Carpal Tunnel Syndrome, What is it?, What to do about it.

Monday, February 17th, 2014

Carpal Tunnel Syndrome (CTS) is a condition characterized by numbness, tingling, and/or pain located on the palm side of the wrist, hand and into the index, third, and half of the ring finger. It’s caused by pressure exerted on the median nerve as it passes through the “tunnel” located in the wrist. The “floor” of the tunnel is a ligament while the “walls” are made up of eight small carpal bones that lock together in the shape of a tunnel. There are nine tendons (tendons attach muscles to bones allowing us to move our fingers), sheaths covering the tendons, blood vessels, and the median nerve that ALL travel through the tunnel, so it’s packed pretty tight. ANYTHING that increases the size of any of these structures or anything “extra” that shouldn’t be there can increase the pressure inside the tunnel, pinch the median nerve, and result in the classic numb/tingling symptoms that wake people up at night, or interfere with work or driving.
In the Unites States (US), about 1 out of 20 people will suffer from CTS. Caucasians have the highest incidence rate and women are affected more than men by a 3:1 ratio between ages of 45-60 years old. Only 10% of the reported cases of CTS are under 30 years old. Occupational CTS (as of 2010) affects 8% of US workers with 24% attributed to manufacturing industry jobs. This equates to approximately 3.1 million cases of work-related CTS in 2010. The risk of developing CTS increases with age, diabetes, hypothyroid, pregnancy, taking birth control pills, having an inflammatory arthritis, being obese, pinched nerves in the neck, thoracic outlet, elbow, and others. Therefore, managing CTS requires a thorough evaluation in order to assure accuracy in the diagnosis. With this background information, let’s look at the question, WHAT CAN YOU DO TO HELP CTS? One answer is, don’t age – good luck with that! In addition to keeping your weight under control, exercise can be VERY effective and YOU can be in charge of that process, but we have to teach you the exercises.
1) The Carpal Stretch (“nerve gliding”): Place your palm on the wall near shoulder height with the fingers pointing down at the floor and press the palm of the hand flat on the wall. Lastly, reach across with the opposite hand and pull your thumb back off of the wall and hold for 5-15 seconds.
2) The Wrist Extensor Stretch: Do the same as #1 but place the back of the hand on the wall in front of you, again fingers pointing downward. Here, there is no need to stretch the thumb.
3) The “Bear Claw”: Make a fist and then open up the hand. Keep the small finger joints flexed while extending the knuckles at the base of each finger straight (not bent). Repeat 5-10x.
4) Putty Squeeze: Simply squeeze putty in your hand for two to five minutes until fatigued.
5) Yoga has been shown to reduce pain and improve grip strength in CTS patients!
Now the question, “…can these exercises prevent surgery?” The answer is “maybe.” They certainly help in some cases, but a multi-dimensional treatment plan is theBEST approach. This includes: 1) Chiropractic manipulation of the hand, wrist, elbow, shoulder, and neck; 2) Soft tissue “release” techniques of the muscles in the forearm, upper arm, shoulder, and neck; 3) Cock-up wrist splint to be used at night, and in some cases, at times during the day; 4) Ergonomic managementof your work station or situation (to minimize repetitive insult to the area); 5) Nutritional support that may include an anti-inflammatory diet and nutrients (vitamins, minerals, herbs, etc.), and 6) Managing any contributing conditionslike diabetes, hypothyroid, and/or the others. Here’s the GOOD NEWS: CHIROPRACTIC can manage these six steps, though some cases will require co-management with primary care and/or specialist.
I would be happy to fully explain and demonstrate this work to you. You only need to schedule an appointment and you can do that right from this website. Just click on the “online appointments now!” above on the menu bar and pick your appointment time.

Carpal Tunnel Syndrome – What Makes My Hands Numb?

Monday, April 22nd, 2013

Carpal Tunnel Syndrome (CTS) sufferers frequently report a cluster of symptoms, but almost all have one symptom in common – numbness, usually in digits 2-4 on palm-side of the hand. CTS is usually attributed to an over-use type of injury such as repetitive work including (but not limited to): typing, assembly work, packaging jobs, machine operators, and many more. Last month, we discussed CTS “Facts” and learned many important points about CTS. This month’s focus centers around the common question, “….where is this numbness coming from?”

To answer this, let’s review the anatomy: The carpal tunnel is made up of 8 small “carpal bones” that form an arch or tunnel, and the base of the tunnel is formed from the transverse carpal ligament. There are nine tendons that attach muscles in the forearm to each finger and work when we grip or form a fist with our hand. Wiggle your fingers and look at your wrist and forearm – do you see all the activity or movement going on?

The tendons travel through sheaths which help lubricate the sliding tendons. When we move our fingers fast (such as typing, playing piano, performing assembly work, etc.), friction and heat builds up, resulting in swelling. If adequate rest does not occur, the increased pressure from the swollen tendons end up squeezing all the contents within the tunnel, which includes the median nerve. It’s the median nerve pinch that results in the numbness, tingling, and/or pain into the index, third and forth fingers.

There are other conditions that can either complicate or cause CTS. These include: hypothyroid disease (due to myxedema), diabetes (due to neuropathy), inflammatory arthritis (of which there are several kinds – rheumatoid is the most common), and pinching of the nerve either in the neck, shoulder, elbow or forearm (called double or multiple crush syndrome).

The reason chiropractic helps so much is that we can alleviate the pressure on the nerve from the neck down to the wrist and restore nerve function. This alleviates the multiple sleep interruptions, weakness in the grip that is so common, as well as helping to restore the nerve’s function. Many studies support the success of chiropractic and CTS – try it first as surgery should be the last resort.

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, we would be honored to render our services.