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Why do my arms feel like they’re “falling asleep?!”

By: Dr. Amanda Meyers 

Have you ever woken up in the middle of the night and you can’t feel your arm?  Have you ever picked your own arm up to hang it over the side of the bed so the feeling comes back?  Is this happening to you during the day?  Although it can be humorous when your arm feels like you you’ve permanently hit your “funny bone,” it is important to determine the cause of such sensations.

An individual may experience numbness and tingling in the arms due to a number of possibilities… but why is it happening to you?

When a patient describes symptoms of “numbness and tingling” the first piece of the puzzle is found.  Nerves are the primary suspect.  Different pain or discomfort descriptors are associated with different structures or systems in the body.  For example, when a patient complains of “throbbing,” the vascular system is considered.  Numbness and tingling in the arms or hands?  The search begins to answer the following questions: what nerves are being affected?  Where are the nerves being affected?

Let’s take a trip… starting in the neck and ending in the fingers.  In the neck, spinal nerves originate from the spinal cord and exit through the vertebrae.  Each spinal nerve from the neck, or cervical spine, and upper back, thoracic spine, represent a particular sensation pattern in the arm known as determatomes.  dermatomesFor example, the 7th cervical spinal nerve supplies sensation to the middle finger.  Each spinal nerve can be injured or compressed by structures surrounding the area of which they exit the spine:

From injury to the spinal cord

From a disc condition, possibly a bulging or herniated disc

From compression within the hole or “foramen” where the nerve exits the spinal column

From soft tissue and musculature where the nerve exits the spinal column

Next we follow the spinal nerves to a bundle where the nerves join together and proceed to split to become “peripheral nerves.”  For example, the Median Nerve contains portions of the 5th, 6th, 7th and 8th cervical spinal nerves and also the 1st thoracic spinal nerve.  The Median Nerve provides sensation to half of the hand begins in this bundle called the “brachial plexus.” brachial plexusAs seen in the picture, the brachial plexus is an extremely complex matrix of nerves that travels through the neck, shoulder and chest before breaking off to supply the arm.  A condition commonly known as “Thoracic Outlet Syndrome” can result in the compression of nerves associated with the brachial plexus.  The following structures can cause possible compression:

  1. The group of scalene muscles in the neck
  2. The muscles of the rotator cuff in the shoulder
  3. The first few ribs
  4. The pectoral muscles

Further down the pathway, nerves continue to divide.  Muscles in the arm, such as the biceps and triceps can entrap the traveling nerves.  For example, the Ulnar nerve follows a path down the back of the arm and can “get caught” by the triceps in a groove in the bone known and the “ulnar groove.”  tricep nerves

Once we pass the elbow, more muscles such as Pronator Teres and the muscles that move the wrist and fingers, can tighten and compress the nerves.  elbow nerves

Finally we reach the wrist and the Carpal Tunnel, of which many people are familiar.  When a person experiences Carpal Tunnel Syndrome, a particular pattern of symptoms are present.  Even the tiny muscles in the hand can contribute to sensations of numbness and tingling. carpal tunnel

As illustrated by the diagrams, the pathway from neck to hand contains many opportunities for your arms to “fall asleep.”  In fact, more than one area of entrapment can be experienced at a time, complicating the diagnosis and treatment.

Chiropractors specialize in the anatomy and nervous system of the body in order to solve the puzzle and find non-invasive treatment possibilities for patients to experience relief.  During an exam, a chiropractor performs neurological and orthopedic testing along with manual palpation of the muscles and joints to locate the origin of the numbness and tingling symptoms.  Determined by the doctor’s findings, a treatment plan is implemented to alleviate symptoms by affecting not only the joints, but also the soft tissue (muscles, tendons and ligaments).

Personally, finding the pieces of the puzzle and relieving the areas of injury and compression is a satisfying and rewarding way to spend my day.  If you experience symptoms of numbness and tingling, find out where it comes from by asking your chiropractor.

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Taking the “Ache” out of Your Headache

By: Dr. Amanda Meyers 

Did you know 9 out of 10 Americans suffers from headaches?

According to the American Chiropractic Association, 95% of headaches are primary, meaning there is no disease involved, but the headache is the primary concern.  Primary headaches include tension, migraine, and cluster.  I will be discussing 3 different triggers of the tension-type headache from which millions suffer. 

Did you know there are multiple joints per vertebral level?

cspineEach one of these joints has nerves that respond to its movements and helps the mind perceive where the body is in space.  If the joint is not moving properly or at all, the body uses nerves called “nociceptors” which respond to improper movement and irritation by sending pain to the brain.  With 7 cervical (neck) vertebrae, there is a great opportunity for the lack of proper movement, therefore, sending pain signals.

Did you know muscles have a particular “referral pattern?”

 When there is a dysfunction or trigger point (area of significant tension) present, the muscle refers pain to surrounding areas.  For example, the trapezius muscle refers pain up the neck and into the side of the head, sometimes reaching to the front over the eyes.  (Gym enthusiasts are familiar with this “shoulder shrug” muscle.)  Many people mistake this referral pattern for a “sinus headache.”  The pain location is almost identical.  Of course, other symptoms help to differentiate between sinus congestion and associated headaches and a tension-type headache.  If you have discharge from your sinuses, you are probably suffering from a sinus headache; however, do not discount the power of a combination of tension headache and sinus headache.

Another fascinating connection within the body is the “Myodural Bridge.” 

TPRP2There are muscles in the back of your neck just below the base of the skull, described as your “suboccipital muscles.”  Although small, the suboccipitals have the ability to generate significant pain and tension.  They are deep within the neck and their muscle fibers reach out and attach inside to the dura mater that covers the spinal cord and brain.  Interestingly, if the muscles are taut they can then pull on the dura causing tension within the central nervous system.  The result is pain generated from the outside muscles and joints and also pain and tension coming from deep within the body.

Why is there muscle tension and joint dysfunction? 

There are many different reasons including the following: posture, sitting at the computer for hours, standing on hard surfaces, performing repetitive motions, driving and traveling frequently and/or for long periods of time, and more.  After times of stress, the body adapts to the changes and retains tension and starts letting you know by sending pain signals, hence, the headache.

Now the big question is “What can chiropractic do for me?”

Chiropractic care reduces the tension by inducing and manipulating the joints in the neck and back to have proper joint motion and relaxing the muscles.  Relief can be achieved using a combination of the chiropractic adjustment (inducing proper motion into the joints) and soft tissue manipulation techniques (which address the trigger points and referral patterns of muscles).   Nutritional advice can have a significant impact as well.  Vitamins and minerals are essential for healthy joints and muscles.  Lastly, addressing the triggers such as posture and compounding activities helps to prevent reoccurrence of the headaches.  The goal is to educate both the body and mind so that the patient can have a pro-active role in his/her own well-being and learn what he/she can do and also when it is necessary to seek help before the problem becomes a “headache!”

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Backpacks, Purses and Brief Cases: A Balancing Act

When did it become customary for people to carry their lives with them?  A purse became the size of an overnight bag, a backpack is bigger than the kid wearing it, and brief cases hold laptops and more.  Convenient?  Yes.  Practical?  Maybe.  Healthy?  NO!

According to the American Consumer Product Safety Commission, in 2001 there were 7,000 reports of backpack-related injuries sent to the emergency room.  Unless a congenital condition is present, our children should not be experiencing back pain.  However, the homework is starting earlier and proper posture is not heavily promoted.  When a child carries a significant amount of weight on his/her back, the center of gravity changes.  The child will lean forward at the waist to counterbalance the extra weight in the back.  Leaning forward adds muscular stress on the shoulders and neck region.  Strain is also placed on the low back muscles in order to maintain a forward bent posture.  Muscular imbalance develops between the front and back of the body. 

Here are a few tips from the American Chiropractic Association to help your child avoid back (pack) pain:

  • The backpack should be no more than 10% of the child’s bodyweight
  • The backpack should not hang more than 4 inches below the waistline
  • Utilizing the individualized compartments helps distribute the weight
  • Bigger is not always better!  Don’t promote carrying a heavier backpack
  • Urge the child to use both shoulder straps
  • Wide padded straps are more comfortable and won’t dig into the child’s shoulders
  • Talk to your child’s teacher if you find the backpack is frequently too heavy

When a child is carrying the backpack on only one shoulder (of which many are guilty) it is similar to holding a purse or brief case.  The one sided carry causes an imbalance between right and left sides of the body as opposed to the front and back.  On the side carrying the bag, the shoulder is usually hiked up to guard against the weight.  Hiking the shoulder causes muscular strain in the neck and back and causes the spine to curve toward the shoulder.  Due to the curvature in the upper portion of the spine, the lower spine must also curve to counterbalance and keep the body in an upright position.  Therefore, the stress of simply a purse can result in both neck and back pain.

Here are a few more tips from the American Chiropractic Association:

  • Select a purse or brief case with a wide adjustable strap long enough to place over the head
  • When carrying, switch sides frequently to avoid placing too much weight on one side
  • Empty unnecessary items
  • Place necessary items in the front pockets to avoid overstretching to reach

How can chiropractic care help?  During an initial examination, the chiropractor is able to collect information such as muscle tone and the alignment of the spine.  The chiropractor and patient can discuss possible sources of poor posture, including carrying heavy items.  Chiropractic adjustments and manual therapy correct the body’s bad habits.  However, a patient must have an active role in treatment by making a conscious effort to avoid provocative activities.

Did you know kids can see a chiropractor too?  In addition to promoting backpack safety, having your child evaluated by a chiropractor at an early age can prove beneficial.  For example, Scoliosis can be caught at an earlier age.  Kids that are active can recover faster from injuries and prevent future musculoskeletal complications.  Also, kids are using computers and texting at a very young age which can lead to poor posture, headaches and muscle strain.  Help your child avoid the aches and pains of the future and take him/her to your chiropractor today!

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Fueling your Body through Nutrition

Nutrition and, more commonly, “diet” have become highly discussed topics. Some people are trying to lose weight, some trying to gain. Ponder this: what is the goal? Why do you need to lose or why do you need to gain? Is it because your doctor said so? Is it because you want to look better in your clothes? Is it because you’re an athlete trying to be faster and stronger? Whatever the reason may be, I ask you to consider… what you consume doesn’t just feed your stomach, it fuels your body. Just like your dream car, your body deserves the best possible and most appropriate fuel for ideal performance.

But I’m not an athlete… is this some- thing I really need to worry about?

Yes! Whether you’re an accomplished Iron Man or the Average Joe sitting at a computer, your body has specific nutritional needs. Every organ in the body requires energy to function. Solving a math problem, digesting food, driving a car, exercising, everything needs energy to be performed. In order for this energy to be produced, a complex series of chemical reactions takes place. What is one of many requirements for the chemical reactions to be completed? B-vitamins! Without a significant source of B-vitamins, the body cannot perform any task to the best of its ability. Also, if the body endures stress during any activity, mental or physical, we need our anti-oxidants! Free radicals are formed when there is stress. Anti-oxidants have the ability to repair stressed cells and rid the body of excess free-radicals.

Did you know… muscles need particular nutrients too?

When we hear “muscle,” people often think about the biceps or quadriceps. In order for muscle contraction to take place, more chemical processes take place. Two very important nutrients necessary for muscle contraction and relaxation are calcium and magne- sium. You may ask, but I thought calcium is for our bones? It certainly is! However, in order for our muscles to relax, calcium must be available. In fact, the body will take calcium from the bones if there is not enough present to perform other tasks, such as muscle contraction. Let’s not forget about a very important muscle, the heart. Although a different type of muscle compared to the biceps and others, calcium is essential for proper functioning. Have you ever experienced muscle cramps? Often, among other reasons, this is a result of not enough calcium. The muscle has the inability to relax when appropriate.

Can’t I get enough vitamins and minerals from my food?

If we were living in the 1950’s, I might say “prob- ably.” Unfortunately, that is not often the case any- more. As a result of over-utilizing crops, pesticides and pollution, and the intense processing of foods today, fewer and fewer nutrients are actually present in what we eat.

What supplements should I take?

Simply the best supplements to take are those of good quality and appropriate for your individual needs. A definite hierarchy exists among supplement companies. First, whole food supplements are best uti- lized by the body while synthetic vitamins are not recognized as well. The biggest consideration to make is that every body is dif- ferent. Are you an Iron Man or a desk worker? Do you have any specific nutrient deficien- cies? Do you have a disorder than inhibits absorption of par- ticular nutrients? It is vital to have answers to these questions before choosing supplements. Meeting with an educated professional such as a chiropractor, clinical nutritionist, or registered dietician to discuss your personal health history and needs is the best way to determine what supplements should be added to your diet.

Why do you have such an interest in nu- trition and its effects on the body?

In 2003, I was diagnosed with multiple food aller- gies, including gluten, via antibody testing. Leading up to my discovery, I suffered from frequent upper respiratory infections, asthma symptoms and could not compete as an athlete to my fullest potential.

After completing an elimination diet, I was able to breathe, avoid unnecessary antibiotics and compete faster. The experience spiked my interest in natural medicine and lead to my completion of a Doctorate of Chiropractic and a Masters degree in Clinical Nutri- tion. My degrees and personal experiences allow for an appropriate amount of empathy and the knowledge to help others. I now offer, along with chiropractic care, clinical nutritional counseling as well as clinical testing to help patients determine the best fuel for their bodies.

Dr. Meyers is pleased to announce the joining of Chi- ropractic with Care and Body Logic Massage Therapy Center. Coming this fall, the new “Body Logic Mas- sage and Chiropractic” will be offering clients and patients massage, chiropractic and nutritional services to the Virginia Beach area. Body Logic will remain in the same location. Information for all services can be found at www.bodylogicvb.com.

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The Anatomical Challenges of Pregnancy

By: Amanda J. Meyers, DC

I would venture to say that most of us realize the female body goes through significant changes during pregnancy.  Pregnancy can be a wonderful and exciting process; however it is not without its physical challenges.  Luckily, chiropractic care can be extremely beneficial to help manage the aches and pains as well as postural changes that accompany pregnancy. 

Is chiropractic care safe during pregnancy?

According to the American Pregnancy Association, “There are no known contraindications to chiropractic care throughout pregnancy. All chiropractors are trained to work with women who are pregnant. Investing in the fertility and pregnancy wellness of women who are pregnant or trying to conceive is a routine treatment for most chiropractors.”

http://www.americanpregnancy.org/pregnancyhealth/chiropracticcare.html

What anatomical changes take place?

pregnancy-postureOne of the biggest changes is posture… you know, that “pregnant walk.”  The body accommodates for the additional weight from the fetus and placenta.  The pelvis naturally begins to tilt forward (anterior pelvic tilt) to adapt to the additional structures as well as to accommodate for the overall weight gain.   As weight is added, the center of gravity changes and the abdomen is drawn forward.  The degree of change varies from woman to woman.  The changes, regardless of degree, can cause a significant amount of low back discomfort.  The joints in the back of the spine (facet joints) and lumbosacral joint at the base of the spine can become compressed.  The compressed joints send pain signals to the brain, thus making it very difficult for a woman to get comfortable, particularly while standing.

sciatic-nerveAs the abdomen and pelvis are drawn forward, the muscles in the back shorten, causing stiffness in the low back and gluteal region.  As these muscles tighten, nerves, such as the Sciatic Nerve, can become impinged.  The impingement of nerves can cause additional low back pain as well as pain down the legs.

Changes also take place throughout the mid-back.  Breast tissue enlarges to allow for the possibility of milk production.  The additional weight pulls on the front of the chest, straining the musculature in the mid-back to fight against the pull forward.  The muscles in turn stress the spinal joints (vertebral joints) and rib joints (costovertebral joints) in the back causing discomfort.  Occasionally, breathing can become stressed and uncomfortable due to improper joint motion.  If the joints are not moving and gliding properly, they can cause pain and also inhibit proper inflation of the lungs making it difficult to take a deep breath.

The combined changes in the mid-back and low back can travel down and add pressure to the knees and feet.  Often women shift their weight slightly down the legs causing hyperextension of the knees and more pressure on the ball of the feet as opposed to the heal.  Plantar fasciitis and pressure within the joints of the feet may result.

What can chiropractic do to help relieve anatomical challenges?

1948-150x150Chiropractors are educated to keep the joints moving, even under stressful conditions!  A variety of techniques exist to alleviate the stress by adjusting and manipulating the joints, including the back, ribs, arms and legs.  The soft tissue (muscles and ligaments) can also be treated to relieve the tightness and compression they may place on the nerves.  Treatment techniques change throughout the pregnancy to adapt to the later protruding abdomen and hormonal changes.  Chiropractic care can also help with the post-natal changes that take place after birth.  The birthing process can be traumatic on the body.  To return the body to its pre-baby size and structure can be eased with the help of a chiropractor.  Less stress for the mom means less stress for the baby!  Don’t we all want to bring a baby into a healthy and pain-free environment?!

Please note: When seeing any health care professional, it is important that you inform him/her of any discomfort during pregnancy.  He/she is trained to determine where the discomfort is coming from and what can be done to help.

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What is having “Core Stability?”

By: Amanda J. Meyers, DC 

Americans have spent decades trying to achieve the perfect abs.  There have been uncountable marketing and publicity ploys to entice consumers that the next product is the miracle worker.  Continually consumers fall for the idea of the next best thing and millions of dollars are spent each year on products that get stored away and forgotten.  Those of you that are sympathizing as you read this know exactly what I’m talking about…

Although many of these products and exercises have yet to prove they are effective, the companies do seem to understand one thing: the importance of “core stability,” a term that has risen in use over the last 10 years.  But what exactly is core stability?  It’s certainly not the ideal flat six-pack stomach.  In fact, it is the musculature deep within the abdomen and even around the spine that denotes a stable core.  Core stability helps maintain good posture and prevent injury.

What muscles provide core strength and which muscles do not?

First, the muscles that we see in the front of the abdomen (rectus abdominis) have very little strength.  Sorry to disappoint those of you who do crunches obsessively to have the six-pack for the beach.  Instead, it is the deeper abdominal muscles known as the “obliques” and tranversus abdominis that provide us with abdominal strength.  Even smaller muscles, such as multifidus and rotatores, lie along the vertebral column (spine) and provide stability.  The above muscles are activated with more of a twisting motion than your typical “sit up” or “crunch.”

psoasSecond, the “iliopsoas” complex can be an inhibitor to strengthening the core and also a major contributor to low back pain.  The iliopsoas consists of the iliacus muscle that sits on the inside of the pelvis and the psoas muscle that attaches to the front of the lumbar vertebrae.  The muscles join to form a common tendon that crosses the hip joint.  The action of the muscles flex the hip, drawing the thigh closer to the abdomen, an action often seen when an “ab workout” is performed.  When iliopsoas is contracted or shortened, the pulling on the front of the spine can be accentuated increasing the arch (lumbar lordosis) of the low back.   Often patients will describe that it feels like “my butt is sticking out” or “my abdomen protrudes forward.”  With an increased lumbar lordosis, the joints in the back of the spine become compressed, there is less room for the spinal nerves to exit and a combination of joints, muscles and nerves may become inflamed resulting in low back pain.

Knowing the action of the iliopsoas, it is easier to understand what it means to cheat when doing an ab workout: any exercise that involves flexing at the hips can be easily performed without activating the abdominals.  The downside to over-activating thie iliopsoas is two-fold: 1) as the exercise is performed, the abdominals are not activated and 2) the psoas muscle actively engages and pulls on the front of the lumbar spine increasing the lumbar lordosis, hence promoting the low back pain.

Is your workout really working against you?

lumbarChange it up!  In order to engage your core stability muscles, isometric exercises such as “planks” or “pelvic tilts” are effective.  These exercises are beneficial for training the body to function with stability and, therefore, protecting the low back.  Once the deep stability muscles are activated regularly, moving on to gentle twisting motions will help further strengthen the core and utilize the obliques and transverses abdominis.  Often a positive change in posture is noticed and low back pain is eased.

Please note that it is imperative to speak with a licensed trainer or chiropractic physician prior to engaging in “hard core” stability exercises.  Awareness to proper form is necessary to appropriately engage the muscles discussed and protect the low back from injury.

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