Thoracic Outlet Syndrome


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Thoracic outlet syndrome (TOS) can cause pain and numbness in the shoulder, arm, and hands. Where is your thoracic outlet?  You will find it at the junction where your neck meets the shoulder area.

Image result for thoracic outlet syndrome

Nerves and blood vessels going into the arm and hand from the neck. Nerves come out of the spine through small openings called neural foramina.  The nerves and vessels travel between the scalene muscles in the neck. The thoracic outlet opening is between the scalene muscles and the rib cage. The nerves and blood vessels then go under the clavicle, through the armpit and down the arm to the hand.

Reasons for Thoracic outlet syndrome.  When the nerves and blood vessels get squeezed, the nerves cry out. There are many reasons why this happened but here are a few.

1.) Pressure on nerves and vessels can happen because they fractured or misaligned clavicle or have the first rib crimping on the nerve, or a herniated disc.

2.) Scalene muscles swollen or scar tissues can also put extra pressure on the nerves and arteries.

3.) Heavy lifting and carrying can bulk up the scalenus muscles to where the nerve and arteries can get squeezed.

4.) Injuries like a car accident can also cause problems that lead to thoracic outlet syndrome. The shoulder harness of the seat belt can strain or tear the muscles. As they heal, scar tissue can build up, putting pressure on the nerves and blood vessels at the thoracic outlet.

5.) Neck and arm positions because of having to hold neck and shoulders in awkward positions, like having to hold their arms up or out for long periods of time. Slouching shoulders can compress the nerves and arteries near the thoracic outlet.

6.) Overweight can cause problems with posture, and women who have very large breasts may also have a droopy posture which is why thoracic outlet syndrome affects three times as many women as men.

Symptoms are pain along the top of the clavicle and shoulder. Pain radiating down the inside edge of the arm. Pain or numbness and tingling of the hand, mostly into the ring and pinky fingers can happen. It can get worse when driving, lifting, carrying, and writing. The arms may also feel tired when held overhead like when you are using a blow dryer. It may be harder to hold and grip things, and you drop things and feel clumsy.

Symptoms related to the blood vessels are not as frequent. If the blood vessels are causing impinged, the arm and shoulder may feel heavy, cold enough to turn blue with swelling. These are serious problems and you should call your medical doctor right away.

Chiropractic can help with many cases of Thoracic Outlet Syndrome. First, we will take your medical history and do a thorough physical examination. The more information you have as to when it started, what you were doing when it happens, and what symptoms you are experiencing always help narrow down what is causing the problem. We will do a X-ray. The X-ray could show an extra cervical rib or other problems with the bones and joints. If warranted, we may also ask you to get an MRI for herniation and other soft tissue interference. We may also do nerve studies to find out about the health of the nerves. We may also do a study of the blood vessels, a vascular study depending on symptoms.

So if you are suffering from any of these problems, it would be wise to get it checked out. Call 334-514-7600 for an appointment today.





Double Crush


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Between the neck and the wrist, there are many possible locations for the “double crush” phenomenon.   What does that mean?

If there is irritation of a nerve root at the opening from the vertebra which is called intervertebral foramina, or if there compression at the triangle formed between the scalene muscles and the first rib,  the nerve itself becomes hampered in its function.   As that nerve passes into the arm, it passes through several muscles before it enters the hand, beneath the transverse carpal ligament.   If the nerve is already hampered, with compression within the arm muscles, or at the wrist, it may cause symptoms.

We call that second insult to the nerve a “double crush” phenomonon.   Remember, this nerve has been exposed to those exact same conditions during your whole life without complaint.   Chiropractors adjusts the neck and removes the irritation at the nerve roots, the secondary, or downstream symptoms simply resolve.   This is true for entrapment syndromes which may have developed associated muscle adhesions or “trigger points” and for the well publicized carpal tunnel syndrome.

If you are suffering from symptoms like these running down your arm to your hand, please call 514-7600 for an appointment.  Many people have benefited from Chiropractic care on this condition.


Shoulder pain


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The shoulder girdle consists of the sternoclavicular, acromioclavicular, and glenohumeral joints, and the scapulothoracic articulation. The shoulder, a ball-and-socket joint, is freely movable and lacks a close connection between its articular surfaces. It has five muscles which hold it in the genohumeral joint and provide various movements.

Injuries of the shoulder can involve the scapula, clavicle, and shoulder. In sports, the shoulder girdle is a common site for injury and some times it can be a serious disability. A careful history recording the mechanism of trauma and the position of the limb during injury, careful inspection and palpation of the entire region, muscle and range-of-motion tests, and other standard neurologic-orthopedic tests will often arrive at an accurate diagnosis without the necessity of x-ray exposure.

Contusions, strains, sprains, bursitis, and neurologic deficits must be alertly recognized and treated. Fractures and dislocations, obviously, take precedence over soft-tissue injuries with the exception of severe bleeding. Not all shoulder problems are rotary cuff tears although it is one of the most common. Always check for bony crepitus, fracture line tenderness and swelling, angulation and deformity. Because the shoulder readily “freezes” after injury, treatment must strive to maintain motion as soon as possible without encouraging recurring problems. The key to avoiding prolonged disability is early recognition and early mobilization. Call 334-514-7600 and set up an appointment today. Tell them Dr. McNally sent you.


Migraine helped with Chiropractic


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How can a headache  or migraine be helped by chiropractic treatment?

We’re learning that most people’s head pain seems to come from structures in the neck. The joints and nerves in the upper neck, the muscles of the upper shoulder, and the muscles of the TM joint, which is in the jaw. Those three are the keys to headache pain.

But what I’ve found, as a headache sufferer myself who has been greatly helped by chiropractic, is that there are several factors involved.

One is sleep. I think that the number one cause certainly of tension headaches is that people are just plain overtired. Sometimes sleep patterns have to be consistent. In other words, going to bed and getting up at the same time seems to be really important.

There are other factors, such as dietary considerations. There are people whose migraines are set off by drinking a little red wine, or by eating chocolate.

Everything in the human body is mediated by the central nervous system. The spinal cord and nerves are involved in every process. That’s why I think so many conditions show up in the spinal column.

For instance, say you’re eating chocolate – it goes into your mouth, there are chemicals released, and there are sensory nerve endings all down the digestive tract. These relay information to the brain, and in some people those chemicals can set off a cascade of events leading to migraine attacks. So the nervous system is key in every condition, and I think that’s why chiropractic has more success than any other form of treatment for people with headaches.

It’s important to emphasize that chiropractic is not a treatment of conditions. It’s a way to help the body to function better.

The central nervous system (CNS) — brain, spinal cord and spinal nerves control the function of every organ, tissue and cell in the human body. If there is any interference to the function of the CNS then the body cannot function in a healthy way. Chiropractic adjustments specifically and directly remove (or in some cases reduce) interference to the CNS thereby allowing the body to function properly.

Does that mean that I am saying that chiropractic treatment is “a cure for all diseases?” Absolutely not. What I am saying is that every human being is far better off from a health and function standpoint without nerve interference in their body. Do we chiropractors sometimes see patients get relief and improvement from conditions other than neck and back pain? Unequivoquely, yes! However, the intent of chiropractic is to help the CNS and therfore the entire body, to function more normally not to treat diseases, conditions or even pain for that matter. Do you see the difference? That’s why every man, woman and child should be checked regularly by a Doctor of Chiropractic – so that their body can function in the healthiest manner possible, regardless of the presence of migraines, irritable bowel or even cancer. The condition that the patient has isn’t nearly as important as the person who has the condition!

One thing you have to realize about the nervous system is that it works in pathways. If that pathway has been set off a lot, then over time that pathway gets set off with less and less stimuli. In other words, if there’s a nerve somewhere in the neck that’s been irritated for years, then that nerve is what we call facilitated. In other words, it will get set off with less and less stimuli. The nervous system learns patterns. For a migraine sufferer, it will take less and less for them to get a migraine attack.

So it’s the upper neck joints and nerves, and the muscles of the upper shoulder and jaw. Those are the big three. And every migraine sufferer has some combination of those, without exception. So call today 334-514-7600 and see if a Chiropractor can help you with your migraines.

Women Get headaches


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Higher prevalence of headaches is noted in women and girls.

Knackstedt H, Bansevicius D, Aaseth K, Grande RB, Lundqvist C, RussellMB (2010)
Cervicogenic Headache in the General Population:
The Akershus Study of Chronic Headache

Cephalalgia. 2010 (Dec);   30 (12):   1468–1476

Kröner-Herwig B, Heinrich M, Morris L (2007)
Headache in German children and adolescents: a population-based epidemiological study.  Cephalalgia 27:519–527

While it is wonderful that research have figured out that women coming up with the excuse of a headache, might be true, women still have to deal with the pain.  The most common of all are what doctors call tension headaches and they can feel like a giant rubber band squeezing your skull, creating soreness in your head, neck and shoulders especially at the bottom of the skull at the back of the neck. The pain radiates up from there to the forehead, behind the eye, and can be either or both sides.

Your headache might be a migraine where one side of your head pulses and throbs, your vision gets a little squiggly dancing lights, you want to be left alone in the dark, and sound hurts.  In this case, it’s best to quietly lie down, relax and call your Chiropractor to set up an appointment.

Headaches are one of the most common complaints that Chiropractors see at the office. There are many different types of headaches originate from mechanical problems in the neck. Some headaches such as migraine and cluster headaches are related to vascular problems. These often include nausea and/or vomiting and can be quite disabling and require rest in a dark, quiet place sometimes for a half or a whole day. Other headaches can be categorized as “tension” headaches. These usually result from tightness in the muscles in the neck and upper back caused from stress, work, lack of sleep, sinusitis, trauma such as whiplash, and others. Pain can be felt in the upper neck or the back of the head as well as in the frontal, sinus region, top or sides of the head. It can vary from a throbbing pain to an ache to just a constant pain.

So “how does chiropractic work?” To answer this, let’s first discuss what we do when the headache patient comes in. First, the history is very important! Here, we’ll ask “how/when did the headaches start. This may glean the actual cause of headaches such as a car accident or injury of some sort.

Next, we’ll ask about activities that increase or create the headache, which gives us ideas of how we might help manage the headache patient. For example, when certain activities precipitate the onset of a headache, we will modify the workstation and/or give specific exercises on a regular schedule to keep the neck tension under control. When information gathered about what decreases or helps the neck pain and headaches, we will recommend treatments often that can be done at home such as a home traction unit. This would be suggested if we are told that “…pulling on my neck feels great!” The quality of pain (throbbing = vascular, ache and tightness = neck), intensity of pain (0-10 pain scale), and timing (worse in the morning vs. evening) help us track change after treatment is rendered, usually gathered once a month.

What most people don’t realize is that mechanical dysfunction of the vertebrae of the neck will cause increased muscle tension as well as irritate the delicate nerves that control blood flow into the head. Improving the movement or alignment of the bones in the neck can relieve the pressure and irritation that results in headaches.

How do we get misalignments in the joints of the neck? This can be due to trauma such as falls or car accidents. Repetitive stress such as hours of work on a computer, poor posture or stress can also take a toll over time. In many patients it is a combination of activities that took place often years before which has led to chronic and recurring headaches.

Chiropractic examination evaluates these issues as well as attempts to rule out other more serious causes, which can occur but are more rare. Call today 334-514-7600 and tell them Dr. McNally, DC sent you.  We have a first visit special for you.



This is not sexy


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It is one thing to put your hands on your hips and throw the hip out in a pose and it is quite another thing to have a spine so bent out of shape that it is called scoliosis.

Take a look in the mirror. If your head is tilted to one side, this is an indication that something is going on in your spine. Take a look at your shoulders. Are they level? Is one rolled forward or higher than the other? Now place both hands on the top of your hips. Do you see one side higher and/or more forward than the other side? All these are indications of back problems. Each of them can cause pain, achy, radiating pain, numbness, or be prone to injury under stress.

Call today 334-514-7600 for an appointment. Tell them Dr. McNally, DC sent you for a special first visit price that included x-rays, examination, therapies, and treatment.

Did you know anxiety or depression also experience chronic low back pain?


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There was a study done on people with anxiety or depression and their experience with pain. This new study showed that chronic pain afflicts about half of adults who have anxiety or depression.

The study was done in Brazil where more than 5,000 adults in Brazil were diagnosed with anxiety or mood disorders like depression and bipolar disorder were. They were also asked about other health problems.

50% reported chronic pain: 33% reported respiratory diseases; 10% with heart disease; 9% had arthritis; and 7% were diabetic. Pain is depressing, and people who suffer from chronic pain can also develop anxiety over the fact that they worry about their seemingly crumbling world of suffering.

The vicious cycle can decrease if the joint pain factor is decreased or eliminated. Chiropractic care has served for over 100 years in helping people get out of the pain cycle for the neck, back, and joint issues throughout their body. Call today 334-514-7600 for an appointment. The relief is worth it.

Patients evaluates Chiropractic Care as very satisfactory


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Studies of all types have been done to see what is the most effective care for a patient with low back pain. This study found that patients were very satisfied with the care and attention they received from their Chiropractor. So if you are looking for a doctor who will listen then maybe you need to think about see if a Chiropractor can help you with your joint pain.

We compare health maintenance organization enrollees’ evaluations of the care they received from family physicians and Chiropractors for low back pain. Patients of chiropractors were three times as likely as patients of family physicians to report that they were very satisfied with the care they received for low back pain (66% versus 22%, respectively).

Compared with patients of family physicians, patients of chiropractors were much more likely to have been satisfied with the amount of information they were given, to have perceived that their provider was concerned about them, and to have felt that their provider was comfortable and confident dealing with their problem.

Although the more positive evaluations of chiropractors may be related to differences in the patient populations served by the two providers or to benefits of spinal manipulation, it is suggested that a potentially more potent force–the therapeutic effect of the patient and provider interaction itself–may explain the observed differences.”  

FROM: Western Journal of Medicine 1989 (Mar);   150 (3):   351–355 ~
Cherkin DC, MacCornack FA




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There are many benefits to stretching, but there are also very counter-productive means of stretching, especially if you are currently in pain. THE NEW YORK TIMES RECENTLY POSTED ANOTHER ARTICLE that had a good overview..

  • BEFORE exercise static stretching is NOT your best means for creating motion.  A more dynamic warm-up is a better way to create motion that will not weaken the joint stability and put you in a place where it is easier to become injured. (If you need help with creating a good warm-up specific to your condition, Ask Dr. McNally, DC).
  • AFTER exercise static stretching has been shown to decrease soreness for prolonged periods.
  • There are “better” ways to stretch. For example, people are frequently doing hamstring stretches where they do a large forward fold and create significant lumbar spine flexion.  Not only is this not the most efficient stretch but it also can be a more dangerous stretch for people with certain histories of back pain.  Forward folding can also load the neurological structures more than efficient hamstring stretches.  (Check out this article about why people are always wanting to stretch their hamstrings). If you have questions about what stretches are good or bad, please ask.
  • There are some stretches that you should probably be doing MORE of, but not doing nearly enough.  These include stretching your ankles, anterior hips, thoracic spine, chest and shoulders.  ESPECIALLY if you sit at a desk for your work or schooling most of the day we’re willing to bet that you’re neglecting these areas.  MOST of the things that come into our office have to deal with stiffness in these areas. They are the by-product of poor posture and need to be actively combated.
  • Stretching itself is not the only answer.  Muscles also need to be turned on and USED.  Doing this in a good, stable pattern is what keeps us healthy.  Correct bending, squatting, lifting, walking, etc are imperative to good health.

If during any stretching exercises you find joints that complain, it is time to have a Chiropractic examination to find out why. Call Dr. Elaine McNally 334-514-7600 for an appointment today.

And you wondered why your mother said “Sit UP”


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Its not just about how you sit, its about how you are effecting the biological, chemical and physiological structure and composition of the tissues inside of you. THIS ARTICLE FROM THE WALLSTREET JOURNAL begins to touch on some of the big points that we try and knock home.  There have been multiple studies in the past year that there is a direct correlation between how much you sit and how soon you will DIE.

Posture is where you will spend the greater part of your day so do yourself a favor and help yourself as much as you can.  If you need any help with creating this posture (many of us have tissues that need some love in order to function optimally) call Dr. Elaine McNally, Dc 334-514-7600