Carpal tunnel syndrome is a nerve compression disorder. It can occur due to repetitive motion at work or at home, or may happen secondary to another condition such as arthritis. Whatever the cause, this condition can be painful and can limit function if not treated early.

Carpal tunnel syndrome occurs when the median nerve of the arm is compressed, or pinched, at the wrist. The median nerve runs from the cervical spine, the lower neck, down the arm to the tips of the thumb and the first three fingers. It supplies the feeling to these fingers and the palm of the hand, as well as portions of the forearm. Just prior to branching to the palm and fingers, the median nerve passes through the carpal tunnel, which is made up of the carpal bones of the wrist on three sides and the transverse carpal ligament on the forth side. The tendons from the flexor muscles in the forearm pass through this tunnel along with the median nerve.

When carpal tunnel syndrome occurs, swelling causes the carpal tunnel to narrow, creating less space in the tunnel for the tendons and median nerve to pass through. If the swelling becomes pronounced, the median nerve becomes compressed. This leads to pain, numbness and tingling in the thumb, index, middle and part of the ring fingers. If the symptoms are severe or occur over a period of time, weakness in the hand may also occur.

There are many factors that can cause carpal tunnel syndrome. The most well known and well debated is repetitive motion, especially as applied to work situations. Working a repetitive motion job where the biomechanics of the job are poorly set up can place a person at an increased risk for carpal tunnel syndrome. An example of this is typing at a keyboard for 8 hours a day at a desk where the keyboard is placed at shoulder height, causing the person to type with his or her wrists bent. Assembly line jobs that do not use ergonomic tools are also at risk for this syndrome.

Prior injury to the wrist also places a person at risk for carpal tunnel syndrome. A prior fracture or ligament tears at the wrist may have resulted in scar tissue in the carpal tunnel. This will naturally narrow the area and will place a person at increased risk for developing the syndrome.

People with arthritis are also at an increased risk for developing carpal tunnel syndrome. As the swelling of arthritis settles into the carpal tunnel, it thickens the fluids, stiffens the tissues and narrows the tunnel, causing compression on the median nerve.

Catching carpal tunnel syndrome early and managing it conservatively is the most effective way to treat this condition. Keeping the wrists in straight, neutral positions will reduce the pressure on the median nerve when completing daily activities. Wrist support braces will help maintain this position, especially at night when people have a tendency to curl their arms while sleeping. Using ergonomic tools and making changes to work stations to make sure the wrists are in straight, neutral positions will also assist in taking the strain off of the carpal tunnel area. Frequent rest breaks and ice or cold packs will help to keep swelling down.

If a person’s carpal tunnel syndrome becomes advanced, surgery to release the transverse carpal ligament is an option. This procedure has become much less invasive in recent years and recovery takes much less time. The wrist structure is not compromised by this procedure, although hand strength may be slightly reduced. Proper precautions, including following the same conservative management techniques while recovering from surgery, are important for the procedure to be effective. If not, scar tissue may form and the same type of compression on the median nerve may occur.

Clearly early identification and treatment of this condition can limit its effects and allow a person to maintain hand function for many years.

By Janet Meydam 

You go to meet your girlfriend and you get ready to hug her and she pushes you away. She has seen that you have excessive armpit perspiration and it really turns her off. How embarrassing for you! This excessive armpit perspiration problem is something that you have had since junior high and it just hasn’t gotten any better.

Although this might not be consolation, you are not alone. There are at least 2-3% of the people in our society that suffer from this problem. Excessive armpit perspiration isn’t something that is easy, but it is something that you can get some control over.

Sometimes just thinking about what to do can bring you some great ideas to stop the excessive armpit perspiration. For instance, one person suggests that you use many different things at one time to stop sweating.

He calls his idea, stacking and it’s basically finding several things that work for you and doing them all at once. As an example, you might try a very strong antiperspirant first, then put on armpit sweat guards under your arms, and then try a product called DeodoRite. Completing this process will help you stop the sweating.

Some people say that the best way to stop excessive armpit perspiration is to watch what you wear. Certain fabrics like spandex make you sweat more. Any clothing that is very tight will also make some people sweat more. It is better to let your body breath with a nice cotton because your body can breathe.

There are a lot of people that really feel like they aren’t clean because of this excessive armpit perspiration so they take a lot of showers and change clothes a lot. This can be very time consuming, difficult and it really doesn’t help the excessive armpit perspiration.

The good news is that there are many things on the market like stronger deodorants and herbal remedies that can help you reduce the excessive armpit perspiration so you aren’t as uncomfortable with it.

The other thing is to celebrate the fact that your body is doing this and that you don’t have to hide it because you can get the help you need. If you are patient and you continue to understand your body’s needs you can control your excessive armpit perspiration.

By Mindy Limbart 

Natural treatments are steadily gaining popularity for good reason. People want to find a healthier way to treat their ailments, including gout. One of the best ways to control the pain of gout is through your diet. Although you’ll want to focus on adding certain foods to your weekly menu plans, there are many foods to avoid with gout as well. Limiting your consumption of these foods can really help you control the pain you experience.

There are a variety of vegetables that are included on the list of foods to avoid with gout. In particular if you suffer with gout you want to forgo having peas, spinach, asparagus and beans. You may recognize that after eating these in the past your gout pain seemed to worsen. Mushrooms need to be removed from your menu plans as well. It’s even worth asking when eating out if any sauces contain mushrooms as that small amount can cause your gout to flare as well.

Seafood is certainly delicious and nutritious but it isn’t always beneficial. This is true for people who suffer with this painful ailment. Scallops, mussels and shrimps are a few of the foods to avoid with gout. Mackerel and sardines make the list of bad foods too, so try and stay clear of them when preparing meals.

Gravy is a staple, especially at the holidays, but you’re going to want to sacrifice eating it. Gravy isn’t going to help your gout at all and can actually cause a flare up. If you find your willpower wearing thin when you are eating mashed potatoes or french fries just remember how painful your gout can be. Use this as inspiration to pass on the gravy.

By Gillian Reynolds 

Now that you understand some of the anatomy involved at the ankle joint, you are ready to learn about the different types of ankle sprain, how they are graded and how they are caused. Once you have a good foundation of the anatomy and the injury we can begin to discuss how to go about minimizing the chances of sustaining this common injury. A sprain is the term used when a ligament is damaged or ruptured. There two ways in which sprains happen. One way is to put a sustained stretch on a ligament.

When a ligament is held in a stretched position for a long period of time it loses some of its elasticity. These sprains are typically midland can heal quickly if the ligament is allowed to return to its proper length. The other mechanism for sprains is an explosive stretch on a ligament. This force can stretch, tear, or completely rupture a ligament. This is the mechanism that is most common to ankle sprains. There are three basic types of ankle sprains. They are inversion sprains, eversion sprains and syndesmosis or “high-ankle” sprains. The most common of the three is the inversion sprain. This is the injury that is commonly sustained when people say that they “rolled” their ankle. Inversion sprains occur when you foot is pointed toward the floor and the foot rolls inward so that all of the weight of the body is over the outside of the foot and on the outer part of the ankle joint. The way this usually happens is by stepping or landing on uneven ground or when making a cutting motion. Inversion sprains damage the ligaments on the outside of the ankle. The anterior talofibular ligament is the most commonly sprained ligament. More severe sprains may involve the calcaneofibular ligament as well.

The posterior talofibular ligament is only damaged in severe ankle sprains. Eversion sprains are less common than inversion sprains. A big part of the reason for this is that the outer malleolus extends lower than the inner one. Since it goes lower the range of movement toward this bone is limited. The difference is easy to see if you try to roll your foot inward as opposed to outward. Eversion ankle sprains require a great deal of force to occur. Often it happens when an athlete has a foot planted and there is a blow from the side to the planted leg. In the most severe cases of eversion ankle sprain, the outer malleolus can fracture as well. The syndesmosis or “high-ankle” sprain can be a common occurrence with inversion sprains. It is a sprain of the distal talofibular ligament which connects the tibia and fibula just above the ankle joint. This occurs when the talus bone twists between the inner and outer malleoli. This twisting motion can pry the tibia and fibula apart and is typically rather painful. These injuries typically occur when the foot is planted and the body twists over the planted foot. Ankle sprains are frequently associated with some muscle strain. You have peronei muscles which reach from the knee and outer leg to the foot. Their job is to properly position the foot while you are walking, jumping, dancing, etc. When an inversion sprains occur the rapid stretch on the peronei muscles can cause some tearing and strain to the muscle. Joint sprains are graded using the following scale²:

Grade 1:

• Mild pain with little to no swelling
• Minor tears and/or stretching of the ligament
• Minimal loss of function with some joint stiffness
• Full symptomatic/functional recovery takes a few days*

Grade 2:

• Moderate to severe pain with swelling
• Partial tear of ligaments
• Moderate loss of function with some joint stiffness
• Full symptomatic/functional recovery takes 2-3 months^*

Grade 3:

• Severe initial pain followed by little or no pain
• Profuse swelling and joint stiffness
• Complete rupture of ligaments (severe laxity in the absence of swelling)
• Complete loss of function
• Full symptomatic/functional recovery can take up to 4 months^*

* Ligaments may not recover full strength for a year or more. Now that you understand the anatomy and mechanism of ankle sprains there is only one more topic to explore before we can begin to explore some ways that ankle sprains can be prevented. This is the issue of risk factors for ankle sprains. There are proven ways to limit your risk. The following articles will examine the roles that shoes, ankle braces, ankle taping, and exercises play in preventing ankle sprains.

[1] Hamill J, Knutzen KM. Biomechanical Basis of Human Movement 2nd ed. Baltimore: Lippincott Williams & Wilkins 2003.
[2] Carnes MA, Vizniak NA. Quick Reference Clinical Chiropractic Conditions Manual. 1st ed. DC Publishing International 2004.
[3] Taylor, M. “Talofibular Ligament Injury”. 2005 eMedicine.com, 25 February 2007 http://www.emedicine.com/sports/topic126.htm
[4] Carnes, Michael. Personal communication. February 2007.

By Dr. Jason J. Young, D.C.

‘As a man thinks within himself, so he is.’ This is one of the great proverbs (23.7a). The is also the title of a great book written over 100 years ago by James Allen and still widely read today. The basic premise is that our character is the sum of all of our thoughts. Our thoughts effect our circumstances, health, our achievements.

Once you decide on a fitness goal ( get in shape, lose weight, run a marathon) you must first get your mind in order. ‘The body is the servant of the mind.’ Unhealthy thoughts will express themselves through an unhealthy body and vice versa. This is important to understand if you are trying to diet or get fit. You will not have lasting changes unless you regard your body as your temple.

So practice some mental fitness along with your physical fitness routine.

- Get honest about how you feel about yourself and your body- if your thoughts towards it are negative then it will be difficult to take proper care of it.
- Practice daily affirmations
- Keep your stress level in check- we unconsciously neglect our bodies because we are so busy doing other things
- Practise self control.
- Keep your mind renewed and refreshed
- Make up your mind- success at anything takes hard work and effort
- Be responsible- you are 100% responsible for being in the healthiest you can be- no one else is standing in your way
- To thine own self be true- list your triggers, boredom, loneliness, anger- what will push you to overeat, what will resign you to the couch instead of going to the gym
- Focus on the positive-

By Cathy Morenzie