Health Update: Carpal Tunnel

The following are excerpts from the expert opinion of Dr. Joseph Cilea of the Advanced Wellness Center in Marlboro, New Jersey.
Pain Management
Acupuncture
Chiropractics
Spine Compression
 

Carpal Tunnel Syndrome (CTS) -  A "Typical" Case Example

     "I've been working on the line for 13 years and started noticing periodic tingling in my fingers.  It didn't last long and I didn't think about it much.  It gradually became more frequent and wouldn't go away when I changed my activity or shook my hand or fingers.  It started to really grab my attention when I started to drop things out of my hand and couldn't open jars as easily.  That's when I decided to see what was wrong.  I didn't know who to go to so I went to my family doctor and he diagnosed carpal tunnel syndrome.  He gave me a splint to wear at night and some anti-inflammatory drugs that irritated my stomach, so I quit the drugs.  The splint helped me sleep and I didn't wake up as often.  The doctor was talking about surgery to undo a pinch the nerve at my wrist if it didn't get better soon, but I overheard some co-workers talk about seeing a chiropractor for their carpal tunnel problems and how much better they felt so I decided to try it.

     "The chiropractor was very thorough and examined my neck, shoulder, elbow as well as my wrist and hand.  He indicated that several areas were putting pressure on the nerve that goes into the hand and the pinch was not just at the wrist but higher up in my neck, shoulder and forearm.  He said if I wasn't at least 50% better in 4 weeks, we would talk about other tests and treatment options and investigate it further.  He worked on my neck, shoulder, elbow, forearm and hand, using manipulations and other methods to loosen it up.  He said the nerve was getting pinched by the muscles working too fast and not getting enough rest.  He gave me exercises to do several times a day at work to stretch the forearm muscles and had me continue the use of the brace at night.  He also taught me how to ice massage the wrist for 5 minutes until it got numb, several times a day and he recommended I use vitamin B6, 50mg, three times a day.  After the 3rd week, I started to notice a decrease in the intensity, frequency and duration of numbness and weakness.  He had me fill out a Carpal Tunnel Questionnaire and my score improved a lot after the first 4 weeks.  He said he may have to evaluate my workstation and make some modifications, if possible.  He asked me a lot about the position of my wrist and hand when I work and didn't seem to like the type of screw driver I was using.  He called my boss and asked if a different type of screw driver with a power source and a pistol shaped handle could be tried and it was arranged.  That seemed to really make a difference."

     Carpal Tunnel Syndrome or CTS, is a common problem that is usually cumulative, slow and gradual in its onset, and can progress to a point where functions like buttoning shirts, threading a needle, and holding a newspaper are greatly affected.  People usually don't run to the doctor at the first signs of CTS as the initial symptoms are vague and initially not too impairing.  Over time, CTS can become quite severe and often prompts a surgical recommendation, without trying a non-surgical approach first.

     There are a number of studies published regarding the chiropractic management of CTS that show these non-surgical methods can be quite successful.  One compared medical care consisting of non-steroidal anti-inflammatory drugs and nocturnal wrist splinting to chiropractic care consisting of spine and extremity manipulation, nocturnal wrist splinting, and ultrasound over the wrist.  Both treatment approaches were helpful, suggesting the importance of trying either or even both of these non-surgical treatments prior to proceeding to surgery.

     We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care.  We realize there are many health care options available and truly appreciate the confidence shown by our patients when choosing our clinic for their health care needs.  If you, a friend or family member requires care for CTS, we would be honored to offer our services.

Health Update: Low Back Pain

 Chiropractic Care and the Elderly

Chiropractic treatment of low back pain (LBP) has been reported to be very safe and highly effective.  In fact, in 1994, guidelines were published recommending that chiropractic treatment of low back pain should be a first consideration / treatment of choice in front of many other forms of back care health services.  Since that time, more and more studies have been published showing continued advantages of chiropractic care over many other forms of LBP care.

Even though studies have shown that the peak prevalence of LBP occurs in the 5th decade of life, LBP is also a significant public health problem in older adults ranging between 13% and 49% with "...soaring costs in terms of health care expenditures." So, what about care for the elderly - is chiropractic care equally safe and effective in this older population as it is in younger patients?

A recent study reported two types of spinal manipulation or adjustments verses minimal conservative medical care (MCMC) in patients with subacute or chronic, non-radiating LBP over 55 years of age.  This included a total of 240 participants, of which 105 were women and 135 were men with an average age of 63 years.  The two types of manipulation included a high velocity low amplitude type (the classic "cracking" type of manipulation) and a low velocity variable amplitude type (stretch - not associated with a "crack") treated 12 times over a 6 week time frame.  A 3rd treatment group (MCMC) served as a "control" to compare against the two manipulation approaches.  All three groups received a half hour exercise session at week 3 and outcomes were studied at 3, 6, 12 & 24 weeks.  The results showed equally effective benefits to the two styles of manipulation over the MCMC group, with no serious adverse events associated with any of the treatment groups.

This study is important in a number of ways. First, it points out that two distinctive styles of manipulation frequently utilized in chiropractic and likely to be encountered by patients obtaining chiropractic care, are equally effective in a population exceeding 55 years of age.  The type of manipulation ultimately decided upon can therefore be based on: 1) patient preference (as some patients just don't like being "cracked") and 2) the chiropractor's clinical experience.

When visiting our clinic, we take pride in providing accurate, up-to-date information about our patient's condition and what must be done to obtain long term, satisfying results.  We are most appreciative to have the opportunity to provide care to our patients and strive to make the experience highly satisfying.

If you, a family member or a friend requires care, we sincerely appreciate the trust and confidence shown by choosing our services.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and, in the future.  

Health Update: Whiplash

Whiplash - Can This Really Happen To You?

The following are excerpts from the expert opinion of Dr. Joseph Cilea of the Advanced Wellness Center in Marlboro, New Jersey.

Pain Management
Acupuncture

     You're stopped at red light awaiting a left turn into the grocery store when out of nowhere, you  hear the screeching of tires, you turn your head and look into the rear view mirror and see that you're about to be hit from behind. Then "POW!"  The sudden force of the impact propels you back into your seat, your head hits the headrest and then bounces forwards, almost hitting the steering wheel.  You feel your body twist due to the angle of the seat belt and your sunglasses fly off and your purse sitting on the seat next to you flies into the dashboard and lands on the floor spilling its contents.  You're not sure what just happened as it all happened so fast.  Is this a dream?


     After collecting yourself and calming down, you get out of the car to inspect the damage and talk to the driver that just ran into you.  You notice that right now, you don't really hurt that much....but you feel kind of dazed.  When you inspect your car, you surprisingly notice very little damage, but it sure felt like your car should be totaled based on the way it felt.  The other driver said he was checking the station on the radio and saw you too late.  He tried to stop and slammed on the brakes but it was too late.  He said, "...I couldn't have been moving more than 5-10 mph when I hit you!"  You ask, "how could this possibly feel so.....hard an impact?  Was he lying to me?" There certainly wasn't much damage to your car...maybe he was right???  When he asked you if you would, "...let it go," and not call the police, you almost agree, but something stops you.  Even though there is little car damage and, "...he is a nice guy....," you just don't feel right in, "...letting it go." 
 

    Within 15-30 minutes, you're REALLY HAPPY you didn't give in and take his advice as by now, your neck is really starting to hurt. You feel kind of nauseated and light headed.  Your head is beginning to pound and you feel like you better sit down.  When the police officer approaches he seems distant and you're having difficulty hearing him.  Pretty soon, you notice others helping you onto a stretcher and attaching a neck brace prior to taking you to a local emergency room.  At the ER, you are confused about the details of the accident but piece together the best you can the events of the evening.  They take x-rays, recommend some Advil and ice, and tell you to contact your primary care physician if you have problems. They tell you that you're going to hurt for a few days and "...that 's normal."  However, over the next several days, pain intensifies to a point where neck and headache pain is constant, you can't sleep, your memory seems blurry, you can't seem to concentrate and loose your place during thought and conversation....something is REALLY WRONG!


     This scenario is not atypical of a low speed collision related injury.  In fact, the less the car is damaged, the greater the impact is to the contents inside the car (this is called "elastic deformity").  That's because crushing metal absorbs the energy of the force (ie, "plastic deformity) and if the speed is "...too low" and little metal crushing/energy absorption occurs, the G-forces that occurred during the collision are transferred to the contents inside the vehicle and that force can be significantly greater than a crash that occurs at 2-4 times the 5-10 mph speed.  In general, when there is less damage to the car, be alert that the force exerted on the contents is greater than when car damage occurs.  This is why when cars crash during a car race, the race car basically falls apart, leaving the driver enclosed in a cage that prevents bodily damage, and they often walk away from the accident.


     If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional assessment and therapeutic approach at our chiropractic facility.