David Perna, D.C.

As with most musculoskeletal conditions, treatment guidelines for carpal tunnel syndrome (CTS) recommend non-surgical or conservative management initially, with surgery only in emergency situations or after non-surgical options are exhausted. So, is there a way to know who will respond best to non-surgical approaches? To answer this, researchers conducted a two-stage study that included an [..]

As we grow older, stretching becomes a more important part of our routine, especially when hip pain is present. Whether you are about to engage in a sport, a job, weight lifting, or errands, it’s best to prepare your muscles for activity. With that said, stretching can be broken down into two main types: static [..]

The term whiplash associated disorders (WAD) describes a constellation of symptoms that includes (partial list) pain, stiffness/limited motion, dizziness, headache, depression/anxiety, and brain-fog. The condition is associated with accelerations/deceleration events like car accidents, sports collisions, or slip and falls. Such injuries are classified into four categories: WAD I (no/minimal complaints/injury), WAD II (soft-tissue injury – [..]

Since falls are a major cause of serious injury, especially for older adults, here’s a simple way to objectively measure and improve your sense of balance… First, stand in a place where you can catch yourself from falling (like behind a chair or in a corner). Place your feet side by side for ten seconds. [..]

BACKGROUND (1)Opium is from the poppy plant.The term opiates are applied to compounds that are purified directly from opium without modification, like morphine and codeine.The term opioid refers to compounds that are synthetic forms of opium, like Fentanyl. Fentanyl is the deadliest drug in America.•••••Members of our military and military veterans are plagued with musculoskeletal pain problems. In addition, for a [..]

When patients present with low back pain (LBP), they are frequently nervous and worried about whether they’re going to respond to the treatment—especially when it comes to getting out of pain and returning to their normal activities. A variety of studies have shown chiropractic care to be an effective option for the LBP patient, and [..]

When it comes to neck pain, many patients seek out chiropractic care. In fact, there are several studies demonstrating that manual therapies performed by doctors of chiropractic can offer significant benefits for non-specific or mechanical neck pain as well as neck pain arising from injuries related to sports, car accidents, and falls. What are some [..]

When treating patients with carpal tunnel syndrome (CTS), doctors of chiropractic can employ a variety of options to reduce pressure on the median nerve. While this can include dietary recommendations (to reduce inflammation), adjustments to address dysfunction elsewhere along the course of the median nerve, or even working with other healthcare providers to manage conditions [..]

When people say, “My shoulder hurts,” they often point to different areas in the vicinity of the shoulder such as the base of neck, the collar bone, the scapula (shoulder blade), the chest, and/or their arm. The challenge with the shoulder is that it’s anatomically comprised of three joints: the glenohumeral joint, or GHJ (ball-and-socket); [..]

Research regarding whiplash or whiplash associated disorders (WAD) classically focuses on neck pain; however, the data show acute thoracic spine / mid-back pain (MBP) occurs in 66% of WAD injures with 23% still complaining of MBP at one-year post-injury. It’s easy to visualize how the cervical spine or neck can be injured in an automobile [..]

Deep slow breathing (DSB) has been widely used for managing various diseases of the heart and lungs as well as for psychiatric disorders including anxiety, depression, and stress-related conditions. There appears to be some research to support DSB as being helpful for pain management, but the results have been inconsistent. However, a 2012 study suggests [..]

A Review of Concepts and EvidenceManipulation of the joints of the lumbar spine usually involves some degree of segmental rotation. Historically, lumbar spine manipulations that are primarily rotational in nature are discouraged because it is assumed that such maneuvers are associated with an increased risk of injury to the annulus of the intervertebral disc. Such [..]