CTS - Prompt Treatment Is Best!
Many people suffer from CTS (Carpal Tunnel Syndrome) and unfortunately, often ignore the initial symptoms of numbness or tingling in the hand(s). These early symptoms are typically not too alarming and hence, they often do not raise the level of concern until more intense symptoms occur; such as waking up from sleep due to numbness, dropping items, difficulty buttoning clothing, needing to switch hands when driving, difficulty writing, typing, knitting, as well as work related pain. There may also be fear of job loss associated with CTS, especially in these hard economic times with frequent lay offs, prompting CTS sufferers to postpone initial care. Unfortunately, delaying treatment is associated with a longer recovery time when compared to prompt management which usually results in a quicker, less complicated and more satisfying recovery.
There are many causes and contributing factors of CTS. The most prevalent cause is mechanical irritation from simply moving the hands too fast for too long, without enough rest. Another risk factor is age (over 50 years old). In this era of an aging workforce, this may be a significant issue. Fast, repetitive movements of the arms and hands are often a direct cause and can be appreciated by watching someone knit rapidly and/or performing line work using fast, repetitive movements. If the hands/wrists have to bend in awkward positions to accomplish a work task, or if a tool that is frequently used places pressure in the palm of the hand, these can also contribute to the onset or perpetuation of CTS. Other conditions can also contribute to CTS including inflammatory arthritis like rheumatoid, diabetes, pregnancy, the use of birth control pills, obesity and hypothyroidism.
The management of CTS is case specific, and is dependant on which of the above mentioned causes or contributors are present. Management of any metabolic disorder such as diabetes or hypothyroid is important, especially compliance with taking appropriate medication, when indicated. The management of weight, hormone replacement therapy, and fluid retention all play a roll in CTS management. Ergonomic or job-related management strategies are very important and can include work station modifications so that unnecessary awkward arm/wrist/hand positions can be avoided. This may require moving the item being worked on to a less stressful position, using a different type of tool handle (screw driver, etc.), changing the height or reach distance at which the material is worked on, and taking “mini-breaks” every ½ to 1 hour when the lack of rest is a contributor. Frequently, the combination of pinching a phone between the head and shoulder, typing data into a computer where the monitor is positioned too high or off to one side, and excessive arm motions using a computer mouse can contribute to pinching the nerve in the neck and/or arm, resulting in CTS. Remedies for this situation include the use of a head set, repositioning the computer monitor so that it is in front of the worker, and using a trackball type of mouse to eliminate arm motion can be extremely helpful. Treatment strategies offered by chiropractors include the use of night splinting to avoid awkward wrist/hand positions during sleep. In addition, manual therapy to the wrist and the tight muscles in the front of the forearm, as well as other nerve constriction areas such as the elbow, shoulder, and neck, manipulation of the joints in hand, wrist, elbow, shoulder, and/or neck, depending on what is unique and needed for that patient, and the use of physiological therapeutics such as low level laser light therapy, electrical stimulation, and/or ultrasound have all been shown to offer beneficial effects. Nutritional recommendations include Vitamin B6 (150mg/day), magnesium, calcium, Co-Q10, omega 3 fatty acids and vitamin D3. Reducing glutens (wheat, oats, barley, and rye) is also very important due to the inflammatory response of these foods. Surgery is typically, the last treatment resort and is appropriate, “when all else fails.” We welcome you to our clinic and are proud to offer you a non-drug, non-surgical solution for CTS and its disabling symptoms.
Friday, July 31, 2009
Friday, July 24, 2009
Monday, July 20, 2009
Friday, July 17, 2009
Tuesday, July 14, 2009
Jonas Brothers Make Sure to Get Spines Adjusted Regularly
The above headline comes from the June 30, 2009 edition of MyCentralJersey.com. The article, written by staff writer Jeff Webber, reports that the pop stars are regular chiropractic patients. The author writes, "One of the most popular music groups right now, at least among the younger generation, is the Jonas Brothers. Since forming in 2005, the three brothers from Wyckoff have become a pop-music phenomenon, releasing four albums, touring all over the world and taking over The Disney Channel."
The article notes that their success is attributed to natural talent as well as good health practices. Part of the good health practices has meant regularly obtaining the services of their hometown chiropractor. Dr. Albert Wolyniec of New Jersey has been the family chiropractor for some time.
Dr. Wolyniec wrote in the Spring 2009 edition of The New Jersey Chiropractor, "They make sure they get their spines adjusted regularly, even if they have to fly me somewhere in the country just for the day. I have even done a coast-to-coast house call solely to maintain their spines free of nerve interference." The article notes that when playing at a local event in New Jersey, the Jonas Brothers and as many as 20 of their traveling party will receive chiropractic adjustments.
Dr. Wolyniec added, "They use chiropractic care not for pain, but to stay healthy. By keeping the nerve pathways open between the brain and the body, it keeps the pressure off the big heavy spinal nerves. When the vertebrae are kept in alignment, it translates into better health and better performance. They recognize this."
The above headline comes from the June 30, 2009 edition of MyCentralJersey.com. The article, written by staff writer Jeff Webber, reports that the pop stars are regular chiropractic patients. The author writes, "One of the most popular music groups right now, at least among the younger generation, is the Jonas Brothers. Since forming in 2005, the three brothers from Wyckoff have become a pop-music phenomenon, releasing four albums, touring all over the world and taking over The Disney Channel."
The article notes that their success is attributed to natural talent as well as good health practices. Part of the good health practices has meant regularly obtaining the services of their hometown chiropractor. Dr. Albert Wolyniec of New Jersey has been the family chiropractor for some time.
Dr. Wolyniec wrote in the Spring 2009 edition of The New Jersey Chiropractor, "They make sure they get their spines adjusted regularly, even if they have to fly me somewhere in the country just for the day. I have even done a coast-to-coast house call solely to maintain their spines free of nerve interference." The article notes that when playing at a local event in New Jersey, the Jonas Brothers and as many as 20 of their traveling party will receive chiropractic adjustments.
Dr. Wolyniec added, "They use chiropractic care not for pain, but to stay healthy. By keeping the nerve pathways open between the brain and the body, it keeps the pressure off the big heavy spinal nerves. When the vertebrae are kept in alignment, it translates into better health and better performance. They recognize this."
Monday, July 13, 2009
Friday, July 10, 2009
Monday, July 6, 2009
Thursday, July 2, 2009
Wednesday, July 1, 2009
FDA Panel Urges Ban on Vicodin, Percocet
FDA Panel Urges Ban on Vicodin, Percocet
Also recommends dosing limits for OTC painkillers that contain acetaminophen, like Tylenol or Excedrin, because of link to liver damage.
By Steve Reinberg, HealthDay Reporter
TUESDAY, June 30 (HealthDay News) -- The popular prescription painkillers Vicodin and Percocet, which combine acetaminophen with an opiate narcotic, should be banned, and the maximum dose of over-the-counter painkillers with acetaminophen, like Tylenol or Excedrin, should be lowered, a U.S. Food and Drug Administration advisory panel urged Tuesday.
The panel's recommendations followed the release of an FDA report last month that found severe liver damage, and even death, can result from a lack of consumer awareness that acetaminophen -- which is easier on the stomach than such painkillers as aspirin and ibuprofen -- can cause such injury.
The dangers from use or abuse of Vicodin and Percocet may be even more concerning, one key panelist said.
"It seems to me that problems with opiate combinations are clearly more prevalent," Dr. Lewis S. Nelson, chairman of the FDA's Drug Safety and Risk Management Advisory Committee, said during a Tuesday press conference held after the two-day meeting.
Explaining the panel's 20-17 vote to ban prescription acetaminophen/opiate drugs, Nelson said, "There are many deaths that relate to problems with prescription opiate combination acetaminophen products, whereas the number of deaths clearly related to the over-the-counter products are much more limited."
But the FDA advisers also took aim at over-the-counter (OTC) acetaminophen products. The agency's report found that many people may consume more than the recommended dose of these pain relievers in the mistaken belief that taking more will prove more effective against pain without posing health risks. Consumers may also not know that acetaminophen is present in many over-the-counter products, including remedies for colds, headaches and fevers, making it possible to exceed the recommended acetaminophen dose, the report said.
Based on that, the FDA advisory panel voted 21-16 to lower the maximum daily dose of nonprescription acetaminophen, which is currently 4 grams -- equal to eight pills of a drug such as Extra Strength Tylenol. The panel was not asked to recommend another maximum daily dose.
The panel also voted 24-13 to limit the maximum single dose of acetaminophen to 650 milligrams. The current single dose of Extra Strength Tylenol, for instance, is 1,000 milligrams.
The panel also voted 26-11 to make the 1,000-milligram dose of acetaminophen available only by prescription.
The advisers voted against other safety restrictions for other over-the-counter drugs such as NyQuil or Theraflu, which contain acetaminophen and other ingredients that treat cough and runny nose. Patients often mix the cold medications with pure acetaminophen drugs, like Tylenol, leaving them vulnerable to dangerously high levels of acetaminophen.
The FDA is not obligated to follow the recommendations of its advisory panels, but it typically does so.
Dr. Sandra L. Kweder, deputy director of the FDA's Office of New Drugs at the Center for Drug Evaluation and Research, gave a strong hint of what the agency might do with the advisory panel's recommendations.
"I think the top recommendation of this committee was that the agency needs to do something to address and decrease the usual dose of acetaminophen, both for over-the-counter products and also prescription combination products," Kweder said during the press conference.
She added, "There was a clear message that there is a high likelihood of overdose from prescription narcotic/acetaminophen combination products. If we don't eliminate these combination products, we should certainly at least lower the usual acetaminophen dose patients receive in those prescription combination products."
At the very least the agency should require new warning labels on these prescription combinations that alert patients to the potential of liver damage if they take too much acetaminophen, she said.
Speaking for the OTC drug industry, Lynda A. Suydam, of the Consumer Healthcare Products Association (CHPA), said her group was "pleased the committee did not recommend eliminating these important nonprescription products."
However, in a statement, she added that CHPA was "disappointed in [the panel's] divided vote to lower the maximum daily dose and the single dose of 1000 mg acetaminophen. There was a notable lack of data referenced by the committee to support these recommendations and overwhelmingly strong data affirming the efficacy and safety of acetaminophen in its current dosage forms."
Another expert took a different view. Dr. John H. Klippel, chief executive officer of the Arthritis Foundation, said Tuesday's votes were very important to "people with arthritis because acetaminophen is a very commonly used medication to control pain."
"Lowering the maximum dose, providing that kind of guidance to patients, if it increases safety, would be something the arthritis community would support," he said. "Every person who takes this drug sees it as valuable, but they want clear guidance so they won't be harmed by the drug."
Dr. Lewis W. Teperman, director of transplant surgery and vice chairman of surgery at New York University School of Medicine, said he also supported the panel's decision to recommend lowering doses of acetaminophen.
"It's not that the doses can get you in trouble, but the very young and the very old can get into trouble easily," he said. Also if you are sick, there is the danger of taking cold remedies that contain acetaminophen plus taking pure acetaminophen drugs as well, he noted.
But Klippel added that the vote to make the 1,000-milligram dose of acetaminophen available by prescription only would overburden the health-care system. "Given the massive number of people who rely on this drug for pain control, making the maximum dose requiring a prescription, I think, is going to place undo burden on the health-care system," he said.
Teperman disagreed.
"The 1,000 milligram pill should never be at the patient's discretion. It should only be prescribed by a physician," Teperman said. "If you took an entire bottle of Tylenol Extra Strength, three days later you would be in a coma and needing a liver transplant."
Also recommends dosing limits for OTC painkillers that contain acetaminophen, like Tylenol or Excedrin, because of link to liver damage.
By Steve Reinberg, HealthDay Reporter
TUESDAY, June 30 (HealthDay News) -- The popular prescription painkillers Vicodin and Percocet, which combine acetaminophen with an opiate narcotic, should be banned, and the maximum dose of over-the-counter painkillers with acetaminophen, like Tylenol or Excedrin, should be lowered, a U.S. Food and Drug Administration advisory panel urged Tuesday.
The panel's recommendations followed the release of an FDA report last month that found severe liver damage, and even death, can result from a lack of consumer awareness that acetaminophen -- which is easier on the stomach than such painkillers as aspirin and ibuprofen -- can cause such injury.
The dangers from use or abuse of Vicodin and Percocet may be even more concerning, one key panelist said.
"It seems to me that problems with opiate combinations are clearly more prevalent," Dr. Lewis S. Nelson, chairman of the FDA's Drug Safety and Risk Management Advisory Committee, said during a Tuesday press conference held after the two-day meeting.
Explaining the panel's 20-17 vote to ban prescription acetaminophen/opiate drugs, Nelson said, "There are many deaths that relate to problems with prescription opiate combination acetaminophen products, whereas the number of deaths clearly related to the over-the-counter products are much more limited."
But the FDA advisers also took aim at over-the-counter (OTC) acetaminophen products. The agency's report found that many people may consume more than the recommended dose of these pain relievers in the mistaken belief that taking more will prove more effective against pain without posing health risks. Consumers may also not know that acetaminophen is present in many over-the-counter products, including remedies for colds, headaches and fevers, making it possible to exceed the recommended acetaminophen dose, the report said.
Based on that, the FDA advisory panel voted 21-16 to lower the maximum daily dose of nonprescription acetaminophen, which is currently 4 grams -- equal to eight pills of a drug such as Extra Strength Tylenol. The panel was not asked to recommend another maximum daily dose.
The panel also voted 24-13 to limit the maximum single dose of acetaminophen to 650 milligrams. The current single dose of Extra Strength Tylenol, for instance, is 1,000 milligrams.
The panel also voted 26-11 to make the 1,000-milligram dose of acetaminophen available only by prescription.
The advisers voted against other safety restrictions for other over-the-counter drugs such as NyQuil or Theraflu, which contain acetaminophen and other ingredients that treat cough and runny nose. Patients often mix the cold medications with pure acetaminophen drugs, like Tylenol, leaving them vulnerable to dangerously high levels of acetaminophen.
The FDA is not obligated to follow the recommendations of its advisory panels, but it typically does so.
Dr. Sandra L. Kweder, deputy director of the FDA's Office of New Drugs at the Center for Drug Evaluation and Research, gave a strong hint of what the agency might do with the advisory panel's recommendations.
"I think the top recommendation of this committee was that the agency needs to do something to address and decrease the usual dose of acetaminophen, both for over-the-counter products and also prescription combination products," Kweder said during the press conference.
She added, "There was a clear message that there is a high likelihood of overdose from prescription narcotic/acetaminophen combination products. If we don't eliminate these combination products, we should certainly at least lower the usual acetaminophen dose patients receive in those prescription combination products."
At the very least the agency should require new warning labels on these prescription combinations that alert patients to the potential of liver damage if they take too much acetaminophen, she said.
Speaking for the OTC drug industry, Lynda A. Suydam, of the Consumer Healthcare Products Association (CHPA), said her group was "pleased the committee did not recommend eliminating these important nonprescription products."
However, in a statement, she added that CHPA was "disappointed in [the panel's] divided vote to lower the maximum daily dose and the single dose of 1000 mg acetaminophen. There was a notable lack of data referenced by the committee to support these recommendations and overwhelmingly strong data affirming the efficacy and safety of acetaminophen in its current dosage forms."
Another expert took a different view. Dr. John H. Klippel, chief executive officer of the Arthritis Foundation, said Tuesday's votes were very important to "people with arthritis because acetaminophen is a very commonly used medication to control pain."
"Lowering the maximum dose, providing that kind of guidance to patients, if it increases safety, would be something the arthritis community would support," he said. "Every person who takes this drug sees it as valuable, but they want clear guidance so they won't be harmed by the drug."
Dr. Lewis W. Teperman, director of transplant surgery and vice chairman of surgery at New York University School of Medicine, said he also supported the panel's decision to recommend lowering doses of acetaminophen.
"It's not that the doses can get you in trouble, but the very young and the very old can get into trouble easily," he said. Also if you are sick, there is the danger of taking cold remedies that contain acetaminophen plus taking pure acetaminophen drugs as well, he noted.
But Klippel added that the vote to make the 1,000-milligram dose of acetaminophen available by prescription only would overburden the health-care system. "Given the massive number of people who rely on this drug for pain control, making the maximum dose requiring a prescription, I think, is going to place undo burden on the health-care system," he said.
Teperman disagreed.
"The 1,000 milligram pill should never be at the patient's discretion. It should only be prescribed by a physician," Teperman said. "If you took an entire bottle of Tylenol Extra Strength, three days later you would be in a coma and needing a liver transplant."
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