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.
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 BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Dr Beecher’s December 23 Weekly Chiropractic Newsletter
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WEEKLY HEALTH NEWS UPDATE
Week of Monday, December 23rd, 2013
Mental Attitude: Meditation May Slow Progression of Dementia. A small study of adults with a diagnosis of mild cognitive impairment (which may progress to dementia) divided participants into two groups. One group participated in Mindfulness- Based Stress Reduction (MBSR) using meditation and yoga. The other group served as a control. The MBSR group participated in a day-long retreat, met as a group for two hours a week, and was encouraged to meditate at home for 15-30 minutes per day. After just eight weeks, brain scans of MBSR group participants showed positive improvements related to memory and cognitive function. This may indicate a slowing in dementia progression. Neuroscience Letters, November 2013
Health Alert: Depression Worldwide! When compared to other diseases and injuries, “major depressive disorder” (MDD) ranked as the second leading cause of global disability and 11th leading cause of global burden (quality years lost to disability). PLoS Medicine, November 2013
Diet: Green Tea Slows Prostate Cancer Progression. New research shows that green tea polyphenols may help slow or prevent some types of cancer. A double-blind, placebo-controlled study found that premalignant prostate lesions were three times less likely to progress to malignant tumors in men who took a 600mg green tea catechins supplement daily for a year (9% vs. 30% in the control group). American Journal of Clinical Nutrition, December 2013
Exercise: Combat Health Conditions! No matter what your current weight, being active boosts high-density lipoprotein (HDL), or “good” cholesterol, and decreases unhealthy triglycerides. This one-two punch keeps your blood flowing smoothly, which decreases your risk of cardiovascular diseases. Regular physical activity can help you prevent or manage a wide range of health problems and concerns including stroke, metabolic syndrome, type 2 diabetes, depression, certain types of cancer, arthritis, and falls. Mayo Clinic, November 2013
Chiropractic: Herniated vs. Bulging Disks? Disks act as cushions between the vertebrae in your spine. They’re composed of an outer layer of tough cartilage that surrounds softer cartilage in the center. A bulging disk extends outside the space it should occupy. The bulge typically affects a large portion of the disk, so it may look a little like a hamburger that’s too big for the bun. A herniated disk results when a tear in the outer layer of cartilage allows some of the inner cartilage to protrude out of the disk. The protrusion of inner cartilage in a herniated disk usually happens in one distinct area. Herniated disks are also called ruptured disks or slipped disks. Mayo Clinic, November 2013
Wellness/Prevention: Stressed Mothers and Offspring. Female rats born to mothers who had been through stressful life events prior to pregnancy showed increased expression of the CRF1 gene (a gene that mediates the body’s response to stress) in the frontal cortex, the part of the brain involved in emotional regulation and decision making. When the female offspring were exposed to stress, they behaved differently than female offspring whose mothers were not stressed prior to pregnancy. This finding is a part of a growing body of evidence that a parent’s experiences can affect their offspring, even before conception takes place. Biological Psychiatry, November 2013
Quote: “There is little success where there is little laughter.” ~ Andrew Carnegie
This Weekly Health News Update is compliments of Dr. Ward Beecher and Beecher Chiropractic Clinic. If you have any questions or comments, please contact us at 281-286-1300 or BeecherChiropractic.com .
What Jobs Cause a Bad Back?
Houston Chiropractor Comments: Back problems are commonplace in society. It is important to ask if there might be certain risk factors for back injury that should be avoided if possible. While we cannot pick our genetic make-up or even our current occupation (for most of us), how we interact with our daily tasks can be the difference between disabling pain and minor aches.
Some of the most strenuous jobs are those tied to the construction industry. Concrete-reinforcement workers and carpenters have more back pain than what is typically seen in office workers. But office workers can be a greater risk for carpal tunnel symptoms. Each of these jobs has unique characteristics that make certain locations of the spine more affected than others.
Lifting heavy weights (e.g. concrete, lumber), especially in awkward positions makes the discs in the low back vulnerable to the load, which can exceed the strength of the ligaments. This is called a sprain and in severe cases the disc can bulge or herniate. If the worker can use good ergonomics (e.g. symmetrical lifting), then the disc can more safely resist the load. It is also known that the spine is stiffer in the morning, and develops higher pressures in the disc when a worker lifts at this time of day. Taking this into account, one can do more light lifting in the early morning. In almost every case one should never lift anything, even a light object, by doing a twisting motion. This action is where the spine can easily be damaged. Getting a buddy to help with a lift is a solution that many do not try.
Sitting for prolonged periods can also be damaging to the spine. First there is the inactivity, which causes muscles to become weak. The spine is designed for movement, especially walking. An apple a day is good but a walk a day is better. Sitting also causes increased pressure in the disks of the low back. If you add vibration (e.g. truck drivers), the sitting seems to be much worse. An anti-vibration seat, frequent walk breaks, along with a chair that provides proper support, are the main counter measures.
Each job has its own unique ergonomic characteristics and should be assessed accordingly. Proper spinal posture while working is a key to overall good health and is the best prevention for back injury.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below.
What is a Degenerated Disc?
Houston Area Chiropractor Comments: A report from your doctor that you have a “degenerated disc” can sound scary until you realize that lots of people have degenerated discs and it does not mean surgery. It is important to understand how the disc works in the low back, how it is injured, and how it can be safely treated, to get the best results with your condition.
So what is a disc? A disc is nothing more than cartilage similar to the cartilage in your knee. Cartilage covers bones and connects them allowing a joint to be formed. Cartilage and ligaments are what make motion possible but they also restrain movements that are too large. In the case of the spine, there are 24 individual bones called vertebrae. The disc is a cartilage that connects each of these vertebrae.
The disc can be injured just like a knee or an ankle can be sprained. The injury will stretch the ligaments and cartilage and cause them to tear. Whenever the body is injured, inflammation follows which serves to begin the healing process. Damaged tissue is consumed and scars are laid down.
In the case of the disc, the degeneration is usually at the back portion of the disc, because that is the location of the original injury. The disc also contains a more watery center called the nucleus. When injury to the disc occurs, the joint does not move properly. Lack of movement can be just as detrimental as too much movement. With this lack of motion there is less movement of water, in and out of the nucleus. The nucleus then dehydrates and the disc begins to collapse under the weight of gravity.
You were likely shown an x-ray of the degenerated disc and told that the space between the vertebrae is smaller because the disc material is degenerating. An MRI or CT scan can also show the degenerated disc. However, it does not mean that you need surgery.
The body is meant to handle degeneration of the disc and many people do quite well despite what an MRI or x-ray may show. Other patients have a bulging of the disc along with the loss of height. This bulging, called a herniation, can press on the nerve and cause back or leg pain (sciatica).
If the pressure within the disc can be lowered, then it is possible to create a vacuum that draws the bulging disc away from the nerve. Decompression treatment uses this effect as a treatment for back pain and leg pain caused by a degenerated disc.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
