Elbow Pain

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At Peak Wellness and Chiropractic, we’ve had several patients come in to the office complaining of elbow pain. Have you experienced elbow pain and were unable to relieve the soreness? Or maybe you have noticed weaker grip strength in your hand?

Well, you have come to the right place…

First lets look at the anatomy of the elbow

There are three bones that connect at the elbow: the humerus, that connects the elbow to the shoulder; the ulna, which is the stationary bone in the lower arm connecting the elbow to the wrist and the radius, which rotates around the ulna allowing the lower arm to twist.

The muscles that flex the elbow are found in the upper arm. They are the brachialis, brachioradialis and biceps brachii. The lower arm muscles that help extend the elbow are triceps brachii and the anconeus.  When any of these are not working properly, elbow pain may occur.

Causes of Elbow Pain

 

Image credit: IdealHealth.com

 

Elbow Joint Pain

In my experience, the most common elbow diseases that I see in patients are directly caused by injury:

  • Tendonitis is the most common injury and is caused by overuse of the tendons in a joint. Tendonitis on the inside of the elbow is commonly referred to as “tennis elbow”. Read my blog on tennis elbow exercises. Tendonitis pain experienced on the inside of the elbow is called “golfer’s elbow.”
  • Fracture – There are three bones at the elbow joint and any combination of these bones may be involved in a fracture which is a slight crack or break in the bone. If you can fully extend your elbow then it is likely not fractured but an x-ray is the best way to rule this out.
  • Dislocation – is when one of the bones in the elbow joint moves completely out of place. This usually happens due to trauma with hyperextension of the elbow joint.
  • Bursitis – The bursae are located at the points where muscles and tendons attach at the joints. Their main purpose is to help protect the joint. When the bursae become inflamed they start to cause pain and swelling. One way the bursae can become inflamed is through overuse.

 

Treatment

Conservative care is the primary form of treatment that should be diagnosed for most patients as long as they do not have a dislocation or fracture. Conservative care involves teaching the patient the proper movement patterns to be able to heal without the use of surgery and medications. Examples of conservative care to treat elbow pain include, but are not limited to, chiropractic caremassage therapy, and acupuncture.

Tendonitis and bursitis are often respond well to conservative care. Fractures or dislocations must first be x-rayed and evaluated by a medical doctor for possible casting in order to heal properly.

At Peak Wellness and Chiropractic, we work through the following steps when evaluating patients experiencing elbow pain:

  1. Proper assessment of the joint and arm/shoulder complex must be completed. (i.e – range of motion, orthopedic tests, neurological tests, movement screens and postural exams)
  2. Palpation (physical examination by feeling the tissues) of the local area to be able to evaluate hypertonicity or unusually tight muscles.
  3. Once evaluated and fractures or dislocations have been ruled out, then muscle-testing using the NKT protocol will help establish which muscles are being overworked and which muscles are not being worked enough. (When a muscle isn’t used properly, other muscles will overcompensate which can cause pain).
  4. Release the muscle(s) or joint that are found to be hypertonic or not moving.
    • Through palpation and muscle testing I will be able to pinpoint the muscle or joint that needs to be adjusted. Once adjusted the area will be able to move and function the way it was supposed to.
  5. Activate the muscle(s) exhibiting compensation patterns. This means that they are either over or under used causing other muscles to move improperly.
    • Once a compensation pattern has been figured out, we work to strengthen the muscle that is not firing properly. In order to retrain this pattern specific activation (strengthening) of a muscle needs to be completed.
  6. Re-check to make sure the treatment worked.
  7. Apply RockTape to the area to help with healing and relaxing the tissues.
  8. Apply ice and make sure patient understands how to reinforce the new movement patterns in their day to day movement so as to prevent the return of elbow pain.

Elbow Joint Pain

If you noticed that your grip strength has gotten worse and now you are having pain near the elbow, the wrist extensors in your elbow could be taking over the job for the tiny grip strength muscles in your hand. All muscles throughout the body are connected. When you reach for a cookie you are not just using one muscle so the days of just diagnosing pain in one muscle are over. The whole group or area should be evaluated.

Checking both muscles and joints are important because if a joint is not moving properly, like in the above example, symptoms will never fully go away.

What to Do About Elbow Pain in Apex?

If you know someone who has been complaining of elbow pain, tell them about Dr. Megan at Peak Wellness and Chiropractic in Apex. I am here to help and educate people about different treatment options! What to do about elbow pain in Apex, NC?  Call us at 919-249-6461.

TMJ

The temporomandibular joint, or TMJ is a small joint on either side of the jaw. The TMJ is a bilateral synovial joint between the mandible and the temporal bones. The upper bone near your ear is the temporal bone and the lower jawbone is the mandible.

When there is some sort of joint dysfunction in the TMJ is can be termed Temporomandibular joint dysfunction or TMD/ TMJD. This is an umbrella term covering the pain and dysfunction of the muscles of mastication (muscles that move the jaw).

TMJ Signs and Symptoms

Here are some TMJ signs and symptoms to help you recognize your pain and hopefully seek assistance from a chiropractor:

  • Pain and tenderness upon palpation of the muscles of mastication or of the joint itself. The joint is located right in front of the ear, which is called preauricular. Pain is most common here and below the ear. Pain is the most defining symptom of TMD and is usually aggravated by chewing, clenching and yawning.
    • Pain is usually dull or achy in nature, poorly localized, and intermittent or constant depending on how severe.
  • Limited range of motion of the mandible. This causes difficulty with eating and even talking.
    • Joint locking or stiffness- usually more so in the morning.
    • Asymmetry or deviation of the jaw during movement.
  • Noises from the TMJ during movement of the mandible.
    • Clicking, popping or crepitus (grating) of the joint.

Other signs and symptoms have also been described, although they are less common than the above.

  • TMJ Headaches
  • Pain elsewhere, such as the teeth, neck and shoulders
  • Bruxim (grinding of the teeth)
  • Hearing loss
  • Tinnitus (ringing in the ears)
  • Dizziness
  • Pain or pressure behind the eyes
  • Sensation of malocclusion (feeling that the teeth do not meet together)

TMJ Pain Relief

TMJ is a musculoskeletal disorder because it is involving the muscles around the jaw and the temporomandibular joint. Chiropractic is known for being able to treat musculoskeletal disorders and offer TMJ pain relief. Dr. Megan Reed is an expert in treating the TMJ.

Some common treatments include:

  • Chiropractic manipulation to both the upper cervical and the TMJ- either manual or with the activator (sometimes less is more with smaller joints).
  • Soft tissue work- both inside and outside of the mouth along with the upper neck
  • Rest

Along with treatment we need to look at the a couple other things going on with the whole person which may offer TMJ pain relief. If the patient has been stressed lately then they could be clenching the jaw, which will aggravate the TMJ after a while. If the patient knows that they grind their teeth then getting a mouth guard along with treating the joints and muscles will help more long term. Another common issue I see is a weak core. If you are not able to use your core properly you could be clenching your jaw to get strength and stability in the activity you are trying to complete. If this is not evaluated and fixed in the office then the TMJ will continually be aggravated. Therefore, if you have already received conservative care for your TMJ and it has not helped then taking a look at these options would be the best next course of action.

Here at Peak Wellness and Chiropractic, we have treated several cases of TMJ with success. If you are having pain or discomfort in the upper neck or jaw area, don’t wait- call 919-249-6461 to get TMJ pain relief now!

Patient Appreciation Week 2016

Patient Appreciation Week in March:

Mon. March 7. to Fri. March 11.

Next week Peak Wellness and Chiropractic will be having our annual patient appreciation week. During this week we will feature the following special offers:

  • $20 Adjustments: If you bring in 3 canned goods, to be donated locally at Wake County Crisis Ministry. (This is for adjustments only – *does not include therapy.)
  • Special Discount for New Patients: Initial consultation, examination and treatment fee will be $50 for anyone who schedules during this week (a savings of $25).
  • $15 Credit for Referrals: If you refer a new patient to Peak Wellness during Patient Appreciation Week and that person lists your name on the intake form you will receive a $15 credit to use in 2016. Credits can be redeemable towards the cost of chiropractic treatment, supplements or supplies.
  • Free Raffles: Any patient who comes into the office this week will have an opportunity to put their name in for a raffle of their choosing. You will get one raffle for each visit this week! Raffles will be:
    • 1 complimentary new patient chiropractic visit by Dr. Megan
    • 1 complimentary 1-hour massage by Ben
    • 1 complimentary new patient acupuncture visit with Yanming
    • 2 Lawn tickets for Miranda Lambart concert at Walnut Creek Friday June 10.
  • Free chair massages: Free chair massages from Ben, our massage therapist will be available.
  • Free healthy snacks and drinks

Please call the office at (919) 249-6461 to schedule an appointment. Walk-Ins are welcome. Note only a half day in the afternoon on Wednesday March. 9th.

*If you decide to purchase additional treatment you have the legal right to change your mind within 3 days and receive a refund.
** This offer does NOT apply to Medicaid and Medicare patients. 

Mark your calendars

On Thursday March 10th at 6:30 there will be a speaker here at the office fromStandard Process to go over healthy ways to prevent allergies.

With allergy season coming up you do not want to miss this! I will also be speaking about how chiropractic can help 🙂

There will be light snacks and drinks!

Please RSVP because we want to make sure we have enough interest to hold it. Call 919-249-6461 or email at apexpeakwellness@gmail.com

In Network vs Out of Network

In network vs out of network is a dilemma for many. I am an Out of Network physician as opposed to in network for a number of reasons. I would like to share them with you so that you all can make an informed decision about your own healthcare.

First and foremost you need to call your insurance company and ask them for your chiropractic benefits. This is the easiest thing to do and yes they will tell you the information may change the next time you call. (More then likely it will not but they do not want to be liable). Once you get the information of your plan for in network vs out of network chiropractors you will have the information to make an informed decision as to what will be more beneficial for you.

Remember that you will have a deductible to meet and once that is met, then you will have your co-pay. Chiropractors are still categorized as a “specialist” unless otherwise told. This is usually a different fee than your Primary Care doctor.

In Network Vs Out of Network:  What is In Network?

If you are going to go with a doctor that accepts your health insurance they are referred to as In-network. What this means is they signed up to “accept” that insurance. This is an application process that everyone must go through. When the doctor’s office signs up, they are given a fee schedule for all of the different services that the health insurance will reimburse them for.

The insurance company will then be allowed to dictate how many visits you are allowed to have. This does not matter if you are fully better or not. Also, most insurance companies lump chiropractic, physical therapy and occupational therapy all together for allotted visits. So make sure you watch out for that as well.

In Network Vs Out of Network:  What is Out of Network?

If you go to an out-of-network doctor, most of the time there will be a flat fee for services. This makes life much easier than having to look up patients’ insurance information to see what their specific co-payment is. The reason I decided to have the fees I do is because I wanted to make it affordable for people to come in. Therefore, my flat fees have typically been lower than what the co-payments are today.

With having a flat fee and not accepting insurance, I am able to decide what care is in the best interest for each individual patient. I do not need to jump through hoops to get a service paid for if they do not allow it. For example if you have an acute injury and your low back is in spasm I will use electronic stimulation and ice on you. If your insurance company does not accept that as a service, then you will not be getting that service even though it would be beneficial to you. I do not agree with that logic so therefore I do not participate. I give my patients the care they need.

There is no deductible that needs to be met. You are more than welcome to get a super bill and submit those into your insurance company to have the amount go towards your out-of-network deductible. This can be down at any time as well. This can be done at any time as well. So if you have a large deductible and you know you will never meet it, then submitting the super bill may not be beneficial to you. But, if something happens and you ended up using a good amount of the deductible, then submitting the charges you have already paid will help you meet it sooner.

In Network Vs Out of Network:  Conclusion

  • Do your research first and see if using your insurance is the best option. Yes, I know you are already paying for the insurance and want to use it, but if it is cheaper for you to go out of network, don’t be afraid to do that!
  • Choose a doctor you like and trust, not just one that is conveniently in your network. You can always switch if it is not a good fit.
  • Out-of-network; there is a flat fee for services and most of the time it is the same or cheaper.
  • If you have a deductible you can submit your visits to get them counted/reimbursed.
  • Which is the best option considering in network vs out of network?:  Depends on you.

Mid-Back Pain

Mid back pain is common among children and middle-aged women. The reason I point this out is because children are in school and they have to carry around a backpack most of the day. This puts a huge strain on the mid back area. Also, children tend to not have great posture so the added weight of slouching slowly builds up. Middle-aged women also tend to have mid back pain as well because of their breasts. This is added weight on the mid back that women have to deal with on a daily bases. This tends to get worse when women become pregnant as well because their breasts are growing and adding extra stress on the mid back.

 

Mid back

The mid back is from Thoracic vertebra 3 to 12. In layman’s terms “in between your shoulder blades”. Here is a picture of the mid back area.

There are multiple muscles in this area as well that can cause pain. The muscles are Upper trapezius, lower trapezius, rhomboids, thoracic erector spinae, infraspinatus, and lattissimus dorsi.

 

Reasons why you can have pain:

  • Poor posture- this leads to loading of joints that are not meant to be loaded, thus causing areas that are not moving the way they are supposed to and causing degeneration in the joints.
  • Muscle inhibition- If one of the muscles is not pulling its weight and helping out, then another muscle has to take over the job. This can cause a muscle to get very tight and painful.
  • Hypomobile joints- When the joints are not moving the way that they should, this causing degeneration in the joints which in turn causes pain. Adjusting the areas is the most common way to relieve this pain.
  • Ribs- rib pain is very pinpoint pain that sometimes can take your breath away. This pain is constant and persistent. It is typically one sided.

Ways to help relieve mid back pain:

The number one way to help relieve mid back pain is to go see a Chiropractor. As chiropractors we are taught to exam and palpate the spine to locate areas that are not moving the way they should. These areas if left untreated for to long, can become irritated and painful. When the joints are not moving like they were designed to do, that degeneration begins and the circle is not broken until movement is back in the joint.

Rib pain is very similar in this manor. The pain will not go away until the rib is able to move without restriction when you breathe.

If the pain persists and adjusting is not helping, then the problem is an imbalance in the muscles. To determine what muscles are not working I use a technique called Neurokinetic Therapy (NKT) which tests each individual muscle to test the function. To learn more about NKT you can go to the website here, http://neurokinetictherapy.com/.

As always I am here to answer any questions you may have about your mid back pain and how chiropractic can help treat it. The number is 919-249-6461 or email me at apexpeakwellness@gmail.com.

-Dr. Megan

Pinched Nerve

Do you think you have a “pinched” nerve? Has someone told you that you have a “pinched” nerve but you do not know what to do about it?

Well you have come to the right place. In this blog we will talk about what exactly a pinched nerve is and then what you can do to help it.

First a little anatomy, nerves extend from the brain and spinal cord, which send important information throughout the body. If a nerve is “pinched” then that information will no longer be able to be transmitted. When the body is not able to function the way that it was designed then it will send out a warning signal. This warning signal is Pain. Pain is only designed to be a warning that something is not right in the body. It is not wise to ignore this pain and hope things will get better. It may go away because the body gets used to the same signal but it will come back and when it does. It is usually worse. Listen to the body the first time!

Damage from a “pinched” nerve may be minor or severe. It may cause temporary or long lasting problems. The earlier you get a diagnosis and treatment, the quicker you will find relief.

Causes of Pinched Nerve:

A “pinched” nerve occurs when there is compression or pressure on a nerve. This pressure may be a result of many different causes.

  • Repetitive motion
  • Holding a body position for an extended amount of time (such as keeping your elbows bent while sleeping)
  • Inflammation around a joint or muscle
  • Tight muscles where the nerves travel through them
  • Degenerative changes in the joint (such as foraminal encroachment, bone spurs)

Symptoms of Pinched Nerve:

With nerve compression, sometimes pain may not be your only symptom. Sometimes you may even have some of these other symptoms without any pain.

  • Pain in the area of compression (such as neck or low back)
  • Radiating pain (such as sciatica or other radicular pain)
  • Numbness and or tingling
  • “Pins and needles” or a burning sensation
  • Muscle weakness, especially with certain activities

Treatment for Pinched Nerve:

The treatment time may vary depending on a couple different factors. How long the pain has been going on. How severe the nerve compression is. If there are any other complicating factors, such as other illnesses or chronic disease.

Every person is going to respond a little differently to care because no two people are the same. Treatment will also vary from individual to individual depending on the severity of the “pinched nerve”.

First thing to do is to stop the activities that aggravate your symptoms. If your symptoms persist call Peak Wellness and Chiropractic to help you relieve the tension of your nerve to get you back to what you love to do. Some other treatments that can help achieve pinched nerve relief are:

  • NSAIDs- Nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help reduce swelling.
  • Splints- this will limit motion and allows the muscle to rest. This if used should be only temporarily
  • Chiropractic– will help reduce inflammation and re-align the joints to proper motion to help take pressure off the nerves.
  • Steroid injections- these injections may reduce swelling and allow inflamed nerves to recover.
  • Narcotics- this should also be used temporally to help reduce severe pain.

Chiropractic is the only one that is drugless and will get to the root problem to help prevent it from coming back again. The other options can be necessary for certain cases to help with the pain and swelling at first. If you want get pinched nerve relief, then give our office a call at (919) 249-6461. I look forward to helping you become pain free!

Tendonitis

So what is tendonitis? It is inflammation of a tendon. So then you might ask what is a tendon. A tendon is a tough band of fibrous connective tissue that usually connects muscles to a bone. There are over hundred tendons all over the body. Therefore, it only follows that tendonitis can occur in any part of the body.

When an area is over used or trauma has occurred (falling or hitting it directly) then it can become inflamed. When the swelling and inflammation do not go away within a couple days to weeks, then it becomes chronic. This is when it can turn into tendonitis, which leads to pain.

Tendonitis is most common in the upper and lower limbs, and is less common in the hips and torso. Tendonitis can vary by individual depending on the type, frequency and severity of the aggravating exercise. For example, swimmers tend to get it in their shoulders, rock climbers tend to get it in their fingers and hands, and runners tend to get it in their knees or calves.

Dr. Megan Reed at Peak Wellness and Chiropractic is expert at treating all forms of tendonitis such as hip, knee, shoulder, bicep, elbow, and patellar tendonitis.

If you are in Apex, NC and having any tendonitis symptoms, especially after an injury, please visit Apex Peak Wellness.  Our hands on brand of family chiropractic will allow you to get back to doing the activities you love.  While you are here, check out our new pricing.

Bursitis

What is Bursitis?

Bursitis is inflammation to one or more of the bursae (small sacs) of synovial fluid in the body. The bursae are lined with a membrane that secretes a lubricating fluid that works to reduce friction in joints such as the elbow. The bursae are located at points in the body where muscles or tendons slide across the bone. There are over 150 bursae in the body. When the bursae are healthy they create a smooth, frictionless surface for painless movement.  However, when the bursae are not working properly, bursitis may occur.

Bursitis more commonly affects the superficial bursae. These include the subacromial [shoulder], prepatellar [knee], retrocalcaneal [foot], and pes anserinus bursae [knee].

Diagnosis

Symptoms for bursitis can vary from minor to severe aches and pains, local joint stiffness, to burning that surrounds the whole joint. In some cases swelling occurs and there may be noticeable redness and heat. With this condition, pain usually gets worse during or after activity. After activity in the days following, the joint can become stiff.

Treatment

  • Rest with gradual return to activity
  • NSAIDS or anti-inflammatory drugs (garlic and ginger are natural forms)
  • Ice – to help with chronic swelling and pain in the area of the busitis
  • NKT protocol – to help figure out the compensation pattern that is causing one muscle to work too hard
  • Adjusting the joint to allow proper motion
  • Kinesiotape – to help decompress the area and promote healing

There should be signs of improvement within 4-6 weeks. If there have not been any improvement and you have done all the above then x-ray and advanced imaging are the next options.

If you have tried to rest the area having the bursitis symptoms without success, please visit Peak Wellness and Chiropractic, the family chiropractic. Dr. Megan Reed specializes in treating injuries and chronic problems of athletes and active individuals. Get help from Peak Wellness and Chiropractic so you can get back to doing what you enjoy.

Tour de Cure

I was very proud to be a part of May’s Tour de Cure bike race in Cary. Peak Wellness & Chiropractic supported the tour with complimentary Kinesiotaping demonstrations and soft tissue adjustments for the benefit of the athletes. Check out some of the pictures of the event below.

The Tour de Cure is a series of fundraising cycling events held in 44 states nationwide to benefit the American Diabetes Association. You can learn more about the Tour on their website.

 

Recipes from Patient Appreciation Week

Black Bean Brownies (Gluten Free and Dairy Free)

  • 1-15oz can black beans, drained and rinsed
  • 2 Tbs cocoa
  • 1/2 c oats
  • 1/4 tsp salt
  • 1/2 maple syrup
  • 1/4 c coconut oil
  • 2 tsp vanilla
  • 1/2 tsp baking powder
  1. Preheat oven to 350*
  2. Combine ingredients in a food processor.
  3. Pulse in 1/2 c chocolate chips.
  4. Pour into an 8×8 baking dish. Bake 15-18 min. (I baked for 25 min. Let stand 20 min to cool then cut and remove from dish.

Nice and gooey!!

 

Power Balls (Gluten Free and Dairy Free)

  • 1 c raw almonds
  • 1 c medjool dates
  • 1/4 c raisins
  • 1/4 tsp cinnamon
  • 1/4 tsp ground cardamom
  • 1/4 c raw almond butter
  1. In a food processor grind almonds until finely ground. Add dates, raisins, & spices. Grind into fine meal.
  2. Add almond butter, process again until fully mixed.
  3. Form into balls and roll in shredded organic coconut (finely shredded…I didn’t end up putting the coconut on mine).
  4. Seal in container on counter for up to 3 days or refrigerate for 1 week.