disability for people in the 30-50 year age bracket, and since these age groups are typically the most productive in the work force, the economic effect of low back pain is huge. Back pain can be explained as follows:

The low back area is prone to injury and pain because it is in a highly unstable portion of the spine, just like the neck is. That instability is one of the reasons for our mobility. This mobility is resposibal for our ability to stand upright, pick something up off the ground, tyeing our shoes and touching our toes, but at the price of increased chance of injury and low back pain.

When the low back is healthy and working properly, it can handle great forces without injury. One illustration is a professional weight lifter who is able to lift several hundred pounds and not injure his lower back. But, if the low back is compromised and out of adjustment or has lost strength in the supporting muscles, an act as basic as lifting a bag of groceries from the trunk of the car, picking up a young child, or bending down to feed the cat can cause a lower back injury.

The old belief that back pain would disappear by itself has been found to be inaccurate. While back pain may disappear for some time even without medical intervention, the latest scientific reports indicate that it will probably reappear. Low back pain should be taken seriously, and it is important to get professional chiropractic treatment. That is particularly true with recurring pain.

Although back pain patients make up the second largest diagnostic group examined by medical professionals, the recommended treatments from these professionals (drugs) are frequently discovered to be less than helpful. A highly regarded medical researcher has suggested that family doctors consider referring their back pain patients for chiropractic treatment, since it has shown to be beneficial for this disorder. Medical intervention is appropriate for lower back pain; a chiropractor can provide that. More and more people every year are visiting chiropractors for help with their lower back pain.

The Causes of Low Back Pain:

Because there are many factors that might cause low back pain, and a few of these factors may be very serious if not treated, it is vital to get the help of a professional. Chiropractors are leaders in determining the causes of lower back pain along with establishing the correct treatment for low back pain.

Lower back pain can be the result of various factors. Among these causes are stress and emotional tension that makes muscles tighten and contract, which results in stiffness and pain. Extra back pain might be due to bad posture and being on your feet for long periods, or sitting improperly (so be careful when you are at the office). A third cause of lower back pain is frequently linked with heavy physical labor, lifting or forceful movement, twisting or bending or awkward positions. This is worsened because of incorrect lifting practices, in other words, mechanical trauma and work. The most routine home or work tasks involving bending, twisting and lifting can stress your lower back muscles resulting in lower back pain. A few of those activities are tennis, biking, gardening, golf and even horseback riding and any of these might potentially injure your back. Finally, mechanical lower back pain might be caused by injuries and accidents, such as car wrecks, sports injuries and slips and falls. Carrying excess weight is another risk for low back pain, since it puts stress and pressure on the back, particularly the low back. Simply getting older is the last risk for back pain. As we get older, the ligaments thicken and discs dry out and we are more prone to back pain. Those age-related changes in the spine can lead to disorders that put pressure on the spinal nerves. The symptoms of pain might be combined with weakness or numbness. You may feel your discomfort on either or both sides of your back.

Our Approach To Your Care:

(treatment for back pain) We provide an all-inclusive, unique approach to treat back pain.

We believe back pain can best be alleviated by chiropractic adjustment. A chiropractic adjustment is an easy, low force correction that realigns the vertebrae, reduces stress to the spine and central nervous system and restores normal joint function. Trigger point therapy is a system of putting pressure on certain points in the body to lessen or get rid of muscle pain. Muscle contraction and lack of flexibility are characteristic of the majority of patients who have long-term back pain. To repair these issues, we create a flexibility and stretching routine that is intended to restore a pain-free range of motion. If the spine has been injured or if an old injury exists that was never properly evaluated and treated, we will frequently combine balance and stabilization rehabilitation to enhance coordination and spinal structural integrity.

The strength of the spine ultimately depends on the strength of the soft tissues supporting it, specifically, the muscles. Back muscles support spines the same way cables support bridges. Back pain can reappear again if any back muscle is not sufficiently strong. To fix this issue, we do a functional evaluation to locate weak spots. The back must be assessed to discover which areas need strengthening to alleviate the condition.

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By: Paul R. Mahler DC
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Understanding Golf Injuries and How to Prevent Them

Golf injure preventionGolf is a sport that is prone to injury. No mater how long you have been involved in the sport the more likely it is that you will injure yourself. It is most likely reason for injuring your self  is inappropriately swing the golf club. Professional golfers commonly injure the wrist, followed by the back, hand, shoulder, and knee. Amateur golfers most commonly injuries the lower back, followed by the elbow, wrist, shoulder, and knee. It is obvious that you can be injured even in non-contact sports such as golf, swimming, and track. If you under stand the golf swing you can avoid or correct these injuries but if they are persistent some sort of physical medicine may help.

Let’s analyze the golf swing. There are three phases to the golf swing, and each can cause injury if executed incorrectly. There are also specific exercises you can perform to help reduce your risk of hurting yourself during that particular swing phase.

Phase 1: Take-Away. The take-away consists of the back swing. Thumb and wrist injuries are most common during this phase particularly on the lead hand. Here is an effective workout for the muscles of the wrist, hand and forearm. To begin, stand with your feet shoulder-width apart holding a 5-pound dumbbell in your right hand. Keeping your arm to your side and using only your wrist, raise the dumbbell as high as you can and lower it as far as you can. Do two sets of 25 reps. Next, do another two sets of 25 reps, but while moving your wrist from side to side as far as you can. Repeat this entire workout with the dumbbell in your left hand. An advanced workout for your wrists would be to take a barbell/dumbbells with a weight you can handle, anywhere from 10-45 pounds, and do three exercises (known as a “tri-set”) back to back to back without rest. Start with your feet shoulder width apart and grab the weight with your hands facing down, shoulder-width apart, held which each thumb. Reverse curl the weight up toward your body, flexing the forearm as you finish the movement at the top. Do 10 reps. Next, hold the weight behind you, palms facing up and even with your gluteus maximus (your buttocks). The back of your hand should be touching the top of your buttocks. Raise the weight as high as you can without moving your arms; use your wrist only for 10 reps. Finally, sit down on the bench and rest your forearms on your thighs. Do not allow your wrists to rest on your knees. Hold the weight with your palms up and move only your wrist vertically for 10 reps. Do not rest and perform another tri-set, but this time do 12 reps, and then finish the last set with 15 reps. Another option is to pyramid: increase the amount of weight while decreasing the number of repetitions. For example: 10 pounds for 15 reps, 12 pounds for 12 reps, and 15 pounds for 10 reps. There is an inverse relationship at play here: As you add more weight, you do less reps.

Phase 2: Impact. The next phase of the swing consists of the downswing and impact with the ball. The most common injuries during this phase knee particularly the back of the knee and compression forces acting on both wrists. Also, the lead elbow and hand/wrist are often hurt during impact. In terms of exercises that can help prevent these injuries, leg extensions/leg curls and abduction/adduction exercises. Many fitness clubs have equipment for these types of exercises. These exercises along with regular stretching and massage, are extremely effective for the legs. Triceps push-downs using a reverse grip with the hands up is an excellent exercise for the triceps and will help to prevent injury to the elbows. High-intensity training (one set to muscle exhaustion for each exercise, using slow, deliberate movements) works well and is a safe method of training for all the exercises above. For the legs, do 15-20 reps; for the triceps/elbows, do 8-12 reps.

Phase 3: Follow-Through. This is the phase after impact where the golfer finishes his swing. From a chiropractic stand point this can be the most damaging phase for your spine because it involves abnormal torque on the low back. This phase requires training the oblique muscles. Using a trunk rotation machine, at your local gym, twist slowly in a circular fashion for 20-25 reps, and also use lower back extension machine for 15-20 reps. Keep the weight light and the reps high for this exercises and make sure to do them slowly and eliminate momentum. Strengthen the core muscles with these exercises will help prevent back injuries. This means that a routine of exercises for the back will help your game and while you are at it don’t forget back stretching as well.

Stretching and massage can also help prevent injury but always warm up before stretching to bring blood area. You should warm up before a round of golf, take a brisk walk or get a quick massage that includes techniques and stretches to increase range of motion. The right way to stretch is important. Begin with three sets of 10-15 deep knee bends and then walk a quarter of a mile. Next, perform a series of stretches. Reciprocal inhibition stretches, performed by stretching to a level at which your body innately says stop, is effective for increasing range of motion without over-stretching and injuring yourself. When you reach the point at which your body says stop, contract the opposite muscle and hold the contraction for several seconds; then release. There should be an increase in of range of motion Now hold the new position for at least 30 seconds, then move on to your next stretch.

Some good stretches are toe-touch stretches and side stretches. When doing the toe-touch stretch, you must keep a flat back. Do not round your back. When you drop down into the stretch, contract your gluteus maximus and hold the contraction for 6-7 seconds, then breathe and release and you will find yourself falling deeper into the stretch. You must remember not to hold your breath even during an Isometric contraction and always feel your breath releasing in and out of your nose. You should also breathe deeply through your diaphragm. The toe-touch stretch will increase flexibility in the hamstrings. Place one arm over you head and bend to the side to do the side stretch. Do this stretch in increments as follows. Go as far as possible without pulling the muscle, then contract the gluteus maximus muscle for several seconds; then release and drop into the stretch, holding for 30 seconds. Repeat 2-3 times on each side.

Cooling down after playing is imperative to do some simple breathing and stretching exercises after golfing. Lie flat on your back and tuck your knees to your chest and breathe; hold for 30 seconds. Extend your arm in the supine position [palm up], grab your finger tips and pull your hand down; again, hold for 30 seconds. Next, extend your arm in the prone position (palm down) and grab your fingertips and pull toward you from the bottom position. Hold for 30 seconds. These simple exercises are essential to injury prevention following each round of golf, practice session, etc.

Injuries can happen at any time in any sport, but following these suggestions can certainly help you avoid severe and permanent injuries whenever you’re golfing.

Why are so many golfers are injured every year? 27 million injuries annually, according to some estimates. The average golfer has no warm-up or stretching protocols for golf then they are swinging the club with violent, intermittent effort. This is a recipe for injury and in addition the average golfer uses the “grip it and rip it” golf swings. On top of this many golfers have varied amounts of pre-existing postural dysfunction and poor flexibility. When you add it all up, this is a recipe for injury. Many of these golfers are suffering from repetitive strain injuries due to lack of flexibility, postural instability and poor swing mechanics.

Isn’t it time to repair your golf swing. Contact Mahler family Chiropractic Center and we will help get your golf game back into the swing of things.

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By: Paul R. Mahler DC
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Shoulder Stretching Routine

Avoiding a rotator cuff injury

Front of the Shoulder Stretch: Pector Elongator

Shoulder stretching for Golf or sports to avoid injuriesMaintaining open, fluid movement in the front of the shoulder during swimming will decrease compression in the joint. With biking and running, the shoulder tends to rotate inward and lift up toward the ear.

This same movement in swimming will add to tension and compression in the neck and shoulder. The pector elongator is a great stretch to use before or after a workout.

  1. Stand with your right hip about two or three feet away from a wall.
  2. Place your right hand on the wall at shoulder level, behind the torso. Keep your elbow loosely bent.
  3. Now rotate your elbow forward and maintain this forward rotation throughout the stretch.
  4. Twist your upper torso to the left, while retaining elbow rotation, to create a stretch in the front of the right shoulder.
  5. Hold the stretch for five to 12 breaths.
  6. Switch arms and repeat.

Variations can be created by moving your hand up and down the wall or by stepping farther away from the wall. Pector elongator is intense, so go easy. When you start to feel the stretch, stop and inhale deeply into the area being stretched.

Also, using a doorway will give you a perfect stretch at home or at the office. The hard part of this stretch is continuing to maintain a forward rotation of the elbow.

Deltoid/Rotator Cuff Stretch

Every shoulder problem seems to have rotator cuff involvement. These muscles are unique because they function as a ligament at the joint, and a muscle in locomotion. Located above the rotators are the deltoids, which can be stretched along with the rotators.

When an athlete has any type of shoulder problem, this is the first stretch I introduce. It’s ideal because it takes care of the muscle, the joint capsule and the range of motion.

  1. Stand facing the wall, approximately a foot away.
  2. Draw your right arm across your body.
  3. Place the back of your right hand on the wall at shoulder level.
  4. Move your left shoulder toward your right hand as far as you can, then lean the right shoulder toward the wall.
  5. To create a slightly different stretch, place the front of your hand on the wall.
  6. Hold the stretch for five to 12 breaths.
  7. Switch arms and repeat.

There’s room to be creative with this stretch. You can walk the hips away from the wall or experiment with your hand in different locations. To intensify the stretch, use the floor instead of the wall. The key is to move the shoulder that’s not being stretched down, and slowly lean the involved shoulder into the wall, floor or couch. (see step 4).

Side of the Torso Stretch: Lateral Bend

The side (lateral) muscles of the torso have a great deal of strength, power, endurance and elasticity. This natural elasticity adds power without increased mass. This stretch will allow you to be more effective in the reaching part of your swim stroke and have more power on the recovery part.

  1. Stand with your feet hip-distance apart, knees slightly bent.
  2. Expand your chest, lift your ribs and raise both hands over your head.
  3. On exhale, pull your abdomen back and lean to the right.
  4. Hold this position and inhale into the ribs.
  5. As you exhale, pull abdomen back and lean to the left, hold, inhale into the ribs.
  6. Repeat this side-to-side motion to the right and left four to six times.

Move from one side to the other on an exhale, allowing for a deep inhale into the ribs. This will increase both extension and strength. Keep the chest slightly in front of the hips and rotate the top of the pelvic girdle back—this will elongate the lower-back muscles and stretch the lats.

Lateral bend is a great stretch to use after a hard workout because of its effect on the lower back.

To concentrate the effects of flexibility training, your breath should be long and smooth, and your mind should be focused on the area you want to effect. Easy, extended breathing like this will improve both performance and recovery. Race and train forever.

A proper stretching routine will help avoid pain in the shoulder and rotator cuff injuries.

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By: Paul R. Mahler DC
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The Rights of An Auto Accident Victim in PA

(This is not intended as legal  advice. It is not provided by an attorney but is a summary of common rights as encountered in our practice and my answer basic questions. Please consult an attorney for a comprehensive view of your legal rights. This information is copied from other sources.)

Every driver in the state of Pennsylvania must carry insurance. And every insurance policy provides medical coverage for anyone who has been injured as a result of an auto accident. This coverage is called med-pay. Another term for med-pay is personal injury protection (or “PIP”). The minimum coverage that Pennsylvania drivers must carry (by law) is $5,000.00 of med-pay. That means that the first $5,000.00 of your medical bills will be covered by your automotive insurance. Also, in 99.9% of the cases, there is no deductible and no co-pays. That means you can get the care you need and without any out-of-pocket costs whatsoever. Pennsylvania is also a “no-fault” state. That means it doesn’t matter who was at fault. You are still protected and are entitled to receive treatment that is paid for by your auto insurance.

Auto accidents and your rights

Can My Insurance Rates Go Up If I Use My Med-Pay?
By law, your insurance company may not raise your insurance rates (premiums) because you used your medical coverage. It doesn’t matter who’s at fault of the accident. You have a right to use this medical coverage.

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By: Paul R. Mahler DC
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Chiropractic Care and MVA’s

Post MVA is an importent time to see your chiropractorInstead using pain pills to numb your body there is a better choice. It is chiropractic care and rehabilitation. Not all chiropractors do the same thing. So it’s important to choose one who has the training and equipment to treat auto accident injuries. At Mahler Family Chiropractic Center, we use a unique approach to treating car accident injuries. Our methods are effective and we can often get you out of pain, restoring range of motion, improving posture, and correcting misalignment. Many of our patients have tried numerous approaches to manage their pain and symptoms including  seeing their medical doctor, various therapists and even other chiropractors. Our methods are different and they work. We use a combination of conservative chiropractic care, which is drug free and surgery free, along with laser therapies and muscle and ligament rehabilitation. We treat each case individually and work with you to develop a chiropractic and home care plan that works.

We’re located in Wilkes Barre area Give us a call or visit us at our facility.

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By: Paul R. Mahler DC
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