Pain Relief Chiropractic

About Pain Relief Chiropractic

Providing listeners with research-based information regarding musculoskeletal topics with an emphasis on chiropractic. New episodes Monday-Thursday.

Publisher

William Holdsworth

Category

health & fitness

Language

en

Explicit

No

First episode

21 Jan 2020

Latest episode

10 Sept 2020

Latest episodes

124 episodes in the feed.

1. 

   10 Sept 2020

   Whiplash and Mid-Back Pain – How Can This Happen?

   Research regarding whiplash or whiplash associated disorders (WAD) classically focuses on neck pain; however, the data show acute thoracic spine / mid-back pain (MBP) occurs in 66% of WAD injures with 23% still complaining of MBP at one-year post-injury. It’s easy to visualize how the cervical spine or neck can be injured in an automobile collision (or sport-related collision or a fall) as the head, which weighs an average or twelve pounds, whips back and forth in a “crack-the-whip” like manner, often well beyond the normal, physiological range of motion. This same stretching (eccentric loading) followed by compression (concentric loading) also occurs in the mid-back, which can injure ligaments, joint capsules, neural structures, and more. Also, the thoracic spine contributes to 33% of flexion and 21% of rotation IN THE NECK, making the mid-back a vital spinal region that facilitates neck movement and function! In WAD cases, mid-back pain often hides in the shadows of a more obvious and often more serious neck injury, as the brain typically perceives pain from the greatest source. Additionally, the neuronal input to the sensory cortex of the brain (the area of the brain that perceives pain) is most highly represented from the head, hands, and feet and less from the mid-back or torso. The seat belt may also contribute to injury—both to the anterior chest region including rib cage, sternum, breast tissue, abdominal organs, as well as to the mid-back. The oblique angle of the chest-restraint is an important factor when discussing the mechanism of injury, as it causes trunk/torso rotation during the rebound or flexion phase of WAD. Another mechanism of injury includes blunt trauma, of which the driver is especially at risk due to the close proximity of the steering wheel and the chest. This can lead to contusion or bruising, fracture, and/or injury to the abdominal and/or chest organs (heart and lungs). Obviously, the speed of impact, angle of the collision, bracing of the person (or lack thereof), and overall physical condition of the patient can greatly affect the outcome of WAD-related injuries. The importance of assessing the whole person is essential in obtaining an accurate diagnosis and establishing a comprehensive treatment plan for the WAD patient. Chiropractic management focuses on the entire person, frequently uncovering complaints in other spinal regions as well as in the extremities in WAD-related injured patients. Moreover, treating postural issues such as a short leg, ankle pronation, oblique pelvis, forward head posture, protracted shoulders, and more is vitally important in obtaining satisfying patient outcomes! www.PainReliefChiroOnline.com

2. 

   9 Sept 2020

   Treatment on the Wrist for Carpal Tunnel Syndrome

   When treating patients with carpal tunnel syndrome (CTS), doctors of chiropractic can employ a variety of options to reduce pressure on the median nerve. While this can include dietary recommendations (to reduce inflammation), adjustments to address dysfunction elsewhere along the course of the median nerve, or even working with other healthcare providers to manage conditions that contribute to CTS (like diabetes), treatment will often focus on the wrist itself. One such approach is referred to as neurodynamic techniques, or mobilization. In a study involving 103 patients with mild-to-moderate CTS, those who received treatment twice a week for ten weeks experienced greater improvements with respect to pain reduction, symptom severity, functional status, and nerve function than participants in a control group who received no treatment. The authors concluded, “The use of neurodynamic techniques in conservative treatment for mild to moderate forms of carpal tunnel syndrome has significant therapeutic benefits.” This finding is supported by two previous studies that found the use of manual therapies on the wrist can alter the shape of the carpal tunnel itself and allow more room for the tendons, blood vessels, and median nerve. Additionally, studies show that when the wrist moves beyond a neutral position, it can alter the shape of the carpal tunnel and increase pressure on its contents. In a healthy wrist, full extension/flexion can double pressure in the carpal tunnel; however, for CTS patients, the pressure can increase as much as 600%. That’s why many treatment guidelines recommend wearing a wrist splint (especially at night) and modifying work and life activities to keep the wrist in a neutral position as much as possible. The good news is that in most cases of CTS, patients will benefit from a conservative treatment approach; however, achieving a successful outcome can be more difficult if the patient delays treatment. That’s why it’s important to consult with your doctor of chiropractic when you experience the signs and symptoms associated with CTS (pain, numbness, tingling, or weakness in the hands or fingers) sooner rather than later. www.PainReliefChiroOnline.com

3. 

   8 Sept 2020

   Multi-Modal Care for Whiplash Patients

   The term whiplash associated disorders (WAD) describes a constellation of symptoms that includes (partial list) pain, stiffness/limited motion, dizziness, headache, depression/anxiety, and brain-fog. The condition is associated with accelerations/deceleration events like car accidents, sports collisions, or slip and falls. Such injuries are classified into four categories: WAD I (no/minimal complaints/injury), WAD II (soft-tissue injury – muscle/tendon and/or ligament injury), WAD III (nerve injury), WAD IV (fracture). More than 85% of those involved in a motor vehicle collision (MVC) experience neck pain, with 29-40% recovering within a little more than three months and about 23% still not having recovered after one year. A 2016 systematic review generated treatment guidelines for patients with WAD and/or neck associated disorders (NAD) in the context of both a recent injury and for cases in which pain has persisted for longer than three months. Importantly, these guidelines were formed with input from several types of healthcare providers, including doctors of chiropractic, medical doctors, and physical therapists. For recent-onset neck pain (0-3 months), the authors recommend multimodal care (multiple types); manipulation or mobilization; range-of-motion home exercise or multimodal manual therapy (for grades I-II NAD); adding supervised graded strengthening exercise (grade III NAD); and multimodal care (grade III WAD). For persistent neck pain (more than 3 months), the review recommends multimodal care or stress self-management; manipulation with soft tissue therapy; high-dose massage; supervised group exercise; supervised yoga; supervised strengthening exercises or home exercises (grades I-II NAD); multimodal care or practitioner’s advice (grades I-III NAD); and supervised exercise with advice or advice alone (grades I-II WAD). For patients with persistent neck and shoulder pain, evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone (grades I-III NAD). The term, “multi-modal care” is defined as a grouping of manipulation, mobilization, and soft tissue techniques (myofascial release, contract-hold, trigger point therapy, muscle energy, and more). Multi-modal care may also incorporate the use of hot or cold packs, assisted stretching, advice to stay active or modify activity, and neck/shoulder exercise training. Doctors of chiropractic often take a multi-modal approach when treating patients with musculoskeletal pain, including those with whiplash associated disorders. www.PainReliefChiroOnline.com

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