Carpal Tunnel Syndrome
Chronic Ear Infections:Uncommon Knowledge
The Importance of Muscle Stretching
Carpal Tunnel Syndrome
By Dr. Sal Masi
Most of us rarely think about the intricate function of our wrist and the complex movements that it can create, unless of course it becomes painful and movement is uncomfortable. One of the common ailments of wrist pain is Carpal Tunnel Syndrome.
In order to understand Carpal Tunnel Syndrome (also known as CTS) let me explain the anatomy and mechanics of the wrist. The word Carpal refers to the eight small bones found in the wrist, each has a name: Hamate, Capitate, Trapezoid, Trapezium, Pisiform, Triquetrum, Scaphoid and Lunate. They are arranged in two rows of four bones and it is these bones that allow the tremendous movement at the wrist. These carpal bones are considered the floor of the carpal tunnel.
Overlying these bones are nine tendons that attach to the fingers an are responsible for movement of the fingers, specifically flexion of the fingers. Each of these tendons are wrapped in a sheath (like a glove) that protects and lubricates these tendons. In between these tendons is a nerve, a very important nerve known as the Median Nerve.
The Median Nerve is responsible for sensation (or feeling) in the first three finger and one half of the fourth finger and movement of the thumb. Lying over all these tendons and the Median Nerve is a strong tissue known as the Flexor Retinaculum. It is like a strong Band-Aid covering from one side to the other and holds everything in place.
Carpal Tunnel Syndrome (CTS) is a condition in which there is irritation of the Median Nerve by the structures in the "tunnel" leading to nerve pain in the wrist, first three fingers and possibly up the arm to the elbow. Trauma, swelling, chronic inflammation, arthritis and excessive flexion of the wrist can cause irritation. Many times there is pain at night that can wake the person from their sleep. Sometimes intense pain can lead to disuse of the hand and wrist.
Irritation of the motor component of the nerve can cause loss of muscle function in the hand, specifically the thumb. CTS becomes a nuisance and can be a chronic condition unless the patient does two things. First they must seek treatment. Second they must modify the use of their hand to prevent future re-injury.
There are many ways to treat CTS. The treatments that we utilize are all manual medicine techniques. We treat the dysfunction tissue by hand utilizing massage, stretching, adjustments, ultrasound and supports to correct the tissue and allow it to return to normal function. Finally, we educate the patient on how to avoid re-injury in the future through the use of sound ergonomic instruction.
Carpal Tunnel Syndrome is treatable and the results can be excellent. Chronic medication usage and surgery are not the only options and actually
should be the last options in the management of CTS. If you need further assistance or information about CTS please let me know. When you are ready I am here to
help you.
In health,
Dr. Sal Masi
Chronic Ear Infections: Uncommon Knowledge
By
Sal Masi, D.C.
Many times I am surprised to read research articles that contradict common knowledge or current
treatments that are used to combat illness. A perfect example is chronic ear infections, or more appropriately described, chronic
middle ear inflammation. Middle ear inflammation, also known as Otitis media, is one of the most common syndromes treated by pediatricians.
Otitis media is most prevalent in children between the ages of 0 to 5 years old. The number of cases of
Otisis Media has steadily increased over the years to approximately 30 million visits per year, at a cost of
over 4 billion dollars per year. Why are the number of cases increasing? This is not an easy question ot answer. Suffice it to say that genetics, anatomy,
allergies, toxins, feeding position, viruses, bacteria and antibiotics have been implicated in Otitis Media.
I would like to discuss the role of antibiotics.
Research has shown that when a child is treated with antibiotics for Otitis Media, the child's chance of a second
ear infection increase by over 3 times. Using antibiotics increases you child's chance of a second, third, fourth and so on, case of Otitis Media.
The purpose of antibiotics is to kill bacteria that can cause ear infections. Unfortunately only a small percentage of cases of Otitis Media are caused by bacteria.
Depending on which research you read, it seems that most cases of Otitis Media are caused by allergens, perhaps up to 70% of all cases.
If antibiotics cure Otitis Media why are the number of cases increasing? Another difficult question.
My intention is not to bash antibiotics. Antibiotics are life saving drugs. If your child has a bacterial infection, antibiotics are probably
the best course of treatment. It is important to realize that there are other treatments and factors to consider when a child is suffering with chronic
ear inflammation.
I would like all parents and guardians to be aware that the future course of events with regard to recurring ear infections is somewhat determined by
the treatment decisions we make. The mose difficult symptoms for parents to deal with is the pain that our child experiences from otitis media; many times
an intense, debilitating pain. Pain can be treated with pain medication, not necessarily with antibiotic.
Europeans utilize a protocol called "watchful waiting". In a nut shell they treat pain with
a pain medication and watch the child's progress. Many times ear infections are self limiting, which means they heal on their own in a few days.
Be open minded, be aware, be informed. Make decisions that are sound, reasonable and in no way cause further complications for your child.
We as parents and guardians must nurture our children... they depend on us.
When you are ready to begin I will be here for you.
In health,
Dr. Sal Masi
The Importance of Muscle Stretching
By Dr. Sal Masi
One of the most common questions a patient will ask me is what can I do to help myself feel better? My typical response is stretch your muscle each day.
Muscle tissue is a dynamic tissue that creates movement of the body. It supports and assists our joint movement, holds us upright and even helps to maintain our body's temperature. Muscle cells that make up muscle tissue have a unique biomechanical layout. These cells contain parallel arrangements of protein strands that literally slide over on another in order to create movement or what is referred to as muscle contraction. When a muscle is contracted or tightened these fibers are bunched up
over on another in short, stout bundles. When a muscle is stretched or lengthened these fibers are pulled apart into long, narrow bundles. Healthy muscle tissue should be able to do both of these functions easily.
Unfortunately,many of us find our muscles to be stuck in the short, stout arrangement.
Over time due to improper use and lack of use of our muscles leads to chronic tightening and shortening of these muscles. Our joint range of motion, for example, the ability to move our arm above our head or turn our neck to all the way right and all the way left, becomes diminished and sometimes even painful to do. Chronic muscle tightness is the first step to chronic joint injury, muscle strain, muscle tears, tendinitis, myofascial pain syndrome, do I need to go on?
Proper maintenance of your muscles is critical to preserving the health of your muscles. One of the best ways to maintain your muscles is to..... stretch your muscles. That being said, you are all eager to begin stretching. A few tips to begin your healthy new start. Begin with an evaluation of your body and muscles by an expert. You will
be quite surprised to find out the condition of your muscles. The practitioner will be able to instruct and assist you in stretching. Passive stretching (stretching done by a practitioner while you relax) is a great way to start you program and insure that you avoid injury. Keep your muscles warm. This allows for easier stretching. Pain can be a warning signal. Do not over do it. Start slow and progress. Always stay hydrated.
Muscles are mostly water.
As always, when you are ready to begin I am ready to help.
In health, Dr. Sal Masi
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