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It’s A Pain in the Neck!

October 17, 2017 By Cassie Zanolini, PT, DPT Leave a Comment

Do you remember sitting in front of your laptop for hours without realizing your head is way too far forward or browsing on your phone with your neck bent and this eventually results in getting stiffness in your neck with a mild headache?

We all have experienced neck stiffness and neck pain once in a while. Neck pain can also accompany by a headache, TMJ pain, shoulder pain or pain radiating in arms. A headache which is coming from your neck is known as a cervicogenic headache. The roots of the upper 3 cervical spinal nerves (located at C1, C2, and C3) share a pain nucleus (which routes pain signals to the brain) with the trigeminal nerve. Because of the shared nerve tracts, pain is misunderstood and thus “felt” by the brain as being located in the head. This headache sometimes can be misdiagnosed as a migraine or cluster headaches.

By far the most common cause of neck pain is poor posture, which can lead to soft tissue or muscle strain in the neck area. The most common muscle that gets involved with this strain is levator scapulae muscle which is located in your back and side of the neck. This muscle connects your shoulder (scapula) and your cervical spine (first four vertebrae).

Levator scapulae can be strained due to, sleeping with the neck in an awkward position or holding the neck in abnormal position for long periods. Sports or motor vehicle injury where getting the sudden impact that pushes the head to the side or repeated activity which involves turning head side to side can also cause levator scapulae strain. Many times, experiencing excessive stress or anxiety can lead to tension in the neck.

Neck pain and related headaches can be prevented by having good postural awareness. Supporting your lower back with a rolled pillow while sitting corrects lumber and cervical (neck) curvature. Always keeping your screen or your book at your eye level helps to prevent any extra strain while bending your neck. Moving neck in all different directions and stretching every couple of hours prevents it from getting stiff. Squeezing shoulder blades together and keeping ears in line with your shoulders prevents it from getting forward head posture.

Ask the Experts at Wendy Webb Schoenewald Physical Therapy and Vestibular Rehabilitation, #WWSPT about good postural awareness.

Understanding Vestibular Disorders via 3-D Imaging

October 16, 2017 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

3-D Imaging of the Inner Ear Provides Insight for Vestibular Disorder Treatment

What are the typical symptoms and signs of a Vestibular Disorder?

The primary symptoms of a Vestibular Disorder include dizziness, vertigo, and disequilibrium. Dizziness is a sensation of lightheadedness or unsteadiness. Vertigo is a perception of movement of the self or surrounding objects that most people described as spinning and can be quite disabling. Dizziness and Vertigo can be a symptom of many Vestibular Diseases and Disorders.

Disequilibrium means unsteadiness and imbalance that can be accompanied by a spatial disorientation. In and this may present itself as stumbling or difficulty walking a straight line will or turning. Other signs and symptoms include visual-spatial problems, hearing loss, frequent falls, and difficulty moving in the dark, difficulty reading, difficulty concentrating and increased anxiety.

How do vestibular disorders impact the quality of life?

An estimated 33% of all adults with chronic balance problems experience difficulty performing basic activities of daily living such as bathing dressing eating and walking safely without falls. We don’t notice what the vestibular system does for us until it is not working properly. It can be very disabling for many people though with the right treatment and diagnosis we can manage your symptoms and often cure them.

Vestibular Therapy

The National Institutes of Health’s 3D Print Exchange Program and the creative expertise of 3D Brooklyn collaborated to produce the Functional Inner Ear which has become a great tool for Physical Therapists to educate patients about #BPPV and demonstrate the canalith repositioning maneuvers to the patient.

The Functional Inner Ear

Wendy Webb Schoenewald Physical Therapy and Vestibular Rehabilitation Staff are the region’s experts in the care and treatment of Vestibular Disorders. Contact #WWSPT to set up an appointment.

https://3dprint.com/187376/vertigo-3d-printed-inner-ear/

Pain Does Not Always Correlate with Imaging

October 12, 2017 By Amanda Nguyen PT, DPT Leave a Comment

Your pain does not always correlate with your imaging studies (X-Rays, MRIs, and CT scans) but the images provide an insight for doctors and other healthcare providers as to what is going on in your body when you have pain. The images allow them to rule in or rule out a specific disease or injury. While imaging can reveal structural changes, it does not necessarily mean these findings are causing your pain.

In a recent research study published in the American Journal of Neuroradiology, researchers took MRI images and CT scans of the spines of groups of people from ages 20 to 80 years old without pain. What they found was that about 37% of the 20-year-olds had disc degeneration, and approximately 96% of 80-year-olds had disc degeneration. Researchers also found that among the 20-year-olds, about 30% had evidence of disc bulging or disc herniation, while 85% of the 80-year-olds had it. While the imaging revealed something abnormal about the participants’ spines, they did not report any pain.

However, there are also people who have one or both of these diagnoses and who do have pain. So if 2 people have the same diagnosis but one is experiencing pain and the other is not, what is the difference? If you did not hurt yourself in a traumatic event like a car accident, odds are you most likely had that structural change long before you started to have pain. You could have irritated the area with a certain movement that you did not find to be a big deal, but it was enough to cause an exacerbation of symptoms. When this irritation calms down you may feel better, though the same disc bulge or degeneration is still present. Even though 2 people may have the same diagnoses, their presentation is never identical; no 2 people have the same past medical histories, comorbidities, work conditions, and personal activities and habits. As a result of all these factors, different muscles are being used more often than others, which leads to asymmetries of the body. If muscles are weak or inflexible, the other muscles of the body have to compensate for those imbalances, which results in improper movement patterns and pain.

Contac Wendy Webb Schoenewald Physical Therapy and Vestibular Rehabilitation for more information.

Posture and Correct Alignment

September 25, 2017 By Cassie Zanolini, PT, DPT Leave a Comment

Your Posture is very important!

Stand up straight! How many times have we heard those words as a child? Well, our parents were right. Good posture is so important. The correct alignment of our body can reduce stress on your joints, while poor alignment can increase stress on our joints.

So what is considered good posture? You can check yourself. Align your ear over the shoulder, your shoulder over your hip, your hip over your knee and your knee over your ankle. Easy right? Not so fast, gravity takes a toll and works against us, compressing us down. The only way to fight back is to use our postural muscles, and this takes a conscious effort. At first, we must really concentrate on standing up straight, but over time, if you keep at it, good posture will become a habit. The only way to strengthen those muscles is to use them. So stand up straight, don’t let gravity win!

Some of the cues I use to encourage good posture are: tuck your chin in, squeeze your shoulder blades back and down, bring your belly button to your spine, and in some cases tuck your tail under. While you are doing this, remember to Breathe!

Fever is a cardinal sign of Infection

September 13, 2017 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

Although Fever is a cardinal sign of infection, classic measurements of temperature are not always accurate in our elderly population.

Compared with younger populations, the elderly have increased susceptibility to infection. The difficulty in measuring fevers in the elderly can make diagnosing serious bacterial or viral infections more challenging. In roughly 20 to 30% of the elderly with serious infections, oral or rectal temperatures will not indicate infection. A “blunting” fever response means a diminished fever reading with typical oral thermometer measures though there is an actual infection active in the patient. Blunting fever response can lead to delayed or missed diagnosis and can cause an increased risk of morbidity and mortality a to our seniors. We don’t know why the “blunting” fever response occurs, but it may be related to some of the biological changes of the aging which including decreased thermoregulatory responses, reduced basal baseline thermal measures, impaired immunity and use of a variety of medications.

Axillary (under the arm) temperature measures which are more commonly used in infants can also be another variation of measuring temperatures in the elderly. and sometimes show fever response that’s not seen in an oral thermometer measure. The normal range for the axillary temperature of 97.7 Degrees. If you’re concerned about your aging parent having an infection and fever, try taking an axillary temperature to additionally rule out infection.

As the fall season arrives and the calendar moves forward toward “Flu Season”, consider having a discussion with your primary doctor about his/her recommendation regarding “Flu Shots” for family members.

It’s A Pain in the Neck!

Understanding Vestibular Disorders via 3-D Imaging

Pain Does Not Always Correlate with Imaging

Posture and Correct Alignment

Fever is a cardinal sign of Infection

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