Radical New Approach To Cedar Rapids Shoulder Pain Treatment

Shoulder Pain in Cedar Rapids Now Has An Answer!

“Rest, ice, pain pills.”

We have all heard these recommendations, some of them were probably prescribed to you by a healthcare provider.  It started to get better and you returned to activity only to find that you are now in worse pain. Stretching and rehab exercises are doing little to nothing.  Let’s be honest.  If you have tried this approach for your pain, and you are still suffering, it’s not going anywhere.

Over half of all injuries, are due to overuse.  Overuse injuries like tennis elbow, swimmers shoulder, runners knee, carpal tunnel, plantar fasciitis, and shin splints are not caused from one single incident.  Overuse injuries occur after repetitive use and trauma to any area of the body. Micro-trauma to tendons, ligaments, and bone eventually begin to add up and cause pain. Unfortunately, overuse injuries are often misdiagnosed and treated.

Many providers will prescribe the above; rest, ice, and possibly NSAIDs.  This may actually be the worst thing for you and your pain.  Tendinitis is often the diagnosis with overuse injuries.  The diagnosis of “tendinitis” means inflammation or irritation of a tendon.  The problem is those overuse injuries are not inflammatory.  They are degenerative.  Allow me to explain.

With any repeated or sustained movement, there is a decrease in blood supply and oxygen to the area.  When dealing with muscles, ligaments, and nerves, this decrease in oxygen leads to the formation of adhesion.  Adhesion acts like glue in the muscle to prevent proper movement and function.  This is very common, yet highly underdiagnosed.  In tendons, lack of oxygen leads to more degeneration.  Adhesion and degenerative tissues will gradually progress in nature leading to pain and weakness.  If left untreated, degenerative tissues could eventually tear and need surgical repair.

Although the research and understanding of overuse injuries are there, most traditional medical paradigms have not yet adapted.  These methods fail to recognize the pathology present.  So what are you supposed to do?

Treatment must focus on the breakdown of this adhesion while also increasing blood flow to the degenerated area for repair.  Exercises should be implemented only after the patient begins to respond to therapy.  Implementing exercise too soon may actually limit the response to care.  Proper treatment of overuse should aim to keep the patient as physically active as possible.  Only in cases where patients fail to respond to therapy should limitations be placed on patients.  This process may take several weeks to months but is ultimately the best plan when dealing with overuse injuries.

If you are reading this right now chances are you are suffering from shoulder pain, or know someone who is.  Impingement, rotator cuff tendinitis, and bursitis are common overuse injuries in the shoulder.  If you have tried traditional medical treatment, and have received little to no benefit, it is time for a new approach.

In our office, we routinely see and solve overuse injuries in the shoulder, even after traditional medical and physical therapy approaches have failed.  Our approach focuses on the elimination of adhesion and rehabilitation of degenerated tissues.  For more information about overuse injuries and shoulder pain treatment in Cedar Rapids, please call our office at 319-423-0925, or visit our website at www.thrivespineandsport.com.

New Effective Sciatica Treatment in Cedar Rapids!

Sciatica is often used as a catch-all term by patients to refer to any pain they feel in their legs.  Millions of dollars are spent each year, with limited effectiveness.  This is understandable when we begin to take into consideration all the possible causes of symptoms and break down the traditional methods of diagnosis and treatment of this condition.

 

Radiating leg pain accounts for around 5-10% of all low back pain cases.  Disc related sciatica symptoms account for only 2.2% of cases.  Tight or overactive muscles are usually to blame in cases diagnosed with piriformis syndrome, and THIS is where the lack of effectiveness in the treatment of radiating leg pain essentially begins!  Whether conservative, or surgical, there is a LACK of diagnosing underlying conditions creating “tight” or overactive muscles!

 

Fortunately, new research being brought to light by researchers and doctors are shining a light on a new paradigm shift in the diagnosis and treatment of radiating pain down the leg.  Deep Gluteal Syndrome, or DGS, has the same pain characteristics as sciatica and piriformis syndrome, but the true cause of the problem has finally been found!  

 

For years, surgeons have noted and treated “fibrous scar bands” during procedures.  Sciatic nerve decompression is a surgery where fibrous scar bands, also known as adhesion, are removed around the sciatic nerve to alleviate pain.  

 

The problem is that surgery is no more beneficial than quality conservative care after 1 year!  Even with surgery, a small but significant group of patients fail to improve all together!  Collagen, the material that makes up adhesion, breaks down with as little as 6 pounds of tension.  The keyword is tension, and its specific application.  Compressive forces take much more pressure.  The good news is that Integrative Diagnosis providers have been effectively treating this problem, without surgery, for over a decade!

 

Adhesion, as it is frequently referred as, is a build up of collagen or fibrotic tissue that acts like glue on muscles and around nerves.  As adhesion builds, it limits flexibility of joints causing weakness and pain.  If adhesion builds up around nerves, like the sciatic nerve, it can create symptoms of tingling, burning, or numbness.  Sound familiar?

 

The good news is this problem is extremely common, one of the most common problems in the body, that also happens to be one of the most reversible conditions in the human body as well!  Adhesion develops most commonly through overuse, think repetitive motions like running, or prolonged positions like sitting on your butt all day.

 

Adhesion builds up most commonly around the sciatic nerve in the buttock. Limited movement accompanies this development often with increasing symptoms.  Normally, with hip flexion the sciatic nerve can stretch over 1 inch in the hip!  As adhesion develops, hip flexion becomes more limited, and more stress is placed not only in the hip, but the low back and knees as well!  This is a big deal for your overall health!

 

The concept of adhesion, or fibrous scar bands, playing a role in symptoms related to sciatic nerve mobility and entrapment represents a radical change and paradigm shift in the current diagnosis of and therapeutic approach to DGS.  Effective treatment aims to break down adhesion using tension.  No other method of treatment is as effective in treating this condition!  In fact, other methods of treatment, like stretching or exercise, could make the condition worse!

 

Manual Adhesion Release, MAR, is a technique used by certified Integrative Diagnosis providers.  This treatment creates enough tension on adhesion to effectively break it down over a series of visits. It is currently the only treatment that focuses on the diagnosis and breakdown of adhesion.  ID providers use specific tests to establish the diagnosis and measure progress from visit to visit.  

 

Previously, Deep Gluteal Syndrome was a complex issue difficult to overcome with traditional therapies and surgery.  With this new research, paradigm shift, and advances in effective treatment coming to fruition, finally patients can get the treatment needed for their desired outcome.

If you, or someone you know has been struggling to find relief from radiating pain going down the leg, the experts at Thrive Spine and Sport can help!  Currently, they are the 2 most experienced Integrative Diagnosis providers in the state of Iowa.  Call us today at 319-423-0925, or click here to schedule an appointment!

Struggling With Carpal Tunnel Syndrome?

Carpal tunnel syndrome, or CTS, is something you are probably familiar with.  Affecting approximately 3-6% of the general population, CTS is usually linked to highly repetitive tasks like heavy manual labor, or typing and desk work.  Characterized by numbness, tingling, or burning sensations in the thumb and fingers, carpal tunnel syndrome is the most common nerve entrapment found in the body.

While there is a lot that we do know about CTS, unfortunately it hasn’t made fixing it any easier.  Successful conservative treatment of carpal tunnel syndrome have been estimated between 3 and 70%!  That is quite a wide range of success to say the least!  The problem in successful treatment may lie in the diagnosis.

Most commonly, CTS is characterized as entrapment of the median nerve in the carpal tunnel of the wrist.  Often times this is not the case.

The median nerve forms in the axilla (armpit) by joining nerves that originate in the neck.  After forming, the median nerve continues its path through the upper arm, into the elbow, through the forearm, and finally through the carpal tunnel and into the hand.  Along this path, the nerve passes through multiple structures before arriving at the carpal tunnel in the wrist.

Median Nerve Pathway
Median Nerve Pathway

When healthy, the nerve glides along other muscles, tendons, and other soft tissue structures without problem.  With overuse and some other conditions, the nerve can become glued and entrapped by adhesion to these structures.  When nerves become entrapped, they cause tingling, burning, and numbness symptoms.  This is where the problem lies in most cases of classic CTS!

Overuse Cycle

While the carpal tunnel, itself, gets most of the recognition for this problem, the median nerve can become entrapped anywhere along its path to the wrist and hand.  The difficulty with treatment is finding where this entrapment exists.

Therapies like drugs, injections, and splinting may offer short term relief, but do nothing to actually fix the entrapment.  The same holds true for stretching and exercise.  Surgery should always be used as a last resort.

In order for resolution of CTS, the nerve must be freed from the entrapment, if present, in the soft tissues of the neck and arm. Fortunately, there are some at home movements for carpal tunnel to see where the entrapment may exist:

Cervical Flexion.  To start, stand with your back flat against the wall including the head.  Start by tucking the chin to the neck without moving the head off the wall.  Note any symptoms into the neck, shoulders, or arms.  Next move further into flexion by tucking the chin to the sternum.  Inability to tuck the chin to the chest, or symptoms into the shoulder or arm can be a sign of entrapment in the neck.

Healthy cervical flexion.
Healthy cervical flexion.

Shoulder Abduction.  Stand upright with the arms along the side.  Slowly bring the arms up to the ears by moving the arms in a motion similar to a “jumping jack.”  The upper arm should touch the ear.  Anything short of this motion or pain or numbness into the hands may be a sign of entrapment.

Shoulder Abduction
Shoulder Abduction with right side more restricted than left. (Note upper arm proximity to ears)

Wrist/Finger Extension.  Place the forearm flat along the wall with the elbow 90 degrees to the shoulder.   Pull back on the wrist until it is 90 degrees to the forearm.  Now, pull back on the fingers.  They should be roughly 65 degrees to the wrist.  Note symptoms. Any motion short of the noted ranges is positive, along with pain, tingling, or burning sensations can be a sign of entrapment in the forearm or wrist.

Wrist Extension
Healthy Wrist/Finger Extension

As mentioned earlier, most conservative treatment fails to diagnose properly, and thus, fails to provide proper treatment to fix carpal tunnel syndrome.  Manual therapy has been shown to be effective for treatment of nerve entrapment.  Carpal tunnel syndrome is progressive in nature, and ultimately leads to surgery in far too many cases where it could have been prevented.  For those suffering with CTS symptoms it is highly recommended to seek proper treatment as soon as possible.

At Thrive Spine and Sport, we focus on finding and fixing nerve entrapment!  If you have been struggling to find relief from carpal tunnel syndrome, call our office today to set up an appointment at 319-423-0925, or fill out the appointment request on this page.  If you have any questions, feel free to email myself at dr.cody@thrivespineandsport.com.