We Have Been Treating Carpal Tunnel Syndrome (CTS) since 1995.

It wasn’t that long ago that patients would look at me strange when I suggested that the source of CTS symptoms is usually in the neck (conditions such as vertebral subluxations, cervical disc bulges and herniations, disc degeneration, facet syndrome, spinal stenosis, and forward head posture).

I used to hear something like this every day…”The pain is in my hand…why are you checking my neck?”

My fellow doctors, my patient’s primary doctors, my wife…everyone thought this was a little strange…that is until they witnessed the results we were getting treating carpal tunnel patients from the neck down to the fingertips.

The reason seems obvious now…now that it is almost a form of malpractice not to consider pathology in the neck when it comes to diagnosing and treating CTS symptoms.
WHY? Because the nerves that innervate or connect and control the arm and hand originate in the neck. And pressure on these nerves in the neck causes the same signs and symptoms as true carpal tunnel syndrome.

The nerve involved is CTS is called the median nerve. The median nerve originates in the neck. It is formed by branches of nerve roots from C5-C8 (C=cervical) which is the lower part of your neck. You have 7 bones in your neck (cervical spine)…and nerves exit from the left and right (underneath) of each bone. These nerves connect and form the 3 major nerves that control the arm and hand. The median nerve, the radial nerve, and the ulnar nerve.

The median nerve (named median because it travels down the middle of the arm) travels through an area of bones and ligaments in the wrist called the carpal tunnel, where it is susceptible to pressure from either the contents of the tunnel expanding (nerves and tendons from inflammation and overuse, repetitive stress injuries-RSI) or the diameter of the tunnel contracting (bones out of alignment from poor ergonomics, trauma, degeneration, and congenital defects, tumors). If either of these situations occur it can put pressure on the median nerve causing clinical CTS. In fact, by definition CTS is median nerve compromise in the carpal tunnel. True CTS is rare.

Again (and this can be hard to grasp)…pressure on the nerves in the neck that form the median nerve causes the same symptoms (in the hands) as CTS when they have pressure on them. Here are the most common symptoms:

• Pain in the arm and hand or hands
• Numbness and Tingling in the arms and hands
• Weakness of grip
• Night pain in the hand/s
• Burning sensations in the hand
• Clumsiness of hand/s
• Neck pain
• Shoulder pain
• Swelling of the hand

So how do you know if you have CTS or if the problem is in the neck? You don’t…you have to be checked by an expert to find out. A doctor that spends the majority of their day treating patients with neck, shoulder, arm and hand pain.

And…just because your doctor may correctly identify your carpal tunnel symptoms cause as originating the neck…it does not mean they know what to do about it.

My treatment approach is to work from the neck to the fingertips on both sides. We also address the entire spine because the spine functions as a unit. Heck…you could even have a problem in your leg that is causing imbalances in the spine, leading to nerve pressure in the neck, resulting in CTS symptoms in your hand. Strange but true.

This is why so my people with hand pain find it hard to get the right kind of treatment and end up in a viscous circle of diagnostic testing, cortisone, pain pills, crazy treatments, and even surgery.

Anyway…the bottom line is this. If you have CTS symptoms you need to find yourself a doctor that not only can diagnose CTS and it’s related disorders…but that also has a proven method of treatment. This is often times not easy.

In any case…don’t just head to the operating table or give up on getting better. It may be that you just have not found the right doctor…a doctor that knows CTS, and the CTS-cervical spine connection…and how to treat it.

To schedule a complimentary CTS evaluation with me, Dr. Paul Kramer call Jennifer at 262-251-8306 or visit us online at www.relieffromcarpaltunnel.com or visit my practice web-site at www.painfree-greatposture.com.

Health is a Choice

They say that 70% of killer diseases like heart disease, cancer, obesity, stroke, and diabetes, are diseases of excess. They are the manifestation of poor lifestyle choices such as smoking, drinking, bad food choices, stress and lack of exercise.

In fact, I remember reading about a study done where they polled a large group of random people (off the street) and asked them…Tell us 3 things that you could change about your lifestyle right now that would extend your lifespan? These were the top 3 answers.

1. Eat better, more vegetables, less fat and processed foods.
2. Lose weight/Exercise more.
3. Stop smoking or drinking.

People are smart, but we can also be lazy and indulge too much in things that taste and feel good.

And the problem with these lifestyle temptations, is they do their damage slowly, and for the most part silently. After-all…the first symptom of heart disease 2/3 of the time is a heart attack, many of those fatal.

So…while health is not a mystery, since most of us know what we should be doing to stay healthy…the mystery is why we don’t do it.

I think it’s because we think we can get away with it. We think…I’m young…I can change my bad habits before it gets too late…then get healthy. Meanwhile…time goes on and nothing happens (and years pass) to you even though you are drinking, smoking, and eating garbage…you get a sense of false security…then BOOM.

Did you hear…Betty was stricken by cancer…like she was hit by a car and had nothing to do with it.

But the thing is…a healthy lifestyle pays dividends now (and later).

You feel better about yourself when you are healthy. You look better. Your body functions better. You sleep better. It gives you a lot more options when it comes to expressing life. And you can do it for longer.

So listen to yourself…because you are right…Health is choice.

To schedule an appointment with Dr. Paul Kramer call Jennifer at 262-251-8306.

Dr. Kramer on “What’s Cookin”

Last month I was on the local TV show called What’s Cookin’ with KC Thorson.  She interviewed me about nutrition.  It was a great little discussion filled with lots of information.

My son’s cub scout troop was there to watch and they had a blast sitting in the audience with big head phones on.

We talked about a variety of hot topics in nutrition and then KC made an excellent pizza.

To check it out, log on here!

Chronic Pain and Vitamin D

Vitamin D is an important nutrient to overall health.  Low vitamin D levels have been associated with persistant, nonspecific, musculoskeletal pain.(fibromyalgia) and depression.

A recent study published in the Mayo Clinic Proceedings tested 150 patients with chronic pain.  93% or 140 of them had low vitamin D levels.  An interesting finding was that 100% of all African American, East African, Hispanic and American Indians were deficient in Vitamin D.  The study concluded that “All patients with persistant, nonspecific musculoskeletal pain are at high risk for the consequences of unrecognized and untreated severe hypovitaminosis D.”

I talk about vitamin D a lot in my practice.  Too little vitamin D is common, especially in the Wisconsin climate.  Typically the symptoms of hypovitaminosis D are treated with drugs that don’t do anything to fix the problem and in fact can deplete the body even more.

This year, I have partnered with a professional co-op so that I can order vitamin D tests at a cost of about $40.00.  Already I have found patients that have severe vitamin D issues and it has been a pleasure to help them with a simple course of supplementation.

To schedule a free consultation with me, contact Jennifer at 262-251-8306 or log on to www.stopyourfibronow.com or www.newbackpainreliefinfo.com.

Why Choose Chiropractic?

Why would you go to a chiropractor instead of an MD, DO or physical therapist?

One thing that makes chiropractic unique is that from day one, chiropractors are trained to think of the body as being designed to function properly.  As long as the body is given proper air, food, water, safety and rest, it will function at its best.

We view disease as a process that happens when the body is not functioning as it should.

Chiropractors focus on the spine because it contains the spinal cord and nerve roots that can get be injured, when the spine misaligns.  The spinal cord and nerve roots carry messages to and from the brain.  If the messages don’t get thru, the body will not function like it should.  Re-aligning the spine helps the body to function better.

But then we go even deeper to find out what caused the spine to misalign in the first place.  Was it caused by a trauma, a bad mattress, a toxin that affected the muscles,  a diet filled with junk, exhaustion from not sleeping or …?  Once the body is given what it needs, it will function like it should and pain will go away.

This way of looking at the body is much different than modern medicine.  Modern medicine treats the body by using drugs to mask symptoms.  The underlying problems are then ignored until they get so bad that surgery becomes necessary.  This is a bad way of thinking and it is probably why our healthcare system is in a shambles today.

Now, I’m not saying that drugs aren’t totally necessary.  I’ve treated many patients who have needed medication because the pain was so intense they couldn’t do anything without it.  But, they got the problem treated properly, so their body functioned better and they no longer needed to take the pills.  Last I checked, there is no pill that will move a bone away from a nerve.

To find out more about how I treat back pain, log on to www.newbackpainreliefinfo.com

Why Fibromyalgia Can Kill You!

I have been treating fibromyalgia for about 8 years now and it has been an adventure to say the least.  Unfortunately, many medical doctors don’t even think it exists.  The average fibromyalgia patient that comes to see me has seen four other doctors.  When I started eight years ago it was six.

The story is always the same.  Pills, pills, pills.  No results.  Live with it.

When treating a fibromyalgia patient I’ve always tried to focus on what might be causing the widespread pain.  I’ve found that about 80% of fibromyalgia patients have a particular type of misalignment in the spine that can be corrected.  When the misalignment is corrected, most of the pain goes away.

I say most, but not all, because I have found that for about half the fibromyalgia patients, spinal adjusting is not enough. They need help with other problems as well.  These problems can lead to other more serious diseases like Alzheimer’s, heart disease and cancer.

The problems have to do with inflammation (swelling) that comes from oxidative stress.  Oxidative stress is a term used to describe what happens when the body is overwhelmed by toxic foods and drugs.  As the body tries to process these toxins, it gets swollen and damaged.  The swelling is systemic, meaning that it happens all over.  It affects the heart, brain, liver, kidneys and digestive tract just as much as the muscles and joints.

The all over pain of fibromyalgia is really a warning signal that more serious problems are going on.

The good news is that it is treatable.  If the body is given the nutrients it needs, it will repair itself.  The pain will go away and many other illnesses can be prevented.

How do you find out if you are one of the fibromyalgia patients that needs nutritional therapy ?  You need to get your blood checked for signs of inflammation.  These are the same tests your MD would use to look for cardiac inflammatory problems.  Tests like CRP, homocysteine and fibrinogen.

In an MD’s office, they would treat the inflammation with drugs.  In my office, I order the blood tests and then I treat the problems with nutrition.  The side effects are non-existent, it works better and the body gets what it really needs.

To find out more about how I treat fibromyalgia, log on to www.stopyourfibronow.com

Reference:  “Why myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may kill you !: disorders in the inflammatory and oxidative and nitrosative stress pathways may explain cardiovascular disorders in ME/CFS”  Maes M, Twisk FN. Neuro Endocrinol Lett. 2009;30(6):677-93.

Fibromyalgia – Does This Sounds Familiar?

“I am exhausted and hurt all over.  I can’t get to sleep at night and when I do, I wake up at the drop of a dime.  I went to my doctor and they ran some blood tests and took some x-rays and said that nothing was wrong.  I just don’t know what is wrong or what to do about it.”

This is a classic history obtained from a patient suffering from fibromyalgia or FM.  Because the onset of fibromyalgia is slow and gradual, it is common for patients to postpone visiting their health care provider until the symptoms are quite significant. The diagnosis may also be delayed as many healthcare providers do not feel fibromyalgia is a legitimate medical condition and minimize the symptoms frequently categorizing them as “depressed,” which postpones an appropriate diagnosis and treatment.

The classic definition as defined by the American College of Rheumatology includes at least a three-month duration of symptoms with the presence of 11 out of 18 potential tender points although diffuse, widespread pain not necessarily restricted to these exact locations may also represent an appropriate diagnostic finding in fibromyalgia.

Fibromyalgia is more common in females and affects approximately 2% of the population in the United States. The risk of developing fibromyalgia increases with age, usually developing during early and middle adulthood but can also develop in children and older adults. Other risk factors include a positive family history where one may be more likely to develop FM if a relative suffers with the same condition.

A major risk factor of developing fibromyalgia includes is disturbed sleep pattern and this remains controversial as to whether sleeping disorders are a direct cause or simply the result of fibromyalgia. However, in either case, people with FM cannot obtain deep “restorative” sleep and feel fatigued and tired upon waking in the morning. Sleep disorders including sleep apnea and restless leg syndrome are often present in patients with fibromyalgia.

Certain conditions such as rheumatoid arthritis, irritable bowel syndrome, hypothyroid, and other endocrine/hormonal conditions may preceded the onset of fibromyalgia in which case the condition is considered “secondary fibromyalgia.” Hence, a diagnostic evaluation usually includes a blood test for hypothyroid, autoimmune diseases such as rheumatoid arthritis, and a complete blood count to rule out infections and/or anemia. In most cases, these tests prove negative and the diagnosis is made by excluding other possible primary conditions.

Other causes can include physical and/or emotional trauma where a high-level of stress can trigger this condition. Although experts still debate why patients with fibromyalgia hurt so intensely, the current explanation centers around a theory called central sensitization. This is essentially a lower pain threshold where patients with FM feel pain much sooner than those without it because of increased sensitivity in the brain and/or spinal cord to incoming pain signals.

Treatment of FM relies on a multidiscipline, multifactorial approach including stress reduction, obtaining enough sleep, exercising regularly, pacing yourself, and maintaining a healthy lifestyle, including diet and exercise. Other highly effective treatments, according to the Mayo Clinic website, include chiropractic treatment, massage therapy, and/or acupuncture. The concepts of chiropractic treatment includes restoring movement in restricted spinal joints resulting in improved nerve function and subsequently, improved overall function and reduced pain. Chiropractic care also includes cold laser, nutritional counseling and patient education. We recognize the importance of including chiropractic in your treatment of FM and realize you have a choice of providers. We would be honored to be part of your management team.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306

Carpal Tunnel Syndrome (CTS) – Can It Be Prevented?

Carpal Tunnel Syndrome or CTS is a very common problem affecting many workers and is one of the most costly conditions afflicting today’s workforce.  It is most often caused by repetitive activity using rapid movements of the arms and hands and can lead to work loss and disability when not properly managed.  CTS occurs when the median nerve that travels through the carpal tunnel (CT) located on the palm side of the wrist becomes pinched by the swelling of the 9 tendons that also travel through the CT and essentially, pinch the nerve up against the transverse carpal ligament.  This results in numbness, tingling and/or pain of the index, middle and forth fingers.

Other symptoms include sleep interruptions where shaking and flicking of the fingers is required to allow for a return to sleep.  This is frequently caused by sleeping with the wrist in a cocked position, increasing the pressure inside the already swollen carpal tunnel.  This is why a cock-up wrist splint usually helps as it disallows the wrist from bending to the extremes and the nerve is not pressured or pinched as much.  Other symptoms include weakness of the grip, making it a challenge to unscrew a jar, open a door, and even sometimes turn the key when starting a car.  Driving can also be affected as the hands often fall asleep while holding onto a steering wheel.

Pain can also affect the rest of the arm and sometimes the neck area.  The median nerve can also be pinched in more than one place and may include the neck, shoulder, elbow as well as the wrist making it necessary to have all the areas treated for a satisfying result.

People at greatest risk are women > men, workers who handle small tools, computer workers, fast repetitive line workers, and people older than 40 years of age.  People with other health conditions including rheumatoid arthritis, Lymes disease, rubella, pregnancy, birth control pill use, diabetes mellitus and menopause are at an increased risk of developing CTS.  Certain foods such as caffeine, tobacco, and/or alcohol may also contribute to CTS.

Though treatment is very important –the sooner the better- prevention is most important.  In fact, some simple approaches can make a big difference!  Some of these include modifying the position of a computer chair, keyboard, monitor, or mouse (work station modifications), alternate between different tasks to reduce the repetition of work, stretch your forearms and fingers before, during and after work, and treat any underlying conditions.  When symptoms first occur, these recommendations, as well as wearing a night wrist cock-up splint and seeing your chiropractor, will often reverse the condition without difficulty.  If you wait too long and nerve damage occurs, it becomes a more challenging process to manage CTS and at times, even surgery will not be very helpful.

Some of the non-surgical treatment approaches you might expect from your chiropractor include joint manipulation and/or mobilization applied to the neck, wrist, elbow and/or shoulder, the application of physical therapy modalities such as ultrasound, electrical stim, and/or low level laser therapy (“light” therapy), as well as the use of wrist splints.

The University of Maryland Medical Center cites two research articles on chiropractic treatment for CTS. They report good results are usually obtained and that these good results continued for at least 6 months after treatment ended.  The same reference also recommends nutrition and supplements in the management of CTS.  Some of these include: eliminate food allergens (often milk, cheese, eggs, ice cream, glutens/wheat-grains, soy, corn, and preservatives) and eating foods high in B-vitamins (dark leafy greens like spinach, kale, and sea vegetables), anti-oxidants (fruits – blueberries, cherries, tomatoes; vegetables – squash, bell peppers),  avoiding refined foods, using olive oil and adding omega 3 fatty acids to the diet (fish oil).  Other vitamins including a multivitamin, B complex, Vit. C, alpha-lipoic acid, MSM, resveratrol, Vit. D, Co-Q10, magnesium can also really help.

We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for CTS, chiropractic care is a logical first choice and we would be honored to offer our services to you.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306