Back or Neck Pain? We can help you!

If you have tried other chiropractors without measurable results, please do not give up.  Come in for a free consultation we can help!

We will use the latest technology to analyze, locate and correct problems and employ strategies for health maximization to unlock your healing potential!

If you have had back or neck surgery, or are thinking about it we can help treat your symptoms and get you back to a pain free lifestyle.

When you become a member of our practice you receive the best of:

  • Advanced Technologies to analyze, locate and correct problems
  • Strategies for Health Maximization
  • Practical Information to Unlock Your Healing Potential
  • Success Principles and Habits to Further Your Improvement toward Optimal Health

Dr. Darrell Swolensky has been practicing in Henderson Nevada for more than 15 years. He focuses on helping people become and remain pain-free. His cutting-edge technologies are the finest in the state of Nevada.

Low Back Pain – What To Do Immediately (Part 2)

Low back pain (LBP), as previously stated, will affect most (if not all) of us at some point in time. Knowing what to do when the warning signs occur is essential to avoiding a disabling level of LBP. Last month, we started the discussion about offering ways to manage the LBP using exercises with the objective of stopping and reversing a potentially serious level of LBP. We offered ways of stretching from a sitting position that can be done in public. Here are some standing exercise options.

1. EXERCISE C: THE HAMSTRING & GROIN STRETCH: From standing 1) Place your foot up onto a seat, bench, chair, pipe of a railing, or anything about knee level (it doesn’t have to be very high). If your balance isn’t very good, make sure to hold onto a wall or counter to keep your balance. 2) Keep your knee bent 20-30 degrees and arch your lower back by sticking out the buttocks until you feel the pull or stretch in the hamstrings (back of the leg). 3) Slowly straighten your knee (keep the buttocks poked out and the low back arched) and you will feel the hamstrings gradually get tighter. 4) Change the angle of the knee and/or the amount of low back arch/pelvic tilt to modify the pulling intensity in the hamstrings. Continue this stretch for 15-30 seconds or until you feel the muscles loosening up. 5) Stay in that EXACT SAME POSITION and rotate your torso inwards (towards the leg you’re standing on) until you will feel the pull change from the hamstrings to the groin (inside thigh) muscles. You can also go back and forth between the hamstrings and the groin (adductor) muscles and continue the exercise until the back of the leg and groin feel adequately stretched (usually 5 to 15 seconds/leg).

2. EXERCISE D: THE HIP FLEXOR STRETCH: From standing: 1) Step forwards with one leg and stand in a semi-long, stride position (one foot ahead of the other). 2) On the back leg side, rotate the pelvis forwards until the hip lines up with the forward leg hip (or, the pelvis is square). 3) Add a posterior pelvic tilt (tuck in your buttock/pelvis or, flatten your low back). 4) Lean backwards (extend the low back) holding the above position. As you extend back, feel for the pull deep inside the upper front part of the thigh/groin area. You can alter between the third and fourth steps to release and re-stretch the hip flexor. Continue the stretch for 5-15 seconds or until you feel it’s stretched out and repeat on the opposite side. This one takes a little work but once you feel it, you will see why it’s so good!

3. EXERCISE E: THE ADDUCTOR STRETCH: As an alternative to the second part of EXERCISE C (step 5 of the standing hamstring stretch), stand with your legs spread apart fairly wide. Shift your pelvis from side to side (left then right) and feel for the stretch on the inner thigh/groin region. You can increase the stretch by adding a lean to the side you’re shifting the pelvis. Try holding the stretch for 5-15 seconds, alternating between sides 5-10 times.

These exercises are meant to be done in public WHEN you need to stretch. Stop the vicious cycle from getting out of control by STOPPING, STRETCHING, and then resuming your activity if you can!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

Neck Pain – Drugs or Chiropractic?

When you have neck pain, do you instinctively reach for that bottle of ibuprofen or Tylenol? If so, is that the best option? Who can we trust for the answer? Since between 10-20% of the population suffer from chronic or persistent neck pain, this is a VERY IMPORTANT question!

If we look at the literature published in peer reviewed journals by authors who have no financial incentives in the outcome of the study, we can find accurate, non-biased information to answer this question. So, let’s start with a landmark study published in SPINE, a leading medical journal that reviewed ALL the publications printed between 2000 and 2010 on neck pain – a total of 32,000 articles with over 25,000 hours of review. (Haldeman S, Carroll L, Cassidy JD, et. al. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: Executive Summary. Spine 2008,33(4S):S5-S7). This resulted in a 220 page comprehensive report from a multidisciplinary International Task Force involving seven years of work from 50+ researchers from 19 different clinical scientific disciplines worldwide looking at the MOST EFFECTIVE approaches available (both surgical and non-surgical) for patients suffering from neck pain.

Highlights from the study include the following: 1) Manipulation/mobilization are safe, effective, and appropriate treatment approaches for most patients with disabling neck pain (both traumatic and non-traumatic); 2) Neck pain patients should be informed of ALL effective treatment options so they can choose effectively; 3) The very rare risk of vertebrobasilar artery (VBI) stroke is NO DIFFERENT when comparing patients consulting a doctor of chiropractic verses a primary care medical physician as the stroke event, in most cases, has occurred prior to the visit; 4) The treatment option(s) available should consider the potential side effects and personal preferences of the patient; 5) For most neck pain patients, treatments that were found to be safe and effective include manipulation, mobilization, exercise, education, acupuncture, analgesics, massage, and low-level laser therapy; 6) For non-neurological neck pain, ineffective treatments (poor choices) include surgery, collars, TENS (transcutaneous electrical nerve stimulation), most injection therapies (including corticosteroid injections and rhizotomy); 7) For neck pain WITH nerve compression, there is very little research published on non-surgical care. Here, in the absence of serious pathology or progressive neurological loss, start with the most conservative (like chiropractic!) followed by more invasive treatments like epidural steroid injections (ESI’s) and surgery; 8) Whiplash patients should follow similar guidelines as described above; 9) Some benefit from the chosen treatment should be seen within the first two to four weeks of care; and, 10) Be realistic about treatment goals – neck pain is often recurrent (comes and goes) as most people (50-80%) will NOT experience complete resolution of symptoms and will have neck pain again one to five years later.

Another study published in The Annals of Internal Medicine (“Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain: A Randomized Trial. 3 January 2012, Vol.156, No. 1, Part 1) reports similar information favoring spinal manipulation and exercise, as these were found to be SUPERIOR to medication use. Another study reported excellent results for 27 patients utilizing chiropractic care who had herniated cervical disks WITH spinal cord compression verified on MRI (70% improved after an average of 12 visits)! TRY CHIROPRACTIC FIRST!!!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain, we would be honored to render our services.

Carpal Tunnel Syndrome – What Can I Do to Help? (Part 2)

Carpal Tunnel Syndrome (CTS) management strategies were introduced last month, which we will conclude this month with Part 2. In part one, we cited three primary goals of CTS management that include the following: 1) Physical management strategies; 2) Chemical management strategies; and 3) Self-management strategies. All three goals include a component that we as doctors of chiropractic control AND (most important), a component that you the patient controls. We will continue this discussion this month with chemical management strategies.

2. Chemical management strategies: Here, MY JOB includes guiding you in methods to reduce swelling or inflammation. The first method involves the use of ice. Different cooling approaches include the use of ice cup/massage (applied directly on the skin until numb, which takes about five minutes) and/or ice packs (takes about 10-15 minutes). We can also offer assistance in choosing various anti-inflammatory herbs (such as ginger, tumeric, boswellia) and vitamins (such as vitamin B6 or pyridoxine; magnesium, fish oil / omega 3 fatty acids, vitamin D) with anti-inflammatory properties. Recently, probiotics have also been demonstrated to reduce inflammation! YOUR JOB is to follow these recommendations that you and I agree upon to help reduce the inflammatory effects of CTS. Other “chemical strategies” may include adding the primary care physician to “the team,” as prescriptions for various conditions such as diabetes, hypothyroidism, rheumatoid arthritis, and others may be appropriate in certain CTS cases.

3) Self-management strategies: Though we have already looked at “MY JOB” and “YOUR JOB” as it pertains to 1) Physical management and 2) Chemical management strategies, overlap exists between all three CTS management goals. In other words, as the name implies, “self-management strategies” includes the need for you to comply with the recommendations. For example, wearing the cock-up wrist splint primarily at night (when sleeping and less commonly at times during the day), following instructions regarding job modifications, nutritional strategies and, when applicable, pharmaceutical intervention are things you can do to alleviate symptoms. One of the MOST IMPORTANT self-help strategies is the training of carpal tunnel specific exercises, as well as exercise in general. Maintaining a proper weight (a BMI between 20-25) is also a goal that will help CTS, as obesity is a risk factor for this condition and a host of other conditions, including diabetes!

EXERCISE #1: Stand near a wall. Place your palm on the wall at shoulder height pointing the fingers down towards the floor, keeping the elbow straight. Reach across with the opposite hand and pull your thumb back as you stretch the palm-side forearm muscles. Hold 5-10 seconds until you feel the muscle “melt.” Repeat three times per side, five times a day. You can use the edge of a counter top rather than a wall, if you like.

EXERCISE #2: Bend the elbow 90 degrees. “Dig” your thumb DEEP into the palm-side forearm muscles close to the elbow. Slowly straighten the elbow and maintain the deep pressure into the muscle until the elbow is completely straight. REPEAT this multiple times moving your thumb one inch closer to your wrist from the last pressure point until you are one to two inches from the wrist (or, until you don’t feel much tenderness). You can vary the speed at which you straighten the elbow but generally, slower is better than fast movement, and the deeper the pressure, the better.

Repeat these two exercises on BOTH sides so you can feel the difference between the two, regardless if you have problems on both sides. Since the neck and shoulder can be involved, we will also show you how to stretch these areas, as keeping the whole “kinetic chain” stretched is very important for long-term benefits.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

Fibromyalgia: Dietary Considerations (Part 1)

For many sufferers, Fibromyalgia (FM) is equivalent to fatigue and muscle pain. Though there are MANY symptoms associated with FM, these two are standouts! The topic this month centers around diet and its role in the management of FM. Last month, we discussed the importance of exercise (particularly walking), and prior topics have focused on the need for a multi-modal treatment plan that is individualized for YOU. Coordinate your dietary strategies with your chiropractor’s office and they will guide you in your personalized nutritional planning as it pertains to FM.

Because we are all truly chemically unique, there is no one “recipe” for every FM sufferer. This is why we recommend making a list of the various approaches AS YOU TRY THEM in order to sort out those most vs. least effective, and most importantly, foods that should be avoided altogether. Patient histories tell us that certain foods can create reactions such as cramping, diarrhea, constipation, and more and that list often includes MSG, certain preservatives, eggs, gluten, dairy, and other high “allergy-based” foods. In a survey published in the journal Clinical Rheumatology, 42% of FM patients reported that certain foods make their symptoms worse. Hence, keep a daily FOOD JOURNAL and grade how different foods make YOU feel on a 0= ”good”, 5= “no change,” and 10= “bad” scale. In as little as two weeks, you will start to see a pattern and avoidance of the “bad” foods makes a big difference! Write down any and all of your symptoms, pro or con, and include things like headache, indigestion, fatigue, aching, etc.

Once you see a “trend” for vs. against certain foods, ELIMINATE the ones that upset your irritable bowel, headaches, fatigue, etc., and avoid these foods for six to eight weeks. Then, to “challenge” your list of foods, you can then ADD ONE food back into your diet at a time to determine consistency and if it TRULY is a culprit FOR YOU! From experience, Dr. Ginevra Liptan, MD, medical director of the Frida Center for Fibromyalgia, in Portland, Oregon and author of Figuring Out Fibromyalgia: Current Science and the Most Effectve Treatements, dairy and gluten appear to be consistent culprits with fatigue, irritable bowel, and leaky gut symptoms like bloating and constipation. We will guide you in this process and/or help coordinate these services with an allergist and/or dietitian when it’s appropriate.

Some preliminary studies are showing that certain medicinal herbs and natural supplements may help manage FM related symptoms – remember to WRITE DOWN your experience with these various options: 1) 5-HTP (5- Hydroxytryptophan): This is a “building block” of serotonin which is a POWERFUL brain chemical associated with sleep and depression. It is thought that serotonin plays a significant role in reducing fibromyalgia suffering, particularly by increasing deep sleep and reducing pain. Studies show improvement in depression, anxiety, and insomnia as well! Though not ALL studies support its benefits, it’s worth a try given its limited side effects and potential for helping! 2) Melatonin: This is a “natural hormone” used to improve sleep patterns, which is a perfect fit for the sleep problems and fatigue associated with FM! Most people tolerate this well but a few may experience drowsiness, and for those, caution is appropriate when driving! 3) Probiotics: This is “…the new kid on the block,” as it’s showing up on labels of everything from yogurt to granola bars! These contain “friendly bacteria” we want in our digestive systems. Certain “strains” or types of “good-guy” bacteria aid in many conditions including irritable bowel, traveler’s diarrhea, reducing inflammation, boosting the immune system, and more! Note, there are MANY strains of probiotics, which we will discuss in PART 2 next month as we continue this “healthy” discussion of dietary approaches in the management of FM!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

10 Facts You Should Know About Whiplash (Part 1)

There have been many statements made about whiplash that are either totally or partially false. Let’s take a look at some of the “FACTS.”

1. Pain is NOT the only symptom: Although neck and/or shoulder area pain is the most common symptom associated with a whiplash injury, look for other symptoms such as (but not limited to) headache, numbness/tingling in the arms, nausea, difficulty swallowing, dizziness, poor concentration, jaw pain, blurred vision, ringing in the ears, and more. Many of these symptoms may not manifest until days, weeks, or months after your collision.

2. Cervical spine injury can occur at low speeds: It doesn’t take a lot of force to inflict injury to the neck. In fact, speeds of only 5-10 mph (~8-16 km/h) can generate significant G-forces to injure the soft tissues (muscles, tendons, ligaments, and disks) in the neck. Factors influencing injury include (but are NOT limited to) vehicles size/weight and speed differential, location of impact direction, head restraint location, seat failure, seat back angle and “spring,” seat back height, surface slipperiness, and more.

3. No vehicular damage does NOT mean no injury: As stated in #2, low speed collisions can generate enough force to cause injury to the neck. It is important to know that an 8 mph (~13 km/h) rear-end collision may result in a 2 g force acceleration of the impacted vehicle, a 5 g force acceleration acting on the occupant’s head, and all within 250-300 msec. after impact. (FYI: 1 g = an acceleration of approximately 32 ft/sec or 10 m/sec.). IF the metal of the car crushes (“plastic deformity”), energy is absorbed and LESS is transferred to the occupants and VICE VERSA! So, to avoid injury, it’s BETTER to have vehicular damage (the opposite of what you’d think)! Studies show a 10 mph (~16 km/h) impact can produce a total collapse of only 2.5 inches or 6.35 cm (mostly to the back bumper). Often, you have to crawl underneath the vehicle to see the damage.

4. An unusual S-shaped curve has been identified during the rear-end impact: There are seven cervical or neck vertebrae which form a 35-40° curve called a lordosis, which is “C-shaped.” In the initial 50-75 milliseconds after impact during a rear end collision, the head remains stationary while the seat moves the torso and rest of the body forwards and for an instance, an “S-shaped” curve is created (flexion in the upper half and extension in the lower half). This abnormal curve occurs BEFORE the head hyperextends backwards POSSIBLY hitting the headrest and then springing forwards (like “cracking a whip”).

5. X-ray CAN prove soft tissue damage: X-rays are often used to “rule-out” a fracture and as a result, they are often initially read as “normal” as radiologists (the specialists who read x-rays) don’t often report on the subtle findings found on the x-ray that may support the presence of a soft tissue injury. As chiropractors, we OFTEN take “stress views,” or flexion and extension x-rays after the initial painful symptoms improve. Stress x-rays can yield a much better image of how well the ligaments are holding the vertebra together. When ligaments are stretched or torn (just like in a sprained ankle), excessive movement and/or angles can form between the bones, which are often only be seen at the extreme end-points of movement. We can measure the angle formed between the vertebrae and the amount of translation or “slip” that occurs to determine if there is a loss of ligament control which results in excessive motion, increasing the likelihood of future problems.

We will have to resume this interesting discussion next month in “Part 2” of this topic.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

Low Back Pain – What To Do Immediately (Part 1)

Low back pain (LBP) will most likely strike at some point for all of us, at least that’s what statistically happens. How we “deal with it” initially can be critical in its progression or cessation. Here are some “highlights” of what to do “WHEN” this happens to you.

STOP:  The most important thing you can do is STOP what you are doing. That is, IF you’re “lucky enough” to be pre-warned BEFORE the crisis point of LBP strikes. This step can be critical, as once it hurts “too much,” it may be too late to quickly reverse the process. The “cause” of LBP is often cumulative, meaning it occurs gradually over time, usually from repetitive motion that overloads the region. As stated previously, “IF YOU’RE LUCKY” you’ll be warned BEFORE LBP becomes a disabling/preventing activity. Typically, when the tissues in the low back are over-stressed and initially injured, the nerve endings in the injured tissue trigger muscle guarding as a protective mechanism. This reflex “muscle spasm” restricts blood flow resulting in more pain creating a vicious cycle that needs to be STOPPED!

REACT: This is the “hard part” as it requires you to perform something specifically, but once you prove to yourself that this approach really works, you won’t hesitate. You’ll need to determine your “direction preference”, or the position that reduces LBP. Once established, you can perform exercises to help mitigate your back pain. To make this work, you must be able to perform these exercises in public without drawing too much attention so you can feel comfortable doing them at any time at any place.

EXERCISE A: If BENDING FORWARD feels relieving, the exercise of choice is to sit and a) cross one leg over the other, b) pull that knee towards the opposite shoulder, and c) move the knee in various positions so the area of “pull” changes. Work out each tight area by adding an arch to the low back, rotate your trunk towards the side of the flexed knee (sit up tall and twist – if it doesn’t hurt) and alternate between these positions (10-15 seconds at a time) until the stretched area feels “loosened up.” A second exercise is to sit and rotate the trunk until a stretch is felt. Again, alternate between different degrees of low back arching during the twists, feeling for different areas of stretch until it feels looser, usually 5-15 seconds per side. A third exercise is to sit and bend forward, as if to tie a shoe, and hold that position until the tightness “melts away.”

EXERCISE B: If BENDING BACKWARDS feels best, exercise options include placing your fists in the small of your back and leaning backwards over the fists, or bending backward and holding the position as long as needed to feel relief (usually 5-15 seconds). From a sitting position, try placing a rolled-up towel (make one with a towel rolled tightly like a sleeping bag held with rubber bands) in the small of the back to increase the curve. Lying on your back with the roll and a pillow under the low back can also feel great!

We will continue this discussion next month!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for back pain, we would be honored to render our services.

Tension-Type Headaches – Management Strategies

Tension-Type Headaches (HA) can significantly alter a person’s quality of life. Moreover, they can interfere and sometimes even prevent an individual from performing important activities such as going to work, attending school, or participating in group activities such as sports, music programs, holiday gatherings, and more. The focus of this month’s Health Update is on Tension-Type Headaches (TTH), a common “primary headache” with tremendous socioeconomic impact.

Compared with migraine headaches, tension-type headaches are actually more common and can be equally as disabling. A recent study reviewing popular treatment approaches for TTH reported that establishing an accurate diagnosis is important prior to beginning treatment and finding “…non-drug management is crucial.” Recommendations regarding treatment also include becoming educated about TTH, obtaining reassurance, and identifying trigger factors that can precipitate a TTH. Psychological treatments with scientifically-proven benefit include relaxation training, EMG biofeedback, and “cognitive-behavioral therapy” (CBT). Physical therapy, chiropractic, and acupuncture are widely used, but further research supporting these approaches is needed. The researchers state “simple analgesics” are the primary drug choice for TTH, but they strongly oppose the use of combination analgesics, triptans, muscle relaxants, and opioids, “….and it is crucial to avoid frequent and excessive use of simple analgesics to prevent the development of medication-overuse headache.”  They state that the tricyclic antidepressant amitriptyline is “drug of first choice” when treating chronic TTH, but they point out side effects can be significant, thus hampering their use. The researchers conclude that the treatment of frequent TTH is often difficult, and multidisciplinary approaches can be helpful. THIS IS WHERE CHIROPRACTIC FITS IN! These researchers state that non-drug approaches as well as medications “…with higher efficacy and fewer side effects [are] urgently needed.” They advise that future studies need to focus on optimizing treatment programs to best suit the individual patient utilizing psychological, physical, and pharmacological-treatment approaches.

So, what can chiropractic bring to the table in this “team” treatment approach? First of all, it is non-drug oriented, the need of which clearly was emphasized in this study. Second, the presence of muscle tension at the base of the skull/top of the neck can be addressed VERY SPECIFICALLY with spinal manipulation of the cervical spine, active release, myofascial release, trigger point therapy, manual cervical traction, and more! Third, the use of NON-PRESCRIPTION nutrients such as ginger, tumeric, boswellia, Bromelain, white willow bark, fish oil/omega-3 fatty acids are all non-drug (with fewer potential side effects) options that facilitate in controlling inflammation. Using a home cervical traction device can also be VERY HELPFUL! Specific exercise training aimed at muscle relaxation, stretching, and strengthening (especially the deep neck flexors) can ALL BE MANAGED by a doctor of chiropractic!!!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for headaches, we would be honored to render our services.

Carpal Tunnel Syndrome – What Can I Do to Help? (Part 1)

Carpal Tunnel Syndrome (CTS) can arise as a result of a number of different causes and as such, treatment is guided by the specific needs of the individual and tailored to each individual case. With that said, there are specific treatment strategies that chiropractors provide that address three primary goals: 1) Physical management strategies; 2) Chemical management strategies; and 3) Self-management strategies. All three goals include a component that we, the doctor, control AND a component that you, the patient, can control or manage. This combined effort or “team approach” ALWAYS works best, especially over the long-term. So, let’s break these three management strategies down along with the two components: my job (as your chiropractor) and your job (as my patient)!

1) Physical management strategies: This category addresses the mechanical nature of CTS. That is, compression of the median nerve at ALL of the possible sites, not JUST the wrist/carpal tunnel area. Since the median nerve arises initially from the neck or cervical spine, nerve root compression of C6-T1 (and a little of C5) can give rise to CTS signs and symptoms. As discussed last month, this area can be one of the “great imposters” of CTS and/or it may contribute as a co-conspirator and combine with CTS, which magnifies or increases the CTS signs and symptoms, the so-called “double-crush syndrome.” Other “mechanical” sites of compression can be reviewed in last month’s Health Update, but in brief, these may include the thoracic outlet (shoulder area), Struther’s ligament (just above the elbow), the pronator tunnel (just below the elbow), the anterior interosseous membrane (forearm), as well as at the carpal tunnel itself.

MY JOB (as your chiropractor) is to reduce the pressure on the nerve at any and/or ALL these locations (remember, each case is unique). This can be done by using manual therapies including (but not limited to) manipulation of joints in the neck, shoulder, arm, elbow, forearm, wrist, hand, and fingers. Mobilization of muscles and other soft tissues may include active release techniques, friction massage, trigger point therapy, stretching with and without resistance, traction, and more. Various modalities might be used to reduce muscle tightness, swelling, or inflammation.

A nighttime wrist splint keeps the wrist in a neutral position, as the carpal tunnel’s pressure goes up A LOT when the wrist is bent. Since you cannot control the position of your wrist while you sleep, the brace can REALLY HELP! A BIG part of my job includes teaching YOU about CTS so that you understand the underlying causes, thus allowing you to identify jobs, hobbies, or situations where you may be inadvertently harming yourself. If you can, PROMPTLY identify offending wrist positions and STOP the repetitive injurious movement and then MODIFY your approach to the task, whether it means taking “mini-breaks,” changing the work station set up, or some other approach. Along with this “teaching concept” is exercise training. It is also VERY IMPORTANT for you to properly perform the carpal tunnel stretches and other exercises (see Part 2 next month) on a regimented/regular basis.

YOUR JOB includes wearing the brace (don’t forget or procrastinate), most importantly at night. You can wear it during the day while driving or doing something where you are not “fighting” the brace. In some cases, the brace can bruise you if you are moving your wrist against it repetitively or too hard, and it can actually do more harm than good in those situations. Your job is also to identify ways to do your job and/or hobbies with less torque or twisting of your wrist.

Next month’s discussion will start chemical strategies (#2 on the list above), which includes several very effective and safe approaches in the CTS management process. We will then address #3, “Self-management strategies,” which will include various CTS-specific exercises.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

Fibromyalgia: Exercise is “Key”

Fibromyalgia (FM) is now considered a central nervous system (CNS) disorder rather than a musculoskeletal condition. FM is managed best from a balance of different approaches including chiropractic adjustments, soft tissue therapies, modalities, exercise, diet, supplementation, sticking to a schedule, taking naps, stress management, cognitive behavioral therapy, and more. Common symptoms of FM include chronic fatigue and mental fog. The focus this month is on exercise and the benefits of exercise as it relates to improving quality of life!

Recent research has been published about the benefits of walking – not just for the FM sufferer, but for EVERYONE! Dr. Marily Oppezzo, a Stanford University doctoral adjunct professor in educational psychology and Dr. Daniel Schwarz, a professor at Stanford, have published very convincing evidence that walking is not only physically good for the body, but it’s also mentally good for the brain! In fact, they’ve discovered walking actually improves CREATIVITY! The study found that walking either indoors on a treadmill or outdoors BOTH similarly boosted creative thinking in participants! Hence, for those stranded indoors during climactic weather, whether snowbound in Wisconsin or heat bound in Florida, equal benefit can be obtained from indoor walking, even if it’s not as much fun as being outdoors! Though past research has shown that aerobic exercise generally protects long-term cognitive (brain) function, until this study, the benefits of walking when compared to sitting had not been considered as important. These authors point out that TWICE AS MANY creative responses were produced by subjects when they walked (whether on a treadmill facing a blank wall vs. walking outdoors in the fresh air) than when they sat from a prolonged period of time. This surprised the authors who thought thinking outdoors would easily be favored. They also found that these creative juices continued to flow when the person sat back down shortly after a walk! Now that we know that walking not only facilitates our bodies but also our brain, are there other exercises that can help the quality of life for the FM sufferer?

Dr. Lesley Arnold, a psychiatrist and FM expert at the Univesity of Cincinnati, College of Medicine in Ohio, recommends “a slow but steady pace” when starting a program, making sure that pain and fatigue are under control prior to introducing aerobic exercise. She recommends an initial assessment of the person’s current fitness level and then starts patients at one to two levels below that level, gradually building up stamina to a goal of 20-30 minutes of moderate aerobic activity 5-6 days/week. Exercises that emphasize low-impact, high-aerobic output are the best, and water-based exercises really fit that ticket due to the buoyant nature of water. Running in water against or without a resisting current and simply swinging the arms and legs against the resistance of water are extremely effective. A study published in Arthritis Research & Therapy reported improved health-related quality of life in women with FM for those participating in water aerobics. The soothing benefits of warm water is a good starting point, and classes are often group-based, adding social benefits of camaraderie and motivation, which creates a fun experience that participants can look forward to.  Since FM is a CNS vs. a muscle condition disorder, another “brain” stimulating exercise includes simply balancing. Depending on the age, agility, and comfort of the person, try adding balance-challenging exercising to the mix. A good program to try can be found here:

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!