Post-Traumatic Fibromyalgia
October 7, 2009
Fibromyalgia (FM) has a long reputation for being a controversial diagnosis. Some health care providers (HCPs) feel FM is a legitimate condition that warrants treatment and research while others feel it’s a “garbage can diagnosis” that HCPs throw patients into when they’re not sure what diagnostic label to use for a patient’s condition. Regardless of the personal beliefs of individual HCPs, there have been two general classifications of FM – primary and secondary. Primary FM occurs when there is no underlying health condition participating in the patient’s overall health status and onset of FM. Secondary FM results from an underlying condition that contributes significantly to the patient’s health status, such as irritable bowel syndrome and over time, gives rise to the onset of FM.
Posttraumatic FM belongs to the secondary FM classification when the traumatic related injury results in the patient developing FM. A Canadian study reported that 25-50% of FM patients reported a traumatic event just before the FM symptoms began. This study surveyed different specialty physician groups to determine which issues were most important in causing the onset of widespread chronic pain after a motor vehicle trauma. Five factors were studied to determine how important each was to the HCP in arriving at a FM diagnosis in a case study of a 45 year-old female with a whiplash injury who developed chronic generalized pain, fatigue, difficulties in sleeping and diffuse muscle tenderness. These five factors included:
- The number of FM cases diagnosed weekly by the HCP
- The patient’s gender
- The force of the initial impact
- The patient’s psychiatric history before the trauma
- The initial injury severity
Also described as important were the patient’s pre-injury health status, fitness level and psychological health. All HCP groups were reluctant to blame the car accident as causing FM, but rather placed more importance on the patient attitude, personality, and level of emotional stress. The least important of the five points were numbers 3 and 5. The orthopedic group also included “ongoing litigation” as a cause but as a group, they were the least likely to agree on the FM diagnosis (29%) in the 45 year old case study. Rheumatologists were highest at 83%, followed by general practitioners at 71%, and physiatrists at 60%. A most interesting observation was that once the data was analyzed, ONLY the patient’s pre-accident psychiatric history remained in the model of predicting agreement or disagreement with the FM diagnosis.
Posttraumatic FM can result from any type of trauma, not just motor vehicle collisions. Other “secondary” FM causes besides trauma, can include systemic conditions such as irritable bowel syndrome, chronic fatigue syndrome, and other internal disorders that in part, alter the person’s ability to obtain restorative sleep. Hence, an important focus of treatment should be placed on helping the FM patient obtain restful sleep. Chiropractic management strategies have included manipulation, mobilization, soft tissue therapies, physiological therapeutic agents such as electrical stimulation, ultrasound, the training for home use of traction, the use of nutritional counseling and supplementation, and the training of exercise. Many studies support success with this multidimensional approach to treating FM as chiropractic attacks the FM condition from multiple directions, often yielding highly satisfying results. We are committed to help you or a loved one that may be suffering with FM, and sharing this information may be one of most significant acts of kindness you can give.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, and South Plainfield.
Carpal Tunnel Syndrome (CTS) – “Fact Sheet”
October 2, 2009
What is it? Carpal Tunnel Syndrome (CTS) occurs when a nerve on the palm side of the wrist is pinched. It is named after the area of the wrist from where the symptoms occur. The Carpal Tunnel is basically a horseshoe shape made from 8 small carpal bones and the ends of the horseshoe are connected with a ligament thus completing the “tunnel.”
What are the symptoms? CTS symptoms include pain from swelling of the tendons inside the CT. When the nerve pinch occurs, numbness, tingling, or a half asleep sensation into the 2nd, 3rd, and 4th fingers occurs. This is often worse at night due to the wrist being bent when asleep. This often wakes the person and shaking/flicking the hand/fingers is needed to “wake them up.” Grip weakness is also associated with CTS such as difficulty opening jars.
What are the causes? Usually, over use from tasks including repetitive line work (meat/fish/poultry packing, cookie/food packing), typing, sewing, carpentry, waiting tables, and the like. Other “contributors” include hormone related conditions such as hypothyroid, dysmenorrhea, diabetes, and obesity. These fast/repetitive movements cause swelling of the tunnel’s contents (9 tendons and the median nerve) and the nerve is pushed into the ligament connecting the ends of the horseshoe/tunnel.
Who is at risk? Gender is a significant factor as women are 3x more likely to develop CTS than men as the CT may be smaller in woman. The dominant hand is often first affected and more severe. Hormone imbalances as described above also increase risk.
How is it diagnosed? The history of the symptoms as well as physical examination of the hands, arms, shoulders and neck can lead to the proper diagnosis. The exam consists of trying to reproduce the numbness into the fingers by pressing/holding over the CT and other areas where the nerve runs down the arm (including the neck where the nerve originates), tapping over the CT with a reflex hammer, bending and holding the wrists at the extreme endpoints of motion. Also, poking the skin with a sharp object and comparing the 2nd to 4th fingers to other parts of the hand and the opposite side commonly yields differences between the two sides. Questionnaires and hand diagrams completed by the patient are helpful and quantify the degree of severity. Tests used during the course of treatment help track improvements. More sophisticated testing includes an EMG (nerve conduction test) that tests the motor and sensory changes when the nerve is pinched.
How is it treated? Chiropractic approaches include manipulation of the wrist, hand, forearm, shoulder and neck, specifically addressing the areas of greatest restricted motion. Soft tissue therapy includes massage, active release, graston, trigger point, and a host of physical therapy modalities such as light/low level laser, IFC, ultrasound, microcurrent, and low frequency approaches. Exercise training to be repeated multiple times per day is very helpful. Wrist bracing especially at night is also a common treatment approach used by all health care providers. Nutritional counseling and supplementation is also very helpful.
How can it be prevented? Work station assessments, staying in shape (avoid obesity), taking “minibreaks” when doing repetitive work, and proper treatment for conditions like hypothyroid, diabetes, and other disorders associated with CTS.
To learn more about Carpal Tunnel Syndrome, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
Whiplash – Important Points To Know
September 30, 2009
What Is It? Whiplash is an injury to the soft tissues in the neck including ligaments, joint capsules, muscles and their tendons, and intervertebral disks. It can also involve the nervous system tissues in more severe cases, resulting in radiating arm pain.
How does it happen? During a car crash, most commonly a rear-end collision. The sudden jolt occurs so fast we cannot brace ourselves adequately and the head accelerates back and forth beyond the limits of the ligaments that hold our bones firmly together (often referred to as a “sprain”). Because of the significant range of motion of the neck, the weight of the head, and how is suspended on the neck, the neck is particularly vulnerable to this type of injury (more commonly worse in woman due to a more slender neck).
What are the symptoms? The primary symptom is neck or upper back pain that may develop immediately or be delayed days, weeks, and sometimes months. A partial list of possible symptoms (each injured person’s symptoms are different) include: muscles spasms, loss of movement, headache, dizziness, concentration &/or memory loss, difficulty swallowing, chewing &/or hoarseness, burning or tingling, shoulder/arm/hand radiating pain, and more.
How is it diagnosed? Even when symptoms do not seem significant, a health care provider can diagnose the condition by taking a careful history and performing a physical exam. X-rays showing a change in the curvature or contour of the neck, &/or MRI or CT scan to better assess the disk and nerve roots when pain radiates down an arm may also be indicated. When persistent concentration/memory loss is present, a consult by a neuropsychologist is helpful.
How is it treated? In most cases, non-surgical methods are usually appropriate. If you go to a medical doctor, typical approaches include a wait & watch approach and/or medications such as anti-inflammatory drugs, pain killers, &/or muscle relaxants. MD’s may refer the patient to physical therapy. When these methods fail, referral to a physiatrist may result in injection therapy (epidural steroid, facet injection, trigger point injections). Chiropractic care includes spinal manipulation, mobilization, soft tissue release techniques, exercise training, activity modification training, and physical therapy modality use (electrical stimulation, traction, ultrasound, low level laser therapy – LLLT, TENS unit). Care may also include a mix of provider approaches, when appropriate.
How can it be prevented? The degree of severity of whiplash can be decreased or maybe avoided completely with the following: the use of seatbelts (especially in high speed collisions), placing the headrest close to the head (< 1 inch) and high enough to avoid “ramping” over it. Placing the seat back more vertical/upright can minimize ramping. Do not partake in distractive activities while driving – cell phone use, adjusting the radio, taking your eyes off the road (eye contact during conversation), dosing off, reading a book (this is more common than you think!), and others. Bracing yourself has not been shown to be very helpful – whiplash happens too quickly to voluntarily brace your neck muscles. For athletes, wear appropriate protective gear when engaging in sporting activities and use proper form / technique during the athletic activity.
To learn more about Whiplash and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
Could Neck Problems Be Affected By Your Posture?
September 25, 2009
Scotch Plains and Bayonne Chiropractor Comments: While most of us have a look in the mirror at least once a day, few of us look at our appearance from a different angle, such as from the side. But, the view from the side can be quite revealing if you suffer from chronic neck pain.
First, note the position of your head in relation to your shoulders. Is it right above the shoulders or does it lean forward from your chest? If it does, this would be called forward head posture, and can come from a problem in your neck. Lower areas of your spine can also cause this problem. Some of us have increased our weight over the years with much of it added to our abdominal region. Because of this increased core weight, the body must counter-balance the weight gain by causing the lumbar spine to “sway- back.”
While this “sway-back” problem can create pain this the lumbar spine, it can also have far reaching effects in the posture of the neck. Usually someone with a protruding stomach and sway back will have somewhat rounded shoulders and a forward head posture. If treatment is only directed at the neck without considering how other areas may affect the stability of the neck, then the results may be less than optimum.
In an accident, many areas of the body can potentially be injured.
As a chiropractor, I not only look at your primary injuries but also how mechanically one area of the spine can affect a distant area. These more distant areas can cause neck pain by referral or they can impede complete recovery because the body is compensating for abnormal posture or movement elsewhere.
X-rays of the full spine can show this abnormal posture as can a detailed postural analysis from our office.
So do you like what you see when you view your posture from the side? If your posture leaves something to be desired, or you’re wondering whether your neck problem could be improved by changing another part of your spine, then it is important to be thoroughly checked. Just examining the neck after a whiplash may leave some injuries undiscovered. Are there tender spots in other areas of the spine? Does your overall upright posture seem lacking?
To learn more about Neck and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski, DC services all of Union County and Hudson County in New Jersey
Headaches in Children
September 23, 2009
Scotch Plains and Bayonne Chiropractor Comments: Ouch! Did you know that 96% of children experienced some acute pain in the previous month? Headache, at 78%, is the most common type of pain reported. You may not have known that your child was experiencing pain. Sometimes children will show behavioral changes rather than complain of head pain. One study tested parents’ knowledge of headache vs. the children’s recollection. The children reported headache about 57.6% of the time for the previous month. Mothers, and especially fathers, tended to underestimate whether their child had suffered a headache.
It is alarming that so many children each month have headaches and 6% of schoolchildren have chronic pain. Over the past 30 years childhood migraine and “frequent headache” have substantially increased. No one really knows for sure what lifestyle changes are producing these painful trends.
Children with frequent and severe headaches are more likely to have difficulties with home life, friendships, classroom learning, and leisure activities. The child’s quality of life and life of those around them is substantially affected by headaches.
You’re probably not sure if taking pain pills at such an early age is the right thing to do. You have to be concerned because it is consumption of pills over many years that leads to problems. They’re not to be taken casually like vitamins, and serious internal bleeding or kidney problems can result from long-term use.
One study looked at headaches in childhood over a 20-year time span. They found that medication use steadily increased, and 70% were still consuming medications daily, 20 years after being originally diagnosed. Most patients had tension-type and migraine, and rated the headaches as moderate to severe. 45% of those surveyed also said that non-drug approaches were the most effective for them. There are non-drug and non-surgical approaches that have been proven effective. It is important to consider these options especially they generally don’t carry with them as many side effects.
Spinal problems in children can begin with neck trauma during delivery. Also many infants fall from a high place during the first year of their life. This can occur as the diaper is changed. These and other tumbles and traumas may cause the spinal joints to sprain, irritating the nerve. The chiropractor’s approach is to look at the child’s spinal structure to determine if there is a spinal cause for the headache. Adjustments are delivered to specifically address the areas in the spine that have sprained or subluxated to allow them to function more normally.
To learn more about Headaches, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski, DC services all of Union County and Hudson County in New Jersey
Fibromyalgia and Cord Compression?
September 21, 2009
Bayonne and Scotch Plains Chiropractor Comments: Fibromyalgia is a difficult problem to diagnose or determine its cause. Since exercises, diet, and weight loss can be so helpful to fibromyalgia patients, we may think they can completely solve the problem.
Chiropractors recognize the importance of good spinal posture in affecting a variety of health problems, including fibromyalgia. It’s important to not think of the disease as having a single solution, but rather as a more complex entity, needing a comprehensive approach. But is there any research on the spine being involved in patients with fibromyalgia?
Recent research (Holman AJ. Positional cervical spinal cord compression and fibromyalgia: a novel comorbidity with important diagnostic and treatment implications. J Pain 2008; May 20 epub.) has looked into a specific problem seen in fibromyalgia patients: spinal cord compression. The scientist took MRIs of fibromyalgia patients with the neck in different positions such as max forward and backward bend. These positions can show the spinal cord is compressed/pinched where a neutrally positioned MRI or CT scan may not. In the study, 71% of patients with fibromyalgia had positional cervical spinal cord compression.
So what does this mean? It means if you have fibromyalgia there may be an undetected cervical compression problem that may also be affecting you.
Good neck posture and mobility are keys to good health. We can diagnose your condition and see if there is a spinal component to your problem that may have been overlooked. Sometimes it’s the low back pain that keeps us from exercising and ultimately getting rid of the fibromyalgia-inactivity-pain cycle. And, as the research above suggests, maybe the problem is in the neck and this needs to be addressed in a specific and comprehensive manner. Sometimes immobility in one area of the spine is compensated for in another, which can make your ability to heal somewhat lessened. Maybe the neck has been a concern of yours for a long time since the fibromyalgia symptoms came on following a neck trauma such as a whiplash. If you also suffer from headaches and have spinal pain, these are important clues that some of your symptoms may be spinally related.
It’s important to view your fibromyalgia symptoms from a global perspective, and not just think of one isolated issue as the root cause, and the only place where treatment needs to be directed.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski, DC services all of Union County and Hudson County in New Jersey
Torticollis and Whiplash
September 18, 2009
Scotch Plains and Bayonne Chiropractor Comments: Torticollis is a condition where a joint or disk is injured and you can’t move your neck. Sometimes the head is bent or turned a little to one side. And sometimes you’re straight but can barely move in any direction. This type of problem is usually caused by a disk injury. Whiplash can cause this condition or it can come on by sleeping in an awkward way.
The spine is meant to move a lot, especially the neck. This is so we can quickly look around, above, and below. When the spine cannot be moved without intense pain, it’s a sign of both a joint and nerve problem. The nerve may be pinched or compressed, stretched, or irritated by chemicals from inflammation/swelling. To protect the nerve, the body puts a splint on it with muscle spasm. This keeps you from moving your head.
If the joint injury is reduced, by aligning the bones of the spine, the healing and scar tissue will stabilize the area in alignment. If the joint is left out of alignment or is hypermobile, this can lead to future degeneration. To get the joint moving and functioning normally again, you need to have motion through the joint adjustment, and exercises to keep activated. One study showed that patients who wear foam collars after whiplash, do worse than patients who were actively mobilized without collars. It may at first seem counterintuitive to move when pain is there, but it’s all about moving within your pain tolerances. Usually small motions are still preserved. Instead many patients wear collars or do not move their neck enough. This causes the muscles to become more inflexible and contracted. Overtime it can lead to substantial weakness and even atrophy (wasting away).
So even in the early stages of a whiplash, when the neck can barely move at all, small movements that are not painful are encouraged. The specific adjustment will reduce the irritation to the nerve that is signaling the muscles to spasm. Once the nerve is freed, then the muscle will usually release. Greater ranges of movement will follow as the body allows. This should not be hurried because the nerve and disk is at risk for re-injury in the very early stages of healing.
Medications and surgery will not correct the alignment of the spine. When the joint is sprained, it needs to be re-aligned to reduce the tension on the ligaments and disk. Your doctor of chiropractic can guide you through this process so the range of motion returns quickly.
To learn more about Whiplash and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services both Hudson County and Union County in New Jersey
New Research on the “Double Crush” link to Carpal Tunnel Syndrome
September 16, 2009
Bayonne and Scotch Plains Chiropractor Comments: Carpal tunnel syndrome patients often complain of neck pain. The same nerves that go through the wrist tunnel, emerge from the neck and can be compressed or irritated at the neck joints. If the nerve is pinched in these two areas, it has been referred to as a “double crush.” Because of this irritation at the neck, focusing only on the wrist for treatment may not be a comprehensive solution to this often debilitating problem.
Recent research (Russel BS. Chiro & Osteo 2008,162doi:10.1186/1746-1340-16-2) has reviewed the evidence for and against this linkage of two problems. Dr. Russel concludes if the wrist symptoms only involve sensation, rather than weakness, then the double crush link may be more tenuous. However, if you have a “motor” problem with a nerve, and experience weakness or loss of grip strength, then the implication of a problem also at the neck appears to be more relevant.
However, since many patients with carpal tunnel will also have neck pain, a trial of chiropractic care at both the wrist and neck is a conservative strategy that seems prudent and should be considered.
If your carpal tunnel symptoms developed after a neck injury or you also have pain into the upper arm or shoulder, these may be clues that your nerve is irritated in more than one location.
Getting to the cause of a problem, rather than just treating the symptoms, is a hallmark of specific chiropractic care. We can assist you with doing corrective wrist strengthening exercises and stretches, which may relieve pressure at the wrist tunnel. Some patients can benefit from nutritional counseling and even weight-loss strategies, since excessive weight is a risk factor for developing carpal tunnel syndrome. Other patients may need simple ergonomic instruction such as modifying your posture at a workstation, to take pressure off of both the neck and wrist.
The important thing is get properly diagnosed, with x-rays if needed, to get a full and comprehensive picture of the actual problem. Simply limiting wrist motion with a splint may not be enough to make the wrist and hand both pain-free and functional. Many people only consider surgery or daily medications as their only alternatives and fail to consider natural and drug-free chiropractic care
To learn more about carpal tunnel syndrome, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services both Hudson County and Union County in New Jersey
Neck and Arm Pain – The Herniated Disk?
September 14, 2009
Scotch Plains and Bayonne Chiropractor Comments: Patients that present with neck pain along with arm numbness, pain, and/or weakness, often ask, “…what’s causing this pain down my arm?” The condition is often caused from a bulging or herniated disk pinching a nerve in the neck. The cause of this complaint can include both trauma as well as non-traumatic events. In fact, sometimes, the patient has no idea what started their condition, as they cannot tie any specific event to the onset.
The classic presentation includes neck pain that radiates into the arm in a specific area as each nerve affects different parts of the arm and hand. Describing the exact location of the arm complaint such as, “I have numbness in the arm and hand that makes my 4th and pinky fingers feel half asleep,” tells us that you have a pinched C8 nerve. This nerve can also be pinched at the elbow and make the same two fingers numb. The difference between the two different conditions is when the nerve is pinched in the neck, the pain is located from the neck down the entire arm and into digits 4 & 5 of the hand. When the nerve is pinched at the elbow, the pain/numbness is located from the elbow down to the 4th & 5th digits, but no neck or upper arm pain exists.
Examination findings usually include limitations in certain cervical (neck) ranges of motion (ROMs) – usually in the direction that increases the pinch on the nerve. Another common finding is the arm is often held over the head because there is more stretching on the nerve when the arm is hanging down and pain in the neck and arm increases. Hence, raising the arm over the head reduces the neck/arm pain. To determine where the nerve is pinched, there are a number of different compression tests that can recreate or increase the symptoms. Some compression tests include placing downward pressure on the head with the head pointing straight ahead, bent or rotated to each side. Other compression tests are performed by pressing in areas where the nerve travels such as in the lower front aspect of the neck, in the front of the shoulder where the arm connects to the chest/trunk, at the elbow and at the wrist. If there is a pinched nerve, numbness, tingling and/or pain will be reproduced when pressure is applied to these regions. Other tests include testing reflexes and muscle strength in the arm. When a nerve is pinched, the reflexes will be sluggish or absent and certain movements in the arm are weak when compared to the opposite side. Another very practical test is called the cervical (neck) distraction test where a traction force is applied to the neck. When neck and/or arm pain is reduced, this means there is a pinched nerve. This test is particularly useful because when pain is reduced, the test supports the need for a treatment approach called cervical traction. It has been reported that the use of cervical traction when applied 3x/day for 15 minutes each, at 8-12 pounds, 78% of 81 patients reported a significant improvement in symptoms, which is very effective. Other forms of care that can be highly effective include spinal manipulation, spinal mobilization, certain exercises, physical therapy modalities, and certain medications.
To learn more about Neck and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services both Hudson County and Union County in New Jersey
Oh, My Aching…Leg?
September 11, 2009
Certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back. When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg. When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks. The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments. The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.
When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.
When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot. It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).
When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way. Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.
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Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
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