Irritable bowel syndrome (IBS) is a very common condition, but in some ways it is still a mystery. There are many different theories about what causes the syndrome, and different doctors will give you different reasons for your illness ? anything from stress to bad bacteria to food intolerance. And once you have been diagnosed, there is no set form of treatment ? instead, sufferers tend to try two or three supplements or therapies to find a combination that works for them.

IBS is clearly a complicated issue, so here is a basic overview of the symptoms, diagnosis and treatment of this disorder.

The symptoms

Although the symptoms of IBS vary from person to person, there are several symptoms which are typical of the illness. The most common symptom is either recurring diarrhea or recurring constipation (although some patients also have alternating diarrhea and constipation).

Additional symptoms can include stomach pain (sometimes relieved by a bowel movement), bloating, nausea and a lot of gas. These symptoms generally go away for a short time before returning again, as IBS can work in cycles. Sufferers may experience a few weeks or even a few months of good health before the symptoms come back.

Sufferers sometimes find that their symptoms begin after a bout of food poisoning or an operation. Others date their symptoms back to a very stressful period in their lives, and some patients can see no clear reason for why their symptoms began.

The diagnosis

There is no set test for IBS, and it is often called a diagnosis of ‘exclusion’. This means that a doctor may rule out other bowel and stomach complaints such as celiac disease or inflammatory bowel disease before giving you a diagnosis of IBS.

Sometimes patients are given a colonoscopy, where a tiny camera is inserted into the intestines to look for abnormalities. In an IBS sufferer the colonoscopy won’t detect any physical signs of disease ? IBS is often called a ‘functional’ disorder, because it seems to be caused by an alteration in the way the body functions rather than an identifiable cause such as inflammation.

However, this does not mean it is any less real than, say, inflammatory bowel disease, it just means that doctors haven’t come up with a proper test for it yet!

It is very important that you receive a diagnosis of IBS from a medical professional rather than self-diagnosing, as bowel symptoms can be present in many other health conditions.

The treatment

The first stage of treatment may involve any medications your doctor has given you to try. This could be an anti-spasmodic, which will relax the muscles in the gut walls, or perhaps a low dose of an anti-depressant, which can help to reduce the pain.

You may also be given one of the new drugs specifically developed for IBS ? Lotronex for diarrhea sufferers and Zelnorm for constipation sufferers.

If the drugs do not help you then you could try using a fiber supplement such as Citrucel to add bulk to your stool ? this can be helpful for both diarrhea and constipation. Also, there are other supplements such as Caltrate Plus which may be useful (Caltrate Plus contains calcium carbonate which can reduce diarrhea).

It may also be worth looking at your diet. A nutritionist can advise on ways to identify any particular food ‘triggers’ which may be setting off your symptoms, and also on whether you might have a food intolerance to something like gluten or lactose.

Finally, there are several alternative therapies which can be effective for IBS. Hypnotherapy has proved very effective, and a special form called gut-directed hypnotherapy has been developed just for digestive problems. Acupuncture may also be worth looking into.

“As an arthritis specialist, one area that I see people complain about more often than almost any other, is their feet.” So says Dr. Nathan Wei, Clinical Director of The Arthritis and Osteoporosis Center of Maryland. “This is too bad because there are many treatments that can be helpful,” Dr. Wei adds.

The foot is made up of 26 bones and 39 muscles…
The foot and ankle are designed to bear weight. The multiple joints in the feet are capable of adjusting to almost any terrain and the padding in the feet are designed to absorb shock.. The ankle joint allows the foot to move up and down, side to side, and inward and outward (inversion and eversion).

Not All Foot Pain Comes From The Foot!
Careful examination of the low back, hip, and knee should be performed because pain from these areas may affect the foot and ankle. In particular, pinched nerves in the low back can cause foot pain and weakness.

Ankle sprains are common- 25,000 people sprain an ankle every day! The goal of treatment is to relieve pain and prevent instability. Treatment of an acute sprain consists of rest, ice compression and elevation (”RICE”). Exercises to help stabilize and strengthen the ankle should be started.

Arthritis of the ankle may cause recurrent pain and swelling. Pain from arthritis typically is made worse by weight-bearing particularly on uneven ground. What this means is you should try to avoid excessive walking or running on uneven ground. Anti-inflammatory medication and proper foot support can do wonders.

Pain in the ball of the foot has many causes…

• Foot strain occurs when a person “overdoes it.” And the treatment is pretty straightforward. Rest.
• Morton’s neuroma (a benign nerve tumor usually located between the 3rd and 4th toes)
• Tarsal tunnel syndrome (pinched nerve in the ankle)
• Arthritis.

Other common causes of foot pain include:

• Stress fractures may occur after excessive walking.
• Achilles tendonitis causes pain in the back of the heel. Treatment consists of anti-inflammatory medicines, rest, a heel lift, and gentle stretching.
• Plantar fasciitis causes pain in the bottom of the heel. Treatment includes rest, anti-inflammatory medication, heel cup, orthotics, stretching, and local steroid injection.
• Flat foot.

Muscle strengthening exercises and orthotics are helpful. Two other common problems are:

• Osteoarthritis, particularly common in the big toe. The big toe will point out to the side. When bursitis alongside the great toe joint develops, this condition is referred to as a bunion. Treatment involves proper padding and footwear. In extreme cases, surgery is required.
• Neuropathy. This painful condition is particularly common in diabetics. This occurs when the small nerves in the feet are damaged. Symptoms include burning, tingling, and pain in the feet - worse at night.

Well fitted orthotics (arch supports) can alleviate not only foot and ankle pain but pain in the knees, hips, low back, and neck!!

We often take the ability to walk for granted. This ability involves the use of two engineering marvels- our feet and ankles. Because of the tremendous amount of force transmitted to the feet with walking, unique problems may develop. Attention to proper preventative care, i.e., comfortable shoes, sox, hygiene, support, along with proper prompt medical care can really put the brakes on foot pain.

Irritable bowel syndrome sufferers often find that they have to deal with two sets of symptoms. The physical symptoms of diarrhea, constipation and pain form the main part of IBS, but sufferers may also develop emotional problems such as mild or moderate depression and anxiety because of the strain that IBS places on their lives.

There’s no doubt that IBS can have a huge impact on your mental and emotional health. One of the reasons why people assume that IBS is caused by stress is that IBS sufferers can appear so stressed and unhappy. But is this really surprising? If you had explosive diarrhea, never-ending constipation or stabbing stomach cramps you’d be a bit stressed too!

The nature of IBS symptoms can mean that they are very difficult to deal with, both practically, in terms of being afraid to go out because of fear of diarrhea, and emotionally, because of embarrassment and the sometimes unsympathetic reactions of others.

Sufferers find that their social lives quickly diminish to nothing, or that they can no longer eat the food at restaurants or dinner parties without ending up in pain. Work or school can become a chronic struggle as you drag yourself in on days when you feel ill, knowing that if you didn’t you’d get fired or kicked off your course.

You may also feel that you have to pretend to be healthy most of the time in spite of how you really feel, because people get tired of hearing about your condition or begin to say things like “Well why don’t you go to the doctor” or “My mum had that and ate lots of bran and now she’s fine. That’s what you should do.”

It can be very hard to bite your tongue and stop yourself answering back. “Oh, go to the DOCTOR, I see, that’s where I’ve going wrong all this time, I thought you had to go to the hardware store. I shall now be cured.”

What is important to remember is that anyone who is battling with IBS is going through a very difficult time, and deserves some genuine support, as does anyone with a chronic, long-term condition.

Hopefully, if you explain your condition to family and friends, support will be forthcoming, but if not you should ask yourself how much misunderstanding you are willing to put up with, and whether it is hazardous to your health.

This is what Heather Van Vorous says in The First Year - IBS: “You may even have friends or family dismiss your problem as ‘all in your head.’ It’s up to you to educate these people, and then dump them if they persist in their ignorance at the expense of your health.”

If they are truly your friends then they will want to learn about the condition and be ready to accept that their views are based on prejudice and assumption rather than fact.

But if they still believe that you’re exaggerating then ask them to explain exactly why they believe that IBS is psychosomatic or ‘all in your head’, what scientific studies they are basing their views on, and how they explain the success of new drugs such as the selective 5-HT3 antagonist Lotronex. That should keep them quiet.

Irritable bowel syndrome can be a nightmare?constant diarrhea and terrible stomach pains, or unbelievable constipation and never-ending gas. While it’s good to stay positive and keep looking for help, sometimes it’s even better to just have a good old moan!

So, without further ado, I would like to present the top 10 reasons why we all hate IBS. These quotes have all come from genuine IBS sufferers.

“Other people are sick for a week and they get fussed over, food made for them, blankets brought to them, and generally an amazing amount of sympathy. I’m sick for years and years and somehow I’m less deserving than they are. Is that because I’m making it up? Or because IBS isn’t real? Or I should just snap out of it?”

“The pain is usually so intense that focus on school or work becomes impossible! There are many days and weeks that I spend curled up in a ball because the pain is so bad.”

“I hate IBS because people think you are just a worrier looking for sympathy, and that you could just ignore it, haha.”

“I am usually constipated, but when I have to go there’s no stopping me. One of these unstoppable occurrences happened the day of the Chicago marathon this year - and I was a participant. During my 18-week training program, I would often think that “it” could happen that day, but simply hoped it would not. Well, it did and it truly was unstoppable. It was so angering after such long, hard training. I finished the race, but not happy with my time or my comfort.”

“Walking through Wal-Mart…your heart beating faster as you approach the restroom…Will I make it in time? Only to the see the “closed” when you arrive. That horrible moment when you know you have to find a place to relieve yourself quickly or it will be the most embarrassing moment of your life.”

“I can really identify with this list of how “I hate IBS” because basically it has ruined my life the past year. I have lost a job, a house, most of my family and friends due to this crippling “so-called disease” that NOBODY UNDERSTANDS. If I appear angry that is because I am, terribly so. I also have crippling migraines and I am going for surgery for a severe carpal tunnel problem. I live in chronic pain in the left side of my pelvis. It has made life very difficult to say the least.”

“I just had company come from New York and I had to stay in bed during most of the visit because of IBS. They think that I am crazy. The gas and explosive bowel movements sap any living energy out of me. I am a single parent now living on social services which doesn’t even cover my rent. I am sooooooo angry at my body betraying me like this.”

“I am sick of living with constant fear and never being able to plan anything in advance. My long-suffering husband has to book holidays as late as possible, cancel theatre trips, and always go for aisle seats or none at all. I’d just for once like to say “Yes, I will definitely be able to go that day” and do it.”

“Eating becomes something I must plan for fear of making a run for the bathroom immediately after (or even during) a meal.”

“I am 12 years old and last year I found out I had IBS. It stinks because I have to go to the doctor more than all my friends and I have to go to Wisconsin children’s hospital every month or so. I have REALLY BAD days and I can have GREAT days but the bad ones are hard to deal with. I HATE IBS and I wish I never got it!”

Stop! and imagine for one moment that your body is being savagely and brutally attacked by chronic pain. This pain is so intense that you become less active. As you become less active you start to develop muscles weakness. Just trying to do normal daily activities such as, working, housekeeping, cooking, playing with the kids, shopping, walking the dog and sleeping has become an extreme ordeal. All is not peaceful in the Land of Nod. In fact, you as a fibromyalgia (FM) sufferer are downright restless.

As of this writing, fibromyalgia is the most misdiagnosed and misunderstood syndrome of the 21 century. Because it mimics other diseases and conditions, many people with FM initially have often been diagnosed as having multiple sclerosis, scleraderma, rheumatoid arthritis or lupus. Fibromyalgia has also been closely associated with chronic fatigue syndrome, it shares many of the same qualities.

Since so many fibromyalgia sufferers have been misdiagnosed, experts have categorized fibromyalgia as a syndrome rather than a disease. A syndrome is defined as “an aggregated of signs and symptoms associated with any morbid process.”

Although it does occur in men, women in their late 40’s and older are at least four times more likely to develop the disorder.

Pain, it is the most common symptom and complaint of the FM sufferer. Some people experience pain, fatigue, muscle stiffness and swelling in their joints, especially in the morning. This stiffness can be quite distinct and be accompanied by pain in key areas of the body, usually in the neck, shoulder, lower back and buttoch.

Irritable bowel syndrome has been reported in approximately 40-70 percent of these patients. It is not unusual for those afflicted to have diarrhea, constipation or a frequent need to empty their bladder. Fatigue and restlessness in FM patients can cause poor concentration, memory loss, non-restorative sleep and secondary endocrine malfunction involving the hypothalamic pituitary and adrenal glands.

Approximately 50 percent of FM sufferers experience some sort of increase sensitivity to stimuli, such as, flashing lights (photophobia), increase sounds (phonophobia), and varies odors.# Some patients often present with a chronic runny nose, congested head cold, and a throat clearing cough. Another common complaint is restless leg syndrome. When a FM sufferer presents to their doctor their are two things they want more than anything in this whole wide world. They want their pain alleviated and one of the greatest pleasures known to all creatures, the ability to get a good night of rest and sleep.

Fibromyalgia and Sleep

Sleep is vital to our very existence, it is during sleep that our temperature decreases conserving energy, sugars are stored for future use, our immune system is blasted into action and growth hormones are released fostering the repair of cells and tissues.# That important journey into sleep is a beautiful time for our bodies and brains to heal themselves from the vigorous wear and tear of daily living. But, numerous studies have been conducted which reveal that persons with fibromyalgia have a sleep disturbance that prevents them from receiving these healing powers. Many physicians are unaware of the importance of getting a sleep study done on their FM patients.

Here’s what we know, a landmark study published in 1975 discovered that 70 percent of patients with FM had NREM (non-rapid eye movement) stages of sleep “contaminated” by an abnormal EEG pattern called alpha-delta sleep, in which incurrent alpha waves (seen when you are awake) are riding on large, slow delta waves. This constant alpha-delta intrusion robs the body of deep sleep (stage 3 and 4 sleep).# It is during this stage of sleep that our body is being repaired. There is also some evidence indicating that fibromyalgia syndrome and sleep disorders are intimately related, but know one is certain which causes the other. Many FM sufferers exhibit bruxism (tooth-grinding), periodic limb movement (PLM), and obstructive sleep apnea (OSA). The absence of stage 3 and 4 sleep in FM can also cause chronic sleep deprivation and may contribute to the rapid physical decline many doctors see in their patients.

Diagnosing FM is not an easy task. To actually receive a diagnosis of fibromyalgia, the American College of Rheumatology, identified 18 separate points on the body called “tender points,” by applying pressure with the index, third and fourth fingers of the examiner’s hand at nine key bilateral surface sites. These include the side of the hip joint, and buttock and the inside of the knee.

In addition, the patient must complain of widespread pain lasting at a duration of 3 months or more. the pain must be radiating on both sides of the body, and be above and below the waist.

Fibromyalgia and the Polygragh

There is no cure for fibromyalgia. The only relief FM sufferers can hope for is the treatment of their symptoms. Majority of FM patients complain that no matter how long they sleep, it is never restful. Their sleep may be interrupted by frequent awakenings, or they wake up gasping for air, or in pain. Even more common most patients complain of waking up day after day feeling exhausted.

Many of the symptoms that FM patients experience are shared by those with other sleep disorders. As sleep care professionals, we do know the symptoms. Now we must raise awareness to patient and doctors treating FM, that their lack of sleep can be caused by so many factors. Such as, pain, sleep apnea, PLM and bruxism.

But how, (you ask) would a doctor know for sure in a patient complaining of sleep deprivation that their lack of sleep is because of pure fibromyalgia verses fibromyalgia overlap with another sleep disorder?

Here’s your answer, “Polysomnography.” The polygraph can be used as one of the tools to help doctors battle the problem. In order for you to better understand how fibromyalgia works in sleep. I invite you to come along with me and peek in on the inner workings of the fibromyalgic brain.

I had been working in sleep medicine as a polysomnography technician for only six months when I saw my first client with fibromyalgia. LT was a forty-eight years old female, mildly over-weight and in poor overall health. Her chief complaint was, (Yep you guess it), pain and lack of sleep.

I meticulously place each EEG electrode on her scalp making sure I properly prep and measure each site. I attached two effort belts, one on her chest, the other on her abdomen. Leads where placed near her eyes and chin. Leads where places on her legs, and EKG leads where placed on her chest. A thermistor airfow was placed at her nares and a pulse oximeter probe on her finger. The setup procedure took about an hour, to pass the time away she and I “chatted” about our families and recent news events

Once in bed the client was hooked up to the EEG machine and monitor. She was allowed to watch a little television around 10:30 PM she started getting sleepy. She lets out one big yawn and shuffled between the covers. On the computer screen I notice LT is drifting in and out of sleep (microsleep). She’s not totally asleep yet, but her body is relaxing and preparing itself for sleep. It is during this time that her body temperature drops, and her pineal gland at the base of her skull is slowly releasing melatonin in her bloodstream, signaling to her brain that it’s time to make that wonderful transition into sleep.

Now this is where the fun for me as a sleep technologist begins. On a computer screen I get to observe all the wonderful electrical activities of the brain. When she was awake I observed those fast, low-voltage type of brain waves called beta waves. But as she closed her eyes, the waves change to a slow-high voltage brain rhythm called alpha waves. Alpha waves danced across the screen for several more minutes, then suddenly right before my eyes the alpha waves were quickly replaced by a new wave pattern called theta. Her mind is no longer thinking about her day, LT has now drifted from a state of conscious wakefulness to that wonderful abyss called stage 1 sleep.

Stage 1 sleep is the lightest stage of sleep. Considered transitional sleep, stage 1 will move LT into a deeper and rewarding sleep state. Her eyes began to roll slightly from side to side, she no longer hear the sounds of cars and trucks passing her window. Or the mild humming noise coming from the fan. But yet if I where to enter her room and lightly touch her arm, she would be easily aroused and not have a sense that she had been sleeping at all.

After 5-7 minutes in stage 1 sleep, LT slowly enters stage 2, during this stage of sleep two identifiable sleep-specific wave forms pop on the screen. Sleep spindles and K-complexes, these are two beautiful wave forms floating across the polygragh. I love vintage cars so every time I look at a sleep spindle, I am reminded of old spoke tires on a ford Model T. K-complexes are quite different then a sleep spindle, it is a super large wave form that appears seconds before a sleep spindle, and looks like the QRS complex on a EKG tracing, with a well delineated negative upward spike which is immediately followed by a positive downward spike. Both of these wave forms appear and disappear across the screen in seconds. LT’s legs begins to twitched several times. She now is definitely showing signs of PLM.

15 minutes later she falls into stage 3 sleep or deep sleep. In stage 3 sleep she is not easily aroused. In this stage of sleep between 20-50 percent of the waves are transformed into delta waves. Over size slow tee-pee shape waves ripple across the EEG computer and appear again and again. When all of a sudden (out of the blue) delta waves are constantly being bombarded by alpha waves. Until finally for every delta wave seen an alpha wave intrudes on its territory. LT is no longer asleep, the alpha-delta intrusion causes her eyes to pop open. After twenty minutes staring at the ceiling, she then takes her first bathroom break, why not, her restful sleep has been interrupted.

Once in bed, her sleep debt built up from her arousal causes her to fall quickly back into stage 1 sleep again. Throughout the night she will repeatedly travel up and down the stages of sleep, never reaching stage 4 or REM sleep because of alpha-delta intrusion and PLM. This constant interruption in her sleep can hamper the proper release of serotonin, (which is necessary for the activation of an important immune system cell called “natural killer cells”)# and growth hormones that aide in rebuilding damage cells. LT’s sleep test ends at 6:00 AM, she had several complaints from being tired, to increase pain, to being unhappy. these are all typical complaints of a FM sufferer.

A trained and experienced polysomnographic technologist then analyzed and scored LT’s sleep data. The report indicated she had frequent leg movements in stage 1 and 2 sleep, consistent with the disorder premature leg movement (PLM), along with frequent arousals and alpha-delta intrusion.

A month later, a follow-up phone call was conducted by the sleep center. Therapy for LT included low dose anti-depressant, physical fitness training and benzodiazepines such as clonazepam which help in promoting better sleep, by relaxing skeletal muscles and reducing her premature leg movements. Every fibromyalgia patient is different and may require a different individualized treatment, (some patients may suffer from sleep apnea or bruxism.) But, for LT these combination of treatment seemed to help and she was happy with the outcome.

Conclusion

I hope this small glimpse into fibromyalgia will help explain why patients need and will benefit from a sleep center. Precise diagnosis is essential to establish the existence of fibromyalgia and distinguish this disease from other sleep disorders. Once the diagnosis is made, a multifaceted approach is then required to ensure healing and restful sleep.

The consequences of fibromyalgia can be significant for those affected as well as bed partners and family members. Although many patients try to self-manage their lack of sleep, most will eventually seek treatment if symptoms are progressive and/or unrelenting. I extend this one challenge to every doctor and that is to ask their fibromyalgia patient one question, “How are you sleeping?”

Do you have foot pain or numbness? You could have a condition known as Tarsal Tunnel Syndrome. Massage Therapy and Bodywork are very effective in treating conditions arising from muscular and connective tissue abnormalities. In my San Antonio, Texas based Massage Therapy and Bodywork practice I often treat pain from various muscular and nerve entrapment syndromes including the supposedly rare Tarsal Tunnel Syndrome. Like many painful conditions Tarsal Tunnel Syndrome responds quite well to treatment by massage therapy and bodywork.

What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome is the name of a painful nerve entrapment condition, in which the posterior tibial nerve is placed under abnormal pressure by the connective tissue forming the tarsal tunnel at the inside of the ankle and the other structures in that space like tendons from lower leg muscles. When the muscle tendons passing through the tarsal tunnel become tight and enlarged, pain results from myofascial trigger points (knots) in the muscle, and pressure on the posterior tibial nerve which passes through the tarsal tunnel. Pain from Tarsal Tunnel Syndrome is usually found in the ankle, heel, and sole of the foot. Additionally, there may be numbness or a pins and needles feeling in sole of the foot and sometimes the toes. Most of the time the symptoms are on one affected side, but may affect both sides at the same time.

What is the cause of Tarsal Tunnel Syndrome?

There are a number of causes for Tarsal Tunnel Syndrome. Some causes of this condition prevent massage therapy from being the best method of treatment. However, there are other causes of this painful syndrome that make massage therapy one of the best methods of treatment. These causes include direct blunt trauma to the inside of the ankle near the tarsal tunnel itself; ankle sprains of the inner ankle are a common cause of this syndrome; and, this syndrome may also be caused by overuse and/or repetitive stress of the flexor muscles of the lower leg especially when fallen arches and/or over pronation is present.

Massage Therapy and Bodywork for Tarsal Tunnel Syndrome

There are many ways that massage therapy and bodywork can be used to treat Tarsal Tunnel Syndrome. The massage therapist will employ a number of techniques to relieve the condition. For example the massage therapist may use Neuromuscular Therapy or Trigger Point Therapy to eliminate myofascial trigger points and associated tension in the flexor muscles whose tendons pass through the tarsal tunnel. The massage therapist could also use Myofascial Release techniques or Deep Tissue Massage techniques to release adhesions between the flexor retinaculum forming the tarsal tunnel and the tissues passing through the tunnel while also using Muscle Energy Techniques to gently lengthen the same muscles to reduce tension in the tissues. Tarsal Tunnel Syndrome also responds well to positional release therapies such as Ortho-Bionomy which work with the body’s nervous system to release muscles and improve joint movement in the area - especially in the subtalar joint and arch of the foot. Comprehensive treatment with massage and bodywork, in conjunction with a home program of stretching and exercise, may help to completely resolve Tarsal Tunnel Syndrome.

Other Treatments for Tarsal Tunnel Syndrome

While massage therapy and bodywork are an excellent treatment for Tarsal Tunnel Syndrome there are other treatments you should discuss with your physician:

Corticosteroid Injections

Anti-inflammatory medications (NSAIDS)

Functional Foot Orthotics

Dorsal Night Splint

Decompressive Surgery

Other Names for Tarsal Tunnel Syndrome

Pinched Nerve

The information on this page has been provided for information purposes only. It is not meant to provide a medical diagnosis, only a licensed physician may diagnose Tarsal Tunnel Syndrome. If you feel that you have the symptoms of Tarsal Tunnel Syndrome please see your physician for a proper diagnosis and plan of treatment which may include massage therapy and bodywork. There are a number of serious conditions that are similar Tarsal Tunnel Syndrome that could require immediate medical attention.

If, after consulting your physician, you would like to pursue treatment of Tarsal Tunnel Syndrome with Massage Therapy and Bodywork please contact me at my San Antonio Massage and Bodywork practice or contact a Massage Therapist near you.

Did you know that one in every one hundred people is affected by what is known as carpal tunnel syndrome at some point in their life? While commonly found in women in the thirty to fifty-year age range, carpal tunnel syndrome can affect nearly anyone, from assembly line workers, to surgeons and dentists, to secretaries and computer data entry personnel, to even those who play musical instruments or video games.

Carpal tunnel syndrome is a very painful and progressive condition that occurs in the wrist, caused by compression to the median nerve. The median nerve runs into the hand starting from the forearm, and when it is squeezed or pressed at the wrist, the message carrying and receiving from the brain is inhibited.

The name carpal tunnel syndrome, however, comes from the eight bones in our wrists that are known as carpals. They form a tunnel-like structure, hence the term “carpal tunnel syndrome.”

Compression of the tunnel walls is the most basic of causes of carpal tunnel syndrome.

Other factors, such as congential predispostion and even trauma based injury can also be to blame. Carpal tunnel syndrome can develop quickly, especially if the wrist has been fractured or injured or rheumatoid arthritis has set in. In many cases, repetitve stress induced carpal tunnel strain can cause the syndrome, especially in those who spend a great deal of time typing.

Symptoms of carpal tunnel can include tingling, numbness, and burning in the fingers, as well as the inability to make a fist or grip things. A person eventually loses the ability to squeeze things and may even find it hard to tie their shoes. In the most extreme cases of carpal tunnel syndrome, the patients are unable to determine hot or cold by touch.

Treatment for carpal tunnel syndrome is available. Most physicians will advise against repetitive and exhaustive activities related to hand movement. Stretching exercises and medicines like corticosteroids can help in relieving the syndrome. However, if the condition worsens, surgery may be the only available course of treatment.

If you feel as though you may be suffering from carpal tunnel syndrome, you should consult your physician immediately to discuss symptoms and treatment options.

Injuries can occur anywhere and at anytime, but the most prevalent place of occurrence is in the workplace. The reason for such a high rate of injury is that people spend 8-18 hours a day, 5-7 days a week performing unidirectional (one-way) movement patterns, causing an imbalance in the musculoskeletal system that results in the overuse and under use of certain muscle groups. If left unchecked, these injuries can be come chronic, resulting in pain and dysfunction that can last for years.

Usually, when one muscle group is overused, the opposing muscle group, acting as a stabilizer, becomes underused. When this imbalance establishes itself in the musculoskeletal system, the body does not function as designed. Instead of muscles working together to perform a specified function, they work against each other, causing the body to exert more energy to perform the same task that previously was perceived by the body as “simple”.

When muscles become too short and tight, they lose their strength as they are in a chronic semi-contracted state and cannot contract (shorten) efficiently due to being pre-fatigued and the fact that they are already in a state where they are too short for proper function. If a muscle is already in a shortened, semi-contracted state, it cannot contract, or shorten very far. And the farther a muscle can contract (shorten) and move, the greater the strength and endurance the muscle will have. Chronically tight, restrictive muscles just don’t function very well and they impinge structures around and beneath them such as nerves and blood vessels, causing disorders like Carpal Tunnel Syndrome, Cubital Tunnel Syndrome and many other associated Repetitive Strain injuries. Short muscles also pull bones out of alignment, which causes a joint imbalance, often resulting in severe pain and dysfunction.

The same goes for underused muscles. Underdeveloped muscles are weak due to lack of direct stimulation. Weak muscles are usually too long, unless they are in a state of spasm, which occurs as a protective response in order to keep from being overstretched. Weak underdeveloped muscles cannot act as efficient stabilizers when the opposing muscle(s) are called into action, which again causes a joint imbalance to develop, as weak muscles cannot stabilize bones in their proper position / alignment. Weather a muscle is short and tight or long and weak, the strength and length imbalance of the affected muscle(s) must be corrected for the body to function optimally without pain, dysfunction and reduced mobility of the involved muscles / joints.

Muscle imbalances are the cause of most biomechanical disorders in the body. From Carpal Tunnel Syndrome to Thoracic Outlet Syndrome, an existing muscle imbalance is at the root cause of the disorder in 90% of the cases. Too many modalities focus on the “band-aid principal”, allowing the muscle imbalance go on for years with a little bit of relief here and there. Now is the time to focus on the actual “cause(s)” of these disorders and eliminate them altogether. With the appropriate exercise and stretch routine, most musculoskeletal disorders can be eliminated quickly and effectively.

Correcting muscle imbalances is achieved through a process consisting of a number of stretches and exercises. Soft-tissue treatment and hot/cold therapy may be utilized to help expedite the rate of recovery if it is so desired. Usually the nature of performing both stretches and exercises within the same program can be quite effective at eliminating the existing condition without the addition of the soft tissue treatment and hydrotherapy. Word of caution; there is a treatment sequence to addressing muscle imbalances if the best results are to be achieved. If random stretches and exercises are performed, an individual may cause themselves more harm than good.

A general rule when addressing a chronic muscle imbalance is to execute the following program:

1. Heat Therapy* : Use heating-pad 5 Min. to warm the affected joint and surrounding muscles, preparing them for upcoming stretches and exercises. (Be sure that all sides of the joint and surrounding muscles are warmed-up.)

2. Soft-Tissue Treatment*: Soft tissue treatment utilizing Effleurage and Trigger Point Therapy to reduce muscle spasm and relax the tight, restrictive overused muscles can be very effective in correcting muscle imbalances. Utilizing Transverse Friction Massage (TFM) on specifically weak, injured muscles and/or tendons to break down adhesions on the soft tissues can also be very effective in reducing overall pain and dysfunction.) Performing basic massage to the tight muscles is the easiest way to address the issue without getting too complex.)

3. Stretching Routine: Once the muscles are warmed up, stretching the tight, restrictive muscle group is key to increasing their length and reducing their impingement of surrounding tissues as well as reducing their effect on the misalignment of the joint. (Stretching the weak, underdeveloped muscles is not recommended as they are already too long and do not need to be lengthened further.)

4. Exercise Routine: Once the tight restrictive muscles have been lengthened from the stretches, it is time to exercise the opposing muscle group, the one that is weak and underdeveloped, in order to shorten and strengthen the muscles in order to reduce the tensile stresses imposed on them from the opposing tight muscle group. Exercising and strengthening the weak underdeveloped muscles not only forces the opposing muscle group to relax and lengthen further, but it also helps to maintain the length created in those muscles from the previous stretches. (Do not perform stretches after the exercises as this misaligns the joints and causes muscle rebounding. Always perform stretches first when addressing chronic muscle imbalances and then immediately follow with exercises.)

5. Contrast Bath*: Utilizing a contrast bath at the end of the complete routine can be helpful in reducing muscle spasm, remove toxins from the muscles and increase circulation and overall nutrient flow to the injury, helping to aid an increase the speed of recovery. Basic procedure is 3-minutes heat to 1-minute of cold. Repeat 3-times, finishing with cold.

This general treatment program for chronic repetitive strain injuries resulting from muscle imbalances is very effective and often eliminates all of the symptoms previously associated with the injury, quickly and effectively. Always consult a physician before beginning any type of exercise or treatment program.

Remember, Your Health is in Your Hands!