Monday, April 24, 2017

Supraspinatous---An Essential Muscle of the Shoulder

     The supraspinatous is a small but powerful muscle located in our back, along the top part of our shoulderblade, or scapula. It connects the scapula with the top of the humerus, the bone in our upper arm, and is essential in our ability to raise our arm (abduction).  
     Technically, it is one of the muscles of the rotator cuff, and is commonly affected in rotator cuff injuries.
     A simple orthopedic test rules out an injury to this muscle. However, if the test is positive and involves a tear in the supraspinatous, treatment may require surgery.  

Monday, April 17, 2017

Over-The-Counter Orthotics

Patients who have fallen arches or who pronate need to support their feet with orthotics, not just for comfort, but also because these conditions in the feet reverberate up into the knees, hips, and pelvis and cause problems. Some may need prescription orthotics, but many people will find over-the-counter orthotics can do the job.
I commonly recommend a patient try one of two types that they can buy “off the rack.” One is softer, made of foam, with a mild arch support, that is easy to get used to. The other is a harder, molded orthotic appropriate for people who need more support. Either should be appropriately fitted by a staff person at the store who knows how to size them.
It’s not a bad idea to start with an over-the-counter orthotics and see if they will be sufficient. Certainly they are kinder on the patient’s wallet. If it turns out more fine-tuned or specialized support is needed, prescription orthotics are the next step.   

Monday, April 10, 2017


Literally, this means “the simultaneous use of multiple drugs by a single patient for one or more conditions.”
There are now patients coming into my office who are taking upward of eleven or twelve different medications. Often their meds are prescribed by different doctors, and there may be no one doctor who is overseeing or coordinating the mix. Potential harmful drug interactions are not being monitored, and the patient is subject to a myriad of side effects of the various drugs.
Sometimes the pharmacist who fills the patient’s prescriptions may be serving as overseer or monitor, but this is not always the case.
For patients on multiple medications, I advise them to talk with their primary care physician about making sure some caregiver is fulfilling this role.

Monday, April 3, 2017

Numbness, Tingling in Arm or Hand

Nerve impingement of the brachial plexus, the nerves exiting the spine in the neck, can be the cause of numbness or tingling in the arm and / or hand. If the alteration of sensation is diffuse throughout the upper extremity, all or most of the nerves in the brachial plexus may be affected, sometimes due to impingement between the clavicle and the first rib, or in passage between the scalene muscles at the sides of the neck. However, if only parts of the arm or hand are affected, it may be possible to pinpoint the specific spinal nerves that are being impinged. This can guide the specific Activator Chiropractic adjustment which can help alleviate the problem.