Fibromyalgia is a condition with no known medical cure. It is characterized by chronic and debilitating pain all over the body, and heightened pain under pressure.  Its symptoms can cause patients to suffer from widespread pain, poor sleep, chronic tiredness and even depression. The causes of fibromyalgia are unknown. Some theories cite that the patient’s low pain threshold may be attributed to increased sensitivity in the brain to pain signals. [1] Other possible causes could be a genetic predisposition [2]; stress; the disruption of normal dopamine related neurotransmission [3]; abnormal serotonin levels [4] and deficient growth hormone secretion [5]. While there is currently no cure for the condition, its symptoms can be alleviated by chiropractic treatment.

Chiropractic treatment uses chiropractic adjustments, which involve short and quick thrusts to the vertebrae in the spine to shift vertebrae back into their correct position.  The treatment found in chiropractic care is based on the idea that illnesses and pain in the body arise from misalignments in the body’s skeletal structure. In order for the body to function healthily, the spine and the skeletal structure need to be set in the correct position – otherwise problems like chronic pain can arise.

Fibromyalgia causes numerous, tender points to occur all over the body, including back and neck pain and leg cramps. As a result of these symptoms, sufferers of fibromyalgia have sought treatment from chiropractors. Because the adjustments made during treatment help to restore the posture of the skeletal system, many sufferers find that treatment can help to reduce a significant amount of pain. Some fibromyalgia sufferers experience a condition known as cervical spinal stenosis, which results in compression of the spine’s meninges, which are the coverings of the upper spine. This can result in debilitating pain all over the body. A chiropractor may be able to help with cervical spinal stenosis by adjusting the spine around the head and neck, releasing this compression and eliminating the symptoms attributed to it.[6]

The effectiveness of chiropractic care has been studied in sufferers of fibromyalgia [6], where patients were asked which method of treatment, medical or alternative, helped the best with their condition. The majority voted for chiropractic treatment. In addition, the effectiveness was tested by using spinal manipulation to relieve fibromyalgia symptoms, and after 15 treatments, results concluded that patients had reduced fatigue and pain as well as improved sleep quality.

While fibromyalgia sufferers continue to look for a cure, it is great to know that there are ways to alleviate the symptoms and live a more normal life. If you or someone you know suffers from undiagnosed chronic pain or fibromyalgia, please give us a call at (703) 912-7822 or visit us at Chiropractor in Springfield, VA.

References Used:

[1] http://edition.cnn.com/HEALTH/library/fibromyalgia/DS00079.html Accessed September 2011

[2]  Buskila D, Sarzi-Puttini P (2006). “Biology and therapy of fibromyalgia. Genetic aspects of fibromyalgia syndrome”. Arthritis Res Ther. 8 (5): 218. doi:10.1186/ar2005. PMC 1779444. PMID 16887010.

[3] Cervenka S, Pålhagen SE, Comley RA et al. (August 2006). “Support for dopaminergic hypoactivity in restless legs syndrome: a PET study on D2-receptor binding”. Brain 129 (Pt 8): 2017–28.doi:10.1093/brain/awl163. PMID 16816393. Retrieved 2008-05-21.

[4] Moldofsky H, Scarisbrick P, England R, Smythe H (1975).”Musculoskeletal symptoms and non-REM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects”. Psychosom Med 37(4): 341–51. PMID 169541. Retrieved 2008-05-21.

[5] Anderberg UM, Liu Z, Berglund L, Nyberg F (1999). “Elevated plasma levels of neuropeptide Y in female fibromyalgia patients”. Eur J Pain 3 (1): 19–30.

[6] http://www.fibromyalgia-symptoms.org/fibromyalgia_chiropractic.html Accessed September 2011

Computer work has become the backbone of most of our daily lives. But with its rise in the workplace, there has been a concurrent increase in injuries associated with repetitive computer work, such as carpal tunnel syndrome and repetitive strain injury. Incorrect usage of a keyboard or a mouse can be the culprit, since unnatural keyboard positions exert stress on the muscles, tendons and ligaments in the hands and wrists. An unsupported wrist can be the cause of wrist fatigue, and if your wrist is resting in the incorrect position, extensive typing, can pose a threat.

Ergonomic equipment can help to minimize the risks of injury during extended computer work. If you are a frequent computer user, it might be worth investing in an ergonomic mouse pad or keyboard.

When looking for an ergonomic mouse pad, there are some key features to take into consideration. Look for a mouse pad that allows you to maintain your natural hand position. It needs to imitate the position the wrist has when at rest, by providing an angled surface. Also, make sure the mouse pad has a non-slip grip to ensure it remains in place under normal movement. Purchasing an ergonomic mouse pad and choosing one made from soft material or filled with a soft gel can help to remove the pressure from the tendons and nerves. Hard materials cause compression and pressure on the tendons and nerves in the wrist, and can lead to pain and discomfort. Most importantly, check that the pad is comfortable, offering a good position for your wrist at rest and good freedom of movement while working.

When it comes to keyboards, a wrist rest is a good investment, since it’s designed to give your wrists a break after typing for long periods of time. If you’re typing incorrectly, it helps to alleviate the pain associated with repetitive strain injury or carpal tunnel syndrome. A good wrist rest helps to keep your wrists off the edge of the hard desk and can also help to prevent incorrect posture during typing. Before buying a wrist rest, make sure you know the height and width of your keyboard. There are many styles available on the market, and it’s important to find the wrist rest comfortable for you. It needs to be the same height and width of your keyboard and it’s key to find a wrist rest that conforms to the shape of your wrist. When placing the wrist rest against the edge of the keyboard, there shouldn’t be a gap between the two. Adjust the position so that the wrist rest is set at the edge of the desk.

Fibromyalgia (FM) is a condition associated with tight, sore muscles but no one REALLY knows where FM comes from or why it picks on certain people and not others.  Some feel it’s caused by lack of sleep, specifically deep sleep, eventually resulting in chronically tight muscles. Others theorize it’s the underlying stress of a person’s lifestyle that leads to the tight muscles. Either way, tight muscles lead to poor blood flow through the muscle and just like pumping up a blood pressure cuff too high and not releasing the tourniquet effect quick enough, pain results when the muscle is starved from lack of oxygen.  Dr. Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical Center, wrote that many people (especially FM patients) tense their muscles and probably don’t even realize it, which reduces blood flow to the muscles, resulting in pain. So, the question is raised, how can the FM patient get their muscles to relax so blood can flow through, bringing it the necessary amount of oxygen to the muscle so it doesn’t hurt?

One method of muscle relaxation is exercise. When the pulse rate increases, more blood reaches the muscle, which reduces pain. The studies are clear that walking, stretching and strength training all help reduce fibromyalgia pain. Exercise also relieves fatigue, helps sleep quality and reduces depression – WHAT A GREAT ANSWER for the FM patient! The key is finding the right combination of exercises and how much should one do. Our advice is to START SLOW and gradually increase the dose once you’ve proven good tolerance to the last workout session. Consider flexibility exercises (stretching) such as Yoga classes, walking around the block, or even playing golf (initially a few holes, then 9 and eventually a full round).

Many FM patients have found water exercises are uniquely helpful because of the weight reduction or buoyancy effect.  This is especially true for the overweight FM patient as land-based exercises may be too traumatic on the feet/ankles, knees, hips, or low back. Also, warm water can be quite comforting. Another nice advantage of water exercises is that you can do these anywhere, as long as there is a pool! The exercises can be taught in a formal water exercise class, which is a good place to start if one is available locally or through a health care service. Studies from Spain report that water exercises improve the FM patient’s quality of life not just for the moment, but also over the long term! Over a 12-week timeframe, they discovered women who exercised in warm water for 60 minutes, 3 times per week improved both mentally and physically, had less FM related pain, and more energy (“vitality”). They reported less depression and found an improved desire to be sociable.  The KEY for exercise to be successful is to increase the pulse rate. As Dr. Cope pointed out, a 20 minute, four times per week workout can make a big difference!

If you, a friend or family member requires care for FM give us a call at (703) 912-7822 or visit us at Chiropractor in Springfield, VA

Carpal tunnel syndrome or, CTS, is a common condition that drives many patients to our chiropractic office in Springfield, VA asking, “…what can chiropractic do for CTS?”

As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:

• A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work – especially if it’s fast and repetitive.  Your doctor will also need to learn about your “co-morbidities” or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.

• A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.

• Treatment can include adjustments, Active Release Techniques, Graston Technique, PT modalities (eg., electric stim., ultrasound).

Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

Here are some of the things that you, the CTS sufferer can self-manage:

• A Carpal tunnel splint  is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.

•  Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times / day) such as: A. The “Bear claw” (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand) B. Tight Fist / open hand (fully open – spread and extend the fingers and then make a fist, with the hand). C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm – hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch! D. Wrist range of motion (dorsiflexion/palmar flexion) – Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times. E. Wrist range of motion (pronation/supination) – Place forearm and whole hand on table– elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times. F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed. G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down. H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.

• Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS please give us a call at (703) 912-7822 or visit us at Chiropractor in Springfield, VA.

Carpal tunnel syndrome is one of the most common causes of pain, loss of work, and work related disability in the United States. It affects approximately 50 per 1000 persons in the general population and the average lifetime cost of carpal tunnel syndrome (including medical bills and lost work time) is estimated to be about $30,000 per each injured worker. In 2003, there were more than 3.8 million visits made to health care providers for carpal tunnel syndrome.

The diagnosis of carpal tunnel syndrome is based on the patient’s complaints, the examination findings, and special testing such as electro-diagnostic tests (like Electromyography or EMG). The success or failure of treating carpal tunnel syndrome rests on the accuracy of the diagnosis. Often, patients with carpal tunnel syndrome will present after surgery complaining of the same symptoms they had prior to surgery, such as numbness and pain in the index, 3rd and 4th fingers, weak grip, sleep interruptions and so on, only to find that the median nerve is pinched higher up than the wrist, such as in the neck or elbow.

Treatment failure, as well as an increased likelihood of developing carpal tunnel syndrome, may also result from the presence of other “risk factors.” These include (but are not limited to) advancing age (>50 years old), females > males, and the presence of diabetes and/or obesity, which often coincide. Other risk factors include pregnancy (due to hormonal shifts and fluid retention), certain occupations (highly repetitive), strong family history of carpal tunnel syndrome, specific medical conditions like hypothyroidism, autoimmune and rheumatologic diseases, certain types of arthritis, kidney disease, trauma, anatomic predisposition of the wrist and hand (shape and size), infectious diseases, and substance abuse. The difficult thing in treating carpal tunnel syndrome is when multiple factors exist – like a female over 50 with a highly repetitive job and who is also obese. Obviously, the “best” treatment here would include weight management, and possibly work station modifications, in addition to the in-office treatment approaches. Patient compliance or, following the doctor’s recommendations is VERY important such as wearing the wrist splint at night, doing the carpal tunnel stretch exercises, weight management / dietary recommendations, and so on. Therefore, successful treatment for carpal tunnel syndrome relies on a balance between the patient and provider communicating about ALL the treatment options – surgical and non-surgical so the patient can make an informed decision. Since each patient is unique, the treatment approach must be tailored to that individual and may require, as previously stated, a number of treatment strategies aimed at patient specific issues.

Chiropractic is in a unique position for managing the carpal tunnel syndrome patient. This is because we look at the whole person, not just the wrist and, we offer the LEAST INVASIVE approach. Many times, there are issues in the neck, shoulder, elbow and forearm in addition to the wrist/hand that MUST BE carefully assessed in order to obtain a successful, satisfying result for the patient. We also consider the many “risk factors” described above and can assess or coordinate services with other health care providers so the many conditions described previously can be properly evaluated. So, the question remains, what do chiropractors do when treating a patient with carpal tunnel syndrome? Treatment often includes “the usual” such as wrist splinting during sleep, work modifications, and anti-inflammatory approaches (ice cupping, herbal, etc.). Unique to chiropractic are manipulation or adjustments (often to the neck, shoulder, elbow, forearm, wrist and hand), Active Release Techniques and Graston Technique to loosen up muscular adhesions and scar tissue, exercise training for the involved areas including the hand/wrist, as well as dietary strategies for weight management, metabolic syndrome (pre-diabetes) and so on.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend or family member require care for carpal tunnel syndrome, we would be honored to render our services.  To learn more about carpal tunnel syndrome visit our website at Chiropractor in Springfield, VA or give us a call at (703) 912-7822.

One of the conditions that we treat at my chiropractic office in Springfield, VA is Carpal Tunnel Syndrome.  Here are five stretches to relieve carpal tunnel syndrome.

1. Circles:  This exercise will strengthen the wrist & forearm muscles, increase the wrist’s range of movement/flexibility, and decreases wrist pain. This can be done multiple times a day as a “mini-break” from keyboard/computer work, as well as a “morning warm-up.”  Slowly rotate your wrist/hand from a palm up to a palm down position and repeat up to 10 times.

2. Prayer Stretch:   Stretching helps to breakup adhesions that form in the carpal tunnel.  Place the palms together, fingers straight & pointing up (prayer position).  Keeping the heels of the hands together, slowly lower the hands and raise the elbows so that the angle at the wrist decreases. Push your fingers together for 5 sec. Hold for 10 seconds and repeat up to 10 times, depending on time availability.  Do this multiple times a day.

3. Strengthening:  Using a hand weight or TheraTubing, assume the same position as #1 above and slowly raise the weight or stretch the tubing by flexing the wrist with the palm in each of 4 positions: palm up, thumb up, palm down and pinky up. Use your opposite hand to support your wrist with the pinky up exercise

4. Ergonomics:  Consider modifying your workstation, especially if your monitor is off to a side or too high, if your elbows are bent more than 90°, if your forearms are digging into the edge of the desk, use a trackball mouse so your arm can stay still, consider a larger screen, and an “ergonomic” keyboard (one that is not flat); use a “good” chair with adjustable arms to rest the forearms on.

5. Posture    Sit “tall” with your chin tucked in (no “chin poking!”), relax your shoulders (no shrugging), feet flat on the floor or on a box, and take mini-breaks” at your workstation.  If you have to, set a timer for every 30-60 minutes that will remind you to stretch.

Two more “tricks” that really help: 1. Reduce your stress on the job – treat others like you would like to be treated (get along with your co-workers); 2. Enjoy your job!

Carpal Tunnel Syndrome or CTS, is one of many “repetitive strain injuries” or RSI’s and it’s one of the most common work place injuries that we treat at my chiropractic office in Springfield, VA.  The term “Carpal Tunnel Syndrome” was first used in 1939 and since the 1950’s, this disabling overuse injury to the hand has been one of the most frequent work injuries reported. So, what jobs carry the greatest risk for developing CTS?

Basically, any job that requires fast, repetitive movements of the hands with little rest can be considered a potential “risky job.”  A partial list of the causes of RSI’s including CTS are: stress, tension/tightness of the arm muscles, inflammation of the wrist tendons, repetitive movements like keyboard/mouse work, poorly designed workstations, poor posture including awkward wrist/hand positions required on the job, heavy lift/carry workloads, vitamin deficiencies, and neck / spine complaints. Couple these jobs with age > 50, and being female – especially if she takes oral contraceptives (as they retain fluids), during pregnancy or menopause.

Here’s a list of jobs we can consider “risky”:

• Typists: When typing speeds reach 60 words / minute, for 8 hrs a day, there can be up to 25 tons of pressure each day exerted in the wrist. Frequent breaks are NEEDED!

• Computer users: The proper position is feet flat on the floor (adjustable chair necessary), arms at the side with elbows bent slightly MORE THAN 90 degrees; sitting up “tall” in the chair (prop a pillow, water bottle, or rolled up towel behind your back if necessary), tuck in the chin (avoid chin poking), and MOST IMPORTANT – TAKE BREAKS AS NEEDED.

• Musicians: If you think about it, what task requires faster, repetitive movements of the fingers in awkward positions?  For example, playing a flute. Or, how about piano, trumpet, saxophone, guitar, violin, drums… wait a minute!  Just about every instrument requires awkward hand positions and fast repetitive movements!  It’s no wonder a large percentage of musicians develop CTS / RSIs! Again, the secret is taking meaningful breaks and stretching and when it’s uncontrolled, come see us (but DON’T wait too long)!

• Line workers: There are many types of jobs where standing on a line while working in fast/repetitive environments such as assembling an engine, packing cookies, pushing wires into a harness, inserting screws, packing meat or fish, using vibrating tools, carpentry tasks such as screw driver use, hammering, sawing, lifting/carrying materials……..you get the picture!  These jobs are notorious for CTS!

• Other RSI’s: include tennis elbow, golfer’s/bowler’s elbow, cubital tunnel syndrome (numbness in the pinky), de Quervain’s disease (thumb tendonitis), and sports injuries (sprains/strains). Postal workers, cake decorators, dentists and hygienists, as well as waiters are all at risk for developing CTS.

The bottom line is: 1. Take multiple breaks. 2. Work at your own pace. 3. Wear a wrist brace at night. (If recommended) 4. See a chiropractor (us!) to loosen up those tight hand, forearm, shoulder and neck joints and muscles to relieve nerve pressure. DON’T jump right to surgery – it’s the “last resort.”

If you, a friend or family member is suffering from carpal tunnel syndrome give us a call today at (703) 912-7822 or visit us at http://www.NovaChiroWellness.com

Fibromyalgia (FM) is a condition that usually affects different organ systems in the body, causing a number of symptoms. Some of these include:

1)      The muscles (the musculoskeletal system): tender, achy, stiff, tight muscles, trigger or tender points all over the body;

2)      The nerves (the nervous system): headaches, light headedness, sleep disruption, depression, anxiety, numbness/tingling (overlaps with the cardiovascular system);

3)      The stomach and intestines (the gastrointestinal system): diarrhea, constipation, irritable bowel, leaky gut, heart burn, lack of appetite, abdominal cramping;

4)      Breathing (the respiratory system): hyperventilation, rapid / shallow breathing patterns;

5)      The heart (the cardiovascular system): racing heart rate – palpitations, feeling cold all the time, numbness/tingling (overlaps with the nervous system);

Because of the multiple systems involved, there are many challenges to managing Fibromyalgia.  Studies suggest a balance between several approaches works best.  Some of these approaches include biomedical treatments, organ-specific treatments, and cognitive interpersonal treatments.  Within these categories, the following can be broken down further:

1)      General – those treatments directed at the whole body such as anti-inflammatory measures.  These include (but are not limited to) medications (corticosteroids, NSAID’s – such as Advil, Aleve) and nutrients (ginger, turmeric, boswellia, Vitamin D, and others).  Other anti-inflammatory measures include diet, such as the Paleo Diet or “caveman diet.”  This diet eliminates grains or flour-based products from the diet.  That means no more breads, pastas, crackers, cookies – anything made with flour.  This approach emphasizes consuming fruits, vegetables, grass-fed lean meats and fish.  The main ingredients in grains that are of concern in the Paleo Diet are gluten and lectins

2)      Central – those treatments directed at the chemical factors in the brain that control mood, depression, anxiety and so on.  These include (but are not limited to) medications (tricyclic antidepressants, muscle relaxers like Cyclobenzaprine, SSRI, SNRI and Trmadol) and certain nutrients (neurotransmitter support such as 5-HTP – tryptophan, DHEA, phenylalanine, and others).

3)      Psychotherapy and active behavioral therapy – treatments that are supportive of nervous system such as cognitive behavior therapy, aerobic exercise, patient education, multidisciplinary therapy, hypnotherapy, biofeedback, and strength training.

4)      Passive physical intervention – chiropractic therapy, massage therapy and other forms of manual therapy, and acupuncture.

If you, a friend or family member requires care for FM call our chiropractic office in Springfield, VA at (703) 912-7822.

Carpal tunnel syndrome is the result of a repetitive use injury caused when the median nerve, which originates in the neck, travels down the arm and crosses the wrist, gets compressed from repeated use of the hands. Often people who work on a computer get carpal tunnel syndrome, but it can also be caused by a pinched nerve in the neck.

Symptoms of carpal tunnel syndrome

Some of the symptoms of Carpal tunnel syndrome include numbness, tingling and sometimes weakness in the hands and fingers. As the problem progresses the pain may begin radiating from your wrist up your arm to your shoulder. Your hands may begin to get weak, causing you to drop things that you try to grip in your fingers.

If you have been experiencing the symptoms of carpal tunnel syndrome and you do repetitive tasks with your hands, you should see your chiropractor in Springfield, VA as early as possible so that the condition can be corrected quickly.

Carpal tunnel syndrome treatment options

Your Chiropractor has several techniques that can treat the many causes of numbness and tingling in your hands and fingers from carpal tunnel syndrome, such as cold laser therapy; the Graston technique, which uses a stainless steel instrument in the doctor’s hands to palpitate soft tissues that can’t be done with the human hand alone; and Active Release Techniques, which combines a deep tissue therapy with a hands-on movement to relax tight, muscle spasms, restore range of motion and free pinched nerves to provide relief.

Another treatment option includes spinal decompression therapy, where the patient’s neck is gently stretched but separates the bones in the spine, freeing up pinched nerves and restoring proper alignment.

Prevention of carpal tunnel syndrome

Since the cause of most carpal tunnel injuries is repetitive use, there are several strategies that you can use to prevent damage to the carpal tunnel.

• Sit in a chair where you can rest your arms, and where your back has good support. Your chair should be at a height which allows your wrist to rest comfortably and in a neutral (un-bent) position.
• Use an ergonomic keyboard with a wrist rest, which allows you to hold your wrists in a neutral position while typing.
• A wrist rest on your mouse pad will keep you from flexing your wrist upward and holding that posture while you use the mouse.
• Wearing a brace that holds your wrist in proper position is helpful as well.
• Do regular hand strengthening exercises, squeeze an ergonomic ball and perform stretching exercises.

Vary your tasks when you can throughout the day. Be mindful of how you are holding your hands and stretch throughout the day when you can take breaks.

Carpal tunnel syndrome and Chiropractic care is a good way to find natural, non-invasive treatment options to heal your carpal tunnel syndrome symptoms.

For relief of your carpal tunnel syndrome contact your chiropractor in Springfield at (703) 912-7822 and you are welcome to visit, www.NovaChiroWellness.com, so that you can get back to living a pain-free, vibrant, healthy lifestyle right away.