Tag Archives: options

Hand Numbness and Tingling?

carpal tunnel treatment san franciscoWe have been providing treatment for the neck, shoulders and hands in downtown San Francisco for over 23 years now.

Most of the patients we treat in the SF Financial District spend the majority of their day sitting in front of a computer doing repetitive motions. This activity can put a lot of stress on the bones of the spine in the neck and well as the muscles, ligaments and tendons of the shoulders, arms and hands.

The nerves that control the arms and hands exit from in between the bones of the spine in the neck. These nerves can become compromised with abnormal wear and tear leading to numbness and tingling in the hands. The problem can be in the neck, shoulders, elbows, or wrists.  All must be checked.

In most cases there is joint dysfunction and muscle imbalances, and even nerve pressure in multiple locations. The good news is that these sorts of problems tend to respond favorably to chiropractic and favorable outcomes are the norm.

The standard treatment for hand pain and numbness at our clinic is chiropractic adjustments to the neck, shoulder, elbow, wrists and fingers, massage or ART, low tech exercises in office and at home, deep tissue laser if needed, and ice or heat. Most cases respond in short order. Chronic long standing cases can take longer to treat.

We also have a team of medical doctors and physical therapists that specialize in sports medicine at our primary clinic, Chiro-Medical Group, Inc. which is a few blocks away from our Embarcadero Center walk-in clinic.

To find out if you are a candidate for hand pain treatment in San Francisco please call 415-392-2225. We validate parking at the Embarcadero Center. 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Whiplash: What’s Best Rest or Treatment?

whiplash treatment downtown SF

Whiplash Treatment in San Francisco

We have been providing treatment for whiplash in downtown San Francisco for over 20 years.

Whiplash, or WAD (whiplash associated disorders) results from the rapid movement of the neck and head resulting in injury. This is the net result of the “classic” motor vehicle collision, though other injury models (like slips and falls) can result in similar injuries. Last month, we listed basic facts, of which one was better results (less long-term pain and disability) occurred from initial active treatment of the neck with mobilization/manipulation, exercise, and encouraging movement vs. placing a collar on the patient and “resting” the injured neck. Though there are a few studies that suggest there is no difference in results, the majority state that it is BEST to actively treat the patient and encourage movement (of course, assuming no unstable fractures have occurred) rather than to place the patient into a collar and limit activities. The first question that we’ll address this month is, why is this important?           

            The simple answer is that you, as an advocate for an injured friend, family member or as a patient yourself, may NOT be offered “the best” treatment approach by the ER or primary care physician. In fact, one study cited a survey regarding the management of whiplash injuries in an ER and reported that between 23-47% of physicians prescribed a soft cervical collar for acute whiplash rather than promoting immediate active treatment. By knowing this information, the knowledgeable patient can refuse the collar method of care and seek care that emphasizes the use of early mobilization and manipulation, like chiropractic! Though referrals to chiropractors are increasing as more research becomes available, chiropractic care is still significantly ignored or not considered by many practicing ER and primary care physicians. As always, you need to be your own “best advocate,” and the only way to do that is to be informed, hence the intention of this Health Update! Some studies even report that the use of a collar may have deleterious or “bad” side effects and can actually make you WORSE (this was reported by the Quebec Task Force)! The majority of studies on the subject of whiplash report that encouraging “normal activity,” as opposed to immobilization, IS the best approach. We will certainly help steer you in the right direction!

            Next, let’s talk about WHY does this method works better? The research supports that soft tissues injuries heal better and with less scar tissue formation when patients receive active treatment/early activity types of care (like manipulation / chiropractic). In general, any treatment approach that reduces patient suffering sooner, encourages one to return to “normal activities” faster, and promotes independence and self-care methods earlier is the best approach!

            We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

To schedule an appointment for whiplash treatment in San Francisco please call 415-392-2225.

~Altadonna Communications   

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Fibromyalgia Diagnosis: What Is It?

 

           

Fibromyalgia in San Francisco

Fibromyalgia Diagnosis and Treatment

We have been providing natural solutions for Fibromyalgia in San Francisco for over 20 years now.

Confirming the diagnosis of fibromyalgia (FM) is challenging, as there are no blood tests to verify accuracy of the diagnosis like so many other disorders. However, blood tests are needed when FM is suspected to “rule in/out” something else that may be mimicking FM symptoms. Also, FM is often associated with other disorders that are diagnosed by blood testing, so it is still necessary to have that blood test. So what is the CURRENT recommendation for diagnosing FM?

 

            The American College of Rheumatology (ACR) developed criteria for diagnosing FM in 1990 and has updated it since then. The original 1990 criteria included the following: 1) A history of widespread (whole body) pain for three months or more; and 2) The presence of pain at 11 or more of 18 tender points which are spread out over the body. The main criticism regarding this approach has come from the poor accuracy and/or improper methods of testing the 18 tender points. As a result, this examination portion of the two main criteria has been either skipped, performed wrong, or mis-interpreted. This left the diagnosis of FM to be made based on symptoms alone. Also, since 1990, other KEY symptoms of FM have been identified that had previously been ignored including fatigue, mental fog (“cognitive symptoms”), and the extent of the body pain complaints (“somatic symptoms”).

 

            As a result, it has been reported that the original 1990 approach was too strict and inaccurate because too many patients with FM were missed – 25% to be exact – by using this method. In 2010, the diagnostic approach was modified by using two different questionnaires: 1) The “Widespread Pain Index” or (WPI), which measures the number of painful body regions; and 2) the development of a “Symptom Severity” scale (SS). The MOST brain fog” common with FM, unrefreshed sleep, fatigue, and the  number of “somatic symptoms” (other complaints). The Symptom Severity scale (SS) incorporates these four categories and is scored by adding the totals from each category.  By using both the WPI and the SS, they correctly classified 88.1% of FM cases out IMPORTANT FM diagnostic variables included the WPI score and scores of “cognitive symptoms,” which includes the “of a group of 829 previously diagnosed FM patients and non-FM controls!

 

            What’s important is that this NEW approach does NOT rely on the “old” physical exam requirement of finding at least 11 of 18 tender points. Because FM patients traditionally present with highly variable symptoms, removing the challenge of determining the diagnosis by physical examination is very important! Plus, now we can TRACK the outcomes of the FM patient to determine treatment success both during and after care. Since the 2010 approach has been released, it has been published in multiple languages and is starting to be used in primary care clinics. Recently, in July 2013, a study reported that the Modified ACR 2010 questionnaire is highly sensitive and specific for diagnosing FM, and its future use in primary care was encouraged. What is most exciting about this is that a referral to a rheumatologist may not be needed since this tool can be easily administered by primary care physicians, which include chiropractors!

 

            In past health updates, we have discussed the need for a “team” of health care providers to best manage the FM patient. This multidisciplinary approach offers the FM patient multi-dimensional treatment strategies that encompass manual therapies, physical therapies, nutritional strategies, pharmacology, exercise, and stress management, cognitive management, and behavioral management. Now, with the release of the Modified ACR 2010 criteria, we can diagnose FM more accurately, track progress of the patient, and make timely modifications to the treatment plan when progress is not occurring. This is a “win-win” for the patient, providers/health care team, and the insurer!

 

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

           

Altadonna Communications ©

To schedule an appointment for Fibromyalgia Treatment in San Francisco call 415-392-2225

Since 1992

                         

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Neck Pain Relief and Best Treatment Options

Neck pain relief in downtown san franciscoWe have been providing natural solutions for neck pain in San Francisco for over 20 years now.

Neck
pain is a very common problem. In fact, 2/3rds of the population will have neck
pain at some point in life. It can arise from stress, lack of sleep, prolonged
postures (such as reading or driving), sports injuries, whiplash injuries,
arthritis, referred pain from upper back problems, or even from sinusitis!
Rarely, it can be caused from dangerous problems including referred pain during
a heart attack, carotid or vertebral artery injuries, or head or neck cancer,
but these, as previously stated, are very uncommon. However, since you don’t
know why your neck hurts, it’s very important to have your neck pain properly
evaluated so the cause can be properly treated and not just covered up from the
use of pain killers!

            Barring the dangerous causes of neck
pain listed above, treatment methods vary depending on whom you elect to
consult. Classically, if you see your primary care physician, pharmaceutical
care is usually the approach. Medications can be directed at reducing pain
(Tylenol, or one of many prescription “pain killers”), at reducing inflammation
and pain (Aspirin, Ibuprofen, Aleve, etc.), to reduce muscle spasms (like
muscle relaxers) or, medications may be directed to reduce depression, anxiety,
or the like. When a sinus infection affects the 2 deep sinuses (ethmoid and
sphenoid sinuses which are located deep in the head), the referred pain is
directed to the back of the head and neck. Here, an antibiotic may be needed
and/or something specifically directed at allergies when present. In general,
in cases that do not respond to usual chiropractic care, co-management with the
primary care physician is a good option.

            However, the good news is that
chiropractic care usually works well, and the need for medication can be
avoided since the side effects of medication can sometimes be worse than the
benefits. Recently, The Bone and Joint Decade Task Force on Neck Pain published
arguably the best review of research published between 2000 and 2010 regarding
neck pain treatment approaches. They concluded that spinal manipulation and
mobilization are highly effective for many causes of neck pain, especially when
arising from the muscles and joints – the most common cause. Therefore it would
seem logical to consult with a Chiropractor FIRST since manipulation and
mobilization are so effective and safe. When we add neck exercises, the results
are even better, according to some studies. As chiropractors, we will often use
different modalities including electric stimulation, ultrasound, hot and/or
cold (which are usually given as a good home-applied remedy), and others. In
particular, low level laser therapy (LLLT) has been shown, “…to reduce pain
immediately after treatment in acute neck pain and up to 22 weeks after
completion of treatment in patients with chronic neck pain” [Lancet, 2009;
374(9705)]. LLLT is a commonly used modality by chiropractors and when combined
with spinal manipulation, the results can be even faster! We will also evaluate
your posture, body mechanics, and consider “ergonomic” or work station problems
and offer recommendations for improving your work environment. We also
frequently utilize anti-inflammatory nutrients including vitamins, minerals,
herbs, and more to avoid the negative side effects to the stomach, liver, and
kidney negative that can result from using non-steroidal anti-inflammatory
drugs (NSAIDs) like aspirin, ibuprofen, or Aleve. Make chiropractic your FIRST
choice when neck pain strikes, NOT last resort!

            We realize that you have a choice in
where you choose your health-care services.
If you, a friend or family member requires care for neck pain, we
sincerely appreciate the trust and confidence shown by choosing our services
and look forward in serving you and your family presently and, in the future.

To schedule an appointment for neck pain relief in San Francisco please call 415-392-2225.

Serving local 94111 downtown and the Financial District since 1992

Dr. Eben Davis

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Study: Torn Knee Ligaments Heal Without Surgery

 


Knee pain treatment san franciscoSan Francisco-
If you suffer with low back pain, you are about
to discover some very important information about potential causes and
treatments.  But first, researchers have
discovered something very important you should know about "anterior cruciate
ligament" (ACL) injuries…

The ACL is one of the major supporting ligaments
of the knee.  You may or may not know,
but one of the most feared injuries an athlete (or anyone else) can suffer from
is a torn ACL.

When it is
torn, the knee is usually left unstable. 
In other words, the ACL ligament helps keep the bones of the knee joint
together.  When there is a tear, the
bones can actually separate or dislocate. 
This can happen when an athlete or person lands from a jump, tries to
stop or attempts to change directions suddenly. 
Sometimes, the knee will just “give out” without warning while simply
walking.

When a knee
is injured, an MRI is often used to help diagnose the problem.  If the MRI shows a torn ACL, it has been
common practice for most doctors to recommend surgery to replace the ACL with
either a cadaver ACL or one made from the person’s own patellar tendon, or
Hamstring tendon.

This is
MAJOR surgery with extensive and lengthy rehabilitation.  Even an athlete in his or her physical prime
may not be able to resume their sport for a minimum of six months.

Surgery for
a torn ACL has been the common treatment because it was believed that once an
ACL was torn, it could not heal.  Now
researchers say this is not true.

In fact, in
a study that appeared online before its publication in the journal Knee Surgery Sports Traumatology Arthroscopy, researchers at the
Hospital for Special Surgery in New
York found that surgery shouldn’t be the first option
for some cases. They found solid evidence that the ACL can, in fact, heal
itself WITHOUT surgery. 

According to
Robert Marx, MD, an orthopedic surgeon in the Sports
Medicine and Shoulder Service at Hospital for Special Surgery (HSS), Some patients who tear their ACL while skiing can get away
without surgery.  Their ligament heals by
itself, they will have stable knees, and they will be able to do whatever they
want, including skiing. It is a huge deal to avoid surgery.”

Dr. Marx
also stated that patients who tear their ACL during recreational skiing should
not rush into surgery.  They should wait
6-12 weeks and be re-evaluated unless there is another obvious reason for
surgery.

The study
found two orthopedic tests that should be performed by a skilled physician to
determine if the patient will need surgery or if the ACL can heal without it.

These two
tests are “Lachman” and “pivot shift test.” 
These tests assess the integrity of the ACL, and if these two tests are
negative, a good outcome and normal knee anterior laxity at more than 2 years
after the injury is expected… without surgery.

A quick and
important side note about this study:  It
was performed on recreational Alpine skiers. 
Researchers noted that ACL tears from skiing are often less traumatic
than other sports.  For example, the
level of knee injury can be much greater in football or soccer.

This does
not mean that an ACL tear from these sports cannot heal without surgery; it
means THIS PARTICULAR STUDY ACKNOWLEDGES THAT THERE IS A DIFFERENCE.  Of course, not all ACL tears in football,
soccer, and similar sports are super traumatic. 
The answer is to have your knee examined by a qualified and skilled
physician who is up-to-date on the research and will assess your knee and give
you the best recommendation for your individual case.

What Does
All This Have To Do With Back Pain?

A lot,
actually.  There are two very big take
home messages from the information above.

First,
doctors are not always right.  The best
doctors use the best and most current research in an attempt to give the
patient the best recommendations and treatments possible.

That is, of
course, limited to the current research. 
No matter what some people think, science (and research) is not
magic.  It does not have all the answers,
especially when it comes to the complexities of the human body.

The ability
of the ACL to heal itself is a great example, but it is not the only one.

The body is
truly amazing, and one of the most amazing things is its incomprehensible
ability to heal itself.

Often, this
means doing less, not more. This is one of the most difficult things for
injured or sick people to understand.

When sick or
injured, many people believe something must be done or the more treatment, the
better.  In reality, in many cases, the
less the doctor does and the quicker he or she gets out of the way, the better.

This Is Often The Best Option

For Back And Neck Pain

Many
Chiropractors are proud that their treatments help back and neck pain.  This, however, is not true.  If you understand how the body works and its
amazing ability to heal itself, you will also understand that the reason why
some Chiropractors have so much success with back and neck pain is because they
simply do as little as possible and then get out of the way and let the body do
its magic.

They
understand that their “treatments” do not get rid of pain.  Their “treatments” simply remove a roadblock
or roadblocks the body had to healing itself.

That’s why
they will recommend the LEAST treatments possible and re-evaluate.  Their goal is to get you out of pain and out
of their office as fast as possible… not commit you to huge and expensive
treatment plans that last months or even years.

Of course,
some patients have more serious causes of back or neck pain and need more
care.  Every case is individual and
should be approached that way.  But the
results can be incredible if your Chiropractor simply removes the roadblock,
steps aside, and lets the REAL healer take over.

Altadonna Communications ©

There are also modern technologies to speed up soft tissue healing and recovery such as deep tissue laser therapy and nonsurgical spinal decompression.

To find out if you are a candidate for care at our San Francisco Chiropractic Clinic please call 415-392-2225

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Carpal Tunnel Syndrome: Natural Solutions

Laser Treatment for CTS in San FranciscoWe have been providing treatment for carpal tunnel syndrome in San Francisco for over 20 years.

Carpal
Tunnel Syndrome
(CTS) is a condition characterized by pain, numbness and/or
tingling in the hand. This includes the palm and the 2nd, 3rd, and half of the
4th finger, usually sparing the thumb. Another indication of CTS is weakness in
grip strength such as difficulty opening a jar to even holding a coffee cup.
CTS can occur from many different causes, the most common being repetitive
motion injuries such as assembly line or typing/computing work. Here is a
PARTIAL list of potential causes of CTS: heredity (a small sized tunnel), aging
(>50 years old), rheumatoid arthritis, pregnancy, hypothyroid, birth control
pill use, trauma to the wrist (especially colles fractures), diabetes mellitus,
acromegaly, the use of corticosteroids, tumors (benign or malignant), obesity
(BMI>29 are 2.5 more likely), double crush (pinching of the nerve in more
than 1 place such as the neck and the carpal tunnel), heterozygous mutations in
a gene (associated with Charcot-Marie-Tooth), Parvovirus b19, and others.
Again, repetitive trauma is still the most common cause. It becomes quite clear
that a COMPLETE physical examination must be conducted, not just evaluation of
the wrist! Once the cause(s) of CTS has been nailed down, then treatment
options can be considered.

            From a treatment perspective, we’ve
previously discussed what chiropractors typically do for CTS (spinal and
extremity joint manipulation, muscle/soft tissue mobilization, physical therapy
modalities such as deep tissue laser, the use of a wrist splint – especially at night, work
task modifications, wrist/hand/arm/neck exercises, vitamin B6, and more). But,
what about using other “alternative” or non-medical approaches, especially
those that can be done with chiropractic treatment? Here is a list of four
alternative or complementary treatment options:

  1. Anti-inflammatory Goals: Reducing systemic inflammation reduces overall
    pressure on the median nerve that travels through the limited space within
    the carpal tunnel at the wrist. An “anti-inflammatory diet” such a
    Mediterranean diet, gluten-free diet, paleo-diet (also referred to as the
    caveman diet) can also help. Herbs that can helps include arnica,
    bromelain, white willow bark, curcumen, ginger, turmeric, boswellia, and
    vitamins such as bioflavinoids, Vitamin B6 (and other B vitamins such as
    B1 and B12), vitamin C, and also omega 3 fatty acids.
  2. Acupuncture: Inserting very thin needles into specific acupuncture points both
    near the wrist and further away can unblock energy channels (called
    meridians), improve energy flow, release natural pain reducing chemicals
    (endorphins and enkephlins), promote circulation and balance the nervous
    system. For CTS, the acupuncture points are located on the wrist, arm,
    thumb, hand, neck, upper back and leg. The number of sessions varies,
    dependant on how long the CTS has been present, the person’s overall
    health, and the severity of CTS.
  3. Laser acupuncture: The use of a low level (or “cold” laser) or a
    class IV pulsed laser over the same acupuncture points as mentioned above
    can have very similar beneficial effects (without needles)! One particular
    study of 36 subjects with CTS for an average of 24 months included 14
    patients who had 1-2 prior surgeries for CTS with poor post-surgical
    results. Even in that group, improvement was reported after 3 laser
    treatments per week for 4-5 weeks! In total, 33 of the 36 subjects
    reported 50-100% relief. These benefits were reportedly long-term as
    follow-up at 1-2 years later showed only 2 out of 23 subjects had pain
    that returned and subsequent laser treatment was again successful within
    several weeks.
  4. Acupressure: Acupuncture point stimulation with manual pressure. These points
    can be self-stimulated by the CTS sufferer multiple times a day via deep
    rubbing techniques.

            We realize you have a choice in who
you consider for your health care provision and we sincerely appreciate your
trust in choosing our service for those needs. 
If you, a friend or family member require care for CTS, we would be
honored to render our services.

To schedule an appointment with one of our carpal tunnel doctors in San Francisco call 415-392-2225. Mention this blog post for a complimentary CTS consultation and trial laser session.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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