134 Executive Drive, Lafayette, IN 47905, 765-448-6489


Posts for category: Chiropractic Medicine

These days, it seems like you can't turn around without bumping into someone who has Carpal Tunnel Syndrome or is on their way in for carpal tunnel surgery. If you are like me, you may, at times, have wondered if you have or have had Carpal tunnel syndrome yourself! In today's blog post, we are going to review what Carpal Tunnel Syndrome (CTS for short) is, some practical ways to treat it and when you might want to consider surgical intervention.

The Carpal tunnel is composed of the bones on the back side of the wrist (carpal bones) and the transverse carpal ligament on the inside. The median nerve and nine flexor tendons (tendons from muscles that cause your fingers and wrist to curl) run through the middle. When the fingers and wrist are used in a neutral (non-bent) fashion, the flexor tendons glide along the tunnel walls, lubricated by their own fluid. However, using the wrist and fingers repetitively in a flexed (bent-forward inclination) posture can set off a cascade of events that creates CTS. Therein lies the rub... LITERALLY!

Continuous use of the wrist and fingers in a flexed posture does the following:

  • Creates an over-development of the flexor tendons (making them larger)

  • Creates a relative weakness of the extensor tendons (the opposing muscle group that would normally keep the wrist and fingers in a neutral inclination)

  • Increases fluid retention and inflammation in and about the Carpal tunnel

  • Causes fluid pressure on the median nerve, which produces the classic presentation of CTS

The Median nerve is the nerve that is impacted by compression of the Carpal tunnel. Though you can have wrist and forearm pain from a number of different sources, if it originates from CTS, you will have some pretty characteristic symptoms:

  1. Numbness along the thumb, index, middle and half of the ring finger

  2. Tapping over the wrist (palm side) will often give a shooting sensation into the same area, as described in number one above

  3. Placing the back of the hands together with the wrists bent at ninety degrees can also increase the numbness

  4. Shaking the hands can often relieve the symptoms for a short time

  5. In long standing conditions, a weakness in the muscles of the thumb and index finger can develop leading to an inability to grasp or hold onto items

What To Do?

First the bad news: Personally, I have had the privilege of working on a number of patients over the years who either had or were on their way to getting CTS. Typically, the ones who had constant numbness and or weakness were beyond conservative measures, and ended up with surgery.

But there is good news:  More often than not, those that did go in for CTS surgery did well, as long as it was not too far along (mostly aggressive muscle weakness). In addition, those patients who were not too advanced in the syndrome were often able to put surgery off, sometimes indefinitely!

The keys to keeping CTS from progressing, and possibly reversing its effects, revolve around balancing the relationship between the flexor muscles (those that close the hand and flex the wrist) and the extensor muscles (those that open the hand and extend the wrist) by focusing on the following:
  1. Stretch the flexor muscles of the wrist and fingers.

  2. Strengthen the extensor muscles of the wrist and fingers.

This can be done fairly easily with an exercise band or even a rubber band. The key to this approach is repetition - just as CTS doesn't "show up" overnight, neither will it go away instantly. You are really reforming the connective tissue in your wrist and forearm - it is a very specific workout program designed to reverse the cumulative effects of years of abnormal movement.

Typically, we encourage people to stretch and do their exercises three times per day, everyday for three months, before deciding this approach will not work for them. In addition to stretching and strengthening, two other things can be useful: a nighttime splint that keeps the wrist neutral, and vitamin B6. Both of these can reduce inflammation and help the nerve tissue heal itself.


Over the last month, we have posted multiple blog posts about conditions that impact the head, neck and wrist. We are completing a short video that will include demonstrations on neck and shoulder stretches, home trigger point therapy for problem muscles, and CTS stretches and exercises. Watch your email over the next week for the link!

Until then,
Eat well, think right and move a lot!

Dr. Doug Williams
Care Chiropractic
Lafayette, Indiana

By Dr. Doug Williams
May 24, 2016
Tags: chiropractic medicine   pain   neck  

Three Simple Solutions for Neck Pain

Over the next few weeks, we are going to be covering some common neck conditions, and ways to address neck pain and other related issues (Text Neck, Standing Desks, etc.). Today's blog post will go over a few basics about how your neck works and three solutions you can do on your own when it isn't working right!

1. Maintain the Neck Curve             

When viewed from the side, the neck should have a forward c-shaped curve. Curves act like shock absorbers - if you lose the normal curve, all of the stress of the weight of your head (up to 12 pounds) is driven into your neck and shoulders (as pictured on the left).

Maintaining a proper neck curve is the first order of business when seeking a solution for neck pain. It all starts with paying attention to times and events on a day-to-day basis where you might lose the curve. This may include:

  • Working on a computer: Make sure the screen is elevated to the point where, if you took a string from your chin straight out, it would hit the middle of the screen. Most screens are situated too low. If you sit on a couch/easy chair and use a laptop, place your laptop on a pillow so it is elevated. If you find yourself working off a table or desk with your laptop, consider getting a plug-in keyboard and raising your whole laptop off the table or desk.
  • Sleeping: When you lay on your back in bed, use a thin pillow; a thick pillow will push your head forward and take out the curve. If you lay on your side, use a slightly thicker pillow so your head does not drop down toward the bed. Your head-to-shoulder angle should be between 70 and 90 degrees.  
  • Reading/Watching TV: If you are reading on a couch or easy chair, use a pillow on your lap to elevate the book or device. If you are reading at a desk or table, try to lean the book against another book, so it sits upright - better yet, use a document or recipe book holder. For watching TV, three things: 1) Don't do it in bed, 2) Don't recline your chair, and 3) Don't sit an angle of more than 30 degrees off the center of the T.V.
  • Texting/Using a mobile device: Seriously, who doesn't know how bad texting is for the neck? I fear for the next generation - they won't know what clouds and stars look like because they'll never look up! When you text, do your best to hold the device up, even a little. If you are sitting at home, prop your elbows on a pillow in your lap, or sit at the table and put your elbows up. If you are texting while driving, YOU SHOULDN'T BE!
2. Take Frequent Stretch Breaks
Often, the source of pain in and around a neck are the muscles that support it. When any part of the spine is held in a position for too long, the muscles may experience a reduced blood supply and become hypoxic, leading to pain. Simply getting up and moving can bring oxygen to the area and remove metabolic build-up. When doing sustained work, most of us check the clock fairly frequently - try to get up and stretch out, and move every half hour. Check out our previous blog post "The Best Two Stretches I Know" for a print out of some easy-to-do stretches for the neck.

3. Get More Magnesium In Your Diet
Magnesium is a rate-limiting nutrient. A rate-limiting nutrient means when there is not enough of it is present, things will not get done. With regard to muscles, this can mean that they have trouble contracting and relaxing. Your neck muscles spend all day trying to keep the bowling ball that is your head balanced on top of your shoulders - if your muscles are low on magnesium, they can start to cramp up, causing neck pain. Incorporating more magnesium-rich foods in your diet and maybe even a supplement (we recommend 400 mg of additional magnesium a day) can often reduce and even eliminate neck pain. You can check out a list of magnesium rich foods here. If you are going to take magnesium as a supplement, remember: magnesium is a muscle relaxer, which means it can also work on the bowels. Don't be too far away from a bathroom until you see how your own body responds!
Additional Help
Because neck pain and headaches often go together, it is worth reading our previous blog post "5 Simple Solutions for Your Headaches" for more good ideas on how to reduce pain in the head and neck region.

Neck pain is a big deal. If these solutions are working for you, don't stop practicing them just because you are feeling better, or you are likely to see the pain creep back in.

If you have tried these things and you are still having trouble, contact our office. It may be time for a more in-depth look to get to the bottom of your pain and get you on your way back to living life!

To Your Health,

Doug Williams, D.C.
Care Chiropractic
Lafayette, Indiana   
By Dr. Doug Williams
April 20, 2016
Tags: chiropractic medicine   relief   pain  

Next to neck and lower back pain, shoulder issues are one of the most common conditions people present for at our office. You can think of shoulder problems as existing on a timeline (pictured below):

Rarely do patients start out at the far end of the spectrum (rotator cuff tears). Most conditions are amendable to conservative treatment over a long period of time before surgery would be required. Except in cases of severe trauma, the majority of shoulder problems either start with or have a mal-positioned shoulder blade as the central problem.

The shoulder blade, or scapula, is a triangle-shaped bone that sits on the back side of the rib-cage and is connected to your collar bone. The upper arm bone, the humerus, butts up against the scapula to form your "shoulder socket." Surrounding the shoulder blade are several large muscles that hold the scapula to the rib-cage itself. Coming off of the scapula are four small muscles that attach to the humerus to keep it set in place when you are making large arm movements, like reaching or throwing. These small muscles are collectively known as your rotator cuff. Rotator cuff muscles are extremely efficient at doing their job (holding the humerus stable), as long as the shoulder blade is solidly locked in the correct position. It is only when the shoulder blade is either out of its normal resting position, or unstable, that things begin to go wrong.

The most common direction for the shoulder blade to mal-position is forward, which creates a rounded shoulder posture. As you can see, sitting can wreck the normal shoulder blade position! Cars, computers, soft furniture - all of it adds up and starts to shift the position of the shoulder blade. As the shoulder blade shifts, all of the rotator cuff muscles are pulled out of their normal resting position and apply tension abnormally on their attachment sites. Over time, this adds up to tears and arthritic spurs, and can often result in needing surgery. Unfortunately, if a surgery is performed to clean everything up, but the shoulder blade remains mal-positioned, the problem just continues.

The most common error in treating shoulder problems is attempting to strengthen the rotator cuff muscles first. Remember, the problem with the rotator cuff muscles usually only occurs late in the game and as a result of the mal-positioned shoulder blade. Attempting to strengthen these muscles before restoring the shoulder blade to its proper position can actually cause further damage.

The next mistake is attempting to strengthen the muscles that pull the shoulder blade backwards. The shoulder blade is a free-floating bone, which means it is anchored to the torso only by muscular attachment, not a ligament or joints. Thus, the shoulder blade reflects the posture of the rib cage. If the rib cage has an increased curve or is shifted back behind the pelvis, then the shoulder blades will flair and rotate forward secondarily to that posture. Just focusing on the shoulder blade, especially initially, is not very fruitful. Treatment needs to be directed first towards the rib cage posture.

An Effective Three-Step Protocol
to Correct a Majority of Shoulder Problems

Step 1: Determine if there is an increase in the curvature of the rib cage, or a rib cage shift behind the pelvis, and address this first. Typically, this requires a foam roller and/or a traction block.

Step 2: Relax the muscles that pull the shoulder blades up and forward (trapezius, levators and pectoral minors).

Step 3: Strengthen the muscles that pull the shoulder blades together and down (rhomboids, lower traps and infraspinatus).

After these three steps are addressed, then, if necessary, address the rotator cuff muscles.


If you, or someone you know, is having shoulder issues, come to our class on Shoulder Pain and Treatment on Monday, May 2nd at 6:30pm in our office (134 Executive Drive #3, Lafayette). We will be discussing the evaluation and treatment of shoulder conditions, and giving some practical home recommendations.

The class is free, but registration is necessary.
Call the office at 765-448-6489 to reserve a spot!

By Dr. Doug Williams
March 07, 2016
Who hasn't had a headache? It is not uncommon for people to have an occasional headache, or with obvious illnesses like the flu. However, if you have been dealing with headaches on a frequent basis (ie, weekly or daily), here are a few suggestions to help alleviate your headaches.

First, the Nasties: When evaluating a patient, clinicians look for what I call the Big Nasties - these are serious, life-threatening issues that need to be handled very carefully and often quickly. In the case of headaches, brain tumors or strokes are the two Big Nasties. Fortunately, they are rare and have specific signs.

Pain from brain tumors is often accompanied by vomiting, light sensitivity, dizziness, and vision problems, and it persists constantly. Strokes are usually accompanied by paralysis, difficulty speaking or swallowing, and may have a fairly sudden onset. If you think you may be dealing with a stroke or bain tumor, seek medical attention immediately.

Common Categories: After brain tumors or strokes have been ruled out, classifying headaches moves pretty fast. By far, the largest and most common categories of headaches are Migraines and Tension Headaches.

The pain-producing tissues of migraines are thought to be the nerves and blood vessels of the brain, while the tissues involved in tension headaches are thought to be the nerves and fibers of the muscles. Migraines and tension headaches may differ in how they present, but when it comes to triggers and causes, they have a lot in common. When working on solutions for pain, it makes the most sense to address the most common and easiest triggers first.

Below, you will find 5 of the most common triggers associated with both migraines and tension headaches, and some simple solutions. Don't miss the answers that are right in front of you!
  Trigger Solution

Too little sleep

  Shoot for 7-9 hours of sleep per day. Naps are okay.

Too little water

  Drink 8 8-oz glasses of water per day, or more if you     drink a lot of soda or other caffeinated drinks.

Too little movement or exercise

  Movement and exercise unlock joints and muscles,   increases blood flow to areas that have been tight         from repetitive postures, and turn on brain chemicals   that help the whole body relax. Vigorous exercise is       good, but a 10-minute brisk walk is often all it takes to   start feeling better.

Too long without eating

  This can vary with the individual, but if you are in the     habit of going a long time between eating, try                   snacking (nuts, lean meats, fruits, or veggies) every       few hours.

Not enough magnesium

  Magnesium has long been known to affect the nerve,     muscle, and vascular systems. It is used to treat blood   pressure, menstrual cramps, heart issues, post-               exercise soreness, anxiety, ADHD and a whole lot         more. Interactions with other medications are        
  uncommon and related to: bisphosphonates,   antibiotics, and some blood pressure medicine. You     can increase your magnesium intake by eating more     magnesium-rich foods. If you are dealing with
  headaches fairly frequently, try taking magnesium as
  a supplement. Most magnesium supplements are in
  100gm tablets - taking 2 in the morning and 2 in the
  evening would be ideal. If you are getting too much
  magnesium, you may have loose stools; if that is the
  case, reduce your intake by half.


What Makes the Most Sense: The solutions listed above aren't limited to just improving headaches - they can improve your overall health! Try incorporating the above solutions into your daily routine over the next 3 or 4 weeks and see how they affect the frequency and duration of your headaches. If you are still having trouble or are concerned that you may have some other cause for your headaches, don't hesitate to contact our office - we are here to help!