Conditions we See

Stenosing Tenosynovitis of the Thumb: (Hand)

De Quervain’s tenosynovitis is a condition that causes pain on the thumb side of the wrist. The pain may start suddenly, but more often it builds gradually over weeks or months. It can spread up the forearm toward the elbow. Movements like pinching, grasping, twisting, or lifting tend to make the pain worse.

Swelling is often seen at the base of the thumb, where the tendons run. Sometimes a small fluid-filled bump, called a cyst, may appear. Some people also notice a snapping or catching feeling when they move their thumb, or even a faint squeaking sound. In certain cases, irritation of a nearby nerve can cause numbness on the back of the thumb and index finger.

During an exam, your doctor will press on the outside of your wrist, near the bone on the thumb side. This area is usually tender in people with De Quervain’s. They may also check your thumb’s range of motion and pinch strength, which are often reduced.

Special movement tests are used to confirm the diagnosis. The most common is called Finkelstein’s test. In this test, you tuck your thumb into your palm and bend your wrist toward your little finger. If this brings on sharp pain, it strongly suggests De Quervain’s. Other simple tests, like resisting thumb movement, can also reproduce the pain and help guide the diagnosis.

With proper treatment and activity guidance, most people recover fully and return to their original activity level without long-term problems.

Sciatic Nerve Tension: (Low Back)

Sciatic nerve tension is a common condition seen in chiropractic practice. The sciatic nerve, the largest nerve in the body, begins in the lower spine and travels through the hips, buttocks, and down the back of each leg. When this nerve becomes irritated, compressed, or overly stretched, it can lead to pain and discomfort that may significantly affect daily activities.

Symptoms of sciatic nerve tension often include sharp, shooting, or burning pain that radiates from the lower back or buttock into the thigh, calf, or foot. Tingling, numbness, or leg weakness may also occur. These symptoms are usually aggravated by bending, sitting for long periods, or lifting, and may ease with certain positions or gentle movement.

There are several possible causes of sciatic nerve irritation. Tight muscles in the hips or glutes, spinal joint dysfunction, herniated discs, and prolonged poor posture are all common contributors. Chiropractors evaluate these underlying issues through a detailed history, physical examination, and specific movement tests that reproduce the nerve-related symptoms.

Treatment typically involves a combination of gentle chiropractic adjustments to improve spinal mobility, soft tissue therapy to reduce muscle tightness, and targeted stretches or exercises designed to relieve pressure on the nerve. Posture, ergonomic, and activity guidance is often recommended to prevent recurrence.

With proper care, most patients experience significant improvement in their symptoms and are able to return to normal activities without long-term problems. Chiropractic management provides a safe, effective, and non-invasive approach to restoring comfort and function.

Cervical Spinal Disc Derangement: (Neck)

The cervical spine is the part of your spine that makes up your neck. Between each bone (vertebra) is a soft, cushion-like disc that works as a shock absorber and helps the neck move smoothly. Sometimes, one of these discs can shift, tear, or become irritated. This is called disc derangement.

When a disc is injured or begins to break down, it can cause pain in the neck that may spread into the shoulders, upper back, or arms. Some people feel tingling, numbness, or weakness in the arms or hands if the disc puts pressure on nearby nerves. The pain can be sharp, aching, or even feel like burning. Movements such as bending, twisting, or holding the head in one position for too long often make symptoms worse.

Disc derangement can result from wear and tear over time, poor posture, repetitive strain, or sudden injury such as whiplash. It is not uncommon in people who spend long hours sitting at a desk, looking down at phones, or performing heavy lifting with improper technique.

Diagnosis usually involves a physical exam to check movement, strength, and nerve function. Imaging like an MRI may sometimes be used if symptoms are severe or persistent.

Treatment often includes chiropractic care, gentle spinal adjustments, exercises to improve function and strengthen the neck, and lifestyle changes to reduce strain. Most people improve with conservative care and do not require surgery. Early attention helps prevent worsening symptoms and supports long-term neck health.

Brachial Neuritis: (Neck)

Brachial neuritis, sometimes called Parsonage-Turner syndrome, is a condition that affects the nerves of the shoulder and arm. These nerves are part of the brachial plexus, which controls strength and sensation in the upper limb. When they become inflamed, it can lead to sudden pain and weakness that may interfere with daily activities.

The condition often begins with severe, sharp pain in the shoulder or upper arm that may appear without warning, sometimes even at night. After the pain starts to ease, many patients experience weakness, limited movement, or numbness in the shoulder, arm, or hand. This can make simple tasks like lifting the arm, carrying objects, or reaching overhead more difficult.

Brachial neuritis may develop after an illness, surgery, or injury, but in many cases the exact cause is unknown. What is clear is that the nerves become irritated, leading to pain and loss of strength.

Treatment focuses on supporting healing, reducing discomfort, and restoring function. Chiropractic adjustments can improve mobility and reduce stress on the spine and surrounding joints. Soft tissue therapies help release tight muscles that may add to discomfort. Individualized exercise plans are designed to rebuild strength, restore movement, and prevent further irritation of the nerves.

In some instances recovery from brachial neuritis can take time, but with proper care most patients see significant improvement and are able to return to their normal activities. Chiropractic care provides a safe, natural approach to managing symptoms and promoting long-term shoulder and arm health.

Ischiofemoral Impingement: (Hip)

Ischiofemoral impingement (IFI) is a condition that causes deep pain in the buttock or hip, sometimes radiating into the back of the thigh. It happens when the space between the upper thigh bone (femur) and part of the pelvis (ischium) becomes narrowed. This space normally allows a small muscle, called the quadratus femoris, to move freely. When the space is reduced, the muscle and nearby soft tissues can become pinched or irritated.

Symptoms may include aching or sharp pain in the buttock, discomfort with long walking strides, running, or activities that extend the hip backward. Some patients also notice sciatica-like pain, numbness, or tingling in the back of the leg if the nearby sciatic nerve is irritated. Sitting for long periods or twisting the hip outward can also worsen symptoms.

IFI can develop for many reasons. Some people are born with natural differences in hip shape that reduce the available space. Others may develop it after hip surgery, arthritis, or injury. Functional factors such as weak hip muscles, poor pelvic control, or repetitive hip movements in sports like running, ballet, or rowing also play a role. Women are more commonly affected, and both hips may be involved in up to 40% of cases.

Treatment usually starts conservatively, focusing on reducing irritation and improving hip function. Activity changes, stretching, and strengthening exercises are often recommended. With proper care, most people experience relief, improve their mobility, and return to their normal activities.

Peroneal Tendonopathy: (Ankle)

Peroneal tendinopathy is a condition that affects the peroneal tendons, which run along the outside of the ankle and connect the lower leg muscles to the foot. These tendons help stabilize the ankle and support movements such as walking, running, and changing direction. When the tendons become irritated from overuse or repetitive stress, they can develop small injuries that lead to pain and swelling.

This condition is most commonly seen in athletes who run, jump, or play sports that involve frequent side-to-side movements, but it can also affect anyone who regularly places extra stress on the ankle. Risk factors include high arches, frequent ankle sprains, or spending long periods on uneven surfaces.

The most common symptom is pain along the outer side of the ankle. This pain may feel sharp during activity or present as a dull ache at rest. Swelling and tenderness are often present, and symptoms typically worsen with exercise or prolonged activity. Many people also describe a sense of weakness or instability, as if the ankle could “give way.” Walking on uneven ground or pushing off the foot can make the discomfort more noticeable.

In some cases, the pain may linger over time and become chronic if the tendons are continually stressed without proper recovery. Recognizing the signs of peroneal tendinopathy early is important so that patients can make changes to their activities and prevent further tendon irritation.

Lateral Ankle Sprain: (Ankle)

A lateral ankle sprain happens when one or more of the ligaments on the outside of the ankle are stretched or torn, usually from the foot rolling inward (inversion). This is the most common type of ankle sprain, especially in sports like basketball, soccer, and football, but it can also occur during everyday activities such as stepping into a hole or landing awkwardly from a jump.

The typical presentation is sudden pain on the outer ankle, sometimes accompanied by a “pop” at the time of injury. Pain may range from mild to intense and is often worse with weight-bearing or later in the day. Swelling and bruising are common, and rapid swelling suggests a more severe ligament tear. Bruising may shift downward into the foot over time. In rare cases, numbness, tingling, or a cold foot may indicate nerve or circulation problems that need urgent attention.

The ankle is stabilized by three main ligaments: the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The ATFL is the most frequently injured, with about 75% of sprains involving this ligament. Injuries can be graded as mild (Grade I), moderate (Grade II), or severe (Grade III, complete tear).

On exam, there is usually tenderness over the injured ligament, swelling, and limited motion—especially with inversion or upward bending (dorsiflexion). Special orthopedic tests may be used to check ligament stability once swelling decreases.

Because ankle sprains are so common and can recur, early recognition and proper care are important for long-term ankle health.

Non-Typical Trigeminal Neuralgia: (Neck)

Trigeminal neuralgia is a condition that affects the trigeminal nerve, which carries sensation from the face to the brain. In its classic form, it causes sudden, sharp, “electric shock” pains in the face that come and go in short bursts. Non-typical trigeminal neuralgia is a variation of this condition where the pain pattern is different and often harder to recognize.

With non-typical trigeminal neuralgia, the pain is usually more constant and less sudden than in the classic type. Patients often describe it as a dull, aching, throbbing, or burning pain in the face rather than sharp shocks. The discomfort may last for minutes, hours, or even be present all day. Because the symptoms overlap with other facial pain conditions, it can sometimes take longer to get an accurate diagnosis.

The pain may still be triggered or worsened by everyday activities like chewing, talking, brushing teeth, or even light touch to the face. However, instead of quick bursts of pain, people with the non-typical form often experience a lingering, more widespread discomfort. The condition most often affects one side of the face, involving areas such as the jaw, cheek, or around the eye.

Non-typical trigeminal neuralgia can be challenging because it doesn’t always respond as well to the same treatments used for the classic type. While not life-threatening, it can significantly impact quality of life, making daily activities uncomfortable or exhausting. Recognizing the difference is important so that patients receive the most appropriate care.

Deep Gluteal Syndrome: (Hip)

Deep gluteal syndrome is a condition where the sciatic nerve, the largest nerve in the body, becomes irritated or compressed by the muscles and tissues deep in the buttock. Unlike a “pinched nerve” in the lower back, this irritation happens outside the spine, usually within the deep gluteal space beneath the larger gluteal muscles.

The sciatic nerve runs from the lower back, through the buttock, and down the back of the leg. When it is squeezed by nearby muscles, such as the piriformis, obturator internus, or quadratus femoris, it can create pain and nerve symptoms. Patients often feel a deep aching or burning pain in the buttock, sometimes radiating into the hip, thigh, or leg. Numbness, tingling, or weakness may also occur if the nerve is significantly affected.

Symptoms are often worse with prolonged sitting, crossing the legs, or repetitive hip movements like running or climbing stairs. Some people describe discomfort when standing up after sitting for a long period, or when trying to sleep on the affected side. Unlike sciatica from a spinal disc problem, imaging of the lower back may appear normal, which can make diagnosis challenging.

Deep gluteal syndrome is one of several causes of sciatic nerve pain outside the spine, sometimes grouped under the term “extra-spinal sciatica.” Identifying the condition is important because it explains buttock and leg pain that does not come from the lower back. With proper evaluation, the underlying muscle irritation can be addressed to relieve nerve pressure and restore mobility

Pronator Teres Syndrome: (Elbow)

Pronator Teres Syndrome (PTS) is a condition in which the median nerve, a major nerve running from the neck through the arm to the hand, becomes compressed by the pronator teres muscle near the elbow. This muscle helps rotate the forearm so the palm faces downward. PTS is the second most common type of median nerve compression after carpal tunnel syndrome and accounts for about 9–12% of median nerve entrapments.

Patients typically experience aching discomfort in the forearm, with tingling or numbness into the thumb, index, middle, and half of the ring finger. Symptoms can mimic carpal tunnel syndrome but have key differences: unlike carpal tunnel, PTS symptoms usually do not worsen at night and are often increased with repetitive forearm pronation or supination rather than wrist flexion alone. Many patients also report weakness in gripping or pinching, leading to difficulty with fine motor tasks.

Clinical evaluation often shows tenderness over the pronator teres muscle and the medial epicondyle. Special tests, like the pronator compression test or resisted pronation test, help reproduce symptoms and confirm the site of nerve entrapment. The median nerve may also be compressed at other nearby structures in the elbow region, such as the bicipital aponeurosis, the arch of the flexor digitorum superficialis, or the anterior interosseous nerve, which can lead to specific motor weaknesses.

PTS is more common in people who perform repetitive forearm movements, such as carpenters, mechanics, athletes, or weightlifters. Early recognition is important to relieve nerve pressure, prevent lasting weakness, and restore normal function in the forearm and hand.