Repetitive Strain Injuries

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a repetitive stress injury that interferes with the use of the hand. Often the dominant wrist is the injured one but in some patients both wrists can be involved. Symptoms are caused by the pinching/entrapment of the median nerve in the carpal tunnel. Symptoms include pain, numbness in the index, middle fingers and thumb, tingling in the hand(s) and pain shooting up the arm. Left untreated, the condition tends to worsen and can lead to permanent nerve damage. 

Since bones and ligaments have no “give”, this puts pressure on the nerve, which can be worsened by repetitive motion and tasks. Examples of repetitive motion include using a computer for long periods of time or performing assembly line tasks.  Middle age is the most common time in life for carpal tunnel syndrome to occur and there is a higher occurrence of carpal tunnel in females compared to males. Patients seeking treatment for repetitive stress injuries such as carpal tunnel do so because it is less invasive to its allopathic counterparts, which rely on medication and surgery.

How do overuse conditions occur?

Over-used muscles change in three important ways:

• Acute conditions (pulls, collisions)
• Micro-trauma (small tears)
• Hypoxia (lack of oxygen)

These factors cause the body to produce tough scar tissue that binds and ties down tissues, restricting movement. 

Over time scar tissue builds up, causing muscles to become shorter and weaker, resulting in a reduced range of motion, loss of strength and pain. 

Active release techniques are patented massage techniques that address problems with tendons, ligaments, fascia and nerves, which are often the result of overuse.
All of Back to Health’s practitioners are certified in Active release techniques.

Clinical Stages of Carpal Tunnel:

Stage 1→ Uncharacteristic discomfort in the hand

Stage 2→ Symptoms localized to territory supplied by the median nerve

Stage 3→ Impairment of digital function and clumsiness

Stage 4→ Sensory loss in median nerve distribution

Tendonitis

Tendonitis is an inflammation of a tendon often caused by repetitive strain. There are many tendons in the body that are susceptible. When someone has tendonitis, it is painful to contract or stretch the affected muscle and it is painful to touch the inflamed tendon.

Tendonitis can be treated using:

• Active Release Technique
• Massage Therapy
• Acupuncture
• Chiropractic Care
• Inferential Current Therapy

Just as the four seasons are of a cyclic nature so are repetitive strain injuries

Illiotibial Band Syndrome

Most people think of Illiotibial Band Syndrome as affecting the knee but it can also cause problems at its origin – the hip. The illiotibial band is a superficial thickening of tissue on the outside of the thigh, extending from outside the pelvis, over the hip and inserting just below the knee. The band is crucial to stabilizing the knee during running. As you can imagine the continual rubbing of the band over bone can cause some pain and irritation at the hip. 

Signs & Symptoms

• “Stinging sensation” just above the knee joint on the outside of the knee and/or along the entire length of the illiotibial band
• Swelling or thickening of the tissue at the point where the band moves over the femur
• Pain tends to worsen when you overstride, run downhill and when the foot strikes the ground.

Causes

• Anatomical variances such as genu varum (bow legs), excessive pronation of the feet, leg length discrepancy or abnormal tightness of the ITB itself
• Running on a banked/uneven surface, such as the shoulder of the road or an indoor track
• Inadequate warm-up or cool-down
• Running excessive distances or increasing mileage too quickly

Short term treatment for ITB syndrome will involve:

• Decreasing weekly mileage
• Icing of the knee & hip after activity
• Stretching of the illiotibial band

For long term treatment have Dr.Rodwin evaluate your biomechanical alignment- she can treat the muscle injury, as well as any joint restrictions which have occurred to the back, hip, knee or foot. The active release (ART) and trigger point therapy are very effective for ITB problems. It is also beneficial to have Keri-Lyn evaluate your gait/feet to see if a custom orthotic is required. Massage therapy performed by our registered massage therapists – Andrew, Jessica and Ashley can help to release imbalanced and tight muscles.

Trigger points are taut bands of muscle usually felt as a palpable nodule. Some causes of trigger points include muscle overload and repetitive strain.

Repetitive stress injuries are often the result of computer and assembly line work or the result of repetitive motions related to sports such as running.

With repetitive strain injuries the overall goal is pain management and restoration of joint mobility. Massage, acupuncture, chiropractic and ART can help to achieve these goals.

Chiropractic & Active Release Technique (ART)

Chiropractic treatment addresses all the possible causes of RSI’s. The key is determining where the problem originates. Chiropractic adjustments restore proper motion in the joints and the spine.

Acupuncture

Acupuncture speeds up the healing process and decreases inflammation by stimulating the natural release of endorphins. Dr. Rodwin is a certified acupuncturist.

Massage Therapy

Massage therapy relieves pressure on the nerves by stretching the tissue responsible and helps reduce scar tissue.

Pinched Nerves

How Nerves work!

Nerves are like electrical cords that carry information from the brain to the rest of the body and vice-versa. They are distributed throughout the entire body. 

Motor (efferent) nerves carry information from the brain out to the body. This allows the brain to send commands to the various organs of the body. For example, these commands are sent to the muscles causing them to contract and move, or sends information to the heart to either beat faster or slower. 

Sensory (afferent) nerves send information from the body back to the brain for processing, including information about pain, touch, taste, temperature or other information.

The information travels along the nerve by an electrochemical signal, much like information traveling along an electrical cord. When a nerve is pinched, the signal is interrupted somewhere along its path.

What causes a Pinched Nerve

A pinched nerve is caused when a nerve is somehow damaged or injured by direct pressure or compression and is unable to properly conduct its signal. There are many potential causes for a pinched nerve, depending on the location of the nerve. This cause can be examined and the problem can be diagnosed.

A pinched nerve in the neck or lower back can be caused by a vertebral joint restrictions, muscle adhesions/scar tissue, herniated disc, arthritis, bone spurs or spinal stenosis. These can be due to an old accident, improper sleeping positions, and posture at your desk, to name a few!

When the nerve is pinched due to one of these issues many different problems or symptoms can result!

Spinal stenosis is a narrowing of the spinal canal through which the nerves pass with the spine. A pinched nerve in the lower back or buttock can compress the sciatic nerve, which can cause sciatica.

How is a Pinched Nerve Diagnosed?

“When a nerve is pinched, less information goes to the areas it supplies.  Much like a kink in a garden hose causes a trickle of water to come out”

Dr. Barbara Rodwin will ask various questions about their pain, numbness, tingling, weakness, and other symptoms. The patient will be asked about other medical conditions, work history, and family medical history. This information can often assist in identifying the nerve(s) affected. Dr. Rodwin will then examine the part of the body involved. This will include testing the patient's strength, sensation, and muscle tone in specific muscles. Depending on the results of the medical history and the physical examination, the patient may need additional tests.

If Dr. Barbara Rodwin suspects the patient has a pinched nerve (compression of the nerves) in the neck or lower back, X-rays may be necessary to assess possible injury to the spine or arthritis of the spine. Depending on the severity and duration of the patient's symptoms, the patient may also need a MRI scan. Dr. Rodwin may also recommend specific tests for the affected nerve including a nerve conduction study or an electromyography (EMG).

Symptoms of a Pinched Nerve

The symptoms of a pinched nerve depend on what nerve is affected. Each nerve is responsible for sending information to or from specific parts of the body. 

The most common symptoms of a pinched nerve are: pain, numbness, tingling (pins and needles), or weakness of the muscles along the path of the nerve, prickly sensation, stabbing sensation, burning sensation, pain radiating outward from the injured area, the pain may come after periods of sitting or standing, the pain maybe intensified while coughing, sneezing, and laughing.  A weakness in the leg or foot is also a common symptom of Sciatica or a pinched nerve. Also your fingers, hand, toes, buttock, foot falls asleep and you have to shake it awake!

Carpal Tunnel Syndrome

A pinched nerve in the wrist from carpal tunnel syndrome typically affects the thumb, index, and middle fingers. It can also cause a weakness in the patient's grip strength, and atrophy (muscle wasting) of the muscle of the palm near the thumb. A pinched nerve in the elbow from cubital tunnel syndrome affects the forearm, the ring (fourth finger), and the small fingers of the hand. Chiropractic adjustments, active release, massage and acupuncture are very effective for treatment.  

As well changes to a workstation and a brace may be needed.

Treatment for Pinched Nerves

Any type of pinched nerve can be treated. Sometimes the treatment may involve surgery! This should be considered as the last result in the course of finding an answer. Surgery does not always solve the answer, as we see when patients come in to have treatment after surgery.

At Back to Health we like to try the conservative approach first for a pinched nerve. This will involve examining the area, determining the reason for the pinched nerve and offering our advice on ways to unpinch it.

We offer treatments such as: massage for the muscles, active release to the nerve and surrounding tissues, a nerve entrapment technique for the nerve, chiropractic for the surrounding joint that are normally involved, acupuncture for the nerve symptoms and aiding in healing the nerve, advice on proper mechanics for the nerve, stretching, strengthening programs to aid in strengthening the area.

Nerves can be tricky and often require more than one treatment approach, take awhile to heal and require management! There is not a cure for nerve issues that is quick and simple.

Why does my neck or lower back hurt? Could it be a pinched nerve?

Does your neck or lower back hurt? Did you do something funky, and now there's pain?

You are not alone! Neck and back pain is in fact such a common problem in humans, studies suggest that over 90% of all adults will experience neck or back pain in their life time. Don't panic, usually neck or lower back pain can be examined and treated! Even though there are temporary cures that bring relief to neck or lower back pain, if you want to secure yourself against future injuries, you need to learn about the REAL cause behind why your neck or lower back hurts & pinched nerves.

Let's clear up any confusion you have about all of this stuff, so that you can get the proper treatment, and not have to suffer from pain any longer. Find out why your neck or lower back hurts and what pinched nerves have to do with it.

A pinched Nerve is a nerve that is trapped and has something pushing on it. That will cause pain to shoot down the length of the nerve, which is why sometimes you will have pain radiating into your leg or arm.

It can be caused from: abnormal sleeping positions, flat pillows, improper work station set-up, leaning forward in you chair, old injuries, accidents, repetitive motions that are not correct, hereditary factors, improper alignment of your body, vertebral joint misalignments, tight muscles, adhesions in the nerve and disc herniations.

Sciatica

Leg pain – often diagnosed as Sciatica –can be a painful and debilitating problem that commonly interferes with walking, standing, sitting, and sleeping. In some cases it is difficult to find any comfortable position at all. Along with pain, symptoms such as throbbing, numbness, weakness, and “pins-and-needles” can also be present. Adding to the frustration of these symptoms, this type of leg pain is often initiated by a seemingly routine task, or in many cases has no clear cause at all. As the lower 5 nerve roots exit the spinal column they join together to form the Sciatica nerve. 

Sciatica refers to pain that develops as a result of compression or irritation of this nerve. As the nerve roots come together to form the Sciatic nerve – which occurs close to the spine in the upper region of the hip – the Sciatica nerve travels down the back of the leg all the way to the foot. As the nerve travels down along the back of the hip, thigh, knee, and calf it must pass between - and in some cases through - the muscles of these regions. As long as the muscles are loose and flexible, and the nerve is able to freely glide along these muscles, the nerve remains healthy. However, if the nerve becomes compressed or irritated at any point along its path from the spine to the foot, Sciatica pain can develop. It is important to realize that Sciatica refers to a group of symptoms that occur as a result of injury and irritation to the Sciatic nerve and the vertebral spinal joints the nerve exits from.  

One common misconception is that Sciatica always results from a disc herniation of the lower back. Although disc herniations often result in Sciatica symptoms, they are actually one of the less common causes of Sciatica. In fact, it is much more common for Sciatica symptoms to develop as a result of vertebral joint issues, and tight muscles of the hip and leg. 

Summer Activities

If you are travelling try to take your pillow with you. Also when sitting support your lower back with a small cushion or roll up a T-shirt and tuck in into the small of the back.  Keep your neck straight above you shoulders by using a neck cushion while sleeping.

When gardening, try to sit on a stool, or kneel on a pillow. Use your legs to squat down; do not bend from the waist to bend down.  

When painting, try to alternate the use of your arms to roll the paint. If painting the ceiling put the roller on a broom handle, this straight up but forward slightly! 

Always maintain excellent body alignment with all sports!  If you have questions, please ask!