Patient Resource | Neuromuscular Spine & Joint Center

Carpal Tunnel Syndrome: Care Instructions

June 12, 2017 Leave a Comment

Carpal tunnel syndrome is a nerve problem. It can cause tingling, numbness, weakness, or pain in the fingers, thumb, and hand. The median nerve and several tough tissues called tendons run through a space in the wrist called the carpal tunnel. The repeated hand motions used in work and some hobbies and sports can put pressure on the nerve. Pregnancy and several conditions, including diabetes, arthritis, and an underactive thyroid, also can cause carpal tunnel syndrome.

You may be able to limit an activity or do it differently to reduce your symptoms. You also can take other steps to feel better. If your symptoms are mild, 1 to 2 weeks of home treatment are likely to ease your pain. Surgery is needed only if other treatments do not work.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

If possible, stop or reduce the activity that causes your symptoms. If you cannot stop the activity, take frequent breaks to rest and stretch or change hand positions to do a task. Try switching hands, such as when using a computer mouse.
Try to avoid bending or twisting your wrists.
Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
If your doctor prescribes corticosteroid medicine to help reduce pain and swelling, take it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
Put ice or a cold pack on your wrist for 10 to 20 minutes at a time to ease pain. Put a thin cloth between the ice and your skin.
If your doctor or your physical or occupational therapist tells you to wear a wrist splint, wear it as directed to keep your wrist in a neutral position. This also eases pressure on your median nerve.
Ask your doctor whether you should have physical or occupational therapy to learn how to do tasks differently.
Try a yoga class to stretch your muscles and build strength in your hands and wrists. Yoga has been shown to ease carpal tunnel symptoms.

To prevent carpal tunnel

When working at a computer, keep your hands and wrists in line with your forearms. Hold your elbows close to your sides. Take a break every 10 to 15 minutes.
Try these exercises:
- Warm up: Rotate your wrist up, down, and from side to side. Repeat this 4 times. Stretch your fingers far apart, relax them, then stretch them again. Repeat 4 times. Stretch your thumb by pulling it back gently, holding it, and then releasing it. Repeat 4 times.
- Prayer stretch: Start with your palms together in front of your chest just below your chin. Slowly lower your hands toward your waistline while keeping your hands close to your stomach and your palms together until you feel a mild to moderate stretch under your forearms. Hold for 10 to 20 seconds. Repeat 4 times.
- Wrist flexor stretch: Hold your arm in front of you with your palm up. Bend your wrist, pointing your hand toward the floor. With your other hand, gently bend your wrist further until you feel a mild to moderate stretch in your forearm. Hold for 10 to 20 seconds. Repeat 4 times.
- Wrist extensor stretch: Repeat the steps for the wrist flexor stretch, but begin with your extended hand palm down.
Squeeze a rubber exercise ball several times a day to keep your hands and fingers strong.
Avoid holding objects (such as a book) in one position for a long time. When possible, use your whole hand to grasp an object. Using just the thumb and index finger can put stress on the wrist.
Do not smoke. It can make this condition worse by reducing blood flow to the median nerve. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor if:

Your pain or other problems do not get better with home care.
You want more information about physical or occupational therapy.
You have side effects of your corticosteroid medicine, such as:
- Weight gain.
- Mood changes.
- Trouble sleeping.
- Bruising easily.
You have any other problems with your medicine.

Care instructions adapted under license by Neuromuscular Spine & Joint Center. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Kopp Medical LLC, DBA Neurmomuscular Spine & Joint Center disclaims any warranty or liability for your use of this information.

Stopping Smoking: Care Instructions

June 12, 2017 Leave a Comment

Cigarette smokers crave the nicotine in cigarettes. Giving it up is much harder than simply changing a habit. Your body has to stop craving the nicotine. It is hard to quit, but you can do it. There are many tools that people use to quit smoking. You may find that combining tools works best for you.

There are several steps to quitting. First you get ready to quit. Then you get support to help you. After that, you learn new skills and behaviors to become a nonsmoker. For many people, a necessary step is getting and using medicine.

Your doctor will help you set up the plan that best meets your needs. You may want to attend a smoking cessation program to help you quit smoking. When you choose a program, look for one that has proven success. Ask your doctor for ideas. You will greatly increase your chances of success if you take medicine as well as get counseling or join a cessation program.

Some of the changes you feel when you first quit tobacco are uncomfortable. Your body will miss the nicotine at first, and you may feel short-tempered and grumpy. You may have trouble sleeping or concentrating. Medicine can help you deal with these symptoms. You may struggle with changing your smoking habits and rituals. The last step is the tricky one: Be prepared for the smoking urge to continue for a time. This is a lot to deal with, but keep at it. You will feel better.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Ask your family, friends, and coworkers for support. You have a better chance of quitting if you have help and support.
Join a support group, such as Nicotine Anonymous, for people who are trying to quit smoking.
Consider signing up for a smoking cessation program, such as the American Lung Association’s Freedom from Smoking program.
Set a quit date. Pick your date carefully so that it is not right in the middle of a big deadline or stressful time. Once you quit, do not even take a puff. Get rid of all ashtrays and lighters after your last cigarette. Clean your house and your clothes so that they do not smell of smoke.
Learn how to be a nonsmoker. Think about ways you can avoid those things that make you reach for a cigarette.
- Avoid situations that put you at greatest risk for smoking. For some people, it is hard to have a drink with friends without smoking. For others, they might skip a coffee break with coworkers who smoke.
- Change your daily routine. Take a different route to work or eat a meal in a different place.
Cut down on stress. Calm yourself or release tension by doing an activity you enjoy, such as reading a book, taking a hot bath, or gardening.
Talk to your doctor or pharmacist about nicotine replacement therapy, which replaces the nicotine in your body. You still get nicotine but you do not use tobacco. Nicotine replacement products help you slowly reduce the amount of nicotine you need. These products come in several forms, many of them available over-the-counter:
- Nicotine patches
- Nicotine gum and lozenges
- Nicotine inhaler
Ask your doctor about bupropion (Wellbutrin) or varenicline (Chantix), which are prescription medicines. They do not contain nicotine. They help you by reducing withdrawal symptoms, such as stress and anxiety.
Some people find hypnosis, acupuncture, and massage helpful for ending the smoking habit.
Eat a healthy diet and get regular exercise. Having healthy habits will help your body move past its craving for nicotine.
Be prepared to keep trying. Most people are not successful the first few times they try to quit. Do not get mad at yourself if you smoke again. Make a list of things you learned and think about when you want to try again, such as next week, next month, or next year.

Sacroiliac Pain: Exercises

June 2, 2017 Leave a Comment

Here are some examples of typical rehabilitation exercises for your condition. Start each exercise slowly. Ease off the exercise if you start to have pain.

Your doctor or physical therapist will tell you when you can start these exercises and which ones will work best for you.

How to do the exercises

Knee-to-chest stretch

Do not do the knee-to-chest exercise if it causes or increases back or leg pain.

Lie on your back with your knees bent and your feet flat on the floor. You can put a small pillow under your head and neck if it is more comfortable.
Grasp your hands under one knee and bring the knee to your chest, keeping the other foot flat on the floor.
Keep your lower back pressed to the floor. Hold for at least 15 to 30 seconds.
Relax and lower the knee to the starting position. Repeat with the other leg.
Repeat 2 to 4 times with each leg.
To get more stretch, keep your other leg flat on the floor while pulling your knee to your chest.

Bridging

Lie on your back with both knees bent. Your knees should be bent about 90 degrees.
Tighten your belly muscles by pulling in your belly button toward your spine. Then push your feet into the floor, squeeze your buttocks, and lift your hips off the floor until your shoulders, hips, and knees are all in a straight line.
Hold for about 6 seconds as you continue to breathe normally, and then slowly lower your hips back down to the floor and rest for up to 10 seconds.
Repeat 8 to 12 times.

Hip extension

Get down on your hands and knees on the floor.
Keeping your back and neck straight, lift one leg straight out behind you. When you lift your leg, keep your hips level. Don’t let your back twist, and don’t let your hip drop toward the floor.
Hold for 6 seconds. Repeat 8 to 12 times with each leg.
If you feel steady and strong when you do this exercise, you can make it more difficult. To do this, when you lift your leg, also lift the opposite arm straight out in front of you. For example, lift the left leg and the right arm at the same time. (This is sometimes called the “bird dog exercise.”) Hold for 6 seconds, and repeat 8 to 12 times on each side.

Clamshell

Lie on your side with a pillow under your head. Keep your feet and knees together and your knees bent.
Raise your top knee, but keep your feet together. Do not let your hips roll back. Your legs should open up like a clamshell.
Hold for 6 seconds.
Slowly lower your knee back down. Rest for 10 seconds.
Repeat 8 to 12 times.
Switch to your other side and repeat steps 1 through 5.

Hamstring wall stretch

Lie on your back in a doorway, with one leg through the open door.
Slide your affected leg up the wall to straighten your knee. You should feel a gentle stretch down the back of your leg.
- Do not arch your back.
- Do not bend either knee.
- Keep one heel touching the floor and the other heel touching the wall. Do not point your toes.
Hold the stretch for at least 1 minute to begin. Then try to lengthen the time you hold the stretch to as long as 6 minutes.
Switch legs, and repeat steps 1 through 3.
Repeat 2 to 4 times.

If you do not have a place to do this exercise in a doorway, there is another way to do it:

Lie on your back, and bend one knee.
Loop a towel under the ball and toes of that foot, and hold the ends of the towel in your hands.
Straighten your knee, and slowly pull back on the towel. You should feel a gentle stretch down the back of your leg.
Switch legs, and repeat steps 1 through 3.
Repeat 2 to 4 times.

Lower abdominal strengthening

Lie on your back with your knees bent and your feet flat on the floor.
Tighten your belly muscles by pulling your belly button in toward your spine.
Lift one foot off the floor and bring your knee toward your chest, so that your knee is straight above your hip and your leg is bent like the letter “L.”
Lift the other knee up to the same position.
Lower one leg at a time to the starting position.
Keep alternating legs until you have lifted each leg 8 to 12 times.
Be sure to keep your belly muscles tight and your back still as you are moving your legs. Be sure to breathe normally.

Piriformis stretch

Lie on your back with your legs straight.
Lift your affected leg, and bend your knee. With your opposite hand, reach across your body, and then gently pull your knee toward your opposite shoulder.
Hold the stretch for 15 to 30 seconds.
Switch legs and repeat steps 1 through 3.
Repeat 2 to 4 times.

Sacroiliac Joint Pain: Care Instructions

June 2, 2017 Leave a Comment

The sacroiliac joints connect the spine and each side of the pelvis. These joints bear the weight and stress of your torso. This makes them easy to injure. Injury or overuse of these joints may cause low back pain.

Stress on these joints can cause joint pain. Sacroiliac joint pain is more common in pregnant women. Certain kinds of arthritis also may cause this type of joint pain.

Home treatment may help you feel better. So can avoiding activities that stress your back. Your doctor also may recommend physical therapy. This may include doing exercises and stretches to help with pain. You may also learn to use good posture.

How can you care for yourself at home?

Ask your doctor about light exercises that may help your back pain. Try to do light activity throughout the day. But make sure to take rests as needed. Find a comfortable position for rest, but don’t stay in one position for too long. Avoid activities that cause pain.
To apply heat, put a warm water bottle, a heating pad set on low, or a warm cloth on your back. Do not go to sleep with a heating pad on your skin.
Put ice or a cold pack on your back for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
If the doctor gave you a prescription medicine for pain, take it as prescribed.
If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label. Take pain medicines exactly as directed.
Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
To prevent future back pain, do exercises to stretch and strengthen your back and stomach. Learn how to use good posture, safe lifting techniques, and proper body mechanics.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You are unable to move a leg at all.

Call your doctor now or seek immediate medical care if:

You have new or worse symptoms in your legs or buttocks. Symptoms may include:
- Numbness or tingling.
- Weakness.
- Pain.
You lose bladder or bowel control.

Watch closely for changes in your health, and be sure to contact your doctor if:

You are not getting better as expected.

Low Back Arthritis: Exercises

June 2, 2017 Leave a Comment

Here are some examples of typical rehabilitation exercises for low back arthritis. Start each exercise slowly. Ease off the exercise if you start to have pain.

Your doctor or physical therapist will tell you when you can start these exercises and which ones will work best for you.

When you are not being active, find a comfortable position for rest. Some people are comfortable on the floor or a medium-firm bed with a small pillow under their head and another under their knees. Some people prefer to lie on their side with a pillow between their knees. Don’t stay in one position for too long.

Take short walks (10 to 20 minutes) every 2 to 3 hours. Avoid slopes, hills, and stairs until you feel better. Walk only distances you can manage without pain, especially leg pain.

How to do the exercises

Pelvic tilt

Lie on your back with your knees bent.
“Brace” your stomach tighten your muscles by pulling in and imagining your belly button moving toward your spine.
Press your lower back into the floor. You should feel your hips and pelvis rock back.
Hold for 6 seconds while breathing smoothly.
Relax and allow your pelvis and hips to rock forward.
Repeat 8 to 12 times.

Back stretches

Get down on your hands and knees on the floor.
Relax your head and allow it to droop. Round your back up toward the ceiling until you feel a nice stretch in your upper, middle, and lower back. Hold this stretch for as long as it feels comfortable, or about 15 to 30 seconds.
Return to the starting position with a flat back while you are on your hands and knees.
Let your back sway by pressing your stomach toward the floor. Lift your buttocks toward the ceiling.
Hold this position for 15 to 30 seconds.
Repeat 2 to 4 times.