CHIROPRACTIC CARE FOR OCCUPATIONAL INJURIES

If you are injured at work you are not alone. Millions of people sustain work-related injuries each year. The suffering can be long term, which is why early treatment of work injuries should be sought.

The doctors at Devine Chiropractic & Rehab Center understand worker’s compensation laws and are ready to help you with all of the paperwork, including filing an accident report with your employer and billing the insurance carrier. We'll help guide you through the red tape, so that you can focus on getting better.

Chiropractic care has become the leading form of medical care for work-related injuries involving the muscular/skeletal system. Some 13 separate studies in various states have repeatedly found that chiropractic care gets people back to work much sooner and at far lower cost than medical care for the same type of on-the-job back and repetitive stress injuries (RSI). For the patient, that means less time in pain and more time to enjoy life.

Dr. Devine has been treating work-related injuries in downtown Seattle for almost 20 years. Low back pain and repetitive stress injuries, including carpal tunnel syndrome, are just two of the more common work – related conditions Dr. Devine treats on a regular basis.
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Repetitive Stress Injuries

If you've developed shooting pains and weakness in your hands after spending weeks glued to the computer or a burning, aching pain in your elbow after playing too many rounds of tennis, or pain in your neck and shoulder after playing a musical instrument you likely have a repetitive strain injury (RSI).

Some common RSI’s are:

• Blackberry thumb
• Carpal tunnel syndrome
• Cubital Tunnel Syndrome
• DeQuervain's syndrome
• Intersection syndrome
• Stenosing tenosynovitis
• Tendonitis
• Tenosynovitis
• Thoracic outlet syndrome
• Trigger finger/thumb
• Tennis elbow

In working with hundreds of patients who have suffered RSIs, Dr. Devine has noticed a common trait. They all believed “the pain would go away”. Musicians attempt to play their instrument, even though their arms, elbows, shoulders, or neck are bothering them. Dancers ignore foot pain. Athletes feel that pain is just a part of the game. Without effective treatment, the pain won’t go away. Instead, many dancers, musicians, and professional athletes have had to temporarily stop or permanently end their careers after developing a repetitive strain injury.

Repetitive stress injuries are caused by repeating the same motions for hours on end over extended periods of time and by bad posture. Damage occurs to muscles and tendons as well as the nerves that run through them. When muscles are used, tiny tears occur in the muscle tissue. The area becomes inflamed as the body attempts to repair the damage. Scar tissue forms over the torn muscle tissue which may cause localized pain. Repeated use causes the scar tissue and pain increase.

The earlier that an RSI is diagnosed and treated, the better the outcome can be. Diagnosis includes physical examination and possibly x-rays. Typically, the chiropractic treatment for RSI includes manipulation of the affected wrist, elbow or other body part affected, as well as manipulation of the upper spine. Dr. Devine also uses the Graston technique to break up adhesions and scar tissue that a formed in response to repetitive stress, and may also advise you to rest the affected area, apply cold to reduce inflammation, perform appropriate exercises, or wear a splint or brace to immobilize the area.

With his effective treatment and success with treating soft-tissue injuries, Dr. Devine has quickly become a rehabilitation resource for patients suffering from repetitive stress injuries in Seattle.
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Preventing Computer-Related Injuries:

• To prevent injuries from computer use, make sure your computer equipment and furniture fit you properly and that you use correct typing and sitting positions.


• Make sure the top of your computer screen is aligned with your forehead.


• Sit up straight with your back touching the back of your seat. Chairs that provide extra support, especially lumbar (lower back) support are helpful. Avoid slouching over your keyboard or tensing your shoulders, which can place unnecessary stress on your neck, back, and spine.


• Let your legs rest comfortably with your feet flat on the floor or on a footrest. If you place pencil on your knee, the pencil should roll toward your waist, not off of your knee.


• Use a light touch when typing. Place the keyboard close to you so that you don't have to reach for it.


• Fingers and wrists should remain level while typing. Use a wrist rest for extra support. Your wrists and forearms should be at a 90-degree angle to the upper part of your arms. Elbows should be placed close to the side of the body to prevent bending the wrists side to side.


• Be sure to take breaks (to stretch or walk around) about every 30 minutes — even if you don't feel tired or feel any pain. Use a timer to remind yourself to take a break.


• Try an ergonomic keyboard that has a curved design, and use a trackball instead of a mouse.
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Tips for Musicians:

• Practice good posture. Find postures that keep joints in the middle of their range of motion, use larger muscle groups when possible, and reduce body usage that involves fixed, tensed positions.


• Make sure your instrument is properly sized for your body. Are you using an instrument that is too large or awkward for you? Is it set up optimally for you? Tiny differences in playing action or tension can make a huge difference. Could you use lighter strings or reeds? Is there a strap or stand that could make playing less stressful? If it's big and heavy (like a string bass), can you get a cart to help transport it? And remember: if it is a new instrument, especially a larger one, you need to take time to adjust to it before you plunge into intense use of it.


• Stretch before and after playing and warm up properly. Athletes do not abruptly start vigorous physical activity without warming up and stretching because they know it is an invitation to injury. Musicians are putting athletic demands on fine motor musculature and should similarly be religious about warming up before practice or performance.


• Ask Dr. Devine for specific exercises to strengthen your arms, wrist and hands. Physical re-education through The Feldenkrais Method, Pilates, Tai Chi, yoga , The Alexander Technique , stretching, or dance classes all may be helpful.


• Take adequate breaks to stretch or walk around - even if you don't feel tired or feel any pain. Use a timer to remind yourself to take a break. This means both momentary breaks every few minutes and longer breaks every hour or so. This may be the single most important thing to remember.
  Constant tension and repetitive motion does not allow the body to flush away metabolic waste products and this is traumatic to tissues over time. Even in the middle of playing a piece you may have a moment to relax a hand or arm to restore circulation. The marathon rehearsals that musicians pride themselves on have great potential to hurt them. Emerging research on athletes reveals that overtraining actually decreases performance. Try two or more shorter rehearsals in a day rather than one long, intense session, and limit total time on your instrument.


• Consider switching to an ergonomic instrument - If a RSI is already affecting your health, you should seriously consider using an ergonomic instrument. Clever engineers and designers have adjusted traditional instruments to provide the same sound while making them easier to play.


• Stop playing when you are hurt. Musicians are notoriously hard to persuade to reduce or stop their playing to allow injuries to heal. "No Pain, No Gain" is a disastrous policy for a musician. Is it worse to have to not play for a few months or to risk a permanent injury, disability, pain, and never play again?
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"As a clarinet player, I need consistent treatment, involving my neck, upper and middle back, wrists, hands, and fingers, and I know from my own experience that not all chiropractors are willing to or are capable. Dr. Devine’s adjustments have been, and continue to be, extremely effective. I cannot imagine being able to do what I do, especially at this stage in my career, without Dr. Devine's assistance. Jim is a warm, bright, thoughtful, and caring person whom I can recommend without any reservation whatsoever. Plus, he's right down the street from Benaroya, so what are you waiting for?! "
- Jennifer Nelson,
Principal Clarinet, Pacific Northwest Ballet Orchestra;
extra clarinet/sax w/Seattle Symphony & Seattle Opera