Carpal Tunnel Syndrome (CTS) – Common Issues

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Houston Doctor Comments: You are driving down the road and you notice numbness and tingling in your fingers.  You find temporary help by shaking and flicking the fingers, trying to “wake them up.” You’ve also noticed your sleep is becoming interrupted and the need to shake and flick the fingers in the middle of the night is becoming more frequent.  If this sounds like you or someone you know, you’re not alone.  This condition affects many workers as well as “stay-at-home moms,” as woman are 3 times more likely to develop CTS, or carpal tunnel syndrome, due in part that the carpal tunnel itself is smaller than those in men. Also, women tend to work faster in fast, repetitive jobs, and are often hired specifically for that reason.  Further, when workers are paid by the number of pieces they produce, the tendency is to try complete as many pieces as possible so as to make that much more over their base hourly wage.cts symptoms


Basically, CTS is caused by pressure building up in a small confined space through which a nerve (the median nerve) and 9 tendons converge into this tight opening into the hand. When repetitive work/fast movements are performed over hours at a time and day after day, the friction produced by the tendons rubbing against each other results in heat, swelling, pain, and median nerve pinching which produces the classic symptom of tingling/numbness into the 2nd, 3rd and half of the 4th fingers.  Hence, those at greatest risk for developing CTS include line workers such as manufacturing, sewing, finishing, cleaning, and fish and/or meat packing.  In 1998, 3 of every 10,000 workers lost work time due to CTS of which half missed more than 10 days of work.  Considering the increased amount in today’s dollars of medical and disability costs, the average lifetime cost of CTS was estimated at $30,000 for each worker back in 1998.


So, how do you know if you have CTS?  The early signs include occasional numbness or tingling in the fingers that you probably wouldn’t think much about since simply shaking your hand or flick the fingers, it goes away.  As the numbness becomes more frequent and it does not respond by shaking and flicking the fingers as quickly, you might take notice.  Without proper management, difficulty buttoning shirts/cuffs, writing, holding onto small objects, opening jars, all become gradually more pronounced.  When sleep becomes interrupted, especially when it becomes necessary to get up and move around before being able to return to sleep, that’s when people usually decide, “I better see someone for this!”


Treatment success is directly related to how fast a person reacts by making a prompt appointment.  The best results always occur when care is obtained quickly, when the initial symptoms first appear. In addition, there are sometimes underlying contributors or causes such as diabetes, arthritis, pregnancy, birth control pill use, hypothyroid, obesity, and other conditions that may need proper management in order to relieve the symptoms.  Non-surgical care includes the use of wrist splints (especially at night when sleeping), anti-inflammatory measures (medications, gluten-free/paleo diet, vitamin B6 and others such as omega 3 fatty acids/fish oil, vitamin D3 in high doses, calcium, magnesium, CoQ10), work station modifications, forearm exercises, chiropractic manipulation of the neck and arm, acupuncture, and certain modalities such as low level laser/light therapy, can all be helpful.


Surgery should always be considered a “last resort” after all non-surgical approaches have been exhausted.  Rarely is there a “medical emergency” that warrants prompt surgical release except in cases of fracture where the carpal tunnel canal is abruptly reduced in size.  You need a “quarterback” to help guide you in the treatment/management process.  Chiropractors are well trained to manage CTS and offer a non-drug, non-surgical solution to this potentially disabling condition.


Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with a Clear Lake chiropractor or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!




Whiplash: Where Is My Neck Pain Coming From?

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Houston Chiropractic Doctor Comments: Last week while driving to work, you’re stopped at a red light and glance in the rearview mirror and notice that a car is approaching from behind way too fast.  The next thing you remember is the squeal of the tires and a loud crash with an accompanied sudden jolt as your car is propelled forward by the impact. Your initial reaction is one of shock, wondering is anyone hurt? How bad is my car damaged? Will there be another hit? Should I get out of the car? I’m going to be late for work! Within a few minutes, the police arrive and after about an hour of taking statements from the two drivers and a few witnesses, you decline an ambulance offer to take you to a nearby hospital for an examination as, “…this little stiffness and ache in my neck is no big deal.”  Happy you can still drive your car, you arrive at work an hour and a half late.  After reviewing the details of the crash with co-workers several times, you begin to notice a headache, your neck stiffening up and movements becoming limited and painful.  After another couple of hours and a few Ibuprofen, the neck pain has increased and you now have a whopping headache. You decide, “I better go see my chiropractor to see if something is wrong.”


After the exam and x-rays, the chiropractor shows you a chart and explains the mechanism of injury that usually occurs in a low Houston Whiplash Treatmentspeed rear-end collision.  A couple of things that were said really hit home in helping you to understand how such a seemingly minor crash can create so much pain.  The first is that it is not possible to voluntarily contract a muscle quick enough and “brace” to prevent the acceleration of the head. Upon impact, as the car is propelled forwards, the head initially goes backwards and then when the muscles in front of the neck are stretched to their limits, the head is then “whipped” forwards in a “crack the whip” type of response and all of this takes less than 600-700 milliseconds!  Because of the far limits of neck motion being reached during this process, the ligaments that hold the vertebra together are often stretched and/or torn.  This can be appreciated on the bending neck x-rays which shows one vertebra sliding forwards on the one below and the angle created being greater when compared to the surrounding vertebra.  The second point of discussion that stands out was the fact that your head was rotated at the time of impact from looking in the rearview mirror places the neck at a greater risk of injury because of the twisting motion that occurs during the “crack the whip” process.  Another interesting point: because there wasn’t a lot of car damage, the shock and force of the impact was not absorbed by crushing metal and that energy is therefore transferred to the contents in the vehicle, including the occupants.  That is why your briefcase ended up on the floor and your glasses flew off during the crash. Another point of discussion was made concerning the difference between genders and the degree of injury, as women are more likely to be injured more severely because of the less muscular and sometimes longer female neck.  The degree of injury is also at greater risk when there is osteoarthritis in the neck that pre-exists the crash.  An analogy of how a young sapling branch can bend without breaking verses the “old oak branch” which snaps and breaks when its only bent slightly. So, if you are a middle aged, female with a long slender neck with pre-existing arthritis looking in the rearview mirror prior to impact in a rear-end collision, ligament over stretching / tearing is highly probable.


In summary, it is important to obtain prompt evaluation and treatment by your chiropractor as soon as possible as when time passes without treatment, it is more difficult to bring about a reduction of pain and increased motion and, it will generally take longer.  Taking medication for pain only postpones the needed process of restoring movement and function of the neck so that should not be the only treatment.  In general, a “wait and watch” approach is not wise in these types of injuries. If you or a loved one is suffering with whiplash, sharing this information may be one of most significant acts of kindness that you can give to those that you care about.


Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!



Neck and Arm Pain – The Herniated Disc?

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Clear Lake Doctor 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 disc 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.Neck and Arm Pain


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. Other forms of care that can be highly effective include spinal manipulation, spinal mobilization, certain exercises, physical therapy modalities, and certain medications.


If you, a friend, or a loved one are struggling with a herniated disc in the neck with associated arm complaints, we will properly assess your condition, run the appropriate tests, and administer the appropriate care that is needed.  We also coordinate services with other health care providers when necessary.  This recommendation may represent one of most significant acts of kindness you can give to those that you care about.


Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

What Makes Low Back Pain So Common?

Clear Lake Doctor Comments: Low back pain (LBP) is one of the most common types of pain involving the musculoskeletal system.  LBP sufferers may sometimes miss work or be unable participate in desired activities, social outings, and the like.  It can be so disabling that out of desperation, they visit the ER.

low back painThere are many causes of LBP. Some of the obvious include over lifting/carrying, performing a task for too long or with too many repetitions, and sitting or standing in one position for too long.  However, frequently LBP seems to occur for no apparent reason, or at least none that can be clearly identified.  One of the most basic causes of LBP is simply standing on two, rather than four legs.  When comparing a 4-legged to a 2-legged subject, arthritis of the spine and disc degeneration occurs much earlier in those of us with two legs.  This is due partially because 2/3rds of our weight is supported by the low back and pelvis.  In addition, vertical loading occurs in the 2-legged subject whereas the load is distributed between four legs in a horizontal fashion in the 4-legged species.  Other less obvious causes of LBP include physical characteristics such as flat feet (fallen arches), a short leg resulting in a tipped pelvis, carrying too much weight, being out of shape/weak muscles, as well as hereditary factors.  Non-physical characteristics include diet, exercise participation, lifestyle, stress and other psychological conditions such as depression, anxiety, bipolar disorders, and others.  Hence, treatment must address the entire person, not just the low back since often, several of the characteristics mentioned here are present and often participating in the cause for LBP.

Because many of these characteristics are not properly attended to, LBP tends to be recurrent, where multiple episodes come and go over time.  In years past, health care providers would focus the majority of their attention on the physical characteristics of LBP and when treatment results was ineffective, the blame was placed on the psychological aspects for which little, if any, treatment was offered.  However, over the last 20 years, the shift towards treating the whole person or, adopting the biopsychosocial model (bio- = physical, psycho- = mental, and social = how LBP is perceived and affects daily social interaction) has been emphasized as the appropriate approach when managing patients with low back pain.  No longer should the psychological aspect be ignored but rather, identified and treated so that this significant barrier to recovery can be properly managed.

Regarding treatment, unless someone presents with a “red-flag” which, for LBP sufferers include cancer, fracture (especially unstable fractures), cauda equine syndrome (spinal cord pinching resulting in bowel / bladder control loss), or infection, immediate/emergent care is not required. A careful health history followed by appropriate tests can usually identify these “red flags.”  Otherwise, surgery for LBP is not recommended until at least 4-6 weeks of treatment with non-surgical approaches are first utilized and, an identifiable “lesion” can be identified that clearly is causing the presenting complaints and clinical findings.  Chiropractic has an obvious advantage over specialty care when considering non-surgical treatment of LBP.  Both physical and emotional issues are identified and a “team” approach with other health care providers when required is ordered.  Moreover, all the international guidelines published for treating LBP recommend spinal manipulation BEFORE most of the other non-surgical approaches are tried due to medication side-effects and, the successes reported in many studies where spinal manipulation is performed.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with your Houston chiropractor or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!